Abstract
This study characterizes the use of HEPA air filters provided to 89 households participating in an intervention study investigating the respiratory health of children with asthma. Free-standing filters were placed in the child's bedroom and monitored continuously for nearly a year in each household. Filter use was significantly affected by study phase, season, and monitoring week. During the “intensive” weeks when a community education worker and a field technician visited the household, the use rate averaged 70 ± 33 %. During season-long “non-intensive” periods between seasonal visits, use dropped to 34 ± 30 %. Filter use rapidly decreased during the 3 to 4 weeks following each intensive, and was slightly higher in spring, summer, and in the evening and at night when the child was likely to be home, although households did not follow consistent diurnal patterns. While participants expressed an understanding of the benefits of filter use and reported good experiences with them, use rates were low, particularly during unobserved non-intensive periods. The provision of free-standing air filters to individuals or households must be considered an active intervention that requires monitoring and evaluation; otherwise, unknown and unexpected patterns of filter use may alter and possibly bias results due to exposure misclassification.
Similar content being viewed by others
References
Batterman S, Du L, Mentz G, Mukherjee B, Parker E, Godwin C, Chin JY, O'Toole A, Robins T, Rowe Z, Lewis T (2012) Particulate matter concentrations in residences: an intervention study evaluating stand-alone filters and air conditioners. Indoor Air 22(3):235–252
Batterman SA, Yu Y, Jia C, Godwin C (2005) Non-methane hydrocarbon emissions from vehicle fuel caps. Atmos Environ 39(10):1855
Brauner EV, Forchhammer L, Moller P, Barregard L, Gunnarsen L, Afshari A, Wahlin P, Glasius M, Dragsted LO, Basu S, Raaschou-Nielsen O, Loft S (2008) Indoor particles affect vascular function in the aged—an air filtration-based intervention study. Am J Respir Crit Care Med 177(4):419–425
Brehler R, Kutting B, Biel K, Luger T (2003) Positive effects of a fresh air filtration system on hay fever symptoms. Int Arch Allergy Immunol 130(1):60–65
Butz AM, Matsui EC, Breysse P (2011) A randomized trial of air cleaners and a health coach to improve indoor air quality for inner-city children with asthma and secondhand smoke exposure. Archives of Pediatrics & Adolescent Medicine 165(8):741–748
Du L, Batterman S, Godwin C, Chin J-Y, Parker E, Breen M, Brakefield W, Robins T, Lewis T (2012) Air change rates and interzonal flows in residences, and the need for multi-zone models for exposure and health analyses. Int J Environ Res Publ Health 9(12):4639–4661
Du L, Batterman S, Parker EA, Godwin C, Chin J-Y, O'Toole A, Robins TG, Brakefield-Caldwell W, Lewis T (2011) Particle concentrations and effectiveness of free-standing air filters in bedrooms of children with asthma in Detroit, Michigan. Build Environ 46(11):2303–2313
Eggleston PA, Butz A, Rand C, Curtin-Brosnan J, Kanchanaraksa S, Swartz L, Breysse P, Buckley T, Diette G, Merriman B, Krishnan JA (2005) Home environmental intervention in inner-city asthma: a randomized controlled clinical trial. Ann Allergy Asthma Immunol 95(6):518–524
Fisk WJ, Faulkner D, Palonen J, Seppanen O (2002) Performance and costs of particle air filtration technologies. Indoor Air 12(4):223–234
Francis H, Fletcher G, Anthony C, Pickering C, Oldham L, Hadley E, Custovic A, Niven R (2003) Clinical effects of air filters in homes of asthmatic adults sensitized and exposed to pet allergens. Clin Exp Allergy 33(1):101–105
Glanz K, Rimer BK, Viswanath K, Ebrary I (2008) Health behavior and health education: theory, research, and practice. Jossey-Bass, San Francisco
Krieger JW, Song L, Takaro TK, Stout J (2000) Asthma and the home environment of low-income urban children: preliminary findings from the Seattle-King County healthy homes project. J Urban Health 77(1):50–67
Lewis TC, Robins TG, Joseph CLM, Parker EA, Israel BA, Rowe Z, Edgren KK, Salinas MA, Martinez ME, Brown RW (2004) Identification of gaps in the diagnosis and treatment of childhood asthma using a community-based participatory research approach. J Urban Health 81(3):472–488
McDonald E, Cook D, Newman T, Griffith L, Cox G, Guyatt G (2002) Effect of air filtration systems on asthma—a systematic review of randomized trials. Chest 122(5):1535–1542
Morgan WJ, Crain EF, Gruchalla RS, O'Connor GT, Kattan M, Evans RI, Stout J, Malindzak G, Smartt E, Plaut M, Walter M, Vaughn B, Mitchell H, G. Inner-City Asthma Study (2004) “Results of a home-based environmental intervention among urban children with asthma.”. N Engl J Med 351(11):1068–1080
Morris RJ, Helm HJ, Schmid W, Hacker D (2006) A novel air filtration delivery system improves seasonal allergic rhinitis. Allergy Asthma Proc 27(1):63–67
Myatt TA, Minegishi T, Allen JG, MacIntosh DL (2008) Control of asthma triggers in indoor air with air cleaners: a modeling analysis. Environ Heal 7
NHLBI (2007). “National Heart Lung and Blood Institute: Guidelines for the Diagnosis and Management of Asthma (EPR-3).” http://www.nhlbi.nih.gov/guidelines/asthma/index.htm. Accessed 1 July 2013.
O'Toole, A. R., E. Parker, S. Batterman, T. Robins, C. Godwin, S. Grant, L. Du, Z. Rowe and R. G. Lewis (2011). “Factors Affecting Air Filter Usage in Homes of Children with Asthma In Detroit, MI.” http://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2011.183.1_MeetingAbstracts.A3905. Accessed 13–18 May 2011.
Reisman RE (2001) Do air cleaners make a difference in treating allergic disease in homes? Ann Allergy Asthma Immunol 87(6):41–43
Sublett JL (2011) Effectiveness of air filters and air cleaners in allergic respiratory diseases: a review of the recent literature. Curr Allergy Asthm R 11(5):395–402
Sublett JL, Seltzer J, Burkhead R, Williams PB, Wedner HJ, Phipatanakul W (2010) Air filters and air cleaners: rostrum by the American Academy of Allergy, Asthma & Immunology Indoor Allergen Committee. J Allergy Clin Immunol 125(1):32–38
Sulser C, Schulz G, Wagner P, Sommerfeld C, Keil T, Reich A, Wahn U, Lau S (2009) Can the use of HEPA cleaners in homes of asthmatic children and adolescents sensitized to cat and dog allergens decrease bronchial hyperresponsiveness and allergen contents in solid dust? Int Arch Allergy Immunol 148(1):23–30
Van der Heide S, Van Aalderen WMC, Kauffman HF, Dubois AEJ, de Monchy JGR (1999) Clinical effects of air cleaners in homes of asthmatic children sensitized to pet allergens. J Allergy Clin Immunol 104(2):447–451
VanderHeide S, Kauffman HF, Dubois AEJ, deMonchy JGR (1997) Allergen reduction measures in houses of allergic asthmatic patients: effects of air-cleaners and allergen-impermeable mattress covers. Eur Respir J 10(6):1217–1223
Verrall B, Muir DCF, Wilson WM, Milner R, Johnston M, Dolovich J (1988) Laminar-flow air cleaner bed attachment—a controlled trial. Ann Allergy 61(2):117–122
Warburton CJ, Niven RM, Pickering CAC, Fletcher AM, Hepworth J, Francis HC (1994) Domiciliary air filtration units, symptoms and lung-function in atopic asthmatics. Respir Med 88(10):771–776
Wood RA, Johnson EF, Van Natta ML, Chen PH, Eggleston PA (1998) A placebo-controlled trial of a HEPA air cleaner in the treatment of cat allergy. Am J Respir Crit Care Med 158(1):115–120
Xu Y, Raja S, Ferro AR, Jaques PA, Hopke PK, Gressani C, Wetzel LE (2010) Effectiveness of heating, ventilation and air conditioning system with HEPA filter unit on indoor air quality and asthmatic children's health. Build Environ 45(2):330–337
Acknowledgments
We thank our study participants, our Detroit and Ann Arbor staff, including Sonya Grant, Leonard Brakefield, Dennis Fair, Ricardo de Majo, Christopher Godwin, Feng-Chiao Su, Graciela Mentz, Shi Li, Ashley O'Toole, Laprisha Berry Vaughn, CESs, interviewers, and our Community Action Against Asthma (CAAA) partners (Arab Community Center for Economic and Social Services; Community Health & Social Services Center; Detroit Hispanic Development Corporation; Detroiters Working for Environmental Justice; Friends of Parkside; Latino Family Services; Warren/Conner Development Coalition; the Detroit Institute of Population Health, Southwest Detroit Environmental Vision, and the University of Michigan Schools of Public Health and Medicine). This study was conducted as part of NIEHS grant R01-ES014566-01A1 and R01-ES014566-04S1, “A Community Based Participatory Research Intervention for Childhood Asthma Using Air Filters and Air Conditioners.” Additional support was provided by grant P30ES017885 from the National Institute of Environmental Health Sciences, National Institutes of Health.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
ESM 1
(DOCX 280 kb)
Rights and permissions
About this article
Cite this article
Batterman, S., Du, L., Parker, E. et al. Use of free-standing filters in an asthma intervention study. Air Qual Atmos Health 6, 759–767 (2013). https://doi.org/10.1007/s11869-013-0216-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11869-013-0216-9