Introduction Elevated particulate matter (PM) concentrations of anthropogenic and/or desert dust origin are associated with increased morbidity among children with asthma. Objective The Mitigating the Health Effects of Desert Dust Storms Using Exposure-Reduction Approaches randomised controlled trial assessed the impact of exposure reduction recommendations, including indoor air filtration, on childhood asthma control during high desert dust storms (DDS) season in Cyprus and Greece. Design, participants, interventions and setting Primary school children with asthma were randomised into three parallel groups: (a) no intervention (controls); (b) outdoor intervention (early alerts notifications, recommendations to stay indoors and limit outdoor physical activity during DDS) and (c) combined intervention (same as (b) combined with indoor air purification with high efficiency particulate air filters in children’s homes and school classrooms. Asthma symptom control was assessed using the childhood Asthma Control Test (c-ACT), spirometry (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC)) and fractional exhaled nitric oxide (FeNO). Results In total, 182 children with asthma (age; mean=9.5, SD=1.63) were evaluated during 2019 and 2021. After three follow-up months, the combined intervention group demonstrated a significant improvement in c-ACT in comparison to controls (β=2.63, 95% CI 0.72 to 4.54, p=0.007), which was more profound among atopic children (β=3.56, 95% CI 0.04 to 7.07, p=0.047). Similarly, FEV1% predicted (β=4.26, 95% CI 0.54 to 7.99, p=0.025), the need for any asthma medication and unscheduled clinician visits, but not FVC% and FeNO, were significantly improved in the combined intervention compared with controls. Conclusion Recommendations to reduce exposure and use of indoor air filtration in areas with high PM pollution may improve symptom control and lung function in children with asthma. Trial registration number [NCT03503812][1]. Data are available on reasonable request. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03503812&atom=%2Fthoraxjnl%2Fearly%2F2024%2F02%2F22%2Fthorax-2023-220877.atom

中文翻译：

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针对沙漠灰尘和人为空气污染进行减少接触干预后，儿童哮喘控制得到改善：MEDEA 随机对照试验

引言 人为和/或沙漠粉尘来源的颗粒物 (PM) 浓度升高与哮喘儿童发病率增加有关。目的 使用减少接触方法减轻沙漠沙尘暴对健康的影响随机对照试验评估了塞浦路斯和希腊沙漠沙尘暴 (DDS) 高发季节期间减少接触建议（包括室内空气过滤）对儿童哮喘控制的影响。设计、参与者、干预措施和设置 将患有哮喘的小学生随机分为三个平行组：(a) 不干预（对照组）；(b) 户外干预（早期警报通知、建议在 DDS 期间留在室内并限制户外体力活动）和 (c) 联合干预（与 (b) 与在儿童家庭和学校使用高效颗粒空气过滤器进行室内空气净化相结合）使用儿童哮喘控制测试 (c-ACT)、肺活量测定（1 秒用力呼气量 (FEV1)、用力肺活量 (FVC)）和呼出一氧化氮分数 (FeNO) 来评估哮喘症状控制情况。 2019 年和 2021 年期间，对 182 名哮喘儿童（年龄；平均值 = 9.5，SD = 1.63）进行了评估。随访三个月后，联合干预组的 c-ACT 与对照组相比有显着改善（β = 2.63 ，95% CI 0.72 至 4.54，p=0.007），这在特应性儿童中更为明显（β=3.56，95% CI 0.04 至 7.07，p=0.047）。同样，FEV1% 预测（β=4.26，95% CI 0.54 至 7.99，p=0.025），与对照组相比，联合干预中对任何哮喘药物的需要和计划外的临床医生就诊显着改善，但 FVC% 和 FeNO 没有显着改善。结论 在 PM 污染高的地区减少暴露和使用室内空气过滤的建议可能会改善哮喘儿童的症状控制和肺功能。试用注册号[NCT03503812][1]。可根据合理要求提供数据。[1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03503812&atom=%2Fthoraxjnl%2Fearly%2F2024%2F02%2F22%2Fthorax-2023-220877.atom