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Home environmental interventions for prevention of respiratory tract infections: a systematic review and meta-analysis

  • Kok Pim Kua ORCID logo EMAIL logo and Dr. Shaun Wen Huey Lee ORCID logo
Published/Copyright: February 3, 2021
Reviews on Environmental Health
From the journal Reviews on Environmental Health Volume 36 Issue 3

Abstract

Objectives

Poor housing conditions have been associated with increased risks of respiratory infections. This review aims to determine whether modifying the physical environment of the home has benefits in reducing respiratory infections.

Content

We performed a systematic review and meta-analysis of the effectiveness of home environmental interventions for preventing respiratory tract infections. Ten electronic databases were searched to identify randomized controlled trials published from inception to July 31, 2020. Random-effects meta-analyses were used to assess the study outcomes. Our search identified 14 eligible studies across 12 countries, which comprised 87,428 households in total. The type of interventions on home environment included kitchen appliance and design, water supply and sanitation, house insulation, and home heating. Meta-analysis indicated a potential benefit of home environmental interventions in preventing overall respiratory tract infections (Absolute RR=0.89, 95% CI=0.78–1.01, p=0.07; Pooled adjusted RR=0.72, 95% CI=0.63–0.84, p<0.0001). Subgroup analyses depicted that home environmental interventions had no significant impact on lower respiratory tract infections, pneumonia, and severe pneumonia. A protective effect against respiratory infections was observed in high income country setting (RR=0.82, 95% CI=0.78–0.87, p<0.00001).

Summary and outlook

Home environmental interventions have the potential to reduce morbidity of respiratory tract infections. The lack of significant impact from stand-alone housing interventions suggests that multicomponent interventions should be implemented in tandem with high-quality health systems.

Keywords: environmental intervention; home; housing; pneumonia; respiratory infection
Corresponding author: Kok Pim Kua, MPharm, MBiomedSc, Puchong Health Clinic, Petaling District Health Office, Ministry of Health Malaysia, 47100 Puchong, Petaling, Selangor, Malaysia, E-mail:
Kok Pim Kua and Shaun Wen Huey Lee contributed equally to this work.

Acknowledgments

This paper was written during the first author’s stay at the Oxford Institute of Population Ageing, University of Oxford as a Leslie Kirkley Visitor.

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: The authors state no conflict of interest.

  4. Informed consent: The conducted research is a systematic review and meta-analysis. Informed consent is not required.

  5. Ethical approval: The conducted research is not related to either human or animals use.

Appendix

Search strategy

NIH PubMed, Wiley Online Library, and Emerald Insight

respiratory tract infection* or respiratory infection* or otitis media or pharyngitis or tonsillitis or rhinosinusitis or laryngitis or rhinitis or sinusitis or sinus infection* or coryza or otalgia or bronchitis or bronchiolitis or pneumonia or empyema or pyothorax or influenza or tonsillopharyngitis or croup or sore throat or throat infection* or cough or earache or ear infection* or cold or common cold or lung infection* or wheez*

AND

home* or house* or housing or residence or apartment or dwelling or residential or improved ventilation or stove* or cookstove* or improved stove* or household air pollution or indoor air pollution or kitchen or chimney or cooking facilit* or permeable wall cladding or air quality or airflow or outdoor cooking area or outdoor chimney or hygienic kitchen or safe water supply or kitchen design or sink or water tap or build* or construct* or renovat* or refurbis*

AND

‘randomised trial’ or ‘randomized trial’ or randomly or random* or ‘randomized controlled trial’ or ‘randomised controlled trial’

ACP Journal Club, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database (HTA), NHS Economic Evaluation Database (NHS EED), and Ovid MEDLINE®

respiratory tract infection* or respiratory infection* or otitis media or pharyngitis or tonsillitis or rhinosinusitis or laryngitis or rhinitis or sinusitis or sinus infection* or coryza or otalgia or bronchitis or bronchiolitis or pneumonia or empyema or pyothorax or influenza or tonsillopharyngitis or croup or sore throat or throat infection* or cough or earache or ear infection* or cold or common cold or lung infection* or wheez*

AND

home* or house* or housing or residence or apartment or dwelling or residential or improved ventilation or stove* or cookstove* or improved stove* or household air pollution or indoor air pollution or kitchen or chimney or cooking facilit* or permeable wall cladding or air quality or airflow or outdoor cooking area or outdoor chimney or hygienic kitchen or safe water supply or kitchen design or sink or water tap or build* or construct* or renovat* or refurbis*

AND

randomised trial or randomized trial or randomly or random* or randomized controlled trial or randomised controlled trial

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/reveh-2020-0169).

Received: 2020-12-17
Accepted: 2021-01-10
Published Online: 2021-02-03
Published in Print: 2021-09-27

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Mini Reviews
  3. Home environmental interventions for prevention of respiratory tract infections: a systematic review and meta-analysis
  4. Water and wastewater as potential sources of SARS-CoV-2 transmission: a systematic review
  5. Review Articles
  6. The role of sensory and olfactory pathways in multiple chemical sensitivity
  7. Temporal assessment of municipal solid waste management in Nigeria: prospects for circular economy adoption
  8. Knowledge, attitude, practice and clinical recommendations of health care workers towards COVID-19: a systematic review
  9. Drinking water heavy metal toxicity and chronic kidney diseases: a systematic review
  10. A systematic review report on tobacco products and its health issues in India
  11. Possible role of Unani Pharmacology in COVID-19 – a narrative review
  12. The indicators and methods used for measuring urban liveability: a scoping review
  13. Complementary and alternative medicine therapies and COVID-19: a systematic review
https://doi.org/10.1515/reveh-2020-0169
Keywords for this article
environmental intervention; home; housing; pneumonia; respiratory infection

Articles in the same Issue

  1. Frontmatter
  2. Mini Reviews
  3. Home environmental interventions for prevention of respiratory tract infections: a systematic review and meta-analysis
  4. Water and wastewater as potential sources of SARS-CoV-2 transmission: a systematic review
  5. Review Articles
  6. The role of sensory and olfactory pathways in multiple chemical sensitivity
  7. Temporal assessment of municipal solid waste management in Nigeria: prospects for circular economy adoption
  8. Knowledge, attitude, practice and clinical recommendations of health care workers towards COVID-19: a systematic review
  9. Drinking water heavy metal toxicity and chronic kidney diseases: a systematic review
  10. A systematic review report on tobacco products and its health issues in India
  11. Possible role of Unani Pharmacology in COVID-19 – a narrative review
  12. The indicators and methods used for measuring urban liveability: a scoping review
  13. Complementary and alternative medicine therapies and COVID-19: a systematic review
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