Dataset Information

Effectiveness of portable HEPA air cleaners on reducing indoor endotoxin, PM_10, and coarse particulate matter in an agricultural cohort of children with asthma: A randomized intervention trial.

ABSTRACT: We conducted a randomized trial of portable HEPA air cleaners in the homes of children age 6-12 years with asthma in the Yakima Valley, Washington. All families received asthma education while intervention families also received two HEPA cleaners (child's bedroom, living room). We collected 14-day integrated samples of endotoxin in settled dust and PM₁₀ and PM_10-2.5 in the air of the children's bedrooms at baseline and one-year follow-up, and used linear regression to compare follow-up levels, adjusting for baseline. Seventy-one families (36 HEPA, 35 control) completed the study. Baseline geometric mean (GSD) endotoxin loadings were 1565 (6.3) EU/m² and 2110 (4.9) EU/m² , respectively, in HEPA vs. control homes while PM₁₀ and PM_10-2.5 were 22.5 (1.9) μg/m³ and 9.5 (2.9) μg/m³ , respectively, in HEPA homes, and 19.8 (1.8) μg/m³ and 7.7 (2.0) μg/m³ , respectively, in control homes. At follow-up, HEPA families had 46% lower (95% CI, 31%-57%) PM₁₀ on average than control families, consistent with prior studies. In the best-fit heterogeneous slopes model, HEPA families had 49% (95% CI, 6%-110%) and 89% lower (95% CI, 28%-177%) PM_10-2.5 at follow-up, respectively, at 50th and 75th percentile baseline concentrations. Endotoxin loadings did not differ significantly at follow-up (4% lower, HEPA homes; 95% CI, -87% to 50%).

SUBMITTER: Riederer AM

PROVIDER: S-EPMC8577577 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Effectiveness of portable HEPA air cleaners on reducing indoor endotoxin, PM10, and coarse particulate matter in an agricultural cohort of children with asthma: A randomized intervention trial.

Riederer Anne M AM Krenz Jennifer E JE Tchong-French Maria I MI Torres Elizabeth E Perez Adriana A Younglove Lisa R LR Jansen Karen L KL Hardie David C DC Farquhar Stephanie A SA Sampson Paul D PD Metwali Nervana N Thorne Peter S PS Karr Catherine J CJ

Indoor air 20210719 6

We conducted a randomized trial of portable HEPA air cleaners in the homes of children age 6-12 years with asthma in the Yakima Valley, Washington. All families received asthma education while intervention families also received two HEPA cleaners (child's bedroom, living room). We collected 14-day integrated samples of endotoxin in settled dust and PM10 and PM10-2.5 in the air of the children's bedrooms at baseline and one-year follow-up, and used linear regression to compa ...[more]

PMID: 34288127

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Project description:Fine particulate matter is considered to be the most significant ambient air pollutant in terms of potential health impacts. Therefore, it is important that regulators are able to accurately assess the exposure of populations to PM10 and PM2.5 across municipal areas. We report on the practicalities of using a laser light scattering portable particulate monitor (Turnkey Instruments DustMate), in combination with a GPS, to map PM10 and PM2.5 concentrations on city-wide scales in Newcastle upon Tyne/Gateshead (UK), during a series of walking surveys. A heated inlet is necessary to remove moisture droplets from the sampled air prior to analysis by the instrument, though this also results in the loss of volatile particulate components, particularly from the PM2.5 fraction. A co-location calibration study was carried out with a reference urban background Tapered Element Oscillating Micro-Balance/Filter Dynamics Measuring System (TEOM-FDMS) system in Newcastle that is part of the UK's Automatic Urban and Rural Network (AURN) of air quality monitoring stations. For PM10, orthogonal regression of the DustMate against TEOM-FDMS data gave a slope and intercept of 1.02 ± 0.06 and -3.7 ± 1.2, respectively (R2 = 0.73), whereas for PM2.5, the respective values were 0.78 ± 0.06 and -0.63 ± 0.55 (R2 = 0.79). These parameters are comparable to literature calibration studies using this technology. There was good agreement between simultaneous samples taken using two DustMate instruments: for PM10, a slope and intercept of 1.05 ± 0.03 and 0.36 ± 0.5, respectively (R2 = 0.73), were obtained, whereas for the PM2.5, the respective values were 0.79 ± 0.01 and 0.19 ± 0.06 (R2 = 0.86). Correction factors based on the slope and intercepts obtained from the calibration exercise were applied to raw data collected from the DustMate. An annually-normalised correction procedure was then used to account for different background particulate concentrations on different sampling days. These corrected PM10 and PM2.5 concentrations and corresponding GPS coordinates were displayed on a base map using Google Fusion Tables and Google Earth Professional. Almost all areas surveyed in Newcastle/Gateshead were well below the EU Air Quality Standards for PM10 and PM2.5.

Project description:Background: The Reducing Air Pollution in Detroit Intervention Study (RAPIDS) was designed to evaluate cardiovascular health benefits and personal fine particulate matter (particulate matter < 2.5 μm in diameter, PM2.5) exposure reductions via portable air filtration units (PAFs) among older adults in Detroit, Michigan. This double-blind randomized crossover intervention study has shown that, compared to sham, air filtration for 3 days decreased 3-day average brachial systolic blood pressure by 3.2 mmHg. The results also showed that commercially available HEPA-type and true HEPA PAFs mitigated median indoor PM2.5 concentrations by 58% and 65%, respectively. However, to our knowledge, no health intervention study in which a significant positive health effect was observed has also evaluated how outdoor and indoor PM2.5 sources impacted the subjects. With that in mind, detailed characterization of outdoor and indoor PM2.5 samples collected during this study and a source apportionment analysis of those samples using a positive matrix factorization model were completed. The aims of this most recent work were to characterize the indoor and outdoor sources of the PM2.5 this community was exposed to and to assess how effectively commercially available HEPA-type and true HEPA PAFs were able to reduce indoor and outdoor PM2.5 source contributions. Methods: Approximately 24 h daily indoor and outdoor PM2.5 samples were collected on Teflon and Quartz filters from the apartments of 40 study subjects during each 3-day intervention period. These filters were analyzed for mass, carbon, and trace elements. Environmental Protection Agency Positive Matrix Factorization (PMF) 5.0 was utilized to determine major emission sources that contributed to the outdoor and indoor PM2.5 levels during this study. Results: The major sources of outdoor PM2.5 were secondary aerosols (28%), traffic/urban dust (24%), iron/steel industries (15%), sewage/municipal incineration (10%), and oil combustion/refinery (6%). The major sources of indoor PM2.5 were organic compounds (45%), traffic + sewage/municipal incineration (14%), secondary aerosols (13%), smoking (7%), and urban dust (2%). Infiltration of outdoor PM2.5 for sham, HEPA-type, and true HEPA air filtration was 79 ± 24%, 61 ± 32%, and 51 ± 34%, respectively. Conclusions: The results from our study showed that intervention with PAFs was able to significantly decrease indoor PM2.5 derived from outdoor and indoor PM2.5 sources. The PAFs were also able to significantly reduce the infiltration of outdoor PM2.5. The results of this study provide insights into what types of major PM2.5 sources this community is exposed to and what degree of air quality and systolic blood pressure improvements are possible through the use of commercially available PAFs in a real-world setting.

Project description:BackgroundData on pediatric asthma morbidity and effective environmental interventions in U.S. agricultural settings are few. We evaluated the effectiveness of HEPA air cleaners on asthma morbidity among a cohort of rural Latino children.MethodsSeventy-five children with poorly controlled asthma and living in non-smoking homes were randomly assigned to asthma education alone or along with HEPA air cleaners placed in their sleeping area and home living room. The Asthma Control Test (ACT) score, asthma symptoms in prior 2 weeks, unplanned clinical utilization, creatinine-adjusted urinary leukotriene E4 (uLTE4 [ng/mg]), and additional secondary outcomes were evaluated at baseline, six, and 12 months. Group differences were assessed using multivariable-adjusted generalized estimating equations. Incident rate ratios of ever experiencing the metrics of poorer asthma health during follow-up (suboptimal asthma management) were estimated using Poisson regression models in secondary analysis.ResultsMean child age was 9.2 and 8.6 years in intervention and control groups, respectively, and two-thirds of participants were male. Primary analysis of repeated measures of ACT score did not differ between groups (HEPA group mean change compared to controls 10% [95% CI: - 12-39%]). A suggestion of greater decrease in uLTE4 (ng/mg creatinine) was observed (- 10% [95% CI: - 20 -1%]). Secondary analysis showed children with HEPAs were less likely to have an ACT score meeting a clinically defined cutoff for poorly controlled asthma using repeated measures (IRR: 0.45 [95% CI: 0.21-0.97]). In Poisson models, intervention participants had reduced risk of ever meeting this cutoff (IRR: 0.43 [95% CI: 0.21-0.89]), ever having symptoms in the past 2 weeks (IRR: 0.71 [95% CI: 0.52-0.98]), and lower risk of any unplanned clinical utilization (IRR: 0.35 [95% CI: 0.13-0.94]) compared to control participants.DiscussionThe HAPI study showed generally improved outcomes among children in the HEPA air cleaner group. However, primary analyses did not meet statistical significance and many outcomes were subjective (self-report) in this unblinded study, so findings must be interpreted cautiously. HEPA air cleaners may provide additional benefit for child asthma health where traditional asthmagens (traffic, tobacco smoke) are not prominent factors, but larger studies with more statistical power and blinded designs are needed.Trial registrationClinicalTrials.gov Identifier: NCT04919915 . Date of retrospective registration: May 19, 2021.

Dataset Information

Effectiveness of portable HEPA air cleaners on reducing indoor endotoxin, PM_10, and coarse particulate matter in an agricultural cohort of children with asthma: A randomized intervention trial.

Publications

Effectiveness of portable HEPA air cleaners on reducing indoor endotoxin, PM<sub>10,</sub> and coarse particulate matter in an agricultural cohort of children with asthma: A randomized intervention trial.

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