The Home Air in Agriculture Pediatric Intervention (HAPI) trial: rationale and methods.

Details

• Personal Author:
  Aisenberg G ; Babadi RS ; Farquhar SA ; Jansen KL ; Karr CJ ; Krenz JE ; Masterson EE ; Metwali N ; Min E ; Perez A ; Riederer AM ; Sampson PD ; Tchong French MI ; Thorne PS ; Torres E ; Younglove LB
• Description:
  Background: Data addressing air quality effects on children with asthma in rural U.S. communities are rare. Our community engaged research partnership previously demonstrated associations between neighborhood NH3 and ambient PM2.5 and asthma in the agricultural lower Yakima Valley of Washington. As a next step, the partnership desired an intervention approach to address concerns about pediatric asthma in this largely Latino immigrant, farm worker community. Objective: The Home Air in Agriculture Pediatric Intervention (HAPI) sought to examine the effectiveness of enrichment of an existing asthma education program with portable high-efficiency particulate air (HEPA) cleaners designed to reduce PM2.5 and NH3. We investigated the effect of this enriched approach on these exposures and asthma health measures. Design: We randomized children with poorly controlled asthma to a control arm (current asthma education program) or an intervention arm (current asthma education program + placement of two indoor air cleaners in the family's home). Outcomes included (1) 14-day integrated samples of indoor air contaminants (PM2.5 and NH3) at baseline and one-year follow-up and (2) child asthma health metrics at baseline, midpoint (4-6 months) and one-year follow-up. These included the Asthma Control Test, symptoms days, clinical utilization, oral corticosteroid use, pulmonary function, fractional exhaled nitric oxide, and urinary leukotriene E4 concentration. Discussion: To our knowledge, this is the first randomized HEPA cleaner intervention designed to assess NH3 as well as PM2.5 and to evaluate health outcomes of children with asthma in an agricultural region. [Description provided by NIOSH]
• Subjects:
  Agriculture Air Pollutants, Occupational Air Pollution Air Pollution, Indoor Asthma Asthma, Occupational Community Health Services Environmental Exposure Farmers Occupational Health Safety

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• Keywords:
  Agricultural Industry; Agriculture; Children; Environmental Exposure; Farm Workers; Community Health; Air Quality; Asthma; Indoor Air Pollution; HEPA Filters; High-efficiency Particulate Air Filters; Author Keywords: Asthma; Pediatrics; Environmental Exposure; Air Pollutants; Agricultural Workers' Diseases; Air Filter
• ISSN:
  1551-7144
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Iowa ; OSHA Region 10 ; OSHA Region 7 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  96
• NIOSHTIC Number:
  nn:20065429
• Citation:
  Contemp Clin Trials 2020 Sep; 96:106085
• Contact Point Address:
  Erin E. Masterson, Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States of America
• Email:
  emaster@uw.edu
• CAS Registry Number:
  Ammonia (CAS RN 7664-41-7)
• Federal Fiscal Year:
  2020
• NORA Priority Area:
  Agriculture, Forestry and Fishing
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20010930
• Source Full Name:
  Contemporary Clinical Trials
• End Date:
  20270929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:85549c9e933ef75920ea942d14a6b2dbaa163f7e8dd352208bd4f43333c9dd12557cf13d010d8ea09b4a8802a71bf27f61dd183cd04b92cfb2ed94b8b28afe53
• Download URL:
  https://stacks.cdc.gov/view/cdc/249433/cdc_249433_DS1.pdf
• File Type:
  [PDF - 820.12 KB ]