How home ventilation rates affect health: A literature review

This paper reviews studies of the relationships between ventilation rates (VRs) in homes and occupant health, primarily respiratory health. Five cross‐sectional studies, seven case‐control studies, and eight intervention studies met inclusion criteria. Nearly all studies controlled for a range of potential confounders and most intervention studies included placebo conditions. Just over half of studies reported one or more statistically significant (SS) health benefits of increased VRs. Wheeze was most clearly associated with VR. No health outcomes had SS associations with VRs in the majority of statistical tests. Most studies that reported SS health benefits from increased VRs also had additional health outcomes that did not improve with increased VRs. Overall, the number of SS improvements in health with increased VRs exceeded the anticipated chance improvements by approximately a factor of seven. The magnitude of the improvements in health outcomes with increased VRs ranged from 20% to several‐fold improvements. In summary, the available research indicates a tendency for improvements in respiratory health with increased home VRs; however, health benefits do not occur consistently and other exposure control measures should be used together with ventilation. The research did not enable identification of a threshold VR below which adverse health effects occur.     

Characterization and variability of endotoxin and 3-hydroxy fatty acids in an office building during a particle intervention study

Air and dust samples were collected on two floors of an office building during a double-blind particle intervention study to examine spatial and temporal variability of airborne endotoxin over a period of weeks, and to characterize endotoxin activity and lipopolysaccharide (LPS) content in carpet and chair dust. Air samples were collected on multiple days within and across weeks. Dust samples were collected from carpets and chairs one day per week for three weeks. Endotoxin was measured using a Limulus assay. Dust samples were analyzed for LPS by determination of 3-hydroxy fatty acids (3-OHFAs) using gas chromatography-mass spectrometry. The geometric mean (geometric standard deviation) for 96 indoor air samples was 0.24 (1.6) EU/m3. Significant within-floor spatial variation of airborne endotoxin was found (P < 0.0001, n = 80). Temporal variability of airborne endotoxin was not significant across weeks. Mean (+/- SD) endotoxin levels in carpet dust (59 +/- 9.3 EU/mg dust, n = 12) and in chair dust (38 +/- 7.7 EU/mg dust, n = 10) were significantly different (P < 0.001). Carbon chain length-dependent differences in 3-OHFA levels by dust source and floor were found. Enhanced air filtration did not significantly affect airborne endotoxin (P = 0.62); however, total dust mass and total endotoxin in carpet dust samples increased significantly after enhanced surface cleaning (P < 0.01). These findings suggest that spatial variability, dust source, and surface cleaning may influence building occupant exposures to endotoxin.     

Ventilation efficiencies of desk-mounted task/ambient conditioning systems

In laboratory experiments, we investigated two task/ambient conditioning systems with air supplied from desk-mounted air outlets to efficiently ventilate the breathing zone of heated manikins seated at desks. In most experiments, the task conditioning systems provided outside air while a conventional ventilation system provided additional space cooling but no outside air. Air change effectiveness (i.e., exhaust air age divided by age of air at the manikin's face) was measured with a tracer gas step-up procedure. Other tracer gases simulated the release of pollutants from nearby occupants and from the floor covering, and the associated pollutant removal efficiencies (i.e., exhaust air concentrations divided by concentrations at manikin's face) were calculated. High values of air change effectiveness (approximately 1.3 to 1.9) and high values of pollutant removal efficiency (approximately 1.2 to 1.6) were measured when these task conditioning systems supplied 100% outdoor air at a flow rate of 7 to 9 L s-1 per occupant. Air change effectiveness was reasonably well correlated with the pollutant removal efficiency. Overall, the experimental data suggest that these task/ambient conditioning systems can be used to improve ventilation and air quality or to save energy while maintaining a typical level of IAQ at the breathing zone.     

Associations between indoor CO2 concentrations and sick building syndrome symptoms in U.S. office buildings: an analysis of the 1994-1996 BASE study data

Higher indoor concentrations of air pollutants due, in part, to lower ventilation rates are a potential cause of sick building syndrome (SBS) symptoms in office workers. The indoor carbon dioxide (CO2) concentration is an approximate surrogate for indoor concentrations of other occupant-generated pollutants and for ventilation rate per occupant. Using multivariate logistic regression (MLR) analyses, we evaluated the relationship between indoor CO2 concentrations and SBS symptoms in occupants from a probability sample of 41 U.S. office buildings. Two CO2 metrics were constructed: average workday indoor minus average outdoor CO2 (dCO2, range 6-418 ppm), and maximum indoor 1-h moving average CO2 minus outdoor CO2 concentrations (dCO2MAX). MLR analyses quantified dCO2/SBS symptom associations, adjusting for personal and environmental factors. A dose-response relationship (p < 0.05) with odds ratios per 100 ppm dCO2 ranging from 1.2 to 1.5 for sore throat, nose/sinus, tight chest, and wheezing was observed. The dCO2MAX/SBS regression results were similar.     

Association of ventilation system type with SBS symptoms in office workers

This paper provides a synthesis of current knowledge about the associations of ventilation system types in office buildings with sick building syndrome (SBS) symptoms and discusses potential explanations for the associations. Most studies completed to date indicate that relative to natural ventilation, air conditioning, with or without humidification, was consistently associated with a statistically significant increase in the prevalence of one or more SBS symptoms, by approximately 30 to 200%. In two of three analyses from a single study (assessments), symptom prevalences were also significantly higher in air-conditioned buildings than in buildings with simple mechanical ventilation and no humidification. The available data also suggest, with less consistency, an increase in risk of symptoms with simple mechanical ventilation relative to natural ventilation. Insufficient information was available for conclusions about the potential increased risk of SBS symptoms with humidification or recirculation of return air. The statistically significant associations of mechanical ventilation and air conditioning with SBS symptoms are much more frequent than expected from chance and also not likely to be a consequence of confounding by several potential personal, job, or building-related confounders. Multiple deficiencies in HVAC system design, construction, operation, or maintenance, including some which cause pollutant emissions from HVAC systems, may contribute to the increases in symptom prevalences but other possible reasons remain unclear.     

Does dampness and mold in schools affect health? Results of a meta‐analysis

This paper provides meta‐analyses of the published findings relating the respiratory health of occupants of schools with visible dampness, water damage, visible mold, and/or mold odor. Random effects models were used to develop central estimates and confidence limits for the associations of respiratory health effects with school dampness and mold. Eleven studies, all with cross‐sectional designs, were included in the meta‐analyses; however, analyses for some health outcomes were based on as few as four studies. Analyses were performed using data from adults and children combined, using only data from children, and using data from adults and children after excluding two studies. The central estimates of odds ratios from the meta‐analyses were consistently above unity. The evidence of adverse health effects was strongest for cough and wheeze, which had confidence limits excluding unity in some or all analyses. The odds ratios of 1.32 for cough and 1.68 for wheeze suggest moderate increases in health risk. Studies not included in the meta‐analyses provide additional evidence that dampness and mold in schools are associated with adverse health outcomes. These meta‐analyses and the published literature not included in the meta‐analyses suggest that dampness and mold in schools are associated with adverse respiratory health effects.     

Effects of ventilation rate per person and per floor area on perceived air quality,sick building syndrome symptoms,and decision‐making

Ventilation rates (VRs) in buildings must adequately control indoor levels of pollutants; however, VRs are constrained by the energy costs. Experiments in a simulated office assessed the effects of VR per occupant on perceived air quality (PAQ), Sick Building Syndrome (SBS) symptoms, and decision‐making performance. A parallel set of experiments assessed the effects of VR per unit floor area on the same outcomes. Sixteen blinded healthy young adult subjects participated in each study. Each exposure lasted four hours and each subject experienced two conditions in a within‐subject study design. The order of presentation of test conditions, day of testing, and gender were balanced. Temperature, relative humidity, VRs, and concentrations of pollutants were monitored. Online surveys assessed PAQ and SBS symptoms and a validated computer‐based tool measured decision‐making performance. Neither changing the VR per person nor changing the VR per floor area, had consistent statistically significant effects on PAQ or SBS symptoms. However, reductions in either occupant‐based VR or floor‐area‐based VR had a significant and independent negative impact on most decision‐making measures. These results indicate that the changes in VR employed in the study influence performance of healthy young adults even when PAQ and SBS symptoms are unaffected.     

Real-time quality authentication of honey using atmospheric pressure chemical ionisation mass spectrometry (APCI-MS)

The aim of this study was to use gas chromatography-mass spectrometry (GC-MS) and APCI-MS techniques to detect adulteration in honey. The key volatile compounds in the headspace of the adulterated honey were marked by GC-MS and their representative fragment ions were utilised in scanning honey samples using the real-time APCI-MS system. The PLS models validated using independent data sets resulted in coefficient of the determination () of 0.97 and 0.96 and root mean square error in prediction (RMSEP) of 2.62 and 2.45 for the GC-MS and APCI-MS data sets respectively. The most efficient volatiles from GC-MS analysis and their corresponding fragment ions m/z from APCI-MS data analysis were then identified and used to develop new PLS models to predict the level of adulteration. The best PLS model gave of 0.95 and RMEP of 2.60% in the independent validation set indicating that the model was very accurate in predicting the level of adulteration.     

Health benefits and costs of filtration interventions that reduce indoor exposure to PM2.5 during wildfires

Increases in hospital admissions and deaths are associated with increases in outdoor air particles during wildfires. This analysis estimates the health benefits expected if interventions had improved particle filtration in homes in Southern California during a 10‐day period of wildfire smoke exposure. Economic benefits and intervention costs are also estimated. The six interventions implemented in all affected houses are projected to prevent 11% to 63% of the hospital admissions and 7% to 39% of the deaths attributable to wildfire particles. The fraction of the population with an admission attributable to wildfire smoke is small, thus, the costs of interventions in all homes far exceeds the economic benefits of reduced hospital admissions. However, the estimated economic value of the prevented deaths exceed or far exceed intervention costs for interventions that do not use portable air cleaners. For the interventions with portable air cleaner use, mortality‐related economic benefits exceed intervention costs as long as the cost of the air cleaners, which have a multi‐year life, are not attributed to the short wildfire period. Cost effectiveness is improved by intervening only in the homes of the elderly who experience most of the health effects of particles from wildfires.