Effects of indoor air purification intervention on blood pressure, blood‑oxygen saturation, and heart rate variability: A double-blinded cross-over randomized controlled trial of healthy young adults

The use of indoor air purifier (IAP) has received growing attention as a mitigation strategy for reducing indoor air pollution, but the evidence on their cardiovascular benefits is unclear. This study aims to evaluate whether the use of IAP can reduce the adverse effects of indoor particulate matter (PM) on cardiovascular health among young healthy population. A randomized, double-blind, cross-over, IAP intervention of 38 college students was conducted. The participants were assigned into two groups to receive the true and sham IAPs for 36 h in random order. Systolic and diastolic blood pressure (SBP; DBP), blood oxygen saturation (SpO₂), heart rate variability (HRV) and indoor size-fractioned particulate matter (PM) were real-time monitored throughout the intervention. We found that IAP could reduce indoor PM by 41.7–50.5 %. Using IAP was significantly associated with a reduction of 2.96 mmHg (95 % CI: −5.71, −0.20) in SBP. Increased PM was significantly associated with increased SBP (e.g., 2.17 mmHg [0.53, 3.81], 1.73 mmHg [0.32, 3.14] and 1.51 mmHg [0.28, 2.75] for an IQR increment of PM₁ [16.7 μg/m³], PM_2.5 [20.6 μg/m³] and PM₁₀ [37.9 μg/m³] at lag 0–2 h, respectively) and decreased SpO₂ (−0.44 % [−0.57, −0.29], −0.41 % [−0.53, −0.30] and − 0.40 % [−0.51, −0.30] for PM₁, PM_2.5 and PM₁₀ at lag 0–1 h, respectively), which could last for about 2 h. Using IAPs could halve indoor PM levels, even in relatively low air pollution settings. The exposure-response relationships suggested that the benefits of IAPs on BP may only be observed when indoor PM exposure is reduced to a certain level.