Housing Interventions and Control of Asthma-Related Indoor Biologic Agents: A Review of the Evidence

Krieger, James MD, MPH; Jacobs, David E. PhD, CIH; Ashley, Peter J. DrPH; Baeder, Andrea MPH; Chew, Ginger L. ScD; Dearborn, Dorr MD, PhD; Hynes, H. Patricia MA, MS; Miller, J. David PhD; Morley, Rebecca MSPP; Rabito, Felicia PhD; Zeldin, Darryl C. MD

Erratum

In this online-only supplement to the September/October 2010 issue, a correction must be noted for the article by James Krieger et al. In the section “House Dust Mites,” the unit of measure in the following sentences was published as μg/mg. That is incorrect. The unit of measure should be given as μg/g, as shown in the text below.

“A body of clinical and epidemiologic evidence suggests that exposure to Der p or Der f antigens at levels greater than 2 μg/g is associated with sensitization and above 10 μg/g with exacerbation of established asthma in mite-sensitized persons.9,10 These cut-points are often used to assess exposure risk in field studies. A recent survey found that more than 80% of homes in the United States have detectable levels of house dust mite allergen in the bedroom, 46% have levels above 2 μg/g, and 24% have levels above 10 μg/g.11

Journal of Public Health Management and Practice. 16(5):, September/October 2010.

Journal of Public Health Management & Practice: September/October 2010 - Volume 16 - Issue 5 - p S11–S20
doi: 10.1097/PHH.0b013e3181ddcbd9
Review of Housing Interventions

Subject matter experts systematically reviewed evidence on the effectiveness of housing interventions that affect health outcomes, primarily asthma, associated with exposure to moisture, mold, and allergens. Three of the 11 interventions reviewed had sufficient evidence for implementation: multifaceted, in-home, tailored interventions for reducing asthma morbidity; integrated pest management to reduce cockroach allergen; and combined elimination of moisture intrusion and leaks and removal of moldy items to reduce mold and respiratory symptoms. Four interventions needed more field evaluation, 1 needed formative research, and 3 either had no evidence of effectiveness or were ineffective. The 3 interventions with sufficient evidence all applied multiple, integrated strategies. This evidence review shows that selected interventions that improve housing conditions will reduce morbidity from asthma and respiratory allergies.

This review discusses housing interventions and control of asthma-related indoor biologic agents and shows that selected interventions that improve housing conditions reduce morbidity from asthma and respiratory allergies.

Chronic Disease and Injury Prevention Section, Public Health—Seattle and King County, Seattle, Washington (Dr Krieger); National Center for Healthy Housing, Columbia, Maryland (Dr Jacobs and Ms Morley); Office of Healthy Homes and Lead Hazard Control, US Department of Housing and Urban Development, Washington, District of Columbia (Dr Ashley); Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Baeder and Dr Chew); Department of Environmental Health Sciences, Case Western Reserve University, Cleveland, Ohio (Dr Dearborn); Boston University, School of Public Health, Boston, Massachusetts (Ms Hynes); Carleton University, Ottawa, Ontario, Canada (Dr Miller); Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana (Dr Rabito); and National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina (Dr Zeldin). James Krieger (Chair), David E. Jacobs, Ginger L. Chew, Dorr G. Dearborn, H. Patricia Hynes, J. David Miller, Darryl C. Zeldin, and Felicia Rabito were members of the expert panel reviewing the evidence for housing interventions to control asthma-related indoor biologic agents.

Correspondence: James Krieger, MD, MPH, Public Health—Seattle and King County, Chinook Bldg, Ste 900, 401 5th Ave, Seattle, WA 98104 (james.krieger@kingcounty.gov).

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

This work was supported by a cooperative grant with the Centers for Disease Control and Prevention, Office of Healthy Homes and Lead Poisoning Prevention, and the National Center for Healthy Housing. In addition, funding was provided by NIH P30 ES 009089.

© 2010 Lippincott Williams & Wilkins, Inc.