Assessing Impact of Household Intervention on Indoor Air Quality and Health of Children with Asthma in the US-Mexico Border: A Pilot Study

Interventions to reduce the effects of air pollution and of extreme heat on maternal, newborn, and child health outcomes: a mapping of the literature

Background

There is an increasing awareness of the ongoing and projected impacts of air pollution and of extreme heat on maternal, newborn, and child health (MNCH) outcomes, showing significant short and long-term health problems. There is a dearth of information available for policy makers on interventions that have been implemented to reduce the impact on MNCH, impeding the integration of action into health planning. This paper presents an inventory of interventions aimed at reducing the effects of these two climate hazards on MNCH.

Methods

We conducted a scoping review of articles published in three databases and grey literature to identify and map interventions implemented to address the impact of air pollution and/or extreme heat on MNCH. Items were included if published between January 2016 and November 2022, regardless of language, and as this is an inventory, regardless of if the intervention was evaluated. Over 32 700 journal items were reviewed for inclusion and a sample of grey literature from web-based searches.

Results

A final inventory of 76 items were included. Interventions identified were primarily based in the Global North (n = 51), with the largest proportion in the USA (n = 17), while 32 items were based in the Global South. Fifty-seven items focused on air pollution, 18 on extreme heat, and one on both. Interventions were categorised in four adapted socioecological components: (i) individual and household interventions (n = 30), (ii) community and service interventions (n = 18), (iii) structural interventions and urban landscape interventions (n = 15), (iv) policy interventions (n = 16). Most items were focused on child health outcomes (n = 65); 61 items were evaluated.

Conclusions

This scoping review maps interventions implemented and proposes a categorisation of these to initiate reflections and dialogue on what has been done and how to start building an evidence base. The review also highlights gaps in interventions and the knowledge base, with most interventions implemented to address air pollution, in the Global North and most addressing child health need. As country programmes seek to address the impact of climate change on MNCH, additional efforts are needed to better understand what has been done, document lessons learned, agree on common outcome measurements and feasible study designs for evaluation to start building the evidence base.

Evidence driven indoor air quality improvement: An innovative and interdisciplinary approach to improving indoor air quality

Indoor air pollution is a recognized emerging threat, claiming millions of lives annually. People are constantly exposed to ambient and indoor air pollution. The latest research shows that people in developed countries spend up to 90% of their time indoors and almost 70% at home. Although impaired Indoor Air Quality (IAQ) represents a significant health risk, it affects people differently, and specific populations are more vulnerable: children, the elderly, and people with respiratory illnesses are more sensitive to these environmental risks. Despite rather extensive research on IAQ, most of the current understanding about the subject, which includes pollution sources, indoor-outdoor relationships, and ventilation/filtration, is still quite limited, mainly because air quality monitoring in the EU is primarily focused on ambient air quality and regulatory requirements are lacking for indoor environments. Therefore, the EDIAQI project aims to improve guidelines and awareness for advancing the IAQ in Europe and beyond by allowing user-friendly access to information about indoor air pollution exposures, sources, and related risk factors. The solution proposed with EDIAQI consists of conducting a characterization of sources and routes of exposure and dispersion of chemical, biological, and emerging indoor air pollution in multiple cities in the EU. The project will deploy cost-effective/user-friendly monitoring solutions to create new knowledge on sources, exposure routes, and indoor multipollutant body burdens. The EDIAQI project brings together 18 organizations from 11 different European countries that provide interdisciplinary skills and expertise in various fields, including environmental science and technology, medicine, and toxicology, as well as policy design and public engagement.

Global Trends and Hotspots in the Research of the Effects of PM2.5 on Asthma: A Bibliometric and Visualized Analysis

BACKGROUND

Fine particulate matter (PM2.5) has been identified as a significant environmental and public health challenge, particularly due to its association with respiratory diseases like asthma. With the global rise in urbanization and industrialization, PM2.5-related asthma research has grown substantially over the past two decades. This study aims to provide a comprehensive bibliometric analysis to map global research trends, highlight key contributors, and identify emerging hotspots in the relationship between PM2.5 and asthma.

METHODS

We performed a bibliometric analysis using the Web of Science Core Collection database, covering research from January 2004 to September 2024. The selected studies were analyzed using CiteSpace and VOSviewer to assess publication trends, global collaborations, and research hotspots through visualized networks and co-occurrence analyses.

RESULTS

A total of 2035 publications were identified, demonstrating a steady increase in research output over the past two decades. The United States and China emerged as dominant contributors, frequently collaborating with countries like Canada, Australia, and South Korea. Key research areas focused on air quality, particulate matter exposure, and asthma exacerbation, with an increasing emphasis on indoor air pollution and long-term exposure risks. Institutional collaborations were led by prominent universities such as the University of California System and Harvard University. Additionally, research on vulnerable populations, particularly children, and the impact of early-life exposure to PM2.5 has gained attention in recent years.

CONCLUSIONS

The global research landscape on PM2.5 and asthma has expanded significantly, with growing attention to interdisciplinary approaches that combine environmental science and public health. Future studies should focus on the global burden of air pollution, particularly in low- and middle-income countries, and address the long-term health impacts of PM2.5 exposure, especially in vulnerable populations.

Effectiveness of Asthma Home Management Manual and Low-Cost Air Filter on Quality of Life Among Asthma Adults: A 3-Arm Randomized Controlled Trial

Background

Asthma affects the quality of life (QoL) of millions of people worldwide. Effective control is paramount to a decline in prevalence and severity. To address this, we aimed to investigate the effectiveness of an asthma home management manual and low-cost air filter in improving resource-limited settings.

Patients and Methods

This randomized controlled trial was conducted between March to July 2022. The participants were 18-55 years old outpatient with asthmatic patients. A total of 114 participants were recruited and randomly assigned to three groups: home management only, home management and air filtering, and control. Validated measurement tools were applied, and the Wilcoxon test was used to evaluate changes in QoL.

Results

Asthma burden was found in at least one-third of participants in each group. At baseline, there was no difference in mAQLQ scores among participants in all group allocations (p-value > 0.05), and the air filter group had an increase in the total mAQLQ score (p-value = 0.044) and post-intervention activity quality of life (p-value = 0.002). The environmental quality of life increased post-intervention (p-value = 0.004) and remained higher after four weeks of follow-up compared to baseline (p-value = 0.041) in the home management group participants.

Conclusion

The findings indicate that the enforcement of a home management manual and the application of low-cost filters in air circulation systems offer advantages in improving the quality of life of patients with moderate and mild asthma.

Feasibility of residential air quality monitoring to address asthma outcomes

Improving asthma outcomes for underserved populations can be addressed through interventions to improve indoor air quality (IAQ). New protocol for measuring IAQ and health outcomes are imperative given advances in IAQ monitoring technology and challenges in conducting intervention research in homes. In this pilot study HEPA air purifiers and HEPA vacuum cleaners were provided to five homes with children with asthma. For 6 weeks, eight common components of air quality were measured using a low-cost multi-channel air quality monitoring device, with data conveyed directly from participant homes via Wi-Fi connection. In conjunction with periodic surveys on asthma control, impact of asthma on quality of life and intervention compliance, outcomes compared IAQ, home characteristics, and asthma-related measures. This pilot study demonstrates the feasibility of a protocol to evaluate a dual component intervention to improve IAQ in homes, as measured with a low-cost air quality monitoring device.

A systematic review and meta-analysis of field studies of portable air cleaners: Performance, user behavior, and by-product emissions

Indoor air quality is important for the health of building occupants, and public interest in controlling indoor airborne pathogens increased dramatically with the COVID-19 pandemic. Pollutant concentrations can be controlled locally using portable air cleaners (sometimes called air purifiers), which allow occupants to apply air cleaning technology to meet their needs in the location and times that they find appropriate. This paper provides a systematic review of scientific literature that describes field studies of the effectiveness of portable air cleaners. Over 500 papers were considered, and 148 were reviewed in detail, to extract 35 specific research results (e.g., particulate removal performance) or characteristics (e.g., type of building). These were aggregated to provide an overview of results and approaches to this type of research, and to provide meta-analyses of the results. The review includes: descriptions of the geographical location of the research; rate of publications over time; types of buildings and occupants in the field study; types of air cleaner technology being tested; pollutants being measured; resulting pollutant removal effectiveness; patterns of usage and potential barriers to usage by occupants; and the potential for by-product emissions in some air cleaner technologies. An example result is that 83 of the 148 papers measured reductions in fine particulates (PM2.5) and found a mean reduction of 49 % with standard deviation of 20 %. The aggregated results were approximately normally distributed, ranging from finding no significant reduction up to a maximum above 90 % reduction. Sixteen of the 148 papers considered gaseous pollutants, such as volatile organic compounds, nitrogen dioxide, and ozone; 36 papers considered biological pollutants, such as bacteria, viruses, pollen, fungi, etc. An important challenge, common to several studies, is that occupants run the air cleaners for shorter periods and on low airflow rate settings, because of concerns about noise, drafts, and electricity cost, which significantly reduces air cleaning effectiveness.

Effectiveness of a community-driven, asthma intervention: Project Asthma In-Home Response

Project Asthma In-home Response (AIR) is a multilevel, home-based intervention to address childhood asthma. This study aims to assess the effectiveness of the community-driven, multilevel Project AIR intervention. We hypothesize that children participating in the Project AIR intervention will have reduced asthma-related emergency room visits, hospitalizations, and asthma exacerbations. Seventy-Five participants of an in-home asthma intervention were surveyed at the onset of intervention and six months after the intervention. The mean age of clients in the sample population was ten years. Most clients in the sample population were 11 to 15 years old (34.7%), followed by 6 to 10 years old (29.3%) and 3 to 5 years (26.0%). Participation in the Project AIR intervention resulted in significant reductions in asthma attacks (p-value 0.0003), asthma-related emergency room visits (p-value >0.0001), and asthma-related hospitalizations (p-value 0.008). The results of this study support that in-home environmental asthma programs are an efficient method of treating asthma in a smaller metro area. Our findings reinforce prior studies in larger metropolitan areas such as New York and Boston (1).

Indoor Air Quality and Health Outcomes in Employees Working from Home during the COVID-19 Pandemic: A Pilot Study

Indoor air quality (IAQ) has a substantial impact on public health. Since the beginning of the COVID-19 pandemic, more employees have worked remotely from home to minimize in-person contacts. This pilot study aims to measure the difference in workplace IAQ before and during the pandemic and its impact on employees’ health. The levels of fine particulate matter (PM2.5) and total volatile organic chemicals (tVOC) were measured in the employees’ offices before the COVID-19 pandemic and at homes while working from home during the pandemic using Foobot air monitors. The frequencies of six sick building syndrome (SBS) symptoms were evaluated at each period of monitoring. The result showed PM2.5 levels in households while working from home were significantly higher than in offices while working at the office for all participants (p < 0.05). The PM2.5 levels in all households exceeded the health-based annual mean standard (12 µg/m3), whereas 90% of offices were in compliance. The tVOC levels were all below the standard (500 µg/m3). We also found a higher frequency of SBS symptoms were observed while working from home as the IAQ was worse at home. This study suggested that working from home might have a detrimental health impact due to poor IAQ and providing interventions to remote employees should be considered.