The feasibility of an air purifier and secondhand smoke education intervention in homes of inner city pregnant women and infants living with a smoker

• Published in: Environmental research 2018-01, Vol.160, p.524-530
• Main Authors: Rice, Jessica L., Brigham, Emily, Dineen, Rebecca, Muqueeth, Sadiya, O’Keefe, Gena, Regenold, Stephanie, Koehler, Kirsten, Rule, Ana, McCormack, Meredith, Hansel, Nadia N., Diette, Gregory B.
• Format: Article
• Language: English
• Subjects: Adult; Air Filters - statistics & numerical data; Air nicotine; Air Pollution, Indoor - prevention & control; Air purifier; AUTOMOBILES; Baltimore; ENVIRONMENTAL PROTECTION; ENVIRONMENTAL SCIENCES; FEASIBILITY STUDIES; Female; Fine particulate matter; Humans; Indoor air; INDOOR AIR POLLUTION; Infant; Infant, Newborn; INFANTS; PARTICULATES; Pregnancy; Salivary cotinine; Secondhand smoke; SMOKES; Smoking Cessation - methods; Smoking Prevention - methods; Tobacco Smoke Pollution - prevention & control; URBAN AREAS; Young Adult
• ISSN: 0013-9351; 1096-0953
• DOI: 10.1016/j.envres.2017.10.020

Secondhand smoke (SHS) and other air pollutants adversely affect the health of pregnant women and infants. A feasibility study aimed at reducing air pollution in homes of pregnant women or infants living with a smoker was completed. In collaboration with the Baltimore City Health Department, women ≥ 18 years of age and either pregnant nonsmokers, or post-partum (any smoking status) with an infant age 0–12 months were recruited. Homes had at least one smoker. Intervention included two air purifiers and secondhand smoke education. Outcomes included feasibility, change in fine particulate matter (PM2.5), air nicotine, and salivary cotinine pre- and post-intervention. Fifty women were enrolled (mean age 27 years, 92% African American, 71% single, 94% Medicaid eligible, 34% reported smoking) and 86% completed the study. Of the 50 women, 32 had infants and 18 were pregnant at time of enrollment. Post- intervention, 70% of participants reported smokers were less likely to smoke indoors, and 77% had at least one air purifier turned on at the final visit. Participant satisfaction was high (91%) and 98% would recommend air purifiers. Indoor PM2.5 was significantly decreased (P < 0.001). Salivary cotinine was significantly decreased for non-smoking women (P < 0.01) but not infants, and no significant change in air nicotine occurred (P = 0.6). Air purifiers with SHS education is a feasible intervention in homes of women and infants. These data demonstrate reduction in indoor PM2.5 and salivary cotinine in non-smoking adults. Air purifiers are not an alternative for smoking cessation and a home/ car smoking ban. Smoking cessation should be strongly encouraged for all pregnant women, and nonsmoking mothers with infants should be counseled to completely avoid SHS exposure. This study provides support for a future intervention evaluating clinical endpoints. •Indoor air pollution in inner city homes was elevated compared to standards set by the U.S. Environmental Protection Agency.•An air purifier and SHS education intervention was feasible in a population of urban pregnant women and infants.•The intervention was effective in reducing particulate matter in homes with a smoker.•Air purifiers are not an alternative for smoking cessation and a home/car smoking ban.•Pregnant women and nonsmoking mothers with infants should be counseled to completely avoid SHS exposure.