Abstract
BackgroundExposure to particulate air pollution increases respiratory and cardiovascular morbidity and mortality, especially in elderly, possibly through inflammation and vascular dysfunction.MethodsWe 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.ResultsThe 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.ConclusionSubstantial 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.
Highlights
Exposure to particulate air pollution increases respiratory and cardiovascular morbidity and mortality, especially in elderly, possibly through inflammation and vascular dysfunction
The air filtration intervention in the 27 study homes resulted in a reduction of 30% in Particle number concentrations (PNC) in the living room and close to 50% of PM2.5 in both living room and bedroom (Table 2)
The reductions in polycyclic aromatic hydrocarbons (PAH), black carbon (BC) and ultraviolet-absorbing particulate matter (UVPM) were similar to the PM2.5 reduction
Summary
Exposure to particulate air pollution increases respiratory and cardiovascular morbidity and mortality, especially in elderly, possibly through inflammation and vascular dysfunction. Exposure to particulate air pollution increases mortality and morbidity related to respiratory and cardiovascular diseases especially among susceptible individuals such as the elderly and people with pre-existing lung- and heart disease [1]. The underlying biological mechanisms are considered to include oxidative stress and inflammation For cardiovascular disease these mechanisms include the pulmonary release of inflammatory and vasoactive molecules into the circulation, altered cardiac autonomic function, altered balance between coagulation and fibrinolysis, endothelial and microvascular dysfunction, atherosclerosis progression and plaque instability [2]. Biomarkers related to risk of cardiovascular and other diseases appear more strongly associated with personal exposure to particles than with ambient particulate air pollution levels [10,11]. Substantial reductions in exposure to particles can be achieved by portable air filtration units in the indoor environment allowing assessment of causality, understanding mechanistic endpoints, identification of relevant sources and development of large scale long-term interventions in relevant risk groups
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