Effect of an Integrated Pest Management Intervention on Asthma Symptoms Among Mouse-Sensitized Children and Adolescents With Asthma: A Randomized Clinical Trial
Open accessAbstract
Importance: Professionally delivered integrated pest management (IPM) interventions can reduce home mouse allergen concentrations, but whether they reduce asthma morbidity among mouse-sensitized and exposed children and adolescents is unknown. Objective: To determine the effect of an IPM intervention on asthma morbidity among mouse-sensitized and exposed children and adolescents with asthma. Design, Setting, and Participants: Randomized clinical trial conducted in Baltimore, Maryland, and Boston, Massachusetts. Participants were mouse-sensitized and exposed children and adolescents (aged 5-17 years) with asthma randomized to receive professionally delivered IPM plus pest management education or pest management education alone. Enrollment occurred between May 2010 and August 2014; the final follow-up visit occurred on September 25, 2015. Interventions: Integrated pest management consisted of application of rodenticide, sealing of holes that could serve as entry points for mice, trap placement, targeted cleaning, allergen-proof mattress and pillow encasements, and portable air purifiers. Infestation was assessed every 3 months, and if infestation persisted or recurred, additional treatments were delivered. All participants received pest management education, which consisted of written material and demonstration of the materials needed to set traps and seal holes. Main Outcomes and Measures: The primary outcome was maximal symptom days defined as the highest number of days of symptoms in the previous 2 weeks among 3 types of symptoms (days of slowed activity due to asthma; number of nights of waking with asthma symptoms; and days of coughing, wheezing, or chest tightness) across 6, 9, and 12 months. Results: Of 361 children and adolescents who were randomized (mean [SD] age, 9.8 [3.2] years; 38% female; 181 in IPM plus pest management education group and 180 in pest management education alone group), 334 were included in the primary analysis. For the primary outcome, there was no statistically significant between-group difference for maximal symptom days across 6, 9, and 12 months with a median of 2.0 (interquartile range, 0.7-4.7) maximal symptom days in the IPM plus pest management education group and 2.7 (interquartile range, 1.3-5.0) maximal symptom days in the pest management education alone group (P = .16) and a ratio of symptom frequencies of 0.86 (95% CI, 0.69-1.06). Conclusions and Relevance: Among mouse-sensitized and exposed children and adolescents with asthma, an intensive year-long integrated pest management intervention plus pest management education vs pest management education alone resulted in no significant difference in maximal symptom days from 6 to 12 months. Trial Registration: clinicaltrials.gov Identifier: NCT01251224.
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In mouse-sensitized individuals, Mus m 1 exposure is associated with worse asthma symptoms, lower lung function, higher FeNO, and increased risk of emergency department visits and hospitalizations, especially in low-income populations.
“For individuals sensitized to mice, exposure to Mus m 1 is associated with worsening asthma symptoms, lower lung function (e.g., reduced FEV1), higher fractional exhaled nitric oxide (FeNO), and increased risk of emergency department visits and hospitalizations, particularly among low-income populations (47).”
From Indoor Allergen Interventions in Homes and Schools for Managing Asthma (2025) · cites this paper as [47]
The Results (Effects of Mouse Allergen Reduction on Asthma; page not provided) associate reduced mouse allergen with fewer asthma symptoms and emergency department visits in a predominantly low-income study population. They report no statistically significant association with lung function or hospitalizations, and the paper does not report FeNO results. The claim therefore extends beyond the outcomes supported by this study. (LLM, conf=0.88)
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- Authors
- Matsui, E. C., Perzanowski, M., Peng, R. D., Wise, R. A., Balcer-Whaley, S., Newman, M., Cunningham, A., Divjan, A., Bollinger, M. E., Zhai, S., Chew, G., Miller, R. L., & Phipatanakul, W.
- Affiliations
- Johns Hopkins University (US)
- Columbia University (US)
- Boston Children's Hospital (US)
- University of Maryland, Baltimore (US)
- Columbia University Irving Medical Center (US)
- Corresponding author
- Matsui, Elizabeth C.
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2017-03-14
- Volume
- 317
- Issue
- 10
- Pages
- 1027
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC5632564
- OpenAlex
- W2591577397
- Cited by
- 113
- References
- 16
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 6 · 2023: 13 · 2022: 13 · 2021: 14 · 2020: 14 · 2019: 20 · 2018: 11 · 2017: 12
- FWCI
- 11.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (R34AI074928, K24AI114769, K24AI106822, U01AI083238, R01AI070630)
- National Institute of Environmental Health Sciences (R01ES023447, R01ES026170, P30ES009089)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Keywords
- integrated pest management, asthma symptoms, rodent infestation, rodenticides, air purifiers, children and adolescents, rodent control, asthma morbidity, trap placement
- MeSH terms
- Adolescent, Allergens, Animals, Asthma, Bedding and Linens, Boston, Child, Child, Preschool, Dust, Environmental Exposure, Female, Humans, Male, Patient Education as Topic, Pest Control, Rodenticides, Time Factors, Baltimore, Mice, Symptom Assessment
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