Elderly exposure to indoor air pollutants

doi:10.1016/j.atmosenv.2013.11.061

Atmospheric Environment

Volume 85, March 2014, Pages 54-63

https://doi.org/10.1016/j.atmosenv.2013.11.061 Get rights and content

Highlights

•
Elderly spend 95% of their time indoors.
•
Indoor is the main site contributing for the elders' exposure to air pollutants.
•
Inadequate ventilation is a significant problem in Elderly Care Centers.
•
Identification of the micro-environments with highest impacts on elderly exposure.

Abstract

The aim of this work was to characterize the indoor air quality in Elderly Care Centers (ECCs) in order to assess the elders' daily exposure to air pollutants. Ten ECCs hosting 384 elderly were selected in Lisbon and Loures. Firstly, a time-budget survey was created based on questionnaires applied in the studied sites. Results showed that in average elders spend 95% of their time indoors splitted between bedrooms and living-rooms. Therefore, a set of physical and chemical parameters were measured continuously during the occupancy period in these two indoor micro-environments and in the outdoor. Results showed that indoor was the main environment contributing for the elders' daily exposure living in ECCs. In the indoor, the principal micro-environment contributing for the elders' daily exposure varied between bedrooms and living-rooms depending not only on the characteristics of the ECCs but also on the pollutants. The concentrations of CO₂, VOCt, O₃ and PM₁₀ exceeded the limit values predominantly due to the insufficient ventilation preconized in the studied sites.

Introduction

Several works have been studied the relation between atmospheric pollutants and human health risks (Martinelli et al., 2013, Viegi et al., 2004, Jones, 1999). Although indoor concentration and number of carcinogenic air pollutants has been decreased since the 1950s (Weschler, 2009), the changes on life-style and the fact that people spend a large part of their life inside the indoor environments have promoted an increase on exposure to indoor air pollutants (Byčenkienė et al., 2009, Dales et al., 2008, Leech et al., 2002). Consequently, we are assisting an increase of studies developed by the scientific community concerning indoor air quality (IAQ) and its effects upon health (Canha et al., 2012a, Franck et al., 2011, Almeida et al., 2011, World Health Organization, 2010, Canha et al., 2010, Saliba et al., 2009, Fraga et al., 2008, Fromme et al., 2007, Kosonen and Tan, 2004, Lee et al., 2002, Spengler and Wilson, 1996, Allen and Miguel, 1995). However, the exposure assessment that should be estimated by the time spent by people in different environments and the concentration of the pollutants for the period of interest (ILO et al., 2000, Sexton et al., 1995) is rarely estimated.

According to the United Nations (2012) the percentage of total population aged 60 years or over in the Europe was 22% for the year 2012 and prospects 34% for 2050 (United Nations, 2012). Europe presents the highest percentages of old people worldwide, being Africa the continent with the lowest percentage of population with more than 60 years (United Nations, 2012). Portugal is the 8^th oldest country in the world and the 6^th in Europe, with 23% of population with more than 60 years old. In Portugal, the number of Elderly Care Centers (ECCs) increased 49% between 1998 and 2010 (GEP/MSSS, 2010). In general, people spend about 19–20 h indoors (Zhao et al., 2009, Bruinen de Bruin et al., 2004, Saksena et al., 2003, Klepeis et al., 2001) and these values increase considering the elders living in ECCs, since their independency is reduced (Bradshaw et al., 2012). By all of these reasons and also by the fact that elder people are considered a susceptible group, along children, sick and pregnant people, mitigate their exposure to air pollutants becomes increasingly important (Almeida et al., 2011, Canha et al., 2011, Pegas et al., 2011a, Pegas et al., 2011b).

The main goal of this work was to characterize the IAQ in ECCs in order to assess the elders' daily exposure to air pollutants.

Section snippets

Material and methodologies

The current study was carried out in 10 ECCs, located in Lisbon and Loures, District of Lisbon (Fig. 1).

Time occupancy by elders

Fig. 3a shows the time spent by the elders in each micro-environment. Due to the lack of differences between weekdays and weekends, the results are presented for typical 24 h. Fig. 3b indicates that elders living in the studied ECCs spend in average 95% of their time indoors. The micro-environment referred as “Others” is defined as other indoor micro-environments inside and/or outside the elderly care centers, such as family houses, restaurants or coffees. A study developed in Italy showed that

Conclusions

Results from this work clearly showed that exposure to indoor air pollutants is a current problem that is necessary to be aware.

The developed time-budget survey showed that elders living in ECCs spend 95% of their time indoors and this value increased in institutions with higher number of bedridden.

Only one of the ECCs was equipped with mechanical ventilation and consequently ventilation rates showed to be insufficient to promote air exchange and to dilute the concentration of indoor air

Acknowledgments

The study would not be possible without the assistance of the Câmara Municipal de Loures, by Dr. Luzia Sousa and Dr. Beatriz Reis. We gratefully acknowledge Prof. Dr. Susana Viegas and Prof. Dr. Carla Viegas of Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL), Portugal, for providing a set of equipments. We also gratefully acknowledge Fundação para a Ciência e Tecnologia (FCT) for funding M. Almeida-Silva by PhD fellowship (SFRH/BD/69700/2010).

References (52)

A.G. Allen et al.
Indoor organic and inorganic pollutants: in-situ formation and dry deposition in southeastern Brazil
Atmos. Environ.
(1995)
S.M. Almeida et al.
Children exposure to air particulate matter in indoor of Lisbon primary schools
Atmos. Environ.
(2011)
J.A. Bernstein et al.
The health effects of nonindustrial indoor air pollution
J. Allergy Clin. Immunol.
(2008)
N. Canha et al.
Seasonal variation of total particulate matter and children respiratory diseases at Lisbon basic schools using passive methods
Proc. Environ. Sci.
(2011)
C. Chao et al.
Residential indoor PM10 and PM2.5 in Hong Kong and the elemental composition
Atmos. Environ.
(2002)
C. Dimitroulopoulou
Ventilation in European dwellings: a review
Build. Environ.
(2012)
S. Fraga et al.
Indoor air quality and respiratory symptoms in Porto schools
Rev. Port. Pneumol.
(2008)
U. Franck et al.
Respiratory effects of indoor particles in young children are size dependent
Sci. Total Environ.
(2011)
H. Fromme et al.
Particulate matter in the indoor air of classrooms-exploratory results from Munich and surrounding area
Atmos. Environ.
(2007)
O. Hänninen
Novel second degree solution to single zone mass-balance equation improves the use of build-up data in estimating ventilation rates in classrooms
J. Chem. Health Saf.
(2013)

A.P. Jones

Indoor air quality and health

Atmos. Environ.

(1999)

N. Jones et al.

Indoor/outdoor relationships of particulate matter in domestic homes with roadside, urban and rural locations

Atmos. Environ.

(2000)

R. Kosonen et al.

The effect of perceived indoor air quality on productivity loss

Energy Build.

(2004)

S. Lawson et al.

The effect of proximity to major roads on indoor air quality in typical Australian dwellings

Atmos. Environ.

(2011)

S.C. Lee et al.

Inter-comparison of air pollutant concentrations in different indoor environments in Hong Kong

Atmos. Environ.

(2002)

N. Martinelli et al.

Air particulate matter and cardiovascular disease: a narrative review

EFIM

(2013)

S.B. Molloy et al.

Indoor air quality in typical temperate zone Australian dwellings

Atmos. Environ.

(2012)

Z.A. Nasir et al.

Particulate pollution in different housing types in a UK suburban location

Sci. Total Environ.

(2013)

J.A. Raub et al.

Carbon monoxide poisoning – a public health perspective

Toxicology

(2000)

N.A. Saliba et al.

Levels and indoor–outdoor relationships of PM10 and soluble inorganic ions in Beirut, Lebanon

Atmos. Res.

(2009)

C.J. Weschler

Changes in indoor pollutants since the 1950s

Atmos. Environ.

(2009)

J.D. Yanosky et al.

A comparison of two direct-reading aerosol monitors with the federal reference method for PM2.5 in indoor air

Atmos. Environ.

(2002)

S.M. Almeida et al.

Children exposure to air particulate matter in indoor of Lisbon primary schools

Atmos. Environ.

(2010)

ASHRAE

Ventilation for Acceptable Indoor Air Quality

(2004)

S. Bradshaw et al.

Living well in care homes: a systematic review of qualitative studies

Age Ageing

(2012)

Y. Bruinen de Bruin et al.

Personal carbon monoxide exposure levels: contribution of local sources to exposures and microenvironment concentrations in Milan

J. Expo. Anal. Environ. Epidemiol.

(2004)

Cited by (128)

Thermal demand characteristics of elderly people with varying levels of frailty in residential buildings during the summer
2024, Journal of Building Engineering
As society ages, there is a growing concern for the comfort and health of elderly people. Differences in the degree of physiological aging in the elderly population lead to possible differences in their ability of adapting to environmental changes to maintain thermal comfort. To verify such differences in thermal environmental demands due to aging and physiological function changes, this study has used Fried’s frailty classification method in combination with a wristband device for a field survey of 394 elderly people in residential buildings in Chongqing, China. The study was carried out in the summer and measured participants’ both psychological and physiological responses. The study result showed that frailer elderly people had higher thermal sensitivity and a narrower range of comfortable temperatures. The neutral temperature was identified to be 25.8 °C for non-frailty people, 26.9 °C for pre-frailty people, and 27.9 °C for frailty people, with comfort temperature intervals of 24.0 °C–30.0 °C for non-frailty people, 24.3 °C–29.3 °C for pre-frailty people and 25.9 °C–29.3 °C for frailty people. In terms of physiological regulation, frail elderly people showed lower sweating rates (SI) and pulse intensity (PI), with higher heart rates (HR) in summer. The study provides evidence that the frailty of physiological functions has an innegletable impact on elderly people’s thermal demand, so when designing indoor thermal environment for them their frailty condition needs to be properly considered.
Environmental data monitoring and infection risks in UK care-homes in the context of COVID-19
2024, Building and Environment
The COVID-19 pandemic drew attention to the critical role of building ventilation as a measure for controlling infection transmission. With the substantial number of COVID-19 outbreaks in care homes worldwide, the effectiveness of ventilation is an important consideration for infection control and wider exposure to indoor air pollutants. In this study, we used IoT-based sensors in two residential care homes to evaluate ventilation in various areas, including bedrooms, corridors, and communal spaces. Our monitoring focused on carbon dioxide (CO $_{2}$ ) levels as a proxy for ventilation, as well as temperature and humidity, during the spring of 2022. We also developed a ventilation model using the software CONTAM and coupled it with an infection risk model to assess airborne transmission risks under different weather and occupancy conditions. Our results suggest that ventilation is generally adequate based on UK COVID-19 guidelines at the time, with CO $_{2}$ below 800 ppm for the majority of the time, and opening windows in communal spaces in elderly care environments can help preserve indoor ventilation during periods of high occupancy. However, modelling data suggests that low CO $_{2}$ values may be indicative of low occupancy in many spaces and therefore ventilation rates may not be sufficient to mitigate infection transmission. Encouraging positive ventilation behaviours in staff and residents, potentially supported by visible CO $_{2}$ monitors, and taking additional precautions such as using air cleaners, enabling additional window openings or staff wearing masks during outbreaks and periods of high disease prevalence is likely to be beneficial for resident and staff health.
Smart indoor air quality monitoring for enhanced living environments and ambient assisted living
2024, Advances in Computers
Indoor air quality has been a major concern for public health and well-being. People who spend 80–90% of their routine time indoors are likely to experience serious complications due to repeated exposure to degraded air quality. Patients with disability and existing health concerns usually interact more with the indoor environment. Therefore, the risk of rising concentration of air pollutants in the building premises in urban and rural areas brings a considerable threat to people with assisted living. This chapter focuses on the importance of smart indoor air quality monitoring for enhanced living environments and ambient assisted living. It throws light on the efforts made by past researchers, potential gaps in the literature, future scopes, and technical recommendations to deal with the problem domain. Furthermore, this chapter also introduces the latest technologies, methods, and approaches to support enhanced living environments and ambient assisted living.
Hygroscopic La<inf>2</inf>O<inf>3</inf> hybridized LaCoO<inf>3</inf>-based composite catalyst for efficient ozone decomposition under humidity conditions
2023, Applied Surface Science
Herein we first report the unique hygroscopic oxide hybrid LaCoO₃-based composite catalyst derived from dual-metal metal organic framework (MOF) for ozone decomposition. First, dual-metal La,Co-MOF is synthesized by solvothermal method, then La,Co-MOF is calcined at high temperature, the hygroscopic oxide (La₂O₃) and active oxides (LaCoO₃ and Co₃O₄) were uniformly hybridized to form porous microspheres. Benefiting from the hybrid action of the two types of oxides, this composite catalyst exhibits highly efficient O₃ removal activity within 12 h over the entire humidity conditions. The outstanding humidity resistance is attributed to the preferential adsorption of water vapor on hygroscopic oxide (La₂O₃), preventing the adsorption of gaseous water molecules on the surface of active oxides. In-situ FTIR further indicates that this composite catalyst possesses superior humidity resistance in the ozone catalytic decomposition.
Effectiveness of filtering or decontaminating air to reduce or prevent respiratory infections: A systematic review
2023, Preventive Medicine
Installation of technologies to remove or deactivate respiratory pathogens from indoor air is a plausible non-pharmaceutical infectious disease control strategy.
We undertook a systematic review of worldwide observational and experimental studies, published 1970–2022, to synthesise evidence about the effectiveness of suitable indoor air treatment technologies to prevent respiratory or gastrointestinal infections.
We searched for data about infection and symptom outcomes for persons who spent minimum 20 h/week in shared indoor spaces subjected to air treatment strategies hypothesised to change risk of respiratory or gastrointestinal infections or symptoms.
Pooled data from 32 included studies suggested no net benefits of air treatment technologies for symptom severity or symptom presence, in absence of confirmed infection. Infection incidence was lower in three cohort studies for persons exposed to high efficiency particulate air filtration (RR 0.4, 95%CI 0.28–0.58, p < 0.001) and in one cohort study that combined ionisers with electrostatic nano filtration (RR 0.08, 95%CI 0.01–0.60, p = 0.01); other types of air treatment technologies and air treatment in other study designs were not strongly linked to fewer infections. The infection outcome data exhibited strong publication bias.
Although environmental and surface samples are reduced after air treatment by several air treatment strategies, especially germicidal lights and high efficiency particulate air filtration, robust evidence has yet to emerge that these technologies are effective at reducing respiratory or gastrointestinal infections in real world settings. Data from several randomised trials have yet to report and will be welcome to the evidence base.
Randomised controlled trial of a behavioural intervention to reduce exposure to PM<inf>2.5</inf> in patients with COPD
2023, Environment International
Fine particulate matter (PM_2.5) is a well-known risk factor for worse outcomes of chronic obstructive pulmonary disease (COPD). However, evidence-based guidance on effective personal behavioural strategies to minimise the effects of PM_2.5 is limited. This study aimed to assess the effectiveness of a behavioural intervention in reducing PM_2.5 exposure and improving clinical outcomes in patients with COPD.
Participants were 1:1 randomised, and the intervention group received a behavioural intervention consisting of five activities, while the control group received usual care. The participants were followed up for 9 months. The primary outcomes were differences in the score of St. George’s Respiratory Questionnaire for patients with COPD (SGRQ-C) and COPD assessment test (CAT) from baseline.
A total of 106 participants were enrolled and 102 completed the study. At the end of the study, the intervention group showed significant improvements in the primary outcomes compared to the control group, with a group difference of −5.9 in the reduction of total SGRQ-C (−3.4 vs. 2.5; p = 0.049) and −3.8 in the CAT score (−1.2 vs. 2.7; p = 0.001). Participants with good adherence to the intervention demonstrated a greater extent of improvement in CAT score and lower PM_2.5 levels compared to those who had poor adherence or were in the control group. Regular checking of air quality forecasts was significantly associated with a reduction in CAT scores among all the intervention activities.
Individual-level behavioural interventions can be an effective strategy for mitigating the health hazards associated with PM_2.5.
ClinicalTrials.gov Identifier: NCT04878367.

View all citing articles on Scopus

View full text

Elderly exposure to indoor air pollutants

Highlights

Abstract

Introduction

Section snippets

Material and methodologies

Time occupancy by elders

Conclusions

Acknowledgments

Atmos. Environ.

Atmos. Environ.

J. Allergy Clin. Immunol.

Proc. Environ. Sci.

Atmos. Environ.

Build. Environ.

Rev. Port. Pneumol.

Sci. Total Environ.

Atmos. Environ.

J. Chem. Health Saf.

Atmos. Environ.

Atmos. Environ.

Energy Build.

Atmos. Environ.

Atmos. Environ.

EFIM

Atmos. Environ.

Sci. Total Environ.

Toxicology

Atmos. Res.

Atmos. Environ.

Atmos. Environ.

Children exposure to air particulate matter in indoor of Lisbon primary schools

Atmos. Environ.

Ventilation for Acceptable Indoor Air Quality

Living well in care homes: a systematic review of qualitative studies

Age Ageing

Personal carbon monoxide exposure levels: contribution of local sources to exposures and microenvironment concentrations in Milan

J. Expo. Anal. Environ. Epidemiol.