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

Details

• Personal Author:
  Bernert, John T. ; Breysse P ; Butz AM ; Curtin-Brosnan J ; Diette G ; Eggleston P ; Matsui EC ; Rand C ; Williams D ; Yuan J
• Description:
  Objective: To test an air cleaner and health coach intervention to reduce secondhand smoke exposure compared with air cleaners alone or no air cleaners in reducing particulate matter (PM), air nicotine, and urine cotinine concentrations and increasing symptom-free days in children with asthma residing with a smoker. Design: Randomized controlled trial, with randomization embedded in study database. Settings: The Johns Hopkins Hospital Children's Center and homes of children. Participants: Children with asthma, residing with a smoker, randomly assigned to interventions consisting of air cleaners only (n = 41), air cleaners plus a health coach (n = 41), or delayed air cleaner (control) (n = 44). Main Outcome Measures: Changes in PM, air nicotine, and urine cotinine concentrations and symptom-free days during the 6-month study. Results: The overall follow-up rate was high (91.3%). Changes in mean fine and coarse PM (PM2.5 and PM2.5-10) concentrations (baseline to 6 months) were significantly lower in both air cleaner groups compared with the control group (mean differences for PM2.5 concentrations: control, 3.5 microg/m3; air cleaner only, -19.9 microg/m3; and air cleaner plus health coach, -16.1 microg/m3; P = .003; and PM2.5-10 concentrations: control, 2.4 microg/m3; air cleaner only, -8.7 microg/m3; and air cleaner plus health coach, -10.6 microg/m3; P = .02). No differences were noted in air nicotine or urine cotinine concentrations. The health coach provided no additional reduction in PM concentrations. Symptom-free days were significantly increased in both air cleaner groups compared with the control group (P = .03). Conclusion: Although the use of air cleaners can result in a significant reduction in indoor PM concentrations and a significant increase in symptom-free days, it is not enough to prevent exposure to secondhand smoke. [Description provided by NIOSH]
• Subjects:
  Air Pollution, Indoor Asthma Asthma, Occupational Environmental Exposure Nicotine Occupational Health Particulate Matter Respiratory System Respiratory Tract Diseases Safety
• Keywords:
  Children Cigarette Smoke Environmental Exposure IAQ Indoor Air Quality Intervention Effectiveness Particulates Respiratory Diseases Secondhand Smoke
• ISSN:
  1072-4710
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Georgia ; Maryland ; OSHA Region 3 ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  165
• Issue:
  8
• NIOSHTIC Number:
  nn:20062706
• Citation:
  Arch Pediatr Adolesc Med 2011 Aug; 165(8):741-748
• Contact Point Address:
  Arlene M. Butz, ScD, MSN, CPNP, Division of General Pediatrics, Department of Pediatrics, The Johns Hopkins University School of Medicine, 200 N Wolfe St, Baltimore, MD 21287
• Email:
  abutz@jhmi.edu
• CAS Registry Number:
  (-)-Nicotine (CAS RN 54-11-5)
• Federal Fiscal Year:
  2011
• Performing Organization:
  Johns Hopkins University
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Archives of Pediatrics and Adolescent Medicine
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1a911fe729dd58044fcebef73fa5c1e3214752c4e15f150453310801f76a5d6c1ff2af6f09f10c1a49fce8c3b91714112b2b99253d9b0f92b53fe23d3e7881d9
• Download URL:
  https://stacks.cdc.gov/view/cdc/225901/cdc_225901_DS1.pdf
• File Type:
  [PDF - 284.78 KB ]