Effects of Air Purifiers on Patients with Allergic Rhinitis: a Multicenter, Randomized, Double-Blind, and Placebo-Controlled Study

Abstract

Purpose Exposure to particulate matter (PM) is a well-known risk factor in the triggering and exacerbation of allergic airway disease. Indoor environments, where people spend most of their time, are of utmost importance. To assess the effects of air purifiers [equipped with high-efficiency particulate air (HEPA) filters] on allergic rhinitis (AR) in adult patients, we performed a multicenter, randomized, double-blind, and placebo-controlled study. Materials and Methods Patients with house dust mite (HDM)-induced AR were randomly assigned to either active or mockup (placebo) air-purification groups. Two air purifiers (placed in living room and bedroom) were operated for 6 weeks in each home environment. The primary study endpoint was to achieve improvement in AR symptoms and medication scores. Secondary endpoints were to achieve improvement in the quality of life (QoL) and visual analog scale (VAS) scores, as well as in the indoor (bedroom and living room) concentrations of PM 2.5 and PM 10 . Results After 6 weeks of air purifier use, medication scores improved significantly in the active (vs. placebo) group, although subjective measures (symptoms, VAS, and QoL scores) did not differ. Bedroom PM 2.5 concentrations initially exceeded living room or outdoor levels, but declined (by up to 51.8%) following active purifier operation. Concentrations of PM 2.5 in living room and PM 10 in bedroom and living room were also significantly reduced through active purification. Conclusion The use of air purifiers with HEPA filters significantly reduced medication requirements for patients with HDM-induced AR and significantly lowered indoor PM 2.5 concentrations, regardless of room placement. Active intervention to reduce household air pollutants may help improve allergic airway disease ( clinicaltrials.gov NCT03313453 ).

Effectiveness of portable HEPA air cleaners on reducing indoor endotoxin, PM 10, and coarse particulate matter in an agricultural cohort of children with asthma: A randomized intervention trial

“…44 adults with allergic rhinitis in two cities in South Korea found 53.2% and 30.7% decreases on average in bedroom and living room PM 10 , respectively, using a repeated measures approach. 100 Mean baseline PM 10 in this study was 33.4 (5.6) μg/m 3 in the bedrooms We observed no meaningful change in endotoxin loadings in homes assigned to the HEPA vs. control families. From baseline to follow-up, geometric mean EDC endotoxin dropped 20% in HEPA homes and 29% in control homes, but the HEPA vs. control group difference was not statistically significant.…”

Effect of air filtration on house dust mite, cat and dog allergens and particulate matter in homes

“…Despite the use of HEPA air purifiers in previous studies to assess their effect on HDM, 39 , 40 , 50 dog 48 , 61 , 62 , 63 and cat 34 , 39 , 48 , 61 , 62 , 63 , 64 allergen exposure, these were either restricted to one 34 , 39 , 61 , 64 or two allergens, 37 , 38 , 62 , 63 based on one home only 50 or did not measure airborne allergen levels. 37 , 38 , 62 , 63 , 64 For instance, Jia‐Ying et al.…”

“…Despite the use of HEPA air purifiers in previous studies to assess their effect on HDM, 39 , 40 , 50 dog 48 , 61 , 62 , 63 and cat 34 , 39 , 48 , 61 , 62 , 63 , 64 allergen exposure, these were either restricted to one 34 , 39 , 61 , 64 or two allergens, 37 , 38 , 62 , 63 based on one home only 50 or did not measure airborne allergen levels. 37 , 38 , 62 , 63 , 64 For instance, Jia‐Ying et al. 40 showed a decrease in HDM allergens similar to the percentage reported in our study, but analyzing bedding and static dust samples (68.3% and 71.0%) and not airborne samples.…”

“…Since these allergens are detected in the airborne PM, a good approach to reduce exposure would be filtering the air. 21 , 35 , 36 In the last few years, significant improvements in allergic rhinitis and asthma symptoms were reported using high‐efficiency particulate air (HEPA) air purifiers, 37 , 38 which also resulted in a decrease in medication. 38 HEPA air purifiers not only removed the HDM allergens, 39 , 40 but also cat allergens.…”

Under the dynamic environment of normal diagnosis and treatment in the bronchoscope room, the study of the removal efficiency of the new air purifier on microbial aerosols

“…However, the microorganisms on the lter will multiply, die or decompose, so the method above cannot directly re ect the microbial aerosols. Some scholars [23][24][25][26][27] have con rmed that air puri ers can effectively reduce the concentration of allergens in indoor air, thereby improving the clinical manifestations of patients with allergic rhinitis, and signi cantly reducing the drug needs. Some scholars [28] have proved that the air puri er has the effect of reducing the total colony number of the culture medium through the method of air sampling and fungus culture in the medium, but it has not been tested for bacterial species, and the puri cation of each microorganism cannot be seen directly.…”