Long-term indoor air conditioner filtration and cardiovascular health: A randomized crossover intervention study

Chuang, Hsiao-Chi; Ho, Kin-Fai; Lin, Lian‐Yu; Chang, Ta-Yuan; Hong, Gui-Bing; Ma, Cui; Liu, I-Jung; Chuang, Kai Jen

doi:10.1016/j.envint.2017.06.008

Cited by 116 publications

(63 citation statements)

References 17 publications

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“…Even the minimum ambient and exposure values for Group A during the intervention period exceeded this guideline, and so these levels are expected to be high enough to elicit a biomarker response. However, a longer intervention of one year with a MERV11/F6-rated filter, which removed even less PM than the F8 filter, led to reductions in several cardiovascular and inflammatory biomarkers,[31] which suggests that biomarkers can respond to small reductions in PM over a longer timeframe.…”

Section: Discussionmentioning

confidence: 99%

“…Another study that showed several biomarker associations with filtration also involved a non-HEPA electret air filter, this time over an entire year of constant use in three in-home air conditioning units. [31] The other studies showing biomarker associations with a filtration intervention have only shown slight improvements in 1–2 biomarkers, such as the microvascular endothelial function marker reactive hyperemia index (RHI) in both Bräuner et al and Allen et al Weichenthal et al did find slight improvements in lung function after 7 days, but these became nonsignificant when excluding two outlying subjects, suggesting that these results may not be generalizable. A 14-day central home AHU HEPA intervention was also associated with biomarker outcomes, but then it was only at 2 days, not 7 or 14 days, into the intervention period that a significant change was observed in monocyte surface CD62L, a selectin implicated in inflammation.…”

Section: Discussionmentioning

confidence: 99%

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Combined use of an electrostatic precipitator and a high-efficiency particulate air filter in building ventilation systems: Effects on cardiorespiratory health indicators in healthy adults

Day

Xiang

et al. 2018

Indoor Air

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High-efficiency particulate air (HEPA) filtration in combination with an electrostatic precipitator (ESP) can be a cost-effective approach to reducing indoor particulate exposure, but ESPs produce ozone. The health effect of combined ESP-HEPA filtration has not been examined. We conducted an intervention study in 89 volunteers. At baseline, the air-handling units of offices and residences for all subjects were comprised of coarse, ESP, and HEPA filtration. During the 5-week long intervention, the subjects were split into 2 groups, 1 with just the ESP removed and the other with both the ESP and HEPA removed. Each subject was measured for cardiopulmonary risk indicators once at baseline, twice during the intervention, and once 2 weeks after baseline conditions were restored. Measured indoor and outdoor PM and ozone concentrations, coupled with time-activity data, were used to calculate exposures. Removal of HEPA filters increased 24-hour mean PM exposure by 38 (95% CI: 31, 45) μg/m . Removal of ESPs decreased 24-hour mean ozone exposure by 2.2 (2.0, 2.5) ppb. No biomarkers were significantly associated with HEPA filter removal. In contrast, ESP removal was associated with a -16.1% (-21.5%, -10.4%) change in plasma-soluble P-selectin and a -3.0% (-5.1%, -0.8%) change in systolic blood pressure, suggesting reduced cardiovascular risks.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Combined use of an electrostatic precipitator and a high-efficiency particulate air filter in building ventilation systems: Effects on cardiorespiratory health indicators in healthy adults

Day

Xiang

et al. 2018

Indoor Air

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“…This same assumption also has precedent in a number of other recent studies in the literature that have evaluated mortality endpoints associated with indoor and outdoor PM 2.5 sources [46][47][48]. Additionally, there is mounting evidence from air filter intervention studies in homes that reducing indoor PM 2.5 concentrations (comprising a mixture of both indoor and outdoor sources) can lead to improvements in some biomarkers and other clinical measures that are associated with both short-term and long-term cardiovascular health endpoints [101][102][103][104][105][106][107].…”

Section: Limitationsmentioning

confidence: 99%

A framework for estimating the US mortality burden of fine particulate matter exposure attributable to indoor and outdoor microenvironments

Azimi

Stephens

2018

J Expo Sci Environ Epidemiol

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Exposure to fine particulate matter (PM 2.5 ) is associated with increased mortality. Although epidemiology studies typically use outdoor PM 2.5 concentrations as surrogates for exposure, the majority of PM 2.5 exposure in the US occurs in microenvironments other than outdoors. We develop a framework for estimating the total US mortality burden attributable to exposure to PM 2.5 of both indoor and outdoor origin in the primary non-smoking microenvironments in which people spend most of their time. The framework utilizes an exposure-response function combined with adjusted mortality effect estimates that account for underlying exposures to PM 2.5 of outdoor origin that likely occurred in the original epidemiology populations from which effect estimates are derived. We demonstrate the framework using several different scenarios to estimate the potential magnitude and bounds of the US mortality burden attributable to total PM 2.5 exposure across all nonsmoking environments under a variety of assumptions. Our best estimates of the US mortality burden associated with total PM 2.5 exposure in the year 2012 range from~230,000 to~300,000 deaths. Indoor exposure to PM 2.5 of outdoor origin is typically the largest total exposure, accounting for~40-60% of total mortality, followed by residential exposure to indoor PM 2.5 sources, which also drives the majority of variability in each scenario.

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“…It is reported that ESP could even increase some cardiovascular risks (Day et al, 2017a). Besides, associations between the use of electret air filters and improved cardiorespiratory function were found among adults (Chen R et al, 2015;Chuang et al, 2017). While to the best of our knowledge, the ionization air purifier and its health effects have not been widely explored.…”

Section: Introductionmentioning

confidence: 99%

Different cardiorespiratory effects of indoor air pollution intervention with ionization air purifier: Findings from a randomized, double-blind crossover study among school children in Beijing

Dong

Liu

Chu

et al. 2019

Environmental Pollution

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Indoor air pollution is associated with numerous adverse health outcomes. Air purifiers are widely used to reduce indoor air pollutants. Ionization air purifiers are becoming increasingly popular for their low power consumption and noise, yet its health effects remain unclear. This randomized, double-blind crossover study is conducted to explore the cardiorespiratory effects of ionization air purification among 44 children in Beijing. Real or sham purification was performed in classrooms for 5 weekdays. Size-fractionated particulate matter (PM), black carbon (BC), ozone (O3), and negative air ions (NAI) were monitored, and cardiorespiratory functions were measured. Mixed-effect models were used to establish associations between exposures and health parameters. Real purification significantly decreased PM and BC, e.g. PM0.5, PM2.5, PM10 and BC were dereased by 48%, 44%, 34% and 50% respectively. O3 levels were unchanged, while NAI was increased from 12 to 12,997 cm-3. Real purification was associated with a 4.4% increase in forced exhaled volume in 1 second (FEV1) and a 14.7% decrease in exhaled nitrogen oxide (FeNO). However, heart rate variability (HRV) was altered negatively. Interaction effects of NAI and PM were observed only on HRV, and alterations in HRV were greater with high NAI. Ionization air purifier could bring substantial respiratory benefits, however, the potential negative effects on HRV need further investigation.

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Long-term indoor air conditioner filtration and cardiovascular health: A randomized crossover intervention study

Cited by 116 publications

References 17 publications

Combined use of an electrostatic precipitator and a high-efficiency particulate air filter in building ventilation systems: Effects on cardiorespiratory health indicators in healthy adults

Combined use of an electrostatic precipitator and a high-efficiency particulate air filter in building ventilation systems: Effects on cardiorespiratory health indicators in healthy adults

A framework for estimating the US mortality burden of fine particulate matter exposure attributable to indoor and outdoor microenvironments

Different cardiorespiratory effects of indoor air pollution intervention with ionization air purifier: Findings from a randomized, double-blind crossover study among school children in Beijing

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