Exposure to Indoor Mouldy Odour Increases the Risk of Asthma in Older Adults Living in Social Housing

Bringing the voice of social housing tenants into shaping the health and care research agenda

BACKGROUND

A larger percentage of social housing tenants have poorer physical and mental health outcomes compared to private renters and homeowners. They are also at a greater risk of respiratory conditions, cardiovascular disease, communicable disease transmission and mortality. One approach that aims to reduce health inequalities is to create research partnerships with underserved local communities. Our primary aim was to develop a research partnership with social housing tenants in Nottingham and our secondary aim was to explore the health priorities of these social housing tenants to inform future research applications. We also hope to provide a descriptive process of PPI within a social housing context for other researchers to learn from.

METHODS

We used Public and Patient Involvement (PPI) as the foundation of this work, as we believed that people with lived experience of social housing, also end-users of the research, were best placed to inform us of the areas with the greatest research need. Through online and in-person focus groups, we discussed with tenants, collectively named a Social Advisory Group (SAG), their health concerns and priorities. Together they raised 26 health issues, which were combined with 22 funding opportunity themes being offered by the NIHR (National Institute for Health and Care Research). This was with the purpose of investigating whether there was alignment between the health needs of Nottingham's social housing tenants and the NIHR's research priorities. A prioritisation technique (Diamond Nine) was used to sort in total, 48 areas of health and wellbeing, into three top priorities. Tenants were provided the opportunity to be involved in public health research in other ways too, such as reviewing this paper and also an NIHR Programme Development Grant application to expand and continue this work. One was also offered the opportunity to be a public co-applicant.

RESULTS

The group prioritised improvements in the quality of social housing, mental health and healthcare services. There was only some alignment between these and the NIHR funding themes. Other factors, such as age and race, also determined individual health priorities. . The diversity and reach of the current project were limited, however this is something we hope to improve in the future with more funding. We learned that tenants have varying degrees of mobility and technological abilities, requiring both online and in-person meetings.

Factors related with lung functions among Orang Asli in Tasik Chini, Malaysia: a cross-sectional study

BACKGROUND

Orang Asli lifestyle and household setting may influence their health status especially respiratory system and lung functions. This cross-sectional study was carried out to investigate the status of lung functions of Orang Asli community and the associated factors.

METHODS

Data collection was carried out from November 2017 until May 2018 among 211 Orang Asli respondents aged 18 years old and above, who lived in five villages in Tasik Chini, Pahang. All respondents who fulfilled the inclusion criteria were recruited in this study. Interview-guided questionnaire was administered, and spirometry test that include Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), and Peak Expiratory Flow Rate (PEFR) was carried out. Data were analyzed using SPSS software version 23.0. In the first stage, descriptive analysis was done to describe the characteristics of the respondents. In the second stage, bivariable analysis was carried out to compare proportions. Finally, multiple logistic regression was performed to assess the effects of various independent predictors on spirometry parameters.

RESULTS

The respondents' age ranged from 18 to 71 years old in which 50.2% of them were female. The majority ethnicity in Tasik Chini was Jakun tribe (94.3%). More than half of the respondents (52.1%) were current smoker, 5.2% were ex-smoker and 41.7% were non-smoker. More than half of them (62.1%) used woodstove for cooking, compared to only 37.9% used cleaner fuel like Liquefied Petroleum Gas (LPG) as a fuel for everyday cooking activity. The lung function parameters (FEV1 and FVC) were lower than the predictive value, whereas the ratio of Forced Expiratory Volume in one second and Forced Vital Capacity (FEV1/FVC) (%) and PEFR were within the predictive value. The FEV1 levels were significantly associated with age group (18-39 years old) (p = 0.002) and presence of woodstove in the house (p = 0.004). FVC levels were significantly associated with presence of woodstove in the house (p = 0.004), whereas there were no significant associations between all factors and FEV1/FVC levels.

CONCLUSIONS

FEV1 levels were significantly associated with age group 18-39 years old, whereas FVC levels were significantly associated with the presence of woodstove in the house. Thus, environmental interventions such as replacing the use of woodstove with LPG, need to be carried out to prevent further worsening of respiratory health among Orang Asli who lived far from health facilities. Moreover, closer health monitoring is crucial especially among the younger and productive age group.

AWMF mold guideline "Medical clinical diagnostics for indoor mold exposure" - Update 2023 AWMF Register No. 161/001

None.

Poorly controlled asthma - Easy wins and future prospects for addressing fungal allergy

Poorly controlled asthma is especially common in low resource countries. Aside from lack of access to, or poor technique with, inhaled beta-2 agonists and corticosteroids, the most problematic forms of asthma are frequently associated with both fungal allergy and exposure, especially in adults leading to more asthma exacerbations and worse asthma. The umbrella term 'fungal asthma' describes many disorders linked to fungal exposure and/or allergy to fungi. One fungal asthma endotype, ABPA, is usually marked by a very high IgE and its differential diagnosis is reviewed. Both ABPA and fungal bronchitis in bronchiectasis are marked by thick excess airway mucus production. Dermatophyte skin infection can worsen asthma and eradication of the skin infection improves asthma. Exposure to fungi in the workplace, home and schools, often in damp or water-damaged buildings worsens asthma, and remediation improves symptom control and reduces exacerbations. Antifungal therapy is beneficial for fungal asthma as demonstrated in nine of 13 randomised controlled studies, reducing symptoms, corticosteroid need and exacerbations while improving lung function. Other useful therapies include azithromycin and some biologics approved for the treatment of severe asthma. If all individuals with poorly controlled and severe asthma could be 'relieved' of their fungal allergy and infection through antifungal therapy without systemic corticosteroids, the health benefits would be enormous and relatively inexpensive, improving the long term health of over 20 million adults and many children. Antifungal therapy carries some toxicity, drug interactions and triazole resistance risks, and data are incomplete. Here we summarise what is known and what remains uncertain about this complex topic.

Biomonitoring of Indoor Air Fungal or Chemical Toxins with Caenorhabditis elegans nematodes

Bad indoor air quality due to toxins and other impurities can have a negative impact on human well-being, working capacity and health. Therefore, reliable methods to monitor the health risks associated with exposure to hazardous indoor air agents are needed. Here, we have used transgenic Caenorhabditis elegans nematode strains carrying stress-responsive fluorescent reporters and evaluated their ability to sense fungal or chemical toxins, especially those that are present in moisture-damaged buildings. Liquid-based or airborne exposure of nematodes to mycotoxins, chemical agents or damaged building materials reproducibly resulted in time- and dose-dependent fluorescent responses, which could be quantitated by either microscopy or spectrometry. Thus, the C. elegans nematodes present an easy, ethically acceptable and comprehensive in vivo model system to monitor the response of multicellular organisms to indoor air toxicity.

Short-Term Exposure of Dactylis glomerata Pollen to Atmospheric Gaseous Pollutants Is Related to an Increase in IgE Binding in Patients with Grass Pollen Allergies

The concentrations of nitrogen dioxide (NO₂) and tropospheric ozone (O₃) in urban and industrial site atmospheres are considered key factors associated with pollen-related respiratory allergies. This work studies the effects of NO₂ and O₃ on the protein expression profile and IgE binding in patients with grass allergies to Dactylis glomerata pollen extracts. Pollens were collected during the flowering season and were exposed to NO₂ and O₃ in a controlled environmental chamber. The amount of soluble protein was examined using the Bradford method, and the protein expression profile and antigenic properties were analysed using the immunoblotting and enzyme-linked immunosorbent assay (ELISA), respectively. Our results showed apparent inter-sera differences concerning the number and intensity of IgE reactivity, with the most prominent at bands of 55 kDa, 35, 33, and 13 kDa. In the 13 kDa band, both gases tend to induce an increase in IgE binding, the band at 33 kDa showed a tendency towards a reduction, particularly pollen exposed to O₃. Reactive bands at 55 and 35 kDa presented an increase in the IgE binding pattern for all the patient sera samples exposed to NO₂, but the samples exposed to O₃ showed an increase in some sera and in others a decrease. Regarding the ELISA results, out of the 21 tested samples, only 9 showed a statistically significant increase in total IgE reactivity after pollen exposure to the pollutants. Our study revealed that although airborne pollen allergens might be affected by air pollution, the possible impacts on allergy symptoms might vary depending on the type of pollutant and the patient's sensitisation profile.

The Ancient Town Residential Environment of the Elderly in Xiangxi Tujia: Survey, Questions, and Recommendations

This study uses behavioral observation, interviews, and questionnaire research to investigate the residential environment. It also evaluates the elderly in four representative ancient towns of Xiangxi, namely, Liye Ancient Town, Furong Ancient Town, Liexi Ancient Town, and Xichehe Ancient Town. It includes indoor air (CO₂, PM_2.5, PM₁₀) and light intensity monitoring for the residential environment. The results showed that the elderly had a significant sense of frustration and loneliness. Of the elderyly, 70% believed the current living environment had an impact on healthy living, and 45% believed the safety and convenience of the living environment should be improved. More than 80% of the elderly were dissatisfied with their indoor acoustic environment, and more than 70% were dissatisfied with their home transportation. More than 85% of the elderly considered traditional wooden components and spaces to be the source of cultural identity. Furthermore, the average indoor PM_2.5 concentration during the fire pit fire was 350-600 µg/m³, about 4.7-8 times the Chinese standard value. The average concentration of PM₁₀ in all rooms was more than 400 µg/m³, approximately three times the Chinese standard value. Also, targeted environmental improvement strategies were proposed. The study results provided actual information to develop a systematic approach and a targeted design based on the needs to improve the residential environment of the elderly in ancient cities.

Indoor Air Quality in Tujia Dwellings in Hunan, China: Field Tests, Numerical Simulations, and Mitigation Strategies

Air pollution is a major health hazard. The traditional habits and unique ethnic fire culture in Hunan Tujia region result in the long-term exposure of residents, especially elderly people, to pollutants. In this study, we conducted field monitoring and assessment of indoor pollutants in the residential houses of Hunan Tujia families and subsequently visualised and simulated fire pollutants in representative residential houses by using fire-dynamic-simulator software. Pollutant-control strategies, using passive smoke collectors and resizing windows, were proposed and simulated for validation. The results revealed that passive smoke collectors reduced the pollutant concentration in the hall house by 43.96%. Furthermore, the optimal window size was 1500 mm × 1500 mm, and the most reasonable windowsill height of the firepit was 1800 mm. The results of the study can be used to improve the indoor air quality of Tujia dwellings and mitigate the adverse health effects of exposure to indoor air pollution without restricting ethnic beliefs and traditional customs.

Indoor Air Quality in Elderly Centers: Pollutants Emission and Health Effects

The world population is ageing, in particular in the developed world, with a significant increase in the percentage of people above 60 years old. They represent a segment of the population that is more vulnerable to adverse environmental conditions. Among them, indoor air quality is one of the most relevant, as elders spend comparatively more time indoors than younger generations. Furthermore, the recent COVID-19 pandemic contributed immensely to raising awareness of the importance of breathing air quality for human health and of the fact that indoor air is a vector for airborne infections and poisoning. Hence, this work reviews the state of the art regarding indoor air quality in elderly centers, considering the type of pollutants involved, their emission sources, and their health effects. Moreover, the influence of ventilation on air quality is also addressed. Notwithstanding the potential health problems with the corresponding costs and morbidity effects, only a few studies have considered explicitly indoor air quality and its impacts on elderly health. More studies are, therefore, necessary to objectively identify what are the impacts on the health of elderly people due to the quality of indoor air and how it can be improved, either by reducing the pollutants emission sources or by more adequate ventilation and thermal comfort strategies.

Household determinants of biocontaminant exposures in Canadian homes

Exposure to biocontaminants, such as dust mites, animal dander, bacteria, and mold, is associated with a range of health effects. This study identified household characteristics associated with indoor biocontaminant loadings in four Canadian cities. Floor dust was collected in 290 Canadian homes in Edmonton, Halifax, Montreal, and Windsor. The dust samples were analyzed for house dust mite allergens (Der f 1 and Der p 1), cat allergen (Fel d 1), cockroach allergen (Bla g 1), beta-(1,3)-D-glucan, and endotoxin. Household information was obtained through questionnaires and home inspections. We performed univariate and multivariate analyses to identify household determinants of biocontaminant loadings and mold odor presence. We observed large regional variations for all biocontaminants, except for cockroach allergen. The ranges of the contaminants measured in loadings and concentrations were similar to that of previous Canadian studies. Household characteristics including presence of carpeting, low floor cleaning frequency, older home age, presence of pets, and indoor relative humidity above 45% were positively associated with the presence of multiple indoor biocontaminants. High floor cleaning frequency and use of dehumidifiers were negatively associated with the presence of multiple indoor biocontaminants. Mold odor was positively associated with older home age, past water damage, and visible mold growth.

The feasibility and acceptability of digital technology for health and wellbeing in social housing residents in Cornwall: A qualitative scoping study

Objective

The aim of this study was to explore the feasibility and acceptability of digital technology for improving health and wellbeing in social housing residents living in a deprived area in Cornwall, England.

Methods

Qualitative scoping study with focus groups and telephone interviews (23 participants in total). Focus groups and interviews were audio-recorded, transcribed verbatim and analysed thematically.

Results

Levels of use and experience with digital technology were diverse in this group, ranging from ‘willing and unable’ to ‘expert’ on a self-perceived scale. Overall, participants had positive perceptions of technology and were keen to try new technologies. Five categories of factors influencing technology use were identified: functional, physical / health, psychological and attitudinal, technology-associated barriers, and privacy, safety and security. Preferred types of digital technology were wearable activity monitors (e.g. Fitbit®), virtual assistants (e.g. Amazon Alexa) and social messaging (e.g. WhatsApp). There was a strong consensus that technology should be easy to use and should have a clear purpose. There was a need to improve awareness, knowledge and confidence in technology use and participants desired further training and support.

Conclusions

There is a need and desire to use digital technology to improve health, wellbeing and social connectedness in social housing residents in Cornwall. The findings will be used to inform a digital training and support programme for the participants of the Smartline project. This study also serves as a template for future research that seeks to scope the feasibility and acceptability of different digital interventions in similar populations.

Indoor PM2.5, VOCs and asthma outcomes: A systematic review in adults and their home environments

INTRODUCTION

As the amount of time people spend indoors increases globally, exposure to indoor air pollutants has become an important public health concern. Asthma is a complex disease caused and/or exacerbated by increased exposure to diverse chemical, physical and biological exposures from multiple indoor and outdoor sources. This review aims to investigate the relationship between increased indoor PM and VOC concentrations (i.e. objectively measured) and the risk of adult asthma in higher-income countries.

METHODS

Eleven databases were systematically searched on the February 1, 2019 and again on the February 2, 2020. Articles were limited to those published since 1990. Reference lists were independently screened by three reviewers and authors were contacted to identify relevant articles. Backwards and forward citation chasing was used to identify further studies. Data were extracted from included studies meeting our eligibility criteria by three reviewers and assessed for quality using the Newcastle-Ottawa scale designed for case-control and cohort studies.

RESULTS

Twelve studies were included in a narrative synthesis. We found insufficient evidence to determine the effect of PM2.5 on asthma in the indoor home environment. However, there was strong evidence to suggest that VOCs, especially aromatic compounds, and aliphatic compounds, were associated with increased asthma symptoms.

DISCUSSION & CONCLUSION

Although no single exposure appears to be responsible for the development of asthma or its associated symptoms, the use of everyday products may be associated with increased asthma symptoms. To prevent poor health outcomes among the general population, health professionals and industry must make a concerted effort to better inform the general population of the importance of appropriate use of and storage of chemicals within the home as well as better health messaging on product labelling.

Changes in Domestic Energy and Water Usage during the UK COVID-19 Lockdown Using High-Resolution Temporal Data

In response to the COVID-19 outbreak, the UK Government provided public health advice to stay at home from 16 March 2020, followed by instruction to stay at home (full lockdown) from 24 March 2020. We use data with high temporal resolution from utility sensors installed in 280 homes across social housing in Cornwall, UK, to test for changes in domestic electricity, gas and water usage in response to government guidance. Gas usage increased by 20% following advice to stay at home, the week before full lockdown, although no difference was seen during full lockdown itself. During full lockdown, morning electricity usage shifted to later in the day, decreasing at 6 a.m. and increasing at midday. These changes in energy were echoed in water usage, with a 17% increase and a one-hour delay in peak morning usage. Changes were consistent with people getting up later, spending more time at home and washing more during full lockdown. Evidence for these changes was also observed in later lockdowns, but not between lockdowns. Our findings suggest more compliance with an enforced stay-at-home message than with advice. We discuss implications for socioeconomically disadvantaged households given the indication of inability to achieve increased energy needs during the pandemic.

Fostering Engagement With Health and Housing Innovation: Development of Participant Personas in a Social Housing Cohort

BACKGROUND

Personas, based on customer or population data, are widely used to inform design decisions in the commercial sector. The variety of methods available means that personas can be produced from projects of different types and scale.

OBJECTIVE

This study aims to experiment with the use of personas that bring together data from a survey, household air measurements and electricity usage sensors, and an interview within a research and innovation project, with the aim of supporting eHealth and eWell-being product, process, and service development through broadening the engagement with and understanding of the data about the local community.

METHODS

The project participants were social housing residents (adults only) living in central Cornwall, a rural unitary authority in the United Kingdom. A total of 329 households were recruited between September 2017 and November 2018, with 235 (71.4%) providing complete baseline survey data on demographics, socioeconomic position, household composition, home environment, technology ownership, pet ownership, smoking, social cohesion, volunteering, caring, mental well-being, physical and mental health-related quality of life, and activity. K-prototype cluster analysis was used to identify 8 clusters among the baseline survey responses. The sensor and interview data were subsequently analyzed by cluster and the insights from all 3 data sources were brought together to produce the personas, known as the Smartline Archetypes.

RESULTS

The Smartline Archetypes proved to be an engaging way of presenting data, accessible to a broader group of stakeholders than those who accessed the raw anonymized data, thereby providing a vehicle for greater research engagement, innovation, and impact.

CONCLUSIONS

Through the adoption of a tool widely used in practice, research projects could generate greater policy and practical impact, while also becoming more transparent and open to the public.

Indoor Microbial Exposures and Chronic Lung Disease: From Microbial Toxins to the Microbiome

Effects of environmental microbial exposures on human health have long been of interest. Microbes were historically assumed to be harmful, but data have suggested that microbial exposures can modulate the immune system. We focus on the effects of indoor environmental microbial exposure on chronic lung diseases. We found contradictory data in bacterial studies using endotoxin as a surrogate for bacterial exposure. Contradictory data also exist in studies of fungal exposure. Many factors may modulate the effect of environmental microbial exposures on lung health, including coexposures. Future studies need to clarify which method of assessing environmental microbial exposures is most relevant.

Master Clinician and Public Health Practitioner: Selected Occupational and Environmental Pulmonary Cases

Occupational and environmental exposures contribute to the development and progression of most lung diseases, yet their impact is greatly under-recognized in clinical practice. Clinicians caring for patients with respiratory diseases should maintain a high index of suspicion for occupational and environmental contributing factors. Mastering occupational and environmental medicine clinical decision making requires specialized clinical skills. These skills include obtaining an appropriate work and exposure history; making an assessment of the magnitude and relevance of exposures and their contribution to a patient's respiratory disease; utilizing appropriate resources for evaluation and management of exposure-related disease; and considering socioeconomic and public health factors.

The Environmental Relative Moldiness Index reveals changes in mold contamination in United States homes over time

The Environmental Relative Moldiness Index (ERMI) is a scale created to compare mold contamination levels in U.S. homes. The ERMI was developed as a result of the Department of Housing and Urban Development's (HUD) first American Healthy Homes Survey (AHHS I), which sampled 1,096 homes selected to be representative of the U.S. housing stock. In AHHS I, a dust sample from each home was analyzed using quantitative PCR assays (qPCR) for 36 common indoor molds: 26 Group 1 molds, which were associated with water damage in homes and 10 Group 2 molds, which primarily enter the home from the outside environment. In 2019, HUD completed AHHS II by sampling 695 homes. Because lead was banned from paint in 1978, a larger proportion of homes selected for AHHS II had been built before 1978 compared to AHHS I. The 36 ERMI molds were analyzed in AHHS II exactly as in AHHS I. For the 36-ERMI molds, the rates of detection, average concentrations, and geometric means were in significant concordance (p < 0.001) between AHHS I and II, indicating that the ERMI methodology was stable over time. However, the average ERMI value in AHHS II homes was greater than in AHHS I. The reason for the difference was investigated by examining the Group 1 and 2 mold populations. The average summed logs of Group 1 molds were significantly greater in homes built before 1978 than the average for homes built later. Conversely, the average summed logs of Group 2 mold populations were the same in homes built before 1978 and homes built later. Since the summed logs of Group 2 mold is subtracted from the summed logs of Group 1 molds in the ERMI calculation, the average ERMI value was higher in AHHS II homes than AHHS I. In conclusion, by using the ERMI metric, we were able to demonstrate that water damage and mold growth were more likely to occur as homes get older.

House characteristics and condition as determinants of visible mold and musty odor: Results from three New Zealand House Condition Surveys in 2005, 2010, and 2015

This study assessed associations between house characteristics and mold and musty odor, using data from three consecutive (2005, 2010, and 2015) New Zealand House Condition Surveys, involving a total of 1616 timber-framed houses. Mold, musty odor, and house characteristics were assessed by independent building inspectors. We used multivariate logistic regression analyses mutually adjusted for other house characteristics for each survey separately. Positive and independent associations were found with tenure, ventilation, insulation, and envelope condition for both mold in living and bedrooms and musty odor. In particular, we found significant dose-response associations with envelope condition, ventilation, and insulation. Odds of mold increased 2.4-15.9 times (across surveys) in houses with the worst building envelope condition (BEC; p < 0.05-0.001 for trend); optimal ventilation reduced the risk of mold by 60% and the risk of musty odor by 70%-90% (p < 0.01 for trend). Other factors associated with mold and musty odor included: tenure, with an approximate doubling of odds of mold across surveys; and insulation with consistent dose-response patterns in all outcomes and surveys tested (p < 0.05 for trend in two surveys with mold and one survey for odor). In conclusion, this study showed the importance of BEC, ventilation, and insulation to avoiding harmful damp-related exposures.

Bioreactivity, Guttation and Agents Influencing Surface Tension of Water Emitted by Actively Growing Indoor Mould Isolates

The secretion of metabolites in guttation droplets by indoor moulds is not well documented. This study demonstrates the guttation of metabolites by actively growing common indoor moulds. Old and fresh biomasses of indoor isolates of Aspergillus versicolor, Chaetomium globosum, Penicillium expansum, Trichoderma atroviride, T. trixiae, Rhizopus sp. and Stachybotrys sp. were compared. Metabolic activity indicated by viability staining and guttation of liquid droplets detected in young (<3 weeks old) biomass were absent in old (>6 months old) cultures consisting of dehydrated hyphae and dormant conidia. Fresh (<3 weeks old) biomasses were toxic more than 10 times towards mammalian cell lines (PK-15 and MNA) compared to the old dormant, dry biomasses, when calculated per biomass wet weight and per conidial particle. Surfactant activity was emitted in exudates from fresh biomass of T. atroviride, Rhizopus sp. and Stachybotrys sp. Surfactant activity was also provoked by fresh conidia from T. atroviride and Stachybotrys sp. strains. Water repealing substances were emitted by cultures of P. expansum, T. atroviride and C. globosum strains. The metabolic state of the indoor fungal growth may influence emission of liquid soluble bioreactive metabolites into the indoor air.

Implementation of the Indoor Environmental Quality (IEQ) Model for the Assessment of a Retrofitted Historical Masonry Building

Achieving a satisfactory level for indoor environments of historical buildings is an ongoing problem that needs to be solved due to a large demand for deep retrofits in the whole of Europe. The implementation of the indoor environmental quality index (IEQ) to predict an occupant’s satisfaction in thermo-modernized historical buildings is a new concept which is a response to existing needs. In this article, a relevant study is provided with the intention to evaluate the indoor environmental performance of retrofitting effects in historical buildings dating back to the years 1873–1878. Considering the historical character of the buildings, some of the cellar spaces were fitted out with an innovative internal insulation system of mineral sheets based on calcium silicate to prevent water vapor condensation and effectively limit mold growth. The IEQ methodology was applied for retrofitted and non-retrofitted spaces as a comparison. Four essential components of indoor quality are investigated: thermal comfort, indoor air quality, acoustic comfort, and visual quality. The results of sub-component indexes are calculated based on the measured indoor parameters and the specific sensory functions. This paper discusses the results of an indoor environmental analysis including a mycological air quality assessment with the newly developed IAQindex (fungal air contamination index), total volatile organic compound concentration (TVOC), CO2, and formaldehyde (HCHO) assessment, the evaluation energy-related thermal comfort, acoustic, and visual quality, of modernized spaces. A questionnaire survey study was additionally carried out among a building’s users intentioned to compare the accounts of satisfaction before and after the retrofitting process and also to compare “subjective” results with the one’s based on in situ tests. The retrofitting approach was proven to be effective in limiting the presence of molds and a significant difference in indoor environmental quality between thermally insulated and uninsulated spaces was observed and discussed.

Health and Habitability in the Solar Decathlon University Competitions: Statistical Quantification and Real Influence on Comfort Conditions

Medicine and architecture are disciplines with the main objectives of satisfying the fundamental needs of human beings: health, comfort, well-being, safety, and ensuring an acceptable quality of life in a sustainable habitat. In both areas of knowledge, the advances and the most innovative proposals in the fields of research and teaching are focused on transversal knowledge and the use of learning methods through problem solving (learning by doing). The student competitions called "Solar Decathlon" are focused on the development of these concepts, in which prototypes of sustainable and, as far as possible, healthy social housing are tested. In these university competitions, the design of energy-efficient and comfortable living environments that contribute to the health of the occupants are encouraged; however, the methodology for evaluating the "comfort conditions" stipulated in the competition rules considers only parameters that can be monitored by sensors. For this article, the prototypes presented by the "Solar Decathlon Team of the University of Seville" to the editions of said competition held in Latin America and Europe (in 2015 and 2019, respectively) are being studied. The present research starts from the fact that the unique consideration of measurable indices (such as temperature, humidity, etc.), is clearly insufficient when it comes to evaluating the real conditions of habitability and comfort that a domestic architectural space presents. For this reason, a theoretical-practical analysis is carried out by means of surveys, with the final objective of determining a methodology for evaluating comfort-complementary to that of the competition-which assesses other relevant issues and which, in short, takes into account the repercussion on people's health. From our analysis, we conclude that at least these two methodologies should be used to evaluate comfort because they are individually considered incomplete in terms of the data provided by each one of them. The survey-based methodology provides complementary information on comfort and health that could be taken into account in future editions of Solar Decathlon.

Fungal Contaminants in Energy Efficient Dwellings: Impact of Ventilation Type and Level of Urbanization

The presence of growing fungi in the indoor environment has been associated with the development of respiratory problems such as asthma or allergic rhinitis, as well as the worsening of respiratory pathologies. Their proliferation indoors could be a result of water leakage or inadequate ventilation. Although the factors promoting mould growth have been widely investigated in traditional dwellings, little work has been done in energy efficient dwellings. Here, the effectiveness of ventilation type, i.e., natural or mechanical, in influencing mould development was estimated in 44 recent and 105 retrofitted energy efficient dwellings. Fungi growing on surfaces were investigated in the dwellings situated in rural, peri-urban, and urban regions of Switzerland. The presence of these fungi was also investigated in bedroom settled dust. Information on building characteristics and owners' lifestyle were collected. Significant associations were found with the level of urbanisation, the location of mouldy area in dwellings, and the diversity of fungal taxa. Dwellings in peri-urban zones showed the most frequent fungal contamination in the owners' bedroom and the highest diversity of fungal genera among dwellings. While the urbanisation level or the ventilation type favoured no specific genus, we found marked disparities in the diversity of fungi growing on surfaces in naturally ventilated versus mechanically ventilated dwellings. Aspergillus, in particular, was a frequent surface contaminant in bedrooms with natural ventilation, but not in those mechanically ventilated. We observed a strong association between fungal growth on surfaces and the number of fungal particles counted in the settled dust of owners' bedrooms. These results demonstrate the importance of ventilation systems in energy efficient dwellings in controlling fungal proliferation in living areas.