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Gangneux JP, Bouvrais M, Frain S, Morel H, Deguen S, Chevrier S, Le Cann P. Asthma and Indoor Environment: Usefulness of a Global Allergen Avoidance Method on Asthma Control and Exposure to Molds. Mycopathologia 2020; 185:367-371. [PMID: 31897973 DOI: 10.1007/s11046-019-00417-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/10/2019] [Indexed: 02/02/2023]
Abstract
The usefulness and feasibility of a global allergens avoidance method with counselors visiting patients' home for allergens measures and adapted advices were prospectively evaluated through asthma control and environment evaluation. Twenty seven patients were prospectively included and compared to a cohort of 30 control patients. The level of control of asthma at inclusion and after 1 year was evaluated by the clinical signs, the evolution of the FEV1, and the healthcare use. Environmental measurements included the fungal load of 5 surfaces of the dwellings and the evaluation of moisture. A significant clinical improvement in the population that benefited from the home counselors visit was observed compared to the baseline (p < 0.0001), as well as a decreased number of hospitalizations for asthma and of the consumption of anti-asthma drugs (p < 0.01). Dampness markers slightly improved with an improvement of the fungal loads in two-third of the dwellings.
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Affiliation(s)
- Jean-Pierre Gangneux
- Irset (Institut de Recherche en santé, environnement et travail) - UMR_S 1085, Univ Rennes, CHU Rennes, Inserm, EHESP, 35000, Rennes, France. .,Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Rennes, 2 rue Henri le Guilloux, 35033, Rennes Cedex 09, France.
| | - Matthieu Bouvrais
- Département de Médecine Générale, Université de Rennes 1, Rennes, France
| | | | - Hugues Morel
- Service de Pneumologie, Centre Hospitalier d'Orléans, Orléans, France
| | - Séverine Deguen
- EHESP, Inserm, Irset (Institut de Recherche en santé, environnement et travail) - UMR_S 1085, 35000, Rennes, France
| | - Sylviane Chevrier
- Irset (Institut de Recherche en santé, environnement et travail) - UMR_S 1085, Univ Rennes, CHU Rennes, Inserm, EHESP, 35000, Rennes, France
| | - Pierre Le Cann
- EHESP, Inserm, Irset (Institut de Recherche en santé, environnement et travail) - UMR_S 1085, 35000, Rennes, France
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Le Cann P, Paulus H, Glorennec P, Le Bot B, Frain S, Gangneux JP. Home Environmental Interventions for the Prevention or Control of Allergic and Respiratory Diseases: What Really Works. J Allergy Clin Immunol Pract 2016; 5:66-79. [PMID: 27665387 DOI: 10.1016/j.jaip.2016.07.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 06/17/2016] [Accepted: 07/08/2016] [Indexed: 12/29/2022]
Abstract
Home health care workers interventions have been implemented in western countries to improve health status of patients with respiratory diseases especially asthma and allergic illnesses. Twenty-six controlled studies dealing with prevention and control of these diseases through home environmental interventions were reviewed. After a comprehensive description of the characteristics of these studies, the effectiveness of each intervention was then evaluated in terms of participants' compliance with the intervention program, improvement of quality of the indoor environment, and finally improvement of health outcomes, in detailed tables. Limitations and biases of the studies are also discussed. Overall, this review aims at giving a toolbox for home health care workers to target the most appropriate measures to improve health status of the patient depending on his and/or her environment and disease. Only a case-by-case approach with achievable measures will warrant the efficacy of home interventions. This review will also provide to the research community a tool to better identify targets to focus in future evaluation studies of home health care workers action.
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Affiliation(s)
- Pierre Le Cann
- Environmental and Occupational Health Department, EHESP School of Public Health, Rennes, France; Inserm UMR 1085-IRSET, Rennes, France.
| | - Hélène Paulus
- ESITC, Engineering School of Construction Works, Cachan, France
| | - Philippe Glorennec
- Environmental and Occupational Health Department, EHESP School of Public Health, Rennes, France; Inserm UMR 1085-IRSET, Rennes, France
| | - Barbara Le Bot
- Environmental and Occupational Health Department, EHESP School of Public Health, Rennes, France; Inserm UMR 1085-IRSET, Rennes, France
| | - Sophie Frain
- Captair Bretagne Association, Dinan Hospital, Dinan, France
| | - Jean Pierre Gangneux
- Inserm UMR 1085-IRSET, Rennes, France; Parasitology-Mycology Laboratory, Rennes Teaching Hospital/University Rennes 1, Rennes, France
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Frain S. [Indoor environment consultant nurse]. Rev Infirm 2012:21-23. [PMID: 22891459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Sustainable development combines a search for comfort with a reduction in energy consumption and these aspects can have a negative impact on health. In Brittany, a nurse trained in respiratory and environmental health as well as therapeutic education carries out, on medical prescription and as part of an association, environmental audits of patients' homes or their workplace. As an indoor environment medical consultant, she informs, orientates and promotes good healthcare practices.
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