Mite allergen avoidance decreases allergic symptoms in children in Ishinomaki city of Japan after natural disasters

Main Article Content

Chiyako Oshikata
Maiko Watanabe
Kazuhiro Hashimoto
Akiko Yamazaki
Naoki Kobayashi
Rumi Konuma
Masatsugu Ishida
Seiichi Kobayashi
Takashi Shimada
Takeshi Kaneko
Yoichi Kamata
Shinichi Kuriyama
Shigeo Kure
Masaru Yanai
Naomi Tsurikisawa

Keywords

allergen avoidance, allergic rhinitis, asthma, atopic dermatitis, Dermatophagoides farina, Great East Japan Earthquake

Abstract

Objective: We investigated the prevalence of asthma, rhinitis, and atopic dermatitis in children, evaluated the mite allergen levels in their bedding after the Great East Japan Earthquake, and assessed changes in allergic symptoms in children and their families after allergen avoidance practices.


Methods: We performed a survey for the International Study of Asthma and Allergies in Childhood (ISAAC) comprising 1109 children, aged 7–8 years, living in Ishinomaki, Japan. We collected responses from 464 children, and in 2016, measured the level of Dermatophagoides group 1 (Der 1) in the bedding of 202 of these children. The intervention group of children attended at least one allergen avoidance seminar. The levels of Der 1 in their bedding were measured, along with changes in allergic symptoms, in 17 children in 2017 and 14 children in 2018. The nonintervention group comprised children who did not attend an allergen avoidance seminar at any time.


Results: Of the 464 children who participated in the ISAAC, 50 (10.8%) reported having asthma, 179 (38.8%) allergic rhinitis, and 126 (27.3%) atopic dermatitis. The average level of Der 1 measured in the bedding of the 202 children in 2016 was 295.8 ng/m2. The levels of Der 1 in the intervention group—but not in the nonintervention group—significantly decreased in 2017 and 2018. The symptoms of asthma, allergic rhinitis, and atopic dermatitis in the children of intervention group and their families decreased after allergen avoidance practices.


Conclusions: Allergen avoidance practices relieved allergic symptoms in school children after the Great East Japan Earthquake.

Abstract 1197 | PDF Downloads 1038 HTML Downloads 164 XML Downloads 63

References

1. Carlos WG, Cruz CD, Jamil S, Kipen H, Rose C. Mold-specific concerns associated with water damage for those with allergies, asthma, and other lung diseases. Am J Respir Crit Care Med. 2017;196:13–4. 10.1164/rccm.1967P13

2. Johanning E, Auger P, Morey PR, Yang CS, Olmsted E. Review of health hazards and prevention measures for response and recovery workers and volunteers after natural disasters, flooding, and water damage: Mold and dampness. Environ Health Prev Med. 2014;19:93–9. 10.1007/s12199-013-0368-0

3. Shinohara N, Tokumura M, Hashimoto K, Asano K, Kawakami Y. Fungal levels in houses in the Fukushima Daiichi nuclear power plant evacuation zone after the Great East Japan Earthquake. J Air Waste Manag Assoc. 2017;67:1106–14. 10.1080/10962247.2017.1330712

4. Naegele A, Reboux G, Scherer E, Roussel S, Millon L. Fungal food choices of Dermatophagoides farinae affect indoor fungi selection and dispersal. Int J Environ Health Res. 2013;23:91–5. 10.1080/09603123.2012.699029

5. Oshikata C, Watanabe M, Saito A, et al. Allergic Bronchopulmonary Mycosis due to Exposure to Eurotium herbariorum after the Great East Japan Earthquake.Prehosp Disaster Med. 2017;32:688–90. 10.1017/S1049023X17006914

6. Ishikuro M, Matsubara H, Kikuya M, et al. Disease prevalence among nursery school children after the Great East Japan earthquake. BMJ Glob Health. 2017;2:e000127. 10.1136/bmjgh-2016-000127

7. Miyashita M, Kikuya M, Yamanaka C, et al. Eczema and asthma symptoms among schoolchildren in coastal and inland areas after the 2011 Great East Japan Earthquake: The ToMMo Child Health Study. Tohoku J Exp Med. 2015;237:297–305. 10.1620/tjem.237.297

8. Yamanda S, Hanagama M, Kobayashi S, et al. The impact of the 2011 Great East Japan Earthquake on hospitalisation for respiratory disease in a rapidly aging society: A retrospective descriptive and cross-sectional study at the disaster base hospital in Ishinomaki. BMJ Open. 2013;3. pii:e000865. 10.1136/bmjopen-2012-000865

9. Oshikata C, Watanabe M, Ishida M, et al. Increase in asthma prevalence in adults in temporary housing after the Great East Japan Earthquake. Int J Disaster Risk Reduct (IJDRR). 2020; 50(9778):101696. 10.1016/j.ijdrr.2020.101696

10. Murray CS, Foden P, Sumner H, Shepley E, Custovic A, Simpson A. Preventing severe asthma exacerbations in children. A randomized trial of mite-impermeable bedcovers. Am J Respir Crit Care Med. 2017;196:150–8. 10.1164/rccm.201609-1966OC

11. Smith H, Horney D, Jones C, Goubet S, Mukhopadhyay S, Frew A. Pragmatic randomized controlled trial of an allergy intervention for children aged 6–16 with asthma and rhinitis in general practice. Clin Exp Allergy. 2016;46:1227–35. 10.1111/cea.12781

12. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. [cited 2019]. Available from: http://www.ginasthma.org/

13. Cloutier MM, Baptist AP, Blake KV, et al. 2020 Focused updates to the asthma management guidelines: A report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. J Allergy Clin Immunol. 2020;146:1217–70. 10.1016/j.jaci.2020.10.003

14. Leas BF, D’Anci KE, Apter AJ, et al. Effectiveness of indoor allergen reduction in asthma management: A systematic review J Allergy Clin Immunol. 2018;141:1854–69. 10.1016/j.jaci.2018.02.001

15. Tsurikisawa N, Saito A, Oshikata C, Yasueda H, Akiyama K. Effective allergen avoidance for reducing exposure to house dust mite allergens and improving disease management in adult atopic asthmatics. J. Asthma. 2016;8:843–53. 10.3109/02770903.2016.1155218

16. Tsurikisawa N, Saito A, Oshikata C, Nakazawa T, Yasueda H, Akiyama K. Encasing bedding in covers made of microfine fibers reduces exposure to house mite allergens and improves disease management in adult atopic asthmatics. Allergy Asthma Clin Immunol. 2013;9:44–53. 10.1186/1710-1492-9-44

17. Asher MI, Keil U, Anderson HR, et al. International Study of Asthma and Allergies in Childhood (ISAAC): Rationale and methods. Eur Respir J. 1995;8:483–91. 10.1183/09031936.95.08030483

18. Kikuya M, Miyashita M, Yamanaka C, et al. Protocol and research perspectives of the ToMMo Child Health Study after the 2011 Great East Japan Earthquake. Tohoku J Exp Med. 2015;236:123–30. 10.1620/tjem.236.123

19. Stewart ST, Cutler DM, Rosen AB. Comparison of trends in US health-related quality of life over the 2000s using the SF-6D, HALex, EQ-5D, and EQ-5D visual analog scale versus a broader set of symptoms and impairments. Med Care. 2014;52;1010–6. 10.1097/MLR.0000000000000181

20. Tovey ER, Marks GB, Matthews M, Green WF, Woolcock A. Changes in mite allergen Der p I in house dust following a spraying with a tannic acid/acaricide solution. Clin Exp Allergy. 1992;22:67–74. 10.1111/j.1365-2222.1992.tb00116.x

21. Yasueda H, Saito A, Akiyama K, et al. Estimation of Der p and Der f 1 quantities in the reference preparations of Dermatophagoides mite extracts. Clin Exp Allergy. 1994;19:1030–5. 10.1111/j.1365-2222.1994.tb02739.x

22. Bandino JP, Hang A, Norton SA. The infectious and noninfectious dermatological consequences of flooding: a field manual for the responding provider. Am J Clin Dermatol. 2015;16:399–424. 10.1007/s40257-015-0138-4

23. Gough H, Grabenhenrich L, Reich A, et al. Allergic multimorbidity of asthma, rhinitis and eczema over 20 years in German birth cohort MAS. Ped Allergy Immunol 2015;26:431–7. 10.1111/pai.12410

24. Oliveira TB, Persigo ALK, Ferrazza CC, Ferreira ENN, Veiga ABG. Prevalence of asthma, allergic rhinitis and pollinosis in a city of Brazil: A monitoring study. Allergol Immunopathol (Madr). 2020;48:537–44. 10.1016/j.aller.2020.03.010

25. Pols DH, Wartna JB, Moed H, Alphen EI, Bohnen AM, Bindels PJE. Atopic dermatitis, asthma and allergic rhinitis in general practice and the open populations: A systematic review. Scand J Prim Health Care. 2016;34:143–50. 10.3109/02813432.2016.1160629

26. Okada Y, Kumagai H, Morikawa Y, Akasawa A. Epidemiology of pediatric allergic disease in the Ogasawara Islands. Allergol Int. 2016;65:37–43. 10.1016/j.alit.2015.06.010

27. Futamura M, Ohya Y, Akashi M, et al. Age-related prevalence of allergic disease in Tokyo schoolchildren. Allergol Int. 2011;60:509–15. 10.2332/allergolint.10-OA-0293