Findings from recent research into air purifiers for reducing the incidence of acute respiratory infections in Australian residential aged care facilities

Bismi Thottiyil Sultanmuhammed Abdul Khadar MSc^1,2, Jenny Sim PhD^1,3  Vanessa M McDonald PhD^1,2 , Julee McDonagh PhD^4,5 , Matthew Clapham BSc³, Brett G Mitchell PhD^{1,2, 6,7,8}

¹School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia, ²Hunter Medical Research Institute, Newcastle, New South Wales, Australia, ³School of Nursing, Midwifery & Paramedicine, Australian Catholic University, North Sydney, New South Wales, Australia, ⁴School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia, 2522, ⁵Centre for Chronic and Complex Care Research, Blacktown Hospital, Western Sydney Local Health District, Blacktown, NSW, Australia, 2148, ⁶School of Nursing, Avondale University, Lake Macquarie, New South Wales, Australia, ⁷Nursing and Midwifery, Monash University, Victoria, Australia, ⁸Central Coast Local Health District, Gosford, New South Wales, Australia.

Abstract:

Introduction

There has been increasing use of in-room air purification to prevent acute respiratory infections (ARIs). We sought to investigate the effect of portable in-room air purifiers with a High-Efficiency Particulate Absorbing (HEPA-14) filter in reducing the incidence of ARIs among residents in residential aged care.

Methods

We conducted a multi-center, double-blind, randomised, two-period, two-treatment, crossover clinician trial during 2023. The intervention consisted of participants receiving in-room air purification. We also assessed the acceptability of using air purifiers from the perspective of residents and staff, using a recognised framework.

Results

Across three facilities, 135 participants were enrolled. The use of air purifiers with HEPA filters led to a non-statistically significant reduction in ARIs compared to the control group (OR 0.57, 95% CI 0.32 to 1.04, p=0.069). Among 104 participants who completed the entire study, the intervention reduced ARIs from 36% to 24% (OR 0.53, 95% CI 0.28 to 1.00, p=0.048). Staff and residents indicated a high acceptability to using purifiers.

Conclusion

The use of in-room air purification using an intention to treat the analysis, did not identify a statistical significance reduction in ARIs. However, significant reductions in ARIs were identified in participants who completed the entire study.