a randomised controlled trial of ion-exchange water softeners for the treatment of eczema in children离子交换水软化剂的随机对照试验的治疗湿疹的儿童.pdfVIP

A Randomised Controlled Trial of Ion-Exchange Water Softeners for the Treatment of Eczema in Children 1 2 3 4 1 5 Kim S. Thomas *, Tara Dean , Caroline O’Leary , Tracey H. Sach , Karin Koller , Anthony Frost , Hywel C. Williams1, the SWET Trial Team 1 Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom, 2 School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, United Kingdom, 3 Medical Research Council Clinical Trials Unit, London, United Kingdom, 4 Medicine, Health Policy and Practice, University of East Anglia, Norwich, United Kingdom, 5 UK Water Treatment Association, Loughborough, United Kingdom Abstract Background: Epidemiological studies and anecdotal reports suggest a possible link between household use of hard water and atopic eczema. We sought to test whether installation of an ion-exchange water softener in the home can improve eczema in children. Methods and Findings: This was an observer-blind randomised trial involving 336 children (aged 6 months to 16 years) with moderate/severe atopic eczema. All lived in hard water areas ($200 mg/l calcium carbonate). Participants were randomised to either installation of an ion-exchange water softener plus usual eczema care, or usual eczema care alone. The primary outcome was change in eczema severity (Six Area Six Sign Atopic Dermatitis Score, SASSAD) at 12 weeks, measured by research nurses who were blinded to treatment allocation. Analysis was based on the intent-to-treat population. Eczema severity improved for both groups during the trial. The mean change in SASSAD at 12 weeks was 25.0 (20% improvement) for the water softener group and 25.7 (22% improvement) for the usual care group (mean difference 0.66, 95% confidence