Dataset Information

Childhood asthma and household exposures to nitrogen dioxide and fine particles: a triple-crossover randomized intervention trial.

ABSTRACT:

Objective

Triple-crossover randomized controlled intervention trial to test whether reduced exposure to household NO₂ or fine particles results in reduced symptoms among children with persistent asthma.

Methods

Children (n = 126) aged 5-11 years with persistent asthma living in homes with gas stoves and levels of NO₂ 15 ppb or greater recruited in Connecticut and Massachusetts (2015-2019) participated in an intervention involving three air cleaners configured for: (1) NO₂ reduction: sham particle filtration and real NO₂ scrubbing; (2) particle filtration: HEPA filter and sham NO₂ scrubbing; (3) control: sham particle filtration and sham NO₂ scrubbing. Air cleaners were randomly assigned for 5-week treatment periods using a three-arm crossover design. Outcome was number of asthma symptom-days during final 14 days of treatment. Treatment effects were assessed using repeated measures, linear mixed models.

Results

Measured NO₂ was lower (by 4 ppb, p < .0001) for NO₂-reducing compared to control or particle-reducing treatments. NO₂-reducing treatment did not reduce asthma morbidity compared to control. In analysis controlling for measured NO₂, there were 1.8 (95% CI -0.3 to 3.9, p = .10) fewer symptom days out of 14 in the particle-reducing treatment compared to control.

Conclusions

It remains unknown if using an air cleaner alone can achieve levels of NO₂ reduction large enough to observe reductions in asthma symptoms. We observed that in small, urban homes with gas stoves, modest reductions in asthma symptoms occurred using air cleaners that remove fine particles. An intervention targeting exposures to both NO₂ and fine particles is complicated and further research is warranted.

Registration number

NCT02258893.

SUBMITTER: Gent JF

PROVIDER: S-EPMC10162040 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Childhood asthma and household exposures to nitrogen dioxide and fine particles: a triple-crossover randomized intervention trial.

Gent Janneane F JF Holford Theodore R TR Bracken Michael B MB Plano Julie M JM McKay Lisa A LA Sorrentino Keli M KM Koutrakis Petros P Leaderer Brian P BP

The Journal of asthma : official journal of the Association for the Care of Asthma 20220707 4

<h4>Objective</h4>Triple-crossover randomized controlled intervention trial to test whether reduced exposure to household NO<sub>2</sub> or fine particles results in reduced symptoms among children with persistent asthma.<h4>Methods</h4>Children (<i>n</i> = 126) aged 5-11 years with persistent asthma living in homes with gas stoves and levels of NO<sub>2</sub> 15 ppb or greater recruited in Connecticut and Massachusetts (2015-2019) participated in an intervention involving three air cleaners con ...[more]

PMID: 35796019

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Project description:BackgroundSchool classrooms, where students spend the majority of their time during the day, are the second most important indoor microenvironment for children.ObjectiveWe investigated factors influencing classroom exposures to fine particulate matter (PM2.5), black carbon (BC), and nitrogen dioxide (NO2) in urban schools in the northeast United States.MethodsOver the period of 10 y (2008-2013; 2015-2019) measurements were conducted in 309 classrooms of 74 inner-city schools during fall, winter, and spring of the academic period. The data were analyzed using adaptive mixed-effects least absolute shrinkage and selection operator (LASSO) regression models. The LASSO variables included meteorological-, school-, and classroom-based covariates.ResultsLASSO identified 10, 10, and 11 significant factors (p<0.05) that were associated with indoor PM2.5, BC, and NO2 exposures, respectively. The overall variability explained by these models was R2=0.679, 0.687, and 0.621 for PM2.5, BC, and NO2, respectively. Of the model's explained variability, outdoor air pollution was the most important predictor, accounting for 53.9%, 63.4%, and 34.1% of the indoor PM2.5, BC, and NO2 concentrations. School-based predictors included furnace servicing, presence of a basement, annual income, building type, building year of construction, number of classrooms, number of students, and type of ventilation that, in combination, explained 18.6%, 26.1%, and 34.2% of PM2.5, BC, and NO2 levels, whereas classroom-based predictors included classroom floor level, classroom proximity to cafeteria, number of windows, frequency of cleaning, and windows facing the bus area and jointly explained 24.0%, 4.2%, and 29.3% of PM2.5, BC, and NO2 concentrations, respectively.DiscussionThe adaptive LASSO technique identified significant regional-, school-, and classroom-based factors influencing classroom air pollutant levels and provided robust estimates that could potentially inform targeted interventions aiming at improving children's health and well-being during their early years of development. https://doi.org/10.1289/EHP10007.

Dataset Information

Childhood asthma and household exposures to nitrogen dioxide and fine particles: a triple-crossover randomized intervention trial.

Objective

Methods

Results

Conclusions

Registration number

Publications

Childhood asthma and household exposures to nitrogen dioxide and fine particles: a triple-crossover randomized intervention trial.

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