Improved indoor air quality during desert dust storms: The impact of the MEDEA exposure-reduction strategies

Souzana Achilleos; Antonis Michanikou; Panayiotis Kouis; Stefania I Papatheodorou; Andrie G Panayiotou; Paraskevi Kinni; Nikos Mihalopoulos; Nikos Kalivitis; Giorgos Kouvarakis; Emmanouil Galanakis; Eleni Michailidi; Filippos Tymvios; Andreas Chrysanthou; Marina Neophytou; Petros Mouzourides; Chrysanthos Savvides; Emily Vasiliadou; Ilias Papasavvas; Theodoros Christophides; Rozalia Nicolaou; Panayiotis Avraamides; Choong-Min Kang; Nicos Middleton; Petros Koutrakis; Panayiotis K Yiallouros

doi:10.1016/j.scitotenv.2022.160973

Improved indoor air quality during desert dust storms: The impact of the MEDEA exposure-reduction strategies

Sci Total Environ. 2023 Mar 10:863:160973. doi: 10.1016/j.scitotenv.2022.160973. Epub 2022 Dec 17.

Authors

Souzana Achilleos¹, Antonis Michanikou², Panayiotis Kouis², Stefania I Papatheodorou³, Andrie G Panayiotou⁴, Paraskevi Kinni⁵, Nikos Mihalopoulos⁶, Nikos Kalivitis⁷, Giorgos Kouvarakis⁷, Emmanouil Galanakis⁸, Eleni Michailidi⁸, Filippos Tymvios⁹, Andreas Chrysanthou⁹, Marina Neophytou¹⁰, Petros Mouzourides¹⁰, Chrysanthos Savvides¹¹, Emily Vasiliadou¹¹, Ilias Papasavvas¹², Theodoros Christophides¹², Rozalia Nicolaou¹², Panayiotis Avraamides¹², Choong-Min Kang¹³, Nicos Middleton¹⁴, Petros Koutrakis¹³, Panayiotis K Yiallouros²

Affiliations

¹ Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus; Cyprus International Institute for Environmental and Public Health, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus. Electronic address: achilleos.s@unic.ac.cy.
² Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus.
³ Cyprus International Institute for Environmental and Public Health, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
⁴ Cyprus International Institute for Environmental and Public Health, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
⁵ Cyprus International Institute for Environmental and Public Health, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus; Respiratory Physiology Laboratory, Medical School, University of Cyprus, Nicosia, Cyprus; Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
⁶ Department of Chemistry, University of Crete, Heraklion, Crete, Greece; National Observatory of Athens, Athens, Greece.
⁷ Department of Chemistry, University of Crete, Heraklion, Crete, Greece.
⁸ Department of Pediatrics, Medical School, University of Crete, Heraklion, Crete, Greece.
⁹ Cyprus Department of Meteorology, Nicosia, Cyprus.
¹⁰ Environmental Fluid Mechanics Laboratory, Department of Civil and Environmental Engineering, University of Cyprus, Nicosia, Cyprus.
¹¹ Air Quality and Strategic Planning Section, Department of Labour Inspection, Ministry of Labour and Social Insurance, Nicosia, Cyprus.
¹² Department of Cardiology, Nicosia General Hospital, Nicosia, Cyprus.
¹³ Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
¹⁴ Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.

PMID: 36539092
DOI: 10.1016/j.scitotenv.2022.160973

Abstract

Desert dust storms (DDS) are natural events that impact not only populations close to the emission sources but also populations many kilometers away. Countries located across the main dust sources, including countries in the Eastern Mediterranean, are highly affected by DDS. In addition, climate change is expanding arid areas exacerbating DDS events. Currently, there are no intervention measures with proven, quantified exposure reduction to desert dust particles. As part of the wider "MEDEA" project, co-funded by LIFE 2016 Programme, we examined the effectiveness of an indoor exposure-reduction intervention (i.e., decrease home ventilation during DDS events and continuous use of air purifier during DDS and non-DDS days) across homes and/or classrooms of schoolchildren with asthma and adults with atrial fibrillation in Cyprus and Crete-Greece. Participants were randomized to a control or intervention groups, including an indoor intervention group with exposure reduction measures and the use of air purifiers. Particle sampling, PM₁₀ and PM_2.5, was conducted in participants' homes and/or classrooms, between 2019 and 2022, during DDS-free weeks and during DDS days for as long as the event lasted. In indoor and outdoor PM₁₀ and PM_2.5 samples, mass and content in main and trace elements was determined. Indoor PM_2.5 and PM₁₀ mass concentrations, adjusting for premise type and dust conditions, were significantly lower in the indoor intervention group compared to the control group (PM_{2.5-intervention}/PM_2.5-control = 0.57, 95% CI: 0.47, 0.70; PM_{10-intervention}/PM_10-control = 0.59, 95% CI: 0.49, 0.71). In addition, the PM_2.5 and PM₁₀ particles of outdoor origin were significantly lower in the intervention vs. the control group (PM_2.5 infiltration intervention-to-control ratio: 0.49, 95% CI: 0.42, 0.58; PM₁₀ infiltration intervention-to-control ratio: 0.68, 95% CI: 0.52, 0.89). Our findings suggest that the use of air purifiers alongside decreased ventilation measures is an effective protective measure that reduces significantly indoor exposure to particles during DDS and non-DDS in high-risk population groups.

Keywords: Air purifier; HEPA; Indoor air quality; Intervention measures; PM.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Air Pollutants* / analysis
Air Pollution, Indoor* / analysis
Air Pollution, Indoor* / prevention & control
Child
Dust / analysis
Dust / prevention & control
Environmental Monitoring
Humans
Particle Size
Particulate Matter / analysis
Trace Elements*

Substances

Air Pollutants
Dust
Trace Elements
Particulate Matter