Research & Evidence

Select References on the Effectiveness of Air Filtration for Children

Reducing Absenteeism and Respiratory Infections

Vartiainen et al. (2024). The Effect of Room Air Cleaners on Infection Control in Day Care Centers. VTT Research, Finland

Design: Interventional crossover trial in 2 daycare centers (n≈43) vs. 607 controls, over 6-month winter.

Key Findings: Portable HEPA cleaners reduced airborne virus concentrations by 37–60% and cut parental work absences due to child illness by 32% (5.53 vs 3.77 days; p=0.009).

Bonan et al. (2025). Air Purifiers and Student Performance: A Cluster RCT in Milan Elementary Schools. RFF Working Paper

Design: Cluster randomized trial across 95 classrooms (grades K–5).

Key Findings: 32% reduction in indoor PM₂.₅; 12.5% reduction in absenteeism (~1.3 fewer days per student per year). Largest effects in high-absence students.

Women for a Healthy Environment (2024). Philadelphia Child-Care Centers Pilot Study

Design: Pilot in 8 child-care centers using commercial HEPA purifiers for one week.

Key Findings: Mean PM₂.₅ dropped from ~6 μg/m³ to ~1 μg/m³. Staff reported less coughing, allergies, and absenteeism.

Cognitive Performance and Academic Outcomes

Gilraine (2020). Air Filters, Pollution and Student Achievement. EdWorkingPaper 20-188

Design: Natural experiment after Aliso Canyon gas leak; 1,756 purifiers installed in 18 schools.

Key Findings: Math scores rose +0.20 SD; English +0.18 SD.

Xu et al. (2024). Reducing Indoor Particulate Pollution Improves Student Test Scores. Environmental Science & Technology

Design: Double-blind randomized crossover with college students.

Key Findings: PM₂.₅ lowered from ~40 → ~13 µg/m³; students scored significantly higher on English tests.

Yang et al. (2024). Cognitive Benefits of Reducing Indoor PM Exposure During Sleep. Environmental Science & Technology

Design: Randomized trial in dormitories.

Key Findings: 0.21 SD increase in next-day cognitive index after nights with filtered air.

Pulmonary and Respiratory Health

Lei et al. (2025). Respiratory Benefits of Multisetting Air Purification in Children. JAMA Pediatrics

Design: Cluster randomized, double-blind crossover trial in 79 Chinese schoolchildren.

Key Findings: 45% reduction in PM₂.₅ exposure; FEV₁ improved 8.0%, PEF 16.5%; airway inflammation (exhaled NO) dropped 22.4%.

James et al. (2020). HEPA Filtration Improves Asthma Control in Children Exposed to Traffic Particles. Indoor Air

Design: Double-blind, placebo-controlled crossover in 43 asthmatic children.

Key Findings: In poorly controlled cases, ACQ scores improved from 1.3 → 0.9 (p=0.003); quality-of-life improved (4.9 → 5.5, p=0.02).

Broader Health Benefits

Walzer et al. (2020). Effects of Home Particulate Filtration on Blood Pressure: A Meta-Analysis. Hypertension

Design: Meta-analysis of 10 RCTs (604 participants).

Key Findings: Portable filtration reduced systolic BP by ~3.9 mmHg.

Lamport et al. (2023). Can Air Purification Improve Sleep Quality? Journal of Sleep Research

Design: Double-blind crossover pilot (n=30).

Key Findings: +12 min total sleep time; +19 min time in bed.

Enkhmaa et al. (2022). Portable HEPA Filters During Pregnancy and Child Cognitive Development. Environmental Research

Design: Randomized trial in Ulaanbaatar, Mongolia.

Key Findings: HEPA use may increase birth weight and child IQ at age 4.

Inadera et al. Association of air purifier usage during pregnancy with adverse birth outcomes: the Japan Environment and Children's Study. BMC Public Health

Design: National cohort.

Key Findings: Maternal purifier use linked to fewer low birth weight infants.

Pandemic Preparedness and Infectious Disease Reduction

Walsh et al. (2021). School Closures and COVID-19 Transmission: A Systematic Review. BMJ Open

Design: Systematic review of observational studies.

Key Findings: Mixed effects; some studies showed ≤60% reduction in transmission, others no effect.

CDC Georgia Elementary Schools Study (2021). MMWR

Design: Survey of 169 schools.

Key Findings: Schools with better ventilation had 39% lower COVID incidence; ventilation + HEPA achieved 48% lower incidence.

Cauchemez et al. (2008). Impact of School Closure on Influenza Transmission. Nature

Design: Natural experiment using staggered school holidays in France.

Key Findings: Holidays cut transmission to children 20–29%, preventing 16–18% of seasonal flu cases.