Methods for control of indoor air quality

This report presents results of a review of available methods for control of environmental hazards applied to indoor air pollutants. Indoor air pollution originates from transport of ambient outdoor air contaminants into occupied spaces by natural infiltration ventilation, or by mechanical ventilation using outdoor makeup air, plus contributions from indoor emission sources. When air exchange with the external ambient environment is reduced to conserve energy, contributions from indoor emission sources may dominate indoor air pollutant levels. This paper identifies alternative methods available to control indoor air pollutant exposures. The performance characteristics of ventilation systems and of air cleaning devices used in mixed modes for ventilation of occupied spaces are described. Models for predicting effectiveness of several alternative modes are reviewed, with field trial validation results cited where available. Results of previous confined-space studies are briefly reviewed as points of departure for consideration of necessary air quality, ventilation, and air cleaning. Understanding of indoor air contaminant generation and controls is aided by examination of earlier studies of indoor air quality, using modern perspectives on occupational environmental health and hygiene.     

Characterizing multi-pollutant air pollution in China: Comparison of three air quality indices

Multi-pollutant air pollution (i.e., several pollutants reaching very high concentrations simultaneously) frequently occurs in many regions across China. Air quality index (AQI) is used worldwide to inform the public about levels of air pollution and associated health risks. The current AQI approach used in China is based on the maximum value of individual pollutants, and does not consider the combined health effects of exposure to multiple pollutants. In this study, two novel alternative indices – aggregate air quality index (AAQI) and health-risk based air quality index (HAQI) – were calculated based on data collected in six megacities of China (Beijing, Shanghai, Guangzhou, Shjiazhuang, Xi'an, and Wuhan) during 2013 to 2014. Both AAQI and HAQI take into account the combined health effects of various pollutants, and the HAQI considers the exposure (or concentration)-response relationships of pollutants. AAQI and HAQI were compared to AQI to examine the effectiveness of the current AQI in characterizing multi-pollutant air pollution in China. The AAQI and HAQI values are higher than the AQI on days when two or more pollutants simultaneously exceed the Chinese Ambient Air Quality Standards (CAAQS) 24-hour Grade II standards. The results of the comparison of the classification of risk categories based on the three indices indicate that the current AQI approach underestimates the severity of health risk associated with exposure to multi-pollutant air pollution. For the AQI-based risk category of ‘unhealthy’, 96% and 80% of the days would be ‘very unhealthy’ or ‘hazardous’ if based on AAQI and HAQI, respectively; and for the AQI-based risk category of ‘very unhealthy’, 67% and 75% of the days would be ‘hazardous’ if based on AAQI and HAQI, respectively. The results suggest that the general public, especially sensitive population groups such as children and the elderly, should take more stringent actions than those currently suggested based on the AQI approach during high air pollution events. Sensitivity studies were conducted to examine the assumptions used in the AAQI and HAQI approaches. Results show that AAQI is sensitive to the choice of pollutant irrelevant constant. HAQI is sensitive to the choice of both threshold values and pollutants included in total risk calculation.     

The toxicology of climate change: Environmental contaminants in a warming world

Climate change induced by anthropogenic warming of the earth's atmosphere is a daunting problem. This review examines one of the consequences of climate change that has only recently attracted attention: namely, the effects of climate change on the environmental distribution and toxicity of chemical pollutants. A review was undertaken of the scientific literature (original research articles, reviews, government and intergovernmental reports) focusing on the interactions of toxicants with the environmental parameters, temperature, precipitation, and salinity, as altered by climate change. Three broad classes of chemical toxicants of global significance were the focus: air pollutants, persistent organic pollutants (POPs), including some organochlorine pesticides, and other classes of pesticides. Generally, increases in temperature will enhance the toxicity of contaminants and increase concentrations of tropospheric ozone regionally, but will also likely increase rates of chemical degradation. While further research is needed, climate change coupled with air pollutant exposures may have potentially serious adverse consequences for human health in urban and polluted regions. Climate change producing alterations in: food webs, lipid dynamics, ice and snow melt, and organic carbon cycling could result in increased POP levels in water, soil, and biota. There is also compelling evidence that increasing temperatures could be deleterious to pollutant-exposed wildlife. For example, elevated water temperatures may alter the biotransformation of contaminants to more bioactive metabolites and impair homeostasis. The complex interactions between climate change and pollutants may be particularly problematic for species living at the edge of their physiological tolerance range where acclimation capacity may be limited. In addition to temperature increases, regional precipitation patterns are projected to be altered with climate change. Regions subject to decreases in precipitation may experience enhanced volatilization of POPs and pesticides to the atmosphere. Reduced precipitation will also increase air pollution in urbanized regions resulting in negative health effects, which may be exacerbated by temperature increases. Regions subject to increased precipitation will have lower levels of air pollution, but will likely experience enhanced surface deposition of airborne POPs and increased run-off of pesticides. Moreover, increases in the intensity and frequency of storm events linked to climate change could lead to more severe episodes of chemical contamination of water bodies and surrounding watersheds. Changes in salinity may affect aquatic organisms as an independent stressor as well as by altering the bioavailability and in some instances increasing the toxicity of chemicals. A paramount issue will be to identify species and populations especially vulnerable to climate–pollutant interactions, in the context of the many other physical, chemical, and biological stressors that will be altered with climate change. Moreover, it will be important to predict tipping points that might trigger or accelerate synergistic interactions between climate change and contaminant exposures.     

Measuring combined exposure to environmental pressures in urban areas: an air quality and noise pollution assessment approach

This study presents a methodological scheme developed to provide a combined air and noise pollution exposure assessment based on measurements from personal portable monitors. Provided that air and noise pollution are considered in a co-exposure approach, they represent a significant environmental hazard to public health. The methodology is demonstrated for the city of Thessaloniki, Greece. The results of an extensive field campaign are presented and the variations in personal exposure between modes of transport, routes, streets and transport microenvironments are evaluated. Air pollution and noise measurements were performed simultaneously along several commuting routes, during the morning and evening rush hours. Combined exposure to environmental pollutants is highlighted based on the Combined Exposure Factor (CEF) and Combined Dose and Exposure Factor (CDEF). The CDEF takes into account the potential relative uptake of each pollutant by considering the physical activities of each citizen. Rather than viewing environmental pollutants separately for planning and environmental sustainability considerations, the possibility of an easy-to-comprehend co-exposure approach based on these two indices is demonstrated. Furthermore, they provide for the first time a combined exposure assessment to these environmental pollutants for Thessaloniki and in this sense they could be of importance for local public authorities and decision makers. A considerable environmental burden for the citizens of Thessaloniki, especially for VOCs and noise pollution levels is observed. The material herein points out the importance of measuring public health stressors and the necessity of considering urban environmental pollution in a holistic way.     

空气污染、空间外溢与公共健康——以中国珠江三角洲9个城市为例

空气污染对居民公共健康的影响,引起了人们高度的关注。但大多数学者研究从样本的独立性出发且不考虑内生性问题,忽视区域之间空间相关性,所得结论和政策建议需谨慎对待。为了弥补上述不足,本文基于Grossman中国宏观健康生产函数,选取2001—2014年中国广东省珠江三角洲9个城市作为样本,选择以PM_(10)和PM_(2.5)作为空气污染的代理指标,在充分考虑空间效应和严格假设检验的基础上选择合适的空间计量经济学模型,对此进行实证研究。主要研究结果显示:空气污染对居民的公共健康带来了负面影响,即PM_(10)和PM_(2.5)每增加1%,导致哮喘疾病和内科门诊等疾病人数不断上升,且影响都比较大,尤其是对哮喘疾病的影响分别为0.2236%和0.2272%。经济增长对公共健康均有显著的促进作用,影响最大;其它财政医疗支出、卫生技术人员和人口密度等要素对居民公共健康的影响较小。由于空气污染的负外部性,研究还发现,区域之间空气污染的"溢出效应"对领域居民公共健康存在显著的影响,说明忽视空间自相关性的存在,会使得空气污染对公众健康的估计产生偏差。从长期看,空气污染对本地居民公共健康的直接效应都显著为正,PM_(2.5)间接效应显著为负,但PM_(10)间接效应并不显著。因此,各级政府除了在源头上治理污染物的排放,提高公共健康水平外,还应该打破各自为阵的行政垄断,应该作为一个整体,实现跨区域环保合作,共同治理和制定公共卫生政策等。这对区域之间协同减排和保护居民公共健康具有重要的理论和现实意义。     

A new conceptual model for quantifying transboundary contribution of atmospheric pollutants in the East Asian Pacific rim region

Transboundary transport of air pollution is a serious environmental concern as pollutant affects both human health and the environment. Many numerical approaches have been utilized to quantify the amounts of pollutants transported to receptor regions, based on emission inventories from possible source regions. However, sparse temporal–spatial observational data and uncertainty in emission inventories might make the transboundary transport contribution difficult to estimate. This study presents a conceptual quantitative approach that uses transport pathway classification in combination with curve fitting models to simulate an air pollutant concentration baseline for pollution background concentrations. This approach is used to investigate the transboundary transport contribution of atmospheric pollutants to a metropolitan area in the East Asian Pacific rim region. Trajectory analysis categorized pollution sources for the study area into three regions: East Asia, Southeast Asia, and Taiwan cities. The occurrence frequency and transboundary contribution results suggest the predominant source region is the East Asian continent. This study also presents an application to evaluate heavy pollution cases for health concerns. This new baseline construction model provides a useful tool for the study of the contribution of transboundary pollution delivered to receptors, especially for areas deficient in emission inventories and regulatory monitoring data for harmful air pollutants.     

Relationship between air pollution and daily mortality in a subtropical city: Taipei, Taiwan

Air pollution has been associated with daily mortality in numerous studies over the past decade. However most of these studies were conducted in the United States and Europe with relatively few done in Asia. In the current study, the association between ambient air pollution and daily mortality in Taipei, Taiwan's largest city which has a subtropical climate was undertaken, for the period 1994-1998 using a case-crossover analysis. This design is an alternative to Poisson time series regression for studying the short-term adverse health effects of air pollution. The air pollutants examined included particulate matter (PM(10)), sulfur dioxide (SO(2)), ozone (O(3)), nitrogen dioxide (NO(2)), and carbon monoxide (CO). The largest observed effect, which was without statistical significance, was seen for NO(2) and CO levels on deaths due to respiratory diseases (ORs=1.013 and 1.014, respectively). The well established link between air pollution levels and daily mortality may not be as strong in cities in subtropical areas, although other factors such as differences in pollutant mix or the underlying health of the population may explain the lack of a strong association in this study. Further studies of this type in cities with varying climates and cultures are needed.     

Short-term effects of air pollution on respiratory morbidity at Rio de Janeiro — PART I: Air Pollution Assessment

Exposure to air pollution has been related with the most varied adverse health outcomes. This study aims to assess the impact of air pollution on the emergency hospitalization for respiratory disease in Rio de Janeiro, Brazil. The study was divided in two parts: Part I specifically addressing the air pollution assessment and Part II addressing the health assessment. Accordingly, this Part I aims to: i) evaluate the concentrations of PM₁₀, SO₂ and CO at two sites in Rio de Janeiro and compare them; ii) analyse the concentrations observed according to the national and international standards; and iii) analyse the air pollutants behaviour, namely, annually, seasonally, daily and considering weekdays/weekends variations. The pollutant concentrations were measured at two different sites in Rio de Janeiro and the analysis was performed for the period between September 2000 and December 2005. Results showed that PM₁₀ concentrations in Rio de Janeiro exceeded the daily and annual standards imposed by the European Union, the Brazilian legislation and WHO guidelines. Regarding SO₂ and CO, concentrations were, generally, below both European and Brazilian standards. Nevertheless, considering WHO guidelines, SO₂ threshold for daily concentrations (20 μg m^− 3) was exceeded around 150 times. Behaviour assessment showed that the influence of traffic is a major factor affecting the air pollution in Rio de Janeiro.Considering the results achieved and the proven health effects of air pollution, strategies should be defined for its reduction, particularly concerning particulate matter, and consequently contribute to the protection of public health.     

Recent advances in SO2, NOx, and O3 personal monitoring

Since the air pollution as measured by stationary monitoring stations is a poor indicator of the population exposure, personal monitors are indispensible to health effects studies. This article reviews the current research on the development of personal monitors. Although most of the analytical methods reviewed in this study appear to be sensitive to the levels of the target pollutants NO₂, SO₂, and O₃ generally encountered in indoor and outdoor air, they lack the desired performance characteristics for a personal monitoring device, such as user safety and ease of operation, weight, and maintenance. Electrochemical transducers/sensors, which have not yet been exploited, are attractive candidates for the application to personal monitoring. This technique has an added feature of generating real-time measurements. A few research models and commercially attractive devices that can be used in field studies are included.     

Indoor air pollution and public policy

In recent years, scientist have come to realize that contaminated air inside buildings is a major route of human exposure to certain air pollutants. While scientific interest in the problem continues to grow, efforts to measure indoor pollution concentrations, define exposure levels, and estimate health risks remain in their infancy. Within this arena, policymakers must deal with the question of how best to protect public health and safety in the face of incomplete and often contradictory information. In the past, official response to environmental pollution has traditionally taken the form of “control by regulation.” However, creation of a regulatory framework for indoor air quality poses special policy issues that suggest the need to explore alternative modes of intervention. Ambient outdoor air is a public good, in the sense that enjoyment by one individual in no way detracts from use or enjoyment by others. Indoor air, on the other hand, is not a public good, especially in private residences. Costs and benefits of maintaining adequate indoor air quality are internalized within households, suggesting the possibility of a private demand for clean indoor air. Promulgation of indoor air quality standards and other regulations must confront the fact that individuals are already making decisions about their own air quality. Regulations might or might not improve these decisions. Development of effective and reasonable policy requires an appreciation of the scope for private action and consideration of the likelihood that public intervention will foster improved private choices. Among the logical and relatively inexpensive modes of intervention are public information programs, development of simple warning devices, and product testing and labeling.     

Modeling indoor air pollution of outdoor origin in homes of SAPALDIA subjects in Switzerland

Given the shrinking spatial contrasts in outdoor air pollution in Switzerland and the trends toward tightly insulated buildings, the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA) needs to understand to what extent outdoor air pollution remains a determinant for residential indoor exposure. The objectives of this paper are to identify determining factors for indoor air pollution concentrations of particulate matter (PM), ultrafine particles in the size range from 15 to 300 nm, black smoke measured as light absorbance of PM (PM_absorbance) and nitrogen dioxide (NO₂) and to develop predictive indoor models for SAPALDIA. Multivariable regression models were developed based on indoor and outdoor measurements among homes of selected SAPALDIA participants in three urban (Basel, Geneva, Lugano) and one rural region (Wald ZH) in Switzerland, various home characteristics and reported indoor sources such as cooking. Outdoor levels of air pollutants were important predictors for indoor air pollutants, except for the coarse particle fraction. The fractions of outdoor concentrations infiltrating indoors were between 30% and 66%, the highest one was observed for PM_absorbance. A modifying effect of open windows was found for NO₂ and the ultrafine particle number concentration. Cooking was associated with increased particle and NO₂ levels. This study shows that outdoor air pollution remains an important determinant of residential indoor air pollution in Switzerland.     

Estimation of age-related vulnerability to air pollution: assessment of respiratory health at local scale

This paper demonstrates association of short-term variation in pollution and health outcomes within the same geographical area for a typical urban setting in the northern part of the UK from time series analysis. It utilises publicly available datasets for regulated air pollutants (PM??, NO?, SO?, CO and O?), meteorology and respiratory hospital admissions (and mortality) between April 2002 and December 2005 to estimate the respiratory health effect of pollution exposure, mainly in the elderly. Our results show that PM?? and O? are positively associated with respiratory hospital admissions in the elderly, specifically in the age group 70-79. CO effects seem to be concentrated on the most elderly age group (80+) whereas NO? seems to have the opposite age-related effect, with lower effects on the more elderly.     

Mutagenic properties of PM2.5 air pollution in the Padana Plain (Italy) before and in the course of XX Winter Olympic Games of "Torino 2006"

PM2.5 is one of the most important aspects of environmental health. This air pollutant is breathable and it is implicated in several chronic adverse health effects such as the decrease of respiratory functionality and cancer. Several in vitro bioassays are able to predict the mutagenic/carcinogenic activity of the environmental pollutants and mixtures of them. In this study PM2.5 air pollution was daily monitored in three cities located in the Northern part of Italy and the mutagenic properties of the PM2.5 organic extracts were also assessed. Samplings lasted 14 months and cover the period of the Winter Olympic Games of "Torino 2006". In this work, the levels of PM2.5, its mutagenic properties (detected with Salmonella typhimurium assay), the role of the Olympic Games as environmental factor and some meteorological data are discussed. The mean concentration of PM2.5 measured in Torino was 45.4 (+/-30.6) microg/m(3), in Pavia 37.6 (+/-25.6) microg/m(3), in Verona 43.1 (+/-28.5) microg/m(3). Findings of the monthly pool bioassay were in Torino 107 (+/-104) net revertans/m(3), in Pavia 108 (+/-89) net revertans/m(3), in Verona 128 (+/-109) net revertans/m(3). The Olympic Games period data show that PM2.5 pollution and its load of mutagenic potential are different and partially independent phenomena. The Olympic Games had not a great impact on the PM2.5 pollution. The exclusive PM2.5 gravimetric analysis shows a potential human risk if compared with the latest international guide values but it does not describe exhaustively the human health risk associated to the presence of this particular air pollutant. Moreover, the chemical and biological activity qualification of the PM organic extracts as a whole, can instead improve the knowledge.     

Differentiating the effects of fine and coarse particles on daily mortality in Shanghai, China

The findings on health effects of ambient fine particles (PM2.5) and coarse particles (PM10-2.5) remain inconsistent. In China, PM2.5 and PM10-2.5 are not the criteria air pollutants, and their monitoring data are scarce. There have been no epidemiological studies of health effects of PM2.5 and PM10-2.5 simultaneously in China. We conducted a time series study to examine the acute effects of PM2.5 and PM10-2.5 on daily mortality in Shanghai, China from Mar. 4, 2004 to Dec. 31, 2005. We used the generalized additive model (GAM) with penalized splines to analyze the mortality, air pollution and covariate data. The average concentrations of PM2.5 and PM10-2.5 were 56.4 microg/m3 and 52.3 microg/m3 in our study period, and PM2.5 constituted around 53.0% of the PM10 mass. Compared with the Global Air Quality Guidelines set by World Health Organization (10 microg/m3 for annual mean) and U.S. National Ambient Air Quality Standards (15 microg/m3 for annual mean), the PM2.5 level in Shanghai was much higher. We found that PM2.5 was associated with the death rates from all causes and from cardiorespiratory diseases in Shanghai. We did not find a significant effect of PM10-2.5 on mortality outcomes. A10 microg/m3 increase in the 2-day moving average (lag01) concentration of PM2.5 corresponded to 0.36% (95% CI 0.11%, 0.61%), 0.41% (95% CI 0.01%, 0.82%) and 0.95% (95% CI 0.16%, 1.73%) increase of total, cardiovascular and respiratory mortality. For PM10-2.5, the effects were attenuated and less precise. Our analyses provide the first statistically significant evidence in China that PM2.5 has an adverse effect on population health and strengthen the rationale for further limiting levels of PM2.5 in outdoor air in Shanghai.     

京津冀PM_(2.5)的主要影响因素及内在关系研究

大气污染物的源排放是形成灰霾天气的内因,气象条件是形成灰霾天气的外因。本研究通过构建PM_(2.5)浓度的两段式分布滞后模型,结合自然环境因素及经济因素对PM_(2.5)的影响因素进行了综合分析。在第一段模型中构建了PM_(2.5)和大气污染物排放量的分布滞后模型,第二段模型中构建了不同的大气污染源对大气污染物排放量的影响因素模型。大气污染物排放源主要包括工业源、生活源、机动车源、集中式污染治理设施源。在工业源中,工业废气重度污染行业是大气污染物排放主要的贡献者;在生活源中,燃煤消费量对大气污染物排放影响很大,这也是冬季供暖期间PM_(2.5)剧增的原因;在机动车源中,尽管黄标车的保有量仅占汽车保有量的10%左右,但却占据了颗粒物排放量的绝大部分。利用京津冀代表性城市PM_(2.5)日度数据研究得出平均气温、平均风速、日照时数、平均气压、降雨量、平均相对湿度、沙尘暴等因素对PM_(2.5)浓度的负向与正向作用。研究发现,大气污染物排放量对PM_(2.5)浓度具有聚集的滞后效应,当期大气污染物排放量、滞后一期、滞后两期、滞后三期大气污染物对PM_(2.5)浓度具有显著的正向作用,且影响依次递减。构建的大气污染物排放量的污染源影响因素模型揭示一个地区煤炭消费量、工业废气重度污染行业工业增加值、黄标车保有量对该地区大气污染物排放量具有显著影响。本研究对优化能源消费结构和产业结构,减少空气污染物排放提出了对策建议。     

A preliminary study of ozone trend and its impact on environment in Hong Kong

As far as the impact of air pollutants on human health being is concerned, ozone (O3) is one of the most pollutant sources, and, in particular, the ground level ozone is responsible for a variety of adverse effects on both human being and plant life. To protect the population from such adverse health effects, early information and precautions about the high ozone level need to be ascertained. In this study, statistical characteristics of ground level ozone is analyzed according to field monitoring data in mixed residential, commercial and industrial areas, e.g., Tsuen Wan area in Hong Kong. The study deals with the characteristics of hourly and daily mean ozone levels under different climatic conditions such as temperature, solar radiation (SR), wind speed (WS), and other pollutant concentration levels. The study aims to investigate the importance of meteorological factors and their impact on relevant pollutant concentration levels from a chemical aspect. Further, reasons for the spatial and temporal variation of ozone levels are discussed. All these results will provide a physical basis for accurately predicting ozone concentration in similar research.     

Relationships among personal,indoor and outdoor NO2 measurements

Using integrating NO₂ diffusion dosimeters, personal, indoor and outdoor exposures were measured for nine families in Topeka, Kansas. NO₂ exposures in homes that used gas for cooking were clearly different from those in homes that used electricity. The gas-cooking homes had indoor levels three times the outdoor levels. Members of the gas-cooking households had levels twice those of electric-cooking families and twice the outdoor levels. A linear model that includes outdoor concentrations and stove types explains 77% of the variance in observed NO₂ exposure. The differential NO₂ exposures in homes with and without gas stoves should be considered in epidemiologic studies of the health effects of air pollution.     

我国技术变迁对环境影响的计量分析

为了促进技术变迁因素在我国环境保护中发挥更大的作用，需要分析其以往对环境的影响，为我国的技术政策提供支持。使用动态基期，用统计方法定量计算了 1994~2004年各年度技术变迁因素对我国主要空气和水污染物排放量的影响。按是否以削减污染为直接目标，可将技术变迁分为2类：(1)生产工艺的变化。这种技术变化不以污染削减为直接目标，但会影响到生产投入物的数量和种类、生产过程中污染物的产生量并因此影响到最终的污染强度和排放量。(2)污染削减技术的变化。这种技术变化以污染削减为直接目标。利用环境统计年鉴中的污染削减量数据将技术效应分解为2部分：源自污染削减技术和源自生产工艺，发现从总体上看技术变迁降低了所有污染物的排放量，其中污染削减技术对所有污染排放量的下降都起了积极作用，但伴随较大的年度变化。生产工艺变化对不同污染物的影响方向不同。可见中国目前的污染削减主要依靠“末端”污染削减技术，“过程控制型”生产工艺没有充分发挥应有作用，也反映出目前技术变迁尚未向“环境友好型”演进。因此，要促使我国技术变迁向“环境友好型”演进，特别需要促进清洁生产技术的开发和推广,在生产过程中减少污染物的产生.     

Impact of climate change on the domestic indoor environment and associated health risks in the UK

There is growing evidence that projected climate change has the potential to significantly affect public health. In the UK, much of this impact is likely to arise by amplifying existing risks related to heat exposure, flooding, and chemical and biological contamination in buildings. Identifying the health effects of climate change on the indoor environment, and risks and opportunities related to climate change adaptation and mitigation, can help protect public health.We explored a range of health risks in the domestic indoor environment related to climate change, as well as the potential health benefits and unintended harmful effects of climate change mitigation and adaptation policies in the UK housing sector. We reviewed relevant scientific literature, focusing on housing-related health effects in the UK likely to arise through either direct or indirect mechanisms of climate change or mitigation and adaptation measures in the built environment. We considered the following categories of effect: (i) indoor temperatures, (ii) indoor air quality, (iii) indoor allergens and infections, and (iv) flood damage and water contamination.Climate change may exacerbate health risks and inequalities across these categories and in a variety of ways, if adequate adaptation measures are not taken. Certain changes to the indoor environment can affect indoor air quality or promote the growth and propagation of pathogenic organisms. Measures aimed at reducing greenhouse gas emissions have the potential for ancillary public health benefits including reductions in health burdens related heat and cold, indoor exposure to air pollution derived from outdoor sources, and mould growth. However, increasing airtightness of dwellings in pursuit of energy efficiency could also have negative effects by increasing concentrations of pollutants (such as PM_2.5, CO and radon) derived from indoor or ground sources, and biological contamination. These effects can largely be ameliorated by mechanical ventilation with heat recovery (MVHR) and air filtration, where such solution is feasible and when the system is properly installed, operated and maintained. Groups at high risk of these adverse health effects include the elderly (especially those living on their own), individuals with pre-existing illnesses, people living in overcrowded accommodation, and the socioeconomically deprived.A better understanding of how current and emerging building infrastructure design, construction, and materials may affect health in the context of climate change and mitigation and adaptation measures is needed in the UK and other high income countries. Long-term, energy efficient building design interventions, ensuring adequate ventilation, need to be promoted.     

Cumulative risk assessment of chemical exposures in urban environments

We performed a cumulative risk assessment for people living in a hypothetical urban environment, called Urbania. The main aims of the study were to demonstrate how a cumulative risk assessment for a middle-sized European city can be performed and to identify the bottlenecks in terms of data availability and knowledge gaps. The assessment focused on five air pollutants (i.e., PM??, benzene, toluene, nonane and naphthalene) and six food pesticides (i.e., acetamiprid, carbendazim, chlorpyrifos, diazinon, imidacloprid and permethrin). Exposure predictions showed that PM??, benzene and naphthalene exposure frequently exceeded the standards, and that the indoor environment contributed more than the outdoor environment. Effect predictions showed that mixture and interaction effects were generally limited. However, model calculations indicated potential synergistic effects between naphthalene and benzene and between chlorpyrifos, diazinon and toluene. PM?? dominated the health impact expressed in Disability Adjusted Life Years (DALYs). We conclude that measures to reduce the health impact of environmental pollution should focus on the improvement of indoor air quality and the reduction of PM?? emissions. Cumulative risk assessment can be improved by (1) the development of person-oriented exposure models that can simulate the cumulative exposure history of individuals, (2) a better mechanistic understanding of the effects of cumulative stressors, and (3) the development of instruments to prioritize stressors for inclusion in cumulative risk assessments.