The influence of air cleaners on indoor particulate matter components and oxidative potential in residential households in Beijing

Air quality in a bus depot and a way of improving it: effect of using air purifiers

This study assessed airborne particulate matter and black carbon concentrations and their distribution inside a restricted bus depot over two campaigns. Particles with a diameter <2.5 μm were evenly distributed across the depot, influenced by limited bus activity and the depot's spacious layout with three entrances and one exit, facilitating particle dispersion. Their average baseline concentration was 25.2 μg m-3, 4.6 times higher than outdoor levels, primarily driven by bus emissions and maintenance activities. Number concentrations of particles smaller than 0.3 μm (0.01-0.3 μm) averaged 1.3 × 103 particles cm-3, while larger particles (0.3-10 μm) averaged 33 × 100 particles cm-3. Black carbon averaged 1.3 μg m-3. Concentration peaks occurred from 23:00-9:00 and 16:00-18:00 due to bus activities, maintenance, and soil resuspension. The impact of air purifiers on air quality was also investigated focusing on their location, number, and air volume flow for optimal results. APs operating at half air volume flow and placed within 6 m of the measurement equipment achieved reductions of up to 45.2 % for PM2.5 and 73.6 % for particles sized 0.3-10 μm. However, air purifiers were much less effective for particles <0.3 μm. Crossed airflows and higher air volume flow decreased effectiveness due to turbulence and particle resuspension. This study underscores the need for optimized air purifiers placement, air volume flow settings, and operational strategies to mitigate air pollution in (semi-)closed transport environments like bus depots, improving air quality and health for passengers and workers.

Enhancing indoor air quality and cardiopulmonary health in patients with asthma by photocatalytic oxidation and filters air cleaner

BACKGROUND

Air purifiers can enhance indoor air quality and health outcomes, and studies have primarily focused on filters and particulate matter (PM) in households. Photocatalytic oxidation (PCO) is a promising technique for eliminating gaseous pollutants and bioaerosols. However, no field study was conducted in household. Therefore, this study evaluated the effects of the PCO and PCO + filters intervention on indoor air pollutants and cardiopulmonary endpoints in households.

METHODS

A randomized, double-blind crossover clinical trial was conducted. Indoor air pollutants, including PM, bioaerosols, and gaseous pollutants and cardiopulmonary endpoints including lung function, fractional exhaled nitric oxide (FeNO), respiratory symptoms, and blood pressure were assessed before and after intervention.

FINDINGS

This was the first study to evaluate the effects of PCO and PCO + filters interventions on indoor air pollutants and cardiopulmonary health in households. Indoor total volatile organic compounds (TVOC) and sulfur dioxides (SO2) significantly reduced after PCO intervention, however, we also observed the significant reduction in percentage of predicted values of forced vital capacity (FVC%) and forced expiratory volume in 3 s (FEV3%) and increased in FeNO after 13 days of PCO intervention. The PCO + filters intervention significantly reduced the levels of indoor PM1, PM2.5, PM4, PM10, total suspended particulate matter, ultrafine particles, airborne bacteria, fungi, endotoxin, mites, TVOC, nitrogen dioxide, and SO2, and marginal reduction in carbon monoxide. However, indoor carbon dioxide significantly increased after PCO/PCO + filters intervention. As for cardiopulmonary health, FVC%, and FEV1 % marginally increased 7 days after the PCO + filters intervention.

Association between exposure to specific PM2.5 constituents and environment, lifestyle, and clinical parameters in patients with COPD

This study investigated the correlation between the individual chemical constituents of particulate matter 2.5 μm (PM2.5) and respiratory parameters as well as the living environment and daily behaviors in patients with chronic obstructive pulmonary disease (COPD). Data were obtained from prospective COPD panel conducted in South Korea. Following collection via a microPEM, 18 metallic elements were determined using energy-dispersive X-ray fluorescence spectroscopy. All participants completed detailed questionnaires on living environments and lifestyle practices. Eighty-nine stable COPD patients (mean age 68.1 years; 94.4% male) were analyzed. Several constituents (titanium, aluminum, bromine, and silicone) were significantly associated with respiratory outcomes. Copper and manganese concentrations were significantly associated with the living environment. Increased ventilation time and air purifier operation were associated with lower concentrations of copper, silicone, barium, and titanium. These findings suggest varying relationships between PM2.5 constituents and clinical parameters in COPD patients, providing a basis for personalized interventions and future research.

Portable Air Cleaner Usage and Particulate Matter Exposure Reduction in an Environmental Justice Community: A Pilot Study

Particulate matter (PM) exposure is associated with adverse health outcomes, including respiratory illness. A large fraction of exposure to airborne contaminants occurs in the home. This study, conducted over 5 months in a community with high asthma rates (Chelsea, MA, USA), investigated the use of portable air cleaners (PACs) to reduce indoor PM. Seven asthma-affected households participated, receiving a PAC (Austin Air Health Mate HEPA filter), a QuantAQ sensor to measure PM1, PM2.5, PM10 (µg/m3), and a HOBO plug-load data logger to track PAC usage. Results describe hourly and daily PM concentrations and PAC usage for each household. Hourly average PM concentrations decreased when PACs were turned on (vs. when they were turned off) across households during the study period: PM1 decreased by 0.46 µg/m3, PM2.5 decreased by 0.69 µg/m3, and PM10 decreased by 3.22 µg/m3. PAC usage varied for each household, including constant usage in one household and only usage at certain times of day in others. Higher filtration settings led to lower PM, with significant reductions in some, but not all, homes. Our findings highlight some difficulties in implementing household PAC interventions, yet also provide evidence to support household-level interventions to reduce PM and other indoor sources of air pollution. We also highlight academic-community partnerships as contributing to evidence-based solutions.

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.

Efficacy of HEPA Air Cleaner on Improving Indoor Particulate Matter 2.5 Concentration

High-efficiency particulate air (HEPA) filters is a potential tool used to remove fine particles and improve indoor air quality. This study aims to analyze the real-world efficacy of portable HEPA air cleaners in a household environment. Laser light dispersion PM_2.5 sensors are used to continuously monitor the indoor and outdoor PM_2.5 level before and after HEPA air cleaner filtration. Overall, HEPA air cleaners significantly reduce the indoor PM_2.5 level (33.5 ± 10.3 vs. 17.2 ± 10.7 µg/m³, mean difference (MD) = -16.3 µg/m³, p < 0.001) and indoor/outdoor PM_2.5% (76.3 ± 16.8 vs. 38.6 ± 19.8%, MD = -37.7%, p < 0.001). The efficacy to reduce PM_2.5 is strongest in three machines with medium-flow setting group (indoor PM_2.5 MD: -26.5 µg/m³, indoor/outdoor PM_2.5 percentage MD: -56.4%). Multiple linear regression demonstrates that outdoor PM_2.5, machine number, airflow speed, and window ventilation are significant factors associated with indoor PM_2.5 concentrations (R = 0.879) and percentage of the indoor/outdoor PM_2.5 ratio (R = 0.808). HEPA air cleaners can effectively improve indoor PM_2.5 air pollution. Adequate air cleaner machine numbers, appropriate airflow, and window ventilation limitations are important to achieve the best efficacy of the HEPA air cleaner.

Effect of portable air purifier on indoor air quality: reduced exposure to particulate matter and health risk assessment

We sought to investigate the impact of air purifiers in the removal of particular matter (PM)₁₀, PM_2.5, PM_1, and particle number concentration (PNC) in the indoor air of dormitories located at Iran's largest medical university, Tehran University of Medical Sciences. Twelve rooms were selected and randomly assigned to two rooms: sham air purifier system deployed room (SR) and true air purifier system deployed room (TR). All study samples were drawn simultaneously from assigned rooms using portable GRIMM dust monitors for 24 h. The PM monitors of air were positioned in the middle of each room next to the air purifier at the height of the breathing zone (1.5 m in height). The mean PM₁₀, PM_2.5, PM₁, and PNC removal efficiency in rooms with and without a smoker were measured to be 40.7 vs 83.8%, 31.2 vs 78.4%, 29.9 vs 72.3%, and 44.3 vs 75.6%, respectively. The results showed that smoking is an important influencing factor on the indoor air quality; smoking lowered the removal efficiency of PM₁₀, PM_2.5, PM₁, and PNC by 43%, 47%, 43%, and 31%, respectively. An air purifier could decline the PM₁₀ and PM_2.5 even lower than the WHO 24-h guideline level in non-smoker rooms. This study revealed that using household air purifiers in rooms with smokers and non-smokers significantly reduces the non-carcinogenic risks of exposure to PM₁₀ and PM_2.5.

Pulmonary Benefits of Intervention with Air Cleaner among Schoolchildren in Beijing: A Randomized Double-Blind Crossover Study

We conducted a crossover study employing air cleaner intervention among 125 schoolchildren aged 9-12 years in a boarding school in Beijing, China. The PM concentrations were monitored, and 27 biomarkers were analyzed. We used the linear mixed-effects model to evaluate the association of intervention/time-weighted PM concentrations with biomarkers. The outcomes showed that air cleaner intervention was associated with FeNO, exhaled breath condensate (EBC) IL-1β, and IL-6, which decreased by 12.57%, 10.83%, and 4.33%, respectively. Similar results were observed in the associations with PMs. Lag 1 day PMs had the strongest relationship with biomarkers, and significant changes were observed in biomarkers such as FEV₁, FeNO, EBC 8-iso, and MCP-1. Boys showed higher percentage changes than girls, and the related biomarkers were FeNO, EBC 4-HNE, IL-1β, IL-6, and MCP-1. The results showed that biomarkers such as FeNO, EBC IL-6, MCP-1, and 4-HNE could sensitively reflect the early abnormal response of the respiratory system under short-term PM exposure among healthy schoolchildren and indicated that (1) air cleaners exert a protective effect on children's respiratory system. (2) PM had lag and cumulative effect, lag 1 day had the greatest effect. (3) The boys were more sensitive than the girls.

Oral cavity response to air pollutant exposure and association with pulmonary inflammation and symptoms in asthmatic children

Exposure to fine particulate matter (PM_2.5) and ozone (O₃) may lead to inflammation and oxidative damage in the oral cavity, which is hypothesized to contribute to the worsening of airway inflammation and asthma symptoms. In this panel study of 43 asthmatic children aged 5-13 years old, each child had 4 clinic visits with a 2-week interval between two consecutive visits. At each visit, saliva samples were collected and subsequently analyzed for interleukin 6 (IL-6) and eosinophil cationic protein (ECP) as biomarkers of inflammation and malondialdehyde (MDA) as a biomarker of oxidative stress in the oral cavity. At each visit, children were measured for fractional exhaled nitric oxide (FeNO) as a marker of pulmonary inflammation. Asthma symptoms of these children were measured using the Childhood Asthma Control Test (C-ACT). We found that an interquartile range (IQR) increase in 24-h average personal exposure to PM_2.5 measured 1 and 2 days prior was associated with increased salivary IL-6 concentration by 3.0% (95%CI: 0.2%-6.0%) and 4.2% (0.7%-8.0%), respectively. However, we did not find a clear association between personal O₃ exposure and any of the salivary biomarkers, except for a negative association between salivary MDA and O₃ exposure measured 1 day prior. An IQR increase in salivary IL-6 concentration was associated with significantly increased FeNO by 28.8% (4.3%-53.4%). In addition, we found that increasing salivary IL-6 concentrations were associated with decreased individual and total C-ACT scores, indicating the worsening of asthma symptoms. We estimated that 13.2%-22.2% of the associations of PM_2.5 exposure measured 1 day prior with FeNO and C-ACT scores were mediated by salivary IL-6. These findings suggest that the induction of inflammation in the oral cavity may have played a role in linking air pollution exposure with the worsening of airway inflammation and asthma symptoms.

Low-Cost Sensors for Air Quality Monitoring - the Current State of the Technology and a Use Overview

In recent years the monitoring of air quality using cheap sensors has become an interesting alternative to conventional analytical techniques. Apart from vast price differences conventional techniques need to be performed by the trained personnel of commercial or research laboratories. Sensors capable of measuring dust, ozone, nitrogen and sulphur oxides, or other air pollutants are relatively simple electronic devices, which are comparable in size to a mobile phone. They provide the general public with the possibility to monitor air quality which can contribute to various projects that differ in regional scale, commercial funding or community-base. In connection with the low price of sensors arises the question of the quality of measured data. This issue is addressed by a number of studies focused on comparing the sensor data with the data of reference measurements. Sensory measurement is influenced by the monitored analyte, type and design of the particular sensor, as well as by the measurement conditions. Currently sensor networks serve as an additional source of information to the network of air quality monitoring stations, where the density of the network provides concentration trends in the area that may exceed specific measured values of pollutant concentrations and low uncertainty of reference measurements. The constant development of all types of sensors is leading to improvements and the difference in data quality between sensors and conventional monitoring techniques may be reduced.

A review on reducing indoor particulate matter concentrations from personal-level air filtration intervention under real-world exposure situations

Improving air quality in indoor environments where people live is of importance to protect human health. In this systematic review, we assessed the effectiveness of personal-level use of air filtration units in reducing indoor particulate matters (PM) concentrations under real-world situations following systematic review guidelines. A total of 54 articles were included in the review, in which 20 randomized controlled/crossover trials that reported the changes in indoor fine PM (PM_2.5 ) concentrations were quantitatively assessed in meta-analysis. Standardized mean differences (SMDs) were calculated for changes in indoor PM concentrations following air filtration interventions. Moderate-to-large reductions of 11%-82% in indoor PM_2.5  concentrations were observed with SMD of -1.19 (95% CI: -1.50, -0.88). The reductions in indoor PM concentrations varied by geographical locations, filtration technology employed, indoor environmental characteristics, and air pollution sources. Most studies were graded with low-to-moderate risk of bias; however, the overall certainty of evidence for indoor PM concentration reductions was graded at very low level. Considering the effectiveness of indoor air filtration under practical uses, socio-economic disparities across study populations, and costs of air filter replacement over time, our results highlight the importance of reducing air pollution exposure at the sources.

Urinary metabolites of polycyclic aromatic hydrocarbons after short-term fine particulate matter exposure: A randomized crossover trial of air filtration

Research on the relationship between short-term exposure to fine particulate matter (PM_2.5) and urinary metabolites of polycyclic aromatic hydrocarbons (PAHs) is sparse in the nonoccupationally exposed populations. A quasi-experimental observation of haze events nested within a randomized crossover trial of alternative 1-week real or sham indoor air filtration was conducted to evaluate the associations of urinary monohydroxy-PAHs (OH-PAHs) with short-term exposure to PM_2.5 and PM_2.5-bound PAHs. The study was conducted among 57 healthy college students in Beijing, China. PM_2.5-bound PAHs and urinary OH-PAHs were quantified using gas chromatography coupled with a triple-quadrupole tandem mass spectrometer. Linear mixed-effect models were applied to evaluate the association of urinary OH-PAHs with time-weighted personal PM_2.5 and PM_2.5-bound PAHs, controlling for potentially confounding variables. The results demonstrated that air filtration could markedly reduce external exposure to PM_2.5 and PM_2.5-bound parent, nitrated, and oxygenated PAHs. In the intervention trial, the urinary concentrations of 2-hydroxyfluorene (2-OH-FLU) and 9-hydroxyphenanthrene (9-OH-PHE) were elevated significantly by 16.5% (95% CI, 2.1%, 33.1%) and 37.9% (95% CI, 8.4%, 75.4%), respectively, in association with a doubling increase in personal PM_2.5 exposure. Urinary 9-OH-PHE was also significantly positively associated with the increase in the sum of PM_2.5-bound parent PAHs. Furthermore, the levels of urinary OH-PAHs such as 2-OH-FLU and 9-OH-PHE in the haze events were elevated by 31.1% (95% CI, 8.7%, 53.4%) and 73.5% (95% CI, 16.0%, 131.0%), respectively, in association with a doubling increase in personal PM_2.5 exposure. The findings indicated that urinary 2-OH-FLU and 9-OH-PHE could serve as potential internal exposure biomarkers for assessing short-term PM_2.5 exposure in nonoccupational populations.

Characterization and exposure assessment of household fine particulate matter pollution in China

Household fine particulate matter (PM_2.5 ) pollution greatly impacts residents' health. To explore the current national situation of household PM_2.5 pollution in China, a study was conducted based on literature published from 1998 to 2018. After extracting data from the literature in conformity with the requirements, the nationwide household-weighted mean concentration of household PM_2.5 (HPL) was calculated. Subgroup analyses of spatial, geographic, and temporal differences were also done. The estimated overall HPL in China was 132.2 ± 117.7 μg/m³ . HPL in the rural area (164.3 ± 104.5 μg/m³ ) was higher than that in the urban area (123.9 ± 122.3 μg/m³ ). For HPLs of indoor sampling sites, the kitchen was the highest, followed by the bedroom and living room. There were significant differences of geographic distributions. The HPLs in the South were higher than the North in four seasons. The inhaled dose of household PM_2.5 among school-age children differed from provinces with the highest dose up to 5.9 μg/(kg·d). Countermeasures should be carried out to reduce indoor pollution and safeguard health urgently.

Verification of particle matter generation due to deterioration of building materials as the cause of indoor fine dust

Particles of fine dust are pollutants that adversely affect indoor air quality and exacerbate human respiratory diseases. The aging of the building was pointed out as a source of fine dust indoors. The aging of buildings has various causes of deterioration. During various deterioration, friction adversely affects the building floor finish. In this study, an accelerated friction deterioration device was used to confirm the generation of fine dust particles through the frictional deterioration of floor finishes in buildings. The study found that the concentration of fine dust particles attributed to deteriorating flooring was 327 mg/m³ in PM2.5 and 4828 mg/m³ in PM10 and confirmed that particle distribution differs depending on the surface of the flooring. Particles of 10 µm or less were observed through particle analysis. The study confirmed that fine dust particles did not diffuse in a specific direction and that the detected fine dust particles could be attributed to deterioration. Further research is needed on the detection of fine dust in degraded building finishing materials.

Role of endogenous melatonin in pathophysiologic and oxidative stress responses to personal air pollutant exposures in asthmatic children

BACKGROUND

Heightening oxidative stress and inflammation is an important pathophysiological mechanism underlying air pollution health effects in people with asthma. Melatonin can suppress oxidative stress and inflammation in pulmonary and circulatory systems. However, the role of melatonin in the oxidative stress and physiological responses to air pollution exposure has not been examined in children with asthma.

METHODS

In this panel study of 43 asthmatic children (5-13 years old), each child had 4 clinic visits with a 2-week interval between two consecutive visits. At each visit, urine samples were collected and subsequently analyzed for 6-sulfatoxymelatonin (aMT6s) as a surrogate of circulating melatonin and for malondialdehyde (MDA) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) as two biomarkers of systemic oxidative stress. At each clinic visit, children were measured for pulmonary function and fractional exhaled nitric oxide (FeNO, a marker of pulmonary inflammation). None of the children reported to have taking melatonin supplementation. Concentrations of indoor and ambient PM_2.5 and ozone (O₃) were combined with individual time-activity data to calculate personal air pollutant exposures.

RESULTS

We found that interquartile range increases in urinary MDA and 8-OHdG concentrations were associated with significantly increased urinary aMT6s concentrations by 73.4% (95% CI: 52.6% to 97.0%) and 41.7% (22.8% to 63.4%), respectively. Increases in daily personal exposure to O₃ and to PM_2.5 were each associated with increased urinary aMT6s concentrations. Increasing urinary aMT6s concentrations were associated with decreased FeNO and resonant frequency, indicating improved airway inflammation and lung elasticity, respectively.

CONCLUSION

The results suggest that systemic oxidative stress heightened by air pollution exposure may stimulate melatonin excretion as a defense mechanism to alleviate the adverse effects.

Improving indoor air quality through an air purifier able to reduce aerosol particulate matter (PM) and volatile organic compounds (VOCs): Experimental results

The adverse effects of fine particulate matter (PM) and many volatile organic compounds (VOCs) on human health are well known. Fine particles are, in fact, those most capable of penetrating in depth into the respiratory system. People spend most of their time indoors where concentrations of some pollutants are sometimes higher than outdoors. Therefore, there is the need to ensure a healthy indoor environment and for this purpose the use of an air purifier can be a valuable aid especially now since it was demonstrated that indoor air quality has a high impact on spreading of viral infections such as that due to SARS-COVID19. In this study, we tested a commercial system that can be used as an air purifier. In particular it was verified its efficiency in reducing concentrations of PM10 (particles with aerodynamic diameter less than 10 μm), PM2.5 (particles with aerodynamic diameter less than 2.5 μm), PM1 (particles with aerodynamic diameter less than 1 μm), and particles number in the range 0.3 μm-10 μm. Furthermore, its capacity in reducing VOCs concentration was also checked. PM measurements were carried out by means of a portable optical particle counter (OPC) instrument simulating the working conditions typical of a household environment. In particular we showed that the tested air purifier significantly reduced both PM10 and PM2.5 by 16.8 and 7.25 times respectively that corresponds to a reduction of about 90% and 80%. A clear reduction of VOCs concentrations was also observed since a decrease of over 50% of these gaseous substances was achieved.

Portable air purification: Review of impacts on indoor air quality and health

A systematic literature review was carried out to examine the impact of portable air purifiers (PAPs) on indoor air quality (PM2.5) and health, focussing on adults and children in indoor environments (homes, schools and offices). Analysed studies all showed reductions in PM2.5 of between 22.6 and 92.0% with the use of PAPs when compared to the control. Associations with health impacts found included those on blood pressure, respiratory parameters and pregnancy outcomes. Changes in clinical biochemical markers were also identified. However, evidence for such associations was limited and inconsistent. Health benefits from a reduction in PM2.5 would be expected as the cumulative body of scientific evidence from various cohort studies shows positive impacts of long-term reduction in PM2.5 concentrations. The current evidence demonstrates that using a PAP results in short-term reductions in PM2.5 in the indoor environment, which has the potential to offer health benefits.

Personal Exposure to PM2.5 Oxidative Potential in Association with Pulmonary Pathophysiologic Outcomes in Children with Asthma

Fine particulate matter (PM_2.5) with a higher oxidative potential has been thought to be more detrimental to pulmonary health. We aim to investigate the associations between personal exposure to PM_2.5 oxidative potential and pulmonary outcomes in asthmatic children. We measured each of the 43 asthmatic children 4 times for airway mechanics, lung function, airway inflammation, and asthma symptom scores. Coupling measured indoor and outdoor concentrations of PM_2.5 mass, constituents, and oxidative potential with individual time-activity data, we calculated 24 h average personal exposures 0-3 days prior to a health outcome measurement. We found that increases in daily personal exposure to PM_2.5 oxidative potential were significantly associated with increased small, large, and total airway resistance, increased airway impedance, decreased lung function, and worsened scores of individual asthma symptoms and the total symptom score. Among the PM_2.5 constituents, organic matters largely of indoor origin contributed the greatest to PM_2.5 oxidative potential. Given that the variability in PM_2.5 oxidative potential was a stronger driver than PM_2.5 mass for the variability in the respiratory health outcomes, it is suggested to reduce PM_2.5 oxidative potential, particularly by reducing the organic matter constituent of indoor PM_2.5, as a targeted source control strategy in asthma management.

Using Feedback to Improve Accountability in Global Environmental Health and Engineering

Engineered environmental health interventions and services in low-income and resource-limited settings-such as water supply and treatment, sanitation, and cleaner household energy services-have had a less than expected record of sustainability and have sometimes not delivered on their potential to improve health. These interventions require both effectively functioning technologies as well as supporting financial, political, and human resource systems, and may depend on user behaviors as well as professionalized service delivery to reduce harmful exposures. In this perspective, we propose that the application of smarter, more actionable monitoring and decision support systems and aligned financial incentives can enhance accountability between donors, implementers, service providers, governments, and the people who are the intended beneficiaries of development programming. Made possible in part by new measurement techniques, including emerging sensor technologies, rapid impact evaluation, citizen science, and performance-based contracting, such systems have the potential to propel the development of solutions that can work over the long-term, allowing the benefits of environmental health improvements to be sustained in settings where they are most critical by improving trust and mutual accountability among stakeholders.

Real-time measurements of PM2.5 and ozone to assess the effectiveness of residential indoor air filtration in Shanghai homes

Portable air cleaners are increasingly used in polluted areas in an attempt to reduce human exposure; however, there has been limited work characterizing their effectiveness at reducing exposure. With this in mind, we recruited forty-three children with asthma from suburban Shanghai and deployed air cleaners (with HEPA and activated carbon filters) in their bedrooms. During both 2-week filtration and non-filtration periods, low-cost PM_2.5 and O₃ air monitors were used to measure pollutants indoors, outdoors, and for personal exposure. Indoor PM_2.5 concentrations were reduced substantially with the use of air cleaners, from 34 ± 17 to 10 ± 8 µg/m³ , with roughly 80% of indoor PM_2.5 estimated to come from outdoor sources. Personal exposure to PM_2.5 was reduced from 40 ± 17 to 25 ± 14 µg/m³ . The more modest reductions in personal exposure and high contribution of outdoor PM_2.5 to indoor concentrations highlight the need to reduce outdoor PM_2.5 and/or to clean indoor air in multiple locations. Indoor O₃ concentrations were generally low (mean = 8±4 ppb), and no significant difference was seen by filtration status. The concentrations of pollutants and the air cleaner effectiveness were highly variable over time and across homes, highlighting the usefulness of real-time air monitors for understanding individual exposure reduction strategies.

Individual- and Household-Level Interventions to Reduce Air Pollution Exposures and Health Risks: a Review of the Recent Literature

PURPOSE OF REVIEW

We reviewed recent peer-reviewed literature on three categories of individual- and household-level interventions against air pollution: air purifiers, facemasks, and behavior change.

RECENT FINDINGS

High-efficiency particulate air/arresting (HEPA) filter air purifier use over days to weeks can substantially reduce fine particulate matter (PM2.5) concentrations indoors and improve subclinical cardiopulmonary health. Modeling studies suggest that the population-level benefits of HEPA filter air purification would often exceed costs. Well-fitting N95 and equivalent respirators can reduce PM2.5 exposure, with several randomized crossover studies also reporting improvements in subclinical cardiovascular health. The health benefits of other types of face coverings have not been tested and their effectiveness in reducing exposure is highly variable, depends largely on fit, and is unrelated to cost. Behavior modifications may reduce exposure, but there has been little research on health impacts. There is now substantial evidence that HEPA filter air purifiers reduce indoor PM2.5 concentrations and improve subclinical health indicators. As a result, their use is being recommended by a growing number of government and public health organizations. Several studies have also reported subclinical cardiovascular health benefits from well-fitting respirators, while evidence of health benefits from other types of facemasks and behavior changes remains very limited. In situations when emissions cannot be controlled at the source, such as during forest fires, individual- or household-level interventions may be the primary option. In most cases, however, such interventions should be supplemental to emission reduction efforts that benefit entire communities.

Effect of particulate matter exposure on patients with COPD and risk reduction through behavioural interventions: the protocol of a prospective panel study

INTRODUCTION

Patients with chronic obstructive pulmonary disease (COPD) are vulnerable to particulate matter (PM) exposure which can increase acute exacerbations and hospitalisation. Interventions to avoid PM exposure are important but evidence-based guidance is lacking. This study aims to assess the impact of PM on lung function, quality of life and exacerbations in patients with COPD using a panel design study; it will also provide evidence for interventional measures to reduce harm from PM exposure.

METHODS AND ANALYSIS

A prospective panel study of patients with COPD aged ≥40 years will be conducted. Patients will be required to have a forced expiratory volume in one second <80% of the predicted value at enrolment. A total of 120 patients from three different regions will be enrolled, 60 from the metropolitan area, 30 from an industrialised area and 30 from a clean rural area. Clinical outcomes will be assessed through COPD assessment test scores, the St. George's Respiratory Questionnaire for patients with COPD and pulmonary function testing. Indoor and outdoor PM in the patients' environments will be measured using gravimetric and light scattering platforms. To estimate the individual dose of PM exposure, a time-activity diary, Geographic Information System and land use regression model will be combined in every season for 1 year. The correlation between PM exposure and the health status of patients with COPD will be evaluated. In addition, 40 patients with the lowest score of life behaviour score to reduce environmental PM exposure will be randomised to a control or intervention group, who will receive in-depth education on risk-reducing behaviours.

ETHICS AND DISSEMINATION

This study was approved by the Institutional Review Board of each site. The participants received comprehensive information and provided informed consent. The result of this study will be discussed in the form of conference presentations and peer-reviewed publications.

TRIAL REGISTRATION NUMBER

NCT04020237.

Children's microenvironmental exposure to PM2.5 and ozone and the impact of indoor air filtration

BACKGROUND

In highly polluted urban areas, personal exposure to PM_2.5 and O₃ occur daily in various microenvironments. Identifying which microenvironments contribute most to exposure can pinpoint effective exposure reduction strategies and mitigate adverse health impacts.

METHODS

This work uses real-time sensors to assess the exposures of children with asthma (N = 39) in Shanghai, quantifying microenvironmental exposure to PM_2.5 and O₃. An air cleaner was deployed in participants' bedrooms where we hypothesized exposure could be most efficiently reduced. Monitoring occurred for two 48-h periods: one with bedroom filtration (portable air cleaner with HEPA and activated carbon filters) and the other without.

RESULTS

Children spent 91% of their time indoors with the majority spent in their bedroom (47%). Without filtration, the bedroom and classroom environments were the largest contributors to PM_2.5 exposure. With filtration, bedroom PM_2.5 exposure was reduced by 75% (45% of total exposure). Although filtration status did not impact O₃, the largest contribution of O₃ exposure also came from the bedroom.

CONCLUSIONS

Actions taken to reduce bedroom PM_2.5 and O₃ concentrations can most efficiently reduce total exposure. As real-time pollutant monitors become more accessible, similar analyses can be used to evaluate new interventions and optimize exposure reductions for a variety of populations.

Malondialdehyde in Nasal Fluid: A Biomarker for Monitoring Asthma Control in Relation to Air Pollution Exposure

Fine particulate matter (PM_2.5) and ozone (O₃) may exert oxidative damage in the nose, which is hypothesized to be associated with worsened asthma symptoms. This study, hence, is to explore whether an oxidative stress biomarker, malondialdehyde (MDA) in the nasal fluid, has the potential to aid personalized asthma control. In a panel study of 43 asthmatic children, 5-13 years old, each child was measured 4 times with a 2-week interval between consecutive clinic visits. At each visit, nasal fluid and urine samples were collected, and fractional exhaled nitric oxide (FeNO) was measured as a biomarker of pulmonary inflammation. In addition to nasal MDA, urinary MDA and 8-hydroxy-2'-deoxyguanosine (8-OHdG) were measured as biomarkers of systemic oxidative stress. We also assessed asthma symptoms using the Childhood Asthma-Control Test (C-ACT). We found that interquartile range (IQR) increases in 24 h average personal PM_2.5 exposure (22.2-33.5 μg/m³), estimated 0 to 5 days prior to a clinic visit, were associated with increased nasal MDA concentrations by 38.6-54.9%. Similarly, IQR increases in 24 h average personal O₃ exposure (7.7-8.2 ppb) estimated 2 to 4 days prior were associated with increased nasal MDA by 22.1-69.4%. Only increased PM_2.5 exposure was associated with increased FeNO. Increased nasal MDA concentration was associated with decreased total and individual C-ACT scores, indicating worsening of asthma symptoms. However, no significant associations were observed between urinary MDA or 8-OHdG and C-ACT scores. The results confirm that oxidative stress plays an important role in linking air pollution exposure and adverse respiratory health effects. These findings support that MDA in the nasal fluid may serve as a useful biomarker for monitoring asthma status, especially in relation to PM_2.5 and O₃ exposures, two known risk factors of asthma exacerbation.

Airborne Aerosols and Human Health: Leapfrogging from Mass Concentration to Oxidative Potential

The mass concentration of atmospheric particulate matter (PM) has been systematically used in epidemiological studies as an indicator of exposure to air pollutants, connecting PM concentrations with a wide variety of human health effects. However, these effects can be hardly explained by using one single parameter, especially because PM is formed by a complex mixture of chemicals. Current research has shown that many of these adverse health effects can be derived from the oxidative stress caused by the deposition of PM in the lungs. The oxidative potential (OP) of the PM, related to the presence of transition metals and organic compounds that can induce the production of reactive oxygen and nitrogen species (ROS/RNS), could be a parameter to evaluate these effects. Therefore, estimating the OP of atmospheric PM would allow us to evaluate and integrate the toxic potential of PM into a unique parameter, which is related to emission sources, size distribution and/or chemical composition. However, the association between PM and particle-induced toxicity is still largely unknown. In this commentary article, we analyze how this new paradigm could help to deal with some unanswered questions related to the impact of atmospheric PM over human health.

Deep Physical-Chemical Purification of Gas Medium in Artificial Ecosystems

The results of experiments on application of a newly developed facility for oxidation of volatile organic compounds on a platinum catalyst are presented. The feasibility of using this method in artificial ecosystems as a whole and in mass exchange of closed biological-technical life support systems in particular is shown. The possibility of deep purification of gas emitted from the reactor of physical-chemical processing of organic wastes is demonstrated. Wheat growing experiment on using the facility for oxidation of volatile organic compounds in a sealed chamber was performed. No adverse effect of probable toxic oxidation products on wheat plants during a 4-day experiment was determined.

Associations of personal exposure to air pollutants with airway mechanics in children with asthma

BACKGROUND

The importance of airway mechanics has been increasingly recognized in pediatric asthma. However, no studies have examined responses of airway mechanics to air pollution exposure in asthmatic children.

METHODS

In this panel study involving indoor air filtration manipulation that created a large gradient of personal exposure to PM_2.5, the airway mechanics and lung function of 43 asthmatic children 5-13 years old in a suburb of Shanghai were measured four times within 3 consecutive months. Concentrations of indoor and outdoor PM_2.5 and ozone were coupled with individual time-activity data to calculate personal exposures. Linear mixed effects models were used to examine the relationships of personal exposure with indicators of airway mechanics and lung function, respectively.

RESULTS

An interquartile range (IQR) increase in 24-hour average PM_2.5 personal exposure (30.3 µg/m³) in the prior day was associated with significant increases in small airway resistance (R₅-R₂₀) of 15.8%, total airway resistance (R₅) of 6.3%, and airway inflammation (FeNO) of 9.6%. These associations were stronger in children with lower blood eosinophil counts (<450/µL). No significant associations were found between personal PM_2.5 exposure and lung function. Low-level ozone exposure (daily maximum 8-hour exposure range 1.1-56.4 ppb) was not significantly associated with any of the outcomes.

CONCLUSION

Changes in personal PM_2.5 exposure, partly enhanced by air filtration, were associated with significant changes in airway resistance and inflammation in children with asthma. These findings suggest the importance of reducing PM_2.5 exposure, via personal air quality management, in improving airflow limitation in the airways, especially the small airways.

Using low-cost sensors to monitor indoor, outdoor, and personal ozone concentrations in Beijing, China

High concentrations of ground-level ozone (O₃) have been measured outdoors across China but there are limited measurements of O₃ in microenvironments, including in homes, and for personal exposure. This highlights the need for cheaper methods to accurately make these measurements and to better capture fine-scale spatial variability in O₃ across cities. With this in mind, we conducted a pilot study at six homes in Beijing, China, over 12 days to evaluate the use of portable, low-cost, time-resolved monitors for measuring O₃ indoors and outdoors. We also assessed personal exposure for one adult in each home for two 48 hour periods using backpack-mounted monitors. Prior to and following sampling we collocated all monitors with a reference analyzer; we used data from these colocations to generate linear calibrations which we applied to all monitor data. Calibration slopes did not change significantly over the study although some intercepts differed. The average limit of detection (LOD) was 7.0 ppb, average root mean square error was 16.7 ppb, mean absolute error was 13.3 ppb and normalized root mean square error was 33%. Performance varied substantially between sensors, underscoring the importance of monitor-specific calibrations and determinations of measurement error. Outdoor concentrations varied spatially, with home-specific peak hourly averages of 32-165 ppb; indoor concentrations ranged from below the LOD to 15 ppb. Hour-averaged personal exposure was generally higher than O₃ indoors, and at times exceeded ambient O₃ indicating contributions to personal exposure from ambient sources of O₃ away from the home. This work illustrates the feasibility of using these monitors to characterize distributions of O₃ spatially and temporally when differences in concentrations are large, and outlines considerations for using these monitors to measure personal exposure.

Efficiency of an Air Cleaner Device in Reducing Aerosol Particulate Matter (PM) in Indoor Environments

Indoor air quality (IAQ) in household environments is mandatory since people spend most of their time in indoor environments. In order to guarantee a healthy environment, air purification devices are often employed. In the present work, a commercial household vacuum cleaner has been tested in order to verify its efficiency in reducing the mass concentration and particle number of aerosol particulate matter (PM). The efficiency has been tested measuring, while the instrument was working, PM₁₀ (particles with aerodynamic diameter less than 10 μm), PM_2.5 (particles with aerodynamic diameter less than 2.5 μm), PM₁ (particles with aerodynamic diameter less than 1 μm), and 7 size-fractions in the range between 0.3 and >10 μm. Measurements have been carried out by means of a portable optical particle counter instrument and simulating the working conditions typical of a household environment. It has been found that the tested commercial device significantly reduces both PM concentrations and particle number, especially in the finest fraction, i.e., particles in the range 0.3–0.5 μm, allowing an improvement of indoor air quality.

Particulate Matter Measurement Indoors: A Review of Metrics, Sensors, Needs, and Applications

Many populations spend ∼90% of their time indoors, with household particulate matter being linked to millions of premature deaths worldwide. Particulate matter is currently measured using particle mass, particle number, and particle size distribution metrics, with other metrics, such as particle surface area, likely to be of increasing importance in the future. Particulate mass is measured using gravimetric methods, tapered element oscillating microbalances, and beta attenuation instruments and is best suited to use in compliance monitoring, trend analysis, and high spatial resolution measurements. Particle number concentration is measured by condensation particle counters, optical particle counters, and diffusion chargers. Particle number measurements are best suited to source characterization, trend analysis and ultrafine particle investigations. Particle size distributions are measured by gravimetric impactors, scanning mobility particle sizers, aerodynamic particle sizers, and fast mobility particle sizers. Particle size distribution measurements are most useful in source characterization and particulate matter property investigations, but most measurement options remain expensive and intrusive. However, we are on the cusp of a revolution in indoor air quality monitoring and management. Low-cost sensors have potential to facilitate personalized information about indoor air quality (IAQ), allowing citizens to reduce exposures to PM indoors and to resolve potential dichotomies between promoting healthy IAQ and energy efficient buildings. Indeed, the low cost will put this simple technology in the hands of citizens who wish to monitor their own IAQ in the home or workplace, to inform lifestyle decisions. Low-cost sensor networks also look promising as the solution to measuring spatial distributions of PM indoors, however, there are important sensor/data quality, technological, and ethical barriers to address with this technology. An improved understanding of epidemiology is essential to identify which metrics correlate most with health effects, allowing indoor specific PM standards to be developed and to inform the future of experimental applications.

Sources of volatile organic compounds in suburban homes in Shanghai, China, and the impact of air filtration on compound concentrations

Air pollution in China is an ongoing concern, with subsets of the population (e.g., asthmatic children) especially susceptible to the associated health effects. In addition, people spend the majority of their time indoors, where pollutant composition may differ from the better characterized ambient environment. Although volatile organic compounds (VOCs) present health risks and have high concentrations indoors, their sources have not been thoroughly quantified in typical homes in suburban China. Similarly lacking is an understanding of how well a purifier with high efficiency particulate air and activated carbon filters can remove VOCs in a real-world setting in China. In this study, we a) quantified total VOCs (TVOC) and 900 + individual VOCs in 20 homes in China, b) identified potential sources of VOCs, and c) evaluated impacts of filtration. We used non-negative matrix factorization, a variable reduction technique, to identify sources. TVOC and individual compounds had higher concentrations indoors than outdoors (mean [range] indoors, filtration with pre-filter only: 302 [56-793] μg m-3; outdoors, entire study: 92 [26-629] μg m-3), indicating prevalent sources indoors. Many compounds detected have not, to our knowledge, been measured in homes in China. Some compounds (e.g., octanal, heptanal, ⍺-cedrene) were specific to the indoor environment, a few were ubiquitous (e.g., acetaldehyde, formaldehyde), and others were detected infrequently. These compounds may originate from consumer products, solvents, vehicle emissions, a hexane source, wooden products, and cooking. Filtration may improve air quality indoors by lowering concentrations of some VOCs, and, specifically, contributions related to solvents and consumer products.

Improving the electrospinning process of fabricating nanofibrous membranes to filter PM2.5

To mitigate PM2.5 emissions is becoming a pressing concern, because these particles pose a threat to public health. Evidence shows that bead-free nanofiber with diameter of <100 nm is more likely to capture the PM2.5, however, currently it is impossible to fabricate bead-free nanofiber with such diameter without introduction of other substances. To fabricate bead-free polyacrylonitrile (PAN) nanofibers with diameter of <100 nm, we improved the electrospinning process of membrane fabrication via design of experiment (DOE), and we then used these nanofibers to filter PM2.5 emissions from burning cigarettes and fused deposition modeling (FDM) three-dimensional (3D) printing. The DOE was based on a L₂₇ (3¹³) orthodoxy array, which consists of six controllable factors, that is, the concentration of solution, the spinning voltage, the rotating speed, the tip-to-collector distance, the flow rate of the syringe pump, and the electrospinning temperature, each of them has three levels. The results showed that the nanofibers of the least diameter (i.e., 77 nm) can be fabricated under the following condition: 8 wt% PAN solution, 12 kV voltage, 5000 r/min, 12 cm tip-to-collector distance, 0.6 ml/h flow rate, and 50 °C electrospinning temperature. Range analysis and analysis of variance (ANOVA) showed that the concentration of PAN solution has the most significant effect on the diameter, and their values are positively correlated. An examination in a two-chamber filtering device showed the PAN membrane with the least fiber diameter has a PM2.5 filtration efficiency of 99.26%. A filtration test on standard FDM 3D printing process showed the membrane has a PM2.5 removal efficiency of 81.16%. This work could mitigate PM2.5 emissions from cigarette tobacco and FDM 3D printing, and it would be used to other scenarios, such as industrial and traffic emissions.