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                                                                                                  Source document:
                                        Indoor Air Quality                                        SCHER (2008)

                                                                                                  Summary & Details:
                                                                                                  GreenFacts (2008)




                                                              1. Introduction – assessing health risks of
Context - Air pollution – be it indoors                          indoor air pollution.................................3
or outdoors – is a major environmental                        2. What are the main factors in indoor air
health concern as it can lead to serious                         quality?................................................3
health effects, such as respiratory                           3. How can scientists determine whether indoor
diseases, including asthma and lung                              air pollutants pose a health risk?.............4
cancer.                                                       4. Are certain people more vulnerable than
                                                                 others to indoor air pollution?..................4
Much progress has been made in Europe                         5. Why are the combined effects of indoor air
in improving outdoor air quality and limit                       pollutants hard to measure?....................4
values have been set for several                              6. Which chemicals found in indoor air are
pollutants. However, indoor air quality                          causing the most concern?......................5
also requires attention because this is
                                                              7. What household chemicals and products can
where we spend most of our time.
                                                                 pollute indoor air? .................................5
                                                              8. Why is dampness in buildings a health
Which indoor air pollutants raise
                                                                 concern?..............................................6
concern? How can indoor air quality be
determined?                                                   9. What kind of research on indoor air quality
                                                                 is needed? ...........................................6
An assessment by the European                                10. Conclusions and recommendations ..........7
Commission Scientific Committee on
Health and Environmental Risks (SCHER)


                 The answers to these questions are a faithful summary of the scientific opinion
           produced in 2008 by the Scientific Committee on Health and Environmental Risks (SCHER):
                              "Opinion on risk assessment on indoor air quality"
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         The full publication is available at: http://copublications.greenfacts.org/en/indoor-air-pollution/
                        and at: http://ec.europa.eu/health/opinions/en/indoor-air-pollution/



      This PDF Document is the Level 1 of a GreenFacts Co-Publication. GreenFacts Co-Publications are published
      in several languages as questions and answers, in a copyrighted user-friendly Three-Level Structure of
      increasing detail:

           •   Each question is answered in Level 1 with a short summary.
           •   These answers are developed in more detail in Level 2.
           •   Level 3 consists of the Source document, the internationally recognised scientific opinion which
               is faithfully summarised in Level 2 and further in Level 1.


             All GreenFacts Co-Publications are available at: http://copublications.greenfacts.org/
    and at: http://ec.europa.eu/health/scientific_committees/policy/opinions_plain_language/index_en.htm
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1. Introduction – assessing health risks of indoor air pollution

Indoor exposure to air pollutants may occur in both private and
public indoor environments such as homes, offices, schools and
transport systems.

Some indoor air pollutants come from the outside, but most are
released inside the building, for example when cleaning or when                                    Several household
                                                                                                   cleaning products emit
burning fuel for cooking and heating. Furniture and construction                                   chemicals
materials can also emit pollutants. Dampness and lack of ventilation                                     Credit: Sanja Gjenero

may further increase indoor air pollution.

Because indoor air can contain a mixture of many different pollutants, it is very difficult to
assess the associated risks to health. Moreover, there is no such thing as a “typical indoor
environment”.

This opinion considers how health risks of indoor air pollutants are currently evaluated and
how they should be assessed in the future, taking into account simultaneous exposure to
multiple pollutants and particularly vulnerable groups of population such as children, pregnant
women and elderly people.


2. What are the main factors in indoor air quality?

Certain chemicals from household products and home appliances
are known to irritate the eyes, nose and throat. However, for many
chemicals present in indoor air information is lacking on possible
health effects of long term exposure, such as cancer or reproductive
effects.

Radon occurs naturally in parts of Europe. It can get inside buildings
and may lead to lung cancer.

Suspended particles can cause harmful effects on health,                                           Pets and pests are
                                                                                                   sources of allergens
particularly on the respiratory system.                                                              Credit: Katya Foldvaryove


Microbes, such as moulds and viruses, can contribute to the development of asthma and
allergies.

Pets and pests such as dust mites, cockroaches, and mice, are important indoor sources
of allergens.

Low humidity causes eye irritation, dryness of the skin and the nose, and rashes, while
high humidity fosters the growth of moulds and dust mites.

Insufficient ventilation, one of the most important factors in poor indoor air quality, may
affect health and work performance.

Indoor temperatures that are too high or too low are unpleasant and can be unhealthy.
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3. How can scientists determine whether indoor air pollutants pose a health
risk?

To determine whether pollutants may cause health effects, it is necessary to consider four
aspects:
     •     Toxicity of pollutants and their concentrations in indoor air. Indoor air can
           for instance contain organic compounds, particles, or microbes that may cause
           allergies or other health effects.
     •     Exposure. People are mainly exposed to air pollutants when breathing but may
           also be exposed via other routes, such as dust ingestion. Since exposures can
           vary, even very low and very high exposures should be considered and not only
           average ones.

       •       Exposure-response relationships. To assess the risk posed by a given
               pollutant, it is important to know how the body responds to different
               concentrations in air. Health effects observed in people who have been exposed
               to pollutants at work are valuable in determining the risks posed by a particular
               pollutant. However, such findings may not be directly applicable to the general
               public.

       •       Risk characterisation. In the final step of the risk assessment process, all the
               collected scientific evidence is analysed to determine the probability that a
               specific pollutant will cause illness.


4. Are certain people more vulnerable than others to indoor air pollution?

Population groups that are potentially more vulnerable than others
to indoor air pollution are children, pregnant women, elderly people,
and people suffering from cardiovascular or respiratory diseases.

Depending on their age, children may be more vulnerable than adults
to certain toxic substances, like lead and tobacco smoke. Even at
low levels, air pollutants may disrupt the development of their lungs,
cause cough, bronchitis and other respiratory diseases, and make
asthma worse.
                                                                                                   Some people are more
Factors other than age and presence of cardiovascular or respiratory                               vulnerable than others to
diseases that may render some people more vulnerable are genetic                                   indoor air pollution
                                                                                                       Credit: Stephan Czuratis
traits, lifestyle, nutrition and other health problems.


5. Why are the combined effects of indoor air pollutants hard to measure?

Like outdoor air, indoor air contains a complex mixture of pollutants (chemical substances,
allergens and microbes) from different sources that changes with time.

Findings on the health effects of single air pollutants cannot necessarily be extended to
mixtures. Indeed, different chemicals may interact with each other and cause more (or
less) harmful effects than the sum of the effects caused by each chemical separately. Very
little is known about the combined effects of indoor air pollutants.

Risk assessments which take into account the combined exposure and cumulative effects
of the pollutants in indoor air are seldom possible. Nonetheless, the possibility of combined
effects should be considered in the risk assessment taking a case-by-case approach.
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6. Which chemicals found in indoor air are causing the most concern?

Among the combustion products that are generated by heating
systems and other home appliances using gas, fuel, or wood, carbon
monoxide (CO) and nitrogen dioxide (NO2) are of special
concern.

Tobacco smoke contains several types of harmful pollutants,
including benzene and fine and ultrafine particles. In adults, passive
smoking can cause irritation, aggravated respiratory symptoms, and
coronary heart disease. In children, it can lead to sudden death
                                                                                                   Tobacco Smoke contains
syndrome and middle ear infections.                                                                several types of harmful
                                                                                                   pollutants
                                                                                                           Credit: Vildan Uysal
Radon occurs naturally in certain regions. It can get inside buildings
and may lead to lung cancer.

Lead, which is still present in paintwork of some old houses, is harmful to children even at
low level exposure.

Organophosphate pesticides, which are often used against insects in the home, can
affect the development of the nervous system and could be of concern for children.

Volatile organic compounds (VOCs) such as benzene, formaldehyde and naphthalene
which are known to have health effects are emitted by many consumer products. VOCs
may react with ground-level ozone to form secondary pollutants that can cause irritation.
Altogether, the concentrations of VOCs and ozone causing mixture effects are as yet poorly
known.


7. What household chemicals and products can pollute indoor air?

Several household consumer products emit chemicals into air, for
instance cleaning products, floor care products, furniture and
household fabrics, air fresheners, glues, paints, paint strippers,
personal care products, printed matter, electronic equipment, candles
and incense.

Some studies show a link between the use of consumer products
and adverse health effects. However, it is not clear to what extent
pollutants are responsible for the observed effects because other
                                                                                                   Certain paints emit
factors may also contribute to them.                                                               chemicals
                                                                                                           Credit: Daniel Case

A recent study investigated the emissions of chemicals from a large number of different
consumer products. Although typical levels in indoor air were in most cases acceptable, in
some occasions, accepted limits were exceeded.
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8. Why is dampness in buildings a health concern?

The majority of the health effects linked to dampness and moisture
of buildings are those of the respiratory system. They range from
irritation of mucous membranes, respiratory symptoms, and
infections to diseases such as asthma and allergy. However, it is still
not known precisely how dampness leads to these symptoms and
which are the main substances responsible.                                                         Humidity promotes the
                                                                                                   growth of moulds
                                                                                                          Credit: Infrogmation
Humidity problems in buildings may originate from leaks,
condensation, or the ground. Excess humidity promotes the growth of micro-organisms
such as moulds and bacteria that lead to release of pollutants into indoor air.

Inadequate ventilation may increase humidity and the levels of pollutants.

Further research is needed to assess how serious or widespread the problem of building
dampness and moisture is at EU level.


9. What kind of research on indoor air quality is needed?

9.1 The data available for risk assessment of indoor air pollution
are scarce and often insufficient. Information is available on the
concentrations in indoor air of some well-known pollutants but is
lacking for others whose effects are unclear. Measurements of
outdoor air quality cannot be extrapolated to predict the
concentrations in buildings.

Monitoring of indicators other than concentrations may be helpful,                                 It is necessary to
for instance ventilation rates, general cleanliness, and signs of                                  investigate how people
                                                                                                   are exposed to pollutants
dampness. The development of health-based guideline values is                                      in indoor air
recommended for key pollutants.

9.2 Existing data on exposure to indoor pollutants and information on risk assessment
strategies should be collected and organised.

Research is needed to identify the main sources of indoor pollutants, including in damp and
water-damaged buildings. In addition, it is necessary to investigate how people are exposed
to pollutants in indoor air and how the exposure levels could be measured or estimated
using computer models.

9.3 There is a need for research on the health effects of mixtures of pollutants and of
less well known indoor air pollutants such as microbes. The contribution of indoor air
pollutants to childhood respiratory diseases, as well as the exposure-response relationships,
especially in vulnerable groups, should also be investigated further.

9.4 Existing measurement standards should be validated and harmonised.
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10. Conclusions and recommendations

Assessing the health risks of indoor air pollution is very difficult as indoor air may contain
over 900 chemicals, particles and biological materials with potential health effects. Factors
like ventilation, cleaning conditions, building characteristics, products used in households,
cultural habits, climate and outdoor environment all influence indoor air quality. Therefore,
large variations can be expected across the EU.

The European Commission Scientific Committee on Health and Environmental Risks (SCHER)
concludes:
     •     The principles used in the EU for risk assessment of chemicals should also be
           applied to indoor air.
     •     More research and data are needed, particularly on particles and microbes,
           volatile organic compounds from consumer products, building dampness, levels
           of exposure, and effects on vulnerable populations.
     •     Gaps in knowledge should be addressed by European-wide multidisciplinary
           research. (see question 9)
     •     Indoor air pollutants of particular concern are carbon monoxide, formaldehyde,
           benzene, nitrogen oxides, naphthalene, environmental tobacco smoke, radon,
           lead and organophosphate pesticides.

The SCHER also recommends:
     •   Data on combined effects of indoor pollutants should be gathered.
     •   All possible routes of exposure should be considered.
     •   Health-based guideline values for key pollutants and other practical guidance
         should be developed.
     •   The impact of indoor exposure should be considered when evaluating the health
         effects of outdoor air pollution.
     •   All relevant sources known to contribute to indoor air pollution should be
         evaluated.

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Indoor Air Quality

  • 1. http://www.greenfacts.org/ Copyright © DG Health and Consumers of the European Commission. page 1/7 http://ec.europa.eu/health/scientific_committees/policy/opinions_plain_language/index_en.htm Source document: Indoor Air Quality SCHER (2008) Summary & Details: GreenFacts (2008) 1. Introduction – assessing health risks of Context - Air pollution – be it indoors indoor air pollution.................................3 or outdoors – is a major environmental 2. What are the main factors in indoor air health concern as it can lead to serious quality?................................................3 health effects, such as respiratory 3. How can scientists determine whether indoor diseases, including asthma and lung air pollutants pose a health risk?.............4 cancer. 4. Are certain people more vulnerable than others to indoor air pollution?..................4 Much progress has been made in Europe 5. Why are the combined effects of indoor air in improving outdoor air quality and limit pollutants hard to measure?....................4 values have been set for several 6. Which chemicals found in indoor air are pollutants. However, indoor air quality causing the most concern?......................5 also requires attention because this is 7. What household chemicals and products can where we spend most of our time. pollute indoor air? .................................5 8. Why is dampness in buildings a health Which indoor air pollutants raise concern?..............................................6 concern? How can indoor air quality be determined? 9. What kind of research on indoor air quality is needed? ...........................................6 An assessment by the European 10. Conclusions and recommendations ..........7 Commission Scientific Committee on Health and Environmental Risks (SCHER) The answers to these questions are a faithful summary of the scientific opinion produced in 2008 by the Scientific Committee on Health and Environmental Risks (SCHER): "Opinion on risk assessment on indoor air quality"
  • 2. http://www.greenfacts.org/ Copyright © DG Health and Consumers of the European Commission. page 2/7 http://ec.europa.eu/health/scientific_committees/policy/opinions_plain_language/index_en.htm The full publication is available at: http://copublications.greenfacts.org/en/indoor-air-pollution/ and at: http://ec.europa.eu/health/opinions/en/indoor-air-pollution/ This PDF Document is the Level 1 of a GreenFacts Co-Publication. GreenFacts Co-Publications are published in several languages as questions and answers, in a copyrighted user-friendly Three-Level Structure of increasing detail: • Each question is answered in Level 1 with a short summary. • These answers are developed in more detail in Level 2. • Level 3 consists of the Source document, the internationally recognised scientific opinion which is faithfully summarised in Level 2 and further in Level 1. All GreenFacts Co-Publications are available at: http://copublications.greenfacts.org/ and at: http://ec.europa.eu/health/scientific_committees/policy/opinions_plain_language/index_en.htm
  • 3. http://www.greenfacts.org/ Copyright © DG Health and Consumers of the European Commission. page 3/7 http://ec.europa.eu/health/scientific_committees/policy/opinions_plain_language/index_en.htm 1. Introduction – assessing health risks of indoor air pollution Indoor exposure to air pollutants may occur in both private and public indoor environments such as homes, offices, schools and transport systems. Some indoor air pollutants come from the outside, but most are released inside the building, for example when cleaning or when Several household cleaning products emit burning fuel for cooking and heating. Furniture and construction chemicals materials can also emit pollutants. Dampness and lack of ventilation Credit: Sanja Gjenero may further increase indoor air pollution. Because indoor air can contain a mixture of many different pollutants, it is very difficult to assess the associated risks to health. Moreover, there is no such thing as a “typical indoor environment”. This opinion considers how health risks of indoor air pollutants are currently evaluated and how they should be assessed in the future, taking into account simultaneous exposure to multiple pollutants and particularly vulnerable groups of population such as children, pregnant women and elderly people. 2. What are the main factors in indoor air quality? Certain chemicals from household products and home appliances are known to irritate the eyes, nose and throat. However, for many chemicals present in indoor air information is lacking on possible health effects of long term exposure, such as cancer or reproductive effects. Radon occurs naturally in parts of Europe. It can get inside buildings and may lead to lung cancer. Suspended particles can cause harmful effects on health, Pets and pests are sources of allergens particularly on the respiratory system. Credit: Katya Foldvaryove Microbes, such as moulds and viruses, can contribute to the development of asthma and allergies. Pets and pests such as dust mites, cockroaches, and mice, are important indoor sources of allergens. Low humidity causes eye irritation, dryness of the skin and the nose, and rashes, while high humidity fosters the growth of moulds and dust mites. Insufficient ventilation, one of the most important factors in poor indoor air quality, may affect health and work performance. Indoor temperatures that are too high or too low are unpleasant and can be unhealthy.
  • 4. http://www.greenfacts.org/ Copyright © DG Health and Consumers of the European Commission. page 4/7 http://ec.europa.eu/health/scientific_committees/policy/opinions_plain_language/index_en.htm 3. How can scientists determine whether indoor air pollutants pose a health risk? To determine whether pollutants may cause health effects, it is necessary to consider four aspects: • Toxicity of pollutants and their concentrations in indoor air. Indoor air can for instance contain organic compounds, particles, or microbes that may cause allergies or other health effects. • Exposure. People are mainly exposed to air pollutants when breathing but may also be exposed via other routes, such as dust ingestion. Since exposures can vary, even very low and very high exposures should be considered and not only average ones. • Exposure-response relationships. To assess the risk posed by a given pollutant, it is important to know how the body responds to different concentrations in air. Health effects observed in people who have been exposed to pollutants at work are valuable in determining the risks posed by a particular pollutant. However, such findings may not be directly applicable to the general public. • Risk characterisation. In the final step of the risk assessment process, all the collected scientific evidence is analysed to determine the probability that a specific pollutant will cause illness. 4. Are certain people more vulnerable than others to indoor air pollution? Population groups that are potentially more vulnerable than others to indoor air pollution are children, pregnant women, elderly people, and people suffering from cardiovascular or respiratory diseases. Depending on their age, children may be more vulnerable than adults to certain toxic substances, like lead and tobacco smoke. Even at low levels, air pollutants may disrupt the development of their lungs, cause cough, bronchitis and other respiratory diseases, and make asthma worse. Some people are more Factors other than age and presence of cardiovascular or respiratory vulnerable than others to diseases that may render some people more vulnerable are genetic indoor air pollution Credit: Stephan Czuratis traits, lifestyle, nutrition and other health problems. 5. Why are the combined effects of indoor air pollutants hard to measure? Like outdoor air, indoor air contains a complex mixture of pollutants (chemical substances, allergens and microbes) from different sources that changes with time. Findings on the health effects of single air pollutants cannot necessarily be extended to mixtures. Indeed, different chemicals may interact with each other and cause more (or less) harmful effects than the sum of the effects caused by each chemical separately. Very little is known about the combined effects of indoor air pollutants. Risk assessments which take into account the combined exposure and cumulative effects of the pollutants in indoor air are seldom possible. Nonetheless, the possibility of combined effects should be considered in the risk assessment taking a case-by-case approach.
  • 5. http://www.greenfacts.org/ Copyright © DG Health and Consumers of the European Commission. page 5/7 http://ec.europa.eu/health/scientific_committees/policy/opinions_plain_language/index_en.htm 6. Which chemicals found in indoor air are causing the most concern? Among the combustion products that are generated by heating systems and other home appliances using gas, fuel, or wood, carbon monoxide (CO) and nitrogen dioxide (NO2) are of special concern. Tobacco smoke contains several types of harmful pollutants, including benzene and fine and ultrafine particles. In adults, passive smoking can cause irritation, aggravated respiratory symptoms, and coronary heart disease. In children, it can lead to sudden death Tobacco Smoke contains syndrome and middle ear infections. several types of harmful pollutants Credit: Vildan Uysal Radon occurs naturally in certain regions. It can get inside buildings and may lead to lung cancer. Lead, which is still present in paintwork of some old houses, is harmful to children even at low level exposure. Organophosphate pesticides, which are often used against insects in the home, can affect the development of the nervous system and could be of concern for children. Volatile organic compounds (VOCs) such as benzene, formaldehyde and naphthalene which are known to have health effects are emitted by many consumer products. VOCs may react with ground-level ozone to form secondary pollutants that can cause irritation. Altogether, the concentrations of VOCs and ozone causing mixture effects are as yet poorly known. 7. What household chemicals and products can pollute indoor air? Several household consumer products emit chemicals into air, for instance cleaning products, floor care products, furniture and household fabrics, air fresheners, glues, paints, paint strippers, personal care products, printed matter, electronic equipment, candles and incense. Some studies show a link between the use of consumer products and adverse health effects. However, it is not clear to what extent pollutants are responsible for the observed effects because other Certain paints emit factors may also contribute to them. chemicals Credit: Daniel Case A recent study investigated the emissions of chemicals from a large number of different consumer products. Although typical levels in indoor air were in most cases acceptable, in some occasions, accepted limits were exceeded.
  • 6. http://www.greenfacts.org/ Copyright © DG Health and Consumers of the European Commission. page 6/7 http://ec.europa.eu/health/scientific_committees/policy/opinions_plain_language/index_en.htm 8. Why is dampness in buildings a health concern? The majority of the health effects linked to dampness and moisture of buildings are those of the respiratory system. They range from irritation of mucous membranes, respiratory symptoms, and infections to diseases such as asthma and allergy. However, it is still not known precisely how dampness leads to these symptoms and which are the main substances responsible. Humidity promotes the growth of moulds Credit: Infrogmation Humidity problems in buildings may originate from leaks, condensation, or the ground. Excess humidity promotes the growth of micro-organisms such as moulds and bacteria that lead to release of pollutants into indoor air. Inadequate ventilation may increase humidity and the levels of pollutants. Further research is needed to assess how serious or widespread the problem of building dampness and moisture is at EU level. 9. What kind of research on indoor air quality is needed? 9.1 The data available for risk assessment of indoor air pollution are scarce and often insufficient. Information is available on the concentrations in indoor air of some well-known pollutants but is lacking for others whose effects are unclear. Measurements of outdoor air quality cannot be extrapolated to predict the concentrations in buildings. Monitoring of indicators other than concentrations may be helpful, It is necessary to for instance ventilation rates, general cleanliness, and signs of investigate how people are exposed to pollutants dampness. The development of health-based guideline values is in indoor air recommended for key pollutants. 9.2 Existing data on exposure to indoor pollutants and information on risk assessment strategies should be collected and organised. Research is needed to identify the main sources of indoor pollutants, including in damp and water-damaged buildings. In addition, it is necessary to investigate how people are exposed to pollutants in indoor air and how the exposure levels could be measured or estimated using computer models. 9.3 There is a need for research on the health effects of mixtures of pollutants and of less well known indoor air pollutants such as microbes. The contribution of indoor air pollutants to childhood respiratory diseases, as well as the exposure-response relationships, especially in vulnerable groups, should also be investigated further. 9.4 Existing measurement standards should be validated and harmonised.
  • 7. http://www.greenfacts.org/ Copyright © DG Health and Consumers of the European Commission. page 7/7 http://ec.europa.eu/health/scientific_committees/policy/opinions_plain_language/index_en.htm 10. Conclusions and recommendations Assessing the health risks of indoor air pollution is very difficult as indoor air may contain over 900 chemicals, particles and biological materials with potential health effects. Factors like ventilation, cleaning conditions, building characteristics, products used in households, cultural habits, climate and outdoor environment all influence indoor air quality. Therefore, large variations can be expected across the EU. The European Commission Scientific Committee on Health and Environmental Risks (SCHER) concludes: • The principles used in the EU for risk assessment of chemicals should also be applied to indoor air. • More research and data are needed, particularly on particles and microbes, volatile organic compounds from consumer products, building dampness, levels of exposure, and effects on vulnerable populations. • Gaps in knowledge should be addressed by European-wide multidisciplinary research. (see question 9) • Indoor air pollutants of particular concern are carbon monoxide, formaldehyde, benzene, nitrogen oxides, naphthalene, environmental tobacco smoke, radon, lead and organophosphate pesticides. The SCHER also recommends: • Data on combined effects of indoor pollutants should be gathered. • All possible routes of exposure should be considered. • Health-based guideline values for key pollutants and other practical guidance should be developed. • The impact of indoor exposure should be considered when evaluating the health effects of outdoor air pollution. • All relevant sources known to contribute to indoor air pollution should be evaluated.