Impact of a New Portable Air Purification Technology Device in the Pediatric Hospital Setting - A Pre-post Assessment Study

Indoor-air purification by photoelectrochemical oxidation mitigates allergic airway responses to aerosolized cat dander in a murine model

Portable air purifiers help improve indoor air quality by neutralizing allergens, including animal dander proteins. However, there are limited in-vivo models to assess the efficacy of these devices. Here, we developed a novel animal model of experimental asthma using aerosolized cat dander extract (CDE) exposure and compared the efficacy of select air purification technologies. Mice were exposed to CDE aerosols for 6 weeks in separate custom-built whole-body exposure chambers equipped with either a photoelectrochemical oxidative (PECO) Molekule filtration device (PFD) or a HEPA-assisted air filtration device (HFD) along with positive (a device with no filtration capability) and negative controls. Compared to the positive control group, the CDE-induced airway resistance, and plasma IgE and IL-13 levels were significantly reduced in both air purifier groups. However, PFD mice showed a better attenuation of lung tissue mucous hyperplasia and eosinophilia than HFD and positive control mice, indicating a better efficacy in managing CDE-induced allergic responses. Cat dander protein destruction was evaluated by LCMS proteomic analysis, which revealed the degradation of 2731 unique peptides on PECO media in 1 h. Thus, allergen protein destruction on filtration media enhances air purifier efficacy that could provide relief from allergy responses compared to traditional HEPA-based filtration alone.

Room-Based Assessment of Mobile Air Cleaning Devices Using a Bioaerosol Challenge

Introduction

The widespread transmission of the SARS-CoV-2 virus has increased scientific and societal interest in air cleaning technologies, and their potential to mitigate the airborne spread of microorganisms. Here we evaluate room scale use of five mobile air cleaning devices.

Methods

A selection of air cleaners, containing high efficiency filtration, was tested using an airborne bacteriophage challenge. Assessments of bioaerosol removal efficacy were undertaken using a decay measurement approach over 3 h, with air cleaner performance compared with bioaerosol decay rate without an air cleaner in the sealed test room. Evidence of chemical by-product emission was also checked, as were total particle counts.

Results

Bioaerosol reduction, exceeding natural decay, was observed for all air cleaners. Reductions ranged between devices from <2-log per m³ room air for the least effective, to a >5-log reduction for the most efficacious systems. One system generated detectable ozone within the sealed test room, but ozone was undetectable when the system was run in a normally ventilated room. Total particulate air removal trends aligned with measured airborne bacteriophage decline.

Discussion

Air cleaner performance differed, and this could relate to individual air cleaner flow specifications as well as test room conditions, such as air mixing during testing. However, measurable reductions in bioaerosols, beyond natural airborne decay rate, were observed.

Conclusion

Under the described test conditions, air cleaners containing high efficiency filtration significantly reduced bioaerosol levels. The best performing air cleaners could be investigated further with improved assay sensitivity, to enable measurement of lower residual levels of bioaerosols.

The implementation of portable air-cleaning technologies in healthcare settings - a scoping review

The COVID-19 pandemic revealed opportunities to improve prevention practices in healthcare settings, mainly related to the spread of airborne microbes (also known as bioaerosols). This scoping review aimed to map methodologies used to assess the implementation of portable air cleaners in healthcare settings, identify gaps, and propose recommendations for future research. The protocol was registered in the Open Science Framework and reported following the checklist provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis - an extension for Scoping Reviews (PRISMA-ScR) statement. The search strategy was performed in five databases and one grey literature source. At the last selection phase, 24 articles that fulfilled our inclusion criteria were summarized and disseminated. Of these, 17 studies were conducted between 2020 and 2022; one of them was a protocol of a multicentre randomized controlled trial. The outcomes measured among the studies include airborne microbe counts, airborne particle concentrations, and rate of infections/interventions. The leading healthcare settings assessed were dental clinics (28%), patient's wards (16%), operating rooms (16%), and intensive care units (12%). Most of the devices demonstrated a significant potential to mitigate the impact of bioaerosols. Although some indoor air quality parameters can influence the mechanics of aerosols, only a few studies controlled these parameters in their analyses. Future clinical research should assess the rate of infections through randomized controlled trials with long-term follow-up and large sample sizes to determine the clinical importance of the findings.

COVID-19 Outbreak and Hospital Air Quality: A Systematic Review of Evidence on Air Filtration and Recirculation

The outbreak of SARS-CoV-2 has made us all think critically about hospital indoor air quality and the approaches to remove, dilute, and disinfect pathogenic organisms from the hospital environment. While specific aspects of the coronavirus infectivity, spread, and routes of transmission are still under rigorous investigation, it seems that a recollection of knowledge from the literature can provide useful lessons to cope with this new situation. As a result, a systematic literature review was conducted on the safety of air filtration and air recirculation in healthcare premises. This review targeted a wide range of evidence from codes and regulations, to peer-reviewed publications, and best practice standards. The literature search resulted in 394 publications, of which 109 documents were included in the final review. Overall, even though solid evidence to support current practice is very scarce, proper filtration remains one important approach to maintain the cleanliness of indoor air in hospitals. Given the rather large physical footprint of the filtration system, a range of short-term and long-term solutions from the literature are collected. Nonetheless, there is a need for a rigorous and feasible line of research in the area of air filtration and recirculation in healthcare facilities. Such efforts can enhance the performance of healthcare facilities under normal conditions or during a pandemic. Past innovations can be adopted for the new outbreak at low-to-minimal cost.