Exploring the residential exposome: Determination of hazardous flame retardants in air filter dust from HVAC systems.

Dust is a sink for flame retardants, which are added to a myriad of consumer products in residential spaces. Organophosphate esters (OPEs) and brominated flame retardants (BFRs) are two classes of flame retardants that are frequently used in consumer products and consequently found in dust. In this present work, a novel solvent-limited microextraction technique, which we detailed in a companion study, was applied for the determination of four OPEs and two BFRs with limits of quantitation at the ng/g level by gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry from n = 47 air filter dust samples collected from forced air HVAC systems. Levels of the BFRs, including tetrabromobisphenol-A and its derivative tribromobisphenol-A, were found at levels <4 µg/g and not frequently detected. Conversely, all four OPEs were detected in all air filter dust samples. Total OPE load was dominated by tris(2,4-di-tert-butylphenyl) phosphate, T24DtBPP, a novel OPE not widely examined in the literature. Comparison of individual and total OPE concentrations to residential characteristics revealed statistically significant relationships to location of the home and dominant flooring type. Overall, this study motivates future work in examining the whole house exposome using air filter dust as a passive sampling regime with more examination of T24DtBPP loads within other indoor spaces.

Pulmonary Benefits of Intervention with Air Cleaner among Schoolchildren in Beijing: A Randomized Double-Blind Crossover Study.

We conducted a crossover study employing air cleaner intervention among 125 schoolchildren aged 9-12 years in a boarding school in Beijing, China. The PM concentrations were monitored, and 27 biomarkers were analyzed. We used the linear mixed-effects model to evaluate the association of intervention/time-weighted PM concentrations with biomarkers. The outcomes showed that air cleaner intervention was associated with FeNO, exhaled breath condensate (EBC) IL-1ß, and IL-6, which decreased by 12.57%, 10.83%, and 4.33%, respectively. Similar results were observed in the associations with PMs. Lag 1 day PMs had the strongest relationship with biomarkers, and significant changes were observed in biomarkers such as FEV1, FeNO, EBC 8-iso, and MCP-1. Boys showed higher percentage changes than girls, and the related biomarkers were FeNO, EBC 4-HNE, IL-1ß, IL-6, and MCP-1. The results showed that biomarkers such as FeNO, EBC IL-6, MCP-1, and 4-HNE could sensitively reflect the early abnormal response of the respiratory system under short-term PM exposure among healthy schoolchildren and indicated that (1) air cleaners exert a protective effect on children's respiratory system. (2) PM had lag and cumulative effect, lag 1 day had the greatest effect. (3) The boys were more sensitive than the girls.

Bottom-Up Synthesized All-Thermal-Catalyst Aerogels for Heat-Regenerative Air Filtration.

Airborne particular matter (PM) pollution is an increasing global issue and alternative sources of filter fibers are now an area of significant focus. Compared with relatively mature hazardous gas treatments, state of the art high-efficiency PM filters still lack thermal decomposition ability for organic PM pollutants, such as soot from coal-fired power plants and waste-combustion incinerators, resulting in frequent replacement, high cost, and second-hand pollution. In this manuscript, we propose a bottom-up synthesis method to make the first all-thermal-catalyst air filter (ATCAF). Self-assembled from ∼50 nm diameter TiO2 fibers, ATCAF could not only capture the combustion-generated PM pollutants with >99.999% efficiency but also catalyze the complete decomposition of the as-captured hydrocarbon pollutants at high temperature. It has the potential of in situ eliminating the PM pollutants from burning of hydrocarbon materials leveraging the burning heat.

An overview of solutions for airborne viral transmission reduction related to HVAC systems including liquid desiccant air-scrubbing.

The spread of the coronavirus SARS-CoV-2 affects the health of people and the economy worldwide. As air transmits the virus, heating, ventilation and air-conditioning (HVAC) systems in buildings, enclosed spaces and public transport play a significant role in limiting the transmission of airborne pathogens at the expenses of increased energy consumption and possibly reduced thermal comfort. On the other hand, liquid desiccant technology could be adopted as an air scrubber to increase indoor air quality and inactivate pathogens through temperature and humidity control, making them less favourable to the growth, proliferation and infectivity of microorganisms. The objectives of this study are to review the role of HVAC in airborne viral transmission, estimate its energy penalty associated with the adoption of HVAC for transmission reduction and understand the potential of liquid desiccant technology. Factors affecting the inactivation of pathogens by liquid desiccant solutions and possible modifications to increase their heat and mass transfer and sanitising characteristics are also described, followed by an economic evaluation. It is concluded that the liquid desiccant technology could be beneficial in buildings (requiring humidity control or moisture removal in particular when viruses are likely to present) or in high-footfall enclosed spaces (during virus outbreaks).

Melamine sponge-based copper-organic framework (Cu-CPP) as a multi-functional filter for air purifiers.

COVID-19 has drawn great attention on the necessity for establishing pathogen-free indoor air. This paper offers an insight into the potential application of a multi-purpose filter to remove fine particulates and disinfect pathogens using melamine sponge with a copper-organic framework. In-situ growth dip coating method was applied to coat Cu-based coordination polymer particle (Cu-CPP) on melamine sponge (MS). The integration of Cu-CPPs with high crystallinity and highly active surface area (1,318.1 m2/g) enabled Cu-CPP/MS to have an excellent capture rate (99.66%) and an instant disinfection rate of 99.54% for Escherichia coli. Electrostatic attraction seemed to play a crucial role in capturing negative-charged pathogens effectively by positive charges on Cu-CPP arising from unbalanced copper ions in Cu-CPP. Disinfection of pathogens was mainly attributed to catalytically active Cu2+ sites. Organic ligand played an important role in bridging and maintaining Cu2+ ions within the framework. This study highlights the design of a new capture-and-disinfection (CDS) air filter system for pathogens using Cu-CPP/MS. It can be applied as a substitute for conventional high-efficiency particulate air (HEPA) filters. Electronic Supplementary Material: Supplementary material is available for this article at 10.1007/s11814-021-1000-4 and is accessible for authorized users.

Indoor Air Quality Strategies for Air-Conditioning and Ventilation Systems with the Spread of the Global Coronavirus (COVID-19) Epidemic: Improvements and Recommendations.

The coronavirus has come to the world and spread with great wide among the countries of the world and has resulted in numerous infections that exceeded 167,181,023 million patients and are close to 3.5 deaths by September 2021. It also brought with it panic and fear, halted many activities, and led to the decline of the global economy. It changed human behavior and forced people to change their lifestyles to avoid infection. One of the most sectors that must be taken into consideration through pandemic coronavirus (COVID-19) around the globe is the air conditioning systems. The HVAC systems depend on the air as a heat transfer medium. The air contains a group of pollutants, viruses, and bacteria, and it affects and destroys human life. The air filter plays a major role as an important component in the air conditioning systems. Thus, it requires more effort by researchers to improve its design to prevent the ultra-size of particles loaded with coronavirus (COVID-19). This paper provides insight into the design of existing combined air-conditioners on their suitability and their impact on the spread of the hybrid coronavirus epidemic and review efforts to obtain a highly efficient air filter to get rid of super-sized particles for protection against epidemic infection. In addition, important guideline recommendations have been made to limit the spread of the COVID-19 virus and to obtain indoor air quality in air-conditioned places.

A highly efficient nanofibrous air filter membrane fabricated using electrospun amphiphilic PVDF-g-POEM double comb copolymer.

Current global emergencies, such as the COVID-19 pandemic and particulate matter (PM) pollution, require urgent protective measures. Nanofibrous air filter membranes that can capture PM0.3 and simultaneously help in preventing the spread of COVID-19 are essential. Therefore, a highly efficient nanofibrous air filter membrane based on amphiphilic poly(vinylidene fluoride)-graft-poly(oxyethylene methacrylate) (PVDF-g-POEM) double comb copolymer was fabricated using atomic transfer radical polymerization (ATRP) and electrospinning. Fourier transform infrared spectroscopy, X-ray diffraction, proton nuclear magnetic resonance, transmission electron microscopy, differential scanning calorimetry, and thermogravimetric analysis were employed to successfully characterize the molecular structure of the fabricated amphiphilic PVDF-g-POEM double comb copolymer. The nanofibrous air filter membrane based on amphiphilic PVDF-g-POEM double comb copolymer achieved a low air resistance of 4.69 mm H2O and a high filtration efficiency of 93.56 % due to enhanced chemical and physical adsorption properties.

Nanostructured composite coating endowed with antiviral activity against human respiratory viruses deposited on fibre-based air filters.

The widespread of viral airborne diseases is becoming a critical problem for human health and safety, not only for the common cold and flu, but also considering more serious infection as the current pandemic COVID-19. Even if the current heating, ventilating and air conditioning (HVAC) systems limit the disease transmission by air, the air filters are susceptible to microbial colonization. In addition, viruses spread via droplets (aerosol) produced by direct or indirect contact with infected people. In this context, the necessity of an efficient HVAC system, able to capture and inactivate viruses- and bacteria-rich aerosols, thus preserving a safe indoor air environment and protecting people, is of enormous importance. The aim of this work is the assessment of the antiviral properties of a silver nanoclusters/silica composite coating deposited via co-sputtering technique on glass, on metallic fibre-based air filters as well as on cotton textiles. The selected human respiratory viruses are: respiratory syncytial virus (RSV), the human rhinovirus (HRV) and the influenza virus type A (FluVA). The coated air filters show that the nanostructured coating develops a strong virucidal activity against RSV and FluVA, but not against the HRV.

A Foldable All-Ceramic Air Filter Paper with High Efficiency and High-Temperature Resistance.

Advanced filter materials with high efficiency, low-pressure drop, and high-temperature resistance are urgently needed in the field of high-temperature gas filtration. Here, an Al2O3-stabilized ZrO2 (ASZ) submicron fiber air filter paper with excellent flexibility and thermal stability (up to 1100 °C) is developed using a cost-effective, scalable solution blow spinning method and subsequent calcination. The ASZ papers demonstrate excellent flexibility and foldability, which can be attributed to the tetragonal phase and small crystallite size of the ASZ fibers due to the presence of Al2O3. In addition, the ASZ papers with an areal density of 56 mg cm-2 show a high filtration efficiency (99.56%) and a low-pressure drop (108 Pa) for 15-615 nm NaCl particles at an airflow velocity of 5.4 cm s-1. We envision that the foldable all-ceramic air filter material will provide a solution for the removal of particulate matter from the high-temperature exhaust gases.

[The effect of mobile air filter systems on aerosol concentrations in large volume scenarios against the background of the risk of infection of COVID-19. Can classroom teaching be resumed?] / Der Effekt von mobilen Luftfiltersystemen auf die Aerosolbelastung in Großraumszenarien vor dem Hintergrund des Infektionsrisikos der COVID-19-Erkrankung. Kann die Präsenzlehre wieder aufgenommen werden?

BACKGROUND: As a consequence of the corona pandemic, universities nationwide had stopped classroom teaching by the start of the summer semester 2020. As part of the second lockdown, in many states schools and day care centers were also closed or reduced to a minimum. In this context the effect of room air filters has already been discussed multiple times; however, mobile devices for air filtration are currently not recommended by the German Federal Environment Agency. The following investigation shows the real effects of mobile air filters on aerosol concentrations when used in lecture theaters, canteens or school learning centers. METHODS: The effects of a mobile air purifier (DEMA-airtech, Stuttgart, Germany) were measured in three large rooms (a lecture theater, a company canteen and a learning center of a grammar school). Aerosol and carbon dioxide concentrations were determined with devices from the company Palas (Karlsruhe, Germany). RESULTS: All three scenarios showed a relevant and permanent decrease in aerosol concentrations through the use of air filters. The effect partly even surpassed the effectiveness of simple ventilation by opening the windows. CONCLUSION: In addition to social distancing and wearing highly efficient face masks, the use air filters is recommended. This measure could enable classroom teaching to be resumed.

HEPA filtration improves asthma control in children exposed to traffic-related airborne particles.

Traffic-related airborne particles are associated with asthma morbidity. The aim of this study was to assess the impact of a high-efficiency particulate air (HEPA) filtration on the concentrations of traffic particles and the resultant effect on children with asthma. Forty-three children with asthma were enrolled in this double-blind, placebo-controlled crossover design. A HEPA air cleaner or a placebo "dummy" was placed in participants' homes for four weeks, interrupted by a one-month washout period, before crossing over to the other treatment arm for four weeks. Air sampling and health outcomes, including asthma control (ACQ) and quality of life (AQLQ) measures, were completed prior to and at the end of each treatment arm. Indoor concentrations of traffic particles were significantly reduced with the HEPA treatment but not with the "dummy" treatment. In participants with poorly controlled asthma and lower quality of life at baseline, ACQ and AQLQ scores were significantly improved (1.3 to 0.9, P = .003 and 4.9 to 5.5, P = .02, respectively) following the HEPA treatment. In this study, HEPA filtration is associated with improved clinical outcomes and quality of life measures in children with uncontrolled asthma.

[Reuse process of positive pressure powered air-filter protective hoods].

OBJECTIVE: To establish reuse process of positive pressure powered air-filter protective hoods during coronavirus disease 2019 (COVID-19) epidemic. METHODS: The procedure of pretreatment, storage, recovery, cleaning, disinfection and sterilization process of positive pressure powered air-filter protective hoods, which were used in the treatment of COVID-19 infection patients was established in Central Sterile Supply Department of the hospital. The cleaning and disinfection effects of the protective hoods after treatment were examined by magnifying glass method, residual protein detection method, real-time PCR, and agar pour plate method. RESULTS: Twenty five used protective hoods underwent totally 135 times of washing, disinfecting and sterilizing procedures. After washing, all the protein residue tests and COVID-19 nucleic acid tests showed negative results. After sterilizing, all the protective hoods met sterility requirement. All the tested protective hoods were undamaged after reprocessing. CONCLUSIONS: The established reuse procedures for used positive pressure powered air-filter protective hoods are safe.

Characterization, concentration and risk assessment of airborne particles using car engine air filter (case study: Tehran metropolis).

Atmospheric elements released into the atmosphere can enter the human body through inhalation, ingestion and dermal contact and are then deposited in the body. Trace elements have potential risks to human health. For this purpose, the particulate matter accumulated by car air filters (CAFs) was studied. The morphology and distribution of particle size were examined using scanning electron microscopy and energy-dispersive X-ray spectroscopy. The concentration of elements in CAFs and CAF-estimated air for 30 elements in Tehran, Iran, was analyzed in winter and summer, from February to July 2017. Samples were determined by inductively coupled mass plasma spectrometry. The most abundantly detected elements in both CAFs and air in both seasons were Ca, Mg, Na and Fe. The shape of the particles was mostly irregular and spherical. Most of the particles were between 0.5 and 1.0 µm. The carcinogenic risks of inhalation exposure to Cr and Co in winter and summer were higher than the acceptable level (< 1 × 10-4) for children and adults. The carcinogenic risks of As and Cr in both seasons were higher than 1 × 10-4 for children and adults via dermal contact. Also, the carcinogenic risks of Cr in both seasons of ingestion exposure were higher than 1.00E-04 for children and adults. The integrated noncarcinogenic risks of all trace elements were higher than the safe level (= 1) for children and adults in both seasons.

Roll-to-Roll Transfer of Electrospun Nanofiber Film for High-Efficiency Transparent Air Filter.

Particulate matter (PM) pollution in air has become a serious environmental issue calling for new type of filter technologies. Recently, we have demonstrated a highly efficient air filter by direct electrospinning of polymer fibers onto supporting mesh although its throughput is limited. Here, we demonstrate a high throughput method based on fast transfer of electrospun nanofiber film from roughed metal foil to a receiving mesh substrate. Compared with the direct electrospinning method, the transfer method is 10 times faster and has better filtration performance at the same transmittance, owing to the uniformity of transferred nanofiber film (>99.97% removal of PM2.5 at ∼73% of transmittance). With these advantages, large area freestanding nanofiber film and roll-to-roll production of air filter are demonstrated.

Synthesis of hybrid carbon nanotube structures coated with Sophora flavescens nanoparticles and their application to antimicrobial air filtration.

Controlling airborne microorganisms has become increasingly important with increase in human indoor activities, epidemic disease outbreaks, and airborne pathogen transmission. Treatments using antimicrobial nanoparticles have shown promise because of the high surface-to-volume ratio of nanoparticles compared to their bulk counterparts, and their unique physical and chemical properties. In this study, hybrid nanostructures of multi-walled carbon nanotubes (MWCNTs) coated with antimicrobial, natural product (NP) nanoparticles were synthesized using a twin-head electrospray system (THES). The coated nanoparticles were then used in antimicrobial air filters to increase their antimicrobial efficiency. Electrosprayed droplets were converted to NP nanoparticles and MWCNTs through ethanol evaporation. Oppositely charged NP nanoparticles and MWCNTs were coagulated via Coulombic collisions to form hybrid nanoparticles that were deposited continuously onto an air filter medium. The size distribution and composition of the hybrid NP/MWCNT particles were characterized using a wide-range particle spectrometer (WPS) and transmission electron microscope (TEM). The concentration of hybrid NP/MWCNT nanoparticles was lower than that of NP nanoparticles but higher than that of MWCNTs and showed a bimodal size distribution with peak diameters of 21.1 and 49 nm. TEM analyses confirmed that the NP nanoparticles were attached to the MWCNT surface with a density of ~4-9 particles/MWCNT. When deposited onto the filter medium, NP/MWCNT particles formed dendrites on the filter׳s fiber surface. The filtration efficiency and pressure drop of the NP/MWCNT-coated filters were higher than those of pristine, NP nanoparticles-coated or MWCNTs-coated filters. The hybrid filter also exhibited stronger antimicrobial activity than those of NP or MWCNT-coated filters at identical deposited volumes (1.1×10-2 cm3/cm2 filter). Ninety-five percent of the tested bacterial aerosols were inactivated on the NP/MWCNTs filter while only <70% were inactivated on NP- or MWCNT-coated filters.

Evaluation of clay aggregate biotrickling filters for treatment of gaseous emissions from intensive pig production.

Treatment of ventilation air from livestock production by biological airfiltration has emerged as a cost-effective technology for reduction of emissions of odorants and ammonia. Volatile sulfur compounds from livestock production include H2S and methanethiol, which have been identified as potentially important odorants that are not removed sufficiently by biological air filters. Light-expanded clay aggregates (Leca(®)) is a biotrickling filter material that contains iron oxides, which can oxidize H2S and methanethiol, and thus potentially may help to remove these two compounds in biological air filters. This study used on-line PTR-MS measurements to investigate the performances of two Leca(®) biotrickling filters (abraded Leca(®) filter and untreated Leca(®) filter) for removal of odorants and ammonia emitted from an experimental pig house. The results indicated that the abraded Leca(®) filter had a similar or slightly better capability for removing odorants than the untreated Leca(®) filter. This may be due to the enlargement of the surface area by the friction process. The volatile sulfur compounds, however, were not removed efficiently by either of the two Leca(®) filters. Kinetic analysis of a ventilation controlled experiment during the first period indicated that Grau second-order kinetics could be applied to analyze the removal of sulfur compounds and other odorants, whereas the Stover-Kincannon model could only be applied to analyze the removal of odorants other than sulfur compounds, partly due to the limitation of mass transfer of these compounds in the biotrickling filters. In the last measurement period, a production of dimethyl disulfide and dimethyltrisulfide coinciding with strongly enhanced removal of methanethiol was observed for the untreated filter. This was assumed to be enhanced by an incidence of low local air velocity in the filter and indicated involvement of iron-catalyzed reactions in the removal of sulfur compounds.

Ethyl cellulose/gelatin/ß-cyclodextrin/curcumin nanofibrous membrane with antibacterial and formaldehyde adsorbable capabilities for lightweight and high-performance air filtration.

Functionalization of bio-based nanofibers is the development tendency of high-performance air filter. However, the conventional structural optimization strategy based on high solution conductivity greatly hinders the development of fully bio-based air filter, and not conducive to sustainable development. This work fabricated fully bio-based nanofibrous membrane with formaldehyde-adsorbable and antibacterial capabilities by electrospinning low-conductivity solution for high-performance air filtration and applied to lightweight mask. The "water-like" ethyl cellulose (EC) was selected as the base polymer to "nourish" functional materials of gelatin (GE), ß-cyclodextrin (ßCD), and curcumin (Cur), thus forming a solution system with high binding energy differences and electrospinning into ultrafine bimodal nanofibers. The filtration efficiency for 0.3 µm NaCl particles, pressure drop, and quality factor were 99.25 %, 53 Pa, and 0.092 Pa-1, respectively; the bacteriostatic rates against Escherichia coli and Staphylococcus aureus were 99.9 % and 99.4 %, respectively; the formaldehyde adsorption capacity was 442 µg/g. This is the first report on antibacterial and formaldehyde-adsorbable high-performance air filter entirely made from bio-based materials. This simple strategy will greatly broaden the selection of materials for preparing high-performance multifunctional air filter, and promote the development of bio-based air filter.

Preparation, Air Filtration Performance of a Fluorinated Polyimide/Polyacrylonitrile Nanofibrous Membrane by Electrospinning.

This paper reports the successful fabrication of a new nanofibrous membrane, F-PI/PAN, through electrospinning of polyacrylonitrile (PAN) and fluorinated polyimide (F-PI). The nanofibrous membrane exhibits comprehensive properties for high-temperature filtration and robust PM2.5 (particulate matter with an aerodynamic equivalent diameter of 2.5 microns or less) removal. The introduction of F enhances the hydrophobicity of the PI. The relationship between the hydrophobic performance and the filtration performance of particles is investigated. The chemical group of the composite membrane was demonstrated using FITR, while the surface morphology was investigated using field emission scanning electron microscopy. The TGA results indicated good thermal stability at 300 °C. Various ratios of F-PI membranes were prepared to characterize the change in properties, with the optimal mass ratio of F-PI being 20 wt%. As the proportion of F-PI increases, its mechanical and filtration efficiency properties and hydrophobicity become stronger. The contact angle reaches its maximum of 128 ± 5.2° when PAN:F-PI = 6:4. Meanwhile, when PAN:F-PI = 8:2, the filtration efficiency reaches 99.4 ± 0.3%, and the elongation at break can reach 76%. The fracture strength can also reach 7.1 MPa, 1.63 times that of the pure PAN membrane.

Electroactive nanofibrous membrane with antibacterial and deodorizing properties for air filtration.

Water vapor from respiration can severely accelerate the charge dissipation of the face mask, reducing filtration efficiency. Moreover, the foul odor from prolonged mask wear tends to make people remove their masks, leading to the risk of infection. In this study, an electro-blown spinning electroactive nanofibrous membrane (Zn/CB@PAN) with antibacterial and deodorization properties was prepared by adding zinc (Zn) and carbon black (CB) nanoparticles to the polyacrylonitrile (PAN) nanofibers, respectively. The filtration efficiency of Zn/CB@PAN for PM0.3 was > 99% and could still maintain excellent durability within 4 h in a high-humidity environment (25 â„ƒ and RH = 95%). Moreover, the bacterial interception rate of the Zn/CB@PAN could reach 99.99%, and it can kill intercepted bacteria. In addition, the deodorization rate of Zn/CB@PAN in the moist state for acetic acid was 93.75% and ammonia was 95.23%, respectively. The excellent filtering, antibacterial, and deodorizing performance of Zn/CB@PAN can be attributed to the synergistic effect of breath-induced Zn/CB galvanic couples' electroactivity, released metal ions, and generated reactive oxygen species. The developed Zn/CB@PAN could capture and kill airborne environmental pathogens under humid environments and deodorize odors from prolonged wear, holding promise for broad applications as personal protective masks.

Effectiveness of Asthma Home Management Manual and Low-Cost Air Filter on Quality of Life Among Asthma Adults: A 3-Arm Randomized Controlled Trial.

Background: Asthma affects the quality of life (QoL) of millions of people worldwide. Effective control is paramount to a decline in prevalence and severity. To address this, we aimed to investigate the effectiveness of an asthma home management manual and low-cost air filter in improving resource-limited settings. Patients and Methods: This randomized controlled trial was conducted between March to July 2022. The participants were 18-55 years old outpatient with asthmatic patients. A total of 114 participants were recruited and randomly assigned to three groups: home management only, home management and air filtering, and control. Validated measurement tools were applied, and the Wilcoxon test was used to evaluate changes in QoL. Results: Asthma burden was found in at least one-third of participants in each group. At baseline, there was no difference in mAQLQ scores among participants in all group allocations (p-value > 0.05), and the air filter group had an increase in the total mAQLQ score (p-value = 0.044) and post-intervention activity quality of life (p-value = 0.002). The environmental quality of life increased post-intervention (p-value = 0.004) and remained higher after four weeks of follow-up compared to baseline (p-value = 0.041) in the home management group participants. Conclusion: The findings indicate that the enforcement of a home management manual and the application of low-cost filters in air circulation systems offer advantages in improving the quality of life of patients with moderate and mild asthma.