A Randomized Cross-over Air Filtration Intervention Trial for Reducing Cardiovascular Health Risks in Residents of Public Housing near a Highway.

Luz Padró-Martínez,Carrie Brown,Mkaya Mwamburi,Ellen Reisner,Wig Zamore,Matthew Simon,Doug Brugge,Emmanuel Owusu,John Durant,Mei Chung

doi:10.3390/ijerph120707814

Abstract

Exposure to traffic-generated ultrafine particles (UFP; particles <100 nm) is likely a risk factor for cardiovascular disease. We conducted a trial of high-efficiency particulate arrestance (HEPA) filtration in public housing near a highway. Twenty residents in 19 apartments living <200 m from the highway participated in a randomized, double-blind crossover trial. A HEPA filter unit and a particle counter (measuring particle number concentration (PNC), a proxy for UFP) were installed in living rooms. Participants were exposed to filtered air for 21 days and unfiltered air for 21 days. Blood samples were collected and blood pressure measured at days 0, 21 and 42 after a 12-hour fasting period. Plasma was analyzed for high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor alpha-receptor II (TNF-RII) and fibrinogen. PNC reductions ranging from 21% to 68% were recorded in 15 of the apartments. We observed no significant differences in blood pressure or three of the four biomarkers (hsCRP, fibrinogen, and TNF-RII) measured in participants after 21-day exposure to HEPA-filtered air compared to measurements after 21-day exposure to sham-filtered air. In contrast, IL-6 concentrations were significantly higher following HEPA filtration (0.668 pg/mL; CI = 0.465–0.959) compared to sham filtration. Likewise, PNC adjusted for time activity were associated with increasing IL-6 in 14- and 21-day moving averages, and PNC was associated with decreasing blood pressure in Lags 0, 1 and 2, and in a 3-day moving average. These negative associations were unexpected and could be due to a combination of factors including exposure misclassification, unsuccessful randomization (i.e., IL-6 and use of anti-inflammatory medicines), or uncontrolled confounding. Studies with greater reduction in UFP levels and larger sample sizes are needed. There also needs to be more complete assessment of resident time activity and of outdoor vs. indoor source contributions to UFP exposure. HEPA filtration remains a promising, but not fully realized intervention.

Highlights

Ultrafine particles (UFP; diameter ≤0.1 μm) in urban air derive from many anthropogenic sources—e.g., combustion of biogenic and fossil fuels, condensation of organic vapors, tire wear, brake wear, aerosol sprays, cigarette smoking, and cooking [1,2,3,4]
We found no evidence that participants turned off the high-efficiency particulate arrestance (HEPA) units, an important consideration in long-term HEPA filtration studies [45]
PNC reductions achieved by HEPA filtration in the apartments (Figure 2 and Table 2) were much smaller than those achieved in the unoccupied, furnished bedroom (Figure A2 and Table A1)

Summary

Introduction

Ultrafine particles (UFP; diameter ≤0.1 μm) in urban air derive from many anthropogenic sources—e.g., combustion of biogenic and fossil fuels, condensation of organic vapors, tire wear, brake wear, aerosol sprays, cigarette smoking, and cooking [1,2,3,4]. While the health impacts of exposure to UFP are less well understood compared to exposure to larger particles (e.g., PM2.5, diameter ≤ 2.5 μm [5,6,7,8]), there is concern that UFP could be toxic. Due to their small size, they can penetrate deeply into the lungs [9] and into the blood stream [10].

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