Dataset Information

Effects of Indoor Air Purifiers on Children with Asthma.

ABSTRACT:

Purpose

To evaluate the effects of air purifiers on the concentrations of indoor air pollutants and on asthma control in children.

Materials and methods

In this randomized crossover trial, daily use of an air purifier filter was compared with a matched placebo with the filter off. Thirty elementary school students who had asthma were enrolled and randomly allocated to one of two groups. The primary endpoints were changes in indoor air quality, asthma severity, lung function, airway inflammatory, urine microbiome, and phthalate after the installation of air purifiers. PM_2.5 and CO? were measured as indoor air pollutants. Asthma severity was assessed in terms of both symptom and medication scores acquired using a daily questionnaire. The higher the score, the better the symptom or the less frequent the use of medication. Peak expiratory flow rate and fractional exhaled nitric oxide were also measured.

Results

The mean age of the enrolled patients was 9.2±1.98 years. The mean concentration of PM_2.5 was 17.0 ?g/m³ in the filter-off condition, but significantly lower at 9.26 ?g/m³ in the filter-on condition. Medication scores were 6.9 for the filter-off and 7.12 for the filter-on conditions, reflecting a statistically significant decrease in the frequency of medications used during air purifier operation. Bacterial richness, as determined using the Chao 1 index, was markedly lower in the filter-on than the filter-off condition.

Conclusion

This study suggests that air purifiers benefit medication burden in children with asthma by reducing PM_2.5 levels.

SUBMITTER: Lee GH

PROVIDER: S-EPMC7105409 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Publications

Effects of Indoor Air Purifiers on Children with Asthma.

Lee Ga Hee GH Kim Jeong Hee JH Kim Sungroul S Lee Sangwoon S Lim Dae Hyun DH

Yonsei medical journal 20200401 4

<h4>Purpose</h4>To evaluate the effects of air purifiers on the concentrations of indoor air pollutants and on asthma control in children.<h4>Materials and methods</h4>In this randomized crossover trial, daily use of an air purifier filter was compared with a matched placebo with the filter off. Thirty elementary school students who had asthma were enrolled and randomly allocated to one of two groups. The primary endpoints were changes in indoor air quality, asthma severity, lung function, airwa ...[more]

PMID: 32233173

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Project description:BACKGROUND:Indoor exposure to fine particulate matter (PM2.5) from outdoor sources is a major health concern, especially in highly polluted developing countries such as China. Few studies have evaluated the effectiveness of indoor air purification on the improvement of cardiopulmonary health in these areas. OBJECTIVES:This study sought to evaluate whether a short-term indoor air purifier intervention improves cardiopulmonary health. METHODS:We conducted a randomized, double-blind crossover trial among 35 healthy college students in Shanghai, China, in 2014. These students lived in dormitories that were randomized into 2 groups and alternated the use of true or sham air purifiers for 48 h with a 2-week washout interval. We measured 14 circulating biomarkers of inflammation, coagulation, and vasoconstriction; lung function; blood pressure (BP); and fractional exhaled nitric. We applied linear mixed-effect models to evaluate the effect of the intervention on health outcome variables. RESULTS:On average, air purification resulted in a 57% reduction in PM2.5 concentration, from 96.2 to 41.3 μg/m3, within hours of operation. Air purification was significantly associated with decreases in geometric means of several circulating inflammatory and thrombogenic biomarkers, including 17.5% in monocyte chemoattractant protein-1, 68.1% in interleukin-1β, 32.8% in myeloperoxidase, and 64.9% in soluble CD40 ligand. Furthermore, systolic BP, diastolic BP, and fractional exhaled nitrous oxide were significantly decreased by 2.7%, 4.8%, and 17.0% in geometric mean, respectively. The impacts on lung function and vasoconstriction biomarkers were beneficial but not statistically significant. CONCLUSIONS:This intervention study demonstrated clear cardiopulmonary benefits of indoor air purification among young, healthy adults in a Chinese city with severe ambient particulate air pollution. (Intervention Study on the Health Impact of Air Filters in Chinese Adults; NCT02239744).

Project description:ImportanceSchool and classroom allergens and particles are associated with asthma morbidity, but the benefit of environmental remediation is not known.ObjectiveTo determine whether use of a school-wide integrated pest management (IPM) program or high-efficiency particulate air (HEPA) filter purifiers in the classrooms improve asthma symptoms in students with active asthma.Design, setting, and participantsFactorial randomized clinical trial of a school-wide IPM program and HEPA filter purifiers in the classrooms was conducted from 2015 to 2020 (School Inner-City Asthma Intervention Study). There were 236 students with active asthma attending 41 participating urban elementary schools located in the Northeastern US who were randomized to IPM by school and HEPA filter purifiers by classroom. The date of final follow-up was June 20, 2020.InterventionsThe school-wide IPM program consisted of application of rodenticide, sealing entry points, trap placement, targeted cleaning, and brief educational handouts for school staff. Infestation was assessed every 3 months, with additional treatments as needed. Control schools received no IPM, cleaning, or education. Classroom portable HEPA filter purifiers were deployed and the filters were changed every 3 months. Control classrooms received sham HEPA filters that looked and sounded like active HEPA filter purifiers. Randomization was done independently (split-plot design), with matching by the number of enrolled students to ensure a nearly exact 1:1 student ratio for each intervention with 118 students randomized to each group. Participants, investigators, and those assessing outcomes were blinded to the interventions.Main outcomes and measuresThe primary outcome was the number of symptom-days with asthma during a 2-week period. Symptom-days were assessed every 2 months during the 10 months after randomization.ResultsAmong the 236 students who were randomized (mean age, 8.1 [SD, 2.0] years; 113 [48%] female), all completed the trial. At baseline, the 2-week mean was 2.2 (SD, 3.9) symptom-days with asthma and 98% of the classrooms had detectable levels of mouse allergen. The results were pooled because there was no statistically significant difference between the 2 interventions (P = .18 for interaction). During a 2-week period, the mean was 1.5 symptom-days with asthma after use of the school-wide IPM program vs 1.9 symptom-days after no IPM across the school year (incidence rate ratio, 0.71 [95% CI, 0.38-1.33]), which was not statistically significantly different. During a 2-week period, the mean was 1.6 symptom-days with asthma after use of HEPA filter purifiers in the classrooms vs 1.8 symptom-days after use of sham HEPA filter purifiers across the school year (incidence rate ratio, 1.47 [95% CI, 0.79-2.75]), which was not statistically significantly different. There were no intervention-related adverse events.Conclusions and relevanceAmong children with active asthma, use of a school-wide IPM program or classroom HEPA filter purifiers did not significantly reduce symptom-days with asthma. However, interpretation of the study findings may need to consider allergen levels, particle exposures, and asthma symptoms at baseline.Trial registrationClinicalTrials.gov Identifier: NCT02291302.

Dataset Information

Effects of Indoor Air Purifiers on Children with Asthma.

Purpose

Materials and methods

Results

Conclusion

Publications

Effects of Indoor Air Purifiers on Children with Asthma.

Similar Datasets

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