A Pilot Home Asthma Intervention Study in Boston

Public Housing

IEMB cosponsored a project to investigate asthma intervention in Boston public housing. Other cosponsors were the U.S. EPA’s NHEERL (National Health and Environmental Effects Research Laboratory) and NERL (National Exposure Research Laboratory). This project was completed in December 2001.

An approach was defined by which the effectiveness of alternative asthma intervention protocols can be compared in inner-city public housing. This approach involved participation by local universities, community organizations, and tenants. The approach was tested using two intervention protocols with a total of nine families in a Boston public housing unit. The feasibility of subsequently applying this approach to a larger cohort, that could provide sufficient statistical power to evaluate the differences between the intervention protocols, was assessed.

We provided physical interventions such as air filters, industrial cleaning, and mattress covers to each apartment. Indoor temperature was high and relative humidity low during the winter. Insulation of exposed steam pipes did not lower temperature. Cockroach, mouse, and pet antigen levels were variable and frequently high in settled dust. Viable fungal spores levels were variable and high in some apartments. Dust mites allergen levels were below the level of concern. Industrial cleaning led to transient reduction in mouse and cockroach antigen burden. Mattress and pillow covers lowered dust mite antigen in bedrooms, but not living rooms. NO2 levels exceeded ambient concentrations due to use of gas stoves, and PM2.5 concentrations were above ambient levels due to smoking. Air filtering systems did not reduce PM levels. Several VOCs were above adverse risk concentrations. We hypothesize that our findings are consistent with a multifactoral model for exacerbation of asthma in this population and that no single problem dominates. A paper has been accepted for publication in the journal Indoor Air.