A Literature Review of Allergen Management in Children with Type 2-High Asthma

Background: Children exposed to indoor and outdoor allergens are at risk of developing asthma, with sensitization a strong predictor of disease severity. Aeroallergen exposure influences asthma outcomes through interplay with socioeconomic determinants of health. Asthma nurses discuss air quality with families so an understanding of evidence is important. Aims and Objectives: A review of outcomes related to aeroallergen exposure in Type 2-high childhood asthma, and treatment strategies to address these. Methods: Descriptive literature review of indoor (house dust mite, pet, cockroach, mold, and rodent) and outdoor (pollens and molds) aeroallergens. All studies involved participants aged 18 years and under. Included studies evaluated the impact of exposure in asthma exacerbations and severity, and the evidence-base for avoidance and treatment strategies. Results: There is a robust link between most aeroallergens and development of asthma (typical risk ratio 1-2). The evidence around clinical and cost-effectiveness outcome for allergen avoidance and mitigation measures varies. Single-strategy approaches to allergen reduction are unlikely to work. Conclusion: Work is needed to understand how nurses can co-develop information and strategies for parents around allergen avoidance. Research is required to identify appropriate strategies that are effective, and affordable for families.