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The effect of portable HEPA filter air cleaners on indoor PM2.5 concentrations and second hand tobacco smoke exposure among pregnant women in Ulaanbaatar, Mongolia: The UGAAR randomized controlled trial.
Sci Total Environ. 2018 Feb 15; 615:1379-1389.ST

Abstract

BACKGROUND

Portable HEPA filter air cleaners can reduce indoor fine particulate matter (PM2.5), but their use has not been adequately evaluated in high pollution settings. We assessed air cleaner effectiveness in reducing indoor residential PM2.5 and second hand smoke (SHS) exposures among non-smoking pregnant women in Ulaanbaatar, Mongolia.

METHODS

We randomized 540 participants to an intervention group receiving 1 or 2 HEPA filter air cleaners or a control group receiving no air cleaners. We followed 259 intervention and 253 control participants to the end of pregnancy. We measured one-week indoor residential PM2.5 concentrations in early (~11weeks gestation) and late (~31weeks gestation) pregnancy and collected outdoor PM2.5 data from centrally-located government monitors. We assessed blood cadmium in late pregnancy. Hair nicotine was quantified in a subset (n=125) to evaluate blood cadmium as a biomarker of SHS exposure. We evaluated air cleaner effectiveness using mixed effects and multiple linear regression models and used stratified models and interaction terms to evaluate potential modifiers of effectiveness.

RESULTS

The overall geometric mean (GM) one-week outdoor PM2.5 concentration was 47.9μg/m3 (95% CI: 44.6, 51.6μg/m3), with highest concentrations in winter (118.0μg/m3; 110.4, 126.2μg/m3). One-week indoor and outdoor PM2.5 concentrations were correlated (r=0.69). Indoor PM2.5 concentrations were 29% (21, 37%) lower in intervention versus control apartments, with GMs of 17.3μg/m3 (15.8, 18.8μg/m3) and 24.5μg/m3 (22.2, 27.0μg/m3), respectively. Air cleaner effectiveness was greater when air cleaners were first deployed (40%; 31, 48%) than after approximately five months of use (15%; 0, 27%). Blood cadmium concentrations were 14% (4, 23%) lower among intervention participants, likely due to reduced SHS exposure.

CONCLUSIONS

Portable HEPA filter air cleaners can lower indoor PM2.5 concentrations and SHS exposures in highly polluted settings.

Authors+Show Affiliations

Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada. Electronic address: pkbarn@sfu.ca.School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia. Electronic address: enkhjargal@mnums.edu.mn.School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia. Electronic address: chimedsuren@mnums.edu.mn.Sukhbaatar District Health Center, 11 Horoo, Tsagdaagiin Gudamj, Sukhbaatar District, Ulaanbaatar, Mongolia.Mongolian National Center for Public Health, Olympic Street 2, Ulaanbaatar, Mongolia. Electronic address: bolor@ncph.gov.mn.School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia.School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia.School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia.Mongolian National Center for Public Health, Olympic Street 2, Ulaanbaatar, Mongolia. Electronic address: tsogtbaatar@ncph.gov.mn.edu.mn.School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo N2L 3G1, Canada. Electronic address: craig.janes@uwaterloo.ca.School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver V6T 1Z3, Canada. Electronic address: patti.janssen@ubc.ca.Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada. Electronic address: blanphear@sfu.ca.Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada. Electronic address: ttakaro@sfu.ca.Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada. Electronic address: scott_venners@sfu.ca.Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada. Electronic address: glenys_webster@sfu.ca.Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada. Electronic address: wyuchi@sfu.ca.New York State Department of Health, Wadsworth Center, Albany, NY, PO Box 509, 12201, USA; School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, NY 12144, USA. Electronic address: christopher.palmer@health.ny.gov.New York State Department of Health, Wadsworth Center, Albany, NY, PO Box 509, 12201, USA; School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, NY 12144, USA. Electronic address: patrick.parsons@health.ny.gov.College of Health Sciences, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada. Electronic address: allenr@sfu.ca.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

29751442

Citation

Barn, Prabjit, et al. "The Effect of Portable HEPA Filter Air Cleaners On Indoor PM2.5 Concentrations and Second Hand Tobacco Smoke Exposure Among Pregnant Women in Ulaanbaatar, Mongolia: the UGAAR Randomized Controlled Trial." The Science of the Total Environment, vol. 615, 2018, pp. 1379-1389.
Barn P, Gombojav E, Ochir C, et al. The effect of portable HEPA filter air cleaners on indoor PM2.5 concentrations and second hand tobacco smoke exposure among pregnant women in Ulaanbaatar, Mongolia: The UGAAR randomized controlled trial. Sci Total Environ. 2018;615:1379-1389.
Barn, P., Gombojav, E., Ochir, C., Laagan, B., Beejin, B., Naidan, G., Boldbaatar, B., Galsuren, J., Byambaa, T., Janes, C., Janssen, P. A., Lanphear, B. P., Takaro, T. K., Venners, S. A., Webster, G. M., Yuchi, W., Palmer, C. D., Parsons, P. J., Roh, Y. M., & Allen, R. W. (2018). The effect of portable HEPA filter air cleaners on indoor PM2.5 concentrations and second hand tobacco smoke exposure among pregnant women in Ulaanbaatar, Mongolia: The UGAAR randomized controlled trial. The Science of the Total Environment, 615, 1379-1389. https://doi.org/10.1016/j.scitotenv.2017.09.291
Barn P, et al. The Effect of Portable HEPA Filter Air Cleaners On Indoor PM2.5 Concentrations and Second Hand Tobacco Smoke Exposure Among Pregnant Women in Ulaanbaatar, Mongolia: the UGAAR Randomized Controlled Trial. Sci Total Environ. 2018 Feb 15;615:1379-1389. PubMed PMID: 29751442.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of portable HEPA filter air cleaners on indoor PM2.5 concentrations and second hand tobacco smoke exposure among pregnant women in Ulaanbaatar, Mongolia: The UGAAR randomized controlled trial. AU - Barn,Prabjit, AU - Gombojav,Enkhjargal, AU - Ochir,Chimedsuren, AU - Laagan,Bayarkhuu, AU - Beejin,Bolor, AU - Naidan,Gerel, AU - Boldbaatar,Buyantushig, AU - Galsuren,Jargalsaikhan, AU - Byambaa,Tsogtbaatar, AU - Janes,Craig, AU - Janssen,Patricia A, AU - Lanphear,Bruce P, AU - Takaro,Tim K, AU - Venners,Scott A, AU - Webster,Glenys M, AU - Yuchi,Weiran, AU - Palmer,Christopher D, AU - Parsons,Patrick J, AU - Roh,Young Man, AU - Allen,Ryan W, Y1 - 2017/10/17/ PY - 2017/08/06/received PY - 2017/09/20/revised PY - 2017/09/27/accepted PY - 2018/5/13/entrez PY - 2018/5/13/pubmed PY - 2018/7/11/medline KW - Cadmium KW - HEPA KW - Intervention KW - PM(2.5) KW - RCT KW - SHS SP - 1379 EP - 1389 JF - The Science of the total environment JO - Sci Total Environ VL - 615 N2 - BACKGROUND: Portable HEPA filter air cleaners can reduce indoor fine particulate matter (PM2.5), but their use has not been adequately evaluated in high pollution settings. We assessed air cleaner effectiveness in reducing indoor residential PM2.5 and second hand smoke (SHS) exposures among non-smoking pregnant women in Ulaanbaatar, Mongolia. METHODS: We randomized 540 participants to an intervention group receiving 1 or 2 HEPA filter air cleaners or a control group receiving no air cleaners. We followed 259 intervention and 253 control participants to the end of pregnancy. We measured one-week indoor residential PM2.5 concentrations in early (~11weeks gestation) and late (~31weeks gestation) pregnancy and collected outdoor PM2.5 data from centrally-located government monitors. We assessed blood cadmium in late pregnancy. Hair nicotine was quantified in a subset (n=125) to evaluate blood cadmium as a biomarker of SHS exposure. We evaluated air cleaner effectiveness using mixed effects and multiple linear regression models and used stratified models and interaction terms to evaluate potential modifiers of effectiveness. RESULTS: The overall geometric mean (GM) one-week outdoor PM2.5 concentration was 47.9μg/m3 (95% CI: 44.6, 51.6μg/m3), with highest concentrations in winter (118.0μg/m3; 110.4, 126.2μg/m3). One-week indoor and outdoor PM2.5 concentrations were correlated (r=0.69). Indoor PM2.5 concentrations were 29% (21, 37%) lower in intervention versus control apartments, with GMs of 17.3μg/m3 (15.8, 18.8μg/m3) and 24.5μg/m3 (22.2, 27.0μg/m3), respectively. Air cleaner effectiveness was greater when air cleaners were first deployed (40%; 31, 48%) than after approximately five months of use (15%; 0, 27%). Blood cadmium concentrations were 14% (4, 23%) lower among intervention participants, likely due to reduced SHS exposure. CONCLUSIONS: Portable HEPA filter air cleaners can lower indoor PM2.5 concentrations and SHS exposures in highly polluted settings. SN - 1879-1026 UR - https://www.unboundmedicine.com/medline/citation/29751442/The_effect_of_portable_HEPA_filter_air_cleaners_on_indoor_PM2_5_concentrations_and_second_hand_tobacco_smoke_exposure_among_pregnant_women_in_Ulaanbaatar_Mongolia:_The_UGAAR_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0048-9697(17)32642-6 DB - PRIME DP - Unbound Medicine ER -