The Home Air in Agriculture Pediatric Intervention (HAPI) Trial: Rationale and Methods

Overview

Journal Contemp Clin Trials

Publisher Elsevier

Date 2020 Jul 30

PMID 32721578

Citations 4

Authors

Erin E Masterson

Lisa B Younglove

Adriana Perez

Elizabeth Torres

Jennifer E Krenz

Maria I Tchong French

Anne M Riederer

Paul D Sampson

Nervana Metwali

Esther Min

Karen L Jansen

Gino Aisenberg

Ryan S Babadi

Stephanie A Farquhar

Peter S Thorne

Catherine J Karr

Affiliations

Soon will be listed here.

Abstract

Background: Data addressing air quality effects on children with asthma in rural U.S. communities are rare. Our community engaged research partnership previously demonstrated associations between neighborhood NH and ambient PM and asthma in the agricultural lower Yakima Valley of Washington. As a next step, the partnership desired an intervention approach to address concerns about pediatric asthma in this largely Latino immigrant, farm worker community.

Objective: The Home Air in Agriculture Pediatric Intervention (HAPI) sought to examine the effectiveness of enrichment of an existing asthma education program with portable high-efficiency particulate air (HEPA) cleaners designed to reduce PM and NH We investigated the effect of this enriched approach on these exposures and asthma health measures.

Design: We randomized children with poorly controlled asthma to a control arm (current asthma education program) or an intervention arm (current asthma education program + placement of two indoor air cleaners in the family's home). Outcomes included (1) 14-day integrated samples of indoor air contaminants (PM and NH) at baseline and one-year follow-up and (2) child asthma health metrics at baseline, midpoint (4-6 months) and one-year follow-up. These included the Asthma Control Test, symptoms days, clinical utilization, oral corticosteroid use, pulmonary function, fractional exhaled nitric oxide, and urinary leukotriene E concentration.

Discussion: To our knowledge, this is the first randomized HEPA cleaner intervention designed to assess NH as well as PM and to evaluate health outcomes of children with asthma in an agricultural region.

Citing Articles

Partnership to Develop and Deliver Curriculum Supporting Student-led Air Quality Research in Rural Washington State.

Stampfer O, Cassio O, Grajales J, Black J, Austin E, Seto E Prog Community Health Partnersh. 2022; 16(3):411-420.

PMID: 36120883 PMC: 9494813. DOI: 10.1353/cpr.2022.0058.

Randomized trial of a portable HEPA air cleaner intervention to reduce asthma morbidity among Latino children in an agricultural community.

Drieling R, Sampson P, Krenz J, Tchong French M, Jansen K, Massey A Environ Health. 2022; 21(1):1.

PMID: 34980119 PMC: 8722199. DOI: 10.1186/s12940-021-00816-w.

Effectiveness of portable HEPA air cleaners on reducing indoor endotoxin, PM and coarse particulate matter in an agricultural cohort of children with asthma: A randomized intervention trial.

Riederer A, Krenz J, Tchong-French M, Torres E, Perez A, Younglove L Indoor Air. 2021; 31(6):1926-1939.

PMID: 34288127 PMC: 8577577. DOI: 10.1111/ina.12858.

Effectiveness of portable HEPA air cleaners on reducing indoor PM and NH in an agricultural cohort of children with asthma: A randomized intervention trial.

Riederer A, Krenz J, Tchong-French M, Torres E, Perez A, Younglove L Indoor Air. 2020; 31(2):454-466.

PMID: 32996146 PMC: 8641645. DOI: 10.1111/ina.12753.

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