Effects of HEPA air cleaners on unscheduled asthma visits and asthma symptoms for children exposed to secondhand tobacco smoke

Pediatrics. 2011 Jan;127(1):93-101. doi: 10.1542/peds.2009-2312. Epub 2010 Dec 13.

Abstract

Objective: The goal was to test the effects of high-efficiency, particulate-arresting (HEPA) air cleaners on unscheduled asthma visits and symptoms among children with asthma exposed to secondhand smoke.

Methods: We enrolled 225 eligible children who were 6 to 12 years of age, had physician-diagnosed asthma, and were exposed to ≥5 cigarettes per day. We conducted a double-blind, randomized trial. Children were assigned randomly to receive 2 active or inactive HEPA air cleaners.

Results: Of 225 enrolled children, 110 (49%) were assigned to the intervention group and 115 (51%) to the control group; 215 (95%) completed the trial. During the trial, there were 42 fewer unscheduled asthma visits among children in the intervention group (18.5% [95% confidence interval: 1.25%-82.75%]; P = .043), compared with those in the control group, after adjustment for baseline differences. There was a significant difference in the reductions of levels of particles of >0.3 μm according to group assignment; there was a 25% reduction in particle levels in the intervention group, compared with a 5% reduction in the control group (P = .026). There were no significant differences in parent-reported asthma symptoms, exhaled nitric-oxide levels, air nicotine levels, or cotinine levels according to group assignment.

Conclusions: These results hold promise for using HEPA air cleaners as part of a multifaceted strategy to reduce asthma morbidity, but further research is necessary before they can be recommended routinely for the medical management of asthma.

Trial registration: ClinicalTrials.gov NCT00006565.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Air Conditioning* / instrumentation
  • Asthma / diagnosis
  • Asthma / epidemiology*
  • Asthma / etiology
  • Asthma / prevention & control*
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Environmental Exposure / adverse effects*
  • Environmental Exposure / prevention & control*
  • Female
  • Humans
  • Male
  • Tobacco Smoke Pollution / adverse effects*
  • Tobacco Smoke Pollution / prevention & control*

Substances

  • Tobacco Smoke Pollution

Associated data

  • ClinicalTrials.gov/NCT00006565