«Health and Productivity Gains from Better Indoor Environments and Their Implications for the U.S. Department of Energy William J. Fisk1 Staff ...»
The most effective method of controlling the indoor concentrations of many indoor-generated air pollutants is to eliminate or reduce the sources present indoors. Many of these sources depend on the design, furnishing, operation, and maintenance of the building; for example, the selection of building and HVAC materials and office equipment. Building ventilation requirements are diminished when indoor pollutant source strengths are reduced; thus, indoor pollutant source reduction can save energy. Research and technology transfer efforts are needed to identify the sources that do and do-not affect health and to develop and demonstrate methods of eliminating or reducing the important sources.
1. There is relatively strong evidence that characteristics of buildings and indoor environments significantly influence the occurrence of communicable respiratory illness, allergy and asthma symptoms, sick building symptoms, and worker productivity.
2. Theoretical and empirical evidence indicate that existing technologies and procedures can improve indoor environments in a manner that increases health and productivity. Estimates of the potential reductions in adverse health effects are provided in Table 1.
3. Existing data and knowledge allows only crude estimates of the magnitudes of productivity gains that may be obtained by providing better indoor environments in a manner that improves health; however, the projected gains are very large. For the U.S., the estimated potential annual savings plus productivity gains, in 1996 dollars, are approximately $20 billion to $50 billion, with a breakdown as indicated in Table 1.
4. Over the next two decades, the current goal of providing an adequate indoor environment may be replaced by an emphasis on providing excellent indoor environments that maximize the health, satisfaction, and performance of building occupants. Factors underlying such a paradigm shift would include increasing affluence of the U.S. population, increased expectations for excellent health, the desire to contain health care costs, and the rapidly increasing evidence, summarized in this paper, that IEQ affects health and productivity.
5. A leadership role for the U.S. Department of Energy is to undertake aggressive research and technology transfer programs which: (1) help stimulate the shift towards excellent indoor environments, thereby improving the health and economic well-being of the US population; and 2) guide the U.S. response so that energy-efficient technologies and practices are used whenever possible to provide excellent IEQ. Research and technology transfer topics that provide opportunities for simultaneous energy savings and improvements in health include the following: building ventilation; evaporative cooling; reducing moisture and humidity problems;
efficient air filtration; better indoor temperature control; natural ventilation;
HVAC system maintenance and operation; rethinking HVAC architectures;
and indoor pollutant source control.
Acknowledgments The author thanks Dr. Richard Diamond and Dr. Ashok Gadgil for their very helpful review of a draft of this document.
This work was supported by the RAND Corporation and by the Assistant Secretary for Energy Efficiency and Renewable Energy, Office of Building Technology, State, and Community Programs, Office of Building Systems of the U.S. Department of Energy (DOE) under contract No. DE-AC03-76SF00098.
References Antonicelli L, Bilo MB, Pucci S, Schou C, Bonifazi F. 1991. Efficacy of an aircleaning device equipped with a high efficiency particulate air filter in house dust mite respiratory allergy. Allergy 46:594-600.
Arshad SH, Matthews S, Gant C, Hide DW. 1992. Effect of allergen avoidance on development of allergic disorders in infancy. The Lancet 339(8809): 1493-1497.
Brightman HS, Womble SE, Girman JR, Sieber WK, McCarthy JF, Spengler JD.
1997. Preliminary comparison of questionnaire data from two IAQ studies:
occupant and workspace characteristics of randomly selected buildings and complaint buildings. Proc. Healthy Buildings / IAQ 1997. 2:453-458. Healthy Buildings / IAQ 1997, Washington DC.
Brundage JF, Scott RM, Lednar WM, Smith DW, Miller RN. 1988. Buildingassociated risk of febrile acute respiratory diseases in army trainees. J.
American Medical Association 259(14):2108-2112.
Committee on the Assessment of Asthma and Indoor Air (1999) Clearing the air:
asthma and indoor air exposures. National Academies of Sciences, Institute of Medicine, National Academy Press, Washington DC.
Committee on Health Effects of Indoor Allergens 1993. Indoor allergens: assessing and controlling adverse health effects. Pope AM, Patterson R, Burge, H, editors.
National Academy Press, Washington, DC.
Dales R, Miller D, White J, Dulberg C, Lazarovits AI. 1998. Influence of residential fungal contamination on peripheral blood lymphocyte populations in children. Archives of Environmental Health 53(3): 190-195.
Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health. 1984. Outbreaks of respiratory illness among employees in large office buildings. Tennessee, District of Columbia. MMWR 33(36): 506-513.
Dixon RE. 1985. Economic costs of respiratory tract infections in the United States. American Journal of Medicine 78(6B): 45-51.
Drinka PJ, Krause P, Schilling M, Miller BA, Shut P, Gravenstein S. 1996. Report of an influenza-A outbreak: nursing home architecture and influenza-A attack rates. J. American Geriatrics Society 44: 910-913.
Energy Information Administration 1998. A look at commercial buildings in 1995:
characteristics, energy consumption, and energy expenditures. DOE/EIA-0625(95), Energy Information Administration, U.S. Department of Energy.
EPA (1996) Air quality criteria for particulate matter, volume III of III, U.S Environmental Protection Agency, EPA/600/AP-95/001c.
Evans D, Levison MJ, Feldman CH, Clark WM, Wasilewski Y, Levin B, Mellins RB. 1987. The impact of passive smoking on emergency room visits of urban children with asthma. American Review of Respiratory Disease 135(3): 567-572.
Fang, L.; Clausen, G.; Fanger, P.O. 1998a. Impact of temperature and humidity on the perception of indoor air quality. Indoor Air 8(2): 80-90.
Fang, L.; Clausen, G.; Fanger, P.O. 1998b. Impact of temperature and humidity on perception of indoor air quality during immediate and longer whole body exposures. Indoor Air 8(4): 276-284.
Fanger PO (2000) Indoor air quality in the 21st century: search for excellence.
Indoor Air 10(2): 68-73.
Faulkner, D., Fisk, W.J., and Sullivan, D.P. (1993) "Indoor Airflow and Pollutant Removal in a Room With Floor-Based Task Ventilation: Results of Additional Experiments", Building and Environment 30(3), pp. 323-332 Faulkner, D, Fisk, W.J., Sullivan, D, and Wyon, D.P. (1998) Ventilation Efficiencies of Desk-Mounted Task/Ambient Conditioning Systems, Indoor Air 9: 273-281.
Federspiel, C.C. (1998) “Statistical analysis of unsolicited thermal sensation complaints in commercial buildings”, ASHRAE Transactions 104(1): 912-923 Fisk WJ, Mendell, MJ, Daisey, JM, Faulkner D, Hodgson AT, Nematollahi M, Macher JM. 1993. Phase 1 of the California health building study: a summary.
Indoor Air 3: 246-254.
Fisk WJ, Rosenfeld, AH. 1997. Estimates of improved productivity and health from better indoor environments. Indoor Air 7: 158-172.
Fisk, W.J. and Rosenfeld, A.H. (1998) “Potential nationwide improvements in productivity and health from better indoor environments”, Proceedings of the ACEEE 1998 Summer Study on Energy Efficiency in Buildings, “Energy Efficiency in a Competitive Environment”, August 23-28, Asilomar, CA, pp.
8.85-8.97 Fisk WJ. 2000a Estimates of potential nationwide productivity and health benefits from better indoor environments: an update, Indoor Air Quality Handbook., eds.
J. Spengler, J.M. Samet, and J.F. McCarthy, McGraw Hill. In press.
Fisk, W.J. 2000b Health and productivity gains from better indoor environments and their relationship with building energy efficiency. Annual Review of Energy and the Environment 25(1):1-30. In press Fisk, W.J., Faulkner D., Sullivan, D., and Mendell, M.J. 2000c Particle concentrations and sizes with normal and high efficiency filtration in a sealed air-conditioned office building, Aerosol Science and Technology 32: 527-544, Garibaldi RA. 1985. Epidemiology of community-acquired respiratory tract infections in adults, incidence, etiology, and impact. American Journal of Medicine 78(6B): 32-37.
GAO 1999. Indoor pollution: status of federal research activities. US General Accounting Office, GAO/RCED-99-254, Washington, DC.
Harving H, Hansen LG, Korsgaard J, Nielsen PA, Olsen OF, Romer J, Svendsen UG, Osterballe O. 1991. House dust mite allergy and anti-mite measures in the indoor environment. Allergy 46 supplement 11: 33-38.
Hoffmann R.E., Wood R.C., Kreiss, K. 1993. Building-related asthma in Denver office workers. American Journal of Public Health 83: 89-93.
Hoge CW, Reichler MR, Dominguez EA, Bremer JC, Mastro TD, Hendricks KA, Mushev DM, Elliot JA, Fackman RR, Breiman RF. 1994. An Epidemic of pneumococcal disease in an overcrowded, inadequately ventilated jail. New England Journal of Medicine 331(10): 643-648.
Husman T. 1996. Health effects of indoor-air microorganisms. Scandinavian J. of Worker Environmental Health 22: 5-13.
Husman T, Koskinen O, Hyvarinen A, Reponen T, Ruuskanen J, Nevalainen A.
1993. Respiratory symptoms and infections among residents in dwellings with moisture problems or mold growth. Proc. of Indoor Air 1993, The 6th International Conference on Indoor Air Quality and Climate. 1: 171 –174.
Indoor Air 1993, Helsinki.
IPMVP IEQ Committee. 1999. Indoor environmental quality: introduction, linkage to energy efficiency, and measurement and verification: Appendix to the 1999 version of the International Performance Measurement and Verification Protocol, http://www.ipmvp.org/info/download.html Jaakkola JJK, Heinonen OP. 1993. Shared office space and the risk of the common cold. European Journal of Epidemiology 11(2): 213-216.
Jaakkola JJK, Miettinen P. 1995. Ventilation rate in office buildings and sick building syndrome. Occupational and Environmental Medicine 52: 709-714.
Johnston SL, Pattermore PK, Sanderson G, Smith S, Lampe F, Josephs L, Symington P, O’Toole S, Myint SH, Tyrrell DA, Holgate ST. 1995. Community study of role of viral infections in exacerbations of asthma in 9-11 year old children. British Medical Journal 310: 1225-1229.
Knobeloch L, Anderson H, Morgan J, Nashold R (1997) Heat related illness and death, Wisconsin 1995. Wisconsin Medical Journal 96(5): 33-38.
Koskinen OM, Husman TM, Hyvarinen AM, Reponen TA, Ruuskanen, Nevalainen AI. (1997). Two moldy day care centers: a follow-up study of respiratory symptoms and infections. Indoor Air 7(4): 262-268.
Koskinen O, Husman T, Hyvarinen A, Reponen T, Ruuskanen, Nevalainen A.
1995. Respiratory symptoms and infections among children in a day-care center with a mold problem. Indoor Air 5(1): 3-9.
Kroner WM, Stark-Martin JA. 1992. Environmentally responsive workstations and office worker productivity. Ed. H Levin, Proc. Indoor Environment and Productivity, June 23-26, Baltimore, MD, ASHRAE, Atlanta.
Lagus Applied Technologies 1995. Air change rates in non-residential buildings in California, Report P400-91-034BCN, California Energy Commission, Sacramento, CA.
Langmuir AD, Jarrett ET, Hollaenber A. 1948. Studies of the control of acute respiratory diseases among naval recruits, III. The epidemiological pattern and the effect of ultra-violet radiation during the winter of 1946-1947. American Journal of Hygiene 48: 240-251.
Lagercrantz L, Wistrand M, Willen U, Wargocki P, Witterseh T, Sundell J (2000) Negative impact of air pollution on productivity: previous Danish findings repeated in a new Swedish test room. Proceedings of Healthy Buildings 2000, vol. 1., pp. 653-658. August 6-10, Helsinki. SIY Indoor Air Information, Oy, Helsinki.
Mendell MJ. 1993. Non-specific symptoms in office workers: a review and summary of the epidemiologic literature. Indoor Air 3: 227-236.
Mendell M.J., Fisk, W.J., Deddens, J.A., Seavey, W.G., Smith, A.H., Smith, D.F., Hodgson, A.T., Daisey J.M., Goldman, L. R. (1996) “Elevated Symptom Prevalence Associated with Ventilation Type in Office Buildings: Findings from the California Healthy Building Study-Phase 1”, Epidemiology 7(6): 583Mendell, MJ, Fisk, W.J, Dong, M.X., Petersen, M., Hines, C.J., Faulkner, D., Deddens, J.A., Ruder, A.M., Sullivan, D., and Boeniger, M.F. (1999) “Enhanced particle filtration in a non-problem office environment: preliminary results from a double-blind crossover intervention”, American Journal of Industrial Medicine 1: 55-57.
Menzies D, Bourbeau J. 1997. Building-related illness. New England Journal of Medicine 337(21): 1524-1531.
Menzies D, Comtois P, Pasztor J, Nunes F, Hanlet JA. 1998. Aeroallergens and work-related respiratory symptoms among office workers. J. Allergy and Clinical Immunology 101(1): 38-44.
Menzies D, Pasztor J, Nunes F, Leduc J, Chan CH. 1997b. Effect of a new ventilation system on health and well being of office workers. Archives of Environmental Health 52(5): 360-367.
Milton DK, Glencross PM, Walters MD 2000. Risk of sick leave associated with outdoor ventilation level, humidification, and building related complaints.
Harvard School of Public Health, Boston. Submitted to Indoor Air.
Myhrvold AN, Olsen E. 1997. Pupils health and performance due to renovation of schools. Proc. Healthy Buildings / IAQ 1997. 1: 81-86. Healthy Buildings / IAQ 1997. Washington, DC.
Myhrvold AN, Olsen E, Lauridsen O. 1996. Indoor environment in schools – pupils health and performance in regard to CO2 concentrations. Proc. Indoor
Air 1996, The 7th International Conference on Indoor Air Quality and Climate. 4:
369-374. SEEC Ishibashi Inc., Japan.
Nelson NA, Kaufman JD, Burt J, Karr C. 1995. Health symptoms and the work environment in four nonproblem United States office buildings. Scand. J. Work Environ. Health 21(1): 51-59 New York State Commission on Ventilation. 1923. The prevalence of respiratory diseases among children in schoolrooms ventilated by various methods.