Written by Kimiko Dunbar
Spoon Feed
Multi-setting air purification in the home and at school improves pulmonary function and reduces markers of airway inflammation in children.
Let’s clear the air
Air pollution is linked to increased risk of respiratory disease. Air purification systems were invented to mitigate this exposure and improve lung health, although little data exist on efficacy in children. This cluster randomized, double-blind crossover trial assessed the impact of multi-setting (meaning both at home and school) air purification on respiratory health in 79 school-aged children (10–12 years) in China. Children from two classrooms in one primary school were enrolled. Participants from group 1 received true air purification during the first intervention stage, followed by a 2 month wash-out period over summer break, and then sham air purification during the second intervention stage. Participants from group 2 received the opposite (i.e. sham purification, washout, true purification). Air purification using machines with HEPA filtration reduced air particle exposure by 45.14% and significantly improved pulmonary function (improvement in FEV1 by 8.04%, peak expiratory flow (PEF) by 16.52%), while decreasing airway inflammation (fractional exhaled nitric oxide (FENO) decreased by 22.38%). FENO levels are thought to be markers of elevated airway inflammation, with higher levels indicative of higher inflammation. This study is limited by the small sample size and relatively homogeneous population of students, which restricts generalizability. Findings highlight the importance of indoor air purification in reducing pediatric respiratory morbidity in high-pollution areas.
How will this change my practice?
While this study has a small sample size with questionable generalizability, I think it’s pretty compelling and certainly supports the use of air purifiers with HEPA filtration. I’ll definitely advise families to use air purifiers, especially in regions of high air pollution or with comorbidities such as asthma or prematurity. I don’t think we can guarantee patient access to HEPA filtration in the home and in school (as was done in this study), but extrapolating from this study, it seems HEPA filtration in the bedroom at least probably makes a difference.
Source
Respiratory Benefits of Multisetting Air Purification in Children: A Cluster Randomized Crossover Trial. JAMA Pediatr. 2025 Feb 1;179(2):122-128. doi: 10.1001/jamapediatrics.2024.5049. PMID: 39621320
