Air filtration, IAQ, and COPD
New HUD-funded study: Air filtration to improve indoor air quality (IAQ) and chronic obstructive pulmonary disease (COPD) outcomes in a high-risk urban population of U.S. military veterans
This new 3-year study, scheduled to begin in early 2020, will investigate the effectiveness of stand-alone air filtration for improving indoor air quality (IAQ) and chronic obstructive pulmonary disease (COPD) outcomes in a high-risk urban cohort of 80 U.S. military veterans with COPD in Chicago, IL.
We are currently recruiting two PhD students to work on this project!
Funding is available for two PhD students for three years each, both with full stipend and tuition. We envision that one student will work as a field lead, visiting military veterans in their homes to conduct indoor air quality measurements, and that one student will work as a data lead, handling air quality and health data processing, quality control, and analysis. Ideal candidates will have a background in environmental engineering, architectural engineering, environmental science, health sciences, or other related fields, with backgrounds and interests in indoor pollutant dynamics, human exposure assessment, building science, data analysis, and/or statistics.
Contact Brent Stephens (brent at iit dot edu) and click here to apply to one of our graduate programs (e.g., PhD civil engineering or environmental engineering).
Air filtration to improve indoor air quality (IAQ) and chronic obstructive pulmonary disease (COPD) outcomes in a high-risk urban population of U.S. military veterans
Project team: Illinois Institute of Technology (IIT), West Side Institute for Science and Education (WISE), Jesse Brown Veterans Affairs Medical Center (JBVAMC), and Elevate Energy
Principal Investigator (PI): Brent Stephens, PhD, Associate Professor and Department Chair, Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Chicago, IL
Co-PI: Mohammad Heidarinejad, PhD, PE, Assistant Professor, Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Chicago, IL
Co-PI: Israel ‘Rudi’ Rubinstein, MD, Professor of Medicine, Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois Hospital & Health Sciences System and Associate Chief of Staff for Research, Jesse Brown Veterans Affairs Medical Center (JBVAMC), Chicago IL
Co-PI: Anne Evens, PhD, CEO, Elevate Energy, Chicago, IL
Study Objectives: The primary goal of this study is to investigate the effectiveness of stand-alone air filtration for improving indoor air quality (IAQ) and chronic obstructive pulmonary disease (COPD) outcomes in a high-risk urban cohort of 80 U.S. military veterans with COPD. Additional secondary goals of the study are to (1) investigate housing-related factors that may contribute to COPD exacerbation, (2) investigate the utility of using low-cost sensors for indoor air pollution epidemiology studies and for providing actionable or useful information on the quality of their indoor air to patients and their physicians, and (3) evaluate the costs and benefits of using stand-alone air filtration to improve IAQ and COPD outcomes. The objectives will be met by combining measurements of environmental conditions and indoor and outdoor air quality (using both research-grade and low-cost sensors) with housing condition assessments, respiratory questionnaires, and records of clinical outcomes. Participants will be recruited from the Jesse Brown Veterans Affairs Medical Center (JBVAMC) through the West Side Institute for Science and Education (WISE) using a community-based participatory process in which stakeholders, including patients, physicians, and local non-profits, will assist in the development of research objectives, recruitment, retention, and dissemination of results.
Study Design: The study design will utilize a randomized, single-blind, placebo-controlled crossover intervention in which stand-alone portable air cleaners will be introduced to the study population over a period of 2 years. In the 1st year, half the study population will receive a sham filtration unit (i.e., an air cleaner with the filter removed) and half the population will receive a normally functioning unit. In the 2nd year, the crossover design will be employed (i.e., the two halves of the study population are reversed). The participants will be blinded; they will not know the status of the filter. Stand-alone portable air cleaning units containing HEPA filters and high clean air delivery rates (CADRs) sufficiently sized for the spaces they will serve will be used. The study will also involve housing condition assessments conducted in each home prior to the air cleaner intervention period in order to characterize housing-related factors that may contribute to COPD exacerbation at baseline, followed by measurements of indoor and outdoor air quality and environmental conditions, participant respiratory questionnaires, and records of clinical outcomes (e.g., COPD exacerbations, emergency room visits, 6-minute walk distance, oxygen saturation, etc.). The validated and extensively used St. George’s Respiratory Questionnaire (SGRQ) will be used to determine health-related quality of life (HR-QoL) of participants. Clinical outcomes will also be used to assess costs of care with and without filtration interventions in this population. Research-grade sensors will be used to assess indoor and outdoor air quality in each home for shorter-term periods of time (i.e., in place for 4-5 days, twice per year per home), while low-cost consumer-grade air quality sensors will be used to monitor for longer-term periods (i.e., in place for the duration of the study). The study will also evaluate the upfront costs and operational and maintenance costs of the air cleaners over the course of the intervention periods and will compare them to the expected impacts on costs of care both with and without filtration interventions in this population.
Expected Results: Results from the proposed research are expected to advance the state of scientific knowledge by: (1) demonstrating the impacts of long-term use (i.e., for up to 1 year) of stand-alone portable air filtration in homes of high-risk COPD patients on indoor pollutant concentrations, indoor environmental conditions, and COPD outcomes; (2) evaluating the costs and benefits of operating stand-alone air cleaners, which includes an analysis of the total costs of installation and operation (i.e., electricity and maintenance costs) versus the impacts on cost of care for a high-risk COPD cohort; (3) providing novel data on associations between housing conditions and COPD outcomes in a high-risk cohort of military veterans; and (4) investigating the utility of low-cost sensors for indoor air pollution epidemiology studies and for providing actionable or useful information on the quality of their indoor air to patients and their physicians. Results from the proposed research will directly inform policy and practice in both healthy housing and patient medical care. Additionally, outcomes of this work will uniquely inform HUD and the VA on the costs and benefits of providing stand-alone air filtration units for its beneficiaries with underlying COPD.
Funding: This project is funded by the U.S. Department of Housing and Urban Development (HUD) through their Healthy Homes Technical Studies program and is expected to begin in early 2020.
In the News: “$1 Million HUD Grant to Support Air Quality Study Directed at Veterans with COPD”
The United States Department of Housing and Urban Development awarded Illinois Institute of Technology a $1 million research grant to investigate the impact of home air quality on the health of veterans with chronic obstructive pulmonary disease.
The research study—led by Brent Stephens, associate professor and director of architectural engineering, director of environmental engineering, and chair of Armour College of Engineering’s civil, architectural, and environmental engineering department—will focus on Chicago-area veterans being treated at the Jesse Brown VA Medical Center in Chicago.
Stephens will collaborate with Mohammad Heidarinejad, assistant professor of architectural engineering, to explore the effectiveness of standalone air filtration for improving indoor air quality, specifically assessing individuals with COPD. For two years veterans will use high-efficiency air cleaners in their homes, which will aid researchers in gathering air quality results and assessing COPD health outcomes compared with results of those who live in homes without air cleaners.
Stephens says, “We are working with veterans, but the research results could help everyone with COPD and give doctors new tools for helping their patients.” He adds, “I’m in engineering but this project has public health implications.”
According to the grant application, the Jesse Brown facility experienced nearly 11,000 clinic visits and 700 emergency room visits from patients with COPD in FY18, costing more than $2.3 million for treatment. If the low-cost sensors prove to be effective, this could be an easy tool for doctors to help assess whether home air quality may be impacting the COPD of their patients.
Ben Carson, secretary of the U.S. Department of Housing and Urban Development, indicates the importance of investing in the science behind protecting families from potentially dangerous home health hazards. He shares, “You can’t be healthy if your home is sick. These grants will improve our knowledge about how to improve living conditions inside our homes.”
Stephens and Heidarinejad will also work in partnership with Israel “Rudi” Rubinstein, M.D., associate chief of staff for research at Jesse Brown VA Medical Center, and Elevate Energy to investigate potential housing-related factors that may contribute to increased COPD exacerbations, particularly within underserved, socioeconomically disadvantaged neighborhoods of Chicago.