Current State of the Science: Health Effects and Indoor
Elements That Contribute to Healthy Building Design
In Search of a Common European Approach to a Healthy Indoor
Childhood Asthma and Environmental Interventions
Improving Indoor Environmental Quality for Public Health
Bringing Green Homes
within Reach: Healthier Housing for More People
ambient, personal, and indoor exposure to fine particulate
The Relationship of Housing and Population Health:A 30-Year
Dr. Jessica Green, Microbes: Buildings are complex ecosystems
Dr. Charles J. Weschler, Healthy Buildings Research: New Developments, Future Directions and Potential Solutions
Of new-onset asthma cases in adults, 15–23% are
American Thoracic Society 2004
The highest percentage of work-related asthma occurred among
operators, fabricators, and laborers (32.9%).
Worker Health Chartbook 2004
Between 35 and 60 million of the 89 million indoor environment
workers have building-related symptoms of eye, nose, and throat
irritations or headache and fatigue (Mendell 2002).
Institute for Occupational Safety and Health (NIOSH)
Kids Health, "to maintain good air quality
inside your home, … “consider buying one with baseboard or
Kids Health Comes From Nemours
Health based web sites and resources with HVAC
Dr. Dean Mitchell's Allergy and Asthma Solution
you have control of deciding what heating to use for your home,
...consider radiant heating"
A note on radiant heating and asthma.
As per my previous discussions cautioning the use
of association to show causality; radiant systems in of themselves do not
They also do not totally eliminate air movement as there will be
both natural convection from the radiant surface and there will
be forced convection from the necessarily required ventilation
system (CSA F326 and ASHRAE 62.1 and 62.2).
What radiant systems do in comparison to all air systems is
drastically reduce the volumetric airflow rate through the
building thereby potentially reducing the recirculation and
redistribution of airborne pollutants.
The secondary benefit
with radiant coupled to
dedicated outdoor air systems, is the
air system (collectively known as a hybrid) is designed and operated
exclusively for treating the air for
moisture, odours, gases and
particulate - regardless of
the need for space heating and cooling. Such dedicated
ventilation systems often use
energy recovery ventilators (HRV’s
or ERV’s) and when ducted to each habitable space is considered
by our team as the benchmark in ventilation design.
When incorporated into buildings constructed with materials
having low toxicity, the above described system can greatly
improve the health of the indoor environment which can be beneficial to all
inhabitants but particularly to those with respiratory illness and/or sensitivities to their surroundings.
you are not clear about inappropriate use of association to show
causality consider the following:
The earth is round - basketballs are round, therefore the earth
is a basketball. Clearly the conclusion is wrong even though the
argument has validity.
Now consider this title, "Heat recovery ventilators prevent respiratory disorders in Inuit
would be advantageous for manufacturers of heat recovery
ventilators (HRV's) to use this to sell product since this
is authored by recognized experts including a medical doctor.
However, it was not the equipment itself which prevented
respiratory disorders but the process of ventilation and
filtration - which can be accomplished without the use of heat
This is a good example of the inappropriate use of association
to show causality.
Remember this, "Scientific studies that show an association
between a factor and a health effect do not necessarily imply
that the factor causes the health effect".
For more on this topic
see this presentation.
HVAC Systems and Indoor Environmental Quality
The following papers present research based
information on the influence of HVAC systems on the indoor
environments (determined by the building scientists) and
subsequently the potential influence on the occupants health
(determined by the health scientists). As always, it's important
to not draw unsupported conclusions such as HVAC system
and equipment directly improve peoples health; or develop creative interpretations such
as HVAC systems prevent asthma. The
use of association to show causality can be very misleading.
Is the indoor environment influenced by HVAC
Does system type change how the indoor environment is
Can different systems improve aspects of indoor environmental quality?
Do some occupants benefit from improvements in indoor environmental
Building Science and Health Science: An illustration
separating and integrating the roles of the those in the
building science field and those from the health science field.
Effects of the Indoor
Environment on the Fraction of Exhaled Nitric Oxide in
Study includes a look at hydronic radiant,
forced air and electric baseboard heating systems.
citation: Kovesi, T.A., Dales, R.E., Effects of
the indoor environment on the fraction of exhaled nitric oxide
in school-aged children, Canadian Respiratory Journal, Vol.16 No
3 May/June 2009, ©
Pulsus Group Inc
Air change rate and concentration of formaldehyde in residential
The purpose of this study was to investigate the
relationship between air change rates and indoor concentrations
of formaldehyde; includes a look at heating systems.
citation: Gilbert, N. L., M. Guay, et al. (2008).
"Air change rate and concentration of formaldehyde in
residential indoor air." Atmospheric Environment, 42(10):
Modeling the airborne survival of influenza virus in a
residential setting: the impacts of home humidification
Study explores the effects of humidification on influenza
virus survival in rooms conditioned with radiant
heating and forced air.
citation: Myatt, T.A, Kaufman, M.H., Allen, J.G., MacIntosh,
D.L., Fabian, M.P., McDevitt, J.J., Modeling the airborne
survival of influenza virus in a residential setting: the
impacts of home humidification, Environmental Health 2010, 9:55
Effects of improved home heating on asthma in community dwelling
children: randomised controlled trial
Study demonstrates benefits from certain heating
citation: Howden-Chapman, P. et
al, Effects of improved home heating on asthma in community
dwelling children: randomised controlled trial,
British Medical Journal (BMJ). 2008; 337: a1411.
Published online 2008 September 23. doi: 10.1136/bmj.a1411.
Heat recovery ventilators prevent respiratory disorders in Inuit
Study explores the use of HRV's to make
improvements to the indoor air quality and demonstrates a
benefit to the occupants.
citation: Kovesi, T., Zaloum, C., Stocco, C.,
Fugler, D., Dales, R. E., Ni, A., Barrowman, N., Gilbert, N.
L., Miller, J.D., Heat recovery ventilators prevent respiratory
disorders in Inuit children, Indoor Air 2009; 19: 489–499
*The above article is
useful but we disagree with the title since any ventilation
system would have the same results ergo its not exclusive to
HRV's but the quality of the air.
Air filters and air cleaners: Rostrum by the American Academy of
Allergy, Asthma & Immunology Indoor Allergen
This paper provides an excellent overview on
filtration from the perspective of healthcare professionals.
citation: Sublett JL, Seltzer J, Burkhead R,
et al. Air Filters and Air Cleaners: Rostrum by the American
Academy of Allergy, Asthma and Immunology Indoor Allergen
Committee. J Allergy Clin Immunol.Volume 125, Issue 1 , Pages
32-38, January 2010
Report of the Surgeon General’s Workshop on Healthy Indoor
This report is a comprehensive overview for the general
public, the medical community, the public health community and
those from the construction industry.
citation: Report of the Surgeon General’s
Workshop on Healthy Indoor Environment, National Institutes of
Health, Bethesda, MD, Department of Health and Human Services,
January 12–13, 2005
Control of asthma triggers in indoor air with air
cleaners: a modeling analysis
Study examines peak and time-integrated
concentrations of common asthma triggers present in indoor air
over a year as a function of natural ventilation, portable air
cleaners, and forced air ventilation equipped with conventional
and high efficiency filtration systems.
citation: Myatt , T.A., Minegishi , T., Allen,
J.G., MacIntosh, D.L., Control of asthma triggers in indoor air
with air cleaners: a modeling analysis, Environmental Health
Reactions of ozone with human skin lipids:
Sources of carbonyls, dicarbonyls, and hydroxycarbonyls in
Study looks at skin reactions to ozone,
implications for ventilation systems and naturally ventilated
citation: Wisthalera, A., Weschler, C.J.,
Reactions of ozone with human skin lipids: Sources of carbonyls,
dicarbonyls, and hydroxycarbonyls in indoor air, Proceedings of
the National Academy of Sciences, April 13, 2010 vol. 107 no. 15
Association of residential dampness and mold with respiratory
tract infections and bronchitis
Study looks at dampness and mold associations
with a variety of adverse respiratory health effects, including
respiratory tract infections.
citation: Fisk, W.J., Eliseeva , E.A., Mendell,
M.J., Association of residential dampness and mold with
respiratory tract infections and bronchitis: a meta-analysis,
Environmental Health 2010, 9:72 doi:10.1186/1476-069X-9-72
Physiological and Subjective Responses in the Elderly When Using
Floor Heating and Air Conditioning Systems
Study looks at two groups of people exposed to
radiant and air conditioning.
citation: Hashiguchi, N., Tochihara, Y., Ohnaka,
T., Tsuchida, Chiaki, C., Otsuki, T., Physiological and
Subjective Responses in the Elderly When Using Floor Heating and
Air Conditioning Systems , Journal of physiological anthropology
and applied human science , Vol. 23: 1345-3475 , Nov. 2004
Housing characteristics, reported mold exposure, and asthma in
the European Community Respiratory Health Survey
Study investigated associations between housing
characteristics including heating systems, related to dampness,
mold exposure, and house dust mite levels and adult asthma.
citation:Zock JP, Jarvis D, Luczynska C, Sunyer J, Burney P.,
European Community Respiratory Health Survey. Housing
characteristics, reported mold exposure, and asthma in the
European Community Respiratory Health Survey, J Allergy Clin
Immunol. 2002;110:285-92. [PubMed: 12170270]
Does usage of domestic heating influence internal
environmental conditions and health?
Study investigates heating use and the presence
of environmental problems in the home, such as mould and
citation: Walker J., Mitchell R., Platt S.D.,
Petticrew M.P., Hopton J., Does usage of domestic heating
influence internal environmental conditions and health?,
Eur J Public Health, 2006;16:463-9.
What Is an Effective Portable Air Cleaning
Device? A Review
Study looks at the use and
testing of portable room air cleaners against common room
citation: Shaughnessy, R.J.,
Sextro, R.G., What Is an Effective Portable Air Cleaning Device?
A Review, Journal of Occupational and Environmental Hygiene, 3:
Eccles, R., An explanation for the
seasonality of acute upper respiratory tract viral
infections. Acta Otolaryngol 2002; 122:183–191. <http://tinyurl.com/mndbpph>
Johnson, C., Eccles, R. Acute cooling of
the feet and the onset of common cold symptoms. Family
Practice 2005; 22: 608–613. <http://fampra.oxfordjournals.org/content/22/6/608.full.pdf html>
Eccles. R., Acute cooling of the body
surface and the common cold. Rhinology, 40, 000-000,
Yale University. "Cold virus replicates better at cooler temperatures." ScienceDaily. ScienceDaily, 5 January 2015. <www.sciencedaily.com/releases/2015/01/150105170014.htm>.
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