Portable HEPA filter air cleaner use during pregnancy and children's body mass index at two years of age: The UGAAR randomized controlled trial

Tamana, Sukhpreet K.; Gombojav, Enkhjargal; Kanlic, Adriana; Banzrai, Chimeglkham; Batsukh, Sarangerel; Enkhtuya, Enkhtuul; Boldbaatar, Buyantushig; Lanphear, Bruce P.; Lear, Scott A.; McCandless, Lawrence C.; Venners, Scott A.; Allen, Ryan

doi:10.1016/j.envint.2021.106728

Cited by 10 publications

(9 citation statements)

References 55 publications

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“…Prior studies indicated that the health burdens associated with exposure to air pollution are distributed geographically unevenly and observed to be higher in countries with increasing levels of air pollution [1,34]. It is speculated that the findings on the protection of respiratory risk via a HEPA filter could vary slightly with enhanced levels of PM 2.5 in areas compared to this study [30][31][32][33]. The notable strength of this study suggests the effective protection of HEPA filtersin reducing PM 2.5 associated with respiratory health risks for both male and female groups through the innovative experimental design.…”

Section: Discussionmentioning

confidence: 59%

“…The symptoms of airway resistance and inflammation were reduced in response to the improvements in air quality with the protection of an indoor air filtration system [15,16]. Another study conducted by Tamana and their colleagues [33] demonstrated that improvements in cardiometabolic health in children with a mean age of 23.8 months in Mongolia were found when the exposure to air pollution in their mothers was reduced through a HEPA filter during the gestation period.…”

Section: Discussionmentioning

confidence: 99%

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The Effects of Indoor Air Filter on Reductions in PM2.5 Associated Health Risks of Respiratory Function in Mouse

Yang

Liu

et al. 2022

Atmosphere

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This study aimed to assess whether protective measures could reduce the health risks of air pollution in mice living in the chambers situated at a suburban site in Beijing. The living chambers of mice were divided into four groups: male mice with and without the high-efficiency particulate air (HEPA) filter (male group A and group B), as well as female mice with and without the HEPA filter (female group A and group B). The experiment was carried out from 1 December 2017 to 31 May 2018. Parameters of respiratory function during periods of clean air and air pollution were determined for all groups to evaluate the role of the indoor air filter (i.e., HEPA) in protection against respiratory health risks in mice. Significant differences in minute volumes were observed in male and female groups with versus without the HEPA. Additionally, respiratory health parameters including respiratory rate, duration of breaking, expiratory time, and relaxation time exhibited differences in female groups with HEPA versus without HEPA. Levels of inflammatory factors in the lungs were measured for all groups after 6months of exposure. Greater mean levels of IL-6 and TNF-α were found in the male groups without HEPA than in those with HEPA. Higher average concentrations of IL-6, T-AOC, SOD, GSH-Px, LDH, TNF-α, and TGF-β1 were found in the female group without HEPA than those without HEPA. Our study has proved the effective protection provided by indoor air filters (i.e., HEPA filters) in reducing respiratory health risks associated with PM2.5.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

The Effects of Indoor Air Filter on Reductions in PM2.5 Associated Health Risks of Respiratory Function in Mouse

Yang

Liu

et al. 2022

Atmosphere

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“…However, as we have described in previous publications, there were fewer spontaneous abortions in the intervention group. 1–6…”

Section: Resultsmentioning

confidence: 99%

“…The Ulaanbaatar Gestation and Air Pollution Research (UGAAR) study is a randomized controlled trial of the effects of portable HEPA filter air cleaner use during pregnancy on fetal growth, and child health outcomes in Mongolia’s highly polluted capital city. 1–6 We found that the HEPA cleaner intervention had little effect on birth weight among all live births (23 g difference in mean birth weight; 95% CI: −79, 125 g). 1 However, after adjusting for preterm birth (PTB), defined as birth at less than 37 weeks gestation, we found that the mean birth weight in the intervention group was 88 g (95% CI: 3, 173 g) greater than in the control group.…”

Section: Introductionmentioning

confidence: 83%

Sensitivity analysis for live birth bias in the Ulaanbaatar Gestation and Air Pollution Research study

McCandless

Gombojav

Allen

2022

Environmental Epidemiology

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Background: The Ulaanbaatar Gestation and Air Pollution Research (UGAAR) study is a randomized controlled trial of the effects of portable high efficiency particulate air (HEPA) filter air cleaner use during pregnancy on fetal growth and child health outcomes. A challenge with the study is that the outcome variables cannot be measured in the absence of a live birth. Thus pregnancy loss is a competing event for the outcome variables that can obscure the intervention-outcome relationship. This phenomenon is called “live birth bias” in the epidemiological literature, and it is an example of selection bias due to adjustment for variables affected by previous exposure. Methods: In this investigation, we reanalyzed data from the UGAAR study and examined the impacts of the intervention on three health outcomes: preterm birth (PTB), birth weight, and full-scale IQ (FSIQ) measured with the Wechsler Preschool and Primary Scale of Intelligence III when children were four years old, while accounting for live birth bias. Specifically, we used a novel multiple imputation approach to simulate scenarios in which pregnancy losses had instead been born alive and experienced a range of health outcomes. Results: After accounting for live birth bias, the association between the intervention and PTB diminished. Additionally, the magnitude of intervention effect on birth weight and FSIQ increased. FSIQ was less sensitive to live birth bias than birth weight. Conclusion: We introduced a novel analysis approach to examine the role of live birth bias, and the findings will be useful in environmental epidemiology studies of birth cohorts.

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“…Effects of short-term waterfall forest aerosol air exposure on rat lung proteomics an effective tool to reduce indoor PM levels and improve the cardiorespiratory health of occupants. This effect is achieved mainly through the production of negative oxygen ions by the apparatus (4,5). A study has suggested that negative air ions have "mysterious" health benefits, such as promoting physiological health and boosting the immune system (6).…”

Section: Original Articlementioning

confidence: 99%

Effects of short-term waterfall forest aerosol air exposure on rat lung proteomics

Zhu¹,

Zhao²,

Zhu³

et al. 2022

Ann Transl Med

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Background: Chronic exposure to airborne microparticles has been shown to increase the incidence of several chronic diseases. Previous studies have found that waterfall forest aerosols contribute to a diminished immune stress response in patients with asthma. However, the specific effects of short-term waterfall forest aerosol exposure on lung proteins have not been fully elucidated.Methods: This study used liquid chromatography-tandem mass spectrometry (LC-MS) to analyze changes in protein expression in the lungs of rats exposed to short-term waterfall forest aerosol environments. Specific protein markers were identified using bioconductivity analysis screening and validated using immunohistochemistry.Results: Waterfall forest aerosol environment exposure on day 5 downregulated the expression of the classical inflammatory pathway nuclear factor κB (NF-κB) signaling pathway. As the waterfall forest aerosol environment increased due to the duration of exposure, it was involved in oxidative phosphorylation and then hormone signaling in lung cells from the very beginning. In contrast, at day 15 of exposure, there is an effect on the regulation of the immune-related high-affinity IgE receptor pathway. In addition, iron-sulfur Rieske protein (Uqcrfs1), mitochondrial Tu translation elongation factor (Tufm) and ribosomal protein L4 (Rpl4) were identified as possible bioindicators for the evaluation of air quality.Conclusions: These results provide a comprehensive proteomic analysis that supports the positive contribution of a good air quality environment to lung health.

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Portable HEPA filter air cleaner use during pregnancy and children's body mass index at two years of age: The UGAAR randomized controlled trial

Cited by 10 publications

References 55 publications

The Effects of Indoor Air Filter on Reductions in PM2.5 Associated Health Risks of Respiratory Function in Mouse

The Effects of Indoor Air Filter on Reductions in PM2.5 Associated Health Risks of Respiratory Function in Mouse

Sensitivity analysis for live birth bias in the Ulaanbaatar Gestation and Air Pollution Research study

Effects of short-term waterfall forest aerosol air exposure on rat lung proteomics

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