Cochrane Database Syst Rev. 2003 ; (3): CD002986.

Ionisers for chronic asthma.

Blackhall K, Appleton S, Cates CJ.

Cochrane Airways Group, Department of Community Health Sciences, St George's Hospital Medical School, London, Tooting, UK, SW17 ORE.

BACKGROUND: Previous reports have shown that ion content in the air may have an effect on respiratory function. Results from studies which test the efficacy of air ionisers to reduce asthma symptoms are often inconclusive and their use as a treatment for asthma remains debatable. OBJECTIVES: We conducted a systematic review of the available evidence to determine the effectiveness of positive and negative ion generators in people with asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group Asthma trials register (January 1966 to March 2003), Cochrane Central Register of Controlled Trials (Cochrane Library issue 2, 2003) as well as The Alternative Medicine Database AMED (1985 to March 2003). SELECTION CRITERIA: Randomised controlled trials (parallel or crossover design studies) comparing ionisers with dummy ionisers (being negative or positive ion emitters), in children or adults with chronic asthma. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed titles and abstracts of studies and assessed trial quality. Study quality was determined using two methods:The Cochrane approach to allocation concealment and the five point Jadad scale. MAIN RESULTS: Six studies were selected for inclusion (106 participants). No results were combined as the studies were all of a crossover design.EFFECTS OF NEGATIVE ION GENERATORS (five studies)No study reported a significant difference in lung function between ionised and control air (morning Peak expiratory flow (PEF) - three studies; forced expiratory flow in one second (FEV1) - one study). There were no significant differences in symptoms or beta-2 agonist usage between ionised and control air in three studies. EFFECTS OF POSITIVE ION GENERATORS (one study)This study demonstrated that although positively ionised air was associated with a larger fall in FEV1 with exercise, this did not reach statistical significance. Baseline FEV1 was not demonstrated to be significantly different between treatment groups. REVIEWER'S CONCLUSIONS: Based on the evidence currently available from randomised controlled trials, a recommendation cannot be given for the use of room air ionisers to reduce symptoms in patients with chronic asthma.