Natural insulation to improve internal building air quality, (IAQ). (#2394)

Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
Natural insulation to improve internal building air quality within both new build and refurbishment health properties.
Overview of Innovation:
Grenian are a specialist company offering natural insulation for both new buildings and refurbishment projects. Natural insulation is sourced from naturally occuring fibres such as sheep wool, hemp, wood and cellulose fibres. All of our insulation products are manufactured with harmless binders such as recycled polyester binders.
​In adiditon research has been published showing that natural insulation can help to improve building internal air quality such as reducing formaldehyde levels. We have supplied insulation on a number of health projects such as Maggies centre, Oldham. The centres offer support for patients suffering from cancer. In Germany research has been carried out showing that schools internal air environment improved by utilising sheep wool insulation in the internal building fabric.
​These examples confirm that natural insulation is a viable alternative to man made insualnts.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
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Innovation 'Elevator Pitch':
Half a million adults and children in the UK experience severe asthma symptoms despite high dose medication. Air4 offers a non pharmacological treatment of allergic disease using Temperature Laminar Airflow to reduce exposure to allergens in the bed.
Overview of Innovation:
Air4 is a unique, innovative medical device which uses Temperture Laminar Airflow (TLA) technology to protect patients with severe allergic asthma and eczema, from exposure to allergens and other airborne particles (pollens, housedust mite and animal danders etc.) that are in and around the bed at night whilst they sleep. The device has no side effects and can therefore be used for adults and children.

Air4 is installed in the bedroom alongside the bed; air is drawn in the device from the room where it is filtered and cooled to 0.5-0.8 degrees centigrade lower than the ambient temperature. As cool air is heavier than room temperature, gravity ensures the air gradually descends without an excessive breeze or draught creating the patients breathing zone; due to the density of the air in the breathing zone airborne allergens are unable to penetrate and therefore the patient sleeps in an allergen free zone.

In reducing the airborne allergens the device has shown in clinical trials that is has reduced exacerbations and the number of hosptial admissions; it has reduced day and night time symptoms in patients and improved quality of life (health related) and has shown to reduce the number of days off work/school.

Air4 has a Medical Technology Innovation briefing from NICE stating the device is clinically and cost effective.There is also an Innovation Medical Technology Overview  from Helath Improve Scotland showing the device is clinically and cost effective compared to standard treatment.

Using the Air4 in adults or children who are still symptomatic despite maximum inhaler treatment; can avoid long term side effects from oral corticosteroids as well as the regular hospital visits from other treatmenst

Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Wealth creation / Innovation and adoption / Person centred care
Benefit to NHS:
  • Reduction in exacerbations leading to fewer hospital admissions and clinic visits
  • Reduction in use of rescue medication leading to a reduction in drug spend
  • Reduction in the number of days taken off school and work
  • Cost effective and in some circumstances cost saving treatment. Annual rental cost is offset by the economc savings in medical costs resulting in a net cost to the NHS 
  • Fulfils Care closer to home: encouraging people to live independently; provide greater choice and control over health; Reduce NHS costs and the demands for hospital resources
Initial Review Rating
4.20 (2 ratings)
Benefit to WM population:
Home based overnight treatment which negates the need for hospital stays.
Improvement in quality of life (HRQLS)
Improvement in sleep
Reduction in the need for rescue medication
Reduction in exacerbations and therefore hospital stays and clinic visits.
Current and planned activity: 
Current Activity: Ongoing UK trial (LASER) with results due in spring 2017 (West Midlands have 2 investigator sites)
                          Working with Innovation Nexus Greater Manchester to support clinicians use of Air4
 Current Device Use: Royal Wolverhampton, Hereford
Planned Device Use: Birmingham Childrens, Sandwell, Worcester
What is the intellectual property status of your innovation?:
IP is held by the company
Current Certification: Class 1 Medical Device; CE Marked
Return on Investment (£ Value): 
Return on Investment (Timescale): 
6-12 mon
Ease of scalability: 
Regional Scalability:
Air4 is already being used in several accounts across the West Midlands with several more interested in trying the device. From a company perspective the warehouse will be informed of potential numbers and they will increase production to ensure they can meet with the increase in demand
Overall measure of success of our innovation will be to see it accepted as a standard of care treatement for allergic disease and no longer applied for by an IFR for clinical exceptionality.
Quality Measures: Airsonett has implemented a quality management system compliant with ISO 9001, 13485 and QSR
Safety: Air4 is a CE marked class 1 medical device. As it is a non pharmacological device there are no known side effects and the device is installed,set up and removed by trained technicians.
Cost: There has been an economic analysis published in the BMJ Open Respiratory Research which found that the Air4 was a cost effective addition to standard treatment in patients with severe uncontrolled atopic asthma. These high risk patients with severe atopic asthma who use Air4 could reduce the incidence of hospitalization which could be cost saving to the NHS. Brazier et al (2015)         Airsonett® would be added to existing treatment and the average cost of long term treatment is £5.72 per day. Estimated cost of add on therapy currently used in the NHS is Omalizumab at approximately £23 per day.
The cost utility analysis estimated an incremental cost effectiveness ratio (ICER) of £8998 per quality of life adjusted year (QALY) with Airsonett®® compared to NHS standard care based on an incremental cost of £553 and a QALY gain of 0.0615.
People Measures:Success of the device will be measured using the following key performance indicators at 3 months for children and 6 months for adults: Improvement in the Asthma Control Test (ACT); reduction in exacerbations (compared to previous 12 months); reduction in or stopping of oral corticosteroids; Improvement in the Asthma Quality of Life Scores, adult and children (AQLQ: PAQLQ) and also improvement in sleep, work/school, and comorbid allergic disease such as eczema and/or perinnial rhinitis.
Adoption target:
Currently in WM there are 2 sites in the Laser trial (adult) and 2 sites (Paediatrics) who have patients on the device; approximately 5 additional sites across the WM with an interest. Based on the current interested sites I would estimate in the first year approximately 30 patients.
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