Use of free-standing filters in an asthma intervention study
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This study characterizes the use of HEPA air filters provided to 89 households participating in an intervention study investigating the respiratory health of children with asthma. Free-standing filters were placed in the child's bedroom and monitored continuously for nearly a year in each household. Filter use was significantly affected by study phase, season, and monitoring week. During the “intensive” weeks when a community education worker and a field technician visited the household, the use rate averaged 70 ± 33 %. During season-long “non-intensive” periods between seasonal visits, use dropped to 34 ± 30 %. Filter use rapidly decreased during the 3 to 4 weeks following each intensive, and was slightly higher in spring, summer, and in the evening and at night when the child was likely to be home, although households did not follow consistent diurnal patterns. While participants expressed an understanding of the benefits of filter use and reported good experiences with them, use rates were low, particularly during unobserved non-intensive periods. The provision of free-standing air filters to individuals or households must be considered an active intervention that requires monitoring and evaluation; otherwise, unknown and unexpected patterns of filter use may alter and possibly bias results due to exposure misclassification.
KeywordsAir quality Behavior HEPA Indoor environment Intervention Exposure misclassification
We thank our study participants, our Detroit and Ann Arbor staff, including Sonya Grant, Leonard Brakefield, Dennis Fair, Ricardo de Majo, Christopher Godwin, Feng-Chiao Su, Graciela Mentz, Shi Li, Ashley O'Toole, Laprisha Berry Vaughn, CESs, interviewers, and our Community Action Against Asthma (CAAA) partners (Arab Community Center for Economic and Social Services; Community Health & Social Services Center; Detroit Hispanic Development Corporation; Detroiters Working for Environmental Justice; Friends of Parkside; Latino Family Services; Warren/Conner Development Coalition; the Detroit Institute of Population Health, Southwest Detroit Environmental Vision, and the University of Michigan Schools of Public Health and Medicine). This study was conducted as part of NIEHS grant R01-ES014566-01A1 and R01-ES014566-04S1, “A Community Based Participatory Research Intervention for Childhood Asthma Using Air Filters and Air Conditioners.” Additional support was provided by grant P30ES017885 from the National Institute of Environmental Health Sciences, National Institutes of Health.
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