Reducing burden of disease from residential indoor air exposures in Europe (HEALTHVENT project)

Background: The annual burden of disease caused indoor air pollution, including polluted outdoor air used to ventilate indoor spaces, is estimated to correspond to a loss of over 2 million healthy life years in the European Union (EU). Based on measurements of the European Environment Agency (EEA), approximately 90 % of EU citizens live in areas where the World Health Organization (WHO) guidelines for air quality of particulate matter sized < 2.5 mm (PM2.5) are not met. Since sources of pollution reside in both indoor and outdoor air, selecting the most appropriate ventilation strategy is not a simple and straightforward task. Methods: A framework for developing European health-based ventilation guidelines was created in 2010–2013 in the EU-funded HEALTHVENT project. As a part of the project, the potential efficiency of control policies to health effects caused by residential indoor exposures of fine particulate matter (PM2.5), outdoor bioaerosols, volatile organic compounds (VOC), carbon oxide (CO) radon and dampness was estimated. The analysis was based on scenario comparison, using an outdoor-indoor mass-balance model and varying the ventilation rates. Health effects were estimated with burden of diseases (BoD) calculations taking into account asthma, cardiovascular (CV) diseases, acute toxication, respiratory infections, lung cancer and chronic obstructive pulmonary disease (COPD). Results: The quantitative comparison of three main policy approaches, (i) optimising ventilation rates only; (ii) filtration of outdoor air; and (iii) indoor source control, showed that all three approaches are able to provide substantial reductions in the health risks, varying from approximately 20 % to 44 %, corresponding to 400 000 and 900 000 saved healthy life years in EU-26. PM2.5 caused majority of the health effects in all included countries, but the importance of the other pollutants varied by country. Conclusions: The present modelling shows, that combination of controlling the indoor air sources and selecting appropriate ventilation rate was the most effective to reduce health risks. If indoor sources cannot be removed or their emissions cannot be limited to an accepted level, ventilation needs to be increased to remove remaining pollutants. In these cases filtration of outdoor air may be needed to prevent increase of health risks.JRC.I.1-Chemical Assessment and Testin

Indoor Air Risks and Impacts of Alternative Policy Interventions in the EU Countries – the IAIAQ study

The purpose of IAIAQ was to provide a robust, Europe wide assessment of the key factors influencing human health via indoor air, and the health benefits of building related policies. Tobacco smoke impacts and policies are not included in this presentation. Building on the EnVIE project, six diseases/symptoms, six exposure agents and six sources of the indoor air caused/mediated burden of disease (indoor air BoD), and ten IAQ policies were selected and analysed by a four dimensional linear matrix model. The total indoor air BoD was estimated to correspond to 2 million healthy years of life lost annually within the EU. Indoor exposure to fine particulate matter originating from outdoor air and indoor combustion sources turned out to be responsible for over half of this BoD, followed by home dampness, bio-aerosols, radon, CO and VOCs. Respectively, the most beneficial policies would control outdoor PM penetration and indoor combustion.JRC.I.1-Chemical Assessment and Testin

Guidelines for healthy environments within European schools

This document describes the guidelines framework for healthy environments within European schools which was developed within SINPHONIE (Schools Indoor Pollution and Health – Observatory Network in Europe) project. Its objective is to provide a reference guide which links together both coherently and comprehensively the most up-to-date knowledge informed by the outcome of the SINPHONIE project. This includes key drivers and prevention, control, remediation and communication strategies for a healthy school environment in Europe. These guidelines for healthy environments within European schools are primarily directed at the relevant policy-makers at both European and national levels and at local authorities aiming to improve the indoor school environment in their countries while respecting the specificities (environmental, social, economic) of their national and local situations. A second target group which is expected to benefit directly from these guidelines includes school-building designers and managers (responsible for the design, construction and renovation of school buildings), schoolchildren and their parents, teachers and other school staff. Users of this guidance should consult relevant national guidance in the first instance and use this publication to access supplementary information.JRC.I.1-Chemical Assessment and Testin

On the Development of Health-Based Ventilation Guidelines: Principles and Framework

This paper summarizes the results of HealthVent project. It had an aim to develop health-based ventilation guidelines and through this process contribute to advance indoor air quality (IAQ) policies and guidelines. A framework that allows determining ventilation requirements in public and residential buildings based on the health requirements is proposed. The framework is based on three principles: 1. Criteria for permissible concentrations of specific air pollutants set by health authorities have to be respected; 2. Ventilation must be preceded by source control strategies that have been duly adopted to improve IAQ; 3. Base ventilation must always be secured to remove occupant emissions (bio-effluents). The air quality guidelines defined by the World Health Organization (WHO) outside air are used as the reference for determining permissible levels of the indoor air pollutants based on the principle that there is only one air. It is proposed that base ventilation should be set at 4 L/s per person; higher rates are to be used only if WHO guidelines are not followed. Implementation of the framework requires technical guidelines, directives and other legislation. Studies are also needed to examine the effectiveness of the approach and to validate its use. It is estimated that implementing the framework would bring considerable reduction in the burden of disease associated with inadequate IAQ.JRC.F.7-Knowledge for Health and Consumer Safet

Environment and Quality of Life. ECA Report No. 23: Ventilation, Good Indoor Air Quality and Rational Use of Energy.

Abstract not availableJRC.I-Institute for Health and Consumer Protection (Ispra

SINPHONIE (Schools Indoor Pollution and Health Observatory Network in Europe): Executive Summary of the Final Report

This report is the executive summary of the final report of the SINPHONIE (Schools Indoor Pollution and Health: Observatory Network in Europe) project. SINPHONIE was funded by the European Parliament and carried out under a contract with the European Commission’s Directorate-General for Health and Consumers (DG SANCO) (SANCO/2009/C4/04, contract SI2.570742). The SINPHONIE project established a scientific/technical network to act at the EU level with the long-term perspective of improving air quality in schools and kindergartens, thereby reducing the risk and burden of respiratory diseases among children and teachers potentially due to outdoor and indoor air pollution. At the same time, the project supports future policy actions by formulating guidelines, recommendations and risk management options for better air quality and associated health effects in schools.JRC.I.1-Chemical Assessment and Testin

Use of Statistical Analyses in the Ophthalmic Literature

Purpose: To identify the most commonly used statistical analyses in the ophthalmic literature and to determine the likely gain in comprehension of the literature that readers could expect if they were to add knowledge of more advanced techniques sequentially to their statistical repertoire.Design: Cross-sectional study.Methods: All articles published from January 2012 through December 2012 in Ophthalmology, the American Journal of Ophthalmology, and Archives of Ophthalmology were reviewed. A total of 780 peer-reviewed articles were included. Two reviewers examined each article and assigned categories to each one depending on the type of statistical analyses used. Discrepancies between reviewers were resolved by consensus.Main Outcome Measures: Total number and percentage of articles containing each category of statistical analysis were obtained. Additionally, we estimated the accumulated number and percentage of articles that a reader would be expected to be able to interpret depending on their statistical repertoire.Results: Readers with little or no statistical knowledge would be expected to be able to interpret the statistical methods presented in only 20.8% of articles. To understand more than half (51.4%) of the articles published, readers would be expected to be familiar with at least 15 different statistical methods. Knowledge of 21 categories of statistical methods was necessary to comprehend 70.9% of articles, whereas knowledge of more than 29 categories was necessary to comprehend more than 90% of articles. Articles related to retina and glaucoma subspecialties showed a tendency for using more complex analysis when compared with articles from the cornea subspecialty.Conclusions: Readers of clinical journals in ophthalmology need to have substantial knowledge of statistical methodology to understand the results of studies published in the literature. the frequency of the use of complex statistical analyses also indicates that those involved in the editorial peer-review process must have sound statistical knowledge to appraise critically the articles submitted for publication. the results of this study could provide guidance to direct the statistical learning of clinical ophthalmologists, researchers, and educators involved in the design of courses for residents and medical students. (C) 2014 by the American Academy of Ophthalmology.National Eye Institute, National Institutes of Health, Bethesda, MarylandBrazilian National Research CouncilCarl-Zeiss Meditec, Inc (Jena, Germany)Heidelberg Engineering, GmBH (Dosseinheim, Germany)Alcon (Hunenberg, Switzerland)Allergan (Irvine, California)Topcon (Itabashi, Tokyo, Japan)Reichert, Inc (Depew, New York)Univ Calif San Diego, Hamilton Glaucoma Ctr, La Jolla, CA 92093 USAUniv Calif San Diego, Dept Ophthalmol, La Jolla, CA 92093 USAUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, BrazilBoston Univ, Sch Med, Boston, MA 02118 USAUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, BrazilNational Eye Institute, National Institutes of Health, Bethesda, Maryland: EY021818National Eye Institute, National Institutes of Health, Bethesda, Maryland: P30EY022589Brazilian National Research Council: 200178/2012-1Web of Scienc