Effect of an integrated pest management intervention on reducing ED and hospital among children (0-17 years) enrolled in an asthma management program

Children 12 years and younger living in the poorest NYC neighborhoods are almost twice as likely to have asthma as their wealthier counterparts. From 2008 to 2012, 635 families received environmental interventions, 163 of whom were also enrolled in the East Harlem Asthma Center of Excellence (EHACE), which provided intensive case management. Generalized estimating equation (GEE) was used to analyze data by assuming a binomial distribution of day- and night-time symptoms in 14 days and 30 days, respectively. Chi-square tests were conducted by environmental exposures, level of treatment, housing and demographic indicators. Of the participating families, both enrollment in EHACE and living in public housing were significantly associated with visible mold exposure (p <.0001), having other building maintenance issues (p=.0018,p=.002) and needing bedroom interventions (p=0.001,p=.0008). Over time, mold exposure and living in public housing were significantly associated with symptom-free nights among children enrolled in EHACE (p=.002, p=.006). Environmental interventions in the bedrooms of EHACE children significantly lengthened the number of symptom-free days (p=0.008) and weakly modified the time span of symptom-free nights (p=.070). Time trends for symptom-free days and nights were significantly different between those receiving and not receiving mold remediation services (p=<.001, p=0.002 respectively). The number of symptom-free days was marginally different among families receiving IPM interventions and those who did not (p= 0.044). Targeted environmental interventions, coupled with intensive case management, can effectively control symptoms in children with persistent asthma.