Damp housing and childhood asthma; respiratory effects of indoor air temperature and relative humidity.

In a questionnaire survey of a random sample of 1000 children aged 7 years, a significantly greater proportion of those living in homes reported as damp were affected by wheeze (22% v 11%), day cough, night cough, and chesty colds. Simultaneous estimation of relative humidity in the bedrooms of 778 children and continuous 7 day recordings of ambient temperature and humidity in a stratified sample of 317 bedrooms showed no association with the same respiratory symptoms. No correlation was found between bedroom conditions and baseline ventilatory function or exercise induced reduction in FEV1. These results run counter to the widely held belief that indoor temperature and humidity are important determinants of respiratory ill health, although they do not directly exclude effects due to mites or moulds, whose survival is determined by the humidity of their respective microenvironments

Audit strategies to reduce hospital admissions for acute asthma

An eightfold rise in hospital admissions for acute asthma from 1971-85 prompted two studies to audit the admissions policy at the Royal Alexandra Hospital. In the first study the on call senior house officer (SHO) was replaced by an experienced registrar and over a four month period 53 children out of 158 were sent home from the receiving room compared with six out of 39 seen by the SHOs. In the second study an SHO training programme was established together with a home treatment package. Over a 12 month period the on call SHOs assessed 687 children with acute asthma; 229 (43.5%) were deemed fit to be sent home. Only seven of these were readmitted within one week. Diary symptom score cards filled in by parents indicated that children sent home without admission fared no worsed at home than those admitted and then discharged for the two weeks after leaving hospital. The development of strategies to improve assessment and immediate management in the hospital receiving room can reduce hospital admissions for acute asthma, allowing more children to be safely managed in the community.</p