Study: Air purification reduces children’s morbidity in daycare environment

The multidisciplinary E3 Excellence in Pandemic Response and Enterprise Solutions (E3) project, which focuses on preventing pandemics and finding out the different routes of infectious diseases, starts publishing final results after three years of work. Among the most significant outcomes are the results from a daycare study performed in four different daycare centres in the city of Helsinki. In the daycare centres, where the air was cleaned with air purifiers, children’s morbidity decreased by 18 percent. Spinverse is part of this exciting project as a coordinator together with Tamlink.

E3 is a multidisciplinary co-innovation project looking for research-based solutions to prevent the spread of pathogens. The project aims to harness science and technology to create effective countermeasures to prevent spreading of infectious diseases. 

The goal has been that during the current pandemic and before the emergence of the next pandemic, scientifically proven technical solutions would be available to reduce the spread of pathogens in places where people meet. The E3 project ends at the end of October 2024.

“In E3, we have joined forces between two major ecosystems CleverHealth Network (CHN) and Indoor Air-Quality ecosystem (IAQe) and brought together key experts from research and industry representing several fields such as medicine, virology, aerosol physics, civil engineering, environmental science, behavioural science and business innovation. This result is a great example of the strength of the genuine multidisciplinary collaboration and our need-based approach to tackle real challenges,” says Dr. Markku Heino from Spinverse, who has been facilitating the joint work with Jari Erkkilä from Tamlink.

Multidisciplinary study on the significance of airborne diseases indoors

A crossover study was performed in four daycare centres in Helsinki to determine the significance of the airborne transmission route of pathogens and to study the effectiveness of air cleaning in reducing infections among children in daycare.

The daycare centres included in the study had well working ventilation systems and the indoor air quality was generally at a good level. The study lasted for two years, during which a year-long intervention was implemented in two daycare centres at a time, increasing the amount of clean air in the premises with air purifiers to reduce airborne exposure. Based on the risk assessment, the placement, number and power of the air purifiers were chosen in such a way that the amount of clean air in the rooms more than doubled on average.

During the intervention, indoor air quality and children's illnesses were monitored and analyzed. Data about children's illnesses was collected in digital diaries in November and April in the winters of 2022–2023 and 2023–2024. All children attending the daycare were invited to participate (n = 262), and consent was obtained from 88 guardians resulting in 51 subjects for the final analysis.

Air purification reduced morbidity in daycare centres

Fresh project results were presented at the European Respiratory Society (ERS) conference. Research doctor Ville Vartiainen from Helsinki University Hospital (HUS) stated in his presentation “An interventional crossover study on effectiveness of air cleaning on incident infections in day care” that the day care centres where the air was purified with air purification systems, the children’s morbidity lowered as much as 18 per cent without implementing any other strategies to mitigate spreading of infections. ”In the study, the intervention was only focused on airborne infections. Even though children only spend a part of their day in day care and there were no additional measures beyond air purification to prevent infections transmitted via bodily contacts or droplets, the study confirmed that air purification makes a significant impact to child morbidity,” he stressed.

The findings highlight growing scientific evidence that common respiratory infections are spread through the air. Since ventilation and air purification can only affect particles travelling in the air stream, the results highlight the possibility of airborne transmission of the spread of infectious pathogens through the air, and air purification as a preventive measure. The importance of these results is emphasized when considering the high probability of other transmission routes, such as contact and droplet infections, among daycare children. Furthermore, the placebo had no effect on the results when the subjects were between 1 and 6 years old.

The study was led by research doctors Enni Sanmark and Ville Vartiainen from the Helsinki University Hospital and Piia Sormunen, Industry Professor (Built environment & Civil engineering) from the Tampere University. Senior researcher Inga Ehder-Gahm from VTT was responsible for dimensioning the air cleaners and the technical implementation of the intervention.

The research bodies in the daycare study were Helsinki University Hospital (HUS), Tampere University, Tampere University of Applied Sciences, Finnish Meteorological Institute, Finnish Institute of Occupational Health, VTT Technical Research Centre of Finland and University of Helsinki. The E3 companies included in the daycare study were Granlund, Air0, Halton Group, Lifa Air, Alme Solutions, Inspector SEC (ISEC), Airlyse, Filterpak, Roche Diagnostics and Tamlink.

The goal is to fight pandemics and epidemics

The research results found in the E3 project have already been utilized, for example, in research and preparedness work related to the spread of bird flu (H5N1 virus). E3 has primarily studied different pathways of pathogens and viruses, virus control and detection methods that can be used to find solutions to keep indoor air clean and safe in offices, public spaces, and vehicles.

The main goal has been to develop solutions that allow the various functions of society to continue without interruption and people can continue to move and live safely despite epidemics and pandemics. 

”When children fall ill, it causes not only human suffering for them, but it also places a heavy burden on families with children, leading, for example, to parents’ absences from work. Consequently, the decrease of 18 percent in morbidity found in the study has concrete and positive impacts both on the everyday lives of families and more broadly on society,” Enni Sanmark concludes.

Join the Tackling Pandemics final seminar on October 30, 2024!

The results and findings of the project will be presented in more detail at the Tackling Pandemics final seminar at the University of Helsinki on October 30, 2024. More information and registration to this public event here.

About the project

E3 is one of the largest co-innovation projects between companies and research organizations ever launched in Finland. The project has a budget of 12 million euros and a duration of three years. The project is jointly financed by Business Finland and the participating companies. The project is coordinated by Spinverse and Samlink.

The participating companies are Afry Oy, Air0 Oy, Airlyse Oy, Alme Solutions Oy, AW2 Architects Oy, Biomensio Oy, Cleamix Oy, Filterpak Oy, Granlund Oy, HUS, Halton Oy, Inspector SEC Oy, Kone Oyj, Lumikko Oy, Ramboll Finland Oy, Olfactomics Oy, Royal Caribbean Group Oyj, Rapal Oy, Rune & Berg Oy, Roche Diagnostics Oy, Vetrospace Oy, Helsinki University Hospital and Lifa Air Oy.

The participating research organisations are Tampere University, VTT Technical Research Centre of Finland, Finnish Meteorological Institute, University of Helsinki, Finnish Institute of Occupational Health, Tampere University of Applied Sciences and Finnish Institute for Health and Welfare.

More information: www.pandemicresponse.fi