Search

The world population is ageing, in particular in the developed world, with a significant increase in the percentage of people above 60 years old. They represent a segment of the population that is more vulnerable to adverse environmental conditions. Among them, indoor air quality is one of the most relevant, as elders spend comparatively more time indoors than younger generations. Furthermore, the recent COVID-19 pandemic contributed immensely to raising awareness of the importance of breathing air quality for human health and of the fact that indoor air is a vector for airborne infections and poisoning. Hence, this work reviews the state of the art regarding indoor air quality in elderly centers, considering the type of pollutants involved, their emission sources, and their health effects. Moreover, the influence of ventilation on air quality is also addressed. Notwithstanding the potential health problems with the corresponding costs and morbidity effects, only a few studies have considered explicitly indoor air quality and its impacts on elderly health. More studies are, therefore, necessary to objectively identify what are the impacts on the health of elderly people due to the quality of indoor air and how it can be improved, either by reducing the pollutants emission sources or by more adequate ventilation and thermal comfort strategies.

Exposure to air pollution in early years can exacerbate the risk of noncommunicable diseases throughout childhood and the entire life course. This study aimed to assess temperature, relative humidity (RH), carbon dioxide (CO2) and monoxide (CO), particulate matter (PM2.5, PM10), ultrafine particles, nitrogen dioxide (NO2), ozone (O3), formaldehyde, acetaldehyde and volatile organic compounds (VOC) levels in the two rooms where infant twins spend more time at home (30 dwellings, Northern Portugal). Findings showed that, in general, the worst indoor environmental quality (IEQ) settings were found in bedrooms. In fact, although most of the bedrooms surveyed presented adequate comfort conditions in terms of temperature and RH, several children are sleeping in a bedroom with improper ventilation and/or with a significant degree of air pollution. In particular, mean concentrations higher than recommended limits were found for CO2, PM2.5, PM10 and total VOC. Additionally, terpenes and decamethylcyclopentasiloxane were identified as main components of emissions from indoor sources. Overall, findings revealed that factors related to behaviors of the occupants, namely related to a conscientious use of cleaning products, tobacco and other consumer products (air-fresheners, incenses/candles and insecticides) and promotion of ventilation are essential for the improvement of air quality in households and for the promotion of children's health. The authors gratefully acknowledge the funding of Project HEALS – ‘Health and Environment-wide Associations based on Large Population Surveys’, through the European Union's Seventh Program for research, technological development and demonstration under grant agreement No info:eu-repo/grantAgreement/EC/FP7/603946/EU. MFG, FF and ZM also gratefully acknowledge the funding of Project NORTE-01-0145-FEDER-000010, Health, Comfort and Energy in the Built Environment (HEBE), cofinanced by Programa Operacional Regional do Norte (NORTE2020), through Fundo Europeu de Desenvolvimento Regional (FEDER). The co-author CR was supported by a PhD Grant PD/BD/135925/2018 funded by the Foundation for Science and Technology (FCT) - Portuguese Ministry of Science, Technology and Higher Education.

Exposure to airborne microorganisms has been linked to the development of health detriments, particularly in children. Microbial pollution can constitute a relevant health concern indoors, where levels of airborne microorganisms may be specially increased. This work aimed to characterize the airborne bacterial levels, and fungal concentration and diversity to which twins are exposed in their bedrooms (n = 30) during the first year of life. Bacterial and fungal levels varied widely across the studied bedrooms, with 10% of the rooms presenting values exceeding the national limit for both indoor bacterial and fungal counts. Cladosporium was the predominant genera, but Penicillium, Aspergillus, Alternaria, Trichoderma and Chrysonilia were also identified in the samples collected. In addition, two toxicogenic species, A. flavus and T. viride, were identified at counts that exceeded the established limit (12 CFU/m

Since children are far more vulnerable than adults to the effects of air pollution and spend about a third of their day in school, strict control of indoor environments in educational buildings is paramount to properly identify, manage and mitigate putative environmental risks for children. In this context, this work aimed to provide a holistic view on the outcomes obtained from the national ARIA project, which was focused on broadening the knowledge on the effects on children’s health of the exposure to schools’ indoor air. In particular, this work performed a comprehensive investigation of the indoor air quality (IAQ) in 20 public primary schools located in Porto (Northern Region, Portugal). This paper presents the results of the investigation along with the recently published main outcomes of ARIA on (1) the characteristics of the environment surrounding the surveyed buildings, and (2) the school’s environment-related health effects in school-age children from the studied classrooms. The investigation consisted in an extensive assessment plan conducted in 71 classrooms to assess temperature, relative humidity, carbon monoxide and dioxide, particulate matter (PM2.5, PM10, and ultrafine particles), nitrogen dioxide, ozone, volatile organic compounds, formaldehyde, acetaldehyde, airborne fungi, bacteria and endotoxins, and investigate their respective sources, during the cold seasons of 2014–2015. A series of studies was also launched to investigate school environment-related health detriments in 916 children. The results showed that comfort and ventilation issues and/or indoor pollutant levels that exceeded recommended limits were found in a substantial number of the classrooms surveyed. The high density of occupants, deficient ventilation, soil characteristics, presence of indoor pollution sources (e.g. classroom materials and consumer products) and outdoor pollution were some of the factors that seemed to explain the high air stuffiness and/or indoor pollution load identified in classrooms. In fact, some of indoor pollutants detected, even at low exposure levels, were associated with the development of respiratory symptoms in school-age children. Moreover, results from this work have also shown that the characteristics of the environment surrounding the schools, namely the presence of green spaces and species richness, can be major determinants of respiratory health among school-age children. Overall, the body of evidence generated from the ARIA project can support new evidence-based perspectives for promotion of health in educational buildings.

Air exposures occurring in indoor swimming pools are an important public health issue due to their popularity and regular use by the general population, including vulnerable groups such as children and elderly people. More comprehensive information on indoor air quality (IAQ) in swimming pools is thus needed in order to understand health risks, establish appropriate protective limits and provide evidence-based opportunities for improvement of IAQ in these facilities. In this context, twenty public indoor swimming pools located in the Northern Region of Portugal were examined in two sampling campaigns: January–March and May–July 2018. For each campaign, a comprehensive set of environmental parameters was monitored during the entire period of the facilities’ operating hours of a weekday, both indoors and outdoors. In addition, four air (1-h samplings) and water samples were collected. Findings show that comfort conditions, ultrafine particles number concentrations and exposure to substances in the indoor air (concentration and composition) is likely to vary greatly from one public indoor swimming pool to another. Trihalomethanes (THM) and dichloroacetonitrile were the predominant disinfection by-products identified in the indoor air but other potentially hazardous volatile organic compounds, such as limonene, 1,2,4-trimethylbenzene, 2,2,4,4,6,8,8-heptamethylnonane, 2- and 3-methylbutanenitrile, acetophenone, benzonitrile, and isobutyronitrile were found to have relevant putative emission sources in the environment of the swimming pools analyzed. Furthermore, indicators of poor ventilation conditions (namely carbon dioxide, relative humidity and existence of signs of condensation in windows) and some water-related parameters (THM levels, conductivity and salinity) were found to be determining factors of the measured airborne THM concentrations that appeared to significantly potentiate the exposure. In summary, this work provides evidence for the need to establish adequate standards for the comprehensive evaluation of IAQ in public swimming pools, in order to guide further development of evidence-based prevention/remediation strategies for promoting healthy environments in swimming pools. Keywords: Indoor air quality, Public health, Swimming pools, Trihalomethanes, Ultrafine particles, Volatile organic compounds

Elite swimmers and swimming pool employees are likely to be at greater health risk due to their regular and intense exposure to air stressors in the indoor swimming pool environment. Since data on the real long-term exposure is limited, a long-term monitoring and sampling plan (22 non-consecutive days, from March to July 2017) was carried out in an indoor Olympic-size pool with a chlorine-based disinfection method to characterize indoor environments to which people involved in elite swimming and maintenance staff may be exposed to. A comprehensive set of parameters related with comfort and environmental conditions (temperature, relative humidity (RH), carbon dioxide (CO2) and monoxide and ultrafine particles (UFP)) were monitored both indoors and outdoors in order to determine indoor-to-outdoor (I/O) ratios. Additionally, an analysis of volatile organic compounds (VOC) concentration and its dynamics was implemented in three 1-hr periods: early morning, evening elite swimmers training session and late evening. Samplings were simultaneously carried out in the air layer above the water surface and in the air surrounding the pool, selected to be representative of swimmers and coaches/employees’ breathing zones, respectively. The results of this work showed that the indoor climate was very stable in terms of air temperature, RH and CO2. In terms of the other measured parameters, mean indoor UFP number concentrations (5158 pt/cm3) were about 50% of those measured outdoors whereas chloroform was the predominant substance detected in all samples collected indoors (13.0–369.3 µg/m3), among a varied list of chemical compounds. An I/O non-trihalomethanes (THM) VOC concentration ratio of 2.7 was also found, suggesting that, beyond THM, other potentially hazardous VOC have also their source(s) indoors. THM and non-THM VOC concentration were found to increase consistently during the evening training session and exhibited a significant seasonal pattern. Compared to their coaches, elite swimmers seemed to be exposed via inhalation to significantly higher total THM levels, but to similar concentrations of non-THM VOC, during routine training activities. Regarding swimming employees, the exposure to THM and other VOC appeared to be significantly minimized during the early morning period. The air/water temperature ratio and RH were identified as important parameters that are likely to trigger the transfer processes of volatile substances from water to air and of their accumulation in the indoor environment of the swimming pool, respectively. Keywords: Disinfection by-products, Exposure assessment, Indoor air quality, Indoor swimming pool, Ultrafine particles

Conducting epidemiological and risk assessment research that considers the exposome concept, as in the case of HEALS project, requires the acquisition of higher dimension data sets of an increased complexity. In this context, new methods that provide accurate and interpretable data summary on relevant environmental factors are of major importance. In this work, a questionnaire was developed to collect harmonized data on potential pollutant sources to air in the indoor environment where children spend an important part of their early life. The questionnaire was designed in a user friendly checklist format to be filled out at the maternity in ten European cities. This paper presents and discusses the rationale for the selection of the questionnaire contents and the results obtained from its application in the households of 309 HEALS-enrolled families with babies recently born in Porto, Portugal. The tool was very effective in providing data on the putative air pollution sources in homes, with special focus on the bedroom of the newborns. The data collected is part of a wider effort to build the databases and risk assessment models of the HEALS project. The results of the analysis of the collected data suggest that, for the population under study, the main concerns on early life exposures at home can be related to emissions from the use of household solid fuels, indoor tobacco, household cleaning products, fragranced consumer products (e.g. air fresheners, incense and candles), moisture-related pathologies and traffic-related outdoor pollution. Furthermore, it is anticipated that the tool can be a valuable means to empower citizens to actively participate in the control of their own exposures at home. Within this context, the application of the checklist will also allow local stakeholders to identify buildings presenting most evident IAQ problems for sampling or intervention as well as to guide them in preparing evidence-based educational/awareness campaigns to promote public health through creating healthy households. The authors gratefully acknowledge the funding of Project HEALS – ‘Health and Environment-wide Associations based on Large population Surveys’, through the European Union’s Seventh Program for research, technological development and demonstration under grant agreement No 603946. MFG, FF and ZM also gratefully acknowledge the funding of Project NORTE-01-0145-FEDER-000010, Health, Comfort and Energy in the Built Environment (HEBE), cofinanced by Programa Operacional Regional do Norte (NORTE 2020), through Fundo Europeu de Desenvolvimento Regional (FEDER). CR was supported by a PhD Grant PD/BD/135925/2018 funded by the Foundation for Science and Technology (FCT) - Portuguese Ministry of Science, Technology and Higher Education. The authors would like also to express their gratitude to the families enrolled in BiTwin for their kindness, all members of the research team and the participating hospitals and their staff for their help and support.

Disinfection by-products (DBP) such as trihalomethanes (THM) are formed when chlorine and bromine interact with natural organic materials in chlorine-treated swimming pools. Epidemiological evidence demonstrated an association between exposure to swimming pool environment and adverse health effects. Therefore, this study aimed to assess carcinogenic and non-carcinogenic risk of long-term exposure of elite swimmers and their coaches. In an Olympic-size indoor chlorinated swimming pool, THM levels were determined in water (21–69 µg/L), in the boundary layer above the water surface (59–397 µg/m3), and in the air surrounding the pool (28–390 µg/m3). These values were used to predict multi-pathway chronic daily intake (CDI), cancer risk (CR) and hazard index (HI). Oral and dermal CDI for swimmers were 2.4 × 10−6 and 2.0 × 10−8, respectively. The swimmers’ inhalation CDI (1.9 × 10−3 mg/kg/day) was estimated to be sixfold higher than levels obtained for coaches (3.3 × 10−4 mg/kg/day). According to guidelines, the HI was acceptable, but CR exceeded the recommended limit for both, coaches (CR: 5.5 × 10−7–8.5 × 10−5; HI: 6.5 × 10−4–1 × 10−1) and swimmers (CR: 1.4 × 10−5–3.6 × 10−4 HI: 1.6 × 10−2–4.3 × 10−1). Our findings provide further support to the need to develop comprehensive guidelines to safeguard the health of individuals involved in elite swimming.