Prof. Daniel Aelenei

As people have become increasingly aware, the age of the European population is rising and the percentage of adults aged 65 years and older is expected to increase. In addition, older people spend about 20 hours per day indoors, and many of them spend essentially their time in elderly care centers (ECC). In this sense, the study of indoor environments and how elder people may be particularly at risk of adverse health effects from pollutants, even at low exposures, due to multiple underlying chronic diseases is becoming an important issue to be addressed by research. Such conditions are highly prevalent, multifactorial, and associated with multiple comorbidities and poor outcomes, such as increased disability and decreased quality of life. The importance of this topic was heightened in 2012 by the World Health Day in 2012 Ageing and health with the theme "Good health adds life to years" and also the ?European Year for Active Ageing and Solidarity between Generations?. Accordingly, this project is suitable to integrate these initiatives and to ensure greater recognition of what older people bring to society and create more supportive conditions for them. To our knowledge, this is the first study in Portugal to assess effects of indoor air contaminants on health status and quality of life in older persons living in ECC. The aim of GERIA project is to carry out a risk assessment, often difficult for older people, involving the identification of multiple factors potentially affecting health and quality of life, the quantification of human exposure to pollutants, and the evaluation of the individual?s response to these stimuli. The results of this project contribute to the understanding of health effects due to indoor environment variables and to provide health benefits to ECC residents with relatively simple measures.

Background Indoor air quality (IAQ) is considered an important determinant of human health. The association between exposure to volatile organic compounds, particulate matter, house dust mite, molds and bacteria in day care centers (DCC) is not completely clear. The aim of this project was to study these effects. Methods ? study design This study comprised two phases. Phase I included an evaluation of 45 DCCs (25 from Lisbon and 20 from Oporto, targeting 5161 children). In this phase, building characteristics, indoor CO2 and air temperature/relative humidity, were assessed. A children's respiratory health questionnaire derived from the ISAAC (International Study on Asthma and Allergies in Children) was also distributed. Phase II encompassed two evaluations and included 20 DCCs selected from phase I after a cluster analysis (11 from Lisbon and 9 from Oporto, targeting 2287 children). In this phase, data on ventilation, IAQ, thermal comfort parameters, respiratory and allergic health, airway inflammation biomarkers, respiratory virus infection patterns and parental and child stress were collected. Results In Phase I, building characteristics, occupant behavior and ventilation surrogates were collected from all DCCs. The response rate of the questionnaire was 61.7% (3186 children). Phase II included 1221 children. Association results between DCC characteristics, IAQ and health outcomes will be provided in order to support recommendations on IAQ and children's health. A building ventilation model will also be developed. Discussion This paper outlines methods that might be implemented by other investigators conducting studies on the association between respiratory health and indoor air quality at DCC.

Children attending day care centers (CDCC) have been reported to be more prone to infectious diseases when compared with those cared for at home, and are exposed to conditions that may increase the risk of allergies and asthma. Several studies revealed that consequences of poor ventilation conditions include high levels of carbon dioxide (CO2) and many other indoor pollutants commonly detected in schools. Nine child day care centers were selected randomly to participate in this study. Fifty-two classrooms were assessed for chemical, biological, physical, and allergen parameters in spring and winter seasons in these nine CDCC located in Porto, Portugal. Outdoor measurements were also conducted for comparison. Our results indicated that (i) particulate matter (PM10) median levels were above the national reference levels, both by classroom type and by season; (ii) TVOC kindergarten peak values may raise some concern; (iii) CO2 was present at high median and maximum levels during spring and winter assessment in both nurseries and kindergartens classrooms; (iv) total bacteria concentrations were 57- and 52-fold higher in the nursery and kindergarten than outdoors, respectively, for the spring season; (v) winter and spring median predicted mean vote (PMV) indices were between "neutral" (0) and "slightly cool" (? -1) in the thermal sensation scale for comfort situations (-2 to 2) for both types of classrooms; (vi) there were significant differences for both PMV and predicted percentage of dissatisfied (PPD) indices by season; and (vii) CO2, total bacteria, and gram-negative bacteria were associated with low airflow rates. These data will help to evaluate the effectiveness of current building operation practices in child day care centers regarding indoor air quality and respiratory health.

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