Indoor Air Quality in Healthcare Units—A Systematic Literature Review Focusing Recent Research

The adequate assessment and management of indoor air quality in healthcare facilities is of utmost importance for patient safety and occupational health purposes. This study aims to identify the recent trends of research on the topic through a systematic literature review following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodology. A total of 171 articles published in the period 2015–2020 were selected and analyzed. Results show that there is a worldwide growing research interest in this subject, dispersed in a wide variety of scientific journals. A textometric analysis using the IRaMuTeQ software revealed four clusters of topics in the sampled articles: physicochemical pollutants, design and management of infrastructures, environmental control measures, and microbiological contamination. The studies focus mainly on hospital facilities, but there is also research interest in primary care centers and dental clinics. The majority of the analyzed articles (85%) report experimental data, with the most frequently measured parameters being related to environmental quality (temperature and relative humidity), microbiological load, CO2 and particulate matter. Non-compliance with the WHO guidelines for indoor air quality is frequently reported. This study provides an overview of the recent literature on this topic, identifying promising lines of research to improve indoor air quality in healthcare facilities.

Indoor Air Quality Intervention in Schools; Effectiveness of a Portable HEPA Filter Deployment in Five Schools Impacted by Roadway and Aircraft Pollution Sources

The Healthy Air, Healthy Schools Study was established in January 2020 to better understand the impact of ultrafine particles (UFP) on indoor air quality in communities surrounding Seattle-Tacoma (Sea-Tac) International Airport. The study team took multipollutant measurements indoor and outdoor air pollution at five participating school locations to infiltration indoors. The schools participating in this project were located within a 7-mile radius of Sea-Tac Airport and within 0.5 miles of an active flight path. Based on experimental measures in an unoccupied classroom, infiltration rates of a) Ultrafine particles of aircraft origin b) Ultrafine particles of traffic origin and c) Wildfire smoke or other outdoor pollutants were characterized before and after the introduction of a classroom based portable HEPA filter intervention. The portable HEPA cleaners were an effective short-term intervention to improve the air quality in classroom environments, reducing the ultrafine particles to approximately 1/10th of that measured outside. Before the HEPA filter deployment, approximately one-half of all outdoor UFPs were measured indoors. This study is unique in focusing on UFP in school settings and demonstrating through multivariate methods that the UFP measured in the classroom space is primarily of outdoor origin. Although existing research suggests that improvements to indoor air quality in homes can significantly improve asthma outcomes, further research is necessary to establish the benefit to student health and academic performance of improved air quality in schools.

Strengthening Taiwan’s Green Building Certification System from Aspects of Productivity and Energy Costs to Provide a Healthier Workplace

This study estimates the relationship between poor indoor environmental quality (IEQ) and the increasing labor costs in green buildings in Taiwan. Specifically, poor performance of IEQ including HVAC, lighting, and indoor air quality, influences the health and well-being of occupants and leads to worse productivity, ultimately causing increased personnel cost. In Taiwan’s green building certification (GBC) system, the energy-savings category is mandatory while the IEQ category is only optional. It means that certified building cases may not reach the expected level in IEQ. Thus, this study reviews the thermal environment, indoor air quality (IAQ), and illumination performances of IEQ-certified and non-IEQ-certified buildings in 20 green buildings. Building energy and IEQ simulations were conducted to analyze the relationships between indoor comfort, energy cost, and personnel cost in green buildings. The results show that IEQ-certified green buildings averagely perform better than non-IEQ-certified ones in the aspects of IEQ and building costs. Besides, 3 of 13 non-IEQ-certified green buildings undertake extremely high additional expenditure for the poor IEQ. The results correspond to some previous findings that green-certified buildings do not necessarily guarantee good building performance. This study further inspects the pros and cons of Taiwan’s GBC system and proposes recommendations against its insufficient IEQ evaluation category. As the trade-off of energy-saving benefits with health and well-being in green buildings has always been a concern, this study aims to stimulate more quantitative research and promote a more comprehensive green building certification system in Taiwan.

Assessment of Indoor Air Quality in Residential Buildings of New England through Actual Data

Several studies on indoor air quality (IAQ) and sick building syndromes have been completed over the last decade, especially in cold countries. Efforts to make homes airtight to improve energy efficiency have created buildings with low ventilation rates, resulting in the build-up of indoor pollutants to harmful levels that would be otherwise unacceptable outdoors. This paper analyzed the infiltration rates, indoor temperatures, and variations in CO2, 2.5 μm particulate matter (PM2.5), and total volatile organic compound (TVOC) concentrations over the fall of 2021 in several homes in New England, USA. A relationship between outdoor and indoor conditions and ventilation strategies has been set using the results from blower door tests and actual indoor air quality data. Although all case studies lacked mechanical ventilation devices, such as those required by ASHRAE Standard 62.2, natural ventilation and air leakage have been enough to keep VOCs and PM2.5 concentration levels at acceptable values most of the studied time. However, results revealed that 25% of a specific timeframe, the occupants have been exposed to concentration levels of CO2 above 1000 parts per million (ppm), which are considered potentially hazardous conditions.

An Investigation of Indoor Air Quality in a Recently Refurbished Educational Building

Young people spend extended periods of time in educational buildings, yet relatively little is known about the air quality in such spaces, or the long-term risks which contaminant exposure places on their health and development. Although standards exist in many countries in relation to indoor air quality in educational buildings, they are rarely subject to detailed post-occupancy evaluation. In this study a novel indoor air quality testing methodology is proposed and demonstrated in the context of assessing the post-occupancy performance of a recently refurbished architecture studio building at Loughborough University, United Kingdom. The approach used provides a monitoring process that was designed to evaluate air quality in accordance with United Kingdom national guidelines (Building Bulletin 101) and international (WELL Building) standards. Additional, scenario-based, testing was incorporated to isolate the presence and source of harmful volatile organic compounds, which were measured using diffusive sampling methods involving analysis by thermal desorption - gas chromatography - mass spectrometry techniques. The findings show that whilst the case-study building appears to perform well in respect to existing national and international standards, these guidelines only assess average CO2 concentrations and total volatile organic compound limits. The results indicate that existing standards, designed to protect the health and wellbeing of students, are likely to be masking potentially serious indoor air quality problems. The presence of numerous harmful VOCs found in this study indicates that an urgent revaluation of educational building procurement and air quality monitoring guidelines is needed.

Room-Level Ventilation in Schools and Universities

Ventilation is of primary concern for maintaining healthy indoor air quality and reducing the spread of airborne infectious disease, including COVID-19. In addition to building-level guidelines, increased attention is being placed on room-level ventilation. However, for many universities and schools, ventilation data on a room-by-room basis are not available for classrooms and other key spaces. We present an overview of approaches for measuring ventilation along with their advantages and disadvantages. We also present data from recent case studies for a variety of institutions across the United States, with various building ages, types, locations, and climates, highlighting their commonalities and differences, and examples of the use of this data to support decision making.

Indoor air quality in wards of dental school clinic: Variations of VOCs, CO2 and airborne particle levels

Introduction: The indoor environment of dental clinics may endanger dental patients and personnel and due to a great variety of air pollutants throughout the usual dental operation. The purpose of the present cross-sectional study was the evaluation of Indoor Air Quality (IAQ) and factors affecting it in a dentistry faculty of Arak University of Medical Sciences. Material and methods: The IAQ of five dental active wards and the patient waiting room was evaluated. The concentrations of Total Volatile Organic Compounds (TVOC), CO2, particulate matter, and bioaerosols were measured. Results: The TVOCs concentration in sampling locations ranged between 817 to 3670 μg/m3 during dental work and exceeded the Leadership in Energy and Environmental Design (LEED) guideline in all sampling locations. The highest values of Particulate Matter (PM) for PM10, PM2.5, and PM1 were observed in the periodontics ward, while the lowest values were observed in the endodontics ward. The PM2.5 concentrations exceeded the WHO limit in periodontics and pediatric wards. TVOC levels had a significant positive correlation with temperature (r=0.374, p<0.01) and RH (r=0.265, p<0.05). The predominant bacterial genus of the patient waiting area was Bacillus (36%), while the dominant bacterial genus of the other sampling site was Micrococcus spp. Penicillium (35.5%) and Cladosporium (28%) were the predominant fungi detected. Conclusion: Controlling of airborne particles is to be standardized by the infection control actions of dental clinics and improved ventilation capacity in the air conditioning system was suggested for reducing VOCs and PM concentrations.