Recorded presentation

Terry Allan, RS, MPH¹, Dorr G. Dearborn, PhD, MD², Carolyn Kercsmar, MD³, Mark Schluchter, PhD⁴, Lester Kirchner, PhD⁴, and John Sobolewski, RS¹. (1) The Cuyahoga County Board of Health, 5550 Venture Drive, Parma, OH 44130, 216.201.2001, N/A, (2) Swetland Center for Environmental Health, 11100 Euclid Avenue, Clevland, OH 44106-5000, (3) Center for the Chronic Conditions of Childhood, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106-5000, (4) Division of Clinical Epidemiology and Biostatistics, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Clevland, OH 44106-5000

The asthma portion of the Urban Mold and Moisture Program addressed the hypothesis that home environmental remediation including measures specifically to reduce mold and moisture would decrease asthma morbidity. Environmental interventions with home remediation and education were compared to environmental education alone. Children were recruited with moderately severe asthma defined as an emergency department or hospitalization for acute asthma within the past year. Enrollment was dependent upon an initial home inspection finding visible water-damage and/or mold. Following baseline home evaluation and clinical measures, their medical care was optimized, whereupon they were randomized to remediation/education or environmental education only. All homes underwent inspection using an extensive visual assessment tool (VAT) and environmental testing of settled dust for common allergens, endotoxin, beta-glucan, and mold (cultured on 3 media and quantitative PCR). Clinical and environmental visits and assessments occurred initially, 3-4 months after remediation (or the equivalent timing), and at one year from initial evaluation. Remediation by trained remediators was directed primarily at mold and moisture problems per specifications with a maximum of $10,000 per unit. A total of 62 children have just completed the study with 30 homes having been remediated. In addition to reporting specific environmental and clinical testing results, we will report on the comparison of the remediation and the control groups regarding acute exacerbations, number of symptom days, and symptom profiles. The statistical power requirements regarding these latter parameters was made larger by the initial optimization of the medical care of the children.

Learning Objectives:

• Participants will be able to identify major water intrusion sources in inner city housing and learn cost-effective measures of remediation.
• Participants will learn the value of quantitative PCR in comparison with standard culture methods for the evaluation of environmental molds.
• Particpants will understand the impact of damp and moldy home environments on the morbidity of childhood asthma

Keywords: Asthma, Environmental Exposures

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation