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Household endotoxin reduction in the Louisa Environmental Intervention Project for rural childhood asthma
Journal article   Open access

Household endotoxin reduction in the Louisa Environmental Intervention Project for rural childhood asthma

Angelico Mendy, Nervana Metwali, Sarah S Perry, Elizabeth A Chrischilles, Kai Wang and Peter S Thorne
Indoor air, Vol.30(1), pp.88-97
01/2020
DOI: 10.1111/ina.12610
PMCID: PMC7889405
PMID: 31605641
url
https://doi.org/10.1111/ina.12610View
Published (Version of record) Open Access

Abstract

Endotoxin exacerbates asthma. We designed the Louisa Environmental Intervention Project (LEIP) and assessed its effectiveness in reducing household endotoxin and improving asthma symptoms in rural Iowa children. Asthmatic school children (N = 104 from 89 homes) of Louisa and Keokuk counties in Iowa (aged 5-14 years) were recruited and block-randomized to receive extensive (education + professional cleaning) or educational interventions. Environmental sampling collection and respiratory survey administration were done at baseline and during three follow-up visits. Mixed-model analyses were used to assess the effect of the intervention on endotoxin levels and asthma symptoms in the main analysis and of endotoxin reduction on asthma symptoms in exploratory analysis. In the extensive intervention group, dust endotoxin load was significantly reduced in post-intervention visits. The extensive compared with the educational intervention was associated with significantly decreased dust endotoxin load in farm homes and less frequent nighttime asthma symptoms. In exploratory analysis, dust endotoxin load reduction from baseline was associated with lower total asthma symptoms score (Odds ratio: 0.52, 95% confidence interval: 0.29-0.92). In conclusion, the LEIP intervention reduced household dust endotoxin and improved asthma symptoms. However, endotoxin reductions were not sustained post-intervention by residents.
Rural Population - statistics & numerical data Asthma - prevention & control Humans Child, Preschool Environmental Exposure - prevention & control Male Adolescent Female Iowa - epidemiology Air Pollution, Indoor - prevention & control Decontamination - methods Environmental Exposure - statistics & numerical data Air Pollution, Indoor - statistics & numerical data Child Endotoxins - analysis Asthma - epidemiology

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