(Press-News.org) Water softeners provide no additional clinical benefit to usual care in children with eczema, so the use of ion-exchange water softeners for the treatment of moderate to severe eczema in children should not be recommended. However, it is up to each family to decide whether or not the wider benefits of installing a water softener in their home are sufficient to consider buying one. These are the findings of a study by Kim Thomas from the University of Nottingham, Nottingham, UK, and colleagues and published in this week's PLoS Medicine.
The authors conducted their randomised controlled trial among 336 children—who all lived in hard water areas in England—aged 6 months to 16 years with a diagnosis of eczema; they were randomised to receive either installation of an ion-exchange water softener plus usual eczema care, or usual eczema care alone for 12 weeks. Research nurses measured each child's eczema severity score at baseline and at 6, 12, and 16 weeks to record changes in eczema severity. The authors also analysed any changes in eczema symptoms over the study period such as sleep loss, itchiness, and the amount of topical treatments used.
Although both treatment groups improved in disease severity during the course of the trial, there were no clinically important differences between the groups in any of the outcomes that were measured objectively (without knowledge of the treatment that the child received). However, parents in the trial did report small health benefits in some of the more subjective outcomes, such as sleep loss and itchiness, and just over 50% chose to buy the water softener at the end of the trial because of perceived improvements in the eczema and the wider benefits of water softeners.
The authors say: "The results of this study are clear, and as a result we cannot recommend the use of ion-exchange water softeners for the treatment of moderate to severe eczema in children."
They add, "Whether or not the wider benefits of installing a water softener in the home are sufficient to justify the purchase of a softener is something for individual householders to consider on a case by-case basis."
###
Funding: This trial was funded by the National Institute for Health Research, Health Technology Assessment (NIHR HTA) Programme, project number HTA 05/16/01. The views and opinions expressed in this article are those of the authors and do not necessarily reflect those of the NIHR HTA Programme. A consortium of water industry representatives helped with this study: Aqua Belgica, Culligan International (UK) Ltd, Ecowater Systems Ltd, Harvey Softeners Ltd, Kennet Water Components Ltd, Kinetico UK Ltd, Monarch Water, Salt Manufacturers Association, and the Water Quality Association (USA). They provided technical advice, generic water softeners, fittings, salt, and analytical testing of the weekly water samples. This assistance was coordinated through the UK Water Treatment Association, which is an independent trade association for the industry. Funding for pilot work for this trial was provided by Kinetico UK Ltd. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: AF is Technical Director of the UK Water Treatment Association, which represents the interests of manufacturers of water treatment equipment used in private and public water supplies. The range of equipment covered includes water softeners. He is a consultant to the European Water Treatment Association with similar interests, and is International Director (unpaid) for the USA Water Quality Association.
Citation: Thomas KS, Dean T, O'Leary C, Sach TH, Koller K, et al. (2011) A Randomised Controlled Trial of Ion-Exchange Water Softeners for the Treatment of Eczema in Children. PLoS Med 8(2): e1000395. doi:10.1371/journal.pmed.1000395
IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000395
CONTACT:
Dr Kim Thomas
University of Nottingham
Centre of Evidence Based Dermatology
King's Meadow Campus
Nottingham, Nottinghamshire NG7 2NR
United Kingdom
01158468632
kim.thomas@nottingham.ac.uk
Or
Professor Hywel Williams
0115 8231048
hywel.williams@nottingham.ac.uk
Ion-exchange water softeners do not improve eczema in children
2011-02-16
ELSE PRESS RELEASES FROM THIS DATE:
Atomic model of tropomyosin bound to actin
2011-02-16
New research sheds light on the interaction between the semi-flexible protein tropomyosin and actin thin filaments. The study, published by Cell Press on February 15th in the Biophysical Journal, provides the first detailed atomic model of tropomyosin bound to actin and significantly advances the understanding of the dynamic relationship between these key cellular proteins.
Tropomyosin is a long protein that associates with actin, a highly conserved thin filament protein found in organisms from yeast to humans. Actin, a major part of the cell's cytoskeleton, drives shape ...
A mental retardation gene provides insights into brain formation
2011-02-16
VIDEO:
This movie shows a typical (wild type) mouse as it spends much more time exploring an object it has never seen before and little time with the object it has...
Click here for more information.
DURHAM, N.C. – Scientists at Duke University Medical Center have uncovered clues to memory and learning by exploring the function of a single gene that governs how neurons form new connections. The finding may also provide insights into a form of human mental retardation.
In a ...
Jefferson researchers provide genetic evidence that antioxidants can help treat cancer
2011-02-16
PHILADELPHIA—Researchers from Jefferson's Kimmel Cancer Center have genetic evidence suggesting the antioxidant drugs currently used to treat lung disease, malaria and even the common cold can also help prevent and treat cancers because they fight against mitochondrial oxidative stress—a culprit in driving tumor growth.
For the first time, the researchers show that loss of the tumor suppressor protein Caveolin-1 (Cav-1) induces mitochondrial oxidative stress in the stromal micro-environment, a process that fuels cancer cells in most common types of breast cancer.
"Now ...
Study finds racial disparities in hospital readmission rates
2011-02-16
Elderly Medicare black patients have a higher 30-day hospital readmission rate for several conditions including congestive heart failure and pneumonia compared to white patients, that is related in part to higher readmission rates among hospitals that disproportionately care for black patients, according to a study in the February 16 issue of JAMA.
"Racial disparities in health care are well documented, and eliminating them remains a national priority. Reducing readmissions has become a policy focus because it represents an opportunity to simultaneously improve quality ...
Higher levels of compound in blood associated with lower risk of respiratory disease
2011-02-16
An analysis of data including more than 500,000 adults indicates that levels in the blood of bilirubin (a compound produced by the breakdown of hemoglobin from red blood cells) in the normal range but relatively higher were associated with a reduced risk of lung cancer, chronic obstructive pulmonary disease and all-cause death, according to a study in the February 16 issue of JAMA.
Serum total bilirubin is routinely measured in the primary care setting to identify hepatobiliary (liver, gall bladder and bile ducts) and blood diseases. Bilirubin may have cytoprotective ...
Large portion of costs at children's hospitals accounted for by patients with frequent readmissions
2011-02-16
Among a group of children's hospitals, nearly 20 percent of admissions and one-quarter of inpatient expenditures were accounted for by a small percentage of patients who have frequent recurrent admissions, according to a study in the February 16 issue of JAMA.
Hospital readmission is increasingly considered an indicator of quality of care. Some children with chronic illnesses may be readmitted on a recurrent basis, but there are limited data regarding the impact of their rehospitalizations, according to background information in the article. "Children with chronic conditions ...
Method of DNA repair linked to higher likelihood of genetic mutation
2011-02-16
Accurate transmission of genetic information requires the precise replication of DNA. Errors in DNA replication are common and nature has developed several cellular mechanisms for repairing these mistakes. Mutations, which can be deleterious (development of cancerous cells), or beneficial (evolutionary adaption), arise from uncorrected errors. Researchers from Indiana University-Purdue University Indianapolis (U.S.A) and Umea° University (Sweden) report that a method by which cells repair breaks in their DNA, known as Break-induced Replication (BIR), is up to 2,800 times ...
Zinc reduces the burden of the common cold
2011-02-16
Zinc supplements reduce the severity and duration of illness caused by the common cold, according to a systematic review published in The Cochrane Library. The findings could help reduce the amount of time lost from work and school due to colds.
The common cold places a heavy burden on society, accounting for approximately 40% of time taken off work and millions of days of school missed by children each year. The idea that zinc might be effective against the common cold came from a study carried out in 1984, which showed that zinc lozenges could reduce how long symptoms ...
Safety of biologic treatment for arthritis depends on the drug
2011-02-16
Some biologic drugs may be safer than others according to a new systematic review by Cochrane researchers. Biologics are a broad class of drugs based on biological molecules. The drugs are used to reduce inflammation in diseases such as rheumatoid arthritis and inflammatory bowel disease.
Although the effectiveness of biologics is now well established, it is thought that some may have rare but serious side effects related to their immune-suppressing activities. Links have been made to increased risk of infections, reactivation of tuberculosis (TB), cancer and congestive ...
Tick population plummets in absence of lizard hosts
2011-02-16
Berkeley — The Western fence lizard's reputation for helping to reduce the threat of Lyme disease is in jeopardy. A new study led by researchers at the University of California, Berkeley, found that areas where the lizard had been removed saw a subsequent drop in the population of the ticks that transmit Lyme disease.
"Our expectation going into this study was that removing the lizards would increase the risk of Lyme disease, so we were surprised by these findings," said study lead author Andrea Swei, who conducted the study while she was a Ph.D. student in integrative ...