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      Indoor Air Quality and Health

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      International Journal of Environmental Research and Public Health
      MDPI

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          Abstract

          In the last few decades, Indoor Air Quality (IAQ) has received increasing attention from the international scientific community, political institutions, and environmental governances for improving the comfort, health, and wellbeing of building occupants. Several studies on this topic have shown both qualitative and quantitative IAQ variations through the years, underlining an increase in pollutants and their levels. To this aim, IAQ-related standards and regulations, policies for non-industrial buildings, and monitoring plans have been developed in several countries. It has been estimated that people spend about 90% of their time in both private and public indoor environments, such as homes, gyms, schools, work places, transportation vehicles, etc.; thus, IAQ has a significant impact on health and quality of life in general. For many people, the health risks from exposure to indoor air pollution may be greater than those related to outdoor pollution. In particular, poor indoor air quality can be harmful to vulnerable groups such as children, young adults, the elderly, or those suffering chronic respiratory and/or cardiovascular diseases. Indoor environments represent a mix of outdoor pollutants prevalently associated with vehicular traffic and industrial activities, which can enter by infiltrations and/or through natural and mechanical ventilation systems, as well as indoor contaminants, which originate inside the building, from combustion sources (such as burning fuels, coal, and wood; tobacco products; and candles), emissions from building materials and furnishings, central heating and cooling systems, humidification devices, moisture processes, electronic equipment, products for household cleaning, pets, and the behavior of building occupants (i.e., smoking, painting, etc.). IAQ can be affected by various chemicals, including gases (i.e., carbon monoxide, ozone, radon), volatile organic compounds (VOCs), particulate matter (PM) and fibers, organic and inorganic contaminants, and biological particles such as bacteria, fungi, and pollen. The large number of variables that impact IAQ inevitably leads to a wide range of studies and scientific papers published in journals from many kinds of scientific subjects (e.g., chemistry, medicine, environmental sciences, etc.). To further underline the importance of IAQ studies, the present special issue was published. It includes 22 contributions by some of the main experts in the field of indoor air pollution in public and private buildings and related health concerns. In particular, an indoor air sampling was monitored by Orecchio et al. [1] to determine 181 VOCs emitted from several sources (fuels, traffic, landfills, coffee roasting, a street-food laboratory, building work, indoor use of incense and candles, a dental laboratory, etc.) located in Palermo (Italy) by using canister auto-samplers and the gas chromatography-mass spectrometry technique for VOC analysis. Concerning indoor air in residential houses, the study of Vilčeková et al. [2] attempted to provide more information about the IAQ of 25 houses in several cities of the Formal Yugoslav Republic of Macedonia. Air pollutants measured included humidity, total VOCs, PM, and sound pressure. The authors found interesting dependences between characteristics of buildings (year of construction, year of renovation, smoke, and heating system) and chemical-physical measurements (temperature, relative humidity, TVOC, PM2.5, and PM10) using statistical approaches (i.e., R software, Van der Waerden test). The influence of particle size on human indoor exposure to airborne halogenated flame retardants (HFRs), released from consumer products, was investigated by La Guardia et al. [3]. Their findings demonstrated that the larger, inhalable air particulates carried the bulk (>92%) of HFRs and indicated that contributions and the bioavailability of respirable and inhalable airborne particles should both be considered in future risk assessment studies. IAQ in enclosed environments was also studied by Chen et al. [4] who investigated the occurrence and levels of chemicals (including humidity, temperature, carbon monoxide, carbon dioxide, formaldehyde, TVOCs, ozone, PM10 and PM2.5, and microbial agent concentrations (i.e., bacteria and fungi) in North Taiwan underground subway stations). Moreover, various studies have been conducted on the health risks of dampness and mold in houses, but few studies have been performed in workplaces and schools. The paper of Lanthier-Veilleux et al. [5] is an examination of the independent contribution of residential dampness or mold (i.e., visible mold, mold odor, dampness, or water leaks) to asthma, allergic rhinitis, and respiratory infections among students at the Université de Sherbrooke (Quebec, QC, Canada); while the work of Szulc et al. [6] evaluated the microbiological contamination at a plant biomass processing thermal power station located in Poland. Among the factors that influence the estimation of human exposure to indoor air pollution, the pattern of human behavior and activity play a fundamental role. Odeh and Hussein [7] evaluated, for the first time, the human activity pattern of 285 subjects (17–63 years old) residents in Amman (Jordan) in order to use the outcomes in future human exposure studies. Environmental tobacco smoke (ETS) is also considered a key contributor to indoor air pollution and public health. In comparison to the large body research on toxicological substances of ETS and concentrations of indoor ETS-dependent PM, less attention has been paid on the correlation between the odor concentration and the chemical composition of ETS. The odor concentrations of field ETS, second-hand smoke (SHS), and third-hand smoke (THS) in prepared samples were determined by Noguchi et al. [8] using the triangle-odor-bag method, while the chemical compositions of the same samples were determined by proton transfer mass spectrometry. Results of this study evidenced that the main contributing components to the odor of the field ETS samples (acetaldehyde, acetonitrile, acetic acid, and other unknown components with a mass-to-charge ratio (m/z) of 39 and 43) were different from those found in SHS and THS samples. A potential threat to IAQ in indoor environments can be related to the contribution of outdoor pollutants concentrations and rates of infiltration, which affect the concentrations to which people are exposed indoors. Scheepers et al. [9] investigated the concentrations of volatile organic compounds (VOCs), acrolein, formaldehyde, nitrogen dioxide (NO2), respirable particulate matter (PM4.0 and PM2.5), and their respective benz(a)pyrene contents over a period of two weeks in indoor and outdoor locations at a university hospital, found that chemical IAQ was primarily driven by known indoor sources and activities, and did not show evidence of significant contributions of known outdoor local sources to any of the IAQ parameters measured. In particular, the ventilation rate (VR) is a fundamental parameter affecting the IAQ and the energy consumption of buildings. The manuscript of Batterman [10] reviews the use of CO2 as a “natural” tracer gas for estimating VRs in school classrooms, and provides details and guidance for the steady-state, build-up, decay, and transient mass balance methods. The CO2 tracer approach was also used by Matthews et al. [11] within a large university building in Manchester to estimate air-exchange rates. The same authors presented an innovative approach based on the use of perfluorocarbon tracers to trace the amount of outdoor material penetrating into the university building and the flow of material within the building itself. Minimizing indoor air pollutants is paramount to high performance schools, due to the potentially detrimental effects that VOCs, particulate matter including allergens and molds, and combustion gases may have on the health and wellbeing of students. In addition to their capacity to trigger asthma or allergy attacks, some of these pollutants are notorious for causing flu-like symptoms, headaches, nausea, and irritation of the eyes, nose, and throat. Moreover, a recent research suggests that a school’s physical environment also can play a major role in academic performance. However, newer designs, construction practices, and building materials for “green” buildings and the use of “environmentally friendly” products have the promise of lowering chemical exposure. Zhong et al. [12] determined VOC concentrations and IAQ parameters in 144 classrooms in 37 conventional and high performance elementary schools in the USA, and found that aromatics, alkanes, and terpenes were the most detected VOCs, whose concentrations did not show significant differences between the two kinds of schools. This special issue also presents the relationships and potential conflicts between IAQ and passive houses and/or other highly energy-efficient buildings, focusing the attention on the influence of ventilation systems. Wallner et al. [13] investigated, between 2010 and 2012, whether occupants of two types of buildings (mechanical vs. natural ventilation) experience different health, wellbeing, and housing satisfaction outcomes, as well as whether associations with indoor air quality existed. The study evidenced that inhabitants of energy-efficient, mechanically ventilated homes rated the quality of indoor air and climate significantly higher and, independently of the type of ventilation, associations between vegetative symptoms (dizziness, nausea, headaches) and formaldehyde concentrations as well as between CO2 levels and perceived stale air were observed. More topics covered in this special issue are related to the IAQ in healthcare facilities together with the air cleanliness in operating theatres, which are fundamental aspects for preserving the health of both the patient and the medical staff. Numerous monitoring campaigns were performed by Romano et al. [14] to determine ultrafine particle concentrations in operating theatres equipped with upward displacement ventilation or with a downward unidirectional airflow system. The results demonstrated that the use of electrosurgical tools generate an increase of particle concentration in the surgical area as well as within the entire operating theatre area, strongly related to the surgical ventilation, ventilation principle, and electrosurgical tools used. Cipolla et al. [15] monitored the VOCs concentrations (including hydrocarbons, alcohols, and terpenes) using passive diffusive samplers in two different anatomical pathology wards in the same hospital, evidencing a different VOC contamination due to the structural difference of the buildings and different organizational systems. Another theme that emerges from the studies presented in this special issue is the household air pollution (HAP) from the combustion of biomass fuels, including wood, agricultural residues, animal dung, coal, and charcoal, in open fires or traditional stoves. Such inefficient cooking and heating practices are still commonly used in developing countries and release many air pollutants, such as carbon monoxide, oxygenated organics, free radicals, and PM, in particular PM2.5, which may be linked to several health complications, including low birth weight, cardiovascular disease, tuberculosis, cataracts, and other respiratory complications. The study of Kurti et al. [16] determined whether HAP exposure was associated with reduced lung function and respiratory and non-respiratory symptoms in Belizean adults and children, demonstrating that adults experienced greater respiratory and non-respiratory symptoms; whereas the research conducted by Medgyesi et al. [17] investigated the effects of exposure to biomass fuel cookstove emissions on women in rural Bangladesh, associated with acute elevated PM2.5 concentrations, and evidencing a decrease in pulmonary function. Novel evidence that using cleaner fuels such as liquefied petroleum gas (LPG) with respect to dirty fuels like wood/straw for domestic cooking is associated with a significant lower probability of chronic or acute diseases was demonstrated by Nie et al. [18], in their study on women in rural China. These findings support literature data showing that inefficient biomass burning stoves may cause high levels of HAP and threaten long-term health diseases. To reduce HAP in developing countries, clean cooking programs and strategic governmental policies should be adopted, taking into consideration the main factors influencing adoption beyond health, such as cost, taste, fears, and cultural traditions, as evidenced in the study of Hollada et al. [19] assessing the attitudes, preferences, and beliefs about traditional versus liquefied petroleum gas (LPG) stoves in primary cooks and their families in rural Puno, Peru. Residential exposure to radon is strictly associated with lung cancer risk; thus, radon monitoring in households located in areas classified by United States–Environmental Protection Agency (US-EPA) as zones with high potential radon exposure is essential to safeguard the health of residents. Stauber et al. [20] presented a pilot study to monitor radon levels in 201 households located in Dekalb county (GA, USA), and found that radon exceeded EPA moderate risk levels in 18% of households and high risks in 4% of the homes tested, suggesting that a more extensive radon screening is needed in the entire county. Taking into account the increasing IAQ concerns and complaints, it becomes important to develop a practical diagnostic tool for proper IAQ management. The study of Wong et al. [21], conducted in Hong Kong, proposes a stepwise IAQ screening protocol to facilitate cost-effective IAQ management among building owners and managers and to identify both lower and higher risk groups for unsatisfactory IAQ. Furthermore, the study of Marques and Pitarma [22] led to the development of an IAQ system through web access and mobile applications to monitor the IAQ of different building rooms in real time. As seen, the contributions to this special issue cover a large area of IAQ-related studies, and it is expected that more deep research will be stimulated and conducted as a result of this special issue.

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          Most cited references21

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          Review and Extension of CO2-Based Methods to Determine Ventilation Rates with Application to School Classrooms

          The ventilation rate (VR) is a key parameter affecting indoor environmental quality (IEQ) and the energy consumption of buildings. This paper reviews the use of CO2 as a “natural” tracer gas for estimating VRs, focusing on applications in school classrooms. It provides details and guidance for the steady-state, build-up, decay and transient mass balance methods. An extension to the build-up method and an analysis of the post-exercise recovery period that can increase CO2 generation rates are presented. Measurements in four mechanically-ventilated school buildings demonstrate the methods and highlight issues affecting their applicability. VRs during the school day fell below recommended minimum levels, and VRs during evening and early morning were on the order of 0.1 h−1, reflecting shutdown of the ventilation systems. The transient mass balance method was the most flexible and advantageous method given the low air change rates and dynamic occupancy patterns observed in the classrooms. While the extension to the build-up method improved stability and consistency, the accuracy of this and the steady-state method may be limited. Decay-based methods did not reflect the VR during the school day due to heating, ventilation and air conditioning (HVAC) system shutdown. Since the number of occupants in classrooms changes over the day, the VR expressed on a per person basis (e.g., L·s−1·person−1) depends on the occupancy metric. If occupancy measurements can be obtained, then the transient mass balance method likely will provide the most consistent and accurate results among the CO2-based methods. Improved VR measurements can benefit many applications, including research examining the linkage between ventilation and health.
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            An Indoor Monitoring System for Ambient Assisted Living Based on Internet of Things Architecture

            The study of systems and architectures for ambient assisted living (AAL) is undoubtedly a topic of great relevance given the aging of the world population. The AAL technologies are designed to meet the needs of the aging population in order to maintain their independence as long as possible. As people typically spend more than 90% of their time in indoor environments, indoor air quality (iAQ) is perceived as an imperative variable to be controlled for the inhabitants’ wellbeing and comfort. Advances in networking, sensors, and embedded devices have made it possible to monitor and provide assistance to people in their homes. The continuous technological advancements make it possible to build smart objects with great capabilities for sensing and connecting several possible advancements in ambient assisted living systems architectures. Indoor environments are characterized by several pollutant sources. Most of the monitoring frameworks instantly accessible are exceptionally costly and only permit the gathering of arbitrary examples. iAQ is an indoor air quality system based on an Internet of Things paradigm that incorporates in its construction Arduino, ESP8266, and XBee technologies for processing and data transmission and micro sensors for data acquisition. It also allows access to data collected through web access and through a mobile application in real time, and this data can be accessed by doctors in order to support medical diagnostics. Five smaller scale sensors of natural parameters (air temperature, moistness, carbon monoxide, carbon dioxide, and glow) were utilized. Different sensors can be included to check for particular contamination. The results reveal that the system can give a viable indoor air quality appraisal in order to anticipate technical interventions for improving indoor air quality. Indeed indoor air quality might be distinctively contrasted with what is normal for a quality living environment.
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              Electrosurgical Smoke: Ultrafine Particle Measurements and Work Environment Quality in Different Operating Theatres

              Air cleanliness in operating theatres (OTs) is an important factor for preserving the health of both the patient and the medical staff. Particle contamination in OTs depends mainly on the surgery process, ventilation principle, personnel clothing systems and working routines. In many open surgical operations, electrosurgical tools (ESTs) are used for tissue cauterization. ESTs generate a significant airborne contamination, as surgical smoke. Surgical smoke is a work environment quality problem. Ordinary surgical masks and OT ventilation systems are inadequate to control this problem. This research work is based on numerous monitoring campaigns of ultrafine particle concentrations in OTs, equipped with upward displacement ventilation or with a downward unidirectional airflow system. Measurements performed during ten real surgeries highlight that the use of ESTs generates a quite sharp and relevant increase of particle concentration in the surgical area as well within the entire OT area. The measured contamination level in the OTs are linked to surgical operation, ventilation principle, and ESTs used. A better knowledge of airborne contamination is crucial for limiting the personnel’s exposure to surgical smoke. Research results highlight that downward unidirectional OTs can give better conditions for adequate ventilation and contaminant removal performances than OTs equipped with upward displacement ventilation systems.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                25 October 2017
                November 2017
                : 14
                : 11
                : 1286
                Affiliations
                Department of Chemistry “Ugo Schiff”, University of Florence, via della Lastruccia 3, 50019 Sesto Fiorentino Florence, Italy; tania.martellini@ 123456unifi.it
                Author notes
                [* ]Correspondence: acincinelli@ 123456unifi.it ; Tel.: +39-055-457-3324
                Article
                ijerph-14-01286
                10.3390/ijerph14111286
                5707925
                29068361
                ca9ad120-503f-4925-8099-8e95e4b4df79
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 16 October 2017
                : 19 October 2017
                Categories
                Editorial

                Public health
                Public health

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