#23 Dust mite avoidance for asthma

Dr. Daniel Aronov

Does dust mite avoidance improve asthma? 

Asthmatics are commonly advised to do things to reduce dust mites in their environment: vacuum regularly, wash the curtains, avoid soft toys, wash bed linen regularly, etc.

This is because there is a strong association between asthma and house dust mite allergy: Around 65% of asthmatics are also allergic to house dust mites (on skin prick testing) and it seems that higher exposures to house dust mite allergens are associated with worsening asthma. But is this relationship causal? Will reducing house dust mite allergens in the environment actually improve asthma?

This episode looks at the evidence around reducing exposure to house dust mites and its impact on asthma management.

Bottom Line:

Using dust mite impermeable bed linen reduces asthma-related hospitalisations for 1 in 8 children per year (provided these children have already had an exacerbation that led them to go to hospital, and that they have a positive skin prick reaction to dust mites) This was shown in a randomised controlled trial (2017) of 286 children. There was, however, no difference in the number of children who required a course of oral steroids and no meaningful difference asthma control scores. Furthermore, other studies, albeit of generally poor quality, have failed to show a benefit with dust mite impermeable bedding.

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