by: Karon Beattie

Encasing mattresses and pillows in special covers may help asthmatic children cut down on their use of powerful anti-inflammatory drugs, new study findings from Denmark suggest.

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After 1 year, about 73% of youngsters given the polyurethane covers cut their dose of inhaled steroids by at least half, compared with 24% of children given cotton covers, according to the report published in the January issue of the Journal of Allergy and Clinical Immunology.

Such polyurethane covers have long been recommended as a way to cut down dust-mite allergen, the most common cause of allergic asthma, although how effective they are has been unclear. The proteins associated with dust mites, the ubiquitous microscopic creatures that live in and on many household surfaces, can collect in pillows and mattresses.

In the current study, Dr. Susanne Halken of the Sonderborg Hospital and colleagues had 26 asthmatic children aged 5 to 15 use pillows and mattresses completely encased in semi-permeable polyurethane. A second group of 21 children were given mattress and pillow covers made of good quality cotton.

All of the children with asthma, were allergic to dust mites and had never used such covers before. Youngsters allergic to cats or pollen were excluded from the study.

Before and during the study, the researchers tapered the children's inhaled steroids to the lowest effective dose. Corticosteroids are medications used to treat inflammatory conditions such as asthma and chronic lung disease. They are usually used in combination with bronchodilators, which are drugs that widen the airways and make it easier to breathe.

"We found a significant effect of the coated polyurethane mattress and pillow encasings on the need for inhaled steroids," the researchers report.

They found that the dose of inhaled steroids was cut by about 50% in those children without causing their symptoms to get worse or requiring an increase in other medications.

Asthma is the most common chronic disease in children, and for reasons that are unknown, the number of asthma cases has been on the rise in the US and other developed countries.

Journal of Allergy and Clinical Immunology 2003;111:169-176.

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