Division of Cardiovascular Medicine, Michigan Medicine, Ann Arbor (Messrs Bard and Bryant, Drs Rubenfire and Brook, and Ms Fink); Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor (Dr Wang and Mss Speth and Zhou); and Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing (Dr Morishita).
J Cardiopulm Rehabil Prev. 2020 Jul;40(4):276-279. doi: 10.1097/HCR.0000000000000516.
Fine particulate matter (PM2.5) air pollution is a leading risk factor for cardiovascular disease. Even low levels common to millions of Americans pose health risks. However, no study has tested protective measures such as in-home portable air cleaners (PACs) among at-risk cardiac patients. We conducted a pilot phase of the Cardiac Rehabilitation Air Filter Trial (CRAFT)-a randomized, double-blind, crossover study of outpatient cardiac rehabilitation patients at Michigan Medicine.
During a routine visit, patients were provided with 2 PACs to run continuously for 5 d in both the bedroom and the main living space. PACs were randomized as active (with HEPA filter) versus sham. On day 4, subjects wore a personal PM2.5 monitor for 24-hr without activity restrictions. After a 1-wk washout, patients crossed over to the opposite mode.
Patients (n = 20; 4 women) were elderly (70.8 ± 9.6 yr) nonsmokers with cardiovascular disease living near the facility (10.7 ± 6.0 mi). Compared with sham, active in-home PAC use significantly lowered personal-level 24-hr PM2.5 exposures by 43.8% (-12.2 μg·m; 95% CI, -24.2 to -0.2). Sensitivity analyses corroborated the reductions in most patients.
An inexpensive in-home PAC can effectively lower personal PM2.5 exposures in cardiac patients. These benefits occurred even in a region with overall good air quality and if maintained over the long-term could translate into major reductions in cardiovascular events.
细颗粒物（PM2.5）空气污染是心血管疾病的主要危险因素。即使是常见于数百万美国人的低水平细颗粒物也会带来健康风险。然而，尚无研究测试过保护措施，例如对存在心血管疾病风险的患者使用室内便携式空气净化器（PAC）。我们在密歇根大学医学中心开展了一项名为“心脏康复空气过滤试验（CRAFT）”的试点研究，这是一项针对门诊心脏康复患者的随机、双盲、交叉研究。
在常规就诊期间，为患者提供 2 台 PAC，让其在卧室和主要起居空间中连续运行 5 天。PAC 随机分配为主动（带高效空气过滤器）与假。在第 4 天，受试者在不限制活动的情况下佩戴个人 PM2.5 监测仪 24 小时。经过 1 周的洗脱期后，患者交叉至相反模式。
患者（n = 20；4 名女性）为年龄较大（70.8 ± 9.6 岁）的不吸烟者，患有心血管疾病，居住在靠近该设施的地方（10.7 ± 6.0 英里）。与假相比，主动使用室内 PAC 可使个人 24 小时 PM2.5 暴露量显著降低 43.8%（-12.2μg·m；95%置信区间，-24.2 至 -0.2）。敏感性分析证实了大多数患者的降幅。
一种廉价的室内 PAC 可有效降低心脏患者的个人 PM2.5 暴露量。即使在空气质量总体良好的地区，这些益处也会出现，如果长期维持下去，可能会大大减少心血管事件。
