Implementation of the “Health-triangle Concept” for a “Biosmart and Safe Bus” as a Solution in the Pandemic Era: An Observational and Randomized Clinical Trial

Abstract

Introduction: The “Health Triangle Concept”, implemented in “Biosmart and Safe Bus”, balances interactions between the host, agent, and environment. This concept results in a safe eco-biological environment in the bus cabin, enhances immune system function, and maintains oxidative stress homeostasis. This study aimed to prove the effectiveness and efficacy of implementing the “Health Triangle Concept” in bus transportation through the development of a bus called the “Biosmart and Safe Bus.” Materials and methods: The “Challenge tests” were conducted at Laboratory for Development of Agro-industrial and Biomedical Technology (LAPTIAB). The pre- and post-test samples were taken from seventy passengers (19-23 years old), divided randomly to control group (n = 35) in a regular bus, and intervention group rode the “Biosmart and Safe Bus” (n = 35). Results: The delta levels of IgA improved (17.89±30.19 mg/mL) in buses adopting the concept, as well as delta levels of IL-6 (13.38±0.96 pg/mL). A significant difference (p = 0.016) and a strong negative correlation (r = -0.611) in delta levels of SOD3 (54.69±163.91 U/ml) and ROS (24.17±45.62 (U/ml) in intervention group. Conclusion: The “Health-Triangle Concept” for the “Biosmart and Safe Bus” resulted in an eco-biological safe bus cabin environment, improved passenger’s airway immune systems, and enhanced oxidative stress homeostasis.