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Purpose: Evaluation of a new individual wearable air purifier (Respiray Wear A+) for birch pollen, house dust mite (HDM), and cat-allergic rhinoconjunctivitis (ARC) patients in a standardized allergen exposure chamber (AEC)., Materials and Methods: Eligible allergic patients were exposed to birch pollen, HDM raw material, and cat allergen in an AEC for 60 minutes without (V1) and with (V3) the use of the Respiray device. Nasal, ocular, bronchial, and other symptoms were rated by the patients every 10 minutes, and their wellbeing, peak nasal inspiratory flow (PNIF), and lung function parameters were assessed every 30 minutes. The primary endpoint was the change in the median of the total symptom score (TSS) at V3 compared to V1 at 60 minutes of exposure. The secondary endpoints consisted of the total nasal symptom score (TNSS) and total eye symptom score (TESS)., Results: 23 patients with birch pollen allergy, 37 patients with HDM allergy, and 41 patients with cat allergy were included in the analysis. Significant reduced symptom scores of ~ 49% were observed when using Respiray Wea A+ under birch pollen exposure (p < 0.05) in the primary endpoint TSS (V3 2.43 compared to V1 4.78). An 48% reduction of symptoms was seen in TSS in case of HDM exposure (V3 3.59; V1 6.92, (t-test: p < 0.01)) and the highest reduction of TSS (60%) under Respiray A+ using cat allergens (V3 2.95, V1 7.44, (t-test p < 0.01) after 60 minutes of exposure. The personal wellbeing revealed clinically meaningful improvements over time in all three studies which manifested in a lower symptom increase during the final allergen exposures., Conclusion: The individual wearable air purifier Respiray Wear A+ protects significantly against airborne pollen, HDM, and cat allergens and may be a very useful device for avoiding indoor allergens in a new way., Competing Interests: The authors declare no conflict of interest. Table 1.Characteristics of probands at the studies with birch pollen, house dust mite, and cat allergens. Subject dataBirch pollen (n = 23)Dust mites (n = 37)Cat allergens (n = 41)Age (years), mean (SD)39.4 (12.5)40.4 (13.6)35.4 (11.8)Female, n (%)17 (73.9)31 (83.8)32 (78)Male, n (%)6 (26.1)6 (16.2)9 (22)Weight (kg), mean (SD)74.7 (27.8)76.4 (20.4)71,7 (13.6)Prick test (mm), mean (SD)9.3 (3.5)7.5 (2.7)6.4 (1.8) Table 2.Flow chart of the entire study. At least 7 days prior to V1Day 1Day 2Day 7Day 8Screening V0Baseline exposure without Respiray V1Safety call V2Exposure with Respiray V3Safety call V4 Figure 1.Components of Respiray Wear A+. 1 = Air is drawn into the device through the intake grille. 2 = Large particles are filtered using the pre-filter. 3 = The body of the device houses fans, battery, and electronics. 4 = The HEPA filter blocks allergens and allows only clean air to pass through. 5 = Clean air is blown out from the output grilles. 6 = The device is worn on the user’s chest using straps.Figure 2.Capture from a CFD simulation depicting the streamlines exiting the device. Table 3.Total symptom score values V1 and V3 at the 60-minute time point are used as base of operation to determine the improvement rate in percentage. The p-value was calculated applying a t-test. „Improvement“ in the table means fewer symptoms using Respiray Wear A+ in comparison to symptom severity without a filter. AllergenMean value baseline (V1)Mean value – with filter (V3)Improvement rate (%)p-valueBirch4.782.43490.01149House dust mite6.923.59480.00236Cat7.442.95600.00308 Figure 3.Mean values of the sums of total symptom score (TSS) for V1 (without Respiray) and V3 (with Respiray) during exposure to birch, house dust mite, and cat allergens.Figure 4.Mean values of the sums of total eye symptom score (TESS) for V1 (without Respiray) and V3 (with Respiray) during exposure to birch, house dust mite, and cat allergens.Figure 5.Mean values of the sums of total nose symptom score (TNSS) for V1 (without Respiray) and V3 (with Respiray) during exposure to birch, house dust mite, and cat allergens. Table 4.Total eye symptom scores for V1 and V3 at the 60-minute time point are used as base of operation to determine the improvement rate in percent. The p-value was calculated applying a t-test. „Improvement“ in the table means fewer symptoms using Respiray Wear A+ in comparison to symptom severity without a filter. AllergenMean value – baseline (V1)Mean value – with filter (V3)Improvement rate (%)p-valueBirch2.481.35460.03390House dust mite3.732.00460.00519Cat4.001.66590.00308 Table 5.Total nasal symptom scores for V1 and V3 at the 60-minute time point are used as base of operation to determine the improvement rate in percent. The p-value was calculated applying a t-test. „Improvement“ in the table means fewer symptoms using Respiray in comparison to symptom severity without a filter. AllergenMean value – baseline (V1)Mean value – with filter (V3)Improvement rate (%)p-valueBirch2.301.09530.00307HDM3.191.59500.00098Cat3.441.29620.00311 Table 6.Visual analog scale well-being values for V1 and V3 at the 60-minute time point are used as base of operation to determine the improvement rate in percent. The p-value was calculated applying a t-test. „Improvement“ in the table means fewer symptoms using Respiray Wear A+ in comparison to symptom severity without a filter. AllergenMean value – baseline (V1)Mean value – with filter (V3)Improvement rate (%)p-valueBirch2114310.5192House dust mite3118400.2556Cat3116460.2565 Figure 6.Mean values of the visual analog scale scores at minutes 0, 30, and 60 at baseline and final exposure to all different allergens without Respiray (V1) and with Respiray (V3). Table 7.Total symptom score values for V1 and V3 over the measured time frame. The mean value of all investigated subjects as well as the standard deviation are depicted. AllergenMoment0 minutes10 minutes20 minutes30 minutes40 minutes50 minutes60 minutesMeanSDMeanSDMeanSDMeanSDMeanSDMeanSDMeanSDBirchBaseline (V1)1.742.801.351.072.701.493.522.003.962.314.302.844.783.22BirchWith filter (V3)1.041.021.571.242.091.472.131.222.221.382.351.612.431.56House dust miteBaseline (V1)1.651.773.382.304.782.656.243.156.703.136.733.176.923.23House dust miteWith filter (V3)1.411.382.051.842.971.643.382.143.272.293.572.573.592.67CatBaseline (V1)1.241.483.201.854.932.606.202.856.712.877.393.537.443.65CatWith filter (V3)1.001.181.801.472.561.663.001.973.122.143.222.662.952.48, (© Dustri-Verlag Dr. K. Feistle.)