Air Purifiers in Classrooms for Infection Control - a Pilot Study

This study aims to investigate the acceptability and feasibility of deploying air purifiers equipped with HEPA (high-efficiency particulate air) filters in classrooms, to study air purifiers as an infection control measure. It will also evaluate the direct effect of air purifiers on air quality, comparing ceiling-mounted purifiers, portable purifiers and no purifier.

Study Overview

• Status: Active, not recruiting
• Conditions: Feasibility; Acceptability
• Intervention / Treatment: Device: Ceiling-Mounted Air Purifiers; Device: Portable Air Purifiers; Device: Portable or Ceiling Mounted Air Purifiers

Detailed Description

Improved ventilation and air purification have been proposed as promising measures to protect the health of students and children while avoiding future school closures during pandemics. However, there is limited knowledge regarding the effectiveness and potential drawbacks of using air purifiers in educational settings. This pilot study was initiated to explore whether a large study of air purifiers in Norwegian primary school classrooms is feasible and acceptable among teachers and students, and to uncover whether air purifiers can reduce particle density in classrooms and thus potentially decrease the spread of infections.

The results will lay the groundwork for larger-scale trials that could form the basis of knowledge for decision-makers on whether the use of air purifiers should be part of the strategy to limit infections in classrooms while avoiding school closures during future pandemics.

The pilot study consists of two parts. The first part will last six weeks, and focus on the feasibility and acceptability among teachers and students. It will describe and compare two arms - ceiling-mounted (arm 1) and portable (arm 2) air purifiers. The second part lasts nine weeks, and will evaluate the direct effect of air purifiers on air quality. It will compare ceiling-mounted, and portable devices and no purifier(arm 3). The study will involve multiple schools, with a total of six schools contributing eight classrooms. Arm 1 will have two schools and arm 2 will have three schools, each school contributing with one classroom. Arm 3 will have one school, contributing with three classrooms. The classrooms will preferably belong to 7th grade students, but 6th and 5th grade student classrooms will also be accepted, based on the schools preferences. Data collection includes interviews and questionnaires from teachers and students, observations, as well as absenteeism data and air quality measurements.

• Study Type: Interventional
• Enrollment (Actual): 6
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Norway
  • Oslo, Norway
    • Norwegian Institute of Public Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria for Schools in arm 1 and 2:

• Having a classroom in the 5th to 7th grade that either has sufficient floor space to accommodate at least two portable air purifiers or has the infrastructure for the installation of a ceiling-mounted air purifier.
• Having at least 15 students in the relevant classroom.

Inclusion Criteria for Schools in arm 3:

• Having three classrooms at the same floor with sufficient floor space to accommodate at least two portable air purifiers AND with the infrastructure for the installation of a ceiling-mounted air purifier.
• The relevant three classrooms should be slightly comparable with regards to use and air quality. The air quality, as perceived by users, should generally be rated as moderate to poor. which should be medium to poor.

Inclusion Criteria for Students in arm 1 and 2:

• Having a classroom with installed air purifier through the study as their primary classroom.
• Informed consent from both legal guardians.

Inclusion Criteria for Teachers in arm 1, 2, and 3:

• Teaching in the classroom with installed air purifiers at least a few hours per week.
• Providing informed consent.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Ceiling-Mounted Air Purifiers; Classrooms in this arm will have ceiling-mounted air purifiers installed. Air quality will be monitored throughout the study period.	Device: Ceiling-Mounted Air Purifiers; The devices will be turned on every working day except Tuesdays. Air purifiers will be set at levels perceived as acceptable by both teachers and students during operational hours.
Experimental: Portable Air Purifiers; Classrooms in this arm will have portable air purifiers installed. Air quality will be monitored throughout the study period.	Device: Portable Air Purifiers; The devices will be turned on every working day except Tuesdays. Air purifiers will be set at levels perceived as acceptable by both teachers and students during operational hours.
Experimental: Both Portable and Ceiling-Mounted Air Purifiers; Classrooms in this arms will have both portable and ceiling-mounted air purifiers installed. The rooms will alternate weekly between having no air purifiers on, or only ceiling-mounted air purifier on, or only portable air purifier on. Air quality will be monitored throughout the study period.	Device: Portable or Ceiling Mounted Air Purifiers; The Ceiling-Mounted and Portable devices will alternate weekly between being activated and deactivated in the three classrooms. Each classroom will also have three weeks with no purifier activated.This alternating pattern aims to assess the impact of the various air purifiers on air quality. Air purifiers will be set at levels perceived as acceptable by both teachers and students during operational hours.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Effectiveness of air purifiers versus no air purifier on improving air quality in classrooms.	Air quality will be measured using specialized monitors, capturing key indicators such as particulate matter levels. The data collected will enable a comprehensive evaluation of the effectiveness of air purifiers versus no air purifier in improving the overall air quality in educational settings.	9 weeks
Effectiveness of ceiling mounted versus portable air purifier on improving air quality in classrooms.	Air quality will be measured using specialized monitors, capturing key indicators such as particulate matter levels. The data collected will enable a comprehensive evaluation of the effectiveness between ceiling mounted and portable air purifiers in improving the overall air quality in educational settings.	9 weeks
Acceptability of having Air Purifiers in Classrooms	Acceptability will be assessed through the in-depth qualitative interviews with teachers and students, exploring perceptions and challenges associated with the use of air purifiers.	6 weeks
Untoward events when installing air purifiers in classrooms	Experiences will be collected from the personnel involved in installing the air purifiers	2 weeks
Untoward events when running air purifiers in classrooms	Experiences will be collected from class teachers and students through in-depth qualitative interviews at the beginning (only teachers) and the end (teachers and students) of the study period. Observations and experiences from the study team during the study period will be collected and described.	9 weeks
How student absence data can be collected from existing school registration systems.	Experiences from collecting data from the individual schools or from the municipalities, on absence per week per class based on the existing absence systems, will be described.	8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Response rate of class teachers to the study surveys.	Consent will be sought from relevant teachers in part 1 schools, and weekly questionnaires will be sent out. Response rates will be described. Results will be supported by answers to interview questions about motivations and challenges in participating in such surveys.	6 weeks
Response rate of students/their guardians to study surveys.	Consent will be sought from students in part 1 schools, and weekly questionnaires will be sent out. Response rate will be described.	8 weeks
Proportion of absence due to respiratory disease.	Answers to surveys from teachers and students on absence and reasons for absence, from part 1 schools, will be analysed.	8 weeks
Absence frequency among students	Based on the absence data from the schools existing registration systems, we will describe the absence frequency among students in the participating classes.	8 weeks

Collaborators and Investigators

• Sponsor: Norwegian Institute of Public Health
• Collaborators: SINTEF Health Research

Publications and helpful links

Helpful Links

• Study Protocol

Study record dates

Study Major Dates

• Study Start (Actual): January 15, 2024
• Primary Completion (Estimated): May 1, 2024
• Study Completion (Estimated): May 1, 2024

Study Registration Dates

• First Submitted: January 30, 2024
• First Submitted That Met QC Criteria: April 15, 2024
• First Posted (Actual): April 18, 2024

Study Record Updates

• Last Update Posted (Actual): April 18, 2024
• Last Update Submitted That Met QC Criteria: April 15, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: Covid-19; School; Infection Control; Air Purifier
• Additional Relevant MeSH Terms: Infections
• Other Study ID Numbers: 2302888

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No