Acceptability, Feasibility
Conditions
Keywords
Infection Control, Air Purifier, Covid-19, School
Brief summary
This study aims to investigate the acceptability and feasibility of deploying air purifiers equipped with HEPA (high-efficiency particulate air) filters in classrooms, to study air purifiers as an infection control measure. It will also evaluate the direct effect of air purifiers on air quality, comparing ceiling-mounted purifiers, portable purifiers and no purifier.
Detailed description
Improved ventilation and air purification have been proposed as promising measures to protect the health of students and children while avoiding future school closures during pandemics. However, there is limited knowledge regarding the effectiveness and potential drawbacks of using air purifiers in educational settings. This pilot study was initiated to explore whether a large study of air purifiers in Norwegian primary school classrooms is feasible and acceptable among teachers and students, and to uncover whether air purifiers can reduce particle density in classrooms and thus potentially decrease the spread of infections. The results will lay the groundwork for larger-scale trials that could form the basis of knowledge for decision-makers on whether the use of air purifiers should be part of the strategy to limit infections in classrooms while avoiding school closures during future pandemics. The pilot study consists of two parts. The first part will last six weeks, and focus on the feasibility and acceptability among teachers and students. It will describe and compare two arms - ceiling-mounted (arm 1) and portable (arm 2) air purifiers. The second part lasts nine weeks, and will evaluate the direct effect of air purifiers on air quality. It will compare ceiling-mounted, and portable devices and no purifier(arm 3). The study will involve multiple schools, with a total of six schools contributing eight classrooms. Arm 1 will have two schools and arm 2 will have three schools, each school contributing with one classroom. Arm 3 will have one school, contributing with three classrooms. The classrooms will preferably belong to 7th grade students, but 6th and 5th grade student classrooms will also be accepted, based on the schools preferences. Data collection includes interviews and questionnaires from teachers and students, observations, as well as absenteeism data and air quality measurements.
Interventions
DEVICECeiling-Mounted Air Purifiers
The devices will be turned on every working day except Tuesdays. Air purifiers will be set at levels perceived as acceptable by both teachers and students during operational hours.
DEVICEPortable Air Purifiers
The devices will be turned on every working day except Tuesdays. Air purifiers will be set at levels perceived as acceptable by both teachers and students during operational hours.
DEVICEPortable or Ceiling Mounted Air Purifiers
The Ceiling-Mounted and Portable devices will alternate weekly between being activated and deactivated in the three classrooms. Each classroom will also have three weeks with no purifier activated.This alternating pattern aims to assess the impact of the various air purifiers on air quality. Air purifiers will be set at levels perceived as acceptable by both teachers and students during operational hours.
Sponsors
SINTEF Health Research
Norwegian Institute of Public Health
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
We will select schools for participation in arm 1 and 2, respectively, based on the feasibility of installing ceiling-mounted and placing portable air purifiers in each relevant classroom. In arm 3, all three classrooms will be equipped with both ceiling-mounted and portable air purifiers, as well as indoor air quality sensors. For this arm, we will randomize the three classrooms to each of three weekly programs for the air purifiers; Program 1) Week 1, 4, and 7: Ceiling-mounted ON, Week 2, 5, and 8: No purifier on, Week 3, 6, and 9: Portable ON. Program 2) Week 1, 4, and 7: Portable ON, Week 2, 5, and 8: Ceiling-mounted ON, Week 3, 6, and 9: No purifier on. Program 3) Week 1, 4, and 7: No purifier on Week 2, 5, and 8: Portable ON, Week 3, 6, and 9: Ceiling-mounted ON. Each classroom will be assigned a computer-generated random number and will based on the ascending order of the random numbers be allocated to the three predetermined sequences of programs.
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
for Schools in arm 1 and 2: * Having a classroom in the 5th to 7th grade that either has sufficient floor space to accommodate at least two portable air purifiers or has the infrastructure for the installation of a ceiling-mounted air purifier. * Having at least 15 students in the relevant classroom. Inclusion Criteria for Schools in arm 3: * Having three classrooms at the same floor with sufficient floor space to accommodate at least two portable air purifiers AND with the infrastructure for the installation of a ceiling-mounted air purifier. * The relevant three classrooms should be slightly comparable with regards to use and air quality. The air quality, as perceived by users, should generally be rated as moderate to poor. which should be medium to poor. Inclusion Criteria for Students in arm 1 and 2: * Having a classroom with installed air purifier through the study as their primary classroom. * Informed consent from both legal guardians. Inclusion Criteria for Teachers in arm 1, 2, and 3: * Teaching in the classroom with installed air purifiers at least a few hours per week. * Providing informed consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| How student absence data can be collected from existing school registration systems. | 8 weeks | Experiences from collecting data from the individual schools or from the municipalities, on absence per week per class based on the existing absence systems, will be described. |
| Effectiveness of ceiling mounted versus portable air purifier on improving air quality in classrooms. | 9 weeks | Air quality will be measured using specialized monitors, capturing key indicators such as particulate matter levels. The data collected will enable a comprehensive evaluation of the effectiveness between ceiling mounted and portable air purifiers in improving the overall air quality in educational settings. |
| Acceptability of having Air Purifiers in Classrooms | 6 weeks | Acceptability will be assessed through the in-depth qualitative interviews with teachers and students, exploring perceptions and challenges associated with the use of air purifiers. |
| Untoward events when installing air purifiers in classrooms | 2 weeks | Experiences will be collected from the personnel involved in installing the air purifiers |
| Untoward events when running air purifiers in classrooms | 9 weeks | Experiences will be collected from class teachers and students through in-depth qualitative interviews at the beginning (only teachers) and the end (teachers and students) of the study period. Observations and experiences from the study team during the study period will be collected and described. |
| Effectiveness of air purifiers versus no air purifier on improving air quality in classrooms. | 9 weeks | Air quality will be measured using specialized monitors, capturing key indicators such as particulate matter levels. The data collected will enable a comprehensive evaluation of the effectiveness of air purifiers versus no air purifier in improving the overall air quality in educational settings. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Response rate of students/their guardians to study surveys. | 8 weeks | Consent will be sought from students in part 1 schools, and weekly questionnaires will be sent out. Response rate will be described. |
| Proportion of absence due to respiratory disease. | 8 weeks | Answers to surveys from teachers and students on absence and reasons for absence, from part 1 schools, will be analysed. |
| Absence frequency among students | 8 weeks | Based on the absence data from the schools existing registration systems, we will describe the absence frequency among students in the participating classes. |
| Response rate of class teachers to the study surveys. | 6 weeks | Consent will be sought from relevant teachers in part 1 schools, and weekly questionnaires will be sent out. Response rates will be described. Results will be supported by answers to interview questions about motivations and challenges in participating in such surveys. |
Countries
Norway
Outcome results
None listed