An updated systematic review and meta-analysis on portable air cleaners and blood pressure: Recommendations for users and manufacturers
Fine particulate matter (PM2.5) air pollution is a leading contributor to the global burden of cardiovascular disease (CVD). One important underlying mechanism is an increase in blood pressure (BP). A growing number of studies have reported a beneficial effect of portable air cleaners (PACs) on syst...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | Ecotoxicology and Environmental Safety |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0147651323007315 |
| _version_ | 1797683209408872448 |
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| author | Sasan Faridi Ryan W. Allen Robert D. Brook Fatemeh Yousefian Mohammad Sadegh Hassanvand Christopher Carlsten |
| author_facet | Sasan Faridi Ryan W. Allen Robert D. Brook Fatemeh Yousefian Mohammad Sadegh Hassanvand Christopher Carlsten |
| author_sort | Sasan Faridi |
| collection | DOAJ |
| description | Fine particulate matter (PM2.5) air pollution is a leading contributor to the global burden of cardiovascular disease (CVD). One important underlying mechanism is an increase in blood pressure (BP). A growing number of studies have reported a beneficial effect of portable air cleaners (PACs) on systolic and diastolic BP; SBP and DBP. We conducted an updated systematic review and meta-analysis of studies using true versus sham mode filtration reporting the effects on BP. Of 214 articles identified up to February 5, 2023, seventeen (from China, USA, Canada, South Korea and Denmark) enrolling approximately 880 participants (484 female) met the inclusion criteria for meta-analyses. Aside from studies conducted in China, research on PACs and BP has been conducted in relatively low pollution settings. Mean indoor PM2.5 concentrations during the active and sham mode purification were 15.9 and 41.2 µg/m3, respectively. The mean efficiency of PACs against indoor PM2.5 was 59.8 % (ranging from 23 % to 82 %). True mode filtration was associated with a pooled mean difference of − 2.35 mmHg (95 % confidence interval [CI]: − 4.5, − 0.2) and − 0.81 mmHg (95 % CI: − 1.86, 0.24) in SBP and DBP, respectively. After removing the studies with high risk of bias, the magnitude of the pooled benefits on SBP and DBP increased to − 3.62 mmHg (95 % CI: − 6.69, − 0.56) and − 1.35 mmHg (95 % CI: − 2.29, − 0.41), respectively. However, there are several barriers to the use of PACs, specifically in low- and middle-income countries (LMICs), such as the initial purchase cost and filter replacements. There may be several avenues to help overcome these economic burdens and improve cost effectiveness, such as implementing government or other subsidized programs to distribute PACs targeting vulnerable and higher-risk individuals. We propose that environmental health researchers and healthcare providers should be better trained to educate the public regarding the use of PACs to reduce the impacts of PM2.5 on cardiometabolic diseases globally. |
| first_indexed | 2024-03-12T00:11:15Z |
| format | Article |
| id | doaj.art-87ef81e9564247719c5950c8e70619ba |
| institution | Directory Open Access Journal |
| issn | 0147-6513 |
| language | English |
| last_indexed | 2024-03-12T00:11:15Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Ecotoxicology and Environmental Safety |
| spelling | doaj.art-87ef81e9564247719c5950c8e70619ba2023-09-16T05:28:14ZengElsevierEcotoxicology and Environmental Safety0147-65132023-09-01263115227An updated systematic review and meta-analysis on portable air cleaners and blood pressure: Recommendations for users and manufacturersSasan Faridi0Ryan W. Allen1Robert D. Brook2Fatemeh Yousefian3Mohammad Sadegh Hassanvand4Christopher Carlsten5Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran; Correspondence to: Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Islamic Republic of Iran.Simon Fraser University, Burnaby, British Columbia, CanadaWayne State University, Detroit, MI, USADepartment of Environmental Health Engineering, Faculty of Health, Kashan University of Medical Sciences, Kashan, Islamic Republic of IranCenter for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of IranAir Pollution Exposure Lab and Legacy for Airway Health, Vancouver Coastal Health Research Institute and University of British Columbia, Vancouver, Canada; Corresponding author.Fine particulate matter (PM2.5) air pollution is a leading contributor to the global burden of cardiovascular disease (CVD). One important underlying mechanism is an increase in blood pressure (BP). A growing number of studies have reported a beneficial effect of portable air cleaners (PACs) on systolic and diastolic BP; SBP and DBP. We conducted an updated systematic review and meta-analysis of studies using true versus sham mode filtration reporting the effects on BP. Of 214 articles identified up to February 5, 2023, seventeen (from China, USA, Canada, South Korea and Denmark) enrolling approximately 880 participants (484 female) met the inclusion criteria for meta-analyses. Aside from studies conducted in China, research on PACs and BP has been conducted in relatively low pollution settings. Mean indoor PM2.5 concentrations during the active and sham mode purification were 15.9 and 41.2 µg/m3, respectively. The mean efficiency of PACs against indoor PM2.5 was 59.8 % (ranging from 23 % to 82 %). True mode filtration was associated with a pooled mean difference of − 2.35 mmHg (95 % confidence interval [CI]: − 4.5, − 0.2) and − 0.81 mmHg (95 % CI: − 1.86, 0.24) in SBP and DBP, respectively. After removing the studies with high risk of bias, the magnitude of the pooled benefits on SBP and DBP increased to − 3.62 mmHg (95 % CI: − 6.69, − 0.56) and − 1.35 mmHg (95 % CI: − 2.29, − 0.41), respectively. However, there are several barriers to the use of PACs, specifically in low- and middle-income countries (LMICs), such as the initial purchase cost and filter replacements. There may be several avenues to help overcome these economic burdens and improve cost effectiveness, such as implementing government or other subsidized programs to distribute PACs targeting vulnerable and higher-risk individuals. We propose that environmental health researchers and healthcare providers should be better trained to educate the public regarding the use of PACs to reduce the impacts of PM2.5 on cardiometabolic diseases globally.http://www.sciencedirect.com/science/article/pii/S0147651323007315Cardiovascular healthBlood pressureAir pollutionParticulate matterPortable air cleaners |
| spellingShingle | Sasan Faridi Ryan W. Allen Robert D. Brook Fatemeh Yousefian Mohammad Sadegh Hassanvand Christopher Carlsten An updated systematic review and meta-analysis on portable air cleaners and blood pressure: Recommendations for users and manufacturers Ecotoxicology and Environmental Safety Cardiovascular health Blood pressure Air pollution Particulate matter Portable air cleaners |
| title | An updated systematic review and meta-analysis on portable air cleaners and blood pressure: Recommendations for users and manufacturers |
| title_full | An updated systematic review and meta-analysis on portable air cleaners and blood pressure: Recommendations for users and manufacturers |
| title_fullStr | An updated systematic review and meta-analysis on portable air cleaners and blood pressure: Recommendations for users and manufacturers |
| title_full_unstemmed | An updated systematic review and meta-analysis on portable air cleaners and blood pressure: Recommendations for users and manufacturers |
| title_short | An updated systematic review and meta-analysis on portable air cleaners and blood pressure: Recommendations for users and manufacturers |
| title_sort | updated systematic review and meta analysis on portable air cleaners and blood pressure recommendations for users and manufacturers |
| topic | Cardiovascular health Blood pressure Air pollution Particulate matter Portable air cleaners |
| url | http://www.sciencedirect.com/science/article/pii/S0147651323007315 |
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