HEPA Purifiers for Indoor Air Pollution

Overseen By Jennifer Dobson, MPH

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Alaska Native Tribal Health Consortium

Disqualifiers: Plan to move, Using HEPA, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

15 Participants Needed

Trial Summary

What is the purpose of this trial?

Alaska Native children experience a high burden of respiratory disease, especially those in the Yukon-Kuskokwim (YK) Delta. Studies have shown that things like wood stove use, poor ventilation, and indoor tobacco smoke exposure can lead to poor indoor air quality inside the children's homes. This leads to more frequent and more severe respiratory infections in children. In the Yukon-Kuskokwim (YK) Delta, it's common for homes to have exposure to woodstoves and tobacco use. Both of these activities affect indoor air quality in homes. We know that high efficiency particulate air (HEPA) purifiers can reduce particulate matter and make air quality better. One way that we measure air quality is through particulate matter (PM2.5). One of the few studies that looked at this in the YK Delta found that PM2.5 levels that were nearly twice as high as homes with woodstoves in other states. We believe it is important to reduce the PM2.5 in YK Delta homes. However, the few studies that looked at HEPA purifiers in rural Alaska did not include homes where smokers lived. We know that breathing air with PM2.5 harms the lungs. We also know that HEPA filters can reduce PM2.5, which can mean reducing cough and wheeze in people with chronic lung conditions. We want to learn how HEPA filters work in homes with woodstoves or where a smoker lives, as it's likely these homes may have more PM2.5 than other homes. We expect that using HEPA filters will make the indoor air better and will mean decreased respiratory symptoms. We plan to include 15 households with a child less than 5 years old in the family. Households that join will be asked to: * Set up study equipment in their homes. * Run the study equipment for 12 weeks and do a weekly report of child's respiratory symptoms by phone or text. * Return the air-quality monitor equipment to the study team and keep the HEPA filters.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of HEPA Purifiers as a treatment for indoor air pollution?

Research shows that HEPA air purifiers can significantly reduce indoor air pollution by lowering the levels of fine particles (PM2.5) in the air. Studies found that these purifiers can decrease indoor PM2.5 levels by up to 48%, improving overall air quality in homes. ^{1 2 3 4 5}

How do HEPA purifiers differ from other treatments for indoor air pollution?

HEPA purifiers are unique because they physically filter out fine particles from the air, improving indoor air quality by significantly reducing particulate matter (PM2.5) levels. Unlike chemical treatments or medications, they work by capturing particles through a high-efficiency filter, making them a non-invasive and chemical-free option for reducing indoor air pollution. ^{1 3 6 7 8}

Eligibility Criteria

This trial is for Alaska Native families with a child under 5 years old living in homes using woodstoves or where someone smokes. It aims to improve air quality and reduce respiratory issues by testing HEPA purifiers.

Inclusion Criteria

I am an Alaska Native living in a home with a woodstove or with someone who smokes.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants set up and operate HEPA purifiers and air monitoring equipment in their homes, with weekly reporting of child's respiratory symptoms

12 weeks

Weekly reports (phone or text)

Follow-up

Participants return air monitoring equipment and are monitored for any changes in respiratory symptoms

4 weeks

Treatment Details

Interventions

• HEPA Purifiers

Trial Overview The study tests if HEPA air purifiers can lower indoor pollution (PM2.5 levels) from woodstoves and tobacco, potentially reducing coughs and wheezing in children in the Yukon-Kuskokwim Delta.

Participant Groups

Group I: Single group Experimental Treatment 1 Intervention

Participants receive HEPA purifiers and air monitoring equipment to operate daily for 12-weeks.

Who Is Running the Clinical Trial?

Alaska Native Tribal Health Consortium

Lead Sponsor

Trials

20

Recruited

9,600+

Findings from Research

Portable HEPA air cleaners significantly reduce indoor PM2.5 levels, with an average decrease from 33.5 µg/m3 to 17.2 µg/m3, demonstrating their effectiveness in improving indoor air quality.

The study found that the most effective reduction in PM2.5 levels occurred with medium-flow setting machines, highlighting the importance of machine type, airflow speed, and window ventilation in optimizing air cleaner performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of HEPA Air Cleaner on Improving Indoor Particulate Matter 2.5 Concentration. Chen, CF., Hsu, CH., Chang, YJ., et al.[2023]

The use of an electrostatic precipitator (ESP) significantly reduced indoor PM2.5 concentrations in homes, with a geometric mean reduction indicating its effectiveness as an air purifying device.

Participants with a history of respiratory exacerbations had higher PM2.5 levels compared to those without, suggesting that the ESP could be particularly beneficial for vulnerable populations, such as smokers or those with respiratory issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Continuous in-home PM2.5 concentrations of smokers with and without a history of respiratory exacerbations in Iowa, during and after an air purifier intervention. Stapleton, EM., Simmering, JE., Manges, RB., et al.[2021]

In a study involving 540 non-smoking pregnant women in Ulaanbaatar, Mongolia, the use of portable HEPA filter air cleaners resulted in a 29% reduction in indoor PM2.5 concentrations compared to control apartments, demonstrating their effectiveness in high pollution settings.

The air cleaners also contributed to a 14% decrease in blood cadmium levels among participants, indicating reduced exposure to secondhand smoke, particularly effective shortly after deployment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of portable HEPA filter air cleaners on indoor PM2.5 concentrations and second hand tobacco smoke exposure among pregnant women in Ulaanbaatar, Mongolia: The UGAAR randomized controlled trial. Barn, P., Gombojav, E., Ochir, C., et al.[2018]

Room air filters can effectively reduce particulate matter (PM) concentrations by 30-70% in homes with heavy cigarette smoking, demonstrating their efficacy in improving indoor air quality.

The filters maintained their performance over a 2-month period, but users may need reminders to clean prefilters to ensure optimal airflow and efficiency.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Long duration tests of room air filters in cigarette smokers' homes. Batterman, S., Godwin, C., Jia, C.[2022]

In a study involving 172 households in areas with high outdoor air pollution, high-efficiency air filtration systems significantly improved indoor air quality, reducing PM2.5 and PM10 concentrations by 48% and 31%, respectively.

Stand-alone HEPA air cleaners were more effective than central system filters, and keeping windows closed while using these systems further enhanced indoor air quality.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reductions in particulate matter concentrations resulting from air filtration: A randomized sham-controlled crossover study. Bennett, DH., Moran, RE., Krakowiak, P., et al.[2022]

In a study involving nine patients allergic to house dust mites, an air-cleaning device with a HEPA filter did not significantly reduce indoor levels of Dermatophagoides sp. allergens or improve symptoms related to bronchial hyperresponsiveness and rhinitis over a 2-month period.

Although the mean level of allergens decreased spontaneously during the study, the air-cleaner alone was found to be insufficient as a substitute for standard avoidance measures for managing mite allergies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of an air-cleaning device equipped with a high efficiency particulate air filter in house dust mite respiratory allergy. Antonicelli, L., Bilò, MB., Pucci, S., et al.[2021]

The study found that using compact High-Efficiency Particulate Air (HEPA) filter systems in homes significantly reduces indoor aerosol concentrations, with reductions of 63% for coarse particles and 76% for inorganic submicron particles.

This reduction in aerosol levels suggests that HEPA filters can improve indoor air quality and potentially benefit individuals with respiratory issues, such as asthma, by decreasing exposure to harmful fine particles.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Microanalysis of indoor aerosols and the impact of a compact high-efficiency particulate air (HEPA) filter system. Abraham, ME.[2019]

Domestic HEPA air purifiers significantly reduce indoor PM2.5 concentrations, with notable decreases observed 24 and 48 hours after operation, indicating their effectiveness in improving indoor air quality.

The purifiers have varying effects on different elemental constituents of PM2.5, with significant changes noted for elements like aluminum, iron, and titanium, suggesting that while overall PM2.5 levels stabilize, specific pollutants may still be influenced by external factors like proximity to traffic.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Effects of high-efficiency particulate air purifiers on indoor fine particulate matter and its constituents in a district of Beijing during winter]. Chu, MT., Dong, W., Chi, R., et al.[2018]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Efficacy of HEPA Air Cleaner on Improving Indoor Particulate Matter 2.5 Concentration. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Continuous in-home PM2.5 concentrations of smokers with and without a history of respiratory exacerbations in Iowa, during and after an air purifier intervention. [2021]

3. Netherlands pubmed.ncbi.nlm.nih.gov

The effect of portable HEPA filter air cleaners on indoor PM2.5 concentrations and second hand tobacco smoke exposure among pregnant women in Ulaanbaatar, Mongolia: The UGAAR randomized controlled trial. [2018]

4. United States pubmed.ncbi.nlm.nih.gov

Long duration tests of room air filters in cigarette smokers' homes. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Reductions in particulate matter concentrations resulting from air filtration: A randomized sham-controlled crossover study. [2022]

6. Denmark pubmed.ncbi.nlm.nih.gov

Efficacy of an air-cleaning device equipped with a high efficiency particulate air filter in house dust mite respiratory allergy. [2021]

7. England pubmed.ncbi.nlm.nih.gov

Microanalysis of indoor aerosols and the impact of a compact high-efficiency particulate air (HEPA) filter system. [2019]

8. China pubmed.ncbi.nlm.nih.gov

[Effects of high-efficiency particulate air purifiers on indoor fine particulate matter and its constituents in a district of Beijing during winter]. [2018]