title: A randomized trial of air cleaners and a health coach to improve indoor air quality for inner-city children with asthma and secondhand smoke exposure.
abstract: OBJECTIVE
  To test an air cleaner and health coach intervention to reduce secondhand smoke exposure compared with air cleaners alone or no air cleaners in reducing particulate matter (PM), air nicotine, and urine cotinine concentrations and increasing symptom-free days in children with asthma residing with a smoker.
  
  
  METHODS
  Randomized controlled trial, with randomization embedded in study database.
  
  
  METHODS
  The Johns Hopkins Hospital Children's Center and homes of children.
  
  
  METHODS
  Children with asthma, residing with a smoker, randomly assigned to interventions consisting of air cleaners only (n = 41), air cleaners plus a health coach (n = 41), or delayed air cleaner (control) (n = 44).
  
  
  METHODS
  Changes in PM, air nicotine, and urine cotinine concentrations and symptom-free days during the 6-month study.
  
  
  RESULTS
  The overall follow-up rate was high (91.3%). Changes in mean fine and coarse PM (PM(2.5) and PM(2.5-10)) concentrations (baseline to 6 months) were significantly lower in both air cleaner groups compared with the control group (mean differences for PM(2.5) concentrations: control, 3.5 μg/m(3); air cleaner only, -19.9 μg/m(3); and air cleaner plus health coach, -16.1 μg/m(3); P = .003; and PM(2.5-10) concentrations: control, 2.4 μg/m(3); air cleaner only, -8.7 μg/m(3); and air cleaner plus health coach, -10.6 μg/m(3); P = .02). No differences were noted in air nicotine or urine cotinine concentrations. The health coach provided no additional reduction in PM concentrations. Symptom-free days were significantly increased [corrected] in both air cleaner groups compared with the control group (P = .03).
  
  
  CONCLUSIONS
  Although the use of air cleaners can result in a significant reduction in indoor PM concentrations and a significant increase in symptom-free days, it is not enough to prevent exposure to secondhand smoke.
authors.affiliation: Division of General Pediatrics, Department of Pediatrics, The Johns Hopkins University School of Medicine, 200 N Wolfe Street, Baltimore, MD 21287, USA. abutz@jhmi.edu
authors.forename: Arlene M
authors.initials: AM
authors.lastname: Butz
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Matsui
authors.forename: Patrick
authors.initials: P
authors.lastname: Breysse
authors.forename: Jean
authors.initials: J
authors.lastname: Curtin-Brosnan
authors.forename: Peyton
authors.initials: P
authors.lastname: Eggleston
authors.forename: Gregory
authors.initials: G
authors.lastname: Diette
authors.forename: D'Ann
authors.initials: D
authors.lastname: Williams
authors.forename: Jie
authors.initials: J
authors.lastname: Yuan
authors.forename: John T
authors.initials: JT
authors.lastname: Bernert
authors.forename: Cynthia
authors.initials: C
authors.lastname: Rand
mesh_terms: D016902:Air Pollution, Indoor / Q000032:analysis / Q000517:prevention & control*; D001249:Asthma / Q000453:epidemiology* / Q000517:prevention & control*; D016009:Chi-Square Distribution; D002648:Child; D003367:Cotinine / Q000652:urine; D005260:Female; D005374:Filtration / Q000295:instrumentation*; D006266:Health Education / Q000379:methods*; D006798:Housing; D006801:Humans; D016015:Logistic Models; D008297:Male; D008396:Maryland / Q000453:epidemiology; D009538:Nicotine / Q000032:analysis; D010316:Particle Size; D018709:Statistics, Nonparametric; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*; D014505:Urban Population; D014691:Ventilation
chemical_list: D014028:Tobacco Smoke Pollution; D009538:Nicotine; D003367:Cotinine