title: Environmental exposure reduction in high-risk newborns: where do we start?
abstract: BACKGROUND
  When analyzing the effect of environmental exposure reduction measures on asthma in high-risk children, one must know how far asthmatic families already have applied such measures, because this would affect the effectiveness and efficiency of interventions aimed at reducing environmental exposure.
  
  
  OBJECTIVE
  To describe the room for improvement by asthmatic families in mite, pet, and food allergen reducing measures and in parental passive smoking and to determine the resulting levels of mite and pet allergens by the applied sanitation measures.
  
  
  METHODS
  Data were sampled by observation, weekly diary entries, and questionnaire when the infant was 6 months old and 1 year old. Dust samples were collected by vacuuming the living room floor and the parental and infant mattresses. Multiple logistic regression analyses were applied with the use of mattress encasing, having a smooth floor covering, having pets, exclusive breast-feeding and/or hypoallergenic formula during the infant's first 6 months, and passive smoking as the dependent variables.
  
  
  RESULTS
  Frequencies of applied measures were as follows: having a smooth floor covering, 36%; daily house cleaning, 27%; use of parental and infant antimite mattress encasings, 13% and 9%, respectively; keeping no pets, 66%; no cow's milk-based regular formula, 13%; no solid foods in the first 6 months of life, 28%; and abstinence of smoking by the mother prenatally, 89%; by the mother postnatally, 85%; and by her partner, 76%. Having a smooth floor covering and daily cleaning but not use of antimite mattress encasings resulted in significantly lower mite and pet allergen levels.
  
  
  CONCLUSIONS
  There is (still) enough room for improvement to reduce exposure to inhalant and food allergens, especially by application of mattress encasings, exclusive breast-feeding and/or hypoallergenic formula feeding, and postponing the time until first solids are given.
authors.affiliation: Department of Family Practice, Research Institute Extra, University Maastricht, Maastricht, The Netherlands. Huub.Schonberger@hag.unimaas.nl
authors.forename: Hubert J A M
authors.initials: HJ
authors.lastname: Schönberger
authors.forename: Tanja
authors.initials: T
authors.lastname: Maas
authors.forename: Edward
authors.initials: E
authors.lastname: Dompeling
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Pisters
authors.forename: Jildou
authors.initials: J
authors.lastname: Sijbrandij
authors.forename: Sicco
authors.initials: S
authors.lastname: van der Heide
authors.forename: André J
authors.initials: AJ
authors.lastname: Knottnerus
authors.forename: Chris
authors.initials: C
authors.lastname: van Weel
authors.forename: Onno P
authors.initials: OP
authors.lastname: van Schayck
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects / Q000032:analysis; D000485:Allergens / Q000009:adverse effects / Q000032:analysis; D000818:Animals; D001249:Asthma / Q000453:epidemiology / Q000209:etiology; D001512:Bedding and Linens; D001942:Breast Feeding; D002415:Cats; D004285:Dogs; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D005260:Female; D005430:Floors and Floorcoverings; D005500:Follow-Up Studies; D006796:Household Work; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D008297:Male; D039981:Pyroglyphidae; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects; D013223:Statistics as Topic; D014886:Weaning
chemical_list: D000485:Allergens