Author + information
- Received December 20, 2014
- Revision received March 15, 2015
- Accepted March 19, 2015
- Published online June 2, 2015.
- Renjie Chen, PhD∗,†,‡,
- Ang Zhao, MS∗,
- Honglei Chen, PhD§,
- Zhuohui Zhao, PhD∗,
- Jing Cai, PhD∗,
- Cuicui Wang, MS∗,
- Changyuan Yang, MS∗,
- Huichu Li, MS∗,
- Xiaohui Xu, PhD‖,
- Sandie Ha, PhD‖,
- Tiantian Li, PhD¶ and
- Haidong Kan, PhD∗,†,‡∗ ()
- ∗School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
- †Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China
- ‡Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
- §Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
- ‖Department of Epidemiology, College of Public Health and Health Professional and College of Medicine, University of Florida, Gainesville, Florida
- ¶Institute of Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing, China
- ↵∗Reprint requests and correspondence:
Dr. Haidong Kan, Department of Environmental Health, School of Public Health, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai 200032, China.
Background Indoor exposure to fine particulate matter (PM2.5) from outdoor sources is a major health concern, especially in highly polluted developing countries such as China. Few studies have evaluated the effectiveness of indoor air purification on the improvement of cardiopulmonary health in these areas.
Objectives This study sought to evaluate whether a short-term indoor air purifier intervention improves cardiopulmonary health.
Methods We conducted a randomized, double-blind crossover trial among 35 healthy college students in Shanghai, China, in 2014. These students lived in dormitories that were randomized into 2 groups and alternated the use of true or sham air purifiers for 48 h with a 2-week washout interval. We measured 14 circulating biomarkers of inflammation, coagulation, and vasoconstriction; lung function; blood pressure (BP); and fractional exhaled nitric. We applied linear mixed-effect models to evaluate the effect of the intervention on health outcome variables.
Results On average, air purification resulted in a 57% reduction in PM2.5 concentration, from 96.2 to 41.3 μg/m3, within hours of operation. Air purification was significantly associated with decreases in geometric means of several circulating inflammatory and thrombogenic biomarkers, including 17.5% in monocyte chemoattractant protein-1, 68.1% in interleukin-1β, 32.8% in myeloperoxidase, and 64.9% in soluble CD40 ligand. Furthermore, systolic BP, diastolic BP, and fractional exhaled nitrous oxide were significantly decreased by 2.7%, 4.8%, and 17.0% in geometric mean, respectively. The impacts on lung function and vasoconstriction biomarkers were beneficial but not statistically significant.
Conclusions This intervention study demonstrated clear cardiopulmonary benefits of indoor air purification among young, healthy adults in a Chinese city with severe ambient particulate air pollution. (Intervention Study on the Health Impact of Air Filters in Chinese Adults; NCT02239744)
- air pollution
- air purification
- cardiovascular health
- pulmonary health
- randomized controlled trial
The National Natural Science Foundation of China (81222036), China Medical Board Collaborating Program (13-152), Cyrus Tang Foundation (CTF-FD2014001), and Public Welfare Research Program of National Health and Family Planning Commission of China (201402022) supported this study. Dr. H. Chen is supported by the intramural research program of the U.S. National Institutes of Health, National Institute of Environmental Health Sciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Dr. R. Chen and Mr. Zhao contributed equally to this work.
- Received December 20, 2014.
- Revision received March 15, 2015.
- Accepted March 19, 2015.
- American College of Cardiology Foundation