An indoor air filtration study in homes of elderly: cardiovascular and respiratory effects of exposure to particulate matter

Dorina Gabriela Karottki, Michal Spilak, Marie Frederiksen, Lars Gunnarsen, Elvira Vaclavik Brauner, Barbara Kolarik, Zorana Jovanovic Andersen, Torben Sigsgaard, Lars Barregard, Bo Strandberg, Gerd Sallsten, Peter Møller, Steffen Loft, Dorina Gabriela Karottki, Michal Spilak, Marie Frederiksen, Lars Gunnarsen, Elvira Vaclavik Brauner, Barbara Kolarik, Zorana Jovanovic Andersen, Torben Sigsgaard, Lars Barregard, Bo Strandberg, Gerd Sallsten, Peter Møller, Steffen Loft

Abstract

Background: Exposure to particulate air pollution increases respiratory and cardiovascular morbidity and mortality, especially in elderly, possibly through inflammation and vascular dysfunction.

Methods: We examined potential beneficial effects of indoor air filtration in the homes of elderly, including people taking vasoactive drugs.Forty-eight nonsmoking subjects (51 to 81 years) in 27 homes were included in this randomized, double-blind, crossover intervention study with consecutive two-week periods with or without the inclusion of a high-efficiency particle air filter in re-circulating custom built units in their living room and bedroom. We measured blood pressure, microvascular and lung function and collected blood samples for hematological, inflammation, monocyte surface and lung cell damage markers before and at day 2, 7 and 14 during each exposure scenario.

Results: The particle filters reduced the median concentration of PM2.5 from approximately 8 to 4 μg/m3 and the particle number concentration from 7669 to 5352 particles/cm3. No statistically significant effects of filtration as category were observed on microvascular and lung function or the biomarkers of systemic inflammation among all subjects, or in the subgroups taking (n = 11) or not taking vasoactive drugs (n = 37). However, the filtration efficacy was variable and microvascular function was within 2 days significantly increased with the actual PM2.5 decrease in the bedroom, especially among 25 subjects not taking any drugs.

Conclusion: Substantial exposure contrasts in the bedroom and no confounding by drugs appear required for improved microvascular function by air filtration, whereas no other beneficial effect was found in this elderly population.

Figures

Figure 1
Figure 1
Percent change with 95% confidence interval in microvascular function corresponding to a 10 μg/m3 decrease in PM2.5 in the bedroom and living room after 2, 7 and 14 days of active filtration and all 3 days combined, estimated by mixed-effects models adjusted for baseline level, BMI, age and gender.

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