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Effect of environmental interventions to reduce exposure to asthma triggers in homes of low-income children in Seattle

Journal of Exposure Science & Environmental Epidemiology volume 14, pages S133–S143 (2004)Cite this article

Abstract

The effectiveness of community health workers (CHWs) assisting families in reducing exposure to indoor asthma triggers has not been studied. In all, 274 low-income asthmatic children were randomly assigned to high- or low-intensity groups. CHWs visited all homes to assess exposures, develop action plans and provide bedding encasements. The higher-intensity group also received cleaning equipment and five to nine visits over a year focusing on asthma trigger reduction. The asthma trigger composite score decreased from 1.56 to 1.19 (Δ=−0.37, 95% CI 0.13, 0.61) in the higher-intensity group and from 1.63 to 1.43 in the low-intensity group (Δ=−0.20, 95% CI 0.004, 0.4). The difference in this measure due to the intervention was significant at the P=0.096 level. The higher-intensity group also showed improvement during the intervention year in measurements of condensation, roaches, moisture, cleaning behavior, dust weight, dust mite antigen, and total antigens above a cut point, effects not demonstrated in the low-intensity group. CHWs are effective in reducing asthma trigger exposure in low-income children. Further research is needed to determine the effectiveness of specific interventions and structural improvements on asthma trigger exposure and health.

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Acknowledgements

Primary funding was provided under NIEHS Grant #5 R21 ES09095, with additional support from Seattle Partners for Healthy Communities (CDC- U48/CCU009654-07) and the Nesholm Foundation. The project community home environmental specialists, Zhoni Gilbert, Jean Jackson, Nilsa Nicholson, Matthew Nguyen and LaTanya Wilson worked devotedly with their clients. Carol Allen and Georgiana Arnold coordinated field operations.

The Hoover Vacuum Company provided vacuum cleaners with dirt-finders at cost. Group Health Cooperative of Puget Sound donated 10 free slots in their Free and Clear tobacco cessation program. The Local Hazardous Waste Management Program of King County donated 300 green cleaning kits and pails. Aerotech Laboratories, Inc. provided reduced cost fungal analysis.

Linda Graybird, Sharon Harris, Blythe Horman, and Scott Jones provided administrative support. Tianji Yu designed the database and tracking system. Lisa Lopez, Barbara Monsey, and Liz Quinn served as research coordinators. Kristy Seidel consulted on statistical analysis.

Sanders Chai, Amy Duggan, Jane Koenig, John Roberts, James Stout, and Todd Yerkes participated on the project steering committee. Harriet Amman, David Bates, Thomas Platts-Mills, and Gail Shapiro served on the Scientific Advisory Group. Carol S. Collins, Ha Vu Minh Duong, Rochelle (Toni) Gibson, Rosie Williams Gordon, Augustine Evon Hampton, Doi Le, Celese McDuffie, Kelly (Trinh) Nguyen, Son Thuy Nguyen, Lauretta Perkins, Mary Tranh Pham, Quoi V. Phung, Debbie Rosenthal, Joann Sampson, Nura Sayed, and Robin Shields participated on the Parent Advisory Group.

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  1. University of Washington School of Public Health and Community Medicine, USA

    Tim K Takaro & James W Krieger

  2. University of Washington School of Medicine, USA

    Tim K Takaro & James W Krieger

  3. Public Health – Seattle and King County, USA

    James W Krieger & Lin Song

  4. Seattle Partners for Healthy Communities, USA

    James W Krieger

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  1. Tim K Takaro
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Correspondence to Tim K Takaro.

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Takaro, T., Krieger, J. & Song, L. Effect of environmental interventions to reduce exposure to asthma triggers in homes of low-income children in Seattle. J Expo Sci Environ Epidemiol 14 (Suppl 1), S133–S143 (2004). https://doi.org/10.1038/sj.jea.7500367

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