• Arlene M Butz, Elizabeth C Matsui, Patrick Breysse, Jean Curtin-Brosnan, Peyton Eggleston, Gregory Diette, D'Ann Williams, Jie Yuan, John T Bernert, and Cynthia Rand.
• 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
• Arch Pediatr Adolesc Med. 2011 Aug 1;165(8):741-8.

ObjectiveTo 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.DesignRandomized controlled trial, with randomization embedded in study database.SettingsThe Johns Hopkins Hospital Children's Center and homes of children.ParticipantsChildren 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).Main Outcome MeasuresChanges in PM, air nicotine, and urine cotinine concentrations and symptom-free days during the 6-month study.ResultsThe 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).ConclusionAlthough 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.

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