Building and Environment 44 (2009) 1980–1989

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Building and Environment

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Towards an integrative approach of improving indoor air quality

Philomena M. Bluyssen*
TNO Built Environment and Geosciences, P.O. Box 49, 2600 AA Delft, The Netherlands

a r t i c l e i n f o a b s t r a c t

Article history: There seems to be a discrepancy between current Indoor Air Quality standards and end-users wishes and
Received 7 November 2008 demands. Indoor air quality can be approached from three points of view: the human, the indoor air of
Received in revised form the space and the sources contributing to indoor air pollution. Standards currently in use mainly address
15 January 2009
the indoor air of the space. ‘‘Other or additional’’ recommendations and guidelines are required to
Accepted 27 January 2009
improve indoor air quality. Even though we do not fully understand the mechanisms behind the physical,
chemical, physiological and psychological processes, it is still possible to identify the different ways to be
Keywords:
taken regulatory, politically–socially (awareness), technically (process and product) and scientifically.
Indoor air quality
Source control Besides the fact that there is an urgent need to involve medicine and neuro-psychology in research to
Labelling investigate the mechanisms behind dose-response, health effects and interactions between and with the
Exposure and effect other factors and parameters of the indoor environment and the human body and mind, a holistic
Risk assessment approach is required including the sources, the air and last but not least the human beings (occupants)
themselves. This paper mainly focuses on the European situation.
Ó 2009 Elsevier Ltd. All rights reserved.

1. Introduction
Defining indoor air quality can be approached from three points
of view: the human, the indoor air of the space and the sources
contributing to indoor air pollution. From the human point of view,
indoor air quality of a space is the physical effect of exposures of
people to indoor air of the space they are visiting or occupying, as
experienced by those people. Indoor air quality at a certain point in
time can for example be expressed in an odorous unit, while indoor
air quality over time can for example be related to the number of
people developing a certain illness. From the indoor air point of
view, indoor air quality is often expressed in a certain ventilation
rate (in L/s per person and/or L/s per m2 floor area) or in concen-
trations for specific compounds. These concentrations are influ-
enced by the sources present in (indoor sources) or outside the
space (outdoor sources and sources present in HVAC systems or
surrounding spaces). So, also from the source point of view indoor
air quality can be approached. Emission rates per source unit for
certain pollutants (used for labelling products in some countries) is
then often the result.
For mainly the second point of view (indoor air), standards and
guidelines are in use for evaluating the indoor air quality (based on
WHO air quality guidelines [1], ASHRAE [2], in some cases CEN [3]
or nationally determined minimum guidelines based on the pres-
ence of people only (CO2 concentration)). Even though those
* Tel.: þ31 6 51806610.
E-mail address: philo.bluyssen@tno.nl
standards and guidelines are met, the quality of the indoor air, as
experienced by the occupants, is still not acceptable and even
unhealthy, causing health and comfort problems. There seems to be
a discrepancy between current standards with end-users wishes
and demands [4,5]. Therefore, ‘‘other or additional’’ recommenda-
tions and guidelines are required to improve indoor air quality.
At European level, several initiatives are being taking ranging
from exposure threshold values of pollutants to labelling of prod-
ucts and even buildings, such as:
- The development of harmonised test methods for release or
emission of dangerous substances to satisfy the requirements
of Essential requirement 3 (ER 3) of the Construction Product
Directive (CPD) (see Fig. 1) [6].
- A standardised voluntary approach for the delivery of envi-
ronmental information on construction products, and to assess
the environmental performance of buildings [7].
- Harmonisation of several national labelling schemes for
construction and furnishing products [8].
- REACH (Registration, Evaluation, Authorisation and Restriction
of Chemicals) [9].
- Several currently running European funded projects: EnVIE
[10], BUMA [11], HealthyAir [12], etc.
This paper describes and discusses the problem(s) encountered
with indoor air quality and possible ways to get to ‘‘other or addi-
tional’’ recommendations, based on examples and initiatives from
mainly European origin.

0360-1323/$ – see front matter Ó 2009 Elsevier Ltd. All rights reserved.
doi:10.1016/j.buildenv.2009.01.012
 P.M. Bluyssen / Building and Environment 44 (2009) 1980–1989 1981

“The construction work must be designed and built in such a way that it will not be a threat
to the hygiene or health of the occupants or neighbours, in particular as a result of the
following:
- The giving-off of toxic gas.
- The presence of dangerous particles or gases in the air.
- The emission of dangerous radiation.
- Pollution or poisoning of the water or soil.
- Faulty elimination of waste water, smoke, solid or liquid wastes.
- The presence of damp- in parts of the works or on surfaces within the works.”

Fig. 1. Essential requirement 3: Hygiene, Health and the Environment [6].

2. Facts and problems compounds transforming to more highly oxidized species [17] or
water facilitating the disproportionation of NO2 in aqueous surface
Basically the following process is taking place in the indoor films, leading to increased levels of nitrous acid (HONO) in indoor
environment. A source (or sources) emits pollutants that come into air [18] (see also Refs. [19–21]). And a source can emit compounds
the indoor air of a space, directly or indirectly. Those pollutants can that arise/develop during the in use phase of the source itself, such
react with each other or with pollutants from other sources, as ageing, cleaning or microbiological growth. Additionally, the mix
creating new pollutants (indoor air chemistry). And pollutants from of pollutants in indoor environments can be transformed due to
other sources can react with the source. A person entering or chemical reactions resulting in a much broader analytical window
occupying that space, is exposed to those pollutants present in the of organic compounds than the classic window (as defined by the
air of the space, which possibly creates a response (immediate or World Health Organisation (WHO)) used to explain the effects [22].
after some time), depending most likely also on previous and future Ozone reactions, hydroxyl radicals reactions, but also other radical
exposures in the same or other spaces. From this latter step can be reactions (for example nitrate radical NO3$) occur in the indoor
concluded that relating a response to a pollutant or source is very environment. Secondary products formed comprise of formalde-
difficult, unless lab controlled exposures using specific pollutants hyde, aldehydes and NO2. The concentrations of free radicals are
focused on specific responses is performed. But even then, since not well-known and are needed to advance indoor chemistry
people can response differently and do have a history, this is modelling [18].
a complex matter.
The following facts and problems can be identified. 2.3. The material constituents and moisture retention
characteristics of a product determine the risk for microbial growth
2.1. The emission behaviour of sources is complex
Secondary emissions can also comprise of emissions of spores,
This complexity is partly related to the fact that the mechanisms mycotoxins, synergizers and VOCs from microbial growth on the
(diffusion, sorption, evaporation [13]) occurring in and on the surface of the product. It is known that moulds grow on practically
sources are not well understood. There are sources in the indoor any organic material provided there is enough water (not neces-
environment that emit compounds which are absorbed on indoor sarily liquid). The availability of water in the indoor environment
surfaces, for example occurring during cooking, cleaning or other and on or in construction products is influenced by several factors:
user activities. Those compounds can be desorbed, react with thermal performance of a building envelope, ventilation, occupant
compounds on the new source, and re-emit (secondary emission). behaviour (cleaning for example) and material characteristics.
This re-emission, but also the primary emission of sources is
a complex phenomenon. For example the mass transfer coefficient
for a compound in a building material differs for each of the
mechanism mentioned but also for each combination compound
(caused by polarity, volatility, vapour pressure) and source (caused
by porosity, roughness and specific area) and for different condi-
tions (such as temperature, humidity, air velocity). For the deter-
mination of these coefficients, for example for the diffusion
coefficient of a pair chemical compound – building material, several
experimental techniques are available, each having their pros and Curve 1: in general for VOCs Curve 2: in general for VVOCs
cons [14].
Another important issue is the emission over time (see Fig. 2).
Depending on the compound emitted, a different pattern of emis-
sion over time can occur. Emission patterns from more compounds
emitted from a source can look quite complex. Nevertheless,
a better understanding can possibly result in predictions and
explanation on the emission behaviour to be expected (level and
time frame of emissions).
Curve 3: in general for SVOCs Curve 4: intermittent release

2.2. Indoor and source surface chemistry create ‘‘new’’ fairly
unknown compounds, not (yet) accounted for in current standards
and guidelines
A source can also emit compounds that are caused by coming
into contact with other products such as Ozone with organic
Fig. 2. Examples of patterns of emission over time for a compound: SVOC (Semi
volatile organic compounds) might have the opposite curve as VVOC (Very volatile
organic compounds) and start their emission much later in time, but will in general
eventually decrease again (for example some sealants) [15,16]. Some VOCs show an
intermittent release due to the conditions in the indoor space (temperature and
humidity variations) influencing the emission rate or due to regular (maintenance and
cleaning) activities related to the product. The latter are named secondary emissions.
1982 P.M. Bluyssen / Building and Environment 44 (2009) 1980–1989
Studies have shown that the latter is the primary reason for
microbial growth [23,24].
Additionally, if a product comprises of organic materials, the risk
for growth is higher than for completely inert materials. The trend
towards eco-friendlier products has thus increased the potential
growth risks (for example the use of water-based paints instead of
oil-based). Organic dirt on inert material can also increase the risk,
making the cleanability of a product an important characteristic.
At present, an increased resistance against microbial attack, and
therefore the prevention of mould growth, requires addition of
biocides, with paints being the main application area. Because the
actual period of time of biocides activity is short (max. 1–2 year),
research is being performed to incapsulate the biocides and when
moulds are present, the encapsulation breaks and slow release of
the biocide occurs. An additional problem is that most traditional
biocides, e.g. mercury compounds, are under prohibitive rules
(European Union Biocidal Product Directive (BPD) [25]) or will be.
Eco-friendlier, less toxic alternatives are needed.
2.4. The HVAC systems can be a source of pollution as well,
which is not always acknowledged
Research [26] has indicated that main sources and reasons for
pollution in a ventilation system may vary considerable depending
on the type of construction, use and maintenance of the system. In
normal comfort ventilation systems the filters and the ducts seem
to be the most common sources of pollution, especially odours. Oil
residuals are the dominating source of pollution in new ducts,
while growth of micro-organisms, dust/debris accumulated in the
ducts during the construction at the work site (mostly inorganic
substances) and organic dust accumulated during the operation
period in the ducts can be sources of pollution as well. If humidi-
fiers and rotating heat exchangers (RHEs) are used, they are also
reasonable to be suspected as remarkable pollution sources espe-
cially if not constructed and maintained properly. Micro-organisms
are the main source of air pollution if the air humidifier is not used
in the manufacturer-recommended way and/or if they are not
properly maintained. Desalinisation and demineralization devices/
agents can also contribute to pollution of the passing air. In general,
RHEs are not pollutant sources in themselves, except when the
wheels are dirty. RHEs may transport contaminants from the
supply to the exhaust in three ways: through air caught by
the wheel, by leakage between wheel and gasket, and by adsorp-
tion–desorption on the surface area of the wheel. The pollution
load caused by the heating and cooling coils seems to be less
notable, except for cooling coils with condense water in the pans,
which can be microbiological reservoirs and amplification sites that
may be a major sources of pollution in the inlet air.
What should be mentioned is that a positive effect of HVAC
systems (i.e. mostly the filters) is perhaps the removal of ozone,
reducing the indoor ozone concentration and levels of potentially
harmful oxidation products [27].
2.5. To truly evaluate an exposure, all routes of exposure
(physiological and psychological) should be taken into
account jointly. And different humans will react
differently to the same exposure
Human exposure to environmental factors (such as indoor air
compounds) occurs mainly through the senses. Receptors in our
nervous system receive sensory information as sensations via the
eyes, ears, nose and skin, enhanced by bodily processes such as
inhalation, ingestion and skin contacts. In addition to the stimuli
that can be processed by our sensory system, the environment
affects us in other ways, which are not recognisable to us. The latter
stimuli can cause changes in our psychological state, of which we
apparently do not know the cause (no conscious experience), but
can also be harmful to our physical state of well-being (for example
gases, chemical compounds, radiation, etc.) [28]. So it seems that
the received information (sensations) can be looked upon from the
physiology of the body and/or from the psychological point of view.
Interactions may occur between stimuli in complex, real-life
mixtures as well as between various body responses to exposure.
Some stimuli cause only nuisance, others can give serious health
problems. Some have short-term effects, others long term. Our
senses perceive individually, but interpretation occurs together.
The bodily responses (physiologically and/or psychologically)
are produced, regulated and sometimes ‘‘killed’’ by several systems
in the body: the nervous system, the immune system and the
endocrine system. The health effects of our human body to stimuli
from the environment are controlled (or better fought against) by
the immune system, while our emotions and evaluations are
controlled by our limbic system and other parts of the brain (Fig. 3).
Additionally, the endocrine system provides boundary conditions
for ‘‘control’’ of environmental stimuli by our immune as well as
our limbic system. So they are pretty much intertwined.
External stress factors such as indoor air compounds, influence
all three systems of the human body (the nervous system, the
immune system and the endocrine system) and can result in both
mental and physical effects.
Not being able to cope with a certain situation (consciously or
unconsciously) can cause a whole range of different diseases and
disorders, mostly indirectly related to the environmental factors
and affected by psycho-social and personal factors as well. Too
much stress can cause short-term illness and long-term health
problems both physical and mental. Hormones play an important
role in the response [29].
Besides the effects of external stress factors, the performance of
the human senses (internal stress factor) can also have a major
influence on the first category of complaints. Degradation of the
eyes, ears, olfactory bulb, etc., usually occurring with age, are
examples of this. Degradation of the immune system functions also
increases with age. Also here genetics can be of influence as well,
such as being anosmic (not being able to smell normally).
The way we evaluate our environment (perception) and the way
we respond to our environment (behaviour) are two different
processes. According to Vroon [30] this can be explained by the fact
that the part of the brain that evaluates the environment is not the
callosum
limbic system
pineal gland
thalamus
hypothalamus
midbrain
pituitary gland
pons
medulla cerebellum
spinal cord
Fig. 3. Limbic system, endocrine system (pineal and pituitary glands), brainstem and
other parts of the brain.
 P.M. Bluyssen / Building and Environment 44 (2009) 1980–1989
same as the part of the brain that controls the behaviour of a human
being. This might explain why there is often a discrepancy between
what people tell us what they need or want and what their
behaviour tells us, or what they tell us what the cause is of certain
complaints and what the real problem is.
2.6. There are diverse techniques available to indicate the IAQ
people are/were exposed to
An indication of the environmental quality the persons were
exposed to can be given in the form of prevalence of symptoms,
acceptability, measurable pollutants in the body fluids, prevalence
of exposure to specific sources, or even investigating the brain.
Questionnaires given to occupants of the investigated buildings
[31,32], interviews per telephone [33], medical examination and
biological monitoring of body fluids of exposed people [34,35], and
the response of visitors of the investigated buildings, all belong to
this group of techniques. There are no absolute tests for lethargy,
headache and dry throat available. Objective measurements have
been used to validate dry eyes, blocked nose and asthma symptoms.
A diagnosis of allergy and hyper-reactivity can be established by
several tests [36]. The same can be said of eye irritation [37–39] and
for sensory irritation of the nose [40].
Sensory evaluation techniques are available to evaluate the
indoor air quality with the human nose or to evaluate the emission of
certain sources (construction and furnishing products, HVAC system
components) [41]. And animals have been used to investigate
problems related to irritation of the respiratory tract in humans [38].
And last but not least, non-invasive brain imaging techniques
are used to investigate people’s behaviour [28].
2.7. It is difficult to relate symptoms with IAQ evaluations
While field studies show every time that it is difficult to relate
symptoms with IAQ evaluations, combined exposures in laboratory
settings (such as [73–75]) give promising results. As Andersson [76]
states: ‘‘Controlled experimental studies in climate chambers and
animal studies will increase the possibilities to test hypothesis and
minimise the usual conclusions of many studies finding significant
results ‘‘indicating potential health effects’’.
From the BASE (Building Assessment Survey and Evaluation)
study, a study in 100 offices in the US, it appeared that human
occupants are still the most sophisticated ‘‘sensors’’ [77]. The most
statistically significant parameters found were occupants percep-
tion of odour and relative humidity, while the biological contami-
nants exhibited lower statistical associations with the examined
health outcomes (upper and lower respiratory sick building
syndrome symptoms, asthma and mould/dust allergies).
Research is required though to fully understand why people
react the way they do [76]. Neuroscience could supply insights in
how the brain interprets and responds to IAQ. Von Kempski [78]
emphasizes the need for focussing on the understanding of the
feelings and emotions of people, applying methods used in
psychology. According to Lan and Lian [79] behaviour origins from
three functional systems: cognition (concerns the information
handling), emotion (feeling and motivation) and executive func-
tions (how behaviour is expressed). These neuro-behavioural
factors can be tested by so-called psychometric tests such as the
profile of mood status (POMS) to measure individuals emotion [80].
To overcome biased self-reported symptoms (as a result of
personal situation and job-related factors for example), objective
clinical methods can be useful as well [81]. Also long-term storage of
human body specimen under stable freezing conditions for later
retrospective analyses provides new aspects in indoor air research
[82].
1983
2.8. Some compounds may have adverse effects on their own while
others, seemingly harmless, become harmful when they interact
with each other or over time. Some compounds behave differently in
a mixture than single
In general, non-specific effects or symptoms have been
observed after exposures to low level indoor air pollution with
particulate matter, gases or vapours, etc. This means that
a symptom does not have a specific cause and may even be
related to other type of exposures (for example light or thermal
exposure) or to other biological mechanisms (e.g. mental stress)
[42]. On the other hand these relations may be seen at higher
prolonged exposure levels, i.e. our senses are more sensitive
than our measuring instruments. The perception of odour and
sensory irritation of the mucous membranes in eyes, are good
examples of this. The latter is probably one of the most
important symptoms in the SBS, nevertheless no strong and
reproducible association between exposures and responses
have been found in the field studies. In laboratory environ-
ments, however, it has been shown that several VOCs in
combination will cause chemosensory irritation of eyes and
nasal passages, even when each individual compound is
substantially below its threshold [43]. This effect increases with
number of compounds and with compounds that have a high
number of carbons. The latter off-gas longer due to lower
vapour pressure, therefore, substituting by longer-chained
hydrocarbons to reduce VOC emissions in the short term can
have the contrary effect than envisaged.
For odour, it is also well-known that our senses (the human
nose) are in general much better in detecting compounds than the
measuring instruments used. The development of instruments, an
artificial nose or an electronic nose, that can evaluate the air
quality as the human nose does, is an ongoing activity (i.e. de
European project SysPAQ [44]). Many attempts have been made,
some successful for the purpose they are designed for, others not.
The reason is not only related to the still incomplete knowledge of
the perception mechanism (information processes in brain), but
also to the fact that the nose is able to detect very low concen-
trations. The human nose is able to detect certain compounds at
parts per trillion (ppt) level. Furthermore, not every nose has the
same sensitivity, i.e. the same compound can be detected by some
persons at a much lower level than others. Using human panels to
simulate the behaviour of any person is therefore not easy, even
though many methods exist [41]. And, last but not least, it seems
very difficult to develop sensors (and arrays of sensors) that are
able to detect low levels and at the same time show a stable
performance over time or under influence of changing environ-
mental conditions.
Although available evidence on VOCs causing health effects is
assumed inconclusive for now [45], recently several studies indi-
cate associations between health, asthma or allergy effects and
phthalates [46–48], dampness and mould [50,51] and normal office
dust [49]. Many compounds which are generated in the indoor
environment are semi volatiles such as phthalates, flame retar-
dants, PAHs, chlorophenols, pesticides, organotins and metals,
which may adsorb to particulate matter present in the indoor air
and to house dust. These particles may be inhaled or ingested,
depending on their size. Particulate air pollutants have very diverse
chemical compositions that are highly dependent on their source,
and they are also diverse in terms of particle size. Even though, the
penetration factor from outdoors to indoors lies between 0.5 and
0.9, being greatest for fine particles (PM2.5) and lowest for coarse
(PM10) and UFP (Ultra Fine Particles) [52], the composition of
particles of outdoor origin can be very different from that of
particles from indoor sources [1].
1984
2.9. Problems with IAQ are not only source related, but also
process related
The dynamic process of managing the indoor environment and
thus the indoor air quality, involves many stakeholders, such as the
owner, the end-user, the contractor, but also the persons that
maintain the indoor environment. If those stakeholders do not
understand each other, problems can occur. It all begins with
a definition of the end-users requirements and the translation of
those end-users requirements in the appropriate way. In the
traditional process, the decision process often used is called the
‘over the bench’ methodology, in which a real team is not formed
and communication between the stakeholders does not really
occur. Parties do not understand each other’s stakes or products
and end-users wishes and demands are only incorporated on an
individual basis, causing discrepancies between end-users
requirements and the end-products. Thus, providing another
reason for problems with the indoor environment and its param-
eters (i.e. indoor air quality, thermal comfort, lighting and sound
quality).
3. Discussion
For ‘indoor air quality’, for most of the 20th century, appropriate
ventilation was considered to be enough. Discussions on how much
ventilation is sufficient to prevent noxious odour and spread of
disease are originating from the beginning of the 19th century [53]
and are still going on (see Fig. 4). It was not until the 1990s, that
a different approach than ventilation was considered: source
control. It was finally acknowledged that occupants are not the only
polluters in indoor environments [31] and therefore a ventilation
rate based on carbon dioxide production of occupants was no
longer valid in buildings where occupants were not the dominant
source of pollution.
Considering, however, the status of our knowledge with respect
to the processes taking place at the emitting side (the sources), in
the indoor air and also on the perceiving side, it is not strange that
we have a hard time in defining standards and guidelines for a good
indoor air quality. All these facts make the definition of a good
indoor air quality not easy. Additionally, it can be observed that
even though scientists, but also regulators, are convinced of the
importance of creating and maintaining a good indoor air quality,
for most stakeholders (and specifically the occupant of a building)
minimum ventilation rates
ventilation rate (l/s per person)
20
17,5
15
12,5
10
7,5
5 primary emissions from building products. The down-side being
2,5
0
1825 1850 1875 1900 1925 1950
year
Fig. 4. The recommended minimum ventilation rate changed over the years: from 2
L/s per person by Tredgold in 1836, to 14 L/s per person by Billings in 1895, back to
4.7 L/s person in 1936 by Yaglou to 7.5 L/s person in 1983 [54,55]. The current rec-
ommended minimum ventilation rate by ASHRAE [2] is 2.5 L/s per person added with
0.3 L/s m2 for single person cellular offices (10 m2) and 4 L/s per person added with
0.4 L/s m2 for single person cellular offices (10 m2) by CEN [3].
P.M. Bluyssen / Building and Environment 44 (2009) 1980–1989
are not aware at all that indoor air influences their comfort and
health status. This makes our task even more difficult.
From the practical point of view it is clear that source control
(what is not emitted, one cannot be exposed to) is still the best
option we have: preventing rather than curing. But this should not
stop us in developing additional ways to improve indoor air quality.
This can be and should be encountered at different levels.
3.1. Regulation
From the regulatory point of view, several ways to control the
effect or possible effect on indoor air quality (exposure to indoor air
compounds) are available:
- Minimum allowable emission rates of pollutants from a source
(resulting in labelling or not).
- Ban of use of certain pollutants in products or in general (for
example asbestos, smoking,.).
- A minimum required ventilation rate.
- A maximum allowable concentration level (exposure level) (for
example for formaldehyde).
- Preventive measures such as design approaches, maintenance
activities to prevent growth of Legionella or strict procedures
of intended use of a space or product.
The first two measures are focussed on the source (source
control) while the third and fourth are dealing with the indoor air.
The latter can be a combination of source, indoor air and human
activities.
Regulation is the most powerful tool to force people to create
a good indoor air quality. From the regulator point of view, one
needs a simple way to test whether a building or future building,
fulfils certain rules to reach a good indoor air quality. REACH [9] as
well as the initiative under the CPD to develop a horizontal method
to test potential sources on their emissions [6], is a good way, since
they both start with the source (see Textbox 1 and 2). However,
understanding of the emission behaviour of dangerous substances
from construction products is crucial for making choices on test
conditions for a horizontal standard to assess impacts to indoor air
quality. Purpose of emission evaluation testing is identifying short-
and long-term emission from a construction product under its
intended conditions of use – those emissions that the user of the
building will face after the construction phase has been completed.
Depending on the substance emitted, a different pattern of emis-
sion over time can occur. Therefore, a proper understanding of the
emission of substances from construction products cannot be
obtained from one or two measurements.
Nevertheless, even though knowledge is lacking about the type
of compounds emitted, the mechanisms behind and more impor-
tantly the potential secondary emission that those sources can
cause, this initiative under the CPD stimulates regulation on the
emission side (which is not common at the moment) and possibly
also labelling of products. The use of the Finnish M1 system [62]
over more than 15 years has shown that it is possible to reduce
the fact that in the last decades VOC were substituted with longer-
chained hydrocarbons (SVOC) to reduce emissions. It is therefore
1975 2000 2025 important to measure SVOCs from construction products as well,
even though this most likely has implications for the procedure of
testing (28 days might not be long enough).
Since the relation of growth of microorganism on materials in
buildings with health effects is pretty clear, it is also strongly rec-
ommended to consider testing on the sensitivity to growth of
microorganism. Microbial growth in buildings is a threat to occu-
pants’ health as well as the sustainability of construction products
 P.M. Bluyssen / Building and Environment 44 (2009) 1980–1989 1985

In December 2005, a proposal for regulation was made in the European Parliament and the Council of
Europe, on REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals), establishing a
European Chemical Agency (ECHA) and amending Directive 1999/45/EC [9]. It provides provisions for
substances and preparations that do not adversely affect human health or the environment. For each
substance manufactured or imported in quantities of ≥1 tonne/year, intended to be released from articles
during normal and reasonably foreseeable conditions of use (except cosmetics), there is a general obligation
for manufacturers and importers to submit a registration to the ECHA. This also applies to substances
manufactured or imported as part of a preparation. Downstream users formulating preparations are required
to classify and label the preparation and prepare Safety Data Sheets. In some cases also exposure scenarios
have to be made.

Textbox 1. REACH.

and the building itself. It could well be that this characteristic has
a much larger effect on health than the primary emissions of VOC,
VVOC and/or SVOC altogether.
For HVAC systems, procedures for testing emissions cannot be
the same as for construction and finishing products. Therefore,
a different approach has to be considered including specific
attention to compounds transferred and emitted in the in-use
phase. Procedures for testing components of HVAC systems have
been developed [63], but they require pre-normative work to
become usable for standardisation purposes.
Regulations on maximum allowable concentrations are only
valid if a clear relation has been established between the compound
regulated and health. In practice these regulations are very difficult
to comply with (measurement in homes cannot be performed on
a regular base and the concentration as well as the types of indoor
air pollutants may vary widely as a function of both time and
space). Regulations for products that possibly emit those regulated
compounds are a much better way to go, specially when it concerns
compounds that are (potentially) carcinogenic. In fact, when
a compound has been clearly identified as being carcinogenic it
should be banned and not allowed to be used at all (asbestos is
a good example, but formaldehyde is a candidate as well, especially
originating from ureaformaldehyde resin used in many wood based
products).
Nevertheless, a minimum ventilation rate to dilute pollutant
concentrations is always required. This minimum ventilation rate
should not be based on presence of occupants only, but include
a certain rate per square meter of surface area of a space [2,3]. Even
though materials are selected based on their minimum emission
rates, still some emission will take place, whether it is primary or
desorbed secondary emissions. But it should be noted that only
regulating on ventilation is not enough!
3.2. Awareness
Awareness of the problem is of utmost importance. We see that
for example with architects and housing corporations, but also
product producers and the end-users (occupants) themselves, this
awareness with respect to IAQ in general is not present. Indoor air is
thought to be the same as indoor climate, and therefore related to
thermal comfort aspects such as too warm and too cold. We have
a long way to go in that perspective.
In the European project HealthyAir interviews are performed
with three target groups (product producers, architects and
housing corporations) to inventory the awareness and the ways to
improve awareness, and moreover to identify ways, strategies,
tools, methods to make them to improve indoor air quality [12]. So
far can be concluded that education is of utmost importance.
Education via press releases, television spots, leaflets, internet,
courses for professionals, introduction at elementary schools (with
kids from 6 to 8 years and older for example), in high school pro-
grammes linked to sustainability; specific courses at universities;
involvement of professional organisations (stakeholders), etc.
In the European coordination project EnVIE [10], the starting
point is health effects and how to reduce those via policy making
(see Textbox 3) at European level mainly. A green paper is expected
to be written as a follow-up.
Another way of raising awareness is to make it commercially
attractive for stakeholders to include indoor air quality in their
daily business. The introduction of labelling is a way of doing that.
On the one hand there is an European initiative to establish
a harmonised labelling system for building products and compo-
nents [8] and on the other hand labelling of buildings linked to
sustainability is promoted (see Textbox 4 and 5). At European level,
the technical commission CEN TC 351 could form the base for

DG Enterprise in cooperation with CEN, is closely working with national standardization bodies (e.g.
NEN in the Netherlands) to implement mandate 366 for the CPD (Construction Productive Directive) [6].
The second generation of harmonized product standards under the CPD requires harmonized test methods
for release or emission of dangerous substances to satisfy the requirements of Essential requirement 3
(ER 3) of the CPD.
The European Commission has issued Mandate M/366 to CEN: “Development of horizontal standardised
assessment methods for harmonised approaches relating to dangerous substances under the construction
products directive (CPD) – Emission to indoor air, soil, surface water and ground water” on 16th march
2005 [6]. In the technical committee of CEN, CEN TC 351, the methods are now being developed.
Unfortunately, the methods for emission to indoor air will be based mainly on the existing ISO-16000
series [56-60]. The German regulation on floor coverings [61] and a number of voluntary labelling
schemes in Europe use these series as a base, although some differences can be identified. The ISO-16000
series comprise of standards for sampling of product, for simulating emissions in either a small scale
emission test cell or a larger emission test chamber, and several different ways of sampling and analyzing
the emitted substances. These standards do not take account of secondary emissions and are focused on the
first 28 days of the life of a product (from the moment that the product is unpacked and placed in a space
according to the definitions in EN ISO 16000-11 [60]) under one set of standardized conditions (so-
called reference room).

Textbox 2. Initiative under the CPD.

1986 P.M. Bluyssen / Building and Environment 44 (2009) 1980–1989

The starting points of the EnVIE project were the Europe wide public health effects of indoor air pollution.
The aim was to identify the key policies - existing and new - to improve European IAQ and reduce the
negative health effects of air pollution, both indoors and outdoors. The EnVIE project focussed at the
understanding of the Europe-wide public health impacts of indoor air quality. The project identified the
most widespread and significant indoor causes for these health impacts, and evaluated the existing and
optional building and housing related policies for controlling them. It addressed in particular how indoor
air quality contributes to the observed rise in asthma and respiratory allergy, together with other acute and
chronic health impacts. The project did not intend to conduct new experimental or field research, but rather
to build on the broad scientific experience, as well as the literature of reports and articles from national and
international indoor air research projects as well as the EU, WHO, ISIAQ and CIB committees and expert
groups in the past 20 years.

Textbox 3. EnVIE.

a building product label, while CEN TC 350 is more focused on the
building label linked to sustainability.
Now the question is: Would both labels have a reason for exis-
tence? In other words: will the labels be used by the target groups
for which they are intended? When it is mandatory, of course, the
labels will have to be used. But, eventually it all comes down to the
fact whether they fit the purpose: improve indoor air quality for its
occupants.
A label on product level, will at least ascertain that the total
emissions of products are reduced and therefore the total amount of
substances emitted to the air, will decrease. Since a ‘‘complete
picture’’ of the effects of substances on each other and on people is
missing, the best that can be done is to reduce exposure and
therefore reduce the sources of emissions.
The labels linked to sustainability as they exist today do not
include the detailed information required to identify sources of
pollutants encountered in the indoor air. Those type of labels
provide generalisations of a building. The gathered information
does make it possible to decide whether a building needs to be
improved, or in the worst case when there is no doubt about the
danger the building has to IAQ, has to be destroyed. The labels also
make it possible for regulators to inventory trends on national level,
but for the individual end-user it will never be possible to guarantee
a healthy building based on those kind of generalisations. The
human factor and the changing indoor and outdoor conditions have
too much influence to make a ‘‘static tool’’ as a building label ever
applicable on an individual level, unless the complete picture is
available and simplifications have been made.
3.3. Risk assessment
Both for the establishment of end-users wishes and demands
(requirements and needs), and, the communication process
required to facilitate the design, construction, maintenance and
occupation of an indoor environment, another approach is
required. The approach could, for example, be the so-called inter-
active top–down approach [5], in which two things are essential:
setting the basic requirements at the start and good communica-
tions between all the stakeholders. Risk-assessment forms the
starting point for setting the basic requirements.
Because it is so difficult to directly relate single measurable
physical and/or chemical parameters with health and comfort
effects in the indoor environment, methods using some sort of
a risk assessment have been developed. These methods consider
and list whether a certain source or action can cause a health or
comfort effect in a certain situation. Clearly identifiable relations
have been found between certain building characteristics/user
patterns and self-reported (health) complaints. The relationship
between ‘‘to fulfil recommendations for design, operation and
maintenance of HVAC systems’’ from the European AIRLESS project
[63], and the number of self-reported complaints in the HOPE
project, is an example [68]. When relations between certain
building characteristics/activity patterns and (health) complaints
are known, it is possible to set new/different guidelines (perfor-
mance indicators and performance criteria) and evaluation
methods, based on which new building concepts can be realised.
In the design and construction of a new building, a risk-
assessment procedure for health and comfort of people in the
indoor environment, could for example comprise the following
steps (inspired by Ref. [69]):
1. Identify the end-users wishes and demands, their profile (if
possible the mental and physical status of the end-users of
concern including the context and attributes discussed above)
and try to translate those to boundary conditions and criteria
for the indoor environment.
2. Identify the possible risks involved, with assistance of all
stakeholders involved (including the end-users), related to the
defined environmental criteria and the end-users profile(s).
3. For simple or known risk problems with few uncertainties the
classical quantitative statistics can be used. For example using
existing standards on formaldehyde, PM, etc. Additionally,
known patterns of risks in relation to certain building charac-
teristics should be applied. (Available field study data could for

As a follow-up on the by ISPRA lead inventory of existing labelling schemes in Europe which resulted in
report 24 of the European Collaborative action “Urban air, Indoor environment and human exposure –
Environment and Quality of life” [8], an harmonising initiative was undertaken by 4 major national schemes
(AgBB scheme (regulated by DiBT in Germany) [64], M1 label in Finland [62], AFSSET (France) and
Indoor Climate Label (Denmark) [65] in 2007. It is expected that this initiative will lead to a harmonised
labelling scheme for Europe, eventually.

Textbox 4. Harmonised labelling system for building products.

 P.M. Bluyssen / Building and Environment 44 (2009) 1980–1989 1987

The programme of work within CEN/TC 350, mandated under the EPBD (Energy Performance Building
Directive) [7], will provide a standardised voluntary approach for the delivery of environmental information
on construction products, and for the assessment of the environmental performance of buildings, including
quality of the indoor environment. The objective is to cover all kinds of building products and all kinds of
buildings, new and existing buildings, and possibly other construction works, if appropriate. In the most
recent FP7 call of the European Commission, FP7-ENV-2009-1 a collaborative project could be submitted
on Benchmarking and labelling of the sustainability performance of buildings, which should result in
improved overall quality of the built environment. This call was an opportunity to implement the thoughts
behind the EPBD with respect to indoor environment, but moreover to tune in the current available tools
and methods such as BREEAM, LEED, etc. [66,67].

Textbox 5. Building label.

example be used to create a knowledge based system for thus
purpose).
4. For comfort related risks (those with the possibility that they
could become a health risk), the end-user needs to be involved
directly. A prototype of the object of concern or a reconstruc-
tion of the intended activity could be applied. If necessary,
(scientific) experts need to be consulted. Please do not assume
that there is a standard responding person.
5. For health related risks related to more than one factor and for
which no acceptable standards or guidelines are available, the
balance between efficiency and fairness needs to be discussed.
For example the risk of getting sick from growth of micro-
organisms on a certain material that is known to be favourable
for such growth, is not easily evaluated even if one knows it can
happen. It is a matter for discussion whether it would be
reasonable to use this material in places favourable for growth
such as bathrooms. Another example is the use of HVAC
systems in the light of energy use versus health.
6. If controversy regarding risk aspects occurs (other than the
probability and extent of health damage), or a new risk previ-
ously unknown is identified then the stakeholders should be
involved in subsequent discussion. For example in the risks of
new design concepts using new materials and configuration, it
is perhaps necessary to perform behavioural observations,
interviews, etc.
7. If uncertainties increase in seriousness and extent (for example
climate change effects or (fine) dust from outdoors), a scientific
analysis or even a political societal debate is required. This will
result in a definition of the widely accepted risk problem,
a strategy to measure the problem or to keep it ‘on the table’
and eventually to design a decision framework.
At European level several initiatives focused on indoor air
quality are working with risk assessment (see Textbox 6 and 7).
Unfortunately, they merely focus on indoor air and do not consider
interactions with other parameters of the indoor environment.
4. Conclusions and recommendations
Minimum ventilation rates based mainly on body odour (with
CO2 as an indicator) and to some extent on primary emissions of
some building materials, are not preventing occupants and visitors
of a space to develop health symptoms (cancer, asthma, etc) and/or
comfort complaints (odour, irritation). The indoor air comprises
a complex mixture of compounds of which the source and effects
are hardly known for all, and threshold levels for all seem unreal-
istic considering the numerous compounds. A clear knowledge gap
exists on health and comfort impacts of contaminants and differ-
ences in these impacts among individuals. But also knowledge gaps
exists on the mechanisms between the different pollutants, inter-
actions with other pollutants in the air but also the surfaces of the
sources.
From current research outcomes it seems that there is an urgent
need to involve medicine and neuro-psychology in research to
investigate the mechanisms behind dose-response, health effects
and interactions between and with the other factors and parame-
ters of the indoor environment and the human body and mind. The
use of humans as sensors is herewith of utmost importance.
Allthough several initiatives are being undertaken at different
levels from different point of views to improve the ways to get to
a better indoor air quality, it should be emphasized that, a holistic
approach is required including the sources, the air and last but not
least the human beings (occupants) themselves, in which more
than one way is applied. Even though we do not fully understand
the mechanisms behind the physical, chemical, physiological and
psychological processes, it is still possible to identify the different
ways to be taken regulatory, politically–socially (awareness),
technically (process and product) and scientifically. Several ways

In response to the recommendation presented in the recent update of the WHO air quality guidelines ([1]
2006a) to explore the development of air quality guidelines specifically designed to facilitate the
management of indoor air quality around the world, a WHO working group was formed which met in 2006
for the first time and set the framework for the IAQ guidelines [70,71]. Besides the health-based
recommendations for concentration levels not to be exceeded, the guidelines may formulate
recommendations concerning indoor air quality problems using qualitative indicators, such as existence of
dampness in the building structures leading to microbial growth. The working group also agreed that the
IAQ guidelines should cover three groups of issue: specific pollutants (formaldehyde, benzene, naphthalene,
nitrogen dioxide, carbon monoxide, radon, particulate matter, halogenated compounds, polycyclic aromatic
hydrocarbons (PAH), especially benzo[a]pyrene), biological agents (dampness and mould; ventilation;
allergens) and indoor combustion products (stove venting, ventilation, combustion quality, fuels). In each
case the exposure and its sources, health effects and evaluation of human health risks will be addressed. The
work on biological agents has started focussing on dampness and mould.

Textbox 6. WHO.
1988 P.M. Bluyssen / Building and Environment 44 (2009) 1980–1989

The Scientific Committee on Health and Environmental Risks (SCHER), set by the European Commission,
gave an “Opinion on risk assessment on indoor air quality” (approved by the SCHER on 29 May 2007) [72]).
The SCHER recognises the importance of mixture/combined effects of pollutants and the need for more
exposure data. It recommends the development of health based guideline values for key pollutants and other
practical guidance in general to help risk management were recommended. Formaldehyde, carbon monoxide,
benzene, naphthalene, environmental tobacco smoke (ETS), radon, lead and organophosphate pesticides are
considered to be chemical compounds of concern in the indoor environment.

Textbox 7. SCHER.

Source control
- Reduction of primary emission of sources via testing and labelling: prevention is better than curing
- Prevention of secondary emission by selecting materials and proper maintenance: fit for purpose
Air
- Removal of emission locally (cleaning, ventilation) and filtering air before entering the building
Human
- Education and awareness: tips and tricks for the end-user
- Process and product: interactive top-down approach in the construction process
Tools and methods
- Policies (national and European):
o Labeling/testing of products and buildings linked to sustainability
o Ban of compounds and products that can lead to unhealthy air
- Research:
o Dose-effect, interactions with other parameters, use of human subjects (i.e. odour),
involvement of neuro-psychology and medicine
o Mechanisms at product and in air (Indoor air chemistry)
o Analysis of previous studies
o Outdoor—indoor: relevance of a.o. fine particles
- Pre-normative research:
o Sensitivity to growth of micro-organism as a material characteristic,
o SVOC measurement and evaluation
- Product development: focused on low-emitted products and promoting good indoor air quality

Textbox 8. Holistic and integrative approach.

have been suggested in the above and summarised in Textbox 8. It
is important to realise that those ways should not be undertaken
separately, but integrative and holistically. A number of the facts,
recommendations and conclusions presented in this article are
originating from ‘‘The Indoor Environment Handbook - How to
make buildings healthy and comfortable’’, author: P.M. Bluyssen,
ISBN 9781844077878, a book to be published by Earthscan in
London.
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