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Explore the impact of indoor environments on health, factors affecting indoor quality, and methods to mitigate health risks in buildings. Learn about common symptoms, determinants of environmental quality, and approaches to enhance indoor health.
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Building-related health effects: what do we know? Ted Schettler MD, MPH Science and Environmental Health Network Institute of Medicine Jan. 10, 2006
Outline • The indoor environment • Building-related health/illness • Building-determinants of indoor environmental quality, comfort, health • Health impacts beyond the building
The indoor environment • Determinants of comfort and health: • Temperature, temperature gradients • Humidity • Light • Noise • Chemical pollutants, odors • Personal health • Job/activity requirements • Psychosocial factors
The indoor environment • Heterogeneous; many microenvironments • Gradients—chemical pollutants, temperature, humidity • Vary over space and time
Building-related health effects • Building related illness—e.g., Legionnaire’s disease • Building-related symptoms • Sick-building syndrome • Perceptions of unacceptable indoor environment • Sensitive occupants—e.g., multiple chemical sensitivity (heightened sensitivity to often poorly defined but “ordinary” contaminant levels)
Sick-building syndrome • Building occupants experience acute health and comfort symptoms that appear to be linked to time spent in the building, but often no specific cause can be identified. • Complaints may be localized, in a zone, or widespread
Common symptoms of SBS • Headache and nausea • Nasal and chest congestion; wheezing • Eye problems (dry, itching, tearing, or sore eyes, blurry vision, burning eyes, problems with contact lenses) • Sore throat, hoarseness, dry throat • Fatigue • Chills and fever • Muscle pain • Neurological symptoms (difficulty remembering or concentrating, depression, tension, or nervousness) • Dizziness • Dry skin
A summary of the context • Heterogeneity of environment; micro- environments • Heterogeneity of building occupants • Variability of symptoms, illnesses • Result: Difficult to study and understand • Interactions among multiple factors • Bias in cross-sectional surveys • Need for new statistical techniques; e.g., principal component analysis
Determinants of indoor environmental quality • Primary building material emissions • VOCs: • Aliphatic hydrocarbons, aromatic hydrocarbons, halogenated hydrocarbons, alcohols, ketones, aldehydes, esters, ethers, terpenes • Generally highest after manufacture and construction
Indoor sources of VOCs • Consumer and commercial products—cleaning agents, pesticides, office supplies, etc. • Paints and associated supplies • Adhesives • Building materials • Furnishings and clothing • Combustion appliances • Outdoor air pollutants
Determinants of indoor environmental quality • Secondary material emissions • e.g., due to moisture • alkali (in concrete) degradation of PVC/DEHP (correlation with asthma symptoms) • ozone from copiers or laser printers, outdoors and nitrogen oxides can react with VOCs • cleaning materials can react with surfaces • Secondary emissions may be a chronic problem
Determinants of indoor environmental quality • Surface materials: • PVC flooring, synthetic carpet, particleboard, wall coverings, furniture • PVC flooring, wall coverings, phthalate levels and asthma, wheezing, allergic symptoms (Jaakkola, 2004; Oie, 1999; Bornehag, 2004; Tuomainen, 2004) • Choice of surface material determines cleaning requirements
Determinants of indoor environmental quality • Temperature; temperature gradients • Ventilation: important but limited effectiveness to solve complex problems • Dampness and humidity: influence mold growth, material emissions • Particulate air pollution: outdoor sources, high speed floor polishing • Landscaping; indoor/outdoor pesticide use
Conclusions • Low emitting materials • Avoid materials that might support mold growth • Avoid potential for moisture accumulation • Consider cleaning requirements • Low emission materials, ventilation, humidity control, surface temperatures all work together to influence environmental quality • Life cycle impacts of materials
Health impacts beyond the building • Public, occupational, environmental health impacts: • Water and energy use • Materials extraction, manufacturing, transport, disposal • Health care activities provided in buildings