Indoor Air Quality

Definition

An assessment of air quality in buildings and homes is based on physical and chemical monitoring of contaminants, physiological measurements, or psychosocial perceptions. Indoor air quality measures can also refer to the air inside types of transportation such as airplanes, trains, buses, and passenger cars. Factors contributing to the quality of indoor air include lighting, ergonomics, thermal comfort, tobacco smoke, noise, ventilation, and psychosocial or work-organizational factors such as employee stress and satisfaction. Sick building syndrome (SBS) and building-related illness (BRI) are responses to indoor air pollution commonly described by office workers. Most symptoms are nonspecific; they progressively worsen during the week, occur more frequently in the afternoon, and disappear on the weekend.

Description

Gases leak indoors from the polluted outdoor environment, but more often the serious pollutants arise from processes that take place indoors. There has been particular concern with indoor air quality regarding the generation of nitrogen oxides by sources such as gas stoves. Similarly formaldehyde (CH2O) from insulating foams causes illnesses and adds to concerns about human exposure to a substance that may induce cancer over a period of time. In the early twenty-first century, it became clear that radon (Rn) leaks from the ground can expose some members of the public to high levels of this radioactive gas within their own homes. Cancers may also result from the emanation of solvents from consumer products, glues, paints, and mineral fibers (asbestos). More generally, these compounds and a range of biological materials, animal hair, skin and pollen spores, and dusts can cause allergic reactions in some people. At one end of the spectrum, these simply cause annoyance, but in extreme cases, such as found with the bacterium Legionella, a large number of deaths can occur.

There are also important issues surrounding the effects of indoor air pollutants on materials. Many industries, especially the electronics industry, must take great care over the purity of indoor air where a speck of dust can destroy a microchip or low concentrations of air pollutants change the composition of surface films in component design. Museums must care for delicate, priceless objects over long periods of time, so precautions must be taken to protect delicate dyes from the effects of photochemical smog, paper and books from sulfur dioxide, and metals from sulfide gases.

Demographics

The prominence of IAQ issues has risen in part due to well-publicized incidents involving outbreaks of Legionnaires’ disease, Pontiac fever, SBS, multiple chemical sensitivity, and asbestos mitigation in public buildings such as schools. Legionnaire’s disease, for example, caused 29 deaths in 1976 in a Philadelphia, Pennsylvania, hotel due to infestation of the building’s air conditioning system by bacteria now called Legionella pneumophila. This microbe affects the gastrointestinal tract, kidneys, and central nervous system. It also causes the nonfatal Pontiac fever.

Purpose

IAQ is important to the general public for several reasons. First, individuals typically spend the vast majority (80% to 90%) of their time indoors. Second, an emphasis on energy conservation measures, such as reducing air exchange rates in ventilation systems and using more energy efficient but synthetic materials, has increased levels of air contaminants in offices and homes. Newer buildings are often airtight and have fewer cracks and openings so minimal fresh air enters these buildings. Low ventilation and exchange rates can result in increased indoor levels of carbon monoxide (CO), nitrogen oxides (NOx), ozone (O3), volatile organic compounds, bioaerosols, pesticides, and high levels of second-hand tobacco smoke. Thus, many contaminants are found indoors at levels that greatly exceed outdoor levels. Third, an increasing number of synthetic chemicals—found in building materials, furnishing, cleaning and hygiene products—are used indoors. Fourth, studies show that exposure to indoor contaminants such as radon (Rn), asbestos, and tobacco smoke pose significant health risks. Fifth, poor IAQ is thought to adversely affect child development and lower productivity in the adult population. Demands for IAQ investigations of problem buildings increased through the 1990s and early 2000s, and many buildings have been identified as having IAQ problems.

Causes and symptoms

Indoor air contains many contaminants at varying but generally low concentration levels. These cause indoor air pollution and can also produce various symptoms.

Causes

Common contaminants include radon and radon progeny from the entry of soil gas and groundwater; from concrete and other mineral-based building materials; tobacco smoke from cigarette and pipe smoking; formaldehyde from polyurethane foam insulation and building materials; volatile organic compounds (VOCs) emitted from binders and resins in carpets, furniture, or building materials, as well as VOCs used in dry cleaning processes and as propellants and constituents of personal use and cleaning products, such as hair sprays and polishes; pesticides and insecticides; carbon monoxide, nitrogen oxides, and other combustion productions from gas stoves, appliances, and vehicles; asbestos from high temperature insulation; and biological contaminants, including viruses, bacteria, molds, pollen, dust mites, and indoor and outdoor biota. Many or most of these contaminants are present at low levels in all indoor environments. High humidity and temperatures can result in increased concentration of some pollutants.

The quality of indoor air can change rapidly over time and from room to room. Many diverse sources emit various physical and chemical forms of contaminants. Some releases are slow and continuous, such as out-gassing associated with building and furniture materials, whereas others are nearly instantaneous, like in the use of cleaners and aerosols. Many building surfaces demonstrate significant interactions with contaminants in the form of sorption-desorption processes. Building-specific variation in air exchange rates, mixing, filtration, building and furniture surfaces, and other factors alter dispersion mechanisms and contaminant lifetimes. Most buildings employ filters that can remove particles and aerosols. Filtration systems do not effectively remove very small particles and have no effect on gases, vapors, and odors.

Symptoms

Diagnosis

The diagnosis of medical problems associated with indoor air pollution is difficult to differentiate from other common causes of respiratory illnesses. A diagnosis of respiratory problems caused by indoor air pollutants is based partially on the presence of common symptoms such as respiratory irritation, shortness of breath, coughing and wheezing, nausea, and headaches. It is also based on the environment within the indoor setting, such as the cleanliness of the volume, the introduction of new furniture, carpet, draperies, or other materials, and other such factors that can cause indoor air pollution.

Signs that indoor air pollution could be present include:

• little or no air movement
• stale, stuffy air
• suspicious or unusual odors
• dirty or faulty heating and/or air conditioning equipment
• damaged flue pipes and/or chimneys
• unvented combustion air sources for fossil fuel appliances, such as fireplaces
• feeling healthier outside of the home when compared to being inside
• excessive humidity
• presence of molds and mildew
• health problems or concerns after home remodeling or weatherizing, while using new furniture, when using household or hobby products, or when moving into a new home

Sources of poor indoor air quality originate from numerous sources. Some of them include:

• asbestos: found in most homes built in the 1970s or before, especially in such products as pipe insulation, acoustical materials, and floor tiles
• combustible products: such as carbon monoxide from unvented gas stoves and ovens and unvented fossil fuel space heaters; along with the backdrafting from furnaces and water heaters
• formaldehyde: used in such products as adhesives; durable press draperies and other textiles; and particle board products such as cabinets and furniture frames
• household products and furnishings: products that release volatile organic compounds (VOCs) such as aerosol sprays, dry-cleaned clothing, fabrics used in carpets, fresheners, hobby supplies, paints, solvents, and fabric additives used in carpets and furniture
• lead: from lead-based paint dust created when removing paint
• moisture and biological pollutants: moisture pollutants include high humidity levels, inadequate ventilation, and poorly maintained humidifiers and air conditioners; while biological pollutants consist of animal dander, cockroaches, mildew, dust mites, and molds
• particulate matter: from such sources as dust and pollen, fireplaces, wood stoves, kerosene heaters and unvented gas space heaters
• radon: the radioactive gas that originates from the soil, rock, and groundwater beneath and around the foundation of homes and other structures
• tobacco smoke: which produces particulate matter, combustion products, formaldehyde, and other toxic materials

Treatment

The treatment of illnesses caused by air pollution depends on the specific illness present. However, generally, anyone with chronic lung or heart disease caused by indoor air pollution should get an annual influenza (flu) shot. People with cardiopulmonary disease related to indoor air pollution should seek medical treatment that parallels those treatments for asthma, chronic obstructive pulmonary disease (COPD), congestive heart failure, and coronary artery disease.

Public health role and response

Prognosis

Indoor air quality can be improved with regular and aggressive cleaning methods, which helps remove the source of as many allergens as possible, including those from carpets, drapes and other window dressings, nonencased mattresses and pillows, materialstuffed furniture, pets, and stuffed toys.

The Asthma and Allergy Foundation of America has identified the following ways for improving indoor air quality:

• Keeping surfaces clean and uncluttered helps control dust mites. Using zippered allergen impermeable or plastic covers on all pillows, mattresses and box springs also helps.
• Vacuuming once or twice weekly reduces allergens. People with allergies should wear a dust mask while doing housework. Using a damp or treated cloth for dusting is also helpful.
• Preventing animal dander reduces allergic responses. People who have allergies to pets should bar the animals from their bedroom and keep the door closed and vents covered with dense material like cheesecloth.
• Keeping windows and doors closed cuts down on pollen. Using air conditioning in warm weather is also helpful.
• Using dehumidifiers helps reduce both mold and dust mites.
• Putting away food or covering garbage reduces the likelihood of infestations. Poison baits, boric acid, and traps can be used in preference to chemical agents that can irritate sinuses.

Prevention

Outdoor air enters indoor spaces via three different methods termed infiltration, natural ventilation, and mechanical ventilation. In infiltration, air enters through cracks and openings around windows, flooring, doors, and walls. Natural ventilation is achieved by opening windows and doors. Mechanical ventilation can be accomplished through the use of outdoorvented fans or air handling systems that use fans and ducts to remove air from inside and to introduce outdoor air inside. By removing indoor air and replacing it with outdoor air, it is possible to remove contaminants or pollutants that have built up inside. Ventilation and air exchange units designed in the heating and cooling systems of buildings are designed to diminish levels of these contaminants by dilution. In most buildings, however, ventilation systems are turned off at night after working hours, leading to an increase in contaminants through the night. Though operation and maintenance issues are estimated to cause the bulk of IAQ problems, deficiencies in the design of the heating, ventilating, and air conditioning (HVAC) system can cause problems as well. For example, locating a building’s fresh air intake near a truck loading dock will bring diesel fumes and other noxious contaminants into the building.

KEY TERMS

Asthma—

Respiratory disease usually caused by allergies; symptoms include coughing, difficulty in breathing, and a tight feeling in the chest.

Curie—

A unit of radioactivity abbreviated Ci that is equal to approximately 3.7 times 1010 decays per second.

Nitrogen oxides—

Any group of compounds consisting of a mixture of oxygen (O) and nitrogen (N).

Ozone—

A gaseous form of oxygen that has three oxygen (O) atoms per molecule with the chemical formula O3.

Particulate matter—

Fine liquid or solid particles that pollute the atmosphere by natural and humanmade processes.

Radon—

With chemical symbol Rn, a heavy gaseous radioactive element that is found mostly in rocks, soil, and underground water sources.

Volatile organic compounds (VOCs)—

Any organic chemicals with a high vapor pressure at normal room temperature and pressure, such as formaldehyde, some of which are harmful to the health of humans and thus are regulated by governments.

QUESTIONS TO ASK YOUR DOCTOR

• What should I do to minimize my chances of being exposed to indoor air pollution?
• Will I recover from illness caused by indoor air pollution?
• What is worse for my health, outdoor or indoor air pollution?
• What lifestyle changes should I consider?
• What should I do if I cannot avoid indoor air pollution?
• Are there specialists I should see to help treat me for my medical problems related to indoor air pollution?

See also Air pollution
; Asbestos
; Asthma
; Chemical sensitivity
; Legionnaire’s disease
; Ozone
; Sick building syndrome
; Smog
; Smoking
; Viruses
.

Resources

BOOKS

Burroughs, H. E., and Shirley J. Hansen. Managing Indoor Air Quality. Lilburn, GA: Fairmont Press, 2008.

Drury, Evan K., and Tylor S. Pridgen, eds. Handbook on Environmental Quality. New York: Nova Science, 2009.

Dudzińska, Marzena R., ed. Management of Indoor Air Pollution. Boca Raton, FL: CRC Press, 2011.

Flannigan, Brian, Robert A. Samson, and J. David Miller, eds. Microorganisms in Home and Indoor Work Environments: Diversity, Health Impacts, Investigation and Control. Boca Raton, FL: CRC Press, 2011.

Hess-Kosa, Kathleen. Indoor Air Quality: The Latest Sampling and Analytical Methods. Boca Raton, FL: CRC Press, 2011.

Wentz, Dave, and Myron Wentz. The Healthy Home: Simple Truths to Protect Your Family from Hidden Household Dangers. New York: Vanguard Press, 2011.

WEBSITES

American Lung Association. “Most Polluted Cities: State of the Air 2011.”
http://www.stateoftheair.org/2011/cityrankings/most-polluted-cities.html
(accessed October 31, 2012).

Asthma and Allergy Foundation of America. “Tips to Control Indoor Allergens.”
http://www.aafa.org/display.cfm?id=9⊂=18&cont=533
(accessed October 31, 2012).

Dickey, Jefferson H. “Air Pollution and Primary Care Medicine.” Physicians for Social Responsibility.
http://www.psr.org/chapters/boston/health-and-environment/air-pollution-and-primary.html#DIAGNOSIS
(accessed October 31, 2012).

Medline Plus. “Indoor Air Pollution.”
http://www.nlm.nih.gov/medlineplus/indoorairpollution.html
(accessed October 31, 2012).

Soos, Andy. “World Wide Air Pollution in the Future.” Environment News Network.
http://www.enn.com/pollution/article/44753
(accessed October 22, 2012).

Tremblay, K. R., Jr., and M. R. Vogel. “Improving Air Quality in Your Home.” Colorado State University.
http://www.ext.colostate.edu/pubs/consumer/09938.html
(accessed October 31, 2012).

U.S. Environmental Protection Agency. “Air Pollutants.”
http://www.epa.gov/oar/airpollutants.html
(accessed October 22, 2012).

U.S. Environmental Protection Agency. “Air Pollution Control Technology Center.”
http://www.epa.gov/etv/center-apc.html
(accessed October 22, 2012).

U.S. Environmental Protection Agency. “Building Air Quality (BAQ).”
http://www.epa.gov/iaq/largebldgs/baqtoc.html
(accessed October 31, 2012).

U.S. Environmental Protection Agency. “Consumer’s Guide to Radon Reduction.”
http://www.epa.gov/radon/pubs/consguid.html
(accessed October 31, 2012).

U.S. Environmental Protection Agency. “National Ambient Air Quality Standards (NAAQS).”
http://www.epa.gov/air/criteria.html
(accessed October 22, 2012).

Walsh, Bryan. “The 10 Most Air-Polluted Cities in the World.” Time magazine.

The 10 Most Air-Polluted Cities in the World

(accessed October 31, 2012).

World Health Organization. “Tackling the Global Clean Air Challenge.”
http://www.who.int/mediacentre/news/releases/2011/air_pollution_20110926/en/index.html
(accessed October 31, 2012).

ORGANIZATIONS

Agency for Toxic Substances and Disease Registry, 4770 Buford Hwy. NE, Atlanta, GA, 30341, (800) 232-4636,
http://www.atsdr.cdc.gov
.

American Lung Association, 1301 Pennsylvania Ave. NW, Ste. 800, Washington, DC, 20004, (202) 785-3355, [email protected],
http://www.lungusa.org
.

Environmental Protection Agency, 1200 Pennsylvania Ave. NW, Ariel Rios Bldg., Washington, DC, 20460, (202) 272-0167,
http://www.epa.gov
.

National Heart, Lung and Blood Institute, PO Box 30105, Bethesda, MD, 20824-0105, (301) 592-8573, Fax: (240) 629-3246, [email protected],
http://www.nhlbi.nih.gov
.

National Institute for Occupational Safety and Health, 1600 Clifton Rd., Atlanta, GA, 30333, (800) 232-4636, [email protected],
http://www.cdc.gov
.

Occupational Safety and Health Administration, 200 Constitution Ave., Washington, DC, 20210, (800) 321-6742,
http://www.osha.gov
.

Stuart Batterman