First the review includes studies from 35 years ago. As AAFA says: "... environmental control techniques, tools and research have advanced over the past 35 years."
Secondly, as AAFA states: "Many of the studies included in the Cochrane review are themselves antiquated, limited and potentially biased, each in its own way. For example, it is well known that several approaches used in the past for reducing mites in homes were not effective, such as acaricidal agents, etc." FYI, acaricidal means it kills mites.
Thirdly, the Cochrane review acknowledges that, "differing physical methods and protocols were employed in each of the several studies ... (i.e. different types/brands/materials of bedding covers and barriers, different care and washing instructions/methods, etc.) making Cochrane's combined "meta analysis" somewhat of an apples-to-oranges exercise."
What To Do?
The Cochrane report concludes: "Chemical and physical methods aimed at reducing exposure to house dust mite allergens cannot be recommended."
Based on what I've read, I cannot agree because of the review's weaknesses as I've mentioned above.
AAFA's conclusion is a balanced assessment: "... dust mite reduction is not easy and that mite reduction alone should not be considered the only method of allergen reduction in the home. A multi-disciplinary approach to allergen and irritant reduction using scientifically validated tools and techniques must be employed, which may include vacuuming, bedding barriers, encasements, removal of pets, anti-smoking measures, mold remediation, rodent and insect removal, indoor pollen avoidance, air filtration and more."
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