Abstract

INTRODUCTION

The current and growing pattern of consumption has consequences for the environment which are, inevitably, reflected in human health. Air quality has implication for our well-being, it influences our future and can affect it. Interior air quality (IAQ) is one of the main environmental risks for public health and is especially significant for vulnerable groups, such as children. ^aaBorrego C, Neuparth N, Carvalho AC, Carvalho A, Miranda AI, Costa AM, et al. A saúde e o ar que respiramos - um caso de estudo em Portugal. Lisboa: Fundação Calouste Gulbenkian; 2008.

The level of pollution in the air inside buildings is often much worse than that outside and may reach figures from two to five times, and occasionally up to one hundred times, higher than the levels of pollution in the exterior. Levels of contamination of interior air become more relevant when we consider that individuals generally spend around 80.0% to 90.0% of their time inside of buildings. Due to the complex and diverse functions carried out within schools, air quality becomes of great importance because of the adverse effects it can have on the occupants’ health, concentration and performance. ⁸8 . Kotzias D, Geiss O, Tirendi S, Barrero-Moreno J, Reina V, Gotti A. Exposure to multiple air contaminants in public buildings, schools and kindergartens - The European Indoor Air Monitoring and Exposure Assessment Study (AIRMEX). Fresenius Environ Bull. 2009;18(5):670-81. ^{, 9}9 . Mendell M, Heath G. Do indoor pollutants and thermal conditions in schools influence student performance? A critical review of the literature. Indoor Air. 2005;15(1):27-52. DOI:10.1111/j.1600-0668.2004.00320.x
https://doi.org/10.1111/j.1600-0668.2004... ^{, 13}13 . Pegas PN, Nunes T, Alves CA, Silva JR, Vieira SLA, Caseiro A, et al. Indoor and outdoor characterisation of organic and inorganic compounds in city centre and suburban elementar schools of Aveiro, Portugal. Atmos Environ. 2012;55:80-9. DOI:10.1016/j.atmosenv.2012.03.059
https://doi.org/10.1016/j.atmosenv.2012....

The effects of air pollution on children has been increasing ^bbKhan I, Freitas MC, Dionisio I, Pacheco AMG. Indoor habits of children aged 5 to years learning at the public basic schools of Lisbon city, Portugal. Proceedings of the Ninth REHVA World Congress Clima - Well Being Indoors, Helsinki; 2007. due to their entering school at ever earlier ages and spending more and more time there. One of the consequences of this is the increase in respiratory problems, namely the increase in prevalence of allergic rhinitis, bronchitis and asthma. ⁶6 . International Study of Asthma and Allergies in Childhood. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet. 1998;351(9111):1225-32. DOI:10.1016/S0140-6736(97)07302-9
https://doi.org/10.1016/S0140-6736(97)07... Air quality in schools is of great importance, as the children spend at least 1/3 of their time inside these buildings, i.e., around seven hours or more a day at school. ²2 . Almeida SM, Canha N, Silva A, Freitas MC, Pegas P, Alves C, et al. Children exposure to air particulate matter in indoor of Lisbon primary schools. Atmos Environ. 2010;45:7594-9. DOI:10.1016/j.atmosenv.2010.11.052
https://doi.org/10.1016/j.atmosenv.2010.... ^{, 11}11 . Pegas PN, Evtyugina MG, Alves CA, Nunes T, Cerqueira M, Franchi M, et al. Outdoor/Indoor air quality in primary schools in Lisbon: a preliminary study. Quim Nova. 2010;33(5):1145-9. DOI:10.1590/S0100-40422010000500027
https://doi.org/10.1590/S0100-4042201000... ^{, c}cUnites States Environmental Protection Agency (US). Managing Asthma in the School Environment – Indoor air quality tools for schools. Washington (DC); 2010 [cited 2012 Jul 20]. Available from: http://www.epa.gov/iaq/schools Poor IAQ can affect performance, effort, comfort and productivity. ³3 . Daisey JM, Angell WJ, Apte MG. Indoor air quality, ventilation and health symptoms in schools: an analysis of existing information. Indoor Air. 2003;13 (1):53-64. DOI:10.1034/j.1600-0668.2003.00153.
https://doi.org/10.1034/j.1600-0668.2003... ^{, 5}5 . Godoi RHM, Avigo DJ, Campos VP, Tavares TM, Marchi MRR, Grieken R, et al. Indoor air quality assessment of elementary schools in Curitiba, Brazil. Water Air Soil Pollut Focus. 2009;9(3-4):171-7. DOI:10.1007/s11267-009-9220-3 The conditions inside the school buildings may affect the incidence of respiratory symptoms. ⁷7 . Kim JL, Elfman L, Mi Y, Johansson M, Smedje G, Norback D. Current asthma and respiratory symptoms among pupils in relation to dietary factors and allergens in the school environment. Indoor Air. 2005;15(3):170-82. DOI:10.1111/j.1600-0668.2005.00334.x
https://doi.org/10.1111/j.1600-0668.2005... ^{, 9}9 . Mendell M, Heath G. Do indoor pollutants and thermal conditions in schools influence student performance? A critical review of the literature. Indoor Air. 2005;15(1):27-52. DOI:10.1111/j.1600-0668.2004.00320.x
https://doi.org/10.1111/j.1600-0668.2004... ^{, 15}15 . Sundell J. On the history of indoor air quality and health. Indoor Air. 2004. 14 Suppl7:51-8. DOI:10.1111/j.1600-0668.2004.00273.x
https://doi.org/10.1111/j.1600-0668.2004... There are various studies on the quality of air quality inside schools. ²2 . Almeida SM, Canha N, Silva A, Freitas MC, Pegas P, Alves C, et al. Children exposure to air particulate matter in indoor of Lisbon primary schools. Atmos Environ. 2010;45:7594-9. DOI:10.1016/j.atmosenv.2010.11.052
https://doi.org/10.1016/j.atmosenv.2010.... ^{, 4}4 . Freitas MC, Canha N, Martinho M, Silva M, Almeida S, Pegas P, et al. Indoor Air quality in primary schools. In: Modoveanu A, editor. Advanced topics in environmental and air pollution case studies. Rijeka: InTech Europe; 2011. p. 361-84. ^{, 11}11 . Pegas PN, Evtyugina MG, Alves CA, Nunes T, Cerqueira M, Franchi M, et al. Outdoor/Indoor air quality in primary schools in Lisbon: a preliminary study. Quim Nova. 2010;33(5):1145-9. DOI:10.1590/S0100-40422010000500027
https://doi.org/10.1590/S0100-4042201000... ^{, 12}12 . Pegas PN, Alves CA, Evtyugina MG, Nunes T, Cerqueira M, Franchi M, et al. Seasonal evaluation of outdoor/indoor air quality in primary schools in Lisbon. J EnvironMonit. 2011;13(3):657-67. DOI:10.1039/c0em00472c
https://doi.org/10.1039/c0em00472c... ^{, a}aBorrego C, Neuparth N, Carvalho AC, Carvalho A, Miranda AI, Costa AM, et al. A saúde e o ar que respiramos - um caso de estudo em Portugal. Lisboa: Fundação Calouste Gulbenkian; 2008. However, there are few studies involving this area in Portugal.

The aim of this study was to analyze air quality in elementary schools and their structural and functional conditions.

METHODS

This was an exploratory study of IAQ, measuring temperature, relative air humidity and concentrations of carbon monoxide (CO), carbon dioxide (CO₂), ozone (O₃), nitrogen dioxide (NO₂), sulphur dioxide (SO₂), volatile organic compounds (VOC), formaldehyde and articulate matter with a diameter between 2.5 μm (PM_2.5) and 10 μm (PM₁₀), in autumn/winter and spring/summer, in 51 elementary schools and 81 classrooms, Coimbra, Portugal, 2011. Coimbra is a municipality with around 143,052 inhabitants, subdivided into 31 prefectures, of which 15 are predominantly urban areas (PUA), 14 are moderately urban area (MUA) and two areas are predominantly rural (PRA). ^ddPortugal. Deliberação nº 2717/2009 de 6 de agosto. 8ª Deliberação da Secção Permanente de Coordenação Estatística. Revisão da tipologia de áreas urbanas. Diario Republica . 28 set 2009. Coimbra was selected as it is one of the largest cities in central region and one of the most important in Portugal, due to its infrastructure, organization and companies, its historical importance and privileged geographical position in the center of the country. This is the first study evaluating IAQ in schools in Coimbra. Elementary schools within the 31 prefectures of Concelho de Coimbra were assessed.

In total, 45 public and six private schools were analyzed, covering 81 classrooms (with a mean of 18 pupils), totaling 1019 children. These schools were selected based on comparative analysis of the 81 public and private schools (230 classrooms) in Concelho de Coimbra .

It was decided to use a non-probabilistic convenience sample. The inclusion criteria were: one school per prefecture and, for the others, the above mentioned comparison criteria were used in the schools whose governors gave permission to participate in the study. If the parents/guardians did not give consent, this was an exclusion criteria.

It was not possible to evaluate biological parameters (due to lack of resources). Chemical and physical parameters inside and outside of 51 schools were evaluated. These evaluations were conducted in the autumn/winter (November 2010 to February 2011) and in spring/summer (March to June 2011).

A preliminary visit was made to educational establishments to assess overall conditions of facilities, type of activities taking place there, type of ventilation system and number of occupants and to identify potential sources of interior and exterior pollution. The sampling stations in the classrooms were decided, considering their layout, the location of doors and windows and the existence of sources of interior and exterior pollution. Quantifying the environmental parameters was based on recommendations described in the NT-SCE-02 ^eeAgência Portuguesa do Ambiente. Sistema Nacional de Certificação Energética da Qualidade do Ar Interior nos Edifícios. Direção Geral de Energia e Geologia, Ministério das Obras Públicas, Transportes e Comunicações, Lisboa; 2006. and in the Portuguese Environmental Agency technical guide to air quality in interior spaces. ^ffAgência Portuguesa do Ambiente. Qualidade do ar em espaços interiores – um guia técnico. Lisboa; 2010 [cited 2010 Sep 27]. Available from: http://www.apambiente.pt/serviços/LaboratórioReferenvia/Documents/Manual%20QAI%20APA%20Maio%202010 .

The reference maximum concentrations (RMC) established in annex VII of Ordinance no. 79/2006, 4^thApril, ^ggPortugal. Decreto-Lei nº 79/2006 de 4 de Abril. Estabelece o Regulamento dos Sistemas Energéticos de Climatização em edifícios/RSECE. Diario Republica . 4 abr 2006:2416-68. on IAQ and in ordinance no. 80/2006, 4^thApril, ^hhPortugal. Decreto-Lei nº 80/2006 de 4 de Abril. Estabelece a Norma Técnica NTSCE02-Metodologia para Auditorias periódicas de qualidade do ar interior em edifícios existentes no âmbito do RSECE. Diario Republica . 4 abr 2006. on parameters of air temperature and relative humidity and international recommendations on Indoor Air Quality Association (IAQA) ⁱiIndoor Air Quality Association. Quick Reference Guide to IAQA 01-2000. Recommended Guidelines for Indoor Environments. Washington (DC); 2000 [cited 2010 Sep 28]. Available from: http://americanhomeinspect.net/reference.html and the American Society of Heating, Refrigeration and Air – Conditioning Engineers, 2001 Standard 62.1. ^jjAmerican National Standards Institute. American Society of Heating, Refrigerating and Air Conditioning Engineers. Standard 62.1 Ventilation for Acceptable Indoor Air Quality. Atlanta; 2004.

The Portuguese legislation does not set a limit for as PM_2.5, SO₂or NO₂inside buildings. There are standards setting limits for exposure to NO₂in the workplace. The average values recorded in the analytical measurements of outdoor air were taken as a reference point.

IAQ was measured during school hours, two hours after lessons started. The equipment was located at around pupils’ head height when seated. The sample was taken at a height of 1 m, at least 3 m from the walls, in representative measuring areas, so as to guarantee there was appropriate distance from the pupils themselves, to ensure there was no interference in reading the instruments.

The measurements were taken according to the method established in the Technical Note NT-SCE-02, of the National Certification System, Portugal, 2009, between 10:30 a.m. and 5:30 p.m., over a 30 minute period, sampling each particulate every 30 seconds, volatile organic compoundsª every 15 seconds and the others every minute, for one week. ^kkCarvalho R, Coelho D, Ferreira C, Nunes T. A monitorização da Qualidade do Ar Interior (QAI) em Portugal - estudo comparativo de metodologias de amostragem e medição de QAI. Aveiro: Universidade de Aveiro; 2009. The measurements of environmental air quality took place during break time, at the same height at which the IAQ measurements were taken, but at least 1m from the school’s exterior walls. ^kkCarvalho R, Coelho D, Ferreira C, Nunes T. A monitorização da Qualidade do Ar Interior (QAI) em Portugal - estudo comparativo de metodologias de amostragem e medição de QAI. Aveiro: Universidade de Aveiro; 2009.

Specific portable equipment ( Table 1 ), calibrated before each sampling period, was used to obtain real time readings, using the reset function whenever necessary, with a comparative base of results found in cases of measurements with exchanged sensors. Variations in temperature and air pressure were considered when converting the readings.

The data were analyzed using SPSS (Statistical Package for the Social Sciences), version 19.0. The data were subject to descriptive and inferential analysis. The mean, standard deviation and range of variation were calculated, with the minimum and maximum values in order to discover the quantitative variables. In some situations, after checking for normality (Kolmogorov-Smirnov and Shapiro-Wilk tests), parametric tests to evaluate differences between mean values were used. When the evaluation of asymmetry was not called into question, parametric measurements were applied. When they were very asymmetrical (> or < 1.96), non-parametric statistical models were applied.

The Student’s-t test for paired samples and the Wilcoxon t test were used.

Statistical interpretation was conducted based on a 0.05 level of significance, with 95% confidence interval.

This study was approved by the Science Committee of the Faculty of Medicine, Universidade de Coimbra (approved December 2010). All of those responsible in the schools signed consent forms.

RESULTS

The majority of the schools had central heating (86.3%), but not had air conditioning. None of the schools had any sort of ventilation system, and ventilation was achieved by opening doors and windows. Most of the classrooms (88.3%) were equipped with a blackboard and chalk and had a wooden floor (80.4%). The mean volume of the classrooms was 150 m ³3 . Daisey JM, Angell WJ, Apte MG. Indoor air quality, ventilation and health symptoms in schools: an analysis of existing information. Indoor Air. 2003;13 (1):53-64. DOI:10.1034/j.1600-0668.2003.00153.
https://doi.org/10.1034/j.1600-0668.2003... .

The environmental parameter with the most significant results and high potential risk was that of CO₂. Mean concentrations of CO₂inside the classrooms were above RMC (984 ppm), reaching 1,942 ppm. The maximum values found inside the classrooms placed the children’s health at risk, reaching 5,320 ppm in one school. CO₂concentrations inside the classrooms in autumn/winter were higher than the values in spring/summer.

In two schools, the mean concentration of VOC exceeded RMC in both seasons. The RMC for particulates with a diameter of 10 μm (PM₁₀) was exceeded in classrooms in four schools.

The mean concentration of formaldehyde was above the RMC (0.08 ppm) in spring/summer in one classroom.

O₃concentrations were below RMC values. Those for CO were significantly below the RMC (10.7 ppm). No relevant values were found for NO₂or SO₂.

Mean air temperature in autumn/winter were below the reference value (20ºC). The majority of schools had insufficient heating, due to the age and size of the buildings and the conditions of their insulation. The values for air temperature inside the schools, in spring/summer, were above the reference value (25ºC) due to the external temperature and the classrooms not having any air conditioning system. The values for relative humidity were within the upper and lower limits in spring/summer and in autumn/winter (30.0% and 70.0%), except in seven schools, which had relative humidity above 70.0% in autumn/winter.

The atmospheric pollutants CO, CO₂, O₃and formaldehyde underwent marked changes between the two seasons assessed. Significant alterations were also noted between the seasons for certain atmospheric pollutants and particulates in classrooms of pupils in the fourth year. Significant variations were also noted between the two seasons when the classrooms used by pupils in the first and fourth years together (all in the same classroom) ( Table 2 ).

CO, CO₂, PM_2,5, PM₁₀and formaldehyde were those which underwent significant changes in the mean in the exterior areas of the different schools.

A pattern of correlation was observed between the mean relative humidity in autumn/winter and CO, CO₂, VOC and formaldehyde ( Table 3 ), as well as patterns of variation between relative humidity and PM₁₀, VOC and formaldehyde in spring/summer.

When the Kruskal Wallis test was used to compare distribution of environmental parameters by geographical area, it was noted that there were statistically significant differences (p < 0.05) in concentrations of CO inside the classrooms in autumn/winter. On average, schools located in predominantly rural areas had higher values than those in moderately or predominantly urban areas. PM₁₀showed higher mean values in schools located in moderately urban areas (p < 0.05). Although the differences are not statistically significant, schools located in predominantly rural areas had higher CO₂and VOC values. Concentrations of PM_2.5and formaldehyde were similar, and higher, in schools located in predominantly rural or moderately urban areas. The highest O₃values were in schools located in predominantly urban areas, and those for SO₂in moderately urban areas ( Table 4 ).

There were statistically significant differences in the mean concentrations of PM_2.5, PM₁₀and VOC I spring/summer. Concentrations of VOC and PM₁₀were higher in schools located in predominantly rural areas. Mean concentrations of PM_2.5were similar, and high, in schools located in predominantly rural and predominantly urban areas. O₃values were highest in schools located in predominantly urban areas, as were SO₂values. Formaldehyde and CO₂had higher mean concentrations in schools located in predominantly rural areas. Schools in moderately urban areas had the highest mean values for CO.

DISCUSSION

The most significant results of this study are those referring to CO₂concentrations, which were above the legislated maximum in most of the schools (92.0%). As the only source of this contamination in the classrooms was the occupants’ metabolism, the level was used as an indicator of the degree of vitiation in the indoor environment, providing an indication of IAQ.

The results found for autumn/winter show higher levels of CO₂than in spring/summer. The classrooms in which doors and windows are habitually open during lessons had better values and had lower number of students (< 10). CO₂is the main indicator of air renewal inside classrooms which exceed the reference value (984 ppm). The volume of the classrooms, associated with the number of occupants, means that it is not possible for the airing during break times to lower CO₂levels to an acceptable value. Some classrooms have the windows open during the lessons. However, this practice is not always possible, given noise levels outside, or when weather conditions, e.g., cold or rain, make it impossible. Airing during the night would be good practice (except in cold periods), but the schools reported that this was not possible for motives of security. Recent studies, including some in Portugal, ³3 . Daisey JM, Angell WJ, Apte MG. Indoor air quality, ventilation and health symptoms in schools: an analysis of existing information. Indoor Air. 2003;13 (1):53-64. DOI:10.1034/j.1600-0668.2003.00153.
https://doi.org/10.1034/j.1600-0668.2003... ^{, 13}13 . Pegas PN, Nunes T, Alves CA, Silva JR, Vieira SLA, Caseiro A, et al. Indoor and outdoor characterisation of organic and inorganic compounds in city centre and suburban elementar schools of Aveiro, Portugal. Atmos Environ. 2012;55:80-9. DOI:10.1016/j.atmosenv.2012.03.059
https://doi.org/10.1016/j.atmosenv.2012.... have indicated the existence of high levels of CO₂in schools, due to high density of occupation and insufficient ventilation. ¹1 . Al-Rashidi K, Loveday D, Al-Mutawa N. Impact of ventilation modes on carbon dioxide concentration levels in Kuwait classrooms. Energy Build. 2012; 47:540-9. DOI:10.1016/j.enbuild.2011.12.030
https://doi.org/10.1016/j.enbuild.2011.1... ^{, 10}10 . Mumovic D, Palmer J, Davies M, Orme M, Ridley I, Oreszczyn T, et al. Winter indoor air quality, termal confort and acoustic performance of newly built schools in England. Build Environ. 2009;44(7):1466-77. DOI: 10.1016/j.buildenv.2008.06.014
https://doi.org/10.1016/j.buildenv.2008.... High levels of CO₂were associated with high levels of other pollutants. ¹²12 . Pegas PN, Alves CA, Evtyugina MG, Nunes T, Cerqueira M, Franchi M, et al. Seasonal evaluation of outdoor/indoor air quality in primary schools in Lisbon. J EnvironMonit. 2011;13(3):657-67. DOI:10.1039/c0em00472c
https://doi.org/10.1039/c0em00472c...

In this study, the values found were below the reference value, with the exception of CO₂, however, the values for some of the environmental parameters analyzed, such as CO and PM₁₀were significant.

Levels of particulate matter above the legislated values were found. The majority of classrooms were equipped with blackboards and chalk and had shelves or cupboards containing large quantities of stored paper, which accumulated dust. Countless activities take place inside the classrooms, often requiring mats, glue, paint, clay and other materials and, according to the results found by Almeida et al ³3 . Daisey JM, Angell WJ, Apte MG. Indoor air quality, ventilation and health symptoms in schools: an analysis of existing information. Indoor Air. 2003;13 (1):53-64. DOI:10.1034/j.1600-0668.2003.00153.
https://doi.org/10.1034/j.1600-0668.2003... (2011) and Pegas et al ¹³13 . Pegas PN, Nunes T, Alves CA, Silva JR, Vieira SLA, Caseiro A, et al. Indoor and outdoor characterisation of organic and inorganic compounds in city centre and suburban elementar schools of Aveiro, Portugal. Atmos Environ. 2012;55:80-9. DOI:10.1016/j.atmosenv.2012.03.059
https://doi.org/10.1016/j.atmosenv.2012.... (2012), children’s activities themselves contribute to increasing the particles in the atmosphere.

The VOC values found, although significant, were below the RMC. There are many possible sources, from glue and paints and all sorts of organic based compounds present in the classrooms.

The CO values found were below the RMC, in both autumn/winter and spring/summer. On average, schools located in predominantly rural areas had higher values of CO compared with those located in areas that were moderately or predominantly urban. The highest value found in autumn/winter was in a school in which there was a noticeable smell of smoke from a stove without a chimney, indicating a problem with extracting smoke from the classrooms.

O₃and formaldehyde levels were below the RMC. Some classrooms had higher levels, although no sources of contamination were perceptible ( Table 2 ). Two classrooms had significant values, although below the RMC, for formaldehyde in autumn/winter. In these classrooms, the pupils had been working with glue in the previous lesson, demonstrating a lack of airing and ventilation in the classroom during this type of activity. One school had significant values for formaldehyde in spring/summer, without any handicraft activities having taken place previously.

Values for NO₂and SO₂mean air temperature in autumn/winter was above the reference limit established in Ordinance no. 80/2006 (20ºC). This is probably because all of the classrooms had heating systems and the doors and windows remained closed. Air temperature values were below the reference value in spring/summer, except for two schools where temperatures higher than the reference (25ºC) were found. Seven schools had values for relative humidity of > 70.0% in the autumn/winter. Diverse sources of contaminants were found inside the buildings. They may originate in the occupants, their activities, construction and decoration materials or from air outside entering the building. Thermo-hygrometric conditions are important in guaranteeing a healthy environment. As well as affecting comfort, temperature and humidity affect the emission of chemical pollutants from existing sources of contamination. ^llViegas J, Papoila Al, Martins P, Aelenei D, Cano M, Proença C, et al. Ventilação, qualidade do ar e saúde em creches e infantários resultados preliminares do Projeto ENVIRH. Seção reabilitação, ambiente interior, conforto e energia. 4º Congresso Nacional, Coimbra, Portugal, dez 2012.

Poor IAQ over short periods (hours) may lead to discomfort, decreased attention and diminished learning capacity. However, prolonged exposure (days and weeks) to interior air pollutants may lead to serious health problems, such as respiratory disease or allergies.

The majority of schools studied were old buildings that had not been restored in a long time. Their constructive aspects were cared for, there was a lack of air conditioning systems and a lack of mechanical or mixed ventilation, this generally being achieved by opening doors and windows. Especially high levels of CO₂were measured in the interior environment, showing the deficiencies in IAQ due to insufficient ventilation.

Concentrations of pollutants in the air inside the classrooms were higher than those observed outside, indicating the significance of interior sources of emission.

It is essential that the schools continually monitor this situation so as to avoid exposing the pupils to risk. It is also important to improve airing systems, to make them more effective and efficient. The behavior and attitudes of the buildings’ occupants also needs to be modified, e.g., developing the simple habit of opening the windows frequently.

Currently, there is debate on restructuring within schools, above all, increasing the numbers of pupils per class. Considering that CO₂is essentially the result of the metabolism of living beings, decision makers concerned in this policy should perceive that, if the classrooms become fuller, levels of CO₂and, consequently, health problems, will increase.

Efforts to develop methodologies of the determining and conditioning factors of air pollutants that affect human health need to be intensified, creating effective tools in the public health area and contributing to drawing up policies aimed at improving air quality. Similarly, control and prevention programs concerning the consequences for the health of the occupants of these environments need to be established.

Developing other studies to evaluate the impact of air pollutants on the population’s health should be encouraged so as to contribute to adequate measuring of environmental health within buildings.

References

Publication Dates

History