How home ventilation rates affect health: A literature review

Optimization of ventilation efficiency in tunnel-type underground spaces using response surface methodology: a case study of Yunlong Mountain civil defense in Xuzhou

Civil defense projects, designed as wartime underground spaces, often lack effective natural ventilation and have considerable depth, which complicates their use as public spaces in peacetime. However, the application of passive ventilation technologies can create effective airflow channels within these structures, significantly enhancing ventilation efficiency and thus improving the overall thermal comfort level. For this study, air age, along with average wind speed, temperature, and relative humidity as stipulated by the "Requirements for Environmental Sanitation of Civil Air Defense Works during Peacetime Use" (GBT 17216-2012), were selected as evaluation metrics. This paper compares the ventilation effectiveness between single ventilation shafts and multiple ventilation shafts under positive and negative pressure conditions in underground civil defense structures. The results indicate that negative pressure ventilation in multiple shaft configurations performs optimally across various ventilation approaches. Subsequently, the Response Surface Methodology (RSM) was utilized to further optimize the positioning of multiple ventilation shafts. The study examined the impact of three ventilation shaft locations on average wind speed, temperature, relative humidity, and air age, leading to an optimized design. Specifically, the optimal positions are 54.76 m for Shaft A, 51.45 m for Shaft B, and 79.85 m for Shaft C, achieving an average wind speed of 0.222 m/s, a temperature of 26 °C, a relative humidity reduction to 85.47%, and an average air age of 10.57 s. This research provides practical insights for the optimization of ventilation in underground civil defense facilities.

Multi-objective optimization of mechanical ventilation with the aid of purifiers in two scenarios: Regular operation and mitigating the spread of respiratory infectious diseases

COVID-19 and its impact on society have raised concerns about scaling up mechanical ventilation (MV) systems and the energy consequences. This paper attempted to combine MV and portable air cleaners (PACs) to achieve acceptable indoor air quality (IAQ) and energy reduction in two scenarios: regular operation and mitigating the spread of respiratory infectious diseases (RIDs). We proposed a multi-objective optimization method that combined the NSGA-II and TOPSIS techniques to determine the total equivalent ventilation rate of the MV-PAC system in both scenarios. The concentrations of PM2.5 and CO2 were primary indicators for IAQ. The modified Wells-Riley equation was adopted to predict RID transmissions. An open office with an MV-PAC system was used to demonstrate the method's applicability. Meanwhile, a field study was conducted to validate the method and evaluate occupants' perceptions of the MV-PAC system. Results showed that optimal solutions of the combined system can be obtained based on various IAQ requirements, seasons, outdoor conditions, etc. For regular operation, PACs were generally prioritized to maintain IAQ while reducing energy consumption even when outdoor PM2.5 concentration was high. MV can remain constant or be reduced at low occupancies. In RID scenarios, it is possible to mitigate transmissions when the quanta were < 48 h-1. No significant difference was found in the subjective perception of the MV and PACs. Moreover, the effects of infiltration on the optimal solution can be substantial. Nonetheless, our results suggested that an MV-PAC system can replace the MV system for offices for daily use and RID mitigation.

Electronic Supplementary Material ESM

The Appendix is available in the online version of this article at 10.1007/s12273-023-0999-z.

Exposure at the indoor water-air interface: Fill water constituents and the consequent air emissions from ultrasonic humidifiers: A systematic review

This systematic review investigates the emissions from ultrasonic humidifiers (e.g., cool mist humidifiers) within indoor air environments, namely soluble and insoluble metals and minerals as well as microorganisms and one organic chemical biocide. Relationships between ultrasonic humidifier fill water quality and the emissions in indoor air are studied, and associated potential adverse health outcomes are discussed. Literature from January 1, 1980, to February 1, 2022, was searched from online databases of PubMed, Web of Science, and Scopus to produce 27 articles. The results revealed clear positive proportional relationships of the concentration of microorganisms and soluble metals/minerals between fill water qualities and emitted airborne particles, for both microbial (n = 9) and inorganic (n = 15) constituents. When evaluating emissions and the consequent health outcomes, ventilation rates of specific exposure scenarios affect the concentrations of emitted particles. Thus, well-ventilated rooms may alleviate inhalation risks when the fill water in ultrasonic humidifiers contains microorganisms and soluble metals/minerals. Case reports (n = 3) possibly due to the inhalation of particles from ultrasonic humidifier include hypersensitivity pneumonitis in adults and a 6-month infant; the young infant exhibited nonreversible mild obstructive ventilator defect. In summary, related literature indicated correlation between fill water quality of ultrasonic humidifier and emitted particles in air quality, and inhalation of the emitted particles may cause undesirable health outcomes of impaired respiratory functions in adults and children.

Latest Trends in Pollutant Accumulations at Threatening Levels in Energy-Efficient Residential Buildings with and without Mechanical Ventilation: A Review

Improving the energy efficiency of buildings is a major target in developed countries toward decreasing their energy consumption and CO₂ emissions. To meet this target, a large number of countries have established energy codes that require buildings to be airtight. While such a retrofitting approach has improved health outcomes in areas with heavy traffic, it has worsened the health outcomes in Nordic countries and increased the risk of lung cancer in areas with high levels of radon emissions. This review highlights the importance of adapting the characteristics of energy-efficient residential buildings to the location, age, and health of inhabitants to guarantee healthy indoor pollutant levels. The implementation of mechanical ventilation in new energy-efficient buildings has solved some of these problems; however, for others, a decrease in the level of outdoor pollutants was still required in order to achieve a good indoor air quality. A good balance between the air exchange rate and the air humidity level (adapted to the location) is key to ensuring that exposure to the various pollutants that accumulate inside energy-efficient buildings is low enough to avoid affecting inhabitants′ health. Evidence of the protective effect of mechanical ventilation should be sought in dwellings where natural ventilation allows pollutants to accumulate to threatening levels. More studies should be carried out in African and Asian countries, which, due to their rapid urbanization, use massive volumes of unproven/unrated building materials for fast-track construction, which are frequent sources of formaldehyde and VOC emissions.

Building and Health: Mapping the Knowledge Development of Sick Building Syndrome

At present, with more and more attention paid to the impact of buildings on the health and well-being of occupants, sick building syndrome (SBS) has become a global concern. Since the introduction of SBS by the World Health Organization (WHO) in 1983, thousands of research literatures have been published in this field. This paper systematically arranges knowledge development of SBS through bibliometric analysis, exploring the most influential countries, institutions, journals and scholars, as well as the main subject categories and keywords. Main path analysis (MPA) was used to list development trajectory under inheritance relationship of SBS knowledge, including symptom analysis, risk factors of SBS and the improved impact of ventilation on SBS and productivity. Furthermore, it is an emerging research trend to propose SBS solution in the building design stage.

Personal Interventions for Reducing Exposure and Risk for Outdoor Air Pollution: An Official American Thoracic Society Workshop Report

Poor air quality affects the health and wellbeing of large populations around the globe. Although source controls are the most effective approaches for improving air quality and reducing health risks, individuals can also take actions to reduce their personal exposure by staying indoors, reducing physical activity, altering modes of transportation, filtering indoor air, and using respirators and other types of face masks. A synthesis of available evidence on the efficacy, effectiveness, and potential adverse effects or unintended consequences of personal interventions for air pollution is needed by clinicians to assist patients and the public in making informed decisions about use of these interventions. To address this need, the American Thoracic Society convened a workshop in May of 2018 to bring together a multidisciplinary group of international experts to review the current state of knowledge about personal interventions for air pollution and important considerations when helping patients and the general public to make decisions about how best to protect themselves. From these discussions, recommendations were made regarding when, where, how, and for whom to consider personal interventions. In addition to the efficacy and safety of the various interventions, the committee considered evidence regarding the identification of patients at greatest risk, the reliability of air quality indices, the communication challenges, and the ethical and equity considerations that arise when discussing personal interventions to reduce exposure and risk from outdoor air pollution.

Effects of mechanical ventilation on indoor air quality and occupant health status in energy-efficient homes: A longitudinal field study

Despite the growing interest in energy-efficient homes (EEHs), there is still a lack of evidence regarding whether the mechanical ventilation system of an EEH positively or negatively impacts indoor air quality (IAQ) and the health and wellbeing of occupants. This study aimed to evaluate the IAQ level and daily health symptoms of adults and children living in EEHs compared to conventional buildings over the course of one year. A two-way mixed analysis of variance was conducted to compare the level of IAQ between the two housing types. A binomial generalized linear mixed model (GLMM) and generalized additive mixed model was developed to investigate the association between IAQ and daily risks of symptoms. Differences in the daily prevalence of symptoms between the two housing types were assessed using a Poisson GLMM model. Overall, the indoor concentrations of particulate matter (PM₁₀ and PM_2.5), carbon dioxide (CO₂), and volatile organic compounds (VOCs) were lower in EEH after controlling for seasonality. The indoor temperature and relative humidity level were relatively constant in the EEH. We also found that an increased level of indoor air quality parameters, particularly CO_2, which is closely related to the indoor ventilation rate, was associated with the daily risk of eye fatigue, allergic rhinitis, and atopic dermatitis symptoms. Considering that EEH effectively reduced indoor air pollutants and IAQ improvement was associated with a reduction in the risk of individual symptoms, the IAQ improvement of EEH may have positively impacted occupants' health. Symptoms such as eye fatigue and skin dryness, which have been reported in previous studies as potential side effects of mechanical ventilation, were reported in this study; however, they were not found to be statistically significantly different from those reported in the conventional building.

Assessment of personal exposure to infectious contaminant under the effect of indoor air stability

The objective of this study is to understand the effect of indoor air stability on personal exposure to infectious contaminant in the breathing zone. Numerical simulations are carried out in a test chamber with a source of infectious contaminant and a manikin (Manikin A). To give a good visual illustration of the breathing zone, the contaminant source is visualized by the mouth of another manikin. Manikin A is regarded as a vulnerable individual to infectious contaminant. Exposure index and exposure intensity are used as indicators of the exposure level in the breathing zone. The results show that in the stable condition, the infectious contaminant proceeds straightly towards the breathing zone of the vulnerable individual, leading to a relatively high exposure level. In the unstable condition, the indoor air experiences a strong mixing due to the heat exchange between the hot bottom air and the cool top air, so the infectious contaminant disperses effectively from the breathing zone. The unstable air can greatly reduce personal exposure to the infectious contaminant in the breathing zone. This study demonstrates the importance of indoor air stability on personal exposure in the indoor environment and provides a new direction for future study of personal exposure reduction in the indoor environment.

Associations between ventilation and children's asthma and allergy in naturally ventilated Chinese homes

Building ventilation is important for occupants' health. There are few studies of associations between home ventilation and occupant's health in China. During 2013-2016, we measured ventilation in 399 homes in Tianjin and Cangzhou, China, and surveyed the health history of children. Ventilation rates were measured using mass balance of occupant generated CO₂ . The associations of home ventilation with children's asthma and allergy were analyzed in different strata of time and space. A low bedroom ventilation at night was significantly associated with an increased proportion of rhinitis among children (rhinitis current, adjusted odds ratio (AOR): 1.59; 95% confidence interval (CI): 1.01-2.49; diagnosed rhinitis, AOR: 3.02 (1.16-7.89)). Our findings suggest a dose-response relationship between ventilation rate at night in children's bedrooms and rhinitis current. The night-time ventilation rate in bedrooms has a greater association with rhinitis than the whole home ventilation rate during daytime.

Residence proximity to traffic-related facilities is associated with childhood asthma and rhinitis in Shandong, China

Associations of asthma and rhinitis with residential traffic proximity were investigated in several studies, but conclusions were inconsistent. From January to April in 2015, a cross-sectional study was conducted in two cities of Shandong, China. Parents-reported questionnaires were collected from 69 kindergartens for 3-6-year-olds preschoolers. Here we investigated associations of four traffic-related facilities (main traffic road, automobile 4S shop, filling station, and ground car park) close to residence with childhood asthma and rhinitis under considering individual and residential characteristics. In the two-level (kindergarten-child) mixed-effect logistic regression analyses among 5640 children who did not change residences since birth, filling station close to residence within 100 m (reference: >200 m) was significantly associated with lifetime-ever asthma (adjusted odds ratio, 95% confidence interval: 2.63, 1.28-5.40), wheeze (2.06, 1.35-3.15), rhinitis (1.69, 1.08-2.64) and current (past 12 months prior to the survey) wheeze (2.11, 1.34-3.34) and rhinitis (1.65, 1.05-2.59). Numbers of the facilities close to residence had dose-response relationships with odds of asthma, wheeze and rhinitis symptoms. These dose-response relationships were generally stronger in children whose bedrooms were in the 1st-3rd floors, and in children with low ventilation in bedroom and kitchen, and in children from families who did not using natural gas for cooking. The similar associations were found in the sensitive analyses among all surveyed 9597 children. Our results indicate that residence close to the traffic-related facilities likely is a risk factor for the occurrence of asthma and rhinitis among preschool children. The studied associations could be modified by household ventilation and air pollutants.

Vapor Intrusion Investigations and Decision-Making: A Critical Review

At sites impacted by volatile organic compounds (VOCs), vapor intrusion (VI) is the pathway with the greatest potential to result in actual human exposure. Since sites with VI were first widely publicized in late 1990s, the scientific understanding of VI has evolved considerably. The VI conceptual model has been extended beyond relatively simple scenarios to include nuances, such as biological and hydrogeological factors that may limit the potential for VI and alternative pathways, such as preferential pathways and direct building contact/infiltration that may enhance VI in some cases. Regulatory guidance documents typically recommend initial concentration- or distance-based screening to evaluate whether VI may be a concern, followed by a multiple-lines-of-evidence (MLE) investigation approach for sites that do not screen out. These recommendations for detailed evaluation of VI currently focus on monitoring of VOC concentrations in groundwater, soil gas, and indoor air and can be supplemented by other lines of evidence. In this Critical Review, we summarize key elements important to VI site characterization, provide the status and current understanding, and highlight data interpretation challenges, as well as innovative tools developed to help overcome the challenges. Although there have been significant advances in the understanding of VI in the past 20 years, limitations and knowledge gaps in screening, investigation methods, and modeling approaches still exist. Potential areas for further research include improved initial screening methods that account for the site-specific role of barriers, improved understanding of preferential pathways, and systematic study of buildings and infrastructure other than single-family residences.

Reaction kinetic study of nonthermal plasma continuous degradation of acetone in a closed-loop reactor

Nonthermal plasma (NTP) degradation has been shown to be a promising method for volatile organic compounds (VOCs) removal from air. However, there have been few studies on the degradation of indoor VOCs using NTP, and even less on their reaction kinetics. In this study, NTP degradation of acetone, a representative of oxygenated VOCs, in a closed-loop reactor operating in recirculation mode was investigated. Acetone and organic by-products were characterized in real-time by proton transfer reaction time-of-flight mass spectrometry. The results showed that approximately 85.7% of the acetone degraded within 7.5 h with dielectric barrier discharge treatment at 4.3 W. Methanol, acetaldehyde, formic acid, and acetic acid were observed to be the main organic byproducts with concentrations time-dependent on the order of ppb/ppm. The concentrations of the inorganic by-products O₃ and NO₂ are also time-dependent and can decrease to nearly 0 after a sufficient degradation time. Based on the concentration measurement in real-time, several rate laws were used to fit the concentration variations of acetone and the organic by-products, and it was observed that they strictly followed the simple kinetic reaction rate laws: acetone followed the first-order rate law, and formic acid formation followed the one-half-order rate law, etc. This study provides a good example of characterizing NTP removal of VOCs in airtight spaces and has important theoretical and practical significance in designing a better NTP device, predicting NTP degradation reaction rate, and accelerating the practical application of NTP technology for indoor air treatment.

Indoor Comfort and Symptomatology in Non-University Educational Buildings: Occupants’ Perception

The indoor environment in non-university classrooms is one of the most analyzed problems in the thermal comfort and indoor air quality (IAQ) areas. Traditional schools in southern Europe are usually equipped with heating-only systems and naturally ventilated, but climate change processes are both progressively increasing average temperatures and lengthening the warm periods. In addition, air renewal is relayed in these buildings to uncontrolled infiltration and windows’ operation, but urban environmental pollution is exacerbating allergies and respiratory conditions among the youth population. In this way, this exposure has a significant effect on both the academic performance and the general health of the users. Thus, the analysis of the occupants’ noticed symptoms and their perception of the indoor environment is identified as a potential complementary tool to a more comprehensive indoor comfort assessment. The research presents an analysis based on environmental sensation votes, perception, and indoor-related symptoms described by students during lessons contrasted with physical and measured parameters and operational scenarios. This methodology is applied to 47 case studies in naturally ventilated classrooms in southern Europe. The main conclusions are related to the direct influence of windows’ operation on symptoms like tiredness, as well as the low impact of CO2 concentration variance on symptomatology because they usually exceeded recommended levels. In addition, this work found a relationship between symptoms under study with temperature values and the environmental perception votes, and the special impact of the lack of suitable ventilation and air purifier systems together with the inadequacy of current thermal systems.

Air infiltration in low-income, urban homes and its relationship to lung function

Previous research has found increased home ventilation, which may affect health by altering the composition of indoor air, is associated with improvement of respiratory health, but evidence linking home ventilation to objectively measured lung function is sparse. The Colorado Home Energy Efficiency and Respiratory health (CHEER) study, a cross-sectional study of low-income, urban, nonsmoking homes across the Northern Front Range of Colorado, USA, focused on elucidating this link. We used a multipoint depressurization blower door test to measure the air tightness of the homes and calculate the annual average infiltration rate (AAIR). Lung function tests were administered to eligible participants. We analyzed data from 253 participants in 187 homes with two or more acceptable spirometry tests. We used generalized estimating equations to model forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), and FEV₁/FVC z-scores as a function of AAIR. AAIRs ranged from 0.10 to 1.98 air changes per hour. Mean z-scores for FEV₁, FVC, and FEV₁/FVC were -0.57, 0.32, and -0.43, respectively. AAIR was positively associated with increased FEV₁/FVC z-scores, such that a 1-unit change in AAIR corresponded to a half of a standard deviation in lung function (β = 0.51, CI: 0.02-0.99). These associations were strongest for healthy populations and weaker for those with asthma and asthma-like symptoms. AAIR was not associated with FEV₁ or FVC. Our study is the first in the United States to link home ventilation by infiltration to objectively measured lung function in low-income, urban households.

Birth month is associated with learning capacity in childhood in Northeast China

It is difficult to evaluate long-term ventilation and indoor-outdoor temperature variation on-site in the birth residence so as to investigate their associations with learning capacity from childhood through adolescence. Here, we conducted a questionnaire-based retrospective cohort study in ten schools from two northeast China cities with warm summers and severe cold winters when residences had very low air exchange rates. Scores for Chinese, Mathematics, and English in the final exams of the summer semester in June 2018 were collected to evaluate learning capacity. We surveyed 6238 students aged 14.7 (SD: 2.1) years old. Using the 2nd quarter (April-May-June) birth as reference, 4th quarter (October-November-December) birth consistently was significantly associated with lower scores in Chinese in bivariate (β, 95%CI: -3.2, -4.3 to -2.0) and multivariate (-1.8, -2.4 to -0.8) linear regression analyses. Stratified sub-analyses showed significant associations for male (-2.4, -3.7 to -1.1), urban (-2.4, -3.4 to -1.4), and primary students (-2.9, -4.5 to -1.4). Since household ventilation and indoor-outdoor temperature variation had great differences between the 2nd and 4th quarter of year, our results suggest that these two factors in the birth residence could be associated with learning capacity in childhood, especially for male and primary students in northeast China.

CO2 Concentration and Occupants’ Symptoms in Naturally Ventilated Schools in Mediterranean Climate

A large part of the school building stock in Andalusia lacks ventilation facilities, so that the air renewal of the classrooms is achieved through the building envelope (air infiltration) or the opening of windows. This research analyses the airtightness of the classrooms in Andalusia and the evolution of CO2 concentration during school hours through in situ monitoring. Pressurization and depressurization tests were performed in 42 classrooms and CO2 concentration was measured in two different periods, winter and midseason, to study the impact of the different levels of aperture of windows. About 917 students (11–17 years of age) were surveyed on symptoms and effects on their health. The mean n50 values are about 7 h−1, whereas the average CO2 concentration values are about 1878 ppm, with 42% of the case studies displaying concentrations above 2000 ppm with windows closed.

The Spatial and Temporal Variability of the Indoor Environmental Quality during Three Simulated Office Studies at a Living Lab

The living lab approach to building science research provides the ability to accurately monitor occupants and their environment and use the resulting data to evaluate the impact that various components of the built environment have on human comfort, health, and well-being. A hypothesized benefit of the living lab approach is the ability to simulate the real indoor environment in an experimentally controlled setting over relatively long periods of time, overcoming a significant hurdle encountered in many chamber-type experimental designs that rarely reflect typical indoor environments. Here, we present indoor environmental quality measurements from a network of sensors as well as building system design and operational data demonstrating the ability of a living lab to realistically simulate a wide range of environmental conditions in an office setting by varying air temperature, lighting, façade control, and sound masking in a series of three human subject experiments. The temporal variability of thermal and lighting conditions was assessed on an hourly basis and demonstrated the significant impact of façade design and control on desk-level measurements of both factors. Additional factors, such as desk layout and building system design (e.g., luminaires, speaker system), also contributed significantly to spatial variability in air temperature, lighting, and sound masking exposures, and this variability was reduced in latter experiments by optimizing desk layout and building system design. While ecologically valid experimental conditions are possible with a living lab, a compromise between realism and consistency in participant experience must often be found by, for example, using an atypical desk layout to reduce spatial variability in natural light exposure. Based on the experiences from these three studies, experimental design and environmental monitoring considerations for future office-based living lab experiments are explored.

Relationships between home ventilation rates and respiratory health in the Colorado Home Energy Efficiency and Respiratory Health (CHEER) study

BACKGROUND

As societies adopt green building practices to reduce energy expenditures and emissions that contribute to climate change, it is important to consider how such building design changes influence health. These practices typically focus on reducing air exchange rates between the building interior and the outdoor environment to minimize energy loss, the health effects of which are not well characterized. This study aims to evaluate the relationship between air exchange rates and respiratory health in a multi-ethnic population living in low-income, urban homes.

METHODS

The Colorado Home Energy Efficiency and Respiratory Health (CHEER) study is a cross-sectional study that enrolled 302 people in 216 non-smoking, low-income single-family homes, duplexes and town-homes from Colorado's Northern Front Range. A blower door test was conducted and the annual average air exchange rate (AAER) was estimated for each home. Respiratory health was assessed using a structured questionnaire based on standard instruments. We estimated the association between AAER and respiratory symptoms, adjusting for relevant confounders.

RESULTS

Air exchange rates in many homes were high compared to prior studies (median 0.54 air changes per hour, range 0.10, 2.17). Residents in homes with higher AAER were more likely to report chronic cough, asthma and asthma-like symptoms, including taking medication for wheeze, wheeze that limited activities and dry cough at night. Allergic symptoms were not associated with AAER in any models. The association between AAER and asthma-like symptoms was stronger for households located in areas with high potential exposure to traffic related pollutants, but this was not consistent across all health outcomes.

CONCLUSIONS

While prior studies have highlighted the potential hazards of low ventilation rates in residences, this study suggests high ventilation rates in single-family homes, duplexes and town-homes in urban areas may also have negative impacts on respiratory health, possibly due to the infiltration of outdoor pollutants.