HEPA filtration improves asthma control in children exposed to traffic-related airborne particles.

Traffic-related airborne particles are associated with asthma morbidity. The aim of this study was to assess the impact of a high-efficiency particulate air (HEPA) filtration on the concentrations of traffic particles and the resultant effect on children with asthma. Forty-three children with asthma were enrolled in this double-blind, placebo-controlled crossover design. A HEPA air cleaner or a placebo "dummy" was placed in participants' homes for four weeks, interrupted by a one-month washout period, before crossing over to the other treatment arm for four weeks. Air sampling and health outcomes, including asthma control (ACQ) and quality of life (AQLQ) measures, were completed prior to and at the end of each treatment arm. Indoor concentrations of traffic particles were significantly reduced with the HEPA treatment but not with the "dummy" treatment. In participants with poorly controlled asthma and lower quality of life at baseline, ACQ and AQLQ scores were significantly improved (1.3 to 0.9, p = 0.003 and 4.9 to 5.5, p = 0.02, respectively) following the HEPA treatment. In this study, HEPA filtration is associated with improved clinical outcomes and quality of life measures in children with uncontrolled asthma.

[1]  J. Hutcheon,et al.  The effect of portable HEPA filter air cleaner use during pregnancy on fetal growth: The UGAAR randomized controlled trial. , 2018, Environment international.

[2]  Luo Jia-Ying,et al.  Efficacy of air purifier therapy in allergic rhiniti. , 2018, Asian Pacific journal of allergy and immunology.

[3]  R. Brook,et al.  Effect of Portable Air Filtration Systems on Personal Exposure to Fine Particulate Matter and Blood Pressure Among Residents in a Low-Income Senior Facility: A Randomized Clinical Trial , 2018, JAMA internal medicine.

[4]  Karen C. Dannemiller,et al.  Effectiveness of a portable air cleaner in removing aerosol particles in homes close to highways , 2018, Indoor air.

[5]  M. Clyde,et al.  Combined use of an electrostatic precipitator and a high‐efficiency particulate air filter in building ventilation systems: Effects on cardiorespiratory health indicators in healthy adults , 2018, Indoor air.

[6]  C. Umscheid,et al.  Effectiveness of indoor allergen reduction in asthma management: A systematic review , 2018, The Journal of allergy and clinical immunology.

[7]  C. Weschler,et al.  Cardiopulmonary effects of overnight indoor air filtration in healthy non-smoking adults: A double-blind randomized crossover study. , 2018, Environment international.

[8]  B. Brunekreef,et al.  Cardiorespiratory responses of air filtration: A randomized crossover intervention trial in seniors living in Beijing: Beijing Indoor Air Purifier StudY, BIAPSY. , 2017, The Science of the total environment.

[9]  D. Brugge,et al.  Lessons from in-home air filtration intervention trials to reduce urban ultrafine particle number concentrations. , 2017, Building and environment.

[10]  W. J. Fisk,et al.  Effectiveness and cost of reducing particle‐related mortality with particle filtration , 2017, Indoor air.

[11]  K. Nadeau,et al.  Effectiveness of air purifier on health outcomes and indoor particles in homes of children with allergic diseases in Fresno, California: A pilot study , 2017, The Journal of asthma : official journal of the Association for the Care of Asthma.

[12]  B. Coull,et al.  School Environmental Intervention to Reduce Particulate Pollutant Exposures for Children with Asthma. , 2017, The journal of allergy and clinical immunology. In practice.

[13]  Tiina Reponen,et al.  Indoor air quality in green-renovated vs. non-green low-income homes of children living in a temperate region of US (Ohio). , 2016, The Science of the total environment.

[14]  Alan E. Simon,et al.  Changing Trends in Asthma Prevalence Among Children , 2016, Pediatrics.

[15]  J. Bousquet,et al.  Asthma control in the Portuguese National Asthma Survey. , 2015, Revista portuguesa de pneumologia.

[16]  Luz T. Padró-Martínez,et al.  A Randomized Cross-over Air Filtration Intervention Trial for Reducing Cardiovascular Health Risks in Residents of Public Housing near a Highway , 2015, International journal of environmental research and public health.

[17]  Parham Azimi,et al.  Evaluating the Long-Term Health and Economic Impacts of Central Residential Air Filtration for Reducing Premature Mortality Associated with Indoor Fine Particulate Matter (PM2.5) of Outdoor Origin , 2015, International journal of environmental research and public health.

[18]  H. Kan,et al.  Cardiopulmonary benefits of reducing indoor particles of outdoor origin: a randomized, double-blind crossover trial of air purifiers. , 2015, Journal of the American College of Cardiology.

[19]  M. Brauer,et al.  The impacts of traffic-related and woodsmoke particulate matter on measures of cardiovascular health: a HEPA filter intervention study , 2015, Occupational and Environmental Medicine.

[20]  W. Teague,et al.  Validation and psychometric properties of the Asthma Control Questionnaire among children. , 2014, The Journal of allergy and clinical immunology.

[21]  Corinne M. Graffunder,et al.  Conclusion and future directions: CDC Health Disparities and Inequalities Report - United States, 2013. , 2013, MMWR supplements.

[22]  W. J. Fisk,et al.  Health benefits of particle filtration. , 2013, Indoor air.

[23]  Z. Andersen,et al.  An indoor air filtration study in homes of elderly: cardiovascular and respiratory effects of exposure to particulate matter , 2013, Environmental Health.

[24]  S. Weichenthal,et al.  A randomized double-blind crossover study of indoor air filtration and acute changes in cardiorespiratory health in a First Nations community. , 2013, Indoor air.

[25]  John Yaphe,et al.  Asthma control, quality of life, and the role of patient enablement: a cross-sectional observational study , 2013, Primary care respiratory journal : journal of the General Practice Airways Group.

[26]  S. Batterman,et al.  Particulate matter concentrations in residences: an intervention study evaluating stand-alone filters and air conditioners. , 2012, Indoor air.

[27]  D. Bernstein,et al.  Poor asthma control and exposure to traffic pollutants and obesity in older adults. , 2012, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[28]  P. Kinney,et al.  Validating a nondestructive optical method for apportioning colored particulate matter into black carbon and additional components. , 2011, Atmospheric environment.

[29]  Kazuhiko Ito,et al.  A Source Apportionment of U.S. Fine Particulate Matter Air Pollution. , 2011, Atmospheric environment.

[30]  Jean Curtin-Brosnan,et al.  A randomized trial of air cleaners and a health coach to improve indoor air quality for inner-city children with asthma and secondhand smoke exposure. , 2011, Archives of pediatrics & adolescent medicine.

[31]  M. Brauer,et al.  An air filter intervention study of endothelial function among healthy adults in a woodsmoke-impacted community. , 2011, American journal of respiratory and critical care medicine.

[32]  R. Hornung,et al.  Effects of HEPA Air Cleaners on Unscheduled Asthma Visits and Asthma Symptoms for Children Exposed to Secondhand Tobacco Smoke , 2011, Pediatrics.

[33]  Joachim Heinrich,et al.  Influence of indoor factors in dwellings on the development of childhood asthma. , 2011, International journal of hygiene and environmental health.

[34]  J. Sastre,et al.  Cut-off points for defining asthma control in three versions of the Asthma Control Questionnaire , 2010, The Journal of asthma : official journal of the Association for the Care of Asthma.

[35]  William Li,et al.  Efficacy of a novel air filtration pillow for avoidance of perennial allergens in symptomatic adults. , 2010, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[36]  M. Miller Agency , 2010 .

[37]  Residential Air Cleaner Use to Improve Indoor Air Quality and Health: A Review of the Evidence , 2010 .

[38]  D. Bernstein,et al.  Exposure to traffic-related particles and endotoxin during infancy is associated with wheezing at age 3 years. , 2009, American journal of respiratory and critical care medicine.

[39]  L. Hildemann,et al.  The effects of human activities on exposure to particulate matter and bioaerosols in residential homes. , 2009, Environmental science & technology.

[40]  E. Sondik,et al.  Status of Childhood Asthma in the United States, 1980–2007 , 2009, Pediatrics.

[41]  Pratim Biswas,et al.  A land-use regression model for estimating microenvironmental diesel exposure given multiple addresses from birth through childhood. , 2008, The Science of the total environment.

[42]  M. Brauer,et al.  Infiltration of forest fire and residential wood smoke: an evaluation of air cleaner effectiveness , 2008, Journal of Exposure Science and Environmental Epidemiology.

[43]  T. Keil,et al.  Can the Use of HEPA Cleaners in Homes of Asthmatic Children and Adolescents Sensitized to Cat and Dog Allergens Decrease Bronchial Hyperresponsiveness and Allergen Contents in Solid Dust? , 2008, International Archives of Allergy and Immunology.

[44]  Alireza Afshari,et al.  Indoor particles affect vascular function in the aged: an air filtration-based intervention study. , 2008, American journal of respiratory and critical care medicine.

[45]  Pamela Ohman-Strickland,et al.  Respiratory effects of exposure to diesel traffic in persons with asthma. , 2007, The New England journal of medicine.

[46]  D. Brugge,et al.  Near-highway pollutants in motor vehicle exhaust: A review of epidemiologic evidence of cardiac and pulmonary health risks , 2007, Environmental health : a global access science source.

[47]  Warren Friedman,et al.  Development of an Environmental Relative Moldiness Index for US Homes , 2007, Journal of occupational and environmental medicine.

[48]  D. Bernstein,et al.  High prevalence of aeroallergen sensitization among infants of atopic parents. , 2006, The Journal of pediatrics.

[49]  Linda Abetz,et al.  Identifying 'well-controlled' and 'not well-controlled' asthma using the Asthma Control Questionnaire. , 2006, Respiratory medicine.

[50]  E M Sparrow,et al.  Use of air-cleaning devices to create airborne particle-free spaces intended to alleviate allergic rhinitis and asthma during sleep. , 2005, Indoor air.

[51]  C. Rand,et al.  Home environmental intervention in inner-city asthma: a randomized controlled clinical trial. , 2005, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[52]  J. Hankinson,et al.  Standardisation of spirometry , 2005, European Respiratory Journal.

[53]  J. Hankinson,et al.  SERIES ''ATS/ERS TASK FORCE: STANDARDISATION OF LUNG FUNCTION TESTING'' Edited by V. Brusasco, R. Crapo and G. Viegi Number 1 in this Series General considerations for lung function testing , 2005 .

[54]  A. Coates,et al.  ‘ ‘ ATS / ERS TASK FORCE : STANDARDISATION OF LUNG FUNCTION TESTING , 2005 .

[55]  K. Berhane,et al.  The effect of air pollution on lung development from 10 to 18 years of age. , 2004, The New England journal of medicine.

[56]  A. Custovic,et al.  Clinical effects of air filters in homes of asthmatic adults sensitized and exposed to pet allergens , 2003, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[57]  G H Guyatt,et al.  Development and validation of a questionnaire to measure asthma control. , 1999, The European respiratory journal.

[58]  A. Dubois,et al.  Clinical effects of air cleaners in homes of asthmatic children sensitized to pet allergens. , 1999, The Journal of allergy and clinical immunology.

[59]  J L Hankinson,et al.  Spirometric reference values from a sample of the general U.S. population. , 1999, American journal of respiratory and critical care medicine.

[60]  M. V. Van Natta,et al.  A placebo-controlled trial of a HEPA air cleaner in the treatment of cat allergy. , 1998, American journal of respiratory and critical care medicine.

[61]  Bert Brunekreef,et al.  Air Pollution from Truck Traffic and Lung Function in Children Living near Motorways , 1997, Epidemiology.

[62]  D. Dockery,et al.  Pulmonary function growth velocity in children 6 to 18 years of age. , 1993, The American review of respiratory disease.

[63]  G. Guyatt,et al.  Evaluation of impairment of health related quality of life in asthma: development of a questionnaire for use in clinical trials. , 1992, Thorax.