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WHAT YOU SHOULD HAVE READ BUT….2011 ,[object Object],University of Verona, Italy Attilio Boner
Efficacy of a novel air filtration pillow for avoidance  of perennial allergens in symptomatic adults Stillerman   Ann Allergy Asthma Immunol 2010;104:440  PureZone system diagram depicting the clean air breathing zone ( a ), which is created by pressurizing room air ( b ); removing allergens through high-efficiency particulate  air filtration ( c ); conveying the clean airflow toward the breathing zone through an upper chamber in the pillowcase over the existing pillow, which is encapsulated in a lower chamber dust mite barrier ( d ); and providing clean airflow to the breathing  zone through the top pillowcase surface ( e ).  A B C D E
Efficacy of a novel air filtration pillow for avoidance  of perennial allergens in symptomatic adults Stillerman   Ann Allergy Asthma Immunol 2010;104:440  ,[object Object],Mean change from baseline in  Total Symptom Scores on waking.  a P  < .05
Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke.  Lanphear   J Ped 2011;127:93
Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke.  Lanphear   J Ped 2011;127:93 ,[object Object],[object Object],[object Object],% reduction in unscheduled asthma visits during 1 yrs follow-up -18% HEPA Air Cleaners p=0.04 0  -10 – -15 – -20 –
Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke.  Lanphear   J Ped 2011;127:93 % reduction of particles  of >0.3  μ m -25% 0  -10 – -15 – -20 – -25 – -30 – HEPA Air Cleaners ,[object Object],[object Object],[object Object]
Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke.  Lanphear   J Ped 2011;127:93 % reduction of particles  of >0.3  μ m -25% 0  -10 – -15 – -20 – -25 – -30 – HEPA Air Cleaners ,[object Object],[object Object],[object Object],There were no  significant differences  in parent-reported  asthma symptoms,  exhaled nitric-oxide levels,  air nicotine levels,  or cotinine levels  according to group assignment.
Eight-year outcomes of the Childhood Asthma Prevention Study   Toelle  JACI  2010;126:388  ,[object Object],[object Object],% children with HDM  allergy at age 7 years 33.2% Intervention Controls 37.9% 40 – 35 – 30 – 25 – 20 – 15 – 10 – 0 5 – 0 0 ns
Eight-year outcomes of the Childhood Asthma Prevention Study   Toelle  JACI  2010;126:388  ,[object Object],[object Object],% children with HDM  allergy at age 7 years 33.2% Intervention Controls 37.9% 40 – 35 – 30 – 25 – 20 – 15 – 10 – 0 5 – 0 0 ns  But among children who were atopic at 8 years of age, the active HDM avoidance intervention was associated with significant absolute risk reduction of 10.6% (95% CI, 0.1% to 21.0%) in poor asthma control compared with those in  the control group.
Major mite allergen Der f 1 concentration is reduced in buildings with improved energy performance Spertini  Allergy 2010;65:623  ,[object Object],[object Object],Der f 1  Der p 1
Major mite allergen Der f 1 concentration is reduced in buildings with improved energy performance Spertini  Allergy 2010;65:623  ,[object Object],[object Object],Mite allergens are significantly less abundant  in LEB than in  CB groups.  Der f 1  Der p 1
Major mite allergen Der f 1 concentration is reduced in buildings with improved energy performance Spertini  Allergy 2010;65:623  Fel d 1  Bla g 2  ,[object Object],[object Object]
Major mite allergen Der f 1 concentration is reduced in buildings with improved energy performance Spertini  Allergy 2010;65:623  ,[object Object],[object Object],(A) Dry temperature p<0.01 p=0.01 (B) relative humidity
Major mite allergen Der f 1 concentration is reduced in buildings with improved energy performance Spertini  Allergy 2010;65:623  In the 1970s, attempts to decrease energy losses by occluding most of a building’s openings led to impaired ventilation and increased humidity, conditions that favoured mite growth.  However, novel concepts in  building construction including high performance mechanical ventilation systems with heat recovery have largely modified the strategies of energy savings, allowing a reduction in annual consumption of <42 kWh/m 2  floor area for heating and hot water in optimal conditions.  (Minergie® label,http://www.minergie.ch/)
Effects of latex avoidance on latex sensitization, atopy and allergic diseases in patients with spina bifida Blumchen Allergy 2010;65:1585 ,[object Object],[object Object],[object Object],% children developing latex sensitization 5% CURRENT  HISTORIC 60 – 50 – 40 – 30 – 20 – 10 – 0 55% GROUP p<0.001
Effects of latex avoidance on latex sensitization, atopy and allergic diseases in patients with spina bifida Blumchen Allergy 2010;65:1585 ,[object Object],[object Object],[object Object],% children developing latex allergy 0.08% CURRENT  HISTORIC 40 – 30 – 20 – 10 – 0 37% p<0.001 GROUP
Effects of latex avoidance on latex sensitization, atopy and allergic diseases in patients with spina bifida Blumchen Allergy 2010;65:1585 ,[object Object],[object Object],[object Object],% children developing latex allergy 0.08% CURRENT  HISTORIC 40 – 30 – 20 – 10 – 0 37% p<0.001 GROUP Latex avoidance  in children with spina bifida  prevents latex sensitization and latex allergy
Compliance  education
Comprehensive environmental management of asthma  and pediatric preventive care Roy   Pediatr  Allergy Immunol  2011;22:277  ,[object Object],[object Object],[object Object],[object Object]
Comprehensive environmental management of asthma  and pediatric preventive care Roy   Pediatr  Allergy Immunol  2011;22:277  ECP  Environmental control practices
Comprehensive environmental management of asthma  and pediatric preventive care Roy   Pediatr  Allergy Immunol  2011;22:277  ECP  Environmental control practices  Comprehensive use of ECPs was associated with having received physician advice
Comprehensive environmental management of asthma  and pediatric preventive care Roy   Pediatr  Allergy Immunol  2011;22:277  ECP  Environmental control practices  Only a minority of parents implement comprehensive ECPs
Comprehensive environmental management of asthma  and pediatric preventive care Roy   Pediatr  Allergy Immunol  2011;22:277  Odds of comprehensive environmental management according to number of routine asthma visits in prior year
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What 2011 allergen avoidance

  • 1.
  • 2. Efficacy of a novel air filtration pillow for avoidance of perennial allergens in symptomatic adults Stillerman Ann Allergy Asthma Immunol 2010;104:440 PureZone system diagram depicting the clean air breathing zone ( a ), which is created by pressurizing room air ( b ); removing allergens through high-efficiency particulate air filtration ( c ); conveying the clean airflow toward the breathing zone through an upper chamber in the pillowcase over the existing pillow, which is encapsulated in a lower chamber dust mite barrier ( d ); and providing clean airflow to the breathing zone through the top pillowcase surface ( e ). A B C D E
  • 3.
  • 4. Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke. Lanphear J Ped 2011;127:93
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14. Major mite allergen Der f 1 concentration is reduced in buildings with improved energy performance Spertini Allergy 2010;65:623 In the 1970s, attempts to decrease energy losses by occluding most of a building’s openings led to impaired ventilation and increased humidity, conditions that favoured mite growth. However, novel concepts in building construction including high performance mechanical ventilation systems with heat recovery have largely modified the strategies of energy savings, allowing a reduction in annual consumption of <42 kWh/m 2 floor area for heating and hot water in optimal conditions. (Minergie® label,http://www.minergie.ch/)
  • 15.
  • 16.
  • 17.
  • 19.
  • 20. Comprehensive environmental management of asthma and pediatric preventive care Roy Pediatr Allergy Immunol 2011;22:277 ECP Environmental control practices
  • 21. Comprehensive environmental management of asthma and pediatric preventive care Roy Pediatr Allergy Immunol 2011;22:277 ECP Environmental control practices Comprehensive use of ECPs was associated with having received physician advice
  • 22. Comprehensive environmental management of asthma and pediatric preventive care Roy Pediatr Allergy Immunol 2011;22:277 ECP Environmental control practices Only a minority of parents implement comprehensive ECPs
  • 23. Comprehensive environmental management of asthma and pediatric preventive care Roy Pediatr Allergy Immunol 2011;22:277 Odds of comprehensive environmental management according to number of routine asthma visits in prior year