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Pest management no more effective than education for reducing pediatric mouse allergen-related asthma
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Intensive year-long professional pest management combined with education on reducing exposure to mouse allergens did not significantly reduce asthma symptoms compared with education alone among mouse-sensitized children.
“Mouse infestation is endemic in many low-income, urban neighborhoods in the United States,” Elizabeth C. Matsui, MD, MHS, from the Johns Hopkins University School of Medicine, and colleagues wrote. “Previous studies found that mouse-sensitized children and adolescents with asthma who are exposed to mouse allergen have greater asthma morbidity than similar children and adolescents who either are not sensitized or not exposed to mouse allergen, but it is unclear if reducing mouse allergen exposure results in a reduction in asthma morbidity among sensitized children and adolescents.”
To determine the impact of professional pest management on asthma morbidity among mouse-sensitized children, the researchers conducted a randomized clinical trial of children aged 5 to 17 years (n = 334) with previously recorded asthma and mouse sensitivity. The researchers randomly assigned one group to receive combined pest management and education whereas the other received education on pest management alone.
Pest management included rodenticide, sealing holes, trap placement, targeted cleaning, the use of allergen-proof mattresses and pillow cases and portable air purifiers. Residences were assessed every 3 months for possible mouse infestation. All participants in the study were educated on pest management strategies, including demonstration of the materials needed to set traps and seal holes, as well as written material.
Maximal symptom days were counted at 6, 9 and 12 months. These numbers included the days of symptoms in the previous 2 weeks when participants experienced slowed activity due to asthma, waking from sleep with asthma symptoms and days of coughing, wheezing and chest tightness. Other symptom outcomes were also analyzed, including rescue medication use, asthma–related acute visits, mouse allergen levels and lung function.
According to study results, there was no statistical difference demonstrated at any assessment for the primary outcome of maximal symptom days between the two groups. The secondary outcome, which included the instances of rescue medication use and asthma-related acute care visits, also demonstrated no statistically significant difference between the two groups at any assessment.
“It is possible that the integrated pest management intervention was not superior to education alone in reducing asthma symptoms and other markers of asthma morbidity because it was not associated with substantially larger decreases in home mouse allergen levels than education alone,” Matsui and colleagues wrote. “The education group had decreases in home mouse allergen levels of approximately 65%, which is larger than that observed in previous home intervention studies among the active intervention group, and approximately 40% had at least a 90% decrease in mouse allergen. This degree of reduction does not appear to be explained by changes in allergen assay performance over time.” —by Katherine Bortz
Disclosure: The researchers report no relevant financial disclosures.
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