This article was originally published on Pharmacy hours®.

Results of a new study assessed the effect of air purification in aged care facility (RACF) rooms, compared to no air purification and its association with acute respiratory infections (ARI), including respiratory syncytial virus (RSV).¹

The results suggest that the use of room air purifiers equipped with HEPA-14 filters did not result in a significant reduction in ARIs such as RSV among RACF residents. | Image credit: Prathankarnpap – stock.adobe.com

ARI can have serious consequences for older people, particularly those living in RACFs. ARIs include influenza, COVID-19, rhinovirus, pneumonia and RSV. However, RSV particularly poses a significant threat among older adults, as the infection is responsible for up to 160,000 hospitalizations and approximately 10,000 deaths among older adults each year in the United States. Symptoms usually present like a mild cold, but could become more severe in this population.²

“Successful prevention of ARI requires a thorough understanding of pathogen transmission,” the study authors said in a press release.¹ “The risks of inhalation transmission and subsequent infection are associated with several factors, including rates of emission and elimination of pathogen-containing aerosols, exposure, cumulative dose, and likelihood of infection.”

Despite the increased use of portable air purification devices, the effectiveness of room air purification systems with a high-efficiency particulate air (HEPA) filter in reducing illnesses like VRS is unknown in RACF. To evaluate utilization, investigators conducted a multicenter, double-blind, randomized, crossover clinical trial from April 7 to October 26, 2023, at 3 RACFs located in Australia. Individuals included in the study were followed every 2 weeks throughout the 6-month study period.

The study included 135 people divided into the intervention group first (n = 70) and the control group first (n = 65). Among the two groups, 78 individuals were female and the average age was 85.2 years.

An air purifier containing a HEPA-14 filter was placed in the rooms of all individuals in the intervention group and an air purifier without a HEPA-14 filter was placed in the rooms of all individuals in the control group . Air purifiers have been reported to provide a minimum of 8 air changes per hour during the day and a minimum of 3 air changes per hour at night. After a period of 3 months, the groups crossed over, according to the study authors.

The primary study outcome was the incidence of AKI, defined as infection or absence of infection. However, the infection was divided between influenza, SARS-CoV-2, rhinovirus, RSV or adenovirus. The secondary outcome of the study was time to first infection and number of emergency room visits, hospital admissions and medical tests caused by AKI.

Results demonstrated that in the intention-to-treat analysis, air purifiers equipped with HEPA-14 filters did not reduce AKI compared to the control analysis. However, among the 104 people who completed the entire study, the intervention reduced the incidence of AKI by 35.6% in the control group and 24% in the intervention group.

The results suggest that the use of room air purifiers equipped with HEPA-14 filters did not result in a significant reduction in ARIs such as RSV among RACF residents.

“Although the study results are not statistically significant, they may be clinically important,” the authors said. “A reduction in the absolute number of AKI among participants using the intervention who completed the study was identified.”