The home air in agriculture pediatric intervention (HAPI) trial: Rationale and methods

Masterson, Erin E.; Younglove, Lisa R.; Pérez, Adriana; Torres, Elizabeth; Krenz, Jennifer; French, Maria I. Tchong; Riederer, Anne M.; Sampson, Paul D.; Metwali, Nervana; Min, Esther; Jansen, Karen; Aisenberg, Gino; Babadi, Ryan S.; Farquhar, Stephanie A.; Thorne, Peter S.; Karr, Catherine J.

doi:10.1016/j.cct.2020.106085

Cited by 6 publications

(3 citation statements)

References 66 publications

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“…The HAPI study design and procedures are described in detail in Masterson et al 16 Briefly, we recruited families of children aged 6‐12 years with poorly controlled asthma residing in small rural towns in the Lower Yakima Valley from July 2015 to November 2017. Eligible participants were identified from referrals to the Yakima Valley Farm Worker Clinic (YVFWC) asthma education home visiting program.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of portable HEPA air cleaners on reducing indoor PM _2.5 and NH ₃ in an agricultural cohort of children with asthma: A randomized intervention trial

et al. 2021

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We conducted a randomized trial of portable HEPA air cleaners with pre‐filters designed to also reduce NH3 in non‐smoking homes of children age 6‐12 with asthma in Yakima Valley (Washington, USA). Participants were recruited through the Yakima Valley Farm Workers Clinic asthma education program. All participants received education on home triggers while intervention families additionally received two HEPA cleaners (child's sleeping area, main living area). Fourteen‐day integrated samples of PM2.5 and NH3 were measured at baseline and one‐year follow‐up. We fit ANCOVA models to compare follow‐up concentrations in HEPA vs control homes, adjusting for baseline concentrations. Seventy‐one households (36 HEPA, 35 control) completed the study. Most were single‐family homes, with electric heat and stove, A/C, dogs/cats, and mean (SD) 5.3 (1.8) occupants. In the sleeping area, baseline geometric mean (GSD) PM2.5 was 10.7 (2.3) μg/m3 (HEPA) vs 11.2 (1.9) μg/m3 (control); in the living area, it was 12.5 (2.3) μg/m3 (HEPA) vs 13.6 (1.9) μg/m3 (control). Baseline sleeping area NH3 was 62.4 (1.6) μg/m3 (HEPA) vs 65.2 (1.8) μg/m3 (control). At follow‐up, HEPA families had 60% (95% CI, 41%‐72%; p < .0001) and 42% (19%‐58%; p = .002) lower sleeping and living area PM2.5, respectively, consistent with prior studies. NH3 reductions were not observed.

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Section: Methodsmentioning

confidence: 99%

Effectiveness of portable HEPA air cleaners on reducing indoor PM _2.5 and NH ₃ in an agricultural cohort of children with asthma: A randomized intervention trial

et al. 2021

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“…The HAPI study design and general procedures are detailed in Ref 73. Briefly, we recruited families of children aged 6–12 years with poorly controlled asthma through the Yakima Valley Farm Worker Clinic (YVFWC) asthma education home visiting program from 2015 to 2017.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2021

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We conducted a randomized trial of portable HEPA air cleaners in the homes of children age 6–12 years with asthma in the Yakima Valley, Washington. All families received asthma education while intervention families also received two HEPA cleaners (child's bedroom, living room). We collected 14‐day integrated samples of endotoxin in settled dust and PM10 and PM10‐2.5 in the air of the children's bedrooms at baseline and one‐year follow‐up, and used linear regression to compare follow‐up levels, adjusting for baseline. Seventy‐one families (36 HEPA, 35 control) completed the study. Baseline geometric mean (GSD) endotoxin loadings were 1565 (6.3) EU/m2 and 2110 (4.9) EU/m2, respectively, in HEPA vs. control homes while PM10 and PM10‐2.5 were 22.5 (1.9) μg/m3 and 9.5 (2.9) μg/m3, respectively, in HEPA homes, and 19.8 (1.8) μg/m3 and 7.7 (2.0) μg/m3, respectively, in control homes. At follow‐up, HEPA families had 46% lower (95% CI, 31%–57%) PM10 on average than control families, consistent with prior studies. In the best‐fit heterogeneous slopes model, HEPA families had 49% (95% CI, 6%–110%) and 89% lower (95% CI, 28%–177%) PM10‐2.5 at follow‐up, respectively, at 50th and 75th percentile baseline concentrations. Endotoxin loadings did not differ significantly at follow‐up (4% lower, HEPA homes; 95% CI, −87% to 50%).

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“…Yakima County's air quality is negatively impacted by PM emissions from episodic wildfires in the summer months, and wood stoves used for home heating during cold winter months (VanderSchelden et al, 2017). In addition, ammonium and secondary aerosol production from animal emissions have contributed to poor air quality and motivated several recent studies on pediatric asthma in the region (Loftus et al, 2015;Masterson et al, 2020). Upon inhalation, PM2.5 adversely impacts the respiratory and cardiovascular systems, even causing premature death (World Health Organization, 2017).…”

Section: Introductionmentioning

confidence: 99%

Mental Distress Associated with Air Quality Vulnerability During COVID-19

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Beeson

Morgan³

et al. 2022

EUROPEAN J ENV PUBLI

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Yakima County, Washington is an area with prolonged exposure to poor air quality (PM 2.5) and has been one of the hardest hit counties in cases per capita of COVID-19 in the Western US. The physical health impacts of poor air quality exposure and COVID-19 have been well documented. However, the mental health impacts of these concurrent exposures are unknown. A pilot study (n=232) surveyed households using random-digit-dialing (RDD) in Yakima, County in Dec 2020-Jan 2021 to understand the spread of COVID-19 in vulnerable communities. Air quality behaviors and contexts including home filtration systems and use of community shelters during poor air quality events were measured. Mental distress was measured by the John Hopkins's Mental Distress COVID-19 Community Response Survey. Descriptive data analysis along with Spearman's rank correlation analysis were performed. Nearly half of the sample (45.3%) did not have access to air quality mitigation measures in their homes. The majority of the sample (54.3%) reported wanting to access clean air shelters during major air quality events such as the smoke and wildfire season of 2020. Participants who were unable to mitigate poor air quality in their households as well as those who were unable to access community clean air shelters were observed to have higher levels of mental distress (p<.05). This study adds to the body of evidence that environmental exposures play a significant role in mental health and that compounding impacts of climate change should be studied more in depth. Household interventions should be explored as COVID-19 has brought community protection measures to a halt, while climate change induced natural disasters will only increase in the future.

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The home air in agriculture pediatric intervention (HAPI) trial: Rationale and methods

Cited by 6 publications

References 66 publications

Effectiveness of portable HEPA air cleaners on reducing indoor PM _2.5 and NH ₃ in an agricultural cohort of children with asthma: A randomized intervention trial

Effectiveness of portable HEPA air cleaners on reducing indoor PM _2.5 and NH ₃ in an agricultural cohort of children with asthma: A randomized intervention trial

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

Mental Distress Associated with Air Quality Vulnerability During COVID-19

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The home air in agriculture pediatric intervention (HAPI) trial: Rationale and methods

Cited by 6 publications

References 66 publications

Effectiveness of portable HEPA air cleaners on reducing indoor PM 2.5 and NH 3 in an agricultural cohort of children with asthma: A randomized intervention trial

Effectiveness of portable HEPA air cleaners on reducing indoor PM 2.5 and NH 3 in an agricultural cohort of children with asthma: A randomized intervention trial

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

Mental Distress Associated with Air Quality Vulnerability During COVID-19

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Product

Resources

About

Effectiveness of portable HEPA air cleaners on reducing indoor PM _2.5 and NH ₃ in an agricultural cohort of children with asthma: A randomized intervention trial

Effectiveness of portable HEPA air cleaners on reducing indoor PM _2.5 and NH ₃ in an agricultural cohort of children with asthma: A randomized intervention trial

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