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Effects of improved home heating on asthma in community dwelling children: randomised controlled trial

Objective To assess whether non-polluting, more effective home heating (heat pump, wood pellet burner, flued gas) has a positive effect on the health of children with asthma. Design Randomised controlled trial. Setting Households in five communities in New Zealand. Participants 409 children aged 6-1...

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Autores principales: Howden-Chapman, Philippa, Pierse, Nevil, Nicholls, Sarah, Gillespie-Bennett, Julie, Viggers, Helen, Cunningham, Malcolm, Phipps, Robyn, Boulic, Mikael, Fjällström, Pär, Free, Sarah, Chapman, Ralph, Lloyd, Bob, Wickens, Kristin, Shields, David, Baker, Michael, Cunningham, Chris, Woodward, Alistair, Bullen, Chris, Crane, Julian
Formato: Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658826/
https://www.ncbi.nlm.nih.gov/pubmed/18812366
http://dx.doi.org/10.1136/bmj.a1411
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author Howden-Chapman, Philippa
Pierse, Nevil
Nicholls, Sarah
Gillespie-Bennett, Julie
Viggers, Helen
Cunningham, Malcolm
Phipps, Robyn
Boulic, Mikael
Fjällström, Pär
Free, Sarah
Chapman, Ralph
Lloyd, Bob
Wickens, Kristin
Shields, David
Baker, Michael
Cunningham, Chris
Woodward, Alistair
Bullen, Chris
Crane, Julian
author_facet Howden-Chapman, Philippa
Pierse, Nevil
Nicholls, Sarah
Gillespie-Bennett, Julie
Viggers, Helen
Cunningham, Malcolm
Phipps, Robyn
Boulic, Mikael
Fjällström, Pär
Free, Sarah
Chapman, Ralph
Lloyd, Bob
Wickens, Kristin
Shields, David
Baker, Michael
Cunningham, Chris
Woodward, Alistair
Bullen, Chris
Crane, Julian
author_sort Howden-Chapman, Philippa
collection PubMed
description Objective To assess whether non-polluting, more effective home heating (heat pump, wood pellet burner, flued gas) has a positive effect on the health of children with asthma. Design Randomised controlled trial. Setting Households in five communities in New Zealand. Participants 409 children aged 6-12 years with doctor diagnosed asthma. Interventions Installation of a non-polluting, more effective home heater before winter. The control group received a replacement heater at the end of the trial. Main outcome measures The primary outcome was change in lung function (peak expiratory flow rate and forced expiratory volume in one second, FEV(1)). Secondary outcomes were child reported respiratory tract symptoms and daily use of preventer and reliever drugs. At the end of winter 2005 (baseline) and winter 2006 (follow-up) parents reported their child’s general health, use of health services, overall respiratory health, and housing conditions. Nitrogen dioxide levels were measured monthly for four months and temperatures in the living room and child’s bedroom were recorded hourly. Results Improvements in lung function were not significant (difference in mean FEV(1) 130.7 ml, 95% confidence interval −20.3 to 281.7). Compared with children in the control group, however, children in the intervention group had 1.80 fewer days off school (95% confidence interval 0.11 to 3.13), 0.40 fewer visits to a doctor for asthma (0.11 to 0.62), and 0.25 fewer visits to a pharmacist for asthma (0.09 to 0.32). Children in the intervention group also had fewer reports of poor health (adjusted odds ratio 0.48, 95% confidence interval 0.31 to 0.74), less sleep disturbed by wheezing (0.55, 0.35 to 0.85), less dry cough at night (0.52, 0.32 to 0.83), and reduced scores for lower respiratory tract symptoms (0.77, 0.73 to 0.81) than children in the control group. The intervention was associated with a mean temperature rise in the living room of 1.10°C (95% confidence interval 0.54°C to 1.64°C) and in the child’s bedroom of 0.57°C (0.05°C to 1.08°C). Lower levels of nitrogen dioxide were measured in the living rooms of the intervention households than in those of the control households (geometric mean 8.5 μg/m(3) v 15.7 μg/m(3), P<0.001). A similar effect was found in the children’s bedrooms (7.3 μg/m(3) v 10.9 μg/m(3), P<0.001). Conclusion Installing non-polluting, more effective heating in the homes of children with asthma did not significantly improve lung function but did significantly reduce symptoms of asthma, days off school, healthcare utilisation, and visits to a pharmacist. Trial registration Clinical Trials NCT00489762.
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spelling pubmed-26588262009-03-20 Effects of improved home heating on asthma in community dwelling children: randomised controlled trial Howden-Chapman, Philippa Pierse, Nevil Nicholls, Sarah Gillespie-Bennett, Julie Viggers, Helen Cunningham, Malcolm Phipps, Robyn Boulic, Mikael Fjällström, Pär Free, Sarah Chapman, Ralph Lloyd, Bob Wickens, Kristin Shields, David Baker, Michael Cunningham, Chris Woodward, Alistair Bullen, Chris Crane, Julian BMJ Research Objective To assess whether non-polluting, more effective home heating (heat pump, wood pellet burner, flued gas) has a positive effect on the health of children with asthma. Design Randomised controlled trial. Setting Households in five communities in New Zealand. Participants 409 children aged 6-12 years with doctor diagnosed asthma. Interventions Installation of a non-polluting, more effective home heater before winter. The control group received a replacement heater at the end of the trial. Main outcome measures The primary outcome was change in lung function (peak expiratory flow rate and forced expiratory volume in one second, FEV(1)). Secondary outcomes were child reported respiratory tract symptoms and daily use of preventer and reliever drugs. At the end of winter 2005 (baseline) and winter 2006 (follow-up) parents reported their child’s general health, use of health services, overall respiratory health, and housing conditions. Nitrogen dioxide levels were measured monthly for four months and temperatures in the living room and child’s bedroom were recorded hourly. Results Improvements in lung function were not significant (difference in mean FEV(1) 130.7 ml, 95% confidence interval −20.3 to 281.7). Compared with children in the control group, however, children in the intervention group had 1.80 fewer days off school (95% confidence interval 0.11 to 3.13), 0.40 fewer visits to a doctor for asthma (0.11 to 0.62), and 0.25 fewer visits to a pharmacist for asthma (0.09 to 0.32). Children in the intervention group also had fewer reports of poor health (adjusted odds ratio 0.48, 95% confidence interval 0.31 to 0.74), less sleep disturbed by wheezing (0.55, 0.35 to 0.85), less dry cough at night (0.52, 0.32 to 0.83), and reduced scores for lower respiratory tract symptoms (0.77, 0.73 to 0.81) than children in the control group. The intervention was associated with a mean temperature rise in the living room of 1.10°C (95% confidence interval 0.54°C to 1.64°C) and in the child’s bedroom of 0.57°C (0.05°C to 1.08°C). Lower levels of nitrogen dioxide were measured in the living rooms of the intervention households than in those of the control households (geometric mean 8.5 μg/m(3) v 15.7 μg/m(3), P<0.001). A similar effect was found in the children’s bedrooms (7.3 μg/m(3) v 10.9 μg/m(3), P<0.001). Conclusion Installing non-polluting, more effective heating in the homes of children with asthma did not significantly improve lung function but did significantly reduce symptoms of asthma, days off school, healthcare utilisation, and visits to a pharmacist. Trial registration Clinical Trials NCT00489762. BMJ Publishing Group Ltd. 2008-09-23 /pmc/articles/PMC2658826/ /pubmed/18812366 http://dx.doi.org/10.1136/bmj.a1411 Text en © Howden et al 2008 http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Howden-Chapman, Philippa
Pierse, Nevil
Nicholls, Sarah
Gillespie-Bennett, Julie
Viggers, Helen
Cunningham, Malcolm
Phipps, Robyn
Boulic, Mikael
Fjällström, Pär
Free, Sarah
Chapman, Ralph
Lloyd, Bob
Wickens, Kristin
Shields, David
Baker, Michael
Cunningham, Chris
Woodward, Alistair
Bullen, Chris
Crane, Julian
Effects of improved home heating on asthma in community dwelling children: randomised controlled trial
title Effects of improved home heating on asthma in community dwelling children: randomised controlled trial
title_full Effects of improved home heating on asthma in community dwelling children: randomised controlled trial
title_fullStr Effects of improved home heating on asthma in community dwelling children: randomised controlled trial
title_full_unstemmed Effects of improved home heating on asthma in community dwelling children: randomised controlled trial
title_short Effects of improved home heating on asthma in community dwelling children: randomised controlled trial
title_sort effects of improved home heating on asthma in community dwelling children: randomised controlled trial
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658826/
https://www.ncbi.nlm.nih.gov/pubmed/18812366
http://dx.doi.org/10.1136/bmj.a1411
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