Comprehensive avoidance of dust mite allergens Multifaceted primary prevention studies
1.7.2.2. Comprehensive avoidance of dust mite allergens
Dust mite allergen levels were lowered for the active group in more stringent environ- mental interventions. In a Manchester, England, intervention study, homes received aller- gen impermeable covers for both the mother’s bed and the child’s bed, a high filtration vacuum cleaner, vinyl flooring in the child’s bedroom after removing carpets, bedding that was washed weekly in hot water and washable toys. At age 3 years, there was no significant difference in the symptoms reported, but airway resistance was significantly better in the active group. Unexpectedly, the children in the active group were signifi- cantly more likely than the children in the control group to be sensitized to dust mite allergens at age 3 years Woodcock et al., 2004. A less stringent intervention study in Australia also reduced allergen levels significantly Marks et al., 2006. Dust mite avoidance measures in the active group included allergen impermeable covers, weekly washing of bedding in hot water and education about dust mite avoidance. At age 5 years, there was no difference in the prevalence of asthma, eczema or atopy between the active and placebo groups. The authors cited several rea- sons for the failure of the intervention, including that while allergen levels were signifi- cantly reduced in the active group, they may not have been low enough to be clinically relevant. They also discussed the possible need for a multifaceted intervention, as was discussed in the previous section on tertiary prevention.1.7.2.3. Multifaceted primary prevention studies
From the studies discussed in the previous two sections, it appears that reducing exposure to allergens alone may not be a sufficient avoidance measure for primary prevention – at least for outcomes in the early years of life. A large multifaceted trial in Canada inclu- ded control of house dust mites in multiple locations in the home, a reduction in expo- Allergic asthma 30 decrease with a substantial reduction orders of magnitude in the pollen allergen, domes- tic allergen reduction for the tertiary prevention of asthma is compelling. However, the efficacy of methods currently used for allergen reduction and whether they should be recommended for asthmatic individuals are controversial O’Connor, 2005. While sin- gle-allergen, single-site allergen-avoidance strategies such as the use of allergen imper- meable mattress covers do not seem effective on their own, recent evidence has shown that multifaceted domestic avoidance measures, which include targeting multiple aller- gens and multiple sites, have some benefit among children who live in urban environ- ments.1.7.2. Primary and secondary prevention
Parts
» TAP.COM - PUBLIC HEALTH SIGNIFICANCE OF URBAN PESTS - WHO/EUROPE - WORLD ...
» Risk of developing allergic sensitization
» Risk factors for developing asthma
» Public health impact of urban asthma
» Dust sampling Airborne sampling Comparison of various methods of allergen exposure assessment
» Cockroach sensitization and asthma
» Size characteristics of airborne mouse and rat allergens Residential exposures
» Dust mites Studies examining thresholds of exposure relevant to disease
» Cockroaches Rodents Studies examining thresholds of exposure relevant to disease
» Comprehensive avoidance of dust mite allergens Multifaceted primary prevention studies
» Limited avoidance of dust mite allergens
» Targeting housing conditions of high-risk groups
» Smokybrown cockroach American cockroach Oriental cockroach
» Brownbanded cockroach Allergy and asthma overview
» Food contamination and disease transmission
» Cost of control and management
» Impact of poverty Cockroaches
» Public costs 1. Cost of health-related conditions
» IPM of cockroaches Cockroaches
» Baits Cockroach control: pesticide applications
» Alternative strategies Cockroach control: sanitation practices
» Biological control Conclusions Cockroaches
» Origins and natural history Habitats within the home
» Food Limiting factors Distribution in Europe and N orth America
» CEH Distribution in Europe and N orth America
» The building envelope Impact of building construction
» The ventilation and heating system
» Furniture and furnishings Overall effect of the housing environment on health or illness
» Sampling methods Dust mite and allergen inspection and detection methods
» Mechanical solutions Modifying environmental conditions
» Washing Dusting Dry cleaning Vacuuming
» Home disinfectants Electric blankets Bed heaters Freezing
» Sunlight Steam cleaning Cleaning
» Autoclaving Steam cleaning Temperature control
» Barrier fabrics Temperature control
» Habitat modification Carpets Physical control methods
» Soft furnishings Air filters
» Anti-allergy sprays Antimicrobial treatments Dehumidifiers
» Pesticides Building construction Methods of house dust mite control
» Control methods Medical practitioners Other
» Background Biology and bionomics
» Other species of Cimicidae that can affect people
» Evidence of resurgence in N orth America
» Future prospects Resurgence of bedbug populations in Europe and North America
» Importance as pests Economic impact Bites and health effects
» Conducive environmental conditions An integrated approach to bedbug management
» Physical removal Exclusion Physical removal and exclusion
» Inspection Detection Inspection, detection and education
» Heat Cold Controlled atmospheres
» Use of pest management products
» Benchmarks for success in bedbug management Conclusions
» Introduction Flea biology Fleas
» Health risk and exposure assessment
» Cost for control and management
» Cost of health-related conditions
» Flea exclusion and physical removal Pesticide applications for flea control
» Foggers General surface treatments IGRs
» On-animal products Conducive environmental conditions
» Pharaoh ant biology Overview of biology and distribution in Europe and North America
» Health hazards 1. Pharaoh ant infestations: pathogen transmission and contamination
» Pharaoh ant distribution and population monitoring
» Fire ant population assessment and monitoring methods
» Fire ant geographic range and potential expansion Fire ants: stinging incidents
» Fire ants: cost of eradication
» Physical exclusion Residual contact insecticides
» Insecticidal baits Fire ants: cost of health-related issues, control and management
» Efficacy of management practices
» Implementation of fire ant control programmes
» Confirmation. Determine where control is needed.
» Fire ants Emerging problems and policy options
» Introduction Biology and bionomics of filth flies in Europe and North America
» N uisance Health hazards 1. Diseases
» Myiasis Health hazards 1. Diseases
» Pesticide applications for fly control Granular baits
» Fly exclusion practices Crack-and-crevice treatments Biological control
» Ultraviolet light traps Sticky traps Jar or bag traps Window traps
» Attractants Perimeter treatments Fly management
» Togaviridae: genus Alphavirus Viruses
» Orthomyxoviridae: genus Orthomyxovirus Bacteria
» Coxiellaceae Anaplasmataceae Spirochaetaceae Bacteria
» Regular nonsporing Gram-positive rods Mycobacteriaceae
» Microsporidia Babesiidae Eimeriidae Protozoa
» Zoonoses and sapronoses of wild birds in the urban ecosystem
» Monitoring and surveillance Management implications 1. Benchmarks
» Techniques for dispersing birds in cities
» Control of wild and feral birds in urban areas
» Economic impact of wild urban birds on human health and of controlling birds
» Introduction Human body lice
» Biological factors Implications for public health
» Louse infestation in Europe and North America
» Physical removal Pesticides Louse management 1. Inspection and detection
» Socioeconomic influences Conducive environmental conditions
» Benchmarks for lice management
» Introduction Ticks of Europe and North America
» LB in Europe and N orth America
» Geographical distribution Lyme borreliosis
» Public health impact of TBE in Europe
» Geographical distribution Geographical distribution Epizootiology and epidemiology
» HME HGA Crimean-Congo haemorrhagic fever
» Boutonneuse fever Rickettsia helvetica
» Clothing Tick removal Clothing impregnation Vaccination
» Host-centred methods Habitat manipulation and urban design
» Tick and tick-borne disease surveillance IPM
» Public activities Pesticide applications
» Surveillance and management Research
» Other mosquito-borne viral infections that cause encephalitides
» Malaria Mosquitoes as a pest nuisance
» Dengue haemorrhagic fever and yellow fever
» Dirofilariasis The spread of mosquitoes and mosquito-borne pathogens
» National reporting and Mosquitoes
» Mosquito control and management
» Sanitation and water management
» Adulticiding Larviciding Mosquito monitoring
» Use of predators biological control Passive protection
» Genetic control and transgenic mosquitoes
» Feeding Biology of commensal rodents 1. Description and natural history
» Reproduction and life cycle of commensal rodents
» Behaviour relevant to control
» Movement Biology of commensal rodents 1. Description and natural history
» Population growth and socialization of commensal rodents
» Sewers and drains Association with urban infrastructure 1. Rodents in housing
» Case study 1 – rat bites in Philadelphia: identifying the factors contributing to risk
» Zoonoses of mice Public health risks in urban areas
» Case study 2: Fairhill case study
» Tree squirrels Types, distribution and abundance
» Chipmunks Ground squirrels, antelope ground squirrels and prairie dogs
» Hamsters Voles Types, distribution and abundance
» Beavers Types, distribution and abundance
» Rabbits and hares Types, distribution and abundance
» Francisella tularensis Major rodent- and lagomorph-related bacterial and rickettsial agents
» California group viruses primarily La Crosse virus CTF virus
» Yersiniae Major rodent- and lagomorph-related bacterial and rickettsial agents
» Borrelia burgdorferi s.l. Tick-borne relapsing fever borreliae
» Toxoplasma Toxocara Major rodent- and lagomorph-related parasitic agents
» Babesiae Leptospirae Major rodent- and lagomorph-related parasitic agents
» Bartonellae Rat-bite fever agents
» Flying squirrels Ground squirrels and antelope ground squirrels
» Tree squirrels Voles and other microtine rodents
» Chipmunks Disease associations with particular types of rodents
» Beavers Disease associations with particular types of rodents
» Rabbits and hares Old World mice
» Dormice N ew World rats and mice
» Introduction The impacts of anthropogenic transformations
» Risk factors for rodent- and lagomorph-related diseases Public health impact
» Costs, control and management of infestations
» Control and management of non-commensal rodents and rodent-related diseases
» Conclusions Non-commensal rodents and lagomorphs
» EU community-level authorization of technical grade active ingredients
» Acute toxicity The precautionary principle
» The substitution doctrine Special considerations given to children’s health
» Toxicity end-points Pesticide hazard identification
» Long-term effects Pesticide hazard identification
» Insecticide synergists N eonicotinoid insecticides
» Spot applications Primary exposure of non-professional users and secondary exposures
» Inhalation Routes of exposure
» Incidental oral exposure Routes of exposure
» Exposure potential Steps of pre-market risk assessment of pesticides
» Tiered approaches to exposure estimation: a basis for risk assessment
» Mathematical mechanistic models Empirical models Some existing models
» Statistical mathematical models SOPs and exposure scenario types
» Comparing pesticide risks from residential and dietary exposures
» Residential applicator exposure assessment
» Toxicity end-points and MOS Residential applicator exposure
» Future actions and data development
» Identification Establishment of threshold levels
» Inspection Evaluation of effectiveness
» Develop an IPM plan Employment of two or more control measures
» Definitions of IPM An integrated approach to managing urban insects and rodents
» Case study 3 Case study 4 Case study 5
Show more