Can changing the timing of outdoor air intake reduce indoor concentrations of traffic‐related pollutants in schools?

Traffic emissions have been associated with a wide range of adverse health effects. Many schools are situated close to major roads, and as children spend much of their day in school, methods to reduce traffic‐related air pollutant concentrations in the school environment are warranted. One promising method to reduce pollutant concentrations in schools is to alter the timing of the ventilation so that high ventilation time periods do not correspond to rush hour traffic. Health Canada, in collaboration with the Ottawa‐Carleton District School Board, tested the effect of this action by collecting traffic‐related air pollution data from four schools in Ottawa, Canada, during October and November 2013. A baseline and intervention period was assessed in each school. There were statistically significant (P < 0.05) reductions in concentrations of most of the pollutants measured at the two late‐start (9 AM start) schools, after adjusting for outdoor concentrations and the absolute indoor–outdoor temperature difference. The intervention at the early‐start (8 AM start) schools did not have significant reductions in pollutant concentrations. Based on these findings, changing the timing of the ventilation may be a cost‐effective mechanism of reducing traffic‐related pollutants in late‐start schools located near major roads.     

Sensory And Physiological Effects On Humans Of Combined Exposures To Air Temperatures And Volatile Organic Compounds

Ten healthy humans were exposed to combinations of volatile organic compounds (VOCs) and air temperature (0 mg/m³ and 10 mg/m³ of a mixture of 22 volatile organic compounds and 18, 22 and 26° C). Previously demonstrated effects of VOCs and thermal exposures were replicated. For the first time nasal cross-sectional areas and nasal volumes, as measured by acoustic rhinometry, were shown to decrease with decreasing temperature and increasing VOC exposure. Temperature and pollutant exposures affected air quality, the need for more ventilation, skin humidity on the forehead, sweating, acute sensory irritation and possibly watering eyes in an additive way. Interactions were found for odor intensity (p = 0.1), perceived facial skin temperature and dryness, general well-being, tear film stability, and nasal cavity dimension. The presence of interactions implies that in the future guidelines for acceptable indoor air concentrations of VOCs should depend on room air temperature.     

Symptoms and Perceived Indoor Air Quality among Occupants of Houses and Apartments with Different Ventilation Systems

The purpose of the study was to evaluate the occurrence of symptoms and the perception of poor indoor air quality among the occupants of houses and apartments with different ventilation systems. The study population consisted of the 473 occupants of 242 dwellings in the Helsinki metropolitan area who responded to a self-administered questionnaire (response rate 93.1%) after a two-week period of indoor air quality measurements. The symptoms of interest were those often related to poor indoor air quality including dryness or itching of the skin; dryness, irritation or itching of the eyes; nasal congestion (“blocked nose”) nasal dry-ness; nasal discharge (“runny nose”); sneezing; cough; breathlessness; headache or migraine; and lethargy, weakness or nausea. Perception of coldness; warm-ness; draught; dryness; stuffiness; and sufficiency of air exchange was also requested. The age-standardized period prevalences of the symptoms and complaints were systematically more common among the occupants of the apartments than those of the houses. The occupants of the houses with natural ventilation seemed to have more symptoms and complaints than those with balanced ventilation. However, in the apartments with balanced ventilation the occupants reported, in general, more symptoms and complaints than those with natural ventilation.     

Current asthma and respiratory symptoms among pupils in Shanghai, China: influence of building ventilation, nitrogen dioxide, ozone, and formaldehyde in classrooms

We investigated 10 naturally ventilated schools in Shanghai, in winter. Pupils (13-14 years) in 30 classes received a questionnaire, 1414 participated (99%). Classroom temperatures were 13-21 degrees C (mean 17 degrees C), relative air humidity was 36-82% (mean 56%). The air exchange rate was 2.9-29.4 ac/h (mean 9.1), because of window opening. Mean CO2 exceeded 1000 ppm in 45% of the classrooms. NO2 levels were 33-85 microg/m3 indoors, and 45-80 microg/m3 outdoors. Ozone were 1-9 microg/m3 indoors and 17-28 microg/m3 outdoors. In total, 8.9% had doctors' diagnosed asthma, 3.1% wheeze, 23.0% daytime breathlessness, 2.4% current asthma, and 2.3% asthma medication. Multiple logistic regression was applied. Observed indoor molds was associated with asthma attacks [odds ratio (OR) = 2.40: P < 0.05]. Indoor temperature was associated with daytime breathlessness (OR = 1.26 for 1 C; P < 0.001), and indoor CO2 with current asthma (OR = 1.18 for 100 ppm; P < 0.01) and asthma medication (OR = 1.15 for 100 ppm; P < 0.05). Indoor NO2 was associated with current asthma (OR = 1.51 for 10 microg/m3; P < 0.01) and asthma medication (OR = 1.45 for 10 microg/m3; P < 0.01). Outdoor NO2 was associated with current asthma (OR = 1.44 for 10 microg/m3; P < 0.05). Indoor and outdoor ozone was negatively associated with daytime breathlessness. In conclusion, asthma symptoms among pupils in Shanghai can be influenced by lack of ventilation and outdoor air pollution from traffic. Practical Implications Most urban schools in Asia are naturally ventilated buildings, often situated in areas with heavy ambient air pollution from industry or traffic. The classes are large, and window opening is the only way to remove indoor pollutants, but this results in increased exposure to outdoor air pollution. There is a clear need to improve the indoor environment in these schools. Building dampness and indoor mold growth should be avoided, and the concept of mechanical ventilation should be introduced. City planning aiming to situate new schools away from roads with heavy traffic should be considered.     

Ventilation characteristics of an air-conditioned office building in Singapore

The primary functions of mechanical ventilation systems include the delivery of outdoor air to the occupants, the removal of indoor contaminants and the maintenance of thermal comfort conditions in the occupied zones. Air exchange effectiveness can be employed to characterise the ventilation air mixing within a room. This paper presents our findings pertaining to air exchange effectiveness values in a seven-storey office building. Tracer gas analysis, based on concentration decay method, is employed to determine these values. The results indicate air flow patterns in the occupied zones which approximate “perfect mixing”. The measured concentration levels of indoor air pollutants are also found to be within reasonable limits.     

Filtration effectiveness of HVAC systems at near‐roadway schools

Concern for the exposure of children attending schools located near busy roadways to toxic, traffic‐related air pollutants has raised questions regarding the environmental benefits of advanced heating, ventilation, and air‐conditioning (HVAC) filtration systems for near‐road pollution. Levels of black carbon and gaseous pollutants were measured at three indoor classroom sites and at seven outdoor monitoring sites at Las Vegas schools. Initial HVAC filtration systems effected a 31–66% reduction in black carbon particle concentrations inside three schools compared with ambient air concentrations. After improved filtration systems were installed, black carbon particle concentrations were reduced by 74–97% inside three classrooms relative to ambient air concentrations. Average black carbon particle concentrations inside the schools with improved filtration systems were lower than typical ambient Las Vegas concentrations by 49–96%. Gaseous pollutants were higher indoors than outdoors. The higher indoor concentrations most likely originated at least partially from indoor sources, which were not targeted as part of this intervention.     

Assessment of ventilation and indoor air pollutants in nursery and elementary schools in France

The aim of this study was to characterize the relationship between Indoor Air Quality (IAQ) and ventilation in French classrooms. Various parameters were measured over one school week, including volatile organic compounds, aldehydes, particulate matter (PM_2.5 mass concentration and number concentration), carbon dioxide (CO₂), air temperature, and relative humidity in 51 classrooms at 17 schools. The ventilation was characterized by several indicators, such as the air exchange rate, ventilation rate (VR), and air stuffiness index (ICONE), that are linked to indoor CO₂ concentration. The influences of the season (heating or non‐heating), type of school (nursery or elementary), and ventilation on the IAQ were studied. Based on the minimum value of 4.2 l/s per person required by the French legislation for mechanically ventilated classrooms, 91% of the classrooms had insufficient ventilation. The VR was significantly higher in mechanically ventilated classrooms compared with naturally ventilated rooms. The correlations between IAQ and ventilation vary according to the location of the primary source of each pollutant (outdoor vs. indoor), and for an indoor source, whether it is associated with occupant activity or continuous emission.     

The influence of ventilation on reactions among indoor pollutants: modeling and experimental observations

This study examines the influence of ventilation on chemical reactions among indoor pollutants. We have used a one compartment mass balance model to simulate unimolecular and bimolecular reactions occurring indoors. The initial modeling assumes steady-state conditions. However, at low air exchange rates, there may be insufficient time to achieve steady-state. Hence we have also modeled non steady-state scenarios. In the cases examined, the results demonstrate that the concentrations of products generated from reactions among indoor pollutants increase as the ventilation rate decreases. This is true for unimolecular and bimolecular reactions, regardless of whether the pollutants have indoor or outdoor sources. It is also true even when one of the pollutants has an outdoor concentration that displays large diurnal variations. We have supplemented the modeling studies with a series of experiments conducted in typical commercial offices. The reaction examined was that between ozone and limonene. The ozone was present as a consequence of outdoor-to-indoor transport while the limonene originated indoors. Results were obtained for low and high ventilation rates. Consistent with the modeling studies, the concentrations of monitored products were much larger at the lower ventilation rates (even though the ozone concentrations were lower). The potential for reactions among indoor pollutants to generate reactive and irritating products is an additional reason to maintain adequate ventilation in indoor environments.     

Factors affecting variability in gaseous and particle microenvironmental air pollutant concentrations in Hong Kong primary and secondary schools

School-age children are particularly susceptible to exposure to air pollutants. To quantify factors affecting children's exposure at school, indoor and outdoor microenvironmental air pollutant concentrations were measured at 32 selected primary and secondary schools in Hong Kong. Real-time PM₁₀, PM_2.5, NO_2, and O₃ concentrations were measured in 76 classrooms and 23 non-classrooms. Potential explanatory factors related to building characteristics, ventilation practice, and occupant activities were measured or recorded. Their relationship with indoor measured concentrations was examined using mixed linear regression models. Ten factors were significantly associated with indoor microenvironmental concentrations, together accounting for 74%, 61%, 46%, and 38% of variations observed for PM_2.5, PM₁₀, O_3, and NO₂ microenvironmental concentrations, respectively. Outdoor concentration is the single largest predictor for indoor concentrations. Infiltrated outdoor air pollution contributes to 90%, 70%, 75%, and 50% of PM_2.5, PM₁₀, O_3, and NO₂ microenvironmental concentrations, respectively, in classrooms during school hours. Interventions to reduce indoor microenvironmental concentrations can be prioritized in reducing ambient air pollution and infiltration of outdoor pollution. Infiltration factors derived from linear regression models provide useful information on outdoor infiltration and help address the gap in generalizable parameter values that can be used to predict school microenvironmental concentrations.     

Do indoor pollutants and thermal conditions in schools influence student performance? A critical review of the literature

To assess whether school environments can adversely affect academic performance, we review scientific evidence relating indoor pollutants and thermal conditions, in schools or other indoor environments, to human performance or attendance. We critically review evidence for direct associations between these aspects of indoor environmental quality (IEQ) and performance or attendance. Secondarily, we summarize, without critique, evidence on indirect connections potentially linking IEQ to performance or attendance. Regarding direct associations, little strongly designed research was available. Persuasive evidence links higher indoor concentrations of NO(2) to reduced school attendance, and suggestive evidence links low ventilation rates to reduced performance. Regarding indirect associations, many studies link indoor dampness and microbiologic pollutants (primarily in homes) to asthma exacerbations and respiratory infections, which in turn have been related to reduced performance and attendance. Also, much evidence links poor IEQ (e.g. low ventilation rate, excess moisture, or formaldehyde) with adverse health effects in children and adults and documents dampness problems and inadequate ventilation as common in schools. Overall, evidence suggests that poor IEQ in schools is common and adversely influences the performance and attendance of students, primarily through health effects from indoor pollutants. Evidence is available to justify (i) immediate actions to assess and improve IEQ in schools and (ii) focused research to guide IEQ improvements in schools. PRACTICAL IMPLICATIONS: There is more justification now for improving IEQ in schools to reduce health risks to students than to reduce performance or attendance risks. However, as IEQ-performance links are likely to operate largely through effects of IEQ on health, IEQ improvements that benefit the health of students are likely to have performance and attendance benefits as well. Immediate actions are warranted in schools to prevent dampness problems, inadequate ventilation, and excess indoor exposures to substances such as NO(2) and formaldehyde. Also, siting of new schools in areas with lower outdoor pollutant levels is preferable.     

Associations between classroom CO2 concentrations and student attendance in Washington and Idaho

Student attendance in American public schools is a critical factor in securing limited operational funding. Student and teacher attendance influence academic performance. Limited data exist on indoor air and environmental quality (IEQ) in schools, and how IEQ affects attendance, health, or performance. This study explored the association of student absence with measures of indoor minus outdoor carbon dioxide concentration (dCO(2)). Absence and dCO(2) data were collected from 409 traditional and 25 portable classrooms from 22 schools located in six school districts in the states of Washington and Idaho. Study classrooms had individual heating, ventilation, and air conditioning (HVAC) systems, except two classrooms without mechanical ventilation. Classroom attributes, student attendance and school-level ethnicity, gender, and socioeconomic status (SES) were included in multivariate modeling. Forty-five percent of classrooms studied had short-term indoor CO(2) concentrations above 1000 p.p.m. A 1000 p.p.m. increase in dCO(2) was associated (P < 0.05) with a 0.5-0.9% decrease in annual average daily attendance (ADA), corresponding to a relative 10-20% increase in student absence. Annual ADA was 2% higher (P < 0.0001) in traditional than in portable classrooms. PRACTICAL IMPLICATIONS: This study provides motivation for larger school studies to investigate associations of student attendance, and occupant health and student performance, with longer term indoor minus outdoor CO(2) concentrations and more accurately measured ventilation rates. If our findings are confirmed, improving classroom ventilation should be considered a practical means of reducing student absence. Adequate or enhanced ventilation may be achieved, for example, with educational training programs for teachers and facilities staff on ventilation system operation and maintenance. Also, technological interventions such as improved automated control systems could provide continuous ventilation during occupied times, regardless of occupant thermal comfort demands.     

Evidence of inadequate ventilation in portable classrooms: results of a pilot study in Los Angeles County

The prevalence of prefabricated, portable classrooms (portables) for United States public schools has increased; in California, approximately one of three students learn inside portables. Limited research has been conducted on indoor air and environmental quality in American schools, and almost none in portables. Available reports and conference proceedings suggest problems from insufficient ventilation due to poor design, operation, and/or maintenance of heating, ventilation and air conditioning (HVAC) systems; most portables have one mechanical, wall-mounted HVAC system. A pilot assessment was conducted in Los Angeles County, including measurements of integrated ventilation rates based on a perfluorocarbon tracer gas technique and continuous monitoring of temperature (T) and relative humidity (RH). Measured ventilation rates were low [mean school day integrated average 0.8 per hour (range: 0.1-2.9 per hour)]. Compared with relevant standards, results suggested adequate ventilation and associated conditioning of indoor air for occupant comfort were not always provided to these classrooms. Future school studies should include integrated and continuous measurements of T, RH, and ventilation with appropriate tracer gas methods, and other airflow measures. PRACTICAL IMPLICATIONS: Adequate ventilation has the potential to mitigate concentrations of chemical pollutants, particles, carbon dioxide, and odors in portable and traditional classrooms, which should lead to a reduction in reported health outcomes, e.g., symptoms of 'sick building syndrome', allergies, asthma. Investigations of school indoor air and environmental quality should include continuous temperature and relative humidity data with inexpensive instrumentation as indicators of thermal comfort, and techniques to measure ventilation rates.     

Ozone in indoor environments: concentration and chemistry

The concentration of indoor ozone depends on a number of factors, including the outdoor ozone concentration, air exchange rates, indoor emission rates, surface removal rates, and reactions between ozone and other chemicals in the air. Outdoor ozone concentrations often display strong diurnal variations, and this adds a dynamic excitation to the transport and chemical mechanisms at play. Hence, indoor ozone concentrations can vary significantly from hour-to-hour, day-to-day, and season-to-season, as well as from room-to-room and structure-to-structure. Under normal conditions, the half-life of ozone indoors is between 7 and 10 min and is determined primarily by surface removal and air exchange. Although reactions between ozone and most other indoor pollutants are thermodynamically favorable, in the majority of cases they are quite slow. Rate constants for reactions of ozone with the more commonly identified indoor pollutants are summarized in this article. They show that only a small fraction of the reactions occur at a rate fast enough to compete with air exchange, assuming typical indoor ozone concentrations. In the case of organic compounds, the "fast" reactions involve compounds with unsaturated carbon-carbon bonds. Although such compounds typically comprise less than 10% of indoor pollutants, their reactions with ozone have the potential to be quite significant as sources of indoor free radicals and multifunctional (-C=O, -COOH, -OH) stable compounds that are often quite odorous. The stable compounds are present as both gas phase and condensed phase species, with the latter contributing to the overall concentration of indoor submicron particles. Indeed, ozone/alkene reactions provide a link between outdoor ozone, outdoor particles and indoor particles. Indoor ozone and the products derived from reactions initiated by indoor ozone are potentially damaging to both human health and materials; more detailed explication of these impacts is an area of active investigation.     

Untersuchungen zum Raumklima und zur Fensterlüftung in Schulen

Investigations on indoor environmental conditions and natural ventilation in school buildings. There are more than 40,000 school buildings in Germany. Most of them are awaiting retrofitting. Retrofitting is not only intended to improve the energetic standards, but first of all to improve indoor environmental conditions for pupils and teachers. As most of German schools are not equipped with mechanical ventilation systems, natural ventilation controlled by the occupants opening the windows is the main way to maintain healthy and comfortable conditions in the classrooms. For that purpose the influence of window opening behaviour of the occupants on the indoor environment was measured in two German schools. Temperature and carbon dioxide concentration of the indoor air as well as the outdoor climate conditions were measured. In one school the frequency of window opening was recorded. Besides high CO₂‐concentrations especially during winter, some of the investigated classrooms are additionally to cold in winter or to hot in summer. Some classrooms do not have a shading device or the shading device is insufficient or it constricts the ventilation of the room. Windows are used as controls in some degree during lessons and during the breaks. But windows get closed after lessons and stay closed until next morning. There is no night or early morning ventilation in summer. A significant weak to moderate positive correlation between total open window ratio and indoor temperature has been found. Correlation between total open window ratio and outdoor temperature is not significant in most cases or show a weak correlation coefficient.     

Subjective Indoor Air Quality in Schools in Relation to Exposure

Abstract This paper presents data on indoor air quality in schools as perceived by those working in them and relates these data to exposure measurements. Data on subjective air quality, domestic exposures and health aspects were gathered by means of a questionnaire which was sent to all personnel in 38 schools; it was completed by 1410 persons (85’4 of the total). Data on exposure were gathered by exposure measurements in classrooms. The results indicate that 53% of the personnel perceived the indoor air quality as bad or very bad. It was perceived as worse by those who were younger, those who were dissatisfied with their psychosocial work climate and those who were not exposed to tobacco smoke at home. In older school buildings and buildings with displacement ventilation there was less dissatisfaction with the air quality. There were no significant relations between complaints and air exchange rate or concentration of carbon dioxide. The air quality was perceived as worse at higher levels of exposure to a number of airborne compounds including volatile organic compounds, moulds, bacteria and respirable dust. It was concluded that exposure to indoor pollutants affects perception even at the low concentrations normally found indoors in nonindustrial buildings.     

Indoor air quality in schools of a highly polluted south Mediterranean area

This study aimed at surveying lower secondary schools in southern Italy, in a highly polluted area. A community close to an industrial area and three villages in rural areas was investigated. Indoor temperature, relative humidity (RH), gaseous pollutants (CO₂ and NO₂), selected biological pollutants in indoor dust, and the indoor/outdoor mass concentration and elemental composition of PM_2.5 were ascertained. Temperature and RH were within, or close to, the comfort range, while CO₂ frequently exceeded the threshold of 1000 ppm, indicating inadequate air exchange rate. In all the classrooms, median NO₂ levels were above the WHO threshold value. Dermatophagoides p. allergen concentration was below the sensitizing threshold, while high endotoxin levels were detected in the classrooms, suggesting schools may produce significant risks of endotoxin exposure. Concentration and solubility of PM_2.5 elements were used to identify the sources of indoor particles. Indoor concentration of most elements was higher than outdoors. Resuspension was responsible for the indoor increase in soil components. For elements from industrial emission (Cd, Co, Ni, Pb, Sb, Tl, V), the indoor concentration depended on penetration from the outside. For these elements, differences in rural vs industrial concentrations were found, suggesting industrial sources may influence indoor air quality nearby schools.     

The MERMAID study: indoor and outdoor average pollutant concentrations in 10 low‐energy school buildings in France

Indoor air quality was characterized in 10 recently built energy‐efficient French schools during two periods of 4.5 days. Carbon dioxide time‐resolved measurements during occupancy clearly highlight the key role of the ventilation rate (scheduled or occupancy indexed), especially in this type of building, which was tightly sealed and equipped with a dual‐flow ventilation system to provide air refreshment. Volatile organic compounds (VOCs) and inorganic gases (ozone and NO₂) were measured indoors and outdoors by passive techniques during the occupied and the unoccupied periods. Over 150 VOC species were identified. Among them, 27 species were selected for quantification, based on their occurrence. High concentrations were found for acetone, 2‐butanone, formaldehyde, toluene, and hexaldehyde. However, these concentrations are lower than those previously observed in conventional school buildings. The indoor/outdoor and unoccupied/occupied ratios are informative regarding emission sources. Except for benzene, ozone, and NO₂, all the pollutants in these buildings have an indoor source. Occupancy is associated with increased levels of acetone, 2‐butanone, pentanal, butyl acetate, and alkanes.     

Physico-chemical characterization of indoor/outdoor particulate matter in two residential houses in Oslo, Norway: measurements overview and physical properties--URBAN-AEROSOL Project

Indoor/outdoor measurements have been performed in the Oslo metropolitan area during summer and winter periods (2002-2003) at two different residential houses. The objective of the measurement study was to characterize, physically and chemically, the particulate matter (PM) and gaseous pollutants associated with actual human exposure in the selected places, and their indoor/outdoor relationship. In this paper, we focus on the PM measurements and examine the relationship between the indoor and outdoor PM concentrations taking into account the ventilation rate, indoor sources and meteorological conditions. The indoor/outdoor measurements indicate the important contribution of the outdoor air to the indoor air quality and the influence of specific indoor sources such as smoking and cooking to the concentration of PM inside houses. However, no specific correlation was found between the indoor/outdoor concentration ratio and the meteorological parameters. This study provides information on the physical characteristics and the relationship of indoor to outdoor concentration of particulate matter in residential houses. Moreover, the parameters that influence this relationship are discussed. The results presented here are specific to the sampled houses and conditions used and provide data on the actual human exposure characteristics which occur in the spatial and temporal scales of the present study.     

Returning characteristics of pollutants for a local domain in the presence of returning and recirculating airflow in indoor environments

Heating, ventilating, and air-conditioning (HVAC) systems usually supply air, which is a mixture of fresh air from the outdoor environment, and return air from rooms via the ventilation ductwork. This air reduces the heat load and cost impact of air conditioning using outdoor air. This recirculation of room air in air-conditioning systems is reasonable in terms of energy saving; however, the deterioration of air quality might be a concern because of the recirculation of contaminated room air. Here, we numerically investigate the effect of pollutant recirculation/return on the formation of concentration distributions of local pollutants in indoor environments when the mixing ratio of recirculated air in the HVAC system changes. We discuss the detailed structure of the formation mechanism of local pollutant concentration distributions using various indices for indoor ventilation efficiency in simplified room models. Among the indices, visitation frequency and net escape probability are the ones that directly assist in evaluating the recirculation/return characteristics of indoor pollutants. As a result, when the proportion of air that is recirculated becomes large, the number of pollutants returning to a target local domain, the visitation frequency, increases exponentially, and the net escape probability—which directly expresses the probability of pollutant discharged from the target domain—is close to zero.     

Comparing the effectiveness of interventions to improve ventilation behavior in primary schools

Poor air quality in schools has been associated with adverse health effects. Indoor air quality can be improved by increasing ventilation. The objective of this study was to compare the effectiveness of different interventions to improve ventilation behavior in primary schools. We used indoor CO(2) concentrations as an indicator. In 81 classes of 20 Dutch primary schools, we applied three different interventions: (i) a class-specific ventilation advice; (ii) the advice combined with a CO(2) warning device and (iii) the advice combined with a teaching package. The effectiveness of the interventions was tested directly after intervention and 6 weeks after intervention by measuring the CO(2) concentrations and comparison with a control group (iv). Before intervention, the CO(2) concentration exceeded 1000 ppm for 64% of the school day. The class-specific ventilation advice without further support appeared an ineffective tool to improve ventilation behavior. The advice in combination with a CO(2) warning device or the teaching package proved effective tools and resulted in lower indoor CO(2) concentrations when compared with the control group. Ventilation was significantly improved, but CO(2) concentrations still exceeded 1000 ppm for more than 40% of the school day. Hence, until ventilation facilities are upgraded, the CO(2) warning device and the teaching package are useful low-cost tools. PRACTICAL IMPLICATIONS: To improve ventilation behavior and indoor air quality in schools, CO(2) warning device and teaching package combined with a class-specific ventilation advice, are effective tools, while giving the ventilation advice solely, is not effective. Although ventilation is significantly improved through behavioral change, the ventilation rate is still insufficient to maintain good air quality during the full school day. Therefore, the improvement of the ventilation facilities is recommended. Hence, until ventilation facilities in schools are upgraded, the CO(2) warning device and the teaching package are useful low-cost tools to improve current indoor air quality.