Indoor air pollution is a significant health risk, especially for vulnerable groups like children, the elderly, and women. Poor indoor air quality can be caused by both natural sources like dust as well as anthropogenic sources like burning biomass fuels. Developing countries rely more on biomass fuels, resulting in high levels of indoor air pollution exposure. This document discusses the health impacts of indoor air pollution and the groups most vulnerable to exposure.

1. INDOOR AIR POLLUTION NOTES

3. • Environmental pollution:
Any undesirable changes in the environment due to the introduction ofdifferent harmful substances isknown as
environmental pollution. This makesenvironment unhealthy to live in.
• Air pollution, Water pollution, Soil pollution,Noise pollution, Thermal pollution…..
ENVIRONMENTAL POLLUTION IS AN INCURABLEDISEASE. IT CAN ONLY BE PREVENTED.
-BARRY COMMONER

4. • Air pollution: Air pollution can be defined as the presence of toxic chemicals or compounds
(including those of biological origin) in the air, at levels that pose a healthrisk.
• Air pollutants: a substance in the air that can cause harm to humans and the environment isknown
as air pollutants. Pollutants may be in the form of solid particles, liquid droplets, or gases.

5. Sources of air pollution

6. Natural
• Wind blown dust, volcanoes, sea-salt spray, wild fires, biological sources

7. Anthropogenic
• Transportation, industrial activities, fuel burning (coal,biomass etc.), agricultural activities etc.

8. Mobile, stationary, area, and natural sources all emit pollution into the air

13. Types of air pollutants
Primary air pollutants
• These pollutants directly emitted from the sources
• e.g. CO, NO2, SO2 etc.
Secondary air pollutants
• They are formed due to thereactions of primary
pollutants or by the chemical transformation ofprimary
pollutants
• e.g. HNO3, H2SO4 etc.
A primary pollutant is an air pollutant emitted directly from a source.A secondary pollutant is not
directly emitted as such, but forms whenother pollutants(primary pollutants) react in the atmosphere.

14. EffEcts…???
• Human Health
• Poor visibility
• Global warming
• Acid rain
• Depletion of ozone layer

15. Introduction
• Indoor air pollution: Air pollution taking placewithin a building
• Building-a structure that has a roof and wallsand stands more or less permanently in one place

16. Need for good indoor air
quality
• People spend about 90% of their time in indoors
• For infants, the elderly, persons with chronic diseases, and most urban residents of any age, the proportion is probably higher.
In addition, theconcentrations of many pollutants indoors exceedthose outdoors. The locations of highest concern are those
involving prolonged, continuing exposure - that is, the home, school, and workplace.

17. • The quality of indoor air can be two to five times (andeven up to 100 times) more polluted than the worst outside air.
• The EPA has ranked indoor air pollution among the topfive environmental dangers.
• Poor indoor air quality may cause symptoms such as headache, wheezing, tiredness, coughing, sneezing, sinus
congestion, shortness of breath, dizziness, nausea, and irritation of the eyes, nose or throat.
• Allergy or asthma symptoms can also get worsebecause of poor indoor air quality.

18. Impact of indoor air on work
performance
• Temperature, relative humidity, and air quality all affect the sensory system via thermo receptors in the skin and the
olfactory system. Air quality is mainly defined by the contaminants in the air. However, the most persistent memory of any
space is often its odor. Strong, emotional, andpast experiences are awakened by the olfactory sense. Odorscan also influence
cognitive processes that affect creative taskperformance, as well as personal memories and moods. Besides nitrogen and
oxygen, the air contains particles and many chemicals that affect the efficiency of the oxygenation process in the blood, and
ultimately the air breathed affects thinking and concentration.

19. • Indoor environmental conditions may directly influence to theperformance of physical and mental work, without affecting
health symptoms.
• Relative humidity below 40% can increasingly give rise to dry throats, and below 20% it may have negative effects
on the eyeblinking rate. 40–60% R.H. is acceptable
• Temperature and noise
• Researchers concluded that (i) indoor-air quality can significantly improve the performance of people, (ii) according to
laboratory studies a 10% increase in dissatisfaction decreases performance by1%, (iii) field studies also show significant
improvements in performance with improved indoor-air quality (fewer pollution sources, higher ventilation rates), and (iv)
with improved indoor-airquality significant savings in health care costs are possible
• Breathing good indoor air is critical for good health

20. Fig: Diagram of relationship between work performance and indoorenvironment (Mahbob et al., 2011)

21. Vulnerability
• Vulnerable-open to attack, harm or damage
• Vulnerability-The quality or state of being exposed to the possibility of being attacked or harmed, either physically or
emotionally.
• Vulnerability is the degree to which a system or unit is likely toexperience harm due to exposure to perturbations or stresses
(Steffen et al., 2002).
• This perspective suggests that the most vulnerable individuals, groups, classes and regions or places are those that
experience the most exposure to perturbations or stresses i.e., most likely to suffer from exposure and have theweakest
capacity to respond and ability to recover

22. Who are the most
vulnerable to
IndoorAir
Pollution (IAP)
???????????

23. Vulnerability of children and women to
indoor air pollution
• CHILDREN’S UNIQUE VULNERABILITY
• Inhale more pollutants per kilogram of body weight than doadults
• Because airways are narrower, irritation can result inproportionately greater airway obstruction
• Infants and young children have a higher resting metabolic rate and rate of oxygenconsumption per unit body weight than
adults because they have a larger surface area per unit body weight and because they are growing rapidly. Therefore, their
exposure to any air pollutant may be greater. In addition to an increased need for oxygen relative to their size, children have
narrower airways than do adults. Thus,irritation caused by air pollution that would produce only a slight response in an adult
can result in potentially significant obstruction in the airways of a young child.

24. • Pulmonary physiology
• Higher minute ventilatory rate than the adults -4000 mL/min/kg in a newborn vs. 150 mL/min/kg in an adult
• Difference in breathing behavior- young infants are obligatorymouth breathers and many older infants and children also
breath through their mouth more than adults. This may
increase the child’s risk of pulmonary exposure to respirableparticulates and fibers otherwise filtered in the upper airway.
• Breathing zone: Child’s Breathing Zone is closer to the groundcompared to an adult. Concentrations of pollutants are higherin
this zone.

25. The effect of oedema on the adult airway is much less than the newborn’s airway. 1 mm of oedema reduces the diameter of the
adult
airway by about 19% whereas in infant by 56%

27. • Compared to that adults, the peripherial (bronchioles) is both relatively and absolutely smaller in infancy allowing
intralumenal debristo cause proportionately greater obstruction.

28. • Higher dose of xenobiotics—children differ from adults in many ways: their absorption, metabolism and elimination of
xenobiotics, their physiology, their proportionately larger doseof an inhaled toxin, and their higher cumulative risk from toxins
over time. Children, by virtue of their long life spans, have a higher risk of the development of cancer from exposure to
inhaled carcinogens.
• The fetus is particularly vulnerable to the transmission of toxins that the mother inhales through the placenta-fetal unit.
Air pollutants to which the mother is exposed in the home or in the workplace are variably conveyed to fetal tissues,
depending on their absorption kinetics and whateverbarrier the placenta might pose.

30. • Children with underlying chronic illness:
C.P.D. like cystic fibrosis or asthma are more susceptible to both indoor and outdoor air pollutants exacerbating their underlying lung
function.

31. Poor children and their homes
• Homes of poor children may be unhealthy
• 2000000 deaths from ARI in <5 yr olds(1/2 due to solid fuel use)
• Coal and biomass fuel
• Suspended PM increases the risk of acuterespiratory infections
• CO and other pollutants impair
development and health
• Secondhand tobacco smoke is a majorconcern

32. • Like the nervous system, the respiratory system continues togrow and develop through linear growth. It may be seen thatat
birth, a baby has about 10 million alveoli, but at age 8 years, the lungs have grown and the number of alveoli has reached
300 million. Exposures during this growth period areknown to have adverse consequences on both structure (growth of the
lungs) and function (which is affected by indoor air quality and ozone exposure).

33. Economic development as a factor/Socioeconomic
disparity
• Developing and industrialized countries
• Rural and urban areas
• Local climate
• Architecture/ventilation
• In urban areas children may spend most of their time indoors
• Most exposure to air contaminants occurs inside homes and
schools.

34. • The level of economic development is a key factor in determiningchildren’s exposures and the potential for responding to
or improving their environment. The level of social and economic development is linked closely to determinants of
indoor air pollution (IAP).
• There are major differences between developing and industrialized countries: IAP results from solid fuel use in theformer,
and from "chemicals" and "new substances" (e.g. formaldehyde, insecticides and phthalates) in the latter. However,
secondhand tobacco smoke is a pollutant commonto both settings.
• Rural and urban areas: IAP also differs between rural and urban areas due to the different economies and lifestyles. For
example, dust and organic particles are more common in agricultural areas and mites or fungal contaminants in closed,
unventilated urban dwellings

35. • Effects of Local climate on architecture and ventilation: Thelocal climate conditions should also be taken into
consideration, as they have an impact on architecture (building materials used, structure, room distribution and
characteristics) and – particularly – on the ventilation of thedwelling.
• Children in urban areas spend most of their time indoors, which means that their primary exposure to air pollution may
come from air inside homes and schools rather than outdoors. There are numerous situationsin homes and schools which
may result in possible exposure to contaminants, such as second-hand tobacco smoke, spraying of insecticides,
accumulation of pollutants in carpets, poor quality air and others. Children may also be exposed where they play or at
workplaces.The quality of children’s environments can cause or prevent illness, disability and injury.

36. In analyses by the World Health Organization (WHO) in 2002, the indoor smoke fromsolid fuels accounted for the third highest
DALYs (disability-adjusted life years)for children 0 to 4 years of age.
The DALY is a health measure that incorporates loss of quality of life as well as loss ofyears of life. One DALY is the loss of one
healthy life year.
Or
The sum of years of potential life lost due to premature mortality and the years ofproductive life lost due to disability.

37. • DALYs for a disease or health condition are calculated as the sum of the Years of Life Lost (YLL) due to premature
mortality in the population and the Years Lost due to Disability(YLD) for people living with the health condition or its
consequences
• DALY=YLL+YLD

38. Table: Summary of prevalence of selected risk factors by income group in WHO regions,
2004

39. • SIZE MATTERS
• Coarse particles (2.5–10 micrometres) deposited in the
upper respiratorytract and large airways
• Fine particles (< 2.5 micrometres) may reach terminal
bronchioles and alveoli
Particle size is the most important factor in determining where particles are deposited in the
lung. Particles greater than 10 micrometres rarely make it past the upper
airways, whereas fine particles smaller than 2 micrometres can make it as far as the alveoli.

40. • Susceptibility implies a greater risk of a healthoutcome at any specific level of exposure while vulnerability refers to a
greater likelihood of being exposure including being exposed to higher concentrations of air pollutants (Samet 2014).

41. WHO and EPA ?????????

42. Vulnerability of women to IAP
• Women are vulnerable to indoor air pollution but there wasdifference in the levels of vulnerability among the
women belonging to different income groups.
• The lower income women are most vulnerable because they areusing biomass fuels/chulhas, cooking in a multipurpose
room, spending long hours in kitchen, they are more exposed to smoke, heat, pollutants and the conditions are
exacerbated because theyare living in substandard housing, in one room leading to congestion/crowding and with no
ventilation.
• They are suffering most from various problems and specific diseases like respiratory infections (ALRI, AURI,
COPD, asthma,pulmonary tuberculosis), perinatal mortality, low birth weight,cataract and eye irritation associated
with indoor air pollution.

43. • Since women take the sole responsibility for household careand management (i.e., cooking, cleaning/dusting, washing,
child care etc.) they are exposed more too indoor pollutantsthan men.
• Vulnerability of women due to use of biomass fuels/chulhasand cooking in a small multipurpose room/small kitchen
without appropriate ventilation
• Vulnerability of women due to cooking related exposures tosmoke, fire and pollutants
• Vulnerability of women due to kutcha/semi-pucca houses, household crowding and inappropriate or lack of ventilation
facilities-it was the economically backward sections who were the mainsufferers because they live in sub-standard housing
having one room, no proper place for cooking food so they cook in the multipurpose room using biomass fuel and chulhas
having no venting facilities

44. • Elderly

45. Risk associated with indoor air
pollutants
• A risk factor is any attribute, characteristic or exposure of an individual that increases the likelihood of developing a
disease or injury.
• Indoor air quality is also damaged by poor choice of building materials, structural risks as well as poor ventilation practices.
• Poor housing (e.g., cold and damp homes) and poverty, combined with other lifestyle characteristics (e.g., smoking, the
presence of pets, and the combustion of fuels for heatingand cooking), all influence the quality of indoor air.
• Housing improvements such as sealing homes to prevent heatloss (i.e., increased household energy efficiency) can lead to the
build up of a range of physical, chemical, and biological agents when combined with inadequate heating and
ventilation.

46. • Increased exposure to these indoor air pollutants are thoughtto play an important role in the development and clinical course
of allergic diseases (including asthma), as well as otherrespiratory, cancerous, and cardiovascular health problems. Asthma
and other allergic diseases are a significant public health interest because they are very common today and represent a heavy
economic and societal burden.
• Besides these disease adverse pregnancy outcome, low birth weight of babies, eye problems, hypertension etc. are
associated with the use of biomass fuel.

47. Indoor air pollution in developed and
developing countries with special reference to
India
• According to EPA, the 4 most dangerous indoor air pollutants in developed countriesare-
• Tobaccosmoke
• Formaldehyde
• Radioactive radon gas
• Very small fine and ultrafine particles

49. Developing countries
• Main factors for poor IAQ-use of solid fuel(biomass and coal), poor quality of house, over-crowding, lack of
proper ventilation

50. IAQ of India-status and missing
links
• The published literature has mostly focused on IAP due to the burning of biomass fuels in unvented cook stoves in rural,
semi urban areas or in urban slums and on their socio-economic status.
• However, a far less attention has been paid to the IAP issues in urban areas which is an equally important problem. This is
becausemultiple sources of indoor air pollutants, apart from biomass fuel burning, co–exist with sources such as burning of
tobacco smoke inurban indoors.

51. • One of the main reasons of lack of IAQ data in India is the lack ofawareness and the myth among the people leading to
the impression that air pollution exists only outdoors and inhabitantsare safe when they are indoors.
• Since the Bhopal gas disaster in 1984, the main focus of Indian regulatory agencies has been to understand and
implement theambient air quality and management practices.
• The Central Pollution Control Board (CPCB) under the Ministry of Environment and Forests (MoEF), Government of
India does not include the IAQ in its agenda of duties ever since its constitution in1974. This has resulted in insufficient
infrastructure and skilled manpower to design/formulate the IAQ monitoring/ modelling protocol in the country.

52. • However, looking at the increasing urbanization and growth of thecities in India and the increasing IAQ problems in urban
areas, theMoEF along with the CPCB has recently created an expert committee including researchers and scientists from
leading research and academic institutions in India (e.g. Indian Institute of Technology (IIT) Delhi, CPCB, National
Environmental EngineeringResearch Institute, NEERI).
• Key mandates of this committee include:
(i) to come out with definite recommendations on the IAQ monitoring and modelling protocol for different types of
buildingsin urban centers in the country,
(ii) organize expert meetings and workshops with stakeholdersincluding industries,
(iii) developing IAQ related products, and
(iv) sensitize the receptors on IAQ issues

53. • Lack of monitored data in sufficient quantity does not allow
using any existing IAQ models for predictions.
• Some of the key input parameters for modelling include:
# Emission factors for various indoor pollutants, their physicochemical characteristics and reactivity, deposition
andresuspension and building ventilation related information.
# The other important issue is lack of consistency in number ofindoor air pollutants need to be monitored.
# Missing information about the monitoring guidelines, suggestionson the type of instruments required and the methods of
sample analysis
# Lack of epidemiological studies to show the linkage between exposure to indoor pollution and adverse health effects impede
proper actions.

54. • Leadership in Energy and Environment Design (LEED) and Indian Green Building Council (IGBC)-recently formed to
emphasize the need to take into account the importance of IAQ while constructingnew buildings .
• However, they are mainly focusing on environmental tobacco smoke (ETS) control and VOCs and do not include IAQ
monitoringand management.
• Additionally, TERI GRIHA also focuses on low VOC and ETS control.
• The emphasis on ventilation, monitoring and management aspects of IAP in different building types is still missing.
Therefore, it is worth of contention that an IAQ regulatory framework is needed tobe established in India, which can frame
the protocol for what pollutants should be considered and what should be their limiting values of exposure in various indoor
environments.
• There are several IAQ regulatory agencies present all across the globe (e.g. Canadian Committee on IAQ and Building,
CCIAQB) which could provide the base information while framing similar IAQframework for India.

55. Future initiatives should be taken at Government, Industrial, and
Research/Academia , to set out the future road map for mitigatingIAQ impacts. Government level :integration between the various
governmental agencies (e.g. MoEF, CPCB, Bureau of Indian Standards) to set up a robust plan that could lead to the formationof IAQ
policies.
First, identify the knowledge gaps (by supporting research studies)and the potential areas for interventions.
Mass awareness and education campaigns on IAQ in both rural and urban areas of India, probably under the national compliance
monitoring programme should be carried out.
A better emphasis to promote the use of cleaner fuel and low–costenvironmental friendly technologies (e.g. solar energy lanterns to
replace indigenously built kerosene lamps, biogas and improved cook stoves) for both the rural and urban poor population.

56. At the industrial level: there is a need to identify the best practices andbenchmarks for IAQ in buildings and sensitise the members,
clients andindustries on IAQ to create demand.
For instance, the manufacturing industry can play a vital role to develop better building materials (e.g. low VOC–emitting materials), and the
energyefficient household appliances that are suitable for Indian conditions.
Likewise, the preferred use of greener building material by the constructionindustry in new residential homes and commercial buildings could
help in reducing the levels of IAP.
Novel approaches for building new homes such as Radon–Resistant New Construction (RRNC) can help reducing the risks of lung cancer
from exposure to radon in indoor air. The RRNC does not require special skills or materials but just the careful design to vent out the radon
gas from the foundation of a building. As per an annual survey of builders conducted by the National Association of Home Builders (NAHB)
Research Center, over 1.5million such new homes have been constructed in the USA since 1990.
Furthermore, the industries can provide the feedback to the Government onthe IAQ guidelines and their suitability according to the demand and
requirements.

57. At the research/academia level: there is a need for a thoroughassessment to identify the gaps in present research space of IAQ,
including energy and fuel usage, types of fuels, pollutant emissions, and health and exposure risk assessment and then carry out
research projects on such areas.
Such a programme could benefit immensely with internationalcollaboration, especially where such IAQ guidelines are already
in practice.
Research community can also assist Government agencies with the mass public awareness campaigns to familiarize the
general public with the IAQ related concerns and possible measures.

58. Indoor air quality regulations
• For some pollutants occurring in indoor air, international(WHO) and national (EPA, OEHHA, ATSDR, ASHREA, OSHA,
Health Canada etc.) health based exposure limit/guidelines exist.
• Proper guidelines and regulations are lacking indeveloping countries
• The WHO guidelines for indoor air quality, developed underthe coordination of WHO/Europe, address three groups of
issues that are most relevant for public health:
• biological indoor air pollutants (dampness and mould)
• pollutant-specific guidelines (chemical pollution)
• pollutants from indoor combustion of fuels

60. Table: Comparison of Regulations and Guidelines

61. Indoor Air Quality Standards -
America
• There are 3 main Indoor Air Quality Standards namely:
• 1) OSHA – Occupational Safety &
HealthAdministration
• American congress enacted the Occupational Safety and Health Act of 1970 which created the Occupational Safety and
Health Administration (OSHA).
• OSHA was created with a mission to help employers and employees reduce on the job injuries, illnesses anddeaths. OSHA is
a very important, infact much needed
Indoor Air Quality Standard and it directs USA’s national compliance initiatives in occupational safetyand health.

62. What does OSHA do?
OSHA employs the following strategies to help employers and employees reduceinjuries, illnesses, and deaths on the job:
Enforcement – making sure OSHA Regulations are followed Assistance – outreach & training to
employers and employees Cooperation – partnerships and alliances through voluntary programsOSHA
promotes workplace safety and health by:
Implementing new (or improved) safety and health management systems. Completing worksite inspections. Companies
failing to OSHA Regulations may becited and/or fined.
Promoting cooperative programs including Voluntary Protection Programs, OSHA Strategic Partnerships, and other industry
Alliances.
Establishing specific rights and responsibilities of employees and employers. Supporting innovation in dealing with workplace
hazards.
Establishing recordkeeping and reporting requirements for employers. Developing training programs for occupational
safety and health personnel. Partnering with states that operate their own occupational safety and healthprograms.
Supporting the OSHA Consultation Program.

63. 2)NIOSH – National Institute of occupational safety
and Health
• the National Institute of occupational safety and Health(NIOSH) was established by the Occupational Safety and
Health Act of 1970.
• NIOSH was established to assist in assuring safe and healthful working conditions by providing research, information,
education, and training in occupational safety and health
• The Department has found six major sources of indoor airquality problems:
1. Inadequate Ventilation — These problems involve lack of adequate fresh air and uneven distribution of fresh air withina
building.
2. Humidity and Temperature — These problems involve levels
of these parameters outside the normal comfort range.

64. 3. Inside Contamination — Copy machines, office products, andchemicals stored indoors have been identified as
significant sources of indoor air problems in some investigations.
4. Outside Contamination — This is caused by the re-entrainment of previously exhausted contaminants, generally
caused by improper air intake placement or by periodic changes in the windconditions. A common problem is vehicle
exhaust fumes from parking garages or loading docks being drawn into a building ventilation system.
5. Microbial Contamination — This type of problem is usually associated with water leaks, water infiltration,
elevated indoorhumidity, humidifiers, and contaminated ventilationductwork.
6. New Building Materials — This results from building materials (including carpeting) releasing gasses into the air
during and shortly after the materials are first installed. Increased ventilationafter installation will enhance the dissipation
of these chemicals. These problems usually resolve with time.

65. 3) EHS & Air Quality Testing
• Environment, health and safety (EHS) is a discipline and specialty that studies and implements practical aspects of
environmental protection and safety at work. In simple terms it is what organizations must do to make sure that their
activities do not cause harm to anyone.
• Organisations based in the United States aresubject to EHS regulations.

66. Indian regulations/guidelines.....
• ISHREA
• The Indian Society of Heating, Refrigerating and Air Conditioning Engineers (ISHRAE), was founded in 1981 at New
Delhi by a group of eminent HVAC&R professionals. ISHRAE today has more than 12,000 HVAC&R professionals as
members and additionally there are 7,500 Student-members. ISHRAE operates from 41 Chapters and sub Chapters spread
all over India, with HQ in Delhi. It is led bya team of elected officers, who are members of the Society, working on a
voluntary basis, and collectively called the Board of Governors.
• Offered courses, standards
• Indoor environmental quality standard
ISHRAE standard 10001:2016
First version: 2016-17
It is performance based standard and will give the target values forgood thermal comfort, indoor air quality, lighting and acoustics.

67. • Advancement of the Arts and Sciences of Heating, Ventilation,Air Conditioning and Refrigeration Engineering and Related
Services.
• Continuing education of Members and other interested persons in the said sciences through Lectures, Workshops,
Product Presentations, Publications and Expositions.
• Rendition of career guidance and financial assistance tostudents of the said sciences.
• Encouragement of scientific research.

68. • Indoor Air Quality Association (IAQA) – India chapter waslaunched in 2016
• The IAQA was established in 1995 in US and it is dedicated to bringing practitioners together to prevent and solve indoor
environmental problems for the benefit of consumers and thepublic. In early 2015, the IAQA and the ASHRAE finalized a
consolidation between the two organizations. The work of IAQA complements the work of ASHRAE in its standards,
research, publications, and educational offerings. The two associations combine their resources to ensure the industry
receives the best indoor air quality technical guidance and educational programs possible, which means improved indoorair
quality.