ABSTRACT
AIM: We compared potential differences in drug delivery between different valved holding chambers (VHCs) used by asthma patients, with and without facemasks. METHODS: An in vitro study design was created using a fluticasone propionate (FP) pressurised metered dose inhaler (pMDI) connected to a VHC. VHCs without facemasks and with sealed and unsealed facemasks were placed against face models that mimicked the features of a 1-year-old infant and a 4-year-old child. We analysed the amount of FP deposited on the filter in the face model after five breaths with a tidal volume of 75 mL. RESULTS: Our measurements showed significant differences in the amounts of FP deposited on the filters, even without facemasks. The amount of FP delivered through the VHC and facemask combinations differed significantly, depending on the degree of the lack of facemask to face seal. All the tested VHCs showed significantly better drug output without a facemask. CONCLUSION: The VHC and facemasks chosen had a considerable and significant impact on FP delivery. The facemask seal should be checked whenever a VHC facemask combination is used. Young children should be taught to use the VHC mouthpiece as early as possible to optimise FP delivery and achieve more effective asthma therapy.
Subject(s)
Inhalation Spacers , Metered Dose Inhalers , Administration, Inhalation , Aerosols , Bronchodilator Agents , Child , Child, Preschool , Equipment Design , Fluticasone , Humans , InfantSubject(s)
Anaphylaxis/prevention & control , Epinephrine/administration & dosage , Health Knowledge, Attitudes, Practice , Patient Education as Topic/methods , Adolescent , Anxiety/psychology , Child , Female , Follow-Up Studies , Humans , Male , Power, Psychological , Self Administration/psychology , Surveys and QuestionnairesABSTRACT
BACKGROUND: Allergens from furred animals are brought to school mainly via clothing of pet owners. Asthmatic children allergic to cat have more symptoms when attending a class with many cat owners, and some schools allocate specific resources to allergen avoidance measures. OBJECTIVE: The aim of the current study was to evaluate the effect of school clothing or pet owner-free classes compared with control classes on airborne cat allergen levels and to investigate attitudes and allergic symptoms among the children. METHODS: Allergen measurements were performed prospectively in 2 classes with school clothing, 1 class of children who were not pet owners, and 3 control classes during a 6-week period in 2 consecutive years. Portable pumps and petri dishes were used for collection of airborne cat allergen, and a roller was used for sampling on children's clothes. Cat allergen (Fel d 1) was analyzed with enzyme-linked immunoassay and immunostaining. Both years, questionnaires were administered to the children. RESULTS: We found 4-fold to 6-fold lower airborne cat allergen levels in intervention classes compared with control classes. Levels of cat allergen were 3-fold higher on clothing of cat owners than of children without cats in control classes. Pet ownership ban seemed less accepted than school clothing as an intervention measure. CONCLUSION: For the first time, it has been shown that levels of airborne cat allergen can be reduced by allergen avoidance measures at school by using school clothing or pet ownership ban, and that both measures are equally efficient. The clinical effect of these interventions remains to be evaluated.
