Air Purification for Asthma

Overseen By Meredith C. McCormack, MD, MHS

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins University

Disqualifiers: Pulmonary, Cardiac, Underweight, Pregnancy, others

Compensation: Varies

Number of Visits: 5

Duration: 12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if air purifiers with HEPA filters can improve asthma symptoms in children, particularly those who are overweight. The study will compare the effects of real air purifiers (Active Air Purifier) with placebo purifiers that do not filter air. It targets children in Baltimore City who have experienced asthma attacks in the past year and are either normal weight or overweight. Participants should spend at least four nights a week at home and have no plans to move during the study. As an unphased trial, this study provides a unique opportunity for participants to contribute to important research that could enhance asthma management for children.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this air purification method is safe for children with asthma?

Research has shown that HEPA air purifiers are generally safe for people. Studies have found that these purifiers can slightly improve issues like sleep problems, but they don't always help with asthma symptoms. While air purifiers are usually well-tolerated, their effectiveness can vary.

No major reports of harmful effects from using HEPA air purifiers have emerged. This suggests that using them at home is likely safe for children with asthma, even if they are overweight. The main purpose of these purifiers is to reduce indoor air pollution, and they seem to achieve this without causing harm. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using active air purifiers for asthma because they offer a non-drug, environmental approach to managing symptoms. Unlike traditional asthma treatments like inhalers and medications that focus on controlling inflammation and opening airways, active air purifiers aim to reduce the triggers by filtering out pollutants and allergens from the air. This method is unique as it targets the environment around the patient rather than the patient's body, potentially reducing asthma attacks and improving overall respiratory health. By using HEPA filters, these purifiers can significantly lower indoor pollutant levels, which is a promising strategy for those with asthma looking for additional ways to manage their condition.

What evidence suggests that air purifiers are effective for asthma?

Research has shown that air purifiers with HEPA filters can help improve asthma symptoms. In one study, 84.2% of parents noticed an improvement in their child's asthma symptoms when using an air purifier. Another study found that air purifiers led to a small but significant improvement in overall symptoms and sleep problems for people with allergies. In this trial, participants will receive either an Active Air Purifier with HEPA filters or a Placebo Air Purifier without filters. While not all air purifiers are the same, those with HEPA filters can reduce indoor air pollution, potentially aiding in better asthma control. Overall, these findings suggest that HEPA air purifiers might be beneficial for children with asthma, particularly in reducing indoor pollution. ^{1 3 5 6 7}

Who Is on the Research Team?

Meredith C. McCormack, MD, MHS

Principal Investigator

Johns Hopkins University, Pulmonary and Critical Care Medicine

Are You a Good Fit for This Trial?

This trial is for children aged 8-17 living in Baltimore with persistent asthma, who are either of normal weight or overweight. They must spend most nights at home and have had an asthma exacerbation within the last year. Kids can't join if they're underweight, pregnant, smoke, have serious lung/heart conditions, or live in homes in disrepair.

Inclusion Criteria

My condition has worsened in the last year.

I have long-term asthma.

No plans to move during the study

Exclusion Criteria

You are considered to be very thin based on your body mass index (BMI).

I have a serious heart or lung condition.

Home not appropriate candidate due to disrepair

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Baseline Assessment

Home and clinical assessments are conducted before randomization

1 week

1 visit (in-person), 1 home assessment

Treatment

Participants receive either active or placebo air purifiers for 12 weeks

12 weeks

2 home assessments, 3 clinic visits

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Active Air Purifier
• Placebo Air Purifier

Trial Overview

The AIRWEIGHS study tests whether using air purifiers with HEPA filters at home can better improve respiratory health for overweight kids with asthma compared to those of normal weight. It's a randomized trial where half get real air purifiers and half get placebo ones without filters.

How Is the Trial Designed?

Group I: Active Air Purifier Active Control 1 Intervention

Two portable air purifiers containing HEPA filters will be placed in the bedroom and room where the participant reports spending the most time. We have chosen to deploy two air purifiers because we have observed a 50% reduction in indoor PM concentrations with two air purifiers. Participants will be instructed to run the air purifiers continually. Participants will receive educational materials about environmental factors that are important for asthma health and environmental modification strategies. Participants will also receive educational materials about health benefits of maintaining a normal weight.

Group II: Placebo Air Purifier Placebo Group 1 Intervention

Homes in the control group will receive placebo air purifiers that have the internal air filters removed, but which will run normally. Participants will receive educational materials about environmental factors that are important for asthma health and environmental modification strategies, and educational materials about health benefits of maintaining a normal weight. At the end of the study, participants in the control group will receive active air purifiers. A control group is needed to ensure that reduced pollutant levels and health effects are not due to temporal trends and 'placebo effects' of being enrolled in an intervention trial. Participants will also be informed that being in the study does not prevent them from purchasing and using air cleaners during the study period.

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials

2,366

Recruited

15,160,000+

National Institute of Environmental Health Sciences (NIEHS)

Collaborator

Trials

294

Recruited

1,233,000+

Published Research Related to This Trial

In a study involving 225 children aged 6 to 12 with asthma exposed to secondhand smoke, the use of HEPA air cleaners resulted in 42 fewer unscheduled asthma visits, indicating a significant reduction in asthma-related emergencies (P = .043).

The intervention group experienced a 25% reduction in airborne particles, while the control group only saw a 5% reduction, suggesting that HEPA air cleaners effectively lower harmful particulate levels, although no significant differences were found in reported asthma symptoms or other biomarkers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of HEPA air cleaners on unscheduled asthma visits and asthma symptoms for children exposed to secondhand tobacco smoke. Lanphear, BP., Hornung, RW., Khoury, J., et al.[2021]

In a study involving 71 households with children aged 6-12 who have asthma, the use of portable HEPA air cleaners significantly reduced PM2.5 levels by 60% in sleeping areas and 42% in living areas after one year, compared to control homes.

Despite the reduction in PM2.5, the HEPA air cleaners did not lead to a significant decrease in ammonia (NH3) levels, indicating that while they are effective for particulate matter, they may not address all air quality concerns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of portable HEPA air cleaners on reducing indoor PM2.5 and NH3 in an agricultural cohort of children with asthma: A randomized intervention trial. Riederer, AM., Krenz, JE., Tchong-French, MI., et al.[2021]

The use of HEPA air filters significantly reduced indoor concentrations of traffic-related airborne particles, which are linked to asthma issues in children.

Children with poorly controlled asthma showed notable improvements in asthma control and quality of life after using HEPA filtration, indicating its potential as an effective intervention for managing asthma symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

HEPA filtration improves asthma control in children exposed to traffic-related airborne particles. James, C., Bernstein, DI., Cox, J., et al.[2021]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC3165134/

Effectiveness of Air Filters and Air Cleaners in Allergic ...

The authors found a small statistically significant improvement in total symptoms and sleep disturbance associated with use of air cleaners, but no improvement ...

2.

publications.ersnet.org

publications.ersnet.org/content/erj/64/suppl68/pa3147

Use of air purifiers in the home to improve asthma outcomes in ...

84.2% of parents and two-thirds of CYP report that their (child's) asthma symptoms have improved since having the air purifier installed.

3.

sciencedirect.com

sciencedirect.com/science/article/pii/S0091743523003602

Effectiveness of filtering or decontaminating air to reduce or ...

Filtered (non HEPA) and cooled air had the best results in terms of reducing symptom severity. The mean effect in Boyle et al., 2012 was −0.31 (95%CI -0.56 to − ...

4.

annallergy.org

annallergy.org/article/S1081-1206(22)01850-6/fulltext

The efficacy of the Dyson air purifier on asthma control

High-efficiency particulate air air purifiers may reduce air pollution and thus improve asthma outcomes. However, the efficacy of such devices for this purpose ...

5.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11134058/

Effectiveness of Asthma Home Management Manual and Low ...

We aimed to investigate the effectiveness of an asthma home management manual and low-cost air filter in improving resource-limited settings.

6.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/34547084/

Effect of School Integrated Pest Management or Classroom Air ...

Among children with active asthma, use of a school-wide IPM program or classroom HEPA filter purifiers did not significantly reduce symptom-days with asthma.

7.

atsjournals.org

atsjournals.org/doi/full/10.1164/rccm.202103-0604OC

Randomized Clinical Trial of Air Cleaners to Improve ...

In per-protocol analysis, there was a statistically significant difference in primary outcome between the active filter versus sham group (SGRQ, ...