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Title: Improved indoor air quality during desert dust storms: The impact of the MEDEA exposure-reduction strategies
Authors: Achilleos, Souzana 
Michanikou, Antonis 
Kouis, Panayiotis 
Papatheodorou, Stefania 
Panayiotou, Andrie G. 
Kinni, Paraskevi 
Mihalopoulos, Nikos 
Kalivitis, Nikos 
Kouvarakis, Giorgos 
Galanakis, Emmanouil 
Michailidi, Eleni 
Tymvios, Filippos 
Chrysanthou, Andreas 
Neophytou, Marina 
Mouzourides, Petros 
Savvides, Chrysanthos 
Vasiliadou, Emily 
Papasavvas, Ilias 
Christophides, Theodoros 
Nicolaou, Rozalia 
Avraamides, Panayiotis C. 
Kang, Choong-Min 
Middleton, Nicos 
Koutrakis, Petros 
Yiallouros, Panayiotis K. 
Major Field of Science: Medical and Health Sciences
Keywords: Air purifier;HEPA;Indoor air quality;Intervention measures;PM
Issue Date: 10-Mar-2023
Source: Science of the total environment, 2023, vol. 863, pp. 1-13
Volume: 863
Start page: 1
End page: 13
Journal: Science of the Total Environment 
Abstract: Desert dust storms (DDS) are natural events that impact not only populations close to the emission sources but also populations many kilometers away. Countries located across the main dust sources, including countries in the Eastern Mediterranean, are highly affected by DDS. In addition, climate change is expanding arid areas exacerbating DDS events. Currently, there are no intervention measures with proven, quantified exposure reduction to desert dust particles. As part of the wider "MEDEA" project, co-funded by LIFE 2016 Programme, we examined the effectiveness of an indoor exposure-reduction intervention (i.e., decrease home ventilation during DDS events and continuous use of air purifier during DDS and non-DDS days) across homes and/or classrooms of schoolchildren with asthma and adults with atrial fibrillation in Cyprus and Crete-Greece. Participants were randomized to a control or intervention groups, including an indoor intervention group with exposure reduction measures and the use of air purifiers. Particle sampling, PM10 and PM2.5, was conducted in participants' homes and/or classrooms, between 2019 and 2022, during DDS-free weeks and during DDS days for as long as the event lasted. In indoor and outdoor PM10 and PM2.5 samples, mass and content in main and trace elements was determined. Indoor PM2.5 and PM10 mass concentrations, adjusting for premise type and dust conditions, were significantly lower in the indoor intervention group compared to the control group (PM2.5-intervention/PM2.5-control = 0.57, 95% CI: 0.47, 0.70; PM10-intervention/PM10-control = 0.59, 95% CI: 0.49, 0.71). In addition, the PM2.5 and PM10 particles of outdoor origin were significantly lower in the intervention vs. the control group (PM2.5 infiltration intervention-to-control ratio: 0.49, 95% CI: 0.42, 0.58; PM10 infiltration intervention-to-control ratio: 0.68, 95% CI: 0.52, 0.89). Our findings suggest that the use of air purifiers alongside decreased ventilation measures is an effective protective measure that reduces significantly indoor exposure to particles during DDS and non-DDS in high-risk population groups.
ISSN: 00489697
DOI: 10.1016/j.scitotenv.2022.160973
Rights: Copyright © Elsevier B.V.
Type: Article
Affiliation : University of Nicosia Medical School 
Cyprus University of Technology 
University of Cyprus 
Harvard T.H. Chan School of Public Health 
University of Crete 
National Observatory of Athens 
Cyprus Department of Meteorology 
Ministry of Labour, Welfare and Social Insurance 
Nicosia General Hospital 
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