Use of Portable Air Cleaners in Washington State Schools: A Qualitative Analysis Based on the Technology Acceptance Model.

BACKGROUND: The US government allocated over $2.5 billion in "Elementary and Secondary School Emergency Relief (ESSER)" funds to Washington State for COVID-19 response and ventilation improvements. Despite available funding, gaps persist in supporting schools to successfully use portable air cleaners (PACs). We evaluated PAC needs within King County, Washington and characterized factors influencing schools' purchase and use of PACs. METHODS: Public Health-Seattle & King County (PHSKC) assessed school's ventilation systems and IAQ improvements through a survey (N = 17). Separately, semi-structured interviews (N = 13) based on the technology acceptance model (TAM) were conducted with school personnel. A thematic analysis using inductive and deductive coding was conducted and logistic regression models assessed the predictive capability of the TAM. RESULTS: The PHSKC survey findings informed our recommendations. Positive attitudes, knowledge, and beliefs in ease of use and effectiveness of PACs were facilitators to PAC use. While barriers included a lack of training, education, and concerns about PAC maintenance and sustainability. TAM constructs of perceived usefulness (PU) and perceived ease of use (PEU) were predictive of having the intention to use PACs in schools. CONCLUSIONS: There is a critical need for solutions to circumvent challenges to implementing PACs in schools. This characterization provides insight for promoting PAC use in IAQ-impacted schools.

Quantification of Byproduct Formation from Portable Air Cleaners Using a Proposed Standard Test Method.

In response to the COVID-19 pandemic, air cleaning technologies were promoted as useful tools for disinfecting public spaces and combating airborne pathogen transmission. However, no standard method exists to assess the potentially harmful byproduct formation from air cleaners. Through a consensus standard development process, a draft standard test method to assess portable air cleaner performance was developed, and a suite of air cleaners employing seven different technologies was tested. The test method quantifies not only the removal efficiency of a challenge chemical suite and ultrafine particulate matter but also byproduct formation. Clean air delivery rates (CADRs) are used to quantify the chemical and particle removal efficiencies, and an emission rate framework is used to quantify the formation of formaldehyde, ozone, and other volatile organic compounds. We find that the tested photocatalytic oxidation and germicidal ultraviolet light (GUV) technologies produced the highest levels of aldehyde byproducts having emission rates of 202 and 243 µg h-1, respectively. Additionally, GUV using two different wavelengths, 222 and 254 nm, both produced ultrafine particulate matter.

Self-reported health impacts of do-it-yourself air cleaner use in a smoke-impacted community.

Background: Smoke exposure from wildfires or residential wood burning for heat is a public health problem for many communities. Do-It-Yourself (DIY) portable air cleaners (PACs) are promoted as affordable alternatives to commercial PACs, but evidence of their effect on health outcomes is limited. Objective: Pilot test an evaluation of the effect of DIY PAC usage on self-reported symptoms, and investigate barriers and facilitators of PAC use, among members of a tribal community that routinely experiences elevated concentrations of fine particulate matter (PM2.5) from smoke. Methods: We conducted studies in Fall 2021 ("wildfire study"; N = 10) and Winter 2022 ("wood stove study"; N = 17). Each study included four sequential one-to-two-week phases: 1) initial, 2) DIY PAC usage ≥8 h/day, 3) commercial PAC usage ≥8 h/day, and 4) air sensor with visual display and optional PAC use. We continuously monitored PAC usage and indoor/outdoor PM2.5 concentrations in homes. Concluding each phase, we conducted phone surveys about participants' symptoms, perceptions, and behaviors. We analyzed symptoms associated with PAC usage and conducted an analysis of indoor PM2.5 concentrations as a mediating pathway using mixed effects multivariate linear regression. We categorized perceptions related to PACs into barriers and facilitators of use. Results: No association was observed between PAC usage and symptoms, and the mediation analysis did not indicate that small observed trends were attributable to changes in indoor PM2.5 concentrations. Small sample sizes hindered the ability to draw conclusions regarding the presence or absence of causal associations. DIY PAC usage was low; loud operating noise was a barrier to use. Discussion: This research is novel in studying health effects of DIY PACs during wildfire and wood smoke exposures. Such research is needed to inform public health guidance. Recommendations for future studies on PAC use during smoke exposure include building flexibility of intervention timing into the study design.

An updated systematic review and meta-analysis on portable air cleaners and blood pressure: Recommendations for users and manufacturers.

Fine particulate matter (PM2.5) air pollution is a leading contributor to the global burden of cardiovascular disease (CVD). One important underlying mechanism is an increase in blood pressure (BP). A growing number of studies have reported a beneficial effect of portable air cleaners (PACs) on systolic and diastolic BP; SBP and DBP. We conducted an updated systematic review and meta-analysis of studies using true versus sham mode filtration reporting the effects on BP. Of 214 articles identified up to February 5, 2023, seventeen (from China, USA, Canada, South Korea and Denmark) enrolling approximately 880 participants (484 female) met the inclusion criteria for meta-analyses. Aside from studies conducted in China, research on PACs and BP has been conducted in relatively low pollution settings. Mean indoor PM2.5 concentrations during the active and sham mode purification were 15.9 and 41.2 µg/m3, respectively. The mean efficiency of PACs against indoor PM2.5 was 59.8 % (ranging from 23 % to 82 %). True mode filtration was associated with a pooled mean difference of - 2.35 mmHg (95 % confidence interval [CI]: - 4.5, - 0.2) and - 0.81 mmHg (95 % CI: - 1.86, 0.24) in SBP and DBP, respectively. After removing the studies with high risk of bias, the magnitude of the pooled benefits on SBP and DBP increased to - 3.62 mmHg (95 % CI: - 6.69, - 0.56) and - 1.35 mmHg (95 % CI: - 2.29, - 0.41), respectively. However, there are several barriers to the use of PACs, specifically in low- and middle-income countries (LMICs), such as the initial purchase cost and filter replacements. There may be several avenues to help overcome these economic burdens and improve cost effectiveness, such as implementing government or other subsidized programs to distribute PACs targeting vulnerable and higher-risk individuals. We propose that environmental health researchers and healthcare providers should be better trained to educate the public regarding the use of PACs to reduce the impacts of PM2.5 on cardiometabolic diseases globally.

Multi-objective optimization of mechanical ventilation with the aid of purifiers in two scenarios: Regular operation and mitigating the spread of respiratory infectious diseases.

COVID-19 and its impact on society have raised concerns about scaling up mechanical ventilation (MV) systems and the energy consequences. This paper attempted to combine MV and portable air cleaners (PACs) to achieve acceptable indoor air quality (IAQ) and energy reduction in two scenarios: regular operation and mitigating the spread of respiratory infectious diseases (RIDs). We proposed a multi-objective optimization method that combined the NSGA-II and TOPSIS techniques to determine the total equivalent ventilation rate of the MV-PAC system in both scenarios. The concentrations of PM2.5 and CO2 were primary indicators for IAQ. The modified Wells-Riley equation was adopted to predict RID transmissions. An open office with an MV-PAC system was used to demonstrate the method's applicability. Meanwhile, a field study was conducted to validate the method and evaluate occupants' perceptions of the MV-PAC system. Results showed that optimal solutions of the combined system can be obtained based on various IAQ requirements, seasons, outdoor conditions, etc. For regular operation, PACs were generally prioritized to maintain IAQ while reducing energy consumption even when outdoor PM2.5 concentration was high. MV can remain constant or be reduced at low occupancies. In RID scenarios, it is possible to mitigate transmissions when the quanta were < 48 h-1. No significant difference was found in the subjective perception of the MV and PACs. Moreover, the effects of infiltration on the optimal solution can be substantial. Nonetheless, our results suggested that an MV-PAC system can replace the MV system for offices for daily use and RID mitigation. Electronic Supplementary Material ESM: The Appendix is available in the online version of this article at 10.1007/s12273-023-0999-z.

Principal stratification analysis to determine health benefit of indoor air pollution reduction in a randomized environmental intervention in COPD: Results from the CLEAN AIR study.

BACKGROUND: Indoor air quality represents a modifiable exposure to Chronic Obstructive Pulmonary Disease (COPD) health. In a randomized controlled trial (CLEAN AIR study), air cleaner assignment had causal effect in improving COPD outcomes. It is unclear, however, what is the treatment effect among those for whom intervention reduced air pollution and whether it was reduction in fine particulate matter (PM2.5) or nitrogen dioxide (NO2) that contributed to such improvement. Because pollution is a posttreatment variable, treatment effect cannot be assessed while controlling for pollution using intention-to-treat (ITT) analysis. OBJECTIVE: Using principal stratification method, we assess indoor pollutants as the intermediate variable, and determine the causal effect of reducing indoor air pollution on COPD health. METHOD: In randomized controlled trial, former smokers with COPD received either active or placebo HEPA air cleaners and were followed for 6 months. Saint George's Respiratory Questionnaire (SGRQ) was the primary outcome and secondary measures included SGRQ subscales, COPD assessment test (CAT), dyspnea (mMRC), and breathlessness, cough, and sputum scale (BCSS). Indoor PM2.5 and NO2 were measured. Principal stratification analysis was performed to assess the treatment effect while controlling for pollution reduction. RESULTS: Among those showing at least 40 % PM2.5 reduction through air cleaners, the intervention showed improvement in respiratory symptoms for the active (vs. placebo), and the size of treatment effect shown for this subgroup was larger than that for the overall sample. In this subgroup, those with active air cleaners (vs. placebo) showed 7.7 points better SGRQ (95%CI: -14.3, -1.1), better CAT (ß = -5.5; 95%CI: -9.8, -1.2), mMRC (ß = -0.6; 95%CI: -1.1, -0.1), and BCSS (ß = -1.8; 95%CI: -3.0, -0.5). Among those showing at least 40 % NO2 reduction through air cleaners, there was no intervention difference in outcomes. CONCLUSION: Air cleaners caused clinically significant improvement in respiratory health for individuals with COPD through reduction in indoor PM2.5. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02236858.

The implementation of portable air-cleaning technologies in healthcare settings - a scoping review.

The COVID-19 pandemic revealed opportunities to improve prevention practices in healthcare settings, mainly related to the spread of airborne microbes (also known as bioaerosols). This scoping review aimed to map methodologies used to assess the implementation of portable air cleaners in healthcare settings, identify gaps, and propose recommendations for future research. The protocol was registered in the Open Science Framework and reported following the checklist provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis - an extension for Scoping Reviews (PRISMA-ScR) statement. The search strategy was performed in five databases and one grey literature source. At the last selection phase, 24 articles that fulfilled our inclusion criteria were summarized and disseminated. Of these, 17 studies were conducted between 2020 and 2022; one of them was a protocol of a multicentre randomized controlled trial. The outcomes measured among the studies include airborne microbe counts, airborne particle concentrations, and rate of infections/interventions. The leading healthcare settings assessed were dental clinics (28%), patient's wards (16%), operating rooms (16%), and intensive care units (12%). Most of the devices demonstrated a significant potential to mitigate the impact of bioaerosols. Although some indoor air quality parameters can influence the mechanics of aerosols, only a few studies controlled these parameters in their analyses. Future clinical research should assess the rate of infections through randomized controlled trials with long-term follow-up and large sample sizes to determine the clinical importance of the findings.

Can air purification improve sleep quality? A 2-week randomised-controlled crossover pilot study in healthy adults.

Insufficient quantity and quality of sleep is a public health concern that can be addressed by interventions for improving sleep outcomes. Environmental factors such as poor air quality are a potential target for intervention, particularly in light of associations between air pollution and worse sleep. The aim of this pilot study was to investigate the effects of using an air purifier on sleep outcomes and mood in 30 healthy adults. There were two conditions: (i) air purifier with a high-efficiency particulate air filter; (ii) air purifier with a placebo filter. Participants undertook both conditions, each over 2 weeks with a 2-week washout, following a counterbalanced, double-blind design. Daily sleep outcomes were measured with actigraphy watches and sleep diaries, whilst daily mood was assessed with the Positive and Negative Affect Schedule. The Insomnia Severity Index, the Pittsburgh Sleep Quality Index, and symptoms of anxiety and depression were measured pre- and post-. The purifier filter was associated with increased total sleep time for an average of 12 min per night, and increased total time in bed for an average of 19 min per night relative to the placebo. There were several sleep and mood outcomes for which no changes were observed, and time awake after sleep onset was higher for the purifier filter. Air quality was better during the high-efficiency particulate air filter condition. These findings offer positive indications that environmental interventions that improve air quality can have benefits for sleep outcomes in healthy populations who are not exhibiting clinical sleep disturbances.

HEPA filters of portable air cleaners as a tool for the surveillance of SARS-CoV-2.

Studies about the identification of SARS-CoV-2 in indoor aerosols have been conducted in hospital patient rooms and to a lesser extent in nonhealthcare environments. In these studies, people were already infected with SARS-CoV-2. However, in the present study, we investigated the presence of SARS-CoV-2 in HEPA filters housed in portable air cleaners (PACs) located in places with apparently healthy people to prevent possible outbreaks. A method for detecting the presence of SARS-CoV-2 RNA in HEPA filters was developed and validated. The study was conducted for 13 weeks in three indoor environments: school, nursery, and a household of a social health center, all in Ciudad Real, Spain. The environmental monitoring of the presence of SARS-CoV-2 was conducted in HEPA filters and other surfaces of these indoor spaces for a selective screening in asymptomatic population groups. The objective was to limit outbreaks at an early stage. One HEPA filter tested positive in the social health center. After analysis by RT-PCR of SARS-CoV-2 in residents and healthcare workers, one worker tested positive. Therefore, this study provides direct evidence of virus-containing aerosols trapped in HEPA filters and the possibility of using these PACs for environmental monitoring of SARS-CoV-2 while they remove airborne aerosols and trap the virus.

Patterns and Predictors of Air Cleaner Adherence Among Adults with COPD.

Rational: Poor indoor air quality has been associated with worse chronic obstructive pulmonary disease (COPD) morbidity. In-home portable air cleaners reduce indoor pollutants and could improve respiratory health. Factors associated with air cleaner adherence among adults with COPD remains unknown. Methods: In a 6-month trial of former smokers with COPD, participants (n=116) received active or sham portable air cleaners. Air cleaner adherence was measured by electronic monitors. Potential baseline predictors of adherence included individual factors (demographics, socioeconomic status, smoking history, psychological well-being), COPD disease severity, and housing characteristics. Time and season were also considered. Stepwise logistic regression and longitudinal fixed effect analysis were performed to assess independent predictors of adherence. Results: A total of 109 participants had an objective measure of adherence, and 76.1% used at least 1 air cleaner 80% of the time (defined a priori as adherent). Higher annual household income ≥$35,000 (odds ratio [OR]=4.4, 95% confidence interval [CI], 1.1-18.0) and use of heat pump/electricity (versus gas) for heating (OR=6.1, 95%CI, 1.7-22.4) were associated with higher odds of adherence. Further, poor quality of life (St George's Respiratory Questionnaire, per 10-point increase) and prior year exacerbations were associated with lower odds of adherence (OR=0.65, 95%CI, 0.4-1.0) and (OR=0.26, 95%CI, 0.1-0.9), respectively. Adherence was highest during the first month and lower during winter compared to other seasons. Conclusion: These findings suggest that cold weather season, use of gas for home heating, and lower annual income negatively impact adherence. Poor quality of life and worse disease control may also decrease adherence. Addressing factors associated with air cleaner adherence should be considered when designing future environmental studies.

Reductions in particulate matter concentrations resulting from air filtration: A randomized sham-controlled crossover study.

One-hundred seventy-two households were recruited from regions with high outdoor air pollution (Fresno and Riverside, CA) to participate in a randomized, sham-controlled, cross-over study to determine the effectiveness of high-efficiency air filtration to reduce indoor particle exposures. In 129 households, stand-alone HEPA air cleaners were placed in a bedroom and in the main living area. In 43 households, high-efficiency MERV 16 filters were installed in central forced-air heating and cooling systems and the participating households were asked to run the system on a clean-air cycle for 15 min per hour. Participating households that completed the study received true air filtration for a year and sham air filtration for a year. Air pollution samples were collected at approximately 6-month intervals, with two measurements in each of the sham and true filtration periods. One week indoor and outdoor time-integrated samples were collected for measurement of PM2.5 , PM10 , and ultrafine particulate matter (UFP) measured as PM0.2 . Reflectance measurements were also made on the PM2.5 filters to estimate black carbon. True filtration significantly improved indoor air quality, with a 48% reduction in the geometric mean indoor PM0.2 and PM2.5 concentrations, and a 31% reduction in PM10 . Geometric mean concentrations of indoor/outdoor reflectance values, indicating fraction of particles of outdoor origin remaining indoors, decreased by 77%. Improvements in particle concentrations were greater with continuously operating stand-alone air cleaners than with intermittent central system filtration. Keeping windows closed and increased utilization of the filtration systems further improved indoor air quality.

Is hydrogen peroxide an effective mouthwash for reducing the viral load of SARS-CoV-2 in dental clinics?

BACKGROUND: Previous studies have demonstrated that SARS-CoV-2 is mainly transmitted by inhalation of aerosols and can remain viable in the air for hours. Viruses can spread in dental settings and put professionals and patients at high risk of infection due to proximity and aerosol-generating procedures, and poor air ventilation. OBJECTIVES: The aim of this study was to investigate the effects of a 1% hydrogen peroxide (H2O2) mouth rinse on reducing the intraoral SARS-CoV-2 load. METHODS: Portable air cleaners with HEPA filters exposed for 3 months were analysed to test for virus presence in a waiting room (where patients wore a face mask but did not undergo mouth rinsing) and three treatment rooms (where patients wore no mask but carried out mouth rinsing). As CO2 is co-exhaled with aerosols containing SARS-CoV-2 by COVID-19 infected people, we also measured CO2 as a proxy of infection risk indoors. Specific primer and probe RT-PCR were applied to detect viral genomes of the SARS-CoV-2 virus in the filters. Specifically, we amplified the nucleocapsid gene (Nuclv) of SARS-CoV-2. RESULTS: CO2 levels ranged from 860 to 907 ppm, thus indicating low ventilation and the risk of COVID-19 transmission. However, we only found viral load in filters from the waiting room and not from the treatment rooms. The results revealed the efficiency of 1-minute mouth rinsing with 1% H2O2 since patients rinsed their mouths immediately after removing their mask in the treatment rooms. CONCLUSIONS: Our findings suggest that dental clinics would be safer and more COVID-19 free by implementing mouth rinsing 1 min with 1% H2O2 immediately after the patients arrive at the clinic.

Are the Portable Air Cleaners (PAC) really effective to terminate airborne SARS-CoV-2?

The transmission of SARS-CoV-2 virus through aerosols has become an outstanding issue, where plenty of spread aspects are being analyzed. Portable Air Cleaners (PAC) with high-efficiency particulate air (HEPA) filters have been discussed as an adjunctive means for indoor environments coronavirus decontamination. This study evaluates, first, the air and surfaces SARS-COV-2 RNA contamination due to positive patients in households, and second, the efficiency of a PAC with HEPA filter to eliminate virus. A total of 29 air and surface samples were collected inside 9 households, by using an air portable collector with gelatin filters and swabs. SARS-CoV-2 RNA detection was performed using real-time reverse transcription polymerase chain reaction (RT-PCR). Overall, all the air samples collected before using PAC and 75% of swab samples were positive for SARS-CoV-2. After the PAC usage, all samples except one were negative, displaying a 80% device effectiveness. Portable HEPA cleaners usage allowed the removal of SARS CoV-2 and, therefore, they could be recommended for places with inadequate ventilation, considering the limitations and functionality of the device.

Personal exposure monitoring of PM2.5 among US diplomats in Kathmandu during the COVID-19 lockdown, March to June 2020.

The 2019 Novel Coronavirus SARS-CoV 2 (COVID-191) pandemic has severely impacted global health, safety, economic development and diplomacy. The government of Nepal issued a lockdown order in the Kathmandu Valley for 80 days from 24 March to 11 June 2020. This paper reports associated changes in ambient PM2.5 measured at fixed-site monitors and changes in personal exposure to PM2.5 monitored by APT Minima by four American diplomats who completed monitoring before and during lockdown (24 h for each period per person, 192 person-hours in total). Time activities and use of home air pollution mitigation measures (use of room air cleaners (RACs), sealing of homes) were recorded by standardized diary. We compared PM2.5 exposure level by microenvironment (home (cooking), home (other activities), at work, commuting, other outdoor environment) in terms of averaged PM2.5 concentration and the contribution to cumulative personal exposure (the product of PM2.5 concentration and time spent in each microenvironment). Ambient PM2.5 measured at fixed-sites in the US Embassy and in Phora Durbar were 38.2% and 46.7% lower than during the corresponding period in 2017-2019. The mean concentration of PM2.5 to which US diplomats were exposed was very much lower than the concentrations of ambient levels measured at fixed site monitors in the city both before and during lockdown. Within-person comparisons suggest personal PM2.5 exposure was 50.0% to 76.7% lower during lockdown than before it. Time spent outdoors and cooking at home were large contributors to cumulative personal exposure. Low indoor levels of PM2.5 were achieved at work and home through use of RACs and measures to seal homes against the ingress of polluted air from outside. Our observations indicate the potential reduction in exposure to PM2.5 with large-scale changes to mainly fossil-fuel related emissions sources and through control of indoor environments and activity patterns.

Does Air Filtration Work for Cat Allergen Exposure?

PURPOSE OF REVIEW: The goal of this review is to compress all important information and results of the research in reducing cat allergen exposure using air filtration. Fel d 1 is the major allergen responsible for IgE responses in 90 to 95% of patients with cat allergy. RECENT FINDINGS: Reduction of cat allergen in indoor air with different air filtration systems and portable devices has been demonstrated in the majority of the studies. Recently, early and late asthmatic responses were significantly reduced using portable HEPA air cleaners in an environmental exposure chamber. This review provides a comprehensive overview of the current state of airborne Fel d 1 air filtration targeting the most efficient devices in cat allergen reduction. Novel emerging HEPA filters are targeting reduction of cat indoor asthma trigger so patient can might benefit from efficient solution.

Efficacy of air cleaners in asthmatics allergic to cat in ALYATEC® environmental exposure chamber.

BACKGROUND: Air cleaners have been promoted for respiratory allergic disease prevention, but there is no clear clinical proof of their efficacy in allergic asthma. OBJECTIVE: To examine the efficacy of a new air cleaner on early and late asthmatic responses in cat-allergic patients. METHODS: This randomized, cross-over, double-blind placebo-controlled study enrolled 24 cat-asthmatic patients with GINA 1 asthma. At baseline, participants were exposed to 40 ng/m3 of airborne cat allergen for a maximum of 2 hours in ALYATEC® environmental exposure chamber (EEC). All participants were subsequently randomized into two groups that were exposed to cat allergen, either with active then placebo air cleaners or with placebo then active air cleaners with a 3-week interval in the EEC. This study was registered under number (NCT03928561). RESULTS: Fewer patients experienced an EAR with active air cleaners (seven patients; 29.17%) than placebo (21 patients; 87.50%). The response incidence was lower with active than with placebo air cleaners. A Cox model demonstrated a significant treatment effect (hazard ratio, 0.10; P = .002). Active air cleaners also prevented late asthmatic response: four patients (16.67%) had a late asthmatic response with active air cleaners compared to 11 patients (45.83%) with placebo (Prescott test P = .002). Active air cleaners also decreased the maximal severity of bronchial response (FEV1 decrease of 17.24% with active vs 25.62% with placebo air cleaners; P = .001). CONCLUSIONS: Our present results demonstrated that Intense Pure Air XL® air cleaners significantly prevented early and late asthmatic responses among cat-allergic asthmatics during cat allergen exposure in the ALYATEC® EEC.

¿Cuál es el efecto en salud de instalar equipos de purificación de aire en establecimientos educacionales para reducir el impacto negativo de la contaminación del aire con compuestos orgánicos volátiles?: síntesis rápida de evidencia / what is the health effect of installing air purification equipment in educational establishments to reduce the negative impact of air pollution with volatile organic compounds?: a rapid evidence synthesis

ANTECEDENTES Y OBJETIVO La contaminación del aire es un importante factor de riesgo y un crucial elemento que contribuye a la carga de enfermedad a nivel global, además de tener una incidencia directa sobre la calidad de vida de la población. Los contaminantes en el aire han sido evaluados como un riesgo, particularmente para niños de edad escolar. En este contexto un asesor del presidente de la República de Chile solicita esta síntesis de evidencia, con el objetivo de conocer si la instalación de purificadores o filtros de aire reduciría el efecto que la contaminación del aire tendría sobre la salud de la población en zonas afectadas por este problema ambiental. METODOLOGÍA Se formuló una estrategia de búsqueda la cual se utilizó en las bases de datos HealthSystemsEvidence, SocialSystemsEvidence, Epistemonikos, PubMed, Campbell Collaboration y la Collaboration for Environmental Evidence con el objetivo de identificar revisiones sistemáticas que abordaran la pregunta formulada. Al no encontrar revisiones que respondieran a la pregunta específica, se buscó estudios primarios en PubMed y EMBASE, los que son presentados en esta síntesis. Se incluyeron todos los tipos de filtros o purificadores de aire, que sean instalados en establecimientos educacionales. No se consideraron equipos destinados a reducir las concentraciones de microorganismos, y estudios que utilizaban únicamente pacientes con asma, alergias u otras condiciones de salud. De igual forma, se excluyeron estudios que midieran la eficiencia de los equipos o que fueran utilizados en otros ambientes distintos a escuelas. RESULTADOS Se utilizan 4 estudios primarios, de los cuales se obtuvieron los siguientes resultados: -No se encontró evidencia del efecto de la instalación de purificadores de aire en establecimientos educacionales sobre la salud de la población afectada. -Los equipos utilizados para purificar el aire tienen, en general, una capacidad limitada para reducir la concentración de compuestos orgánicos volátiles (COV). Más aún, en algunos de los estudios contemplados, la concentración de COV se incrementó. -Sería relevante monitorear el impacto que estos dispositivos tendrían sobre los niños, considerando que éstos solo estarían expuestos una parte del día al aire purificado por estos equipos.

Portable air cleaners should be at the forefront of the public health response to landscape fire smoke.

Landscape fires can produce large quantities of smoke that degrade air quality in both remote and urban communities. Smoke from these fires is a complex mixture of fine particulate matter and gases, exposure to which is associated with increased respiratory and cardiovascular morbidity and mortality. The public health response to short-lived smoke events typically advises people to remain indoors with windows and doors closed, but does not emphasize the use of portable air cleaners (PAC) to create private or public clean air shelters. High efficiency particulate air filters and electrostatic precipitators can lower indoor concentrations of fine particulate matter and improve respiratory and cardiovascular outcomes. We argue that PACs should be at the forefront of the public health response to landscape fire smoke events.

Experimental Study on Ultrafine Particle Removal Performance of Portable Air Cleaners with Different Filters in an Office Room.

Size- and time-dependent aerodynamic behaviors of indoor particles, including PM1.0, were evaluated in a school office in order to test the performance of air-cleaning devices using different filters. In-situ real-time measurements were taken using an optical particle counter. The filtration characteristics of filter media, including single-pass efficiency, volume and effectiveness, were evaluated and analyzed. The electret filter (EE) medium shows better initial removal efficiency than the high efficiency (HE) medium in the 0.3-3.5 µm particle size range, while under the same face velocity, the filtration resistance of the HE medium is several times higher than that of the EE medium. During service life testing, the efficiency of the EE medium decreased to 60% with a total purifying air flow of 25 × 104 m³/m². The resistance curve rose slightly before the efficiency reached the bottom, and then increased almost exponentially. The single-pass efficiency of portable air cleaner (PAC) with the pre-filter (PR) or the active carbon granule filter (CF) was relatively poor. While PAC with the pre-filter and the high efficiency filter (PR&HE) showed maximum single-pass efficiency for PM1.0 (88.6%), PAC with the HE was the most effective at removing PM1.0. The enhancement of PR with HE and electret filters augmented the single-pass efficiency, but lessened the airflow rate and effectiveness. Combined with PR, the decay constant of large-sized particles could be greater than for PACs without PR. Without regard to the lifetime, the electret filters performed better with respect to resource saving and purification improvement. A most penetrating particle size range (MPPS: 0.4-0.65 µm) exists in both HE and electret filters; the MPPS tends to become larger after HE and electret filters are combined with PR. These results serve to provide a better understanding of the indoor particle removal performance of PACs when combined with different kinds of filters in school office buildings.

Portable photocatalytic air cleaners: efficiencies and by-product generation.

Portable photocatalytic air cleaners were investigated in 24 and 48 m(3) emission test chambers with regard to efficiency and by-product generation. For this purpose, formaldehyde, decane, 1,2-dichlorobenzene, toluene, α-pinene and heptanal were doped at sub-ppm concentration levels into the chambers individually and in mixtures. By way of specified test protocols, efficiencies could be distinguished but were strongly dependant on the choice of test compounds, especially on whether single or multi compound dosing was used, and on long-term effects. Initial clean air delivery rates (CADRs) up to 137 m(3)/h were measured. Typical by-products were found in significant concentrations. The main ones were formaldehyde up to 50 ppb (62 µg/m(3)) and acetone up to 80 ppb (190 µg/m(3)). Other aldehydes were also found, but at smaller levels. The detection of chloroacetone, a strong irritating compound, at concentrations up to 15 ppb (57 µg/m(3)) strengthens the importance of such investigations especially in cases were chloro-organic compounds are involved.