A systematic review and meta-analysis of interventions used to reduce exposure to house dust and their effect on the development and severity of asthma.
OBJECTIVE
We assessed whether any household dust reduction intervention has the effect of increasing or decreasing the development or severity of atopic disease.


METHODS
Electronic searches on household intervention and atopic disease were conducted in January 2007 in EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials. No date or language restriction was placed on the literature search.


METHODS
We included randomized controlled trials comparing asthma outcomes in a household intervention group with either placebo intervention or no intervention.


RESULTS
Fourteen studies met the inclusion criteria. Eight recruited antenatally and measured development of atopic disease. Six recruited known atopic individuals and measured disease status change. Meta-analyses on the prevention studies found that the interventions made no difference to the onset of wheeze but made a significant reduction in physician-diagnosed asthma. Meta-analysis of lung function outcomes indicated no improvement due to the interventions but found a reduction in symptom days. Qualitatively, health care was used less in those receiving interventions. However, in one study that compared intervention, placebo, and control arms, the reduction in heath care use was similar in the placebo and intervention arms.


CONCLUSIONS
This review suggests that there is not sufficient evidence to suggest implementing hygiene measures in an attempt to improve outcomes in existing atopic disease, but interventions from birth in those at high risk of atopy are useful in preventing diagnosed asthma but not parental-reported wheeze.
MacDonald
Clare
C
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, United Kingdom.
Sternberg
Anna
A
Hunter
Paul R
PR
D001249:Asthma / Q000209:etiology / Q000473:pathology* / Q000517:prevention & control*; D004391:Dust / Q000517:prevention & control*; D004781:Environmental Exposure / Q000517:prevention & control*; D006801:Humans; D016032:Randomized Controlled Trials as Topic
D004391:Dust