Assessment of Exposure to Indoor Air Pollutants

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Assessment of Exposure to Indoor Air Pollutants ASSESSMENT OF EXPOSURE TO INDOOR AIR POLLUTANTS In.-,.r,... 7- WHO Regional Publications European Series, No. 78 The World Health Organization is a specialized agency of the United Nations with primary responsibility for international health matters and public health. Through this Organization, which was created in 1948, the health professions of over 190 countries exchange their knowledge and experience with the aim of making possible the attain- ment by all citizens of the world of a level of health that will permit them to lead a socially and economically productive life. The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health problems of the countries it serves. The European Region embraces some 860 million people living in an area stretching from Greenland in the north and the Mediterranean in the south to the Pacific shores of the Russian Federation. The European programme of WHO therefore concentrates both on the problems associated with industrial and post -industrial society and on those faced by the emerg- ing democracies of central and eastern Europe and the former USSR. In its strategy for attaining the goal of health for all the Regional Office is arranging its activities in three main areas: lifestyles conducive to health, a healthy environment, and appropriate services for preven- tion, treatment and care. The European Region is characterized by the large number of languages spoken by its peoples, and the resulting difficulties in disseminating information to all who may need it. Applications for rights of translation of Regional Office books are therefore most welcome. Assessment of exposure to indoor air pollutants WHO Library Cataloguing in Publication Data Assessment of exposure to indoor air pollutants /edited by M. Jantunen, J.J.K. Jaakkola and M. Krzyzanowski (WHO regional publications. European series ; No. 78) I.Air pollution, Indoor 2.Air pollutants - adverse effects 3. Environmental exposure 4.Risk assessment 5.Methods I.Jantunen, M. II.Jaakkola, J.J.K. IILKrzyzanowski, M. IV. Series ISBN 92 890 1342 7 (NLM Classification: WA 754) ISSN 0378 -2255 Text editing:David Breuer World Health Organization Regional Office for Europe Copenhagen Assessment of exposure to indoor airpollutants Edited by M. Jantunen J.J.K. Jaakkola M. Krzyzanowski WHO Regional Publications, European Series, No. 78 ISBN 92 890 1342 7 ISSN 0378 -2255 The Regional Office for Europe of the World Health Organization wel- comes requests for permission to reproduce or translate its publications, in part or in full. Applications and enquiries should be addressed to the Office of Publications, WHO Regional Office for Europe, Scherfigsvej 8, DK -2100 Copenhagen 0, Denmark, which will be glad to provide the latest information on any changes made to the text, plans for new edi- tions, and reprints and translations already available. World Health Organization 1997 Publications of the World Health Organization enjoy copyright protec- tion in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concern- ing the legal status of any country, territory, city or area or of its authori- ties, or concerning the delimitation of its frontiers or boundaries. The names of countries or areas used in this publication are those that ob- tained at the time the original language edition of the book was pre- pared. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The views expressed in this publication are those of the contributors and do not necessarily represent the decisions or the stated policy of the World Health Organization. PRINTED IN DENMARK Contents Page Foreword vii Preface ix Contributors xi Introduction 1 PART 1. BACKGROUND 1 General aspects of exposure assessment 7 2Concepts of exposure assessment 10 3 Direct methods of exposure assessment 15 4Indirect methods of exposure assessment 18 5 Assessment of exposure to mixtures: the example of volatile organic compounds 24 6Temperature and humidity 27 7Design of exposure assessment surveys 32 8Quality assurance 38 References and bibliography 43 PART 2. EXPOSURE ASSESSMENT METHODS FOR SELECTED FACTORS 9Introduction 47 Gaseous air pollutants 10 Nitrogen dioxide 49 11 Volatile organic compounds 54 12 Formaldehyde 66 13 Carbon monoxide 70 14 Sensory air pollutants 74 15 Radon 77 Particulate air pollutants 16 Particulate matter 81 17 Asbestos and other mineral fibres 87 18 Environmental tobacco smoke 91 19 Pesticides 96 Biological contaminants 20 Bacteria and fungi 99 21 House dust mites 104 22 Determinants of microbial growth 109 ANNEX Introduction 113 Indoor air quality in the United Kingdom: the Avon Longitudinal Study of Pregnancy and Childhood 115 An environmental survey in Germany in 1990 -1992 119 National Human Exposure Assessment Survey in the United States 124 Draft protocol for a proposed population -based study of indoor exposure to VOC in Helsinki, Finland 127 Foreword The World Health Organization (WHO) and its Regional Office for Europe have recognized the potential significance of the quality of the indoor envi- ronment for a long time. The current understanding of the magnitude of the health effects of poor indoor air quality is still far from complete. Neverthe- less, there is sufficient knowledge for this issue to be listed as one of the lead- ing environmental health problems in Europe in the Declaration on Action for Environment and Health in Europe, which was endorsed by the Second European Conference on Environment and Health, held in Helsinki in June 1994. The WHO European Centre for Environment and Health, which is responsible for the Regional Office programme related to air quality, is con- tinuing the involvement of the Regional Office in projects on indoor air qual- ity and contributing to achieving the regional target for health for all related to air quality. This monograph is an extension of a series of reports published by the Regional Office devoted to indoor air quality and to methods of assessing exposure. It is addressed to the broad public health community. The text sum- marizes the present methods and discusses the advantages and limitations of various approaches. The implementation of the methods presented should optimize efforts aimed at creating indoor environments supporting the health of people indoors, and thus improve the health of the European population. The experts participating in the work on this publication represent vari- ous disciplines and various experiences. I am grateful to them for their contri- butions to the text, for their creative and constructive discussion at working group meetings and for their critical revision of drafts of this book. I grate- fully acknowledge the financial contribution of the Government of Germany, which made this project possible. J.E. Asvall WHO Regional Director for Europe vii Preface Most people spend most of their time indoors, where they are subject to conditions they can control to a limited extent. The poor quality of the indoor environment is a strong determinant of a variety of health problems. The effects include discomfort caused by extremes of temperature or unpleasant smells, sensitization and asthmatic reactions related to biological aero- sols in the indoor air, and the fatal consequences of exposure to pathogenic organisms or chemicals. Attempts to conserve energy and to regulate some aspects of indoor climate may adversely affect other aspects of indoor air quality. A variety of building materials and chemical agents contained in consumer products used indoors may be harmful to health. Economic growth and development induce changes in lifestyle, increase the use of these products and indirectly affect health. The principal method of preventing adverse health effects is to eliminate exposure to hazardous factors. Nevertheless, the cost of preventive measures may be excessive and not justified if the measures are implemented in environments where the exposure does not pose any risk to health. In some cases, the measures may even harm health, such as when intensive ventilation in- creases the penetration of outdoor air pollutants. People often increase the use of household equipment without considering its potential contribution to indoor air pollution. In other situations they may attribute symptoms of ill health to unsatisfactory in- door air quality even if other factors are the cause. In such situa- tions, standardized methods of assessing population exposure to indoor air pollution are necessary to assess the risk to health and to select optimal risk management actions. A working group convened by the WHO European Centre for Environment and Health has prepared this publication with the ix X ASSESSMENT OF EXPOSURE TO INDOOR AIR POLLUTANTS aim of facilitating the implementation of exposure assessment methods in public health practice. The expertise necessary for applying exposure assessment methods is distributed among a number of disciplines, including chemistry, toxicology, physiol-
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