Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Environ Res. 2023 Jul 15;229:115708. doi: 10.1016/j.envres.2023.115708. Epub 2023 Mar 20.
Evidence supporting the effect of individual protective measures (IPMs) on air pollution is relatively scarce. In this study, we performed a systematic review and meta-analysis to investigate the effects of air purifiers, air-purifying respirators, and cookstove changes on cardiopulmonary health outcomes. We searched PubMed, Scopus, and Web of Science until December 31, 2022, 90 articles and 39,760 participants were included. Two authors independently searched and selected the studies, extracted information, and assessed each study's quality and risk of bias. We performed meta-analyses when three or more studies were available for each IPMs, with comparable intervention and health outcome. Systematic review showed that IPMs were beneficial in children and elderly with asthma along with healthy individuals. Meta-analysis results showed a reduction in cardiopulmonary inflammation using air purifiers than in control groups (with sham/no filter) with a decrease in interleukin 6 by -0.247 μg/mL (95% confidence intervals [CI] = -0.413, -0.082). A sub-group analysis for air purifier as an IPMs in developing counties reduced fractional exhaled nitric oxide by -0.208 ppb (95% confidence intervals [CI] = -0.394, -0.022). However, evidence describing the effects of air purifying respirator and cook stove changes on cardiopulmonary outcomes remained insufficient. Therefore, air purifiers can serve as efficient IPMs against air pollution. The beneficial effect of air purifiers is likely to have a greater effect in developing countries than in developed countries.
支持个体防护措施（IPMs）对空气污染影响的证据相对较少。在本研究中，我们进行了系统评价和荟萃分析，以调查空气净化器、空气净化呼吸器和炉灶更换对心肺健康结果的影响。我们检索了 PubMed、Scopus 和 Web of Science，截至 2022 年 12 月 31 日，共检索到 90 篇文章和 39760 名参与者。两位作者独立搜索并选择研究，提取信息，并评估每个研究的质量和偏倚风险。当每个 IPM 有 3 项或更多研究可用且干预和健康结果具有可比性时，我们进行了荟萃分析。系统评价显示，IPMs 对哮喘儿童和老年人以及健康个体有益。荟萃分析结果表明，空气净化器组的心肺炎症减少，与对照组（假/无过滤器）相比，白细胞介素 6 减少了-0.247μg/mL（95%置信区间[CI] = -0.413，-0.082）。作为发展中国家 IPMs 的空气净化器亚组分析可使呼出的一氧化氮分数减少-0.208 ppb（95%置信区间[CI] = -0.394，-0.022）。然而，描述空气净化呼吸器和炉灶更换对心肺结果影响的证据仍然不足。因此，空气净化器可以作为对抗空气污染的有效 IPMs。空气净化器的有益效果在发展中国家可能比在发达国家更为显著。
