Investigation of different approaches to reduce allergens in asthmatic children's homes--the Breath of Fresh Air Project, Cornwall, United Kingdom

During 2001 to 2004, a study was conducted to assess the indoor environmental and health impact of installing allergen-reducing interventions in the homes of asthmatic children. Based on the results of a pilot study, to determine an intervention that would provide improved symptom scores and a reduction in house dust mite allergen (Der p 1), mechanical ventilation and heat recovery (MVHR) systems were installed in 16 homes. Environmental and respiratory health assessments were conducted before and after the installation of the MVHR systems. The results indicated that the installation of MVHR systems reduced Der p 1 concentrations in living room carpets and mattresses. There were significant reductions in symptom scores for breathlessness during exercise, wheezing, and coughing during the day and night. Although, there was not a parallel control group for the main study, the lack of change in the pilot study control group (who did not receive an intervention), indicated that the changes in symptom scores were in part to do with the intervention. Larger scale trials are needed to determine the efficacy of MVHR systems in homes to improve indoor air quality and reduce asthma symptoms.     

Exhaust ventilation in attached garages improves residential indoor air quality

Previous research has shown that indoor benzene levels in homes with attached garages are higher than homes without attached garages. Exhaust ventilation in attached garages is one possible intervention to reduce these concentrations. To evaluate the effectiveness of this intervention, a randomized crossover study was conducted in 33 Ottawa homes in winter 2014. VOCs including benzene, toluene, ethylbenzene, and xylenes, nitrogen dioxide, carbon monoxide, and air exchange rates were measured over four 48‐hour periods when a garage exhaust fan was turned on or off. A blower door test conducted in each garage was used to determine the required exhaust fan flow rate to provide a depressurization of 5 Pa in each garage relative to the home. When corrected for ambient concentrations, the fan decreased geometric mean indoor benzene concentrations from 1.04 to 0.40 μg/m³, or by 62% (P<.05). The garage exhaust fan also significantly reduced outdoor‐corrected geometric mean indoor concentrations of other pollutants, including toluene (53%), ethylbenzene (47%), m,p‐xylene (45%), o‐xylene (43%), and carbon monoxide (23%) (P<.05) while having no impact on the home air exchange rate. This study provides evidence that mechanical exhaust ventilation in attached garages can reduce indoor concentrations of pollutants originating from within attached garages.     

Association between ventilation rates in 390 Swedish homes and allergic symptoms in children

The aim of the study was to test the hypothesis that a low-ventilation rate in homes is associated with an increased prevalence of asthma and allergic symptoms among children. A total of 198 cases (with at least two of three symptoms: wheezing, rhinitis, eczema) and 202 healthy controls, living in 390 homes, were examined by physicians. Ventilation rates were measured by a passive tracer gas method, and inspections were carried out in the homes. About 60% of the multi-family houses and about 80% of the single-family houses did not fulfill the minimum requirement regarding ventilation rate in the Swedish building code (0.5 air changes per hour, ach). Cases had significantly lower ventilation rates than controls and a dose-response relationship was indicated. PRACTICAL IMPLICATIONS: A low-ventilation rate of homes may be a risk factor for allergies among children. Families with allergic children should be given the advice to have good ventilation in the home. In investigations, of associations between environmental factors and allergies, the air change rate in homes has to be considered.     

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.     

Quantitative filter forensics with residential HVAC filters to assess indoor concentrations

Analysis of the dust from heating, ventilation, and air conditioning (HVAC) filters is a promising long‐term sampling method to characterize airborne particle‐bound contaminants. This filter forensics (FF) approach provides valuable insights about differences between buildings, but does not allow for an estimation of indoor concentrations. In this investigation, FF is extended to quantitative filter forensics (QFF) by using measurements of the volume of air that passes through the filter and the filter efficiency, to assess the integrated average airborne concentrations of total fungal and bacterial DNA, 36 fungal species, endotoxins, phthalates, and organophosphate esters (OPEs) based on dust extracted from HVAC filters. Filters were collected from 59 homes located in central Texas, USA, after 1 month of deployment in each summer and winter. Results showed considerable differences in the concentrations of airborne particle‐bound contaminants in studied homes. The airborne concentrations for most of the analytes are comparable with those reported in the literature. In this sample of homes, the HVAC characterization measurements varied much less between homes than the variation in the filter dust concentration of each analyte, suggesting that even in the absence of HVAC data, FF can provide insight about concentration differences for homes with similar HVAC systems.     

Home interventions are effective at decreasing indoor nitrogen dioxide concentrations

Nitrogen dioxide (NO₂), a by‐product of combustion produced by indoor gas appliances such as cooking stoves, is associated with respiratory symptoms in those with obstructive airways disease. We conducted a three‐armed randomized trial to evaluate the efficacy of interventions aimed at reducing indoor NO₂ concentrations in homes with unvented gas stoves: (i) replacement of existing gas stove with electric stove; (ii) installation of ventilation hood over existing gas stove; and (iii) placement of air purifiers with high‐efficiency particulate air (HEPA) and carbon filters. Home inspection and NO₂ monitoring were conducted at 1 week pre‐intervention and at 1 week and 3 months post‐intervention. Stove replacement resulted in a 51% and 42% decrease in median NO₂ concentration at 3 months of follow‐up in the kitchen and bedroom, respectively (P = 0.01, P = 0.01); air purifier placement resulted in an immediate decrease in median NO₂ concentration in the kitchen (27%, P < 0.01) and bedroom (22%, P = 0.02), but at 3 months, a significant reduction was seen only in the kitchen (20%, P = 0.05). NO₂ concentrations in the kitchen and bedroom did not significantly change following ventilation hood installation. Replacing unvented gas stoves with electric stoves or placement of air purifiers with HEPA and carbon filters can decrease indoor NO₂ concentrations in urban homes.     

Household endotoxin reduction in the Louisa Environmental Intervention Project for rural childhood asthma

Endotoxin exacerbates asthma. We designed the Louisa Environmental Intervention Project (LEIP) and assessed its effectiveness in reducing household endotoxin and improving asthma symptoms in rural Iowa children. Asthmatic school children (N = 104 from 89 homes) of Louisa and Keokuk counties in Iowa (aged 5-14 years) were recruited and block-randomized to receive extensive (education + professional cleaning) or educational interventions. Environmental sampling collection and respiratory survey administration were done at baseline and during three follow-up visits. Mixed-model analyses were used to assess the effect of the intervention on endotoxin levels and asthma symptoms in the main analysis and of endotoxin reduction on asthma symptoms in exploratory analysis. In the extensive intervention group, dust endotoxin load was significantly reduced in post-intervention visits. The extensive compared with the educational intervention was associated with significantly decreased dust endotoxin load in farm homes and less frequent nighttime asthma symptoms. In exploratory analysis, dust endotoxin load reduction from baseline was associated with lower total asthma symptoms score (Odds ratio: 0.52, 95% confidence interval: 0.29-0.92). In conclusion, the LEIP intervention reduced household dust endotoxin and improved asthma symptoms. However, endotoxin reductions were not sustained post-intervention by residents.     

The effect of increased classroom ventilation rate indicated by reduced CO2 concentration on the performance of schoolwork by children

The article reports on an experiment which investigated the effect of increased classroom ventilation rate on the performance of children aged 10–12 years. The experiment was executed at two different schools (two classrooms at each school) as a double‐blind 2 × 2 crossover intervention where four different performance tests were used as surrogates for short‐term concentration and logical thinking. Only complete pairs of test responses were included in the within‐subject comparisons of performance, and data were not corrected for learning and fatigue effects. Analysis of the total sample suggested the number of correct answers was improved significantly in four of four performance test, addition (6.3%), number comparison (4.8%), grammatical reasoning (3.2%), and reading and comprehension (7.4%), when the outdoor air supply rate was increased from an average of 1.7 (1.4–2.0) to 6.6 l/s per person. The increased outdoor air supply rate did not have any significant effect on the number of errors in any of the performance tests. Results from questionnaires regarding pupil perception of the indoor environment, reported Sick Building Syndrome symptoms, and motivation suggested that the study classroom air was perceived more still and pupil were experiencing less pain in the eyes in the recirculation condition compared to the fresh air condition.     

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.     

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.     

Dampness and mold in homes across China: Associations with rhinitis,ocular, throat and dermal symptoms,headache and fatigue among adults

We studied dampness and mold in China in relation to rhinitis, ocular, throat and dermal symptoms, headache and fatigue. A questionnaire study was performed in six cities including 36 541 randomized parents of young children. Seven self‐reported signs of dampness were evaluated. Multilevel logistic regression models were used to calculate odds ratios (ORs). Totally, 3.1% had weekly rhinitis, 2.8% eye, 4.1% throat and 4.8% skin symptoms, 3.0% headache and 13.9% fatigue. Overall, 6.3% of the homes had mold, 11.1% damp stains, 35.3% damp bed clothing, 12.8% water damage, 45.4% window pane condensation, 11.1% mold odor, and 37.5% humid air. All dampness signs were associated with symptoms (ORs from 1.2 to 4.6; P < 0.001), including rhinitis (ORs from 1.4 to 3.2; P < 0.001), and ORs increased by number of dampness signs. The strongest associations were for mold odor (ORs from 2.3 to 4.6) and humid air (ORs from 2.8 to 4.8). Associations were stronger among men and stronger in Beijing as compared to south China. In conclusion, dampness and mold are common in Chinese homes and associated with rhinitis and ocular, throat and dermal symptoms, headache and fatigue. Men can be more sensitive to dampness and health effects of dampness can be stronger in northern China.     

The impact of particle filtration on indoor air quality in a classroom near a highway

A pilot study was performed to investigate whether the application of a new mechanical ventilation system with a fine F8 (MERV14) filter could improve indoor air quality in a high school near the Amsterdam ring road. PM10, PM2.5, and black carbon (BC) concentrations were measured continuously inside an occupied intervention classroom and outside the school during three sampling periods in the winter of 2013/2014. Initially, 3 weeks of baseline measurements were performed, with the existing ventilation system and normal ventilation habits. Next, an intervention study was performed. A new ventilation system was installed in the classroom, and measurements were performed during 8 school weeks, in alternating 2‐week periods with and without the filter in the ventilation system under otherwise identical ventilation conditions. Indoor/outdoor ratios measured during the weeks with filter were compared with those measured without filter to evaluate the ability of the F8 filter to improve indoor air quality. During teaching hours, the filter reduced BC exposure by, on average, 36%. For PM10 and PM2.5, a reduction of 34% and 30% was found, respectively. This implies that application of a fine filter can reduce the exposure of schoolchildren to traffic exhaust at hot spot locations by about one‐third.     

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.     

Current wheeze,asthma, respiratory infections,and rhinitis among adults in relation to inspection data and indoor measurements in single‐family houses in Sweden—The BETSI study

In the Swedish Building Energy, Technical Status and Indoor environment study, a total of 1160 adults from 605 single‐family houses answered a questionnaire on respiratory health. Building inspectors investigated the homes and measured temperature, air humidity, air exchange rate, and wood moisture content (in attic and crawl space). Moisture load was calculated as the difference between indoor and outdoor absolute humidity. Totally, 7.3% were smokers, 8.7% had doctor’ diagnosed asthma, 11.2% current wheeze, and 9.5% current asthma symptoms. Totally, 50.3% had respiratory infections and 26.0% rhinitis. The mean air exchange rate was 0.36/h, and the mean moisture load 1.70 g/m³. Damp foundation (OR=1.79, 95% CI 1.16‐2.78) was positively associated while floor constructions with crawl space (OR=0.49, 95% CI 0.29‐0.84) was negatively associated with wheeze. Concrete slabs with overlying insulation (OR=2.21, 95% CI 1.24‐3.92) and brick façade (OR=1.71, 95% CI 1.07‐2.73) were associated with rhinitis. Moisture load was associated with respiratory infections (OR=1.21 per 1 g/m³, 95% CI 1.04‐1.40) and rhinitis (OR=1.36 per 1 g/m³, 95% CI 1.02‐1.83). Air exchange rate was associated with current asthma symptoms (OR=0.85 per 0.1/h, 95% CI 0.73‐0.99). Living in homes with damp foundation, concrete slabs with overlying insulation, brick façade, low ventilation flow, and high moisture load are risk factors for asthma, rhinitis, and respiratory infections.     

The effect of low‐volatile organic compounds,water‐based paint on aggravation of allergic disease in schoolchildren

Whether indoor painting aggravates preexisting allergic diseases remains unclear. We aimed to evaluate the impact of new classroom painting on aggravation of asthma, allergic rhinitis (AR), and atopic dermatitis (AD) in children. Studied school was previously painted with conventional water‐based paint 20 years ago and had natural ventilation system. We identified a total of 172 children aged 10–12 years with allergic diseases in 17 classrooms, which were allocated to newly painted rooms with low‐volatile organic compounds (VOC), water‐based paint, or existing rooms. After painting, there was no intervention or internal airflow to influence indoor air environment in both classrooms. We prospectively assessed the symptom severity and serious events of allergic diseases between both classrooms at baseline and after one and eight weeks after painting. At one and eight weeks, there were no significant changes in the Childhood Asthma Control Test scores, the fractional nitric oxide levels, lung function in asthmatic children in either classroom. There were also no significant changes in the severity score of AR or AD, or serious events in all allergic diseases. These findings suggest classroom painting with this new paint at the levels encountered in this study might not be a major aggravating factor for school‐aged children with allergic diseases.     

Housing characteristics and indoor air quality in households of Alaska Native children with chronic lung conditions

Alaska Native children experience high rates of respiratory infections and conditions. Household crowding, indoor smoke, lack of piped water, and poverty have been associated with respiratory infections. We describe the baseline household characteristics of children with severe or chronic lung disease participating in a 2012–2015 indoor air study. We monitored indoor PM2.5, CO₂, relative humidity %, temperature, and VOCs and interviewed caregivers about children's respiratory symptoms. We evaluated the association between reported children's respiratory symptoms and indoor air quality indicators using multiple logistic regression analysis. Compared with general US households, study households were more likely overcrowded 73% (62%–82%) vs 3.2% (3.1%–3.3%); had higher woodstove use as primary heat source 16% (9%–25%) vs 2.1% (2.0%–2.2%); and higher proportion of children in a household with a smoker 49% (38%–60%) vs 26.2% (25.5%–26.8%). Median PM2.5 was 33 μg/m³. Median CO₂ was 1401 ppm. VOCs were detectable in all homes. VOCs, smoker, primary wood heat, and PM2.5>25 μg/m³ were associated with higher risk for cough between colds; VOCs were associated with higher risk for wheeze between colds and asthma diagnosis. High indoor air pollutant levels were associated with respiratory symptoms in household children, likely related to overcrowding, poor ventilation, woodstove use, and tobacco smoke.     

Normal Range Criteria for Indoor Air Bacteria and Fungal Spores in a Subarctic Climate

Indoor air bacteria and fingal spore levels were studied in 71 non-complaint homes. lk data were analyzed according to the season and the higher limit of the range within which 95% of the cases fall was computed. On the basis of the data the following highest normal levels are proposed for winter: for bacteria 5000 cfulm³ and for fingal spores 500 cfulm³. The recommended levels apply in a subarctic climate for urban and suburban homes when the measurements are made using the same method as in this study. We recommend that if abnormal indoor sources are suspected, indoor samples should be taken in winter when the ground is frozen and covered with snow. At that time, the background levels are at their lowest and the abnormal indoor sources are most easily detected. lk recommended levels should not be used as an indicator of a health risk, but as an indication of abnormal indoor sources or insufficient ventilation.     

Classroom ventilation and indoor air quality—results from the FRESH intervention study

Inadequate ventilation of classrooms may lead to increased concentrations of pollutants generated indoors in schools. The FRESH study, on the effects of increased classroom ventilation on indoor air quality, was performed in 18 naturally ventilated classrooms of 17 primary schools in the Netherlands during the heating seasons of 2010–2012. In 12 classrooms, ventilation was increased to targeted CO₂ concentrations of 800 or 1200 ppm, using a temporary CO₂ controlled mechanical ventilation system. Six classrooms were included as controls. In each classroom, data on endotoxin, β(1,3)‐glucans, and particles with diameters of <10 μm (PM₁₀) and <2.5 μm (PM_2.5) and nitrogen dioxide (NO₂) were collected during three consecutive weeks. Associations between the intervention and these measured indoor air pollution levels were assessed using mixed models, with random classroom effects. The intervention lowered endotoxin and β(1,3)‐glucan levels and PM₁₀ concentrations significantly. PM₁₀ for instance was reduced by 25 μg/m³ (95% confidence interval 13–38 μg/m³) from 54 μg/m³ at maximum ventilation rate. No significant differences were found between the two ventilation settings. Concentrations of PM_2.5 and NO₂ were not affected by the intervention. Our results provide evidence that increasing classroom ventilation is effective in decreasing the concentrations of some indoor‐generated pollutants.     

Measured performance of filtration and ventilation systems for fine and ultrafine particles and ozone in an unoccupied modern California house

This study evaluated nine ventilation and filtration systems in an unoccupied 2006 house located 250 m downwind of the I‐80 freeway in Sacramento, California. Systems were evaluated for reducing indoor concentrations of outdoor particles in summer and fall/winter, ozone in summer, and particles from stir‐fry cooking. Air exchange rate was measured continuously. Energy use was estimated for year‐round operation in California. Exhaust ventilation without enhanced filtration provided indoor PM_2.5 that was 70% lower than outdoors. Supply ventilation with MERV13 filtration provided slightly less protection, whereas supply MERV16 filtration reduced PM_2.5 by 97‐98% relative to outdoors. Supply filtration systems used little energy but provided no benefits for indoor‐generated particles. Systems with MERV13‐16 filter in the recirculating heating and cooling unit (FAU) operating continuously or 20 min/h reduced PM_2.5 by 93‐98%. Across all systems, removal percentages were higher for ultrafine particles and lower for black carbon, relative to PM_2.5. Indoor ozone was 3‐4% of outdoors for all systems except an electronic air cleaner that produced ozone. Filtration via the FAU or portable filtration units lowered PM_2.5 by 25‐75% when operated over the hour following cooking. The energy for year‐round operation of FAU filtration with an efficient blower motor was estimated at 600 kWh/year.     

The effects of bedroom air quality on sleep and next‐day performance

The effects of bedroom air quality on sleep and next‐day performance were examined in two field‐intervention experiments in single‐occupancy student dormitory rooms. The occupants, half of them women, could adjust an electric heater to maintain thermal comfort but they experienced two bedroom ventilation conditions, each maintained for 1 week, in balanced order. In the initial pilot experiment (N = 14), bedroom ventilation was changed by opening a window (the resulting average CO₂ level was 2585 or 660 ppm). In the second experiment (N = 16), an inaudible fan in the air intake vent was either disabled or operated whenever CO₂ levels exceeded 900 ppm (the resulting average CO₂ level was 2395 or 835 ppm). Bedroom air temperatures varied over a wide range but did not differ between ventilation conditions. Sleep was assessed from movement data recorded on wristwatch‐type actigraphs and subjects reported their perceptions and their well‐being each morning using online questionnaires. Two tests of next‐day mental performance were applied. Objectively measured sleep quality and the perceived freshness of bedroom air improved significantly when the CO₂ level was lower, as did next‐day reported sleepiness and ability to concentrate and the subjects' performance of a test of logical thinking.