Even though dust mites are usually mentioned as a controllable environmental trigger, a Cochrane review of 49 controlled trials found no evidence that either physical or chemical methods aimed at reducing exposure to house dust mite allergens had any benefit (Gotzsche et al., 2004). On the other hand, a controlled trial of an intervention to reduce cockroach and dust mite allergens and passive exposure to tobacco smoke among urban children with atopic asthma was effective in reducing both allergens in the home and asthma symptom-days (Morgan et al., 2004). Teaching patients to self-monitor and self-manage their asthma using an action plan and ongoing review with their physician is effective in reducing exacerbations and symptoms (Gibson et al., 2002). As with most pulmonary diseases, the most effective preventive strategy is to eliminate smoking as a risk factor from the patient, the household, and the workplace.

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