The Melbourne House Dust Mite Study: Eliminating house dust mites in the domestic environment☆,☆☆,★,★★
Section snippets
Conduct of study
This study was conducted between winter (July) and late spring (November 1991).
One hundred seven children with moderately severe asthma (median dose of inhaled steroids, 600 μg/day), 71 boys with a median age of 8 years (range, 4 to 17 years) and 36 girls with a median age of 9.3 years (range, 4 to 16 years) who were all under the care of a single physician, were enrolled in the 5-month study. All had demonstrated skin prick test reactivity (wheals >6 mm) to an extract of D. pteronyssinus
Patient numbers
One hundred seven homes were entered into the study. Seven were withdrawn after the first visit, and 12 were withdrawn after the second. Among these withdrawals, 11 families moved, five were unwilling to follow the trial's protocol, and three were difficult to contact for further sampling for logistical reasons. Consequently, 88 dwellings were available for analysis at the end of the study.
Meteorologic data
The study was conducted within 15 km of the central business district of Melbourne, a capital city in
DISCUSSION
Two major findings from this study have public health implications in terms of controlling house dust mite allergen exposure. First, the concentration of Der p 1 in these domestic dwellings of mite-sensitive patients with asthma are among the highest in the world, being similar to those from Sydney18 and some dwellings in the United Kingdom 19, 20 but up to 100 times higher than levels in Sweden,21, 22 The Netherlands, 23, 24 Canada,25 and other parts of Australia.26 Second, the only dwellings
Acknowledgements
We thank Tina Colgan, Carmel Swingler, Joan Sedmak, Department of Allergy; Patty Chondros, Clinical Epidemiology and Biostatistics Unit; the staff of Biomedical Engineering, Royal Children's Hospital, Melbourne; and Karen Krska, Princess Margaret Hospital, Perth, Western Australia, for their assistance. Dr. Martin Chapman, University of Virginia, provided monoclonal antibody kits for Der p 1.
References (37)
- et al.
Dust mite allergens and asthma: Report of the 2nd International Workshop
J Allergy Clin Immunol
(1992) - et al.
Reduction of bronchial hyperactivity during prolonged allergen avoidance
Lancet
(1982) - et al.
Reducing domestic exposure to house dust mite allergen reduces bronchial hyperactivity in sensitive children with asthma
J Allergy Clin Immunol
(1992) - et al.
A 2-site monoclonal antibody ELISA for the quantification of the two major Dermatophagoides SPP. allergens Der p I and Der f I
J Immunol Methods
(1989) - et al.
Mite allergen (Der p 1) concentration in houses and its relation to severity of asthma in a population of Sydney schoolchildren
J Allergy Clin Immunol
(1995) - et al.
Control of house dust mite antigen in bedding
Lancet
(1990) - et al.
House dust mite sensitization in children and residential characteristics in a temperate region
J Allergy Clin Immunology
(1991) - et al.
High allergen exposure increases the risk of sensitization in atopic children and young adults
J Allergy Clin Immunol
(1989) - et al.
Mite allergen control with acaricide fails
J Allergy Clin Immunol
(1994) - et al.
The effect of allergen avoidance on development of allergic disorders in infancy
Lancet
(1992)
Effect of allergen avoidance of infancy on allergic manifestations at age 2 years
J Allergy Clin Immunol
International comparison of asthma prevalence in children: Australia, Switzerland, Chile
Pediatr Pulmonol
Childhood asthma in 4 countries: a comparative survey
Int J Epidemiol
A study on the prevalence of bronchial asthma in school children in western districts of Japan: comparison between the studies in 1992 and 1982 with the same methods and same districts
Arerugi
Prevalence of asthma in adults in Busselton, Western Australia
Br Med J
Changing prevalence of asthma in Australian children
Br Med J
Exposure to house dust mite allergen (Der p 1) and the development of asthma in childhood
A prospective study. N Engl J Med
Importance of house dust mite and Alternaria allergens in childhood asthma: an epidemiological study in two climatic regions of Australia
Clin Exp Allergy
Cited by (0)
- ☆
From aDepartment of Allergy, Royal Children's Hospital, Parkville; bDepartment of Medicine, University of Western Australia; cDepartment of Microbiology, University of Western Australia; dClinical Epidemiology and Biostatistics Unit, Royal Children's Hospital; eUniversity of Melbourne Department of Paediatrics; and fClinical Immunology, Royal Children's Hospital.
- ☆☆
Supported by a grant from The Victorian Health Promotion Foundation, Melbourne, Australia.
- ★
Reprint requests: David J. Hill, FRACP, Director, Department of Allergy, Royal Children's Hospital, Parkville, 3052 Australia.
- ★★
1/1/77359