Effects of inflammatory markers and sleep quality in stroke patients by reducing residential PM_2.5 levels: A case-crossover intervention study

To assess the health impacts of a home intervention involving protective window screens and air purifiers on stroke patients in typical residential buildings in southern Taiwan.

Chronic ischemic stroke patients were recruited from hospitals in southern Taiwan. A crossover study design was used, with home interventions consisting of protective window screens alone and protective window screens combined with air purifiers. Environmental monitoring indicators (indoor and outdoor PM_2.5 and indoor CO₂ concentration), inflammatory markers of the subjects (NT-ProBNP, Hs-CRP, TnI, and IL-6), and sleep quality data were collected.

Eleven cases (male:female = 9:2) were completed. The proportion of time with indoor PM_2.5 ≤ 15 μg/m³ was higher with protective window screens (PWS) than primary window screens (44.5 % vs. 37.5 %) and further increased with PWS plus air purifier (PWS + AP) (63.1 %). During high-pollution seasons, PWS significantly improved PM_2.5 removal compared with primary window screens for north-, northeast-, northwest-, and south-facing windows when outdoor levels exceeded 30 μg/m³. Reductions in Hs-CRP, NT-ProBNP, and IL-6 were associated with lower indoor PM_2.5 and CO₂ in the PWS and PWS + AP interventions. Sleep quality, measured by PSQI, was significantly better with PWS than with primary window screens.

Residential installation of protective window screens reduced indoor PM2.5, improved air quality, and positively influenced inflammatory markers and sleep in stroke patients in this case-crossover study. Further research is recommended to investigate its practical implementation and effectiveness in real-world residential settings.