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American Journal of Respiratory and Critical Care Medicine Vol 166. pp. 307-313, (2002)
© 2002 American Thoracic Society

Original Article

Placebo-controlled Trial of House Dust Mite–impermeable Mattress Covers

Effect on Symptoms in Early Childhood

Laurens P. Koopman, Rob T. van Strien, Marjan Kerkhof, Alet Wijga, Henriette A. Smit, Johan C. de Jongste, Jorrit Gerritsen, Rob C. Aalberse, Bert Brunekreef and Herman J. Neijens

Department of Pediatrics, Erasmus University Medical Center/Sophia Children's Hospital, Rotterdam; Department of Environmental and Occupational Health, Institute for Risk Assessment Sciences, University of Utrecht, Utrecht; Department of Epidemiology and Statistics, Groningen University, Groningen; Department of Chronic Disease Epidemiology, National Institute of Public Health and the Environment; Department of Pediatric Pulmonology, Beatrix Children's University Hospital, Groningen; and Central Laboratory for the Blood Transfusion Services, Amsterdam, The Netherlands

Correspondence and requests for reprints should be addressed to Prof. H.J. Neijens, Department of Pediatrics, Sophia Children's Hospital, PO Box 2060, 3000 CB, Rotterdam, The Netherlands. E-mail: neijens{at}alkg.azr.nl

We investigated the effect of house dust mite (HDM)-allergen avoidance on the development of respiratory symptoms, atopic dermatitis, and atopic sensitization by performing a double blind, placebo-controlled trial. In total, 1,282 allergic pregnant women were selected (416 received HDM allergen–impermeable mattress covers for the parents' and child's mattress in the third trimester of pregnancy [active], 394 received placebo covers, 472 received no intervention). Data on allergen exposure, clinical symptoms, and immunoglobulin E were collected prospectively. The prevalence of night cough without a cold in the second year of life was lower in the group with active covers compared with the group with placebo covers (adjusted odds ratio 0.65; 95% confidence interval 0.4–1.0). No effect of the intervention was seen on other respiratory symptoms, atopic dermatitis, and total and specific immunoglobulin E. It can be concluded that application of HDM-impermeable mattress covers on the child's and parents' beds reduced night cough, but not other respiratory symptoms, atopic dermatitis, and atopic sensitization in the first 2 years of life. Follow-up will determine the long-term effect of the intervention on the development of atopic disease.

Key Words: mite control • wheezing • asthma • atopy • allergens




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