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

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.