Assessing the Efficacy of Air Cleaning Machines in Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review
Article Sidebar
Main Article Content
Abstract
Introduction: Chronic Obstructive Pulmonary Disease (COPD) poses a significant medical burden, with a high demand for medication. If effective interventions beyond medication and surgery exist, they can benefit patients and reduce the strain on healthcare resources. One of the major causes of COPD is air pollution, and many researches show global warming is interconnected with air pollution. Air cleaning machines (ACMs) can lower the indoor air pollutants level, so it may offer benefits for COPD patients.
Method: We systematically searched articles from EMBASE, PubMed, and Cochrane Library. Following the PRISMA diagram, we include studies mentioning the effects of ACMs on COPD patients.
Result: Finally, we analysed 6 randomised controlled trials. Two studies indicated significant improvements in the St. George's Respiratory Questionnaire (SGRQ) symptoms, and also in Breathlessness Cough and Sputum Score (BCSS) with air cleaners versus placebo. One study reported lower rates of rescue inhaler use, and fewer moderate exacerbations with air cleaners compared to placebo, but no significant effect on severe exacerbations was found. In addition, one study showed improved autonomic functions with air cleaners compared to placebo measured by Root Mean Square of Successive Differences (RMSSD) and High Frequency (HF). However, studies showed no significant improvement in lung functions and blood pressure with the ACMs.
Conclusion: ACMs may benefit COPD patients by alleviating COPD symptoms, decreasing rates of moderate exacerbation and rescue inhaler use, increasing heart rate variabilities. ACMs could potentially help COPD patients reduce the severity and further lower the healthcare burdens. Due to the limited number of studies included, more studies should be conducted to clarify the effects.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
© Journal of Asian Medical Students’ Association (JAMSA). Released under a Creative Commons license.
References
Afifa, Arshad K, Hussain N, Ashraf MH, Saleem MZ. Air pollution and climate change as grand challenges to sustainability. Sci Total Environ. 2024;928:172370.
Blanchard M, Gervès-Pinquié C, Feuilloy M, Le Vaillant M, Trzepizur W, Meslier N, et al. Hypoxic burden and heart rate variability predict stroke incidence in sleep apnoea. Eur Respir J. 2021;57(3).
Boers E, Barrett M, Su JG, Benjafield AV, Sinha S, Kaye L, et al. Global Burden of Chronic Obstructive Pulmonary Disease Through 2050. JAMA Netw Open. 2023;6(12):e2346598.
Chen S, Kuhn M, Prettner K, Yu F, Yang T, Bärnighausen T, et al. The global economic burden of chronic obstructive pulmonary disease for 204 countries and territories in 2020-50: a health-augmented macroeconomic modelling study. Lancet Glob Health. 2023;11(8):e1183-e93.
Christenson SA, Smith BM, Bafadhel M, Putcha N. Chronic obstructive pulmonary disease. Lancet. 2022;399(10342):2227-42.
Dekker JM, Crow RS, Folsom AR, Hannan PJ, Liao D, Swenne CA, et al. Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC Study. Atherosclerosis Risk In Communities. Circulation. 2000;102(11):1239-44.
Fawzy A, Woo H, Raju S, Belz DC, Putcha N, Williams MS, et al. Indoor particulate matter concentrations and air cleaner intervention association with biomarkers in former smokers with COPD. Environ Res. 2024;243:117874.
Fyfe-Johnson AL, Muller CJ, Alonso A, Folsom AR, Gottesman RF, Rosamond WD, et al. Heart Rate Variability and Incident Stroke: The Atherosclerosis Risk in Communities Study. Stroke. 2016;47(6):1452-8.
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2024 report). Global Initiative for Chronic Obstructive Lung Disease; 2024.
Hansel NN, Putcha N, Woo H, Peng R, Diette GB, Fawzy A, et al. Randomized Clinical Trial of Air Cleaners to Improve Indoor Air Quality and Chronic Obstructive Pulmonary Disease Health: Results of the CLEAN AIR Study. Am J Respir Crit Care Med. 2022;205(4):421-30.
Kahnert K, Jörres RA, Behr J, Welte T. The Diagnosis and Treatment of COPD and Its Comorbidities. Dtsch Arztebl Int. 2023;120(25):434-44.
Kariisa M, Foraker R, Pennell M, Buckley T, Diaz P, Criner GJ, et al. Short- and Long-Term Effects of Ambient Ozone and Fine Particulate Matter on the Respiratory Health of Chronic Obstructive Pulmonary Disease Subjects. Archives of Environmental & Occupational Health. 2015;70(1):56-62.
May SM, Li JT. Burden of chronic obstructive pulmonary disease: healthcare costs and beyond. Allergy Asthma Proc. 2015;36(1):4-10.
Nct. Residential Cleaning of Indoor Air to Protect COPD Patients. https://clinicaltrialsgov/show/NCT03750292. 2018.
Raju S, Woo H, Fawzy A, Putcha N, Balasubramanian A, Mathai SC, et al. Decreased Cardiac Autonomic Function is Associated with Higher Exacerbation Risk and Symptom Burden in Chronic Obstructive Pulmonary Disease. Chronic Obstr Pulm Dis. 2023;10(3):328-34.
Raju S, Woo H, Koehler K, Fawzy A, Liu C, Putcha N, et al. Indoor Air Pollution and Impaired Cardiac Autonomic Function in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2023;207(6):721-30.
Regis da Costa EOJ, Base LH, Maia LCP, Ferreira de Lima Antão JYF, de Abreu LC, Oliveira FR, et al. Geometric indexes of heart rate variability in healthy individuals exposed to long-term air pollution. Environ Sci Pollut Res Int. 2020;27(4):4170-7.
Sabil A, Gervès-Pinquié C, Blanchard M, Feuilloy M, Trzepizur W, Goupil F, et al. Overnight Oximetry-derived Pulse Rate Variability Predicts Stroke Risk in Patients with Obstructive Sleep Apnea. Am J Respir Crit Care Med. 2021;204(1):106-9.
Shao D, Du Y, Liu S, Brunekreef B, Meliefste K, Zhao Q, et al. Cardiorespiratory responses of air filtration: A randomized crossover intervention trial in seniors living in Beijing: Beijing Indoor Air Purifier StudY, BIAPSY. Sci Total Environ. 2017;603-604:541-9.
Wedzicha JA, Seemungal TA. COPD exacerbations: defining their cause and prevention. Lancet. 2007;370(9589):786-96.
Woo H, Koehler K, Putcha N, Lorizio W, McCormack M, Peng R, et al. Principal stratification analysis to determine health benefit of indoor air pollution reduction in a randomized environmental intervention in COPD: Results from the CLEAN AIR study. Sci Total Environ. 2023;868:161573.
Zhu R, Chen Y, Wu S, Deng F, Liu Y, Yao W. The Relationship between Particulate Matter (PM10) and Hospitalizations and Mortality Of Chronic Obstructive Pulmonary Disease: A Meta-Analysis. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2013;10(3):307-15.