Should homes and workplaces purchase portable air filters to reduce the transmission of SARS-CoV-2 and other respiratory infections? A systematic review.
Should homes and workplaces purchase portable air filters to reduce the transmission of SARS-CoV-2 and other respiratory infections? A systematic review.
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DOI：
10.1371/journal.pone.0251049
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Hay AD
中科院分区：
文献类型：
--
作者：
Hammond A;Khalid T;Thornton HV;Woodall CA;Hay AD
呼吸道感染，包括SARS-CoV-2，通过吸入或摄入空气传播的病原体传播。空气传播很难控制，尤其是在室内。高效微粒空气过滤器（HEPA）的制造商声称，他们可以去除几乎所有的小颗粒，包括空气中的细菌和病毒。本研究调查现代便携式市售空气过滤器是否能减少呼吸道感染的发生率和/或清除室内空气中的细菌和病毒。我们系统地检索了Medline、Embase和Cochrane，检索了2000年1月至2020年9月间发表的研究。如果研究包括在任何室内环境（包括养老院、学校或医疗机构）中使用便携式、市售的空气过滤器，调查其与呼吸道感染发生率的关系，或调查过滤器内空气中雾化细菌和病毒的去除和/或捕获情况，则研究符合纳入条件。双重数据筛选和提取与叙事综合。没有研究发现空气过滤器对呼吸道感染发病率的影响。两项研究调查了过滤器内的细菌捕获和室内空气中的细菌负荷。一份报告称，HEPA过滤器中的活菌数量高于地板灰尘样本中的活菌数量。另一种报道的HEPA过滤结合紫外线使空气中的细菌负荷减少了41%（采样时间未报道）。这两篇论文都没有研究对病毒的影响。关于对包括SARS-CoV-2在内的呼吸道感染的室内传播进行可能具有成本效益的干预的有效性，严重缺乏证据。两项研究提供了“原理证明”，即空气过滤器可以在室内环境中捕获空气中的细菌。迫切需要随机对照试验来调查便携式HEPA过滤器对呼吸道感染发生率的影响。
Respiratory infections, including SARS-CoV-2, are spread via inhalation or ingestion of airborne pathogens. Airborne transmission is difficult to control, particularly indoors. Manufacturers of high efficiency particulate air (HEPA) filters claim they remove almost all small particles including airborne bacteria and viruses. This study investigates whether modern portable, commercially available air filters reduce the incidence of respiratory infections and/or remove bacteria and viruses from indoor air. We systematically searched Medline, Embase and Cochrane for studies published between January 2000 and September 2020. Studies were eligible for inclusion if they included a portable, commercially available air filter in any indoor setting including care homes, schools or healthcare settings, investigating either associations with incidence of respiratory infections or removal and/or capture of aerosolised bacteria and viruses from the air within the filters. Dual data screening and extraction with narrative synthesis. No studies were found investigating the effects of air filters on the incidence of respiratory infections. Two studies investigated bacterial capture within filters and bacterial load in indoor air. One reported higher numbers of viable bacteria in the HEPA filter than in floor dust samples. The other reported HEPA filtration combined with ultraviolet light reduced bacterial load in the air by 41% (sampling time not reported). Neither paper investigated effects on viruses. There is an important absence of evidence regarding the effectiveness of a potentially cost-efficient intervention for indoor transmission of respiratory infections, including SARS-CoV-2. Two studies provide ‘proof of principle’ that air filters can capture airborne bacteria in an indoor setting. Randomised controlled trials are urgently needed to investigate effects of portable HEPA filters on incidence of respiratory infections.
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