How a Simple Device Could Make a Big Difference in Preventing Chronic Disease

Physicians have long emphasized individual actions to prevent chronic disease such as eating well, exercising, and avoiding smoking. But even as global smoking rates have dropped, the amount of chronic disease at the population level hasn’t fallen as much as public health researchers had hoped it would. Lately, investigators are studying how environmental factors, such as air pollution, might play a role in driving certain cancers, as well as lung and cardiovascular diseases. They found that air pollution particulate mattercan trigger the start of a cancerous cell in lab animals, may reduce the effectiveness of certain cancer immunotherapies, and may weaken the immune systems of older people, making it harder for them to fend off respiratory infections.

Now, an interdisciplinary team of scientists is looking at an important way to intervene on air pollution and chronic disease: namely through improving indoor air quality. The project, one of eight funded by Columbia Mailman Centennial Grand Challenges grants, involves testing whether cleaner indoor air can reduce inflammatory biomarkers across two generations. The team is equipping New York City families with HEPA air purifiers and measuring biomarkers for chronic disease. They are also giving the families green cleaning products and an educational video about environmental and lifestyle risk factors and chronic disease risk reduction strategies.

Mary Beth Terry, a Columbian Mailman professor of epidemiology and one of the project leads, describes the work as a proof of concept that if successful could lead to new city policies that would bring air purifiers into public housing units, schools, and other buildings.

In addition to Terry, who is also the associate director of Population Science and Community Outreach at Herbert Irving Comprehensive Cancer Center, the other co-leaders of the project are Jeanine Genkinger, associate professor of epidemiology, and Rebecca Kehm, associate research scientist in the department of epidemiology.

What made you decide to focus on indoor air pollution?

We often think about particulate matter in outdoor air pollution, but most people spend 80 to 90 percent of their time indoors. And now with climate change, more and more people are forced to stay indoors because of extreme weather. Think about the wildfire smoke from Canada last summer that made outdoor air quality dangerous in many places. What we’re hoping is to show that a simple household intervention, using an air purifier, can reduce some chronic disease markers across a generation. We have been enrolling family members and will look how having an indoor air purifier affects adults and their children.

What’s the long-term goal?

If we can show this is an effective intervention then, hopefully, through city policies—these air purifiers are relatively inexpensive— we can see more of these devices in public housing, schools, and other indoor spaces. If we want to address health disparities, and we can show that indoor air pollution is just as important as outdoor air pollution, then we have a very inexpensive way to reduce and hopefully prevent many chronic diseases. We have health economists that are part of our team who will be able to show just how this intervention is a cost-effective way to lower disease rates.

You have many partners from different departments helping with the study and the interdisciplinary aspect of the work extends to master’s students, can you elaborate?

Students in the first semester of the MPH core curriculum train together, academically. The first group of students who worked on this project last summer were from Biostatistics, Population and Family Health, and Epidemiology. They each brought different skills to the table and there was more peer-to-peer support and cohesion. The students also worked closely with the Community Outreach and Engagement office at the Herbert Irving Comprehensive Cancer Center doing community outreach and engagement. So, they gained experience on this study, but then they also gained experience, in general, about how to work with different community partners and a better understanding of what community-engaged research entails.