The effect of ventilation strategies of child care centers on indoor air quality and respiratory health of children in Singapore

This paper reports the effects of ventilation strategies on indoor air quality (IAQ) and respiratory health of children within 104 child care centers (CCCs) in a hot and humid climate. The CCCs were categorized by ventilation strategies: natural (NV), air-conditioned and mechanically ventilated (ACMV), air-conditioned using split units (AC), and hybrid (NV and AC operated intermittently). The concentration levels of IAQ parameters in NV CCCs are characterized by the influence of the outdoors and good dilution of indoor pollutants. The lower ventilation rates in air-conditioned CCCs result in higher concentrations of occupant-related pollutants but lower outdoor pollutant ingress. This study also revealed lower prevalence for most asthma and allergy, and respiratory symptoms in children attending NV CCCs. In multivariate analyses controlled for the effects of confounders, the risk of current rhinitis among children is significantly higher if they attend mechanically ventilated CCCs compared to NV CCCs. Air-conditioned CCCs were also associated with higher adjusted prevalence ratio of severe phlegm and cough symptoms and lower respiratory illness. Finally, children attending CCCs with hybrid ventilation are at high risk for almost all the respiratory symptoms studied. PRACTICAL IMPLICATIONS: This large field study indicates that different ventilation strategies employed by child care centers can cause significant variations in the indoor air quality and prevalence of asthma, allergies and respiratory symptoms of attending children. The higher prevalence rates of allergic and respiratory symptoms among young children, whose immune system is still under-developed, in child care centers, whether fully or partially air-conditioned, suggest that ventilation and plausible growth and propagation mechanisms of allergens and infectious agents be further investigated.     

Indoor air pollution and lung function growth among children in four Chinese cities

Ambient air pollution has been associated with decreased growth in lung function among children; but little is known about the impact of indoor air pollution. We examined relationships between indoor air pollution metrics and lung function growth, among children (n = 3273) aged 6-13 years living in four Chinese cities. Lung function parameters (FVC and FEV(1) ) were measured twice a year. Questionnaires were used to determine home coal burning and ventilation practices. Generalized estimating equations were used to examine associations. Use of coal as a household fuel was associated with 16.5 ml/year lower (33%, P < 0.001) and 20.5 ml/year lower (39%, P < 0.001) growth in children's FEV(1) and FVC, respectively. FEV(1) growth was 10.2 ml/year higher (20%, P = 0.009), and FVC growth was 17.0 ml/year higher (33%, P < 0.001) among children who lived in houses with the presence of a ventilation device. Among children living in houses where coal was used as a fuel and no ventilation devices were present, adjusted FVC and FEV(1) growth, respectively, were 37% and 61% that of the average growth per year in the full cohort. This suggests that household coal use may cause deficits in lung function growth, while using ventilation devices may be protective of lung development. PRACTICAL IMPLICATIONS: Nearly 3.4 billion people use solid fuels in homes for cooking and/or heating. We report the following findings from a longitudinal study: (i) household coal use is significantly associated with reduction in children's lung function growth and (ii) the use of household ventilation devices is significantly associated with higher lung function growth, particularly among children living in households where coal is used as a fuel. These findings not only provide evidence that indoor coal use impairs children's lung development but also point to the importance of improving ventilation conditions in reducing harmful effects of indoor air pollution sources.     

Variations of formaldehyde and VOC levels during 3 years in new and older homes

Indoor air organic compounds were continuously monitored during 3 years in new and older homes which were voluntarily selected throughout countries. The levels of volatile organic compounds (VOCs) in the new homes decreased markedly after 1 year, and steady emissions of VOCs were obtained in the initial months. Formaldehyde and a-pinene related to wooden materials need a longer flushing period than the other compounds in the new homes. The levels of the indoor air organic compounds in the older homes showed no significant fluctuation during the 3-year period. Decreases of the indoor-produced compounds in the new homes did not depend upon the ventilation systems. The results indicate that the indoor-produced compounds in the new homes will be more influenced by the aging decreases of emission source strengths than ventilation systems. The quantitative information on the trend of the indoor air organic compound levels will be useful for the risk assessment of indoor exposure to those compounds, and also for Japanese IAQ guidelines. PRACTICAL IMPLICATIONS: The initial levels of VOCs in the new homes decreased dramatically and were close to the mean values for the older homes after one year. The results suggest that steady emissions of VOCs are obtained within initial months. However, formaldehyde and a-pinene did not follow the trend for VOCs, particularly in the wooden framed houses. The results tend to suggest that formaldehyde and a-pinene related to wooden materials will need more long a flushing period than other compounds in the new homes. Decreasing tendency of indoor air organic compound levels in the new homes did not appear to show any dependency upon the ventilation systems over the whole period. Absence of data for ventilation rates in the houses dose not permit interpretation of the relation between ventilation rates and indoor air organic compound levels with statistical certainty, but the results suggest that indoor air organic compound levels in the homes will be more influenced by emission source strengths than ventilation systems. The levels of indoor air organic compounds in the new homes are sufficiently decreased according to the ageing decreases of organic compounds when the home is ventilated with adequate quantities.     

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.     

Energy efficient demand controlled ventilation in single family houses

This paper presents a strategy for a simple demand controlled ventilation system for single family houses where all sensors and controls are located in the air handling unit. The strategy is based on sensing CO₂-concentration and moisture content in the outdoor air and exhaust air. The CO₂-concentration is used to ensure adequate ventilation during occupancy and the moisture content is used to ensure adequate removal of moisture produced in the house. The ventilation rate can be switched between two flow rates: a high rate and a low rate. The high flow rate is based on existing requirements in the Danish building regulations and the low flow rate is based on minimum requirements in indoor air quality standards. Measurements were performed on an existing single family house where the controls were installed on the existing mechanical ventilation system. The results showed that the ventilation can be reduced to the low rate 37% of the time without significant changes in the CO₂-concentration and moisture level in the house. In theory this gives a 35% saving on electric energy for fans.     

Ventilation rates in the bedrooms of 500 Danish children

The ongoing “Indoor Environment and Children’s Health” (IECH) study investigates the environmental risk factors in homes and their association with asthma and allergy among children aged 1–5 years. As part of the study, the homes of 500 children between 3 and 5 years of age were inspected. The selected children included 200 symptomatic children (cases) and 300 randomly selected children (bases). As part of the inspection, the concentration of carbon dioxide in the bedrooms of the children was continuously measured over an average of 2.5 days. The ventilation rates in the rooms during the nights when the children were sleeping in the room were calculated using a single-zone mass balance for the occupant-generated CO₂. The calculated air change rates were log-normally distributed (R² > 0.98). The geometric mean of the air change rates in both the case and the base group was 0.46 air changes per hour (h⁻¹; geom. SD = 2.08 and 2.13, respectively). Approximately 57% of both cases and bases slept at a lower ventilation rate than the minimum required ventilation rate of 0.5 h⁻¹ in new Danish dwellings. Only 32% of the bedrooms had an average CO₂ concentration below 1000 ppm during the measured nights. Twenty-three percent of the rooms experienced at least a 20-minute period during the night when the CO₂ concentration was above 2000 ppm and 6% of the rooms experienced concentrations above 3000 ppm. The average air change rate was higher with more people sleeping in the room. The air change rate did not change with the increasing outdoor temperature over the 10-week experimental period. The calculation method provides an estimate of the total airflow into the bedroom, including airflows both from outdoors and from adjacent spaces. To study the accuracy of the calculated air change rates and their deviation from the true outside air change rates, we calculated CO₂ concentrations at different given air change rates using an indoor air quality and ventilation model (Contam). Subsequently we applied our calculation procedure to the obtained data. The air change rate calculated from the generated CO₂ concentrations was found to be between 0% and 51% lower than the total air change rate defined in the input variables for the model. It was, however, higher than the true outside air change rate. The relative error depended on the position of the room in relation to the adjacent rooms, occupancy in the adjacent room, the nominal air change rate and room-to-room airflows.     

Ventilation rates and health: multidisciplinary review of the scientific literature

The scientific literature through 2005 on the effects of ventilation rates on health in indoor environments has been reviewed by a multidisciplinary group. The group judged 27 papers published in peer-reviewed scientific journals as providing sufficient information on both ventilation rates and health effects to inform the relationship. Consistency was found across multiple investigations and different epidemiologic designs for different populations. Multiple health endpoints show similar relationships with ventilation rate. There is biological plausibility for an association of health outcomes with ventilation rates, although the literature does not provide clear evidence on particular agent(s) for the effects. Higher ventilation rates in offices, up to about 25 l/s per person, are associated with reduced prevalence of sick building syndrome (SBS) symptoms. The limited available data suggest that inflammation, respiratory infections, asthma symptoms and short-term sick leave increase with lower ventilation rates. Home ventilation rates above 0.5 air changes per hour (h(-1)) have been associated with a reduced risk of allergic manifestations among children in a Nordic climate. The need remains for more studies of the relationship between ventilation rates and health, especially in diverse climates, in locations with polluted outdoor air and in buildings other than offices. PRACTICAL IMPLICATIONS: Ventilation with outdoor air plays an important role influencing human exposures to indoor pollutants. This review and assessment indicates that increasing ventilation rates above currently adopted standards and guidelines should result in reduced prevalence of negative health outcomes. Building operators and designers should avoid low ventilation rates unless alternative effective measures, such as source control or air cleaning, are employed to limit indoor pollutant levels.     

Residential air-to-air heat exchangers: Performance energy savings,and economics

Residential energy consumption can be decreased if air infiltration is reduced by constructing houses more tightly. In some cases, however, reduced air infiltration can lead to problems with indoor air quality (e.g., excess humidity and high levels of indoor-generated air contaminants). One solution to this problem is to install a residential air-to-air heat exchanger. The heat exchanger provides a controlled supply of ventilation which counteracts the adverse effects of reduced infiltration. In addition, the heat exchanger recovers much of the energy that would normally be lost when ventilation occurs by air infiltration. Thus, by employing heat exchangers in low-infiltration houses, it is possible to save energy without sacrificing indoor air quality.This paper discusses the performance of residential heat exchangers and summarizes results from tests of several models. It also compares the energy consumed, during the heating season, in low-infiltration houses with heat exchangers, with the energy consumed in typical houses in four cities throughout the United States. For each city, a cost-benefit analysis is performed from the point of view of a home-owner. Houses with natural gas, oil, and electrical heating systems are considered. Our analysis indicates that the energy required to heat ventilation air in homes employing heat exchangers is 5.3 – 18.0 GJ less than the energy required to heat ventilation air in typical homes. In homes with heat exchangers, the heat exchanger's fan system required 2.2 – 3.6 GJ of electrical energy during the heating season. The net present benefit for homes employing heat exchangers, when compared with typical homes, ranged from —$1350 to +$2400 and discounted payback periods ranged from five to over 30 years. The cost-effectiveness of employing heat exchangers was found to be highly affected by climate, type of heating fuel, heat exchanger performance, and ventilation rate.     

Building characteristics, indoor air quality and recurrent wheezing in very young children (BAMSE)

This study was conducted to examine the impact of building characteristics and indoor air quality on recurrent wheezing in infants. We followed a birth cohort (BAMSE) comprising 4089 children, born in predefined areas of Stockholm, during their first 2 years of life. Information on exposures was obtained from parental questionnaires when the children were 2 months and on symptoms and diseases when the children were 1 and 2 years old. Children with recurrent wheezing, and two age-matched controls per case, were identified and enrolled in a nested case-control study. The homes were investigated and ventilation rate, humidity, temperature and NO2 measured. We found that living in an apartment erected after 1939, or in a private home with crawl space/concrete slab foundation were associated with an increased risk of recurrent wheezing, odds ratio (OR) 2.5 (1.3-4.8) and 2.5 (1.1-5.4), respectively. The same was true for living in homes with absolute indoor humidity >5.8 g/kg, OR 1.7 (1.0-2.9) and in homes where windowpane condensation was consistently reported over several years, OR 2.2 (1.1-4.5). However, air change rate and type of ventilation system did not seem to affect the risk. In conclusion, relatively new apartment buildings, single-family homes with crawl space/concrete slab foundation, elevated indoor humidity, and reported wintertime windowpane condensation were associated with recurrent wheezing in infants. Thus, improvements of the building quality may have potential to prevent infant wheezing.     

Ventilation and health in non-industrial indoor environments: report from a European multidisciplinary scientific consensus meeting (EUROVEN)

Scientific literature on the effects of ventilation on health, comfort, and productivity in non-industrial indoor environments (offices, schools, homes, etc.) has been reviewed by a multidisciplinary group of European scientists, called EUROVEN, with expertise in medicine, epidemiology, toxicology, and engineering. The group reviewed 105 papers published in peer-reviewed scientific journals and judged 30 as conclusive, providing sufficient information on ventilation, health effects, data processing, and reporting, 14 as providing relevant background information on the issue, 43 as relevant but non-informative or inconclusive, and 18 as irrelevant for the issue discussed. Based on the data in papers judged conclusive, the group agreed that ventilation is strongly associated with comfort (perceived air quality) and health [Sick Building Syndrome (SBS) symptoms, inflammation, infections, asthma, allergy, short-term sick leave], and that an association between ventilation and productivity (performance of office work) is indicated. The group also concluded that increasing outdoor air supply rates in non-industrial environments improves perceived air quality; that outdoor air supply rates below 25 l/s per person increase the risk of SBS symptoms, increase short-term sick leave, and decrease productivity among occupants of office buildings; and that ventilation rates above 0.5 air changes per hour (h-1) in homes reduce infestation of house dust mites in Nordic countries. The group concluded additionally that the literature indicates that in buildings with air-conditioning systems there may be an increased risk of SBS symptoms compared with naturally or mechanically ventilated buildings, and that improper maintenance, design, and functioning of air-conditioning systems contributes to increased prevalence of SBS symptoms.     

Radon and Natural Ventilation in Newer Danish Single-Family Houses

Abstract To investigate the effect of ventilation on indoor radon (²²²Rn), simultaneous measurements of radon concentrations and air change rates were made in 117 Danish naturally ventilated slab-on-grade houses built during the period 1984–1989. Radon measurements (based on CR-39 alpha-track detectors) and air change rate measurements (based on the perfluorocarbon tracer technique; PFT) were in the ranges 12–620 Bq m^?3 and 0.16?0.96 h^?1, respectively. Estimates of radon entry rates on the basis of such time-averaged results are presented and the associated uncertainty is discussed. It was found that differences in radon concentrations from one house to another are primarily caused by differences in radon entry rates whereas differences in air change rates are much less important (accounting for only 80,0% of the house-to-house variation). In spite of the large house-to-house variability of radon entry rates it was demonstrated, however, that natural ventilation does have a significant effect on the indoor radon concentration. Most importantly, it was found that the group of houses with an air change rate above the required level of 0.5 h^?1 on average had an indoor radon concentration that was only 50% (0.5±0.1) of that of the group of houses with air change rates below 0.5 h^?1. The reducing effect of increased natural ventilation on the indoor radon concentration was found to be due mainly to dilution of indoor air. No effect could be seen regarding reduced radon entry rates.     

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.     

Improvement of indoor air quality in four problem homes

The occupants of six houses suffered from symptoms which improved upon leaving their houses. In a previous study, tests were conducted in these six houses to measure various physical parameters related to their indoor environments. Four of these houses were subsequently renovated to improve indoor air quality. Tests were repeated on the four houses to assess the effectiveness of the applied remedial measures. The post-renovation tests which were identical to the pre-renovation tests, included measurements of air temperature, relative humidity, ventilation rates, air distribution patterns, levels of carbon dioxide, concentrations of formaldehyde, and concentrations of volatile organic compounds.This paper describes the remedial measures applied to these houses. Also presented is a comparison of the ventilation conditions, and concentrations of chemical contaminants in the houses before and after the renovation.     

Formaldehyde and acetaldehyde exposure mitigation in US residences: in‐home measurements of ventilation control and source control

Measurements were taken in new US residences to assess the extent to which ventilation and source control can mitigate formaldehyde exposure. Increasing ventilation consistently lowered indoor formaldehyde concentrations. However, at a reference air exchange rate of 0.35 h^?1, increasing ventilation was up to 60% less effective than would be predicted if the emission rate were constant. This is consistent with formaldehyde emission rates decreasing as air concentrations increase, as observed in chamber studies. In contrast, measurements suggest acetaldehyde emission was independent of ventilation rate. To evaluate the effectiveness of source control, formaldehyde concentrations were measured in Leadership in Energy and Environmental Design (LEED)‐certified/Indoor airPLUS homes constructed with materials certified to have low emission rates of volatile organic compounds (VOC). At a reference air exchange rate of 0.35 h^?1, and adjusting for home age, temperature and relative humidity, formaldehyde concentrations in homes built with low‐VOC materials were 42% lower on average than in reference new homes with conventional building materials. Without adjustment, concentrations were 27% lower in the low‐VOC homes. The mean and standard deviation of formaldehyde concentration was 33 μg/m³ and 22 μg/m³ for low‐VOC homes and 45 μg/m³ and 30 μg/m³ for conventional.     

Association between indoor mold and asthma among children in Buffalo, New York

Asthma is a leading chronic disease among children and places a significant burden on public health. Exposure to indoor mold has been associated with asthma symptoms. However, many mold assessments have relied on visual or other identification of damp conditions and mold presence, thus have not examined associations with specific fungal genera. The objective of this case-control study was to examine the relationship between airborne mold concentrations and asthma status among children and to identify the contribution from specific mold genera in air. Participants completed a questionnaire of home environmental conditions and underwent indoor air sampling in the home, from which viable and total-count fungal spores were quantified. The most prevalent fungi in the homes were the allergenic molds Cladosporium (98% and 87% of homes from viable and total count samples, respectively) and Penicillium (91% and 73%). There were no significant differences in mean fungal concentrations between the homes of cases and controls, although the observed rate of exposure to several molds was higher among the cases. Among children who lacked a family history of asthma, cases had significantly higher exposures to viable Aspergillus. Measured humidity levels in the home corresponded with some self-reported indicators of mold and dampness. PRACTICAL IMPLICATIONS: The results of this study support existing literature that indoor fungal exposures play a role in current asthma status and that some qualitative assessments of mold exposure correspond to fungi present in indoor air.     

The IVAIRE project – a randomized controlled study of the impact of ventilation on indoor air quality and the respiratory symptoms of asthmatic children in single family homes

A randomized controlled trial was carried out to measure the impact of an intervention on ventilation, indoor air contaminants, and asthma symptoms of children. Eighty‐three asthmatic children living in low‐ventilated homes were followed over 2 years. Several environmental parameters were measured during the summer, fall, and winter. The children were randomized after Year 1 (43 Intervention; 40 Control). The intervention included the installation of either a Heat Recovery Ventilator (HRV) or Energy Recovery Ventilator (ERV). During the fall and winter seasons, there was a significant increase in the mean ventilation rate in the homes of the intervention group. A statistically significant reduction in mean formaldehyde, airborne mold spores, toluene, styrene, limonene, and α‐pinene concentrations was observed in the intervention group. There was no significant group difference in change in the number of days with symptoms per 14 days. However, there was a significant decrease in the proportion of children who experienced any wheezing (≥1 episode) and those with ≥4 episodes in the 12‐month period in the intervention group. This study indicates that improved ventilation reduces air contaminants and may prevent wheezing. Due to lack of power, a bigger study is needed.     

What is IAQ?

In spaces for human occupancy indoor air quality (IAQ) is often defined as the extent to which human requirements are met. But what requirements do people have in relation to indoor air? The desire is that the air be perceived as fresh and pleasant, that it has no negative impact on their health, and that the air is stimulating and promotes their work, i.e. it increases their productivity and the learning of their children in the classroom at school. Present ventilation standards and guidelines do not care about productivity and learning and have the very modest requirement that the indoor air shall be 'acceptable,' meaning that the most sensitive group of persons (usually 20%) perceive the air as unacceptable while the remaining less sensitive persons may find the air barely acceptable. With such a modest aim it is not surprising that comprehensive field studies in many countries in buildings in which ventilation standards are met show high percentages of dissatisfied persons and of those suffering from sick building syndrome symptoms. Recent studies show that improvement of IAQ by a factor of 2-7 compared with existing standards increases office productivity and school learning significantly, while decreasing the risk of allergic symptoms and asthma in homes. To make indoor air acceptable, even for the most sensitive persons, an improvement of 1-2 orders of magnitude may be required. The paper will discuss the development of new methods that can provide such substantial improvements of IAQ while maintaining or even decreasing ventilation and energy usage. A paradigm shift is required and further future shifts are foreseen where we learn how to make indoor air equally fresh and pleasant as outdoors when it is best. Or even better, i.e. 'out of this world.' PRACTICAL IMPLICATIONS: The paper estimates an enormous potential for improving IAQ in practice utilizing new emerging technologies. This will enable us to provide IAQ which is acceptable even for the most sensitive persons. Already modest improvements compared to present minimum standards and typical conditions in practice can significantly decrease the risk of asthma/allergy in homes, improve learning in schools and increase productivity.     

Volatile organic compound concentrations and emission rates in new manufactured and site-built houses

Concentrations of 54 volatile organic compounds (VOCs) and ventilation rates were measured in four new manufactured houses over 2-9.5 months following installation and in seven new site-built houses 1-2 months after completion. The houses were in four projects located in hot-humid and mixed-humid climates. They were finished and operational, but unoccupied. Ventilation rates ranged from 0.14-0.78 h-1. Several of the site-built houses had ventilation rates below the ASHRAE recommended value. In both manufactured and site-built houses, the predominant airborne compounds were alpha-pinene, formaldehyde, hexanal, and acetic acid. Formaldehyde concentrations were below or near 50 ppb with a geometric mean value for all houses of 40 ppb. Similarities in the types of VOCs and in VOC concentrations indicated that indoor air quality in the houses was impacted by the same or similar sources. Major identified sources included plywood flooring, latex paint and sheet vinyl flooring. One site-built house was operated at ventilation rates of 0.14 and 0.32 h-1. VOC emission rates calculated at the two conditions agreed within +/- 10% for the most volatile compounds. Generally, the ratios of emission rates at the low and high ventilation rates decreased with decreasing compound volatility. Changes in VOC emission rates in the manufactured houses over 2-9.5 months after installation varied by compound. Only several compounds showed a consistent decrease in emission rate over this period.     

Indoor air quality risk factors for severe lower respiratory tract infections in Inuit infants in Baffin Region, Nunavut: a pilot study

Inuit infants have extremely high rates of lower respiratory tract infection (LRTI), but the causes for this are unclear. The aims of this study were to assess, in young Inuit children in Baffin Region, Nunavut, the feasibility of an epidemiologic study of the association between indoor air quality (IAQ) and respiratory health; to obtain data on IAQ in their housing; and to identify and classify risk factors for LRTI. Twenty houses in Cape Dorset, Nunavut with children below 2 years of age, were evaluated using a structured housing inspection and measurement of IAQ parameters, and a respiratory health questionnaire was administered. Twenty-five percent of the children had, at some time, been hospitalized for chest illness. Houses were very small, and had a median of six occupants per house. Forty-one percent of the houses had a calculated natural air change rate <0.35 air changes per hour. NO(2) concentrations were within the acceptable range. Smokers were present in at least 90% of the households, and nicotine concentrations exceeded 1.5 microg/m(3) in 25% of the dwellings. Particulates were found to be correlated closely with nicotine but not with NO(2) concentrations, suggesting that their main source was cigarette smoking rather than leakage from furnaces. Mattress fungal levels were markedly increased, although building fungal concentrations were low. Dust-mites were virtually non-existent. Potential risk factors related to IAQ for viral LRTI in Inuit infants were observed in this study, including reduced air exchange and environmental tobacco smoke exposure. Severe lower respiratory tract infection is common in Inuit infants. We found reduced air change rates and high occupancy levels in houses in Cape Dorset, which may increase the risk of respiratory infections. This suggests the measures to promote better ventilation or more housing may be beneficial. Further health benefits may be obtained by reducing bed sharing by infants and greater turnover of mattresses, which were found to have high levels of fungi.     

Formaldehyde Concentrations in Modern Houses

This article from the Institute of Occupational Health, Helsinki, briefly discusses the risks to air quality which may arise from low ventilation rates in modern dwellings. Measurements have shown that nearly half the houses examined had ventilation rates below the accepted minimum, and the incidence of unacceptable formaldehyde concentration was greater in newer houses, emphasising the need for a minimum ventilation rate of 0.5 ach.