Efficacy of interventions targeting household air pollution from residential wood stoves

Wood is commonly used for residential heating, but there are limited evidence-based interventions for reducing wood smoke exposures in the indoor environment. The Asthma Randomized Trial of Indoor Wood Smoke (ARTIS) study was designed to assess the efficacy of residential interventions to reduce indoor PM exposure from wood stoves. As part of a three-arm randomized placebo-controlled trial, two household-level interventions were evaluated: wood stove changeouts and air filtration units. Exposure outcomes included indoor measures such as continuous PM_2.5, particle counts, and carbon monoxide. Median indoor PM_2.5 concentration was 17.5 μg/m³ in wood-burning homes prior to interventions. No significant reductions in PM_2.5 concentrations were observed in the 40 homes receiving the placebo filter intervention. Sixteen homes received the wood stove changeout and showed no significant changes in PM_2.5 or particle counts. PM_2.5 concentrations were reduced by 68% in the filter intervention homes. Relative to placebo, air filtration unit homes had an overall PM_2.5 reduction of 63% (95% CI: 47-75%). Relative to the wood stove changeout, the filtration unit intervention was more efficacious and less expensive, yet compliance issues indicated a need for the evaluation of additional strategies for improving indoor air quality in homes using wood stoves.