摘要：Asthma is now the leading cause of school absence among children of color in impoverished urban neighborhoods. Environmental interventions have the potential to augment clinical approaches to asthma management by directly reducing exposure to environmental triggers (e.g., cockroaches, rodents, and mold). We implemented an apartment-based intervention to reduce exposures to indoor allergens among children living with asthma in 2 areas in New York City with rates of asthma morbidity and mortality that rank among the highest in the United States. Although the intervention phase of the present study is not yet complete, timely reporting of our field experiences may prove useful to other groups engaged in environmental intervention trials in urban communities. ASTHMA IS NOW THE LEADING cause of school absence among children of color in impoverished urban neighborhoods, thereby contributing to decreased quality of life and hindering opportunities for educational and career advancement. 1 Exposure to high levels of indoor allergens (e.g., from cockroaches, rodents, and mold) among allergic asthmatic children results in more frequent and severe asthma episodes. 2 Environmental interventions have the potential to augment clinical approaches to asthma management by directly reducing exposure to environmental triggers. We recruited 30 asthmatic children aged 5 to 18 years who were allergic to cockroaches and lived in apartments with self-reported cockroach infestation. Each apartment underwent a baseline inspection for the presence of cockroaches and mice and an environmental assessment that included collection of dust samples for later analysis of cockroach, mouse, and dust mite allergens. Individual sensitization was assessed in all enrolled children via skin prick tests and allergen-specific IgE levels. Asthma symptoms were assessed by means of standardized questionnaires. All homes underwent a comprehensive integrated pest management (IPM) intervention, half at baseline (the intervention group) and the other half 8 months later (the lagged-intervention group); group assignment was random. The intervention consisted of the following: sealing cracks and crevices in the structural envelope of each apartment, applying low-toxicity pesticides, thoroughly cleaning surfaces, eliminating food and water sources, and educating household members about maintaining a pest-free environment. Follow-up assessments of cockroach and rodent populations, allergen exposures, immunologic sensitizations, and asthma symptoms are currently under way. Results from our pilot work were reported previously as abstracts only. 3, 4
