Building and Environment 47 (2012) 109e125

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Building and Environment

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Ventilation in European dwellings: A review

C. Dimitroulopoulou
University of West Macedonia, Dept of Mechanical Engineering, Sialvera and Bakola, Kozani, Greece

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

Article history: Adequate ventilation is essential for the health and comfort of building occupants. This review examines,
Received 15 February 2011 first of all, why residential ventilation is an issue of concern in Europe and how is related to the human
Received in revised form health. A review of the current status of residential ventilation standards and regulations in Europe is
15 July 2011
also provided, as a reference. Finally, a review of measurements of ventilation rates in European
Accepted 17 July 2011
dwellings is provided, where the compatibility with the European standards/regulations is examined.
The review shows that ventilation is increasingly becoming recognised as an important component of
Keywords:
a healthy dwelling. Ventilation requirements receive major attention in building regulations, across
Ventilation
Rates
Europe. However, ventilation measurements across Europe show that ventilation is in practice often
Regulations poor, resulting in reduced ventilation rates (lower than 0.5 h
1, which is currently a standard in many
Health European countries), increased concentrations of indoor pollutants and hence exposure to health risk.
Surveys showed that although occupants generally think that ventilation is important, their under-
standing of the ventilation systems in their own houses is low, resulting to under-ventilated homes.
Ó 2011 Elsevier Ltd. All rights reserved.

1. Introduction
Ventilation is the means by which ‘fresh’ air is introduced and
circulated throughout the building while contaminated or ‘stale’ air
is removed or diluted. The primary purpose of ventilation is to create
optimal conditions, in terms of air quality and thermal comfort in
indoor environments, for people living or working there, taking into
account their health, comfort and productivity [1]. The role of
ventilation in residential buildings is mainly to maintain good air
quality by diluting air pollutants. This process is described in more
detail in AIVC Publications (e.g [1,2]). More specifically, the steady
concentration of a pollutant, with a given emission rate, depends on
the ventilation rates. As the ventilation rate increases, the ultimate
steady state pollutant concentration is reduced. However, this
includes an energy penalty. Therefore, the dominant pollutant
needs to be identified in order to reduce the steady state concen-
tration to at or below an acceptable ‘comfort’ and ‘safe’ concentra-
tion. In such a case, the needs for less ventilation and hence less
energy will also be satisfied. However, the removal of pollution
sources is a more effective way to control indoor air quality than
diluting the pollutant concentrations by ventilation. Therefore,
indoor sources should be avoided and eliminated wherever is
possible (e.g. by use of low emitting materials and products) [3].
Today there is a variety of ventilation strategies in various
European countries. In some countries, uncontrolled air infiltration
E-mail address: sanidimi@gmail.com.
and window opening is often the only ventilation, while in others,
passive stack ventilation systems are more or less used. In countries
with colder climates, mechanical systems have been installed,
which are either exhaust only or balanced, with or without heat
recovery units [4,5].
Each system has its advantages, disadvantages and applications.
The choice of ventilation system ultimately depends on indoor air
quality requirements, heating and cooling loads, outdoor climate,
cost and design preference. The choice is often predetermined - in
moist, temperate climates, such as Britain’s, the structure of houses
used to be so leaky that mechanical ventilation was not considered
to be economic. However, in colder climates (e.g. Scandinavian
countries), houses need to be as airtight as possible to conserve
heat. In this case, natural ventilation is often unable to provide
adequate ventilation for odour or contaminant removal and
mechanical ventilation is necessary to achieve minimum ventila-
tion rates. This is also stands for the warmer regions, where
buildings are airtight in order to reduce energy consumption
during cooling rather than heating periods [6]. Apart from northern
Europe, the dominating European ventilation system is natural
ventilation. The natural ventilation systems are driven by wind and
thermally (stack) generated pressures. Designing for natural
ventilation is concerned with harnessing these forces by the careful
sizing and positioning of openings [7].
The infiltration of air through the fabric of the building, which
occurs if the building is not airtight, may lead to energy waste and
sometimes discomfort. It is important, therefore, to achieve

0360-1323/$ e see front matter Ó 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.buildenv.2011.07.016
110 C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125
a balance between indoor air quality, energy conservation and the
necessary ventilation requirements for the wellbeing of occupants
in buildings [5].
The impact of energy reservation on ventilation rates started in
1973 in the States with the Arab Oil Embargo, which led to
increased costs for energy, and thus for the heating of buildings.
This had as a result the tightening of building envelopes and
reduced ventilation. The decrease in ventilation rates coincides in
time with the increase in allergic diseases, since the prevalence of
asthma was increased during the past decades in the industrialised
countries [8,9].
A comprehensive review based on epidemiological studies [9],
of the indoor factors in dwellings that influence the development of
asthma in children concluded that, the most consistent findings are
exposure to environmental tobacco smoke, to traffic related
pollutants that penetrate indoors, and to dampness in homes with
visible moulds. He recommended that more research is needed to
understand better the potential risk for exposure to volatile and
semi-volatile organic compounds due to renovation, painting
activities and floorings, to phthalates and chlorine due to the
frequent use of cleaning chemical agents and, to emissions of damp
mould components. Finally he pointed out that in order to prevent
asthma onset in children, measures that need to be considered is to
avoid or reduce the source and to increase ventilation.
To reduce levels of indoor pollutants, modest improvements in
construction practice and living conditions should aim to eliminate
first the sources, by applying mitigation techniques and supply
simultaneously with adequate ventilation [10,11]. Improved venti-
lation may be advisable even when source control measures have
significantly reduced the indoor concentrations of contaminants
since adequate ventilation is essential for the health, safety and
comfort of building occupants [12].
This review examines, first of all, why residential ventilation is
an issue of concern in Europe and how is related to the human
health. A review of the current status of residential ventilation
standards and regulations in Europe is also provided, as a reference.
Finally, a review of measurements of ventilation rates in European
dwellings has been carried out and the compatibility with the
European standards/regulations is examined.
2. Residential ventilation and health
Ventilation has a significant impact on several important human
responses [13,14]. Low ventilation rates may result in increased
concentration of indoor generated pollutants, which may be asso-
ciated with:
 Sick building syndrome symptoms;
 Comfort (perceived air quality);
 Health effects (inflammation, infections, asthma, allergy), and
 Productivity.
A review of the human responses to ventilation [15] pointed out
that, regarding ventilation in residential buildings, little informa-
tion is available on the health effects of measured ventilation rates.
Following that review, a few conclusive studies were found
regarding residential ventilation and its association to health
effects of vulnerable groups (children and elderly people).
In these studies, the value of 0.5 air changes per hour (h
1),
which is frequently used in national standards/regulations in
Europe (see Section 3), is reported as a threshold below which
associations may occur (see the next sub-Section). However, this
value should not be considered as a recommendation for the
minimum ventilation level, based on health criteria. On-going
research funded by EU DG Sanco (HealthVent project) aims at
developing health-based ventilation guidelines, considering both
health and energy impacts.
2.1. Ventilation and children’s health
Asthma is a complex chronic inflammatory disease of the
airways, which has a characteristic of the reversible airway
obstruction. The clinical diagnosis of asthma is based on the
medical history of the patient, a physical examination and the
exclusion of other diseases with similar symptoms. However, this
diagnosis methodology cannot be used in epidemiological studies
dealing with large population samples, since the reversibility of
airway obstruction can only be tested by repeated medical exam-
ination [9]. Thus, there is no commonly accepted set of criteria to
identify asthma in epidemiological studies. It should also be noted
that studies on asthma, especially in early life (<6 years old), have
a high risk of misclassification, since there is no harmonised diag-
nosis of asthma, worldwide. As a result, the disease may not be
effectively predicted or prevented (e.g [16]). Finally, due to the lack
of harmonisation, asthma may be overdiagnosed in some devel-
oped countries, given that there is also an increased tendency to
diagnose asthma in patients with respiratory symptoms [17].
In the above review [9], it was followed the definition used in
observational studies of “asthma onset” for incidence and preva-
lence studies using ‘doctor’s diagnosed asthma and wheezing with
and without asthma medication. So the results of some of the
studies discussed below should also be seen under this light,
keeping in mind, however, all the above considerations.
In two Nordic studies (Sweden and Norway), no direct associa-
tion was found between home ventilation rates and asthma and
allergy among children ([18,19], Sweden [20];, Norway). However,
in both studies, ventilation rates greater than 0.5 h
1 were
reported.
More specifically, the Swedish studies [18,19] examined the
impact of building characteristics and indoor air quality on recur-
rent wheezing in infants (4089 children) in Stockholm, during their
first 2 years of their life. The mean ventilation rate was 0.68 h
1.
They found out that the age of the building, certain types of
buildings (e.g. relatively new apartment buildings and single-
family homes with crawl space/concrete slab foundation), and
indoor air humidity (>45%) were associated with recurrent
wheezing in children up to the age of two. The results from this
study should be seen keeping in mind that a reliable diagnosis
cannot be achieved under the age of six. A strong correlation
between indoor and outdoor humidity levels were also found
during the winter months, which shows that indoor humidity was
influenced by that outdoors. A weak association was found
between ventilation rates and NO2 levels in homes with no NO2
indoor sources.
In the Norwegian study, 63% of the homes had rates greater than
0.5 h
1 [20,21]. In this study, it was hypothesised that bronchial
obstruction among children was associated with exposure to
phthalates from PVC materials and with dampness and that this
association became elevated at a low ventilation rate (below
0.5 h
1). However, the hypothesis regarding the potential role of
phthalates exposure to asthma was severely criticised [22,23]. The
former [22] concluded that there are no reported chemicals in
indoor environments that promote development of allergy by
adjuvant effects (in agreement with [24,25]). Indoor dust was
associated with allergy-promoting effects in humans, although
further research is required. Exposures to dampness and combus-
tion particles (e.g. [26]) may also be associated with the promotion
of asthma and asthmatic symptoms, but not the phthalates.
Insufficient ventilation has recently been associated with the
observed increase in allergic diseases among children. The relation
 C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125
between IAQ and asthma/allergy was studied in a Swedish inves-
tigation comprising 11,000 children [27,28]. Detailed chemical,
physical, biological and medical measurements were performed in
200 homes with asthmatic children (cases) and 200 homes with
healthy children (controls). In contrast to the previous studies with
higher ventilation rates, the single-family houses had a mean rate
of 0.36 h
1, whereas the multi-family house had a rate of 0.48 h
1.
The results showed that allergic symptoms were related to venti-
lation. Cases with doctor-diagnosed rhinitis and eczema lived in
single-family houses where the ventilation rates in the child’s
bedroom (0.35 h
1) were lower compared with controls (0.51 h
1).
However, no association was found between ventilation rate and
doctor-diagnosed asthma. The lack of an association indicates that
there are no immunological mechanisms involved. Instead, a low
ventilation rate could be considered as a risk factor for irritation.
The effects of different types of buildings to cases and controls
were also examined [28]. Regarding single-family houses, cases
were more likely than controls to live in houses that had
mechanical exhaust ventilation, were constructed in the period
1961e1983, had a concrete foundation, and were one-storey
buildings. In multi-family houses and row houses, there were no
significant effects to the cases and controls, given also the higher
ventilation rates measured there.
Adequate ventilation is important to reduce indoor air humidity.
This is confirmed by the negative correlation between ventilation
rate and the indoor humidity found in another study [19]. Indoor air
humidity increases the risk of dampness in dwellings and of
infestation with house dust mites (HDM). Excess moisture on
indoor materials leads to microbial growth, i.e., mould, fungi and
bacteria, which subsequently emit spores, cells, fragments and
MVOCs into indoor air (e.g. [29e32]). Sufficient epidemiological
evidence from different studies and under different climatic
conditions show that the occupants of damp or mouldy houses are
at increased risk of respiratory symptoms, respiratory infections
and exacerbation of asthma. Some evidence suggests increased
risks of allergic rhinitis and asthma (e.g. [33e37]). For instance,
damp housing was one of the factors associated with wheeze ever,
significantly associated with recurrent wheeze and strongly asso-
ciated with severe wheeze in a study of Dutch infants (1115 ques-
tionnaires), in their first year of their life [38].
Observations and measurements were carried out in a nested
caseecontrol study of 198 children with asthmatic and allergic
symptoms (cases) and 202 healthy controls, in Sweden [39]. These
were performed by inspectors, and the children were examined by
physicians for diagnoses of asthma, eczema, and rhinitis. They
found an association between mouldy odour along the skirting
board (which can be a proxy for hidden moisture problem inside
the wall construction or in the foundation construction) and
allergic symptoms among children, mainly rhinitis. They pointed
out that the highest odds ratios for case children were found in
homes with a low ventilation rate (below the median of 0.34 h
1)
and the strongest association was found for rhinitis. They did not
find any associations with any of the allergic symptoms for dis-
coloured stains, floor dampness or a general mould odour in the
rooms. Furthermore, in a subsequent study, no association could be
found between the spore concentration in indoor air and asthma/
allergy in the children [36].
Exposure to HDM is a well-known risk for sensitisation and
symptoms among sensitised persons (e.g. [40,41]). For dwellings in
a Nordic climate, the EUROVEN group concluded that ventilation
rates above 0.5 h
1 decrease the risk infestation of HDM [14]. Based
on the results of theoretical modelling, a study in the UK suggested
that although in most cases 0.5 h
1 is required to avoid mould
growth, significantly higher ventilation rates (0.8 h
1) may be
required to control mites’ growth [42]. Although there is evidence
111
that mechanical ventilation in combination with improved thermal
insulation of walls and windows reduce indoor RH and HDM
allergen burden (e.g. [32,43]), the clinical effects of mechanical
ventilation remained unproven.
The hypothesis that, domestic mechanical heat recovery
(MHRV), in addition to allergen avoidance measures can improve
asthma control, was recently tested in half the homes of 120 adults
with asthma in the UK, allergic to Der p 1 [44]. They did not find any
effect of MHRV on mite allergen levels, but indoor relative humidity
(RH) was improved and evening peak expiratory flow of the MHRV
group also improved compared to the control group. This suggested
that improved ventilation may need to be considered in the
bedrooms of asthmatic children.
Furthermore, another study was carried out to test the
hypothesis that targeted low-cost interventions in homes of asth-
matic children improve asthma symptoms [45]. The major inter-
ventions were HVAC servicing, dehumidification, and improved air
filtration. The most effective intervention types at reducing
breathing problems were HVAC servicing (p < 0.05) and dehu-
midifiers (p < 0.05). Coughing was significantly reduced (p < 0.005)
for homes with one of the three interventions and for homes
receiving all interventions. Wheezing was slightly but not signifi-
cantly decreased for all interventions and increased or stayed the
same when dehumidification and room air cleaners were evaluated
alone.
Although a few intervention studies are available, their results
show that remediation of dampness problems can reduce adverse
health impacts [37]. According to WHO guidelines, well-designed,
well-constructed and well-maintained building envelopes can
prevent and control excess moisture and microbial growth. Control
of temperature and ventilation distributed effectively throughout
spaces are required to avoid excess humidity, condensation on
surfaces and excess moisture in materials.
Finally, home ventilation can modify the risk of asthma/allergic
symptoms among children due to exposure to outdoor traffic
penetrating indoors. Increased ventilation rates may have a negative
effect on indoor air quality. Thus, in homes with no indoor sources,
a positive correlation between indoor and outdoor NO2 levels was
reported (e.g. [19]). However, homes with air-conditioning can have
reduced ventilation rates and hence smaller exposure to indoor
pollutant levels of outdoor origin. A cross-sectional study of 2994
children living in homes without any other risk factors [46], reported
that for preschool children sleeping in non-air conditioned homes,
there were strong associations between asthma and rhinitis symp-
toms studied; however, there were no associations for children
sleeping in air-conditioned homes.
2.2. Ventilation and elderly
A survey of 96 subjects was carried out between the ages of 60
and 95 years, living close to Paris in a social collective habitat [47].
Their results suggest that the lifestyle and the behaviour of elderly
people (e.g. long hours of gas-cooking, overuse of chemical
cleaners, increased time spent in the kitchen instead of the living
room, drying clothes in the living room) cause indoor air pollution.
However, they point out that the principal risk for health problems
is inadequate ventilation (e.g. unclean screens, blocked air vents
and closed windows), which increases the concentration of indoor
pollutants. These risks are amplified by ignorance or negligence
about the hazards of indoor pollutants and inadequate ventilation.
2.3. Ventilation and perceived IAQ
The “sick building syndrome” [48] involved a set of symptoms
which office workers have reported, although today attention is
112 C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125
given on single symptoms [49,50]. However, there is not much
information on how common these symptoms are among the
occupants of dwellings and whether the occurrence of the symp-
toms is related to the home environment.
A study in the Helsinki Metropolitan Area [51] was performed
among 473 occupants of 242 dwellings (houses and apartments),
with different ventilation systems, in order to evaluate the occur-
rence of “sick building syndromes” and the perception of poor
indoor air quality among the occupants. Simultaneously, a two-
week period of indoor air quality monitoring was performed
between November 1988 and April 1989. Their main conclusions
were as follows:
 The most common perception was stuffiness;
 22% of the occupants perceived that the ventilation rate of the
bedroom was often insufficient;
 46% of the occupants felt the bedroom air was sometimes or
often stuffy in the mornings during the two weeks;
 40% of the occupants felt the bedroom air was usually too dry
in winter-time;
 At least one day over the two-week period,
B Half of the occupants reported that they had had sneezing
(51%) and/or nasal congestion (50%);
B One third of the occupants expressed nasal discharge (34%),
nasal dryness (33%), dryness or itching of the skin (36%),
headache or migraine (31%) and lethargy, weakness or
nausea (35%);
B 25% of the occupants reported that they had had cough and
19% dryness, irritation or itching of the eyes, whereas 6% of
the occupants expressed breathlessness on at least one day
during the two weeks.
The occupants of the apartments reported systematically more
symptoms and perception of poor indoor air quality than the
occupants of the houses. Furthermore, the occupants of the natu-
rally ventilated houses reported eight out of ten symptoms and
complaints more commonly than those in the houses with
balanced ventilation. However, the measurements of ventilation
rates in the different types of dwellings did not provide a clear
answer regarding the differences in the occurrence of symptoms
and complaints, since the measured air change rates were on
average higher in the apartments (0.64  0.30 h
1) than in the
houses (0.45  0.22 h
1).
Reduced ventilation flow in dwellings below the value of 0.5 h
1
may cause a perception of impaired air quality. A one-year cross-
over intervention study [52] was carried out in 44 subjects in
a multi-family building, to determine if seasonal adapted ventila-
tion (i.e. a 25e30% reduction of outdoor ventilation flow during
heating season) influenced sick building syndrome (SBS) and the
perception of the indoor environment. Their measurements
showed that reduced ventilation slightly increased the relative air
humidity by 1e3% in the living room and 1e5% in the bathroom,
during heating season, increased the room temperature slightly by
0.1e0.3  C, and the mean CO2 concentration in the bedroom. The
indoor air quality was perceived as poorer, whereas there was
a significant increase of stuffy odour. However, there was no
significant influence on SBS symptoms or specific perceptions such
as draught or air dryness.
3. Regulations on ventilation in European dwellings
On European level, there are two directives that relate to
ventilation, but in an indirect way: the Construction Product
Directive (CPD, 1989), and the Energy Performance of Buildings
Directive (EPBD, 2002). Thus, CPD requires construction product
standards that relate to hygiene, health and the environment to be
aligned within the member countries, whereas EPBD mentions that
energy “requirements shall take account of general indoor climate
conditions, in order to avoid possible negative effects such as
inadequate ventilation”. The European Committee for Standardi-
zation (CEN) is the body responsible for most of the standards
relating to ventilation. Many standards have already been pub-
lished and others are in development [53].
Table 1 summarises the standards/regulations related to the
whole building and room by room ventilation rates in European
dwellings. These derived from AIVC Annotated Bibliography 13
[48], a review paper on ventilation regulations [54] and other
individual sources ([55] for Portugal [56]; for Czech Republic).
4. Measurements/modelling of residential ventilation rates
Measurements of ventilation rates as well as modelling work
have been carried out in several European Countries with emphasis
given in the Nordic Countries as well as the North European.
Recently, ventilation measurements were also reported in the
Mediterranean countries. The ventilation conditions of dwellings in
a number of European countries are discussed in this Section. The
results from monitoring or modelling studies for all the countries
are reported in Table 2.
4.1. Belgium
Building regulations in Belgium have recently been in place. The
regulation on the Energy Performance of Building (in place since
2006 in Flanders, since 2008 in Brussels Region and foreseen in
2010 in the Walloon Region) requires that new buildings fulfil
certain ventilation requirements (standard NBN D 50-001). No legal
requirements are in place for the airtightness of buildings. In
consequence, it is expected that new constructed building will
become more and more airtight and the ventilation rates are
expected to decrease.
Given the absence of regulation, there are no reported measure-
ments of ventilation rates in the open literature. However, modelling
work has been carried out using CONTAM to determine the air
change rates in a model detached house, for various conditions and
systems of ventilation, under fixed conditions for airtightness, and
for compliance with the standard NBN D 50-001 [57].
The parameters used in the simulations are briefly summarised
below.
 Building model house with 4 façades, floor space of 153.7 m2
and volume of 379.7 m3.
 Dynamic simulations during the heating season (from 28/9 to
15/4) using Contam.
 Ventilation:
B System A standard I (natural ventilation), according to NBN
D 50-001;
B System C standard I (natural supply and mechanical
exhaust), according to NBN D 50-001;
B System D standard I (mechanical ventilation), according to
NBN D 50-001;
B System "D low energy", characterised by a lower operation
flow (about 50% for the flow of fresh air) and an air recycling
from 2 bedrooms to the living room;
B System "D occupancy” the ventilation system operates on
occupant demand (assuming an occupancy profile).
 Airtightness of the building envelope:
B 3 m3/h/m2 for the System D low energy;
B 12 m3/h/m2 for all the other systems.
Table 1
Ventilation standards/Regulations in European dwellings.

Country and Standard/ Whole building Living room Bedroom Kitchen Bathroom þ WC WC only
Regulation reference ventilation rates
Belgium (NBN D Supply Supply Exhaust Exhaust Exhaust
50-001 1991) 1 l/s/m2 1 l/s/m2 1 l/s/m2 1 l/s/m2 25 m3/h
<21 m2, <7 m2, <14 m2, <14 m2,
75 m3/h 25 m3/h 50 m3/h 50 m3/h
21e42 m2, 7e20 m2, 14e21 m2, 14e21 m2,
3.6 m3/h.m2 3.6 m3/h.m2 3.6 m3/h.m2 3.6 m3/h.m2
>42 m2 >20 m2 >21 m2 or open >21 m2
150 m3/h 72 m3/h 75 m3/h 75 m3/h
Czech Republic (CSN 0.5 h
1 0.3e0.6 h
1 0.3e0.6 h
1 Extraction: Extraction: Extraction:
73 4301 Residential 100 m3/h 75 m3/h 25 m3/h
Buildings,
CSN 73 0540 Thermal
protection of
Buildings)
Denmark (DS 418:2002) 0.5 h
1 Supply fresh air: Hinged Supply: Hinged window, Supply: Hinged window, Supply: Hinged

C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125

Finland (NBC e D2) > 0.4 h
1
General rule: Outdoor air
flow should be at least
0.35 l/s.m2 (1.26 m3/h.m2)
France (Arreté du Min air flow for dwellings,
24.3.82) according to number of
habitable rooms (R)
1 R: 105 m3/h
2 R: 120 m3/h
3 R: 150 m3/h
4 R: 165 m3/h
5 R: 210 m3/h
6 R: 210 m3/h
7 R: 210 m3/h
Germany (DIN 1946 <50 m2, up to 2 occupants,
Part 6, DIN 18017, Nat. vent: 60 m3/h Mech.
VDI 2088) vent: 60 m3/h
50e80 m2 up to 4 occupants
Nat. vent: 90 m3/h Mech.
vent: 120 m3/h
>80 m2 up to 6occupants Nat.
vent: 120 m3/h Mech. vent:
180 m3/h
window, hatch or door,
together with one or more
fresh air valves
Small dwellings: total clear
opening of at least 2.4 cm2/
m2 (nat. vent) 1.2 cm2/m2
(mech.vent)
Multi-storey: total clear
opening of at least 1.2 cm2/m2
0.5 l/s/m2
(1.8 m3/h.m2)
1.0e1.5 h
1
hatch or door, or fresh hatch or door, or fresh window,hatch or
air valve. air valve. And/or opening door, or fresh air
Extraction: 20 l/s (72 m3/h). to the access. valve. And/or opening
The air shall be extracted Extraction: 15 l/s to the access.
through an extractor hood. (54 m3/h) Extraction: 10 l/s
(36 m3/h)
Min 4.0 l/s/person or Exhaust 20 l/s (72 m3/h) Exhaust 15 l/s (54 m3/h)
0.7 l/s/m2 floor area
(2.52 m3/h.m2)
Extract flow depends on 1 R: 15 m3/h 1 R: 15 m3/h
number of habitable 2 R: 15 m3/h 2 R: 15 m3/h
rooms (R). 3 R: 30 m3/h 3 R: 15 m3/h
Continuous: 20e45 m3/h 4 R: 30 m3/h 4 R: 30 m3/h
Intermittent:: R: 75 m3/h 5 þ R: 30 m3/h 5 þ R:
(min 35 m3/h) 30 m3/h
2 R: 90 m3/h
(min 60 m3/h)
3 R: 105 m3/h
(min 75 m3/h)
4 R: 120 m3/h
(min 90 m3/h)
5 þ R: 135 m3/h
(min 105e135 m3/h)
Normal: 40 m3/h (>12 h 40 m3/h (>12 h occup./day) 20 m3/h (>12 h
occupation/day) 60 m3/h 60 m3/h (overall air flow) occup./day) 30 m3/h
(overall air flow) (overall air flow)
Purge: 200 m3/h (>12 h
occupation/day) 200 m3/h
(overall air flow)
Kitchenet: 40 m3/h (>12 h
occupation/day) 60 m3/h
(overall air flow)
(continued on next page)

113
Table 1 (continued )

114
Country and Standard/ Whole building Living room Bedroom Kitchen Bathroom þ WC WC only
Regulation reference ventilation rates
Greece (Greek Detached houses, Estimated Detached houses Detached houses Detached houses and Flats, Detached houses and Flats,
Legislative 5 persons/100 m2 of floor area. and Flats, and Flats, Min: Min: Min:
Framework Block of Flats, Estimated 7 Min: 8.5 m3/h/p 34 m3/h/p 34 m3/h/p Recommend:
Document) persons/100 m2 of floor area. 8.5 m3/h/p Recommend: Recommend: 50e85 m3/h/p
Recommend: 12e17 m3/h/p 50e85 m3/h/p
12e17 m3/h/p
Italy (Ministerial Decree Naturally ventilated dwelling 15 m3/h/p 1.0 h
1 2.0 h
1
05.07.75) 0.35e0.5 h
1
Netherlands(Building 300 m3/h 0.9 dm3/s/m2 floor area 0.9 dm3/s/m2 floor area 21 dm3/s (75.6 m3/h) 14 dm3/s (50.4 m3/h) 7 dm3/s (25.2 m3/h)
Decree) (3.24 m3/h/m2) (3.24 m3/h/m2)
Norway (Norwegian Not less than 0.5 h
1 Supply: Openable window Supply: Openable window Extract: 10 l/s þ 20 l/s Extract: Min 10 l/s Extract: 10 l/s
Building Code) or inlet bigger than 100 cm2 or inlet bigger than 100 cm2 (from exhaust hood in use) (36 m3/h) (openable (36 m3/h)
in external wall. in external wall. ( 36 m3/h þ 72 m3/h) window) Max 30 l/s
(108 m3/h)
Portugal (NP 1037e1 1.0 h
1 1.0 h
1 4.0 h
1 4.0 h
1
Standard for natural

C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125

ventilation)
Sweden Requirements: Rooms shall Recommend: Not less than Extract: Min 10 l/s 10 l/s (36 m3/h) with
(Swedish Building have continuous 0.35 l/s/m2 4.0 l/s/person (14.4 m3/h/p) (36 m3/h) Kitchenette openable window or
RegulationsBBR94) floor area (1.26 m3/h/m2) 15 l/s (54 m3/h) 10 l/s with high speed
when in use; rate up to 30 l/s
This corresponds to 0.5 h
1 (108 m3/h) or 15 l/s
in a room with height 2.5 m. (54 m3/h) without
openable window
Switzerland (SIA 180, 12e15 m3/h/person (non-smoking,
1988) max CO2 1500 ppm) 30e70 m3/h/
(SIA 382, 1992) person (smoking)
25e30 m3/h/person (non-smoking,
max CO2 1000 ppm)
Air change rate in unoccupied
rooms more than 0.3 h
1
UK (Building Rapid vent (opening Rapid vent (opening Rapid vent: opening window Rapid vent: opening Rapid vent: opening
Regs. Approved windows): 1/20th of floor windows): 1/20th of Background vent: 4000 mm2 window Background vent: window Background
Doc. F) area Background vent: floor area Background Extract: 30 l/s adjacent to hob 4000 mm2 Extract: 15 l/s vent: 4000 mm2
8000 mm2 vent: 8000 mm2 or 60 l/s elsewhere or PSV or PSV Extract: 15 l/s or PSV.
 C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125 115

4.2. Denmark window (higher rates at less condensation), year of construction

Studies from Denmark performed in homes built in the mid
1980’s indicated that the ventilation rates in naturally ventilated
dwellings were lower than 0.5 h
1, which has been the minimum
requirement in the Danish building code for more than 20 years.
For instance, a study [58] (reported in [59]) carried out measure-
ments in 28 dwellings and found despite the mean value was
greater than the required, about 30% of the dwellings had a venti-
lation rate lower than 0.5 h
1. Similarly, low values were reported
by a study that performed ventilation measurements during the
winter period (October to March) in 117 single houses built over the
period 1984e1989 [60]. The homes were situated in suburban and
rural areas in Denmark.
CO2 measurements were carried out in 500 children’s bedrooms
and the corresponding ventilation rates were estimated [59]. The
subset of 500 children was between 3 and 5 years of age and was
selected as the second phase of a large investigation, involving
11,120 children, on the impact of the indoor environment on
asthma and allergy among children in Odense, Denmark. The 500
children represented 200 symptomatic children (cases) and 300
randomly selected children (bases). The results show that similar
ventilation rates for bedrooms were estimated in both cases. The
rates were higher while more people sleeping in the measured
room. In both groups, 57% of the rooms did not fulfil the minimum
requirement of 0.5 h
1.
Following this study, the same team [61] analysed the ventila-
tion rates measured previously by some of the most significant
variables e.g. room volume (higher rates in smaller rooms), number
of people sleeping in the bedroom (higher rates with more people),
average window and door opening habits (higher rates with more
opening), sharing the bedroom with other family members (higher
rates in shared rooms), location of the measured room (higher rates
above ground floor), observed condensation on the bedroom
(lowest rates in buildings from early 1970s). The generally low
ventilation rates in newer homes may raise concern about whether
or not current construction practices meet the ventilation
requirements set by the current guidelines.
4.3. Finland
A sample of 242 dwellings, with different ventilation systems
(natural ventilation, mechanical exhaust and balanced ventilation
(mechanical supply and exhaust)) was studied in the Helsinki
Metropolitan area over periods of two weeks during the
1988e1989 heating season [51,62]. The air exchange rates had
a high variation, but the majority of the dwellings (73%), had rates
between 0.2 and 0.7 h
1. The recommended Finnish value (0.5 h
1)
was achieved in less than half of the dwellings (48%). The ventila-
tion rates were significantly lower in the houses than in the
apartments. However, comparison of the different ventilation
systems did not reveal any great differences.
Finland is the country with the highest market penetration of
mechanical supply and exhaust ventilation in the EU [63]. Almost
all new dwellings are fitted with mechanical ventilation with heat
recovery (MVHR) systems. Ventilation practice in Finland changed
as a result of the changes in regulation in 2003. According to this,
guideline ventilation rates increased from 4 to 6 l/s per person and
required a minimum of 30% heat recovery from exhaust air.
To examine the effect of this system on ventilation, a study was
carried out in 102 newly built detached houses in Finland [64]. Air
flow rate measurement showed that only 57% of the houses
complied with the regulations. The non-compliance was a result of
occupants reducing fan speeds to reduce noise. There were
complaints of noisy systems, which correlated closely with noise
levels in bedrooms. The study revealed that the fan speed was very
rarely changed.

Table 2
Ventilation measurements and modelling in European countries.

Study Country Number of buildings Ventilation Units (h
1, m3/h, Comments

rates m3/h.m2)
De Brouwere et al. Belgium 1 detached dwelling, 1.033  0.37 h
1 A standard I/Airtightness 12 m3/h/m2
(2009) modelling study using (0.198e2.897,
CONTAM 15-min values)
1.016  0.32 h
1 C standard I/Airtightness 12 m3/h/m2
(0.482e2.57,
15-min values)
1.289  0.209 h
1 D standard I/Airtightness 12 m3/h/m2
(1.048e1.628,
15-min values)
0.368 for infiltration
0.921 for ventilation
0.603  0.087 h
1 D low energy I/Airtightness 3 m3/h/m2
(0.503e1.24) (15-min values) for infiltration for
0.142 ventilation
0.461
0.83  0.24 h
1 D occupancy I/Airtightness 12 m3/h/m2
(0.18e2.24) (15-min values)
Hänninen et al. (2004) Czech Republic 50 dwellings, esimates 0.75  0.43 h
1 EXPOLIS study, Prague, estimated rates
from PM2.5 monitoring data analysis
Kvistgaard et al. (1990; Denmark 28 dwellings 0.67 h
1 Mean
reported in Bekö
et al., 2010
Bergsøe Denmark 123 dwellings 0.33 or 0.86 h
1 m3/h.m2 Single-family houses with natural
(1991; reported in ventilation, mean
Bekö et al. (2010) and 0.55 or 1.37 h
1 m3/h.m2 Single-family houses with mechanical
in Øie et al. (1998)) exhaust ventilation, mean
0.59 or 1.44 h
1 m3/h.m2 Apartments with exhaust ventilation, mean
Andersen et al. (1997) Denmark 117 single-family 0.34 (geo.m) h
1 Winter measurements (October to March).
one-story houses; 0.37 (ar. m)
(continued on next page)
116 C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125

Table 2 (continued )

Study Country Number of buildings Ventilation Units (h
1, m3/h, Comments

rates m3/h.m2)
Bekö et al. (2010) Denmark 500 children’s homes 0.46  2.09 (geo m) h
1 Case study (200 homes)
0.62  0.56 (ar. m)

1
0.46  2.13 (geo m) h Base study (300 homes)
0.62  0.59 (ar. m)
0.41 (geo m) h
1 80% of homes, with windows closed
0.52 (ar. m)
0.76 (geo m) h
1 19% of homes, with windows open
1.05 (ar. m)

1
0.24 (geo m) h 1% of homes, with door and window closed
0.31 (ar. m)
Bekö et al. (2011) Denmark 500 children’s homes 0.68 (a.m)/0.50 (g.m) h
1 Volume of measured room (n ¼ 500)**
e ventilation data analysis 0.61 (a.m)/0.46 (g.m) Smaller than 20 m3 (24.8%)
Notes: 0.58 (a.m)/0.41 (g.m) 20e30 m3 (49.6%)
*1st phase questionnaire Bigger than 30 m3 (26.6%)
**Home inspection 0.56 (a.m)/0.41 (g.m) h
1 Size of dwelling (n ¼ 496)*
***parent-recorded during 0.63 (a.m)/0.47 (g.m) 70e89 m2 (12.1%)
the days of measurements 0.70 (a.m)/0.50 (g.m) 90e109 m2 (15.7%)
0.59 (a.m)/0.45 (g.m) 110e139 m2 (24.6%)
>140 m2 (47.6%)
N/A h
1 Location of measured room (n ¼ 492)*
0.53 (a.m)/0.40 (g.m) Basement (0)
0.70 (a.m)/0.52 (g.m) Ground floor (GF) (52.4%)
Higher (H) (47.6%)
0.59 (a.m)/0.44 (g.m) h
1 Ventilation in the home (n ¼ 500)**
0.66 (a.m)/0.49 (g.m) Natural incl. kitchen fan (58.8%)
Mechanical exhaust (n ¼ 202) or exhaust
and supply (n ¼ 4) (41.2%)
0.61 (a.m)/0.44 (g.m) h
1 Vicinity to road (n ¼ 486)**
0.63 (a.m)/0.48 (g.m) Highway/heavily trafficked road (66.0%)
Quiet road (34.0%)
0.67 (a.m)/0.50 (g.m) h
1 Constr. year of the dwelling (n ¼ 482)*
0.46 (a.m)/0.48 (g.m) Before 1941 (I) (26.3%)
0.54 (a.m)/0.40 (g.m) 1941e1960 (II) (21.4%)
0.47 (a.m)/0.41 (g.m) 1961e1970 (III) (17.2%)
0.75 (a.m)/0.54 (g.m) 1971e1976 (IV) (10.0%)
0.72 (a.m)/0.47 (g.m) 1977e1983 (V) (7.3%)
0.53 (a.m)/0.45 (g.m) 1984e1993 (VI) (6.4%)
After 1993 (VII) (11.4%)
0.63 (a.m)/0.47 (g.m) h
1 House type (n ¼ 491)*
0.62 (a.m)/0.45 (g.m) Family house (69.2%)
0.54 (a.m)/0.41 (g.m) Row house (18.3%)
Apartment (12.5%)
0.62 (a.m)/0.46 (g.m) h
1 Dwelling location (n ¼ 492)*
0.59 (a.m)/0.44 (g.m) City (43.9%)
0.63 (a.m)/0.47 (g.m) Suburb (45.7%)
0.78 (a.m)/0.56 (g.m) Rural area (5.9%)
Village (4.5%)
0.46 (a.m)/0.38 (g.m) h
1 No. of people sleeping in the bedroom
0.63 (a.m)/0.48 (g.m) (n ¼ 500)***
1.08 (a.m)/0.82 (g.m) 1 (59.2%)
1.39 (a.m)/1.09 (g.m) 2 (24.2%)
3 (12.4%)
4 or 5 (4.2%)
0.48 (a.m)/0.39 (g.m) h
1 Sharing the bedroom (n ¼ 486)*
0.60 (a.m)/0.46 (g.m) Own room of child (59.5%)
1.03 (a.m)/0.73 (g.m) Shared with siblings (20.4%)
Shared with parents (20.1%)
0.52 (a.m)/0.41 (g.m) h
1 Average window opening during night
1.05 (a.m)/0.76 (g.m) in the measured room (n ¼ 495)***
N/A Closed (80.8%)
Ajar (19.2%)
Fully open (0)
0.48 (a.m)/0.30 (g.m) h
1 Average door opening during night in
0.55 (a.m)/0.43 (g.m) the measured room (n ¼ 479)***
0.71 (a.m)/0.53 (g.m) Closed (9.6%)
Ajar (45.3%)
Fully open (45.1%)
0.70 (a.m)/0.53 (g.m) h
1 Condensation in winter on the window of
0.59 (a.m)/0.43 (g.m) the measured room (n ¼ 473)*
0.54 (a.m)/0.40 (g.m) None (31.9%)
<5 cm (49.3%)
>5 cm (18.8%)
 C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125 117

Table 2 (continued )

Study Country Number of buildings Ventilation Units (h
1, m3/h, Comments

rates m3/h.m2)
Ruotsalainen et al. Finland 242 dwellings 0.52 h
1 3 ventilation systems, mean value
(1991; 1992) (also (0.07e1.55) (range)
reported in Øie 0.45  0.22 Houses
et al., 1998) 0.64  0.30 Apartments
0.41  0.22 Natural ventilation
0.46  0.19 Mechanical ventilation
0.49  0.26 Balanced ventilation
1.01 m3/h.m2 Single-family houses with natural
1.12 ventilation, mean
1.26 Single-family houses with mechanical exhaust
1.55 ventilation, mean
1.69 Single-family houses with balanced ventilation
1.52 Apartments with natural ventilation, mean
Apartments with exhaust ventilation, mean
Apartments with balanced ventilation, mean
Kurnitski et al. (2007) Finland 102 newly built 0.4 h
1 Houses equipped with MVHR systems
detached houses
Hänninen et al. (2004) Finland 50 dwellings 0.81  0.85 h
1 EXPOLIS study, Helsinki,
estimated rates from PM2.5 monitoring
data analysis
Lucas et al. (2009) France 447 bedrooms 27.4 (1e212) m3/h Night-time measurements 1 h e 5 h10 am
(peak values)
19.8 (1e142) m3/h Night-time measurements, average
18.0 m3/h Night-time measurements, median
10.0 Night-time measurements, median, closed
doors and windows
94 bedrooms 32.9 (4e210) m3/h Night-time measurements, no ventilation
system
46 bedrooms 23.5 (3e119) m3/h Night-time measurements, local fans
169 bedrooms 22.7 (3e196) m3/h Night-time measurements, mechanical
ventilation
138 bedrooms 29.6 (1e212) m3/h Night-time measurements, natural
ventilation
Mailahn et al. (1989) Germany 10 houses in West Berlin 1.2 (0.3e3.7) h
1 September 1986eApril 1987
1.0 (0.2e1.8) Hexafluorobenzene (HFB tracer)
Polytetrafluoroethylene (PTFE tracer)
Kroob et al. (1997) Germany 0.36 h
1 Dwellings
Reported in 0.65 Rooms with double windows, with sealing
BIA (2001) 0.78 Rooms with double windows, without sealing
0.35 Rooms with highly insulated windows
Feist et al. (2007) Germany Modelling results 0.4 h
1 PassivHaus Standard
(minimum 0.3)
Santamouris et al. Greece 50 dwellings 1.14  1.05 h
1 Winter 2004, naturally ventilation
(2007) 0.74 Smoking activity (median)
0.52 Non-smoking dwellings (median)
Sfakianaki et al. (2008) Greece 20 dwellings Range 0.5e1.5 h
1 Summer 2005, naturally ventilation
1.5 Low airtightness level (10 h
1 at 50 Pa)
0.5 Tight dwellings (4 h
1 at 50 Pa)
Bartzis et al. (2009) Greece 2 flats 0.21 and 0.28 h
1 Winter, natural ventilation
0.97 and 0.35 Summer, natural ventilation
Hänninen et al. (2004) Greece 50 dwellings, 1.3  1.1 h
1 EXPOLIS study, Athens,
estimates estimated rates from PM2.5 monitoring
data analysis
Van der Wal et al. Netherlands 14 houses 0.3e0.9 (mean 0.6) h
1 Rotterdam, 4 apartments, naturally ventilated
(1991) 1.05e1.35 Rotterdam, 4 apartments, mech. balanced
(mean 1.2) ventilated
0.6 (0.6) Rotterdam, 2 single houses, naturally
1.7e8.3 ventilated
0.6e3.1 ’s Hertogenbosch, 4 houses, mech.
0.3e0.9 balanced ventilated
1.5e4.0 ’s Hertogenbosch, Kitchen
’s Hertogenbosch, Living room
’s Hertogenbosch, Bedroom (closed windows)
’s Hertogenbosch, Bedroom (open windows)
Hasselaar (2002) Netherlands 38 houses 0.3.
0.3 h
1 all openings closed;
0.5e0.7 door to circulation area (indoors) open;
0.5e0.7 window open, door closed;
0.7 - >1.2 window and door open.
De Gids (2004) Netherlands 86 houses <0.3 h
1 10% of houses
<0.5 33% of houses
(continued on next page)
118 C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125

Table 2 (continued )

Study Country Number of buildings Ventilation Units (h
1, m3/h, Comments

rates m3/h.m2)
Balvers et al. (2008) Netherlands 4 PassivHaus homes 13e20 m3/h Ranges of arithmetic means; Bedroom 1
6.5e23 (2 persons);
5.5e15 Bedroom 2
8e62 Bedroom 3
62e110 Bathroom
Total air flow
Øie et al. (1998) Norway 344 1.69 m3/h.m2 Single-family houses, natural ventilation
1.58 Single-family houses, exhaust ventilation
1.84 Apartment buildings, natural ventilation
1.51 Apartment buildings, exhaust ventilation
0.73 h
1 Before 1945, mean
0.69 1946e1965, mean
0.64 1966e1974, mean
0.60 1975e1987, mean
0.75 1988e1993, mean
Pinto et al. (2006) Portugal 7 flats 0.65 h
1 Mixed system, summer, mean values
0.81 Mixed system, winter, mean values
0.51 Natural ventilation, summer
0.63 Natural ventilation, winter
Fernandes (2004) Portugal 4 flats 1.1 h
1 Winter, healthy building, living room
0.8 Winter, healthy building, living room
0.5 Winter, unhealthy building, living room
1.2 Winter, unhealthy building, living room
Montoya et al. (2010) Spain modelling results <0.5 h
1 Summer and autumn (80% of dwellings);
Spring (70% of dwellings); Winter (50% of
dwellings)
Montoya et al. (2011) Spain 16 single-family 0.23 (geo m) h
1 Dwellings
dwellings (0.07e0.54) Shelters (sealed rooms inside the dwellings)
0.16 (geo m)
(0.06e0.58)
Stymne et al. (1994) Sweden 1143 dwellings 0.83 m3/h.m2 Single-family houses with natural ventilation,
(reported also in 0.86 mean
Øie et al., 1998) 1.04 Single-family houses with mechanical exhaust
1.19 ventilation, mean
1.40 Single-family houses with balanced ventilation
1.44 Apartments with natural ventilation, mean
Apartments with exhaust ventilation, mean
Apartments with balanced ventilation, mean
Emenius et al. (2004) Sweden 540 infants homes 0.68  0.32 h
1 Apartments and single-family houses, mean
Bornehag et al. (2005) Sweden 390 children’s homes 0.36 h
1 Single-family houses, Whole dwelling, mean
0.35 Single-family houses, Child’s bedroom, mean
0.35 h
1 Raw houses, Whole dwelling, mean
0.37 Raw houses, Child’s bedroom, mean
0.48 h
1 Multi-family houses, Whole dwelling, mean
0.51 Multi-family houses; Child’s bedroom, mean
0.37/0.34 h
1 Single-family houses, Ventilation system:
0.32/0.32 Natural ventilation; whole dwelling/children
0.44/0.47 bedroom
Mechanical exhaust ventilation; whole
dwelling/children bedroom
Mechanical exhaust/supply ventilation;
whole dwelling/children bedroom
0.41/0.37 h
1 Single-family houses, Construction period:
0.30/0.29 Before 1960; whole dwelling/children bedroom
0.39/0.42 1961e1983; whole dwelling/children bedroom
After 1984; whole dwelling/children bedroom
0.36/0.34 h
1 Single-family houses, Type of foundation:
0.42/0.40 Basement; whole dwelling/children bedroom
0.32/0.31 Crawl space; whole dwelling/children bedroom
Concrete on ground; whole dwelling/children
bedroom
0.31/0.29 h
1 Single-family houses, Number of floors:
0.39/0.38 One floor; whole dwelling/children bedroom
>1 floor; whole dwelling/children bedroom
Wichmann et al. Sweden 18 homes of children 0.65  0.27 h
1 3 with exhaust ventilation, 8 with natural
(2010) (6e11 years old) (0.20e1.31) ventilation, 3 with inlet and exhaust, 4 with
inlet heated and exhaust ventilation
Hänninen et al. Switzerland 50 dwellings, estimates 0.83  0.46 h
1 EXPOLIS study, Basle, estimated rates from
(2004) PM2.5 monitoring data analysis
 C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125 119

Table 2 (continued )

Study Country Number of buildings Ventilation Units (h
1, m3/h, Comments

rates m3/h.m2)
Dimitroulopoulou UK 33 dwellings 0.44  0.11 h
1 Dwellings built after 1995
et al. (2005) (0.19e0.68) Main study, winter

1
0.62  0.23 h Main study, summer
(0.19e1.06)
5 dwellings 0.49  0.24 h
1 Peak level study, winter, whole building
(0.24e0.83)
5 dwellings 0.54  0.27 h
1 Peak level study, winter, living room
(0.26e0.92)

1
0.59  0.39 h Peak level study, winter, kitchen
(0.25e1.22)
0.39  0.13 h
1 Peak level study, winter, bedroom 1 (main)
(0.25e0.56)
0.43  0.23 h
1 Peak level study, winter, bedroom 2 (children)
(0.21e0.74)

1
0.48  0.31 h Peak level study, winter, bathroom
(0.20e1.00)

1
4 dwellings 0.61  0.42 h Peak level study, summer, whole building
(0.28e1.18)
0.49  0.24 h
1 Peak level study, summer, living room
(0.27e0.75)
0.70  0.45 h
1 Peak level study, summer, kitchen
(0.31e1.27)

1
0.64  0.50 h Peak level study, summer, bedroom 1
(0.27e1.35) (main)
1.01  0.98 h
1 Peak level study, summer, bedroom 2
(0.28e2.12) (children)
0.48  0.24 h
1 Peak level study, summer, bathroom
(0.26e0.73)
Aizlewood and UK Flat A1 0.13 h
1 HOPE project, spring, living room;
Dimitroulopoulou 0.13 bedroom

1
(2006) Flat A2 0.16 h Living room; bedroom
0.17
Flat A3 0.28 h
1 Living room; bedroom
0.25
Flat A4 0.48 h
1 Living room; bedroom
0.63

1
Flat B1 0.32 h Living room; bedroom
0.26
Flat B2 0.69 h
1 living room; bedroom
0.48
Flat B3 0.75 h
1 Living room; bedroom
0.85

1
Flat B4 1.08 h Living room; bedroom
0.85

4.4. France individual houses. Mechanical ventilation is equally present in

The Indoor Air Quality Observatory (“OQAI” in French), under-
took a national survey to assess the air quality in 567 French
dwellings, during the period 2003 and 2005 [65]. Following this
work, these data, which represent of 24 million primary residences
in mainland France Metropolitan, were revisited to establish at the
national level, a description as complete as possible of ventilation in
dwellings. During the ventilation study, CO2 measurements were
carried out for one week in the master bedroom of 447 dwellings,
during the night, and the equivalent air change rates have been
calculated [66,67].
Half of the residential building stock was built before 1967, i.e.
before the first regulations requiring whole-house ventilation, in
1969. Approximately, 70% of the dwellings have mechanical
ventilation (35%) and natural ventilation installed (ventilation
through lower and higher openings in the walls, passive stack
ventilation by ducts or shunt ducts) (34.5%). 9.1% of the dwellings
have local fans and 21.45 have no ventilation system.
More precisely, natural ventilation is present in older or retro-
fitted dwellings, while it has almost disappeared from new build-
ings. It is present in 41% of apartment buildings but only 29% of
individual houses (35.7%) and apartment buildings (34%). Around
8% of the buildings were built before 1968 and later retrofitted with
mechanical ventilation. Around 20% of buildings built after 1975 do
not respect the regulation requirements of 1969 or 1982 (i.e. they
provide local or no ventilation, instead of whole-house ventilation).
4.5. Germany
There are no many measurements of ventilation rates in German
dwellings reported in the open literature. Ventilation rates were
measured during a program undertaken in West Berlin with VOC
sampling in 12 households [68]. The ventilation rates were
measured in 10 dwellings during the second half of the campaign
(winter period), using the HFB (hexafluorobenzene) technique and
comparing the results with those from PTFE (polytetrafluoro-
ethylene) technique [69], applied also in the same dwellings. The
mean values using the HFB technique were in the range of
0.5e2.4 h
1, whereas the lowest ventilation rates of were measured
during the absence of occupants on vacation.
The BIA report from the Institute for Occupational Safety [70],
presents some values for air change rates in dwellings, based on an
120 C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125
earlier work [71]. These values were used in the calculation
methods and model investigations as alternatives to exposure
measurement.
However, the standard which is currently well known in
Germany is the PassivHaus standard [72]. This was developed in
Germany and its development was funded by EC between 1997 and
2002 [73], in order to be a leading standard for energy efficient
design and construction for cold-climate houses. The PassivHaus
Programme, with over 5000 houses built prior to 2005, has
promoted development and production of components such as low
capacity compact HVAC units, windows and doors and innovative
building systems. This standard is used in Germany, Austria and
Ireland [74].
The average expected ventilation rates, based on modelling
work are given in the PassivHaus Planning Package 2007 [72]. It is
recommended that in winter the ventilation rates should be low-
ered to maintain internal humidity values at acceptable levels [75].
There is a need to demonstrate whether the buildings built under
this standard actually perform as well as indicated by the modelled
data [76].
4.6. Greece
Measurements of indoor air pollutants were performed in 50
dwellings in Athens, together with measurements of ventilation
rates, between December 2003 and April 2004 [77]. The ventilation
rates were continuously measured by monitoring CO2 concentra-
tion. The research was conducted in low income households
located in the poor zones of the city. Almost all the residential
buildings in Greece are naturally ventilated, especially during the
winter period. During the monitoring period, all openings
remained closed. Their results show that 95% of the dwellings had
a flow rate below 2 h
1.
Airtightness and infiltration measurements were carried out in
20 dwellings, in the Greater Athens Area, during the summer 2005
[78]. For the infiltration measurements, the tracer gas decay
method was used. The ventilation rate of dwellings in Athens
varied between 0.5 and 1.5 h
1, as a function of the envelope
airtightness.
During the European BUMA project field campaigns were
carried out in five cities across Europe (Milan, Copenhagen, Dublin,
Athens and Nicosia) [79]. These campaigns covered, among others,
winter and summer weekly ventilation measurements in two
public buildings and two private houses in each city, using a tracer
gas technique. The results varied a lot due to the different condi-
tions observed, such as absence of occupants and opening of
windows.
4.7. Netherlands
Indoor air quality was investigated in different types of dwelling
in two Dutch cities, in the winter season [80]. The air permeability
of the dwellings and the airflows of mechanical air supplies and
exhausts were also measured. Based on these, the whole houses air
change rates were calculated for 10 and 4 dwellings in Rotterdam
and in ’s Hertogenbosch, respectively. The results show that the
ventilation rates were generally lower in the naturally ventilated.
The mean rates for the whole sample were greater than 0.5 h
1.
The majority of dwellings had also similar ventilation rates
(>0.5 h
1) in a survey carried out in 86 houses in the Netherlands
[81]. A passive tracer gas technique was used and the sampling was
undertaken in the living room and the master bedroom, over
a period of three months during the heating season.
"Ventilation in practice" [82] is also an important source of data
and is based on 500 home visits with inspection and interview. The
ventilation rates were calculated for 38 dwellings, based on CO2
concentration logging over periods of 1e10 days per room, under
normal weather conditions in April/May and November, and
included a diary written by the occupants. The range of values was
0.2e1.6 h
1. There was no correlation between ventilation rates and
actual exhaust volume, indicating that the use of windows (cross
flow and infiltration) determines the rate rather than the type of
ventilation system.
Regarding the low energy houses, a study investigated whether
the installed mechanical ventilation systems provide sufficient
indoor air quality in four Dutch PassivHaus houses [83]. In the
Netherlands, a number of houses have been built according to this
standard, but the actual performance of these houses has not been
thoroughly investigated. The results revealed that the average air
flow in use was in all cases lower than recommended by the Dutch
Building Code. The questionnaire survey showed the residents
played an important role in the level of ventilation and air quality in
their own houses; the mechanical ventilation system of all houses
was on setting 1, which is the default and should be used when no
one is at home. These results indicate that residents must be
educated to properly use the PassivHaus ventilation system, in
order to improve the indoor environment conditions.
4.8. Norway
The total air change rate (h
1) was measured in 344 Norwegian
dwellings using the PFT-method (perfluorocarbon tracer gas
method), a passive tracer gas method, over a 14-day sampling
period [21]. The results show that 36% of all dwellings had rates
lower than 0.5 h
1, required by the national building code. The
differences between types of dwellings were small. The study
revealed that 40% of the single-family houses, 40% of the apart-
ments, and 29% of the detached and semi-detached houses had
ventilation rates lower than 0.5 h
1. The ventilation rates between
different types of ventilation system did not show substantial
differences, either.
The dwellings were also categorised according to the
construction year. The years 1945, 1965, 1974 and 1987 were major
turning points for residential ventilation. After the war, the building
techniques and regulations led to more airtight buildings, without,
however, simultaneous enhancement of mechanical ventilation,
resulting in this way in lower ventilation rates in dwellings.
However, in 1980’s, the public awareness increased about the
indoor air quality issues and in 1993 the minimum guideline of
0.5 h
1 was introduced.
Finally, this study is compared to other Scandinavian studies
[62,84,85] and concluded that Norwegian dwellings seem to be
better ventilated. The differences in ventilation rates may be due to
local climate, inhabitant behaviour with respect to ventilation and
selection of population and ventilation rate measurement technique.
4.9. Portugal
Ventilation rates were measured and analysed in seven similar
flats in a four storey apartment building, using the PFT technique
[55]. Six of the studied flats had mixed ventilation (continuous fan
driven exhaust system in the kitchen and natural exhaust in the
bathroom). For comparison, the seventh flat was naturally venti-
lated. The measurements were carried out in summer (August
2005) and winter (January/February 2006), in unoccupied flats.
The results showed that the average ventilation rates in the flats
with a mixed system were always greater than those in the flat with
the natural ventilation system. The former were considered by the
authors as more “reasonable”, given the high rates in the habitable
rooms that are allowed by the Portuguese standards. These rates
 C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125
varied slightly with location in terms of height and the orientation
of the flats.
Within the framework of HOPE project, measurements of
ventilation rates were carried out based on SF6 concentration decay
[86]. They studied in the living rooms of two flats in naturally
ventilated apartment buildings, which were characterised either as
“healthy” or “unhealthy”, according to the symptoms reported by
the occupants. The results showed that the measurements of
ventilation rates alone could not be used to excuse the above
characterisation, since in a flat of a healthy building, high CO2
concentrations (>900 ppm) were reported, indicating non-
sufficient ventilation.
4.10. Spain
Modelling airtighness studies in Spain [87] helped to provide
some estimates of ventilation rates, since no experimental data
either on ventilation rates or airtightness was not available, until
very recently, for Catalan dwellings. The results from these studies
showed that the highest ventilation rates were predicted in winter,
due to extreme meteorological conditions. The lowest values, under
average meteorological conditions were predicted in summer,
whereas the lowest values under extreme average meteorological
conditions, in autumn.
Very recently, some ventilation measurements were performed
by the same team in 16 single-family dwellings throughout Cata-
lonia, as well as in sealed rooms inside those dwellings, that could
be used as indoor shelters [88]. The dwellings covered different
types, years of construction years, floor areas, number of stories,
and locations, representing the range of actual dwellings found in
Catalonia. All of them had heavy structures, which are typical in
Catalonia, i.e. they were built with materials such as concrete,
masonry and bricks. The dwellings were naturally ventilated
(through windows, doors, and grille vents in kitchens and storage
rooms), whereas electrical extractors were only found in kitchens,
as required under Spanish law, and in bathrooms without windows.
The results show that the Catalan dwellings were airtight, with
a geometric mean well below 0.5 h
1. This is probably due to the
prevailing construction techniques in Catalonia, which are mainly
based on heavy materials.
4.11. Sweden
A large Swedish national survey was performed in 1143 dwell-
ings, which is the only representative among the studies in Nordic
countries [84]. Their results showed that 85% of single-family
houses and 55% of multi-family houses had a ventilation rate
below 0.5 h
1 and that these rates are generally low compared to
the requirements in Sweden since 1975.
A caseecontrol study that was part of the birth cohort study
(BAMSE), monitored the homes of 540 infants (cases and controls)
of whom 181 were cases for wheezing [19]. Four-week measure-
ments of ventilation and physical parameters were carried out in
winter (OctobereMarch). Ventilation rates were measured in all
rooms of each infant’s home, using a passive tracer gas technique.
Their results showed that in 69% of the homes the ventilation rate
exceeded 0.5 h
1. A strong correlation was found between the
whole building ventilation rate and the child’s bedroom. The only
category of homes, with a mean below 0.5 h
1, was the naturally
ventilated single-family homes that were built on crawl space or
concrete slab foundation.
Ventilation rates were measured in 390 Swedish homes, as part
of a large investigation on the impact of the indoor environment on
asthma and allergy among children in Sweden [28]. Ventilation
rates both of the whole house and bedroom of the children were
121
measured during one week in winter (October 2001 and April
2002) with a passive tracer gas method.
The sample of dwellings included multi-family and single-
family houses, either naturally or mechanically ventilated. The
measured air change rate in the 390 houses was generally low. The
results indicated that more than 55% of multi-family homes and
80% of single-family houses did not meet the national building code
requirement of 0.5 h
1. In this study, the mean ventilation rate in
the single-family houses were very similar with the ventilation
rates in the respective children bedroom.
Multi-family houses had higher mean ventilation rates
compared to other types. Single-family houses with a mechanical
exhaust and supply ventilation system had higher ventilation rates
compared to other houses. Dwellings built between 1961 and 1983
had the lowest ventilation rates, together with houses with
concrete on ground as foundation. Finally, single-family houses
with only one floor had lower ventilation rates than those with
more than one floor.
Indoor pollutants and ventilation rates were monitored [89],
during winter and summer, indoors and outdoors at 18 homes
(mostly apartments) of 18 children (6e11 years old), as well as at
schools that the children attended. The study was carried out
between December 2003 and July 2004. The whole house venti-
lation rate, were measured using a tracer gas technique (using
perfluorobenzene and perfluoromethylbenzene). The rates were
measured during day and night in the homes. The houses had
different ventilation systems. Unfortunately, this study does not
distinguish between the ventilation rates for the various systems.
Total ventilation rates for all the types of buildings (both homes and
schools) are given, although these buildings have completely
different types of building characteristics and use and consequently
the ventilation rates should not be mixed up.
4.12. United Kingdom
A BRE study [90] investigated the adequacy of ventilation and
indoor air quality in homes built since 1995, when the Building
Regulations were revised. Measurements of air tightness, ventila-
tion rates, indoor pollutant concentrations, temperature and rela-
tive humidity in homes during normal occupancy were performed.
The project was divided into a pilot study (NovembereDecember
2001; 4 homes), the main study (January to March 2002; June to
September 2002) and the peak level study (January to March 2003;
June to September 2003). The total number of homes was 37,
monitored twice, in winter and summer. All homes were naturally
ventilated but, in bathrooms and kitchens, 34 had extract fans and 3
homes had passive stack ventilators. In the main study, the whole
building ventilation rates were measured using the PFT technique
over a two-week period. In the peak level study, ventilation
measurements were performed in living room, kitchen, bedroom 1
(main), bedroom 2 (children’s) and bathroom.
The results of the main study show that in winter (pilot study
and phase 1), 68% of homes had a whole house ventilation rate
below the minimum design value of 0.5 h
1, which according to
BRE research is necessary to avoid condensation [91,92]. In summer
(phase 2), 30% of homes had a whole house ventilation rate below
0.5 h
1. Flats seem to be less ventilated than the other types of
houses, both in winter and summer. The types of houses with
higher ventilation rates are the semi-detached in winter and the
centre-terrace houses in summer. However, the statistical analysis
shows that there are no significant differences between dwelling
types, although a greater sample size may show a significant
difference.
The peak level study involved further investigation of relative
humidity, indoor air quality and ventilation rates in selected homes,
122 C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125
during the main study (winter and summer months). The selected
homes for the peak level study had one or more of the following
characteristics: high relative humidity, high indoor air pollutant
concentrations, low ventilation rates and occupants reporting the
greatest dissatisfaction with air quality during the main study.
During the winter peak level study, the highest mean ventilation
rates were in kitchens and living rooms and the lowest in
bedrooms. In the summer study, the highest mean ventilation rates
were in the children’s bedrooms and kitchens.
Ventilation measurements were performed in 8 naturally
ventilated flats normally occupied (4 flats in two buildings), within
the framework of the HOPE project in the UK [93]. The monitoring
work was carried out in AprileMay 2004.
The ventilation rates in Flats A1 - A4 are at the lowest end of the
values measured in the previous study of 37 homes. According to
the UK Building Regulations, the trickle ventilators, which are small
openings at the top of the window frame, should be left open to
provide adequate ventilation. All trickle ventilators were closed in
these four flats and consequently, they did not provide the intended
background ventilation.
The ventilation rates in flats B1eB3 were higher than the
minimum design value of 0.5 h
1. The trickle vents in all these flats
were fully open (blocked only in Flat B4), although the occupants
were not aware of their purpose. The trickle vents provided at least
the intended background ventilation. The highest ventilation rates
were further explained by open patio doors in the living room and
windows in the bedrooms.
4.13. EXPOLIS study
The indoor residential and outdoor air PM2.5 concentrations
measured in the EXPOLIS study were analysed [94], in order to
estimate the infiltration efficiency of PM2.5 particles in four cities
(Helsinki, Athens, Basle and Prague). Solving a mass balance
equation, the infiltration factor Finf (or Indoor/Outdoor ratio) is as
follows:
Finf ¼ I=O ¼ Cinfiltrated =Cgenerated ¼ P a=ða þ kÞ ¼ >a
 
¼ kFinf = P
Finf
where P the penetration efficiency (dimensionless), a the air
exchange rate (h
1), k the decay rate indoors (h
1), The air
exchange rates were estimated for the four cities based on PM2.5
decay rates estimated in the US (0.39 h
1) and assuming that the
penetration of PM2.5 particles is approximately 1.0. The mean air
exchange rate was highest in Athens and lowest in Prague.
4.14. International modelling study
An modelling study was carried out in order to investigate the
impact of regulations on the house minimum air changes in 15
developed countries, all over the world [95]. Initially, a literature
review was carried out on the regulations, standards or guidelines
of ventilation requirements for residential buildings of various
countries. Then, the minimum air change rates for each country
were applied to a model house proposed by the Architectural
Institute of Japan in order to compare each other. The model was
assumed to have a surface area of 125.9 m2 and a volume of
302.1 m3 and is occupied by a family with 2 children. The estimated
whole house minimum air flow rates after the application to the
Japanese model house of the regulations for Sweden, Finland,
Denmark, Italy and Greece was 0.5 h
1, in the case of Norway and
France was 0.7, whereas for Germany and Switzerland were 0.6 and
0.4 h
1, respectively.
The above results show that a large percentage of the dwellings,
especially in Northern Europe are under-ventilated with ventilation
rates below 0.5 h
1. Furthermore, there is an international effort to
reduce CO2 emission by using less energy in the domestic sector,
which is expected to further reduce these rates. An extensive
review regarding the state-of-the art of highly airtight houses
around the world [96] concluded that changes in construction
practice lead to highly insulated and airtight structures designed
and built with an expectation of a greater use of mechanical
ventilation with heat recovering (MVHR) systems. This will have an
impact on the quality of air in homes as well as other aspects of the
internal environment, such as acoustics and daylight. There are
associated risks of declining air quality, but also opportunities for
improvement provided that appropriate measures are adopted. It
was pointed out the urgent need for research into the performance
of highly energy efficient homes with respect to the quality of the
internal environment ventilation systems used, and the impact on
the health and wellbeing of occupants.
5. Conclusions
The major findings from the review on residential ventilation in
Europe can be summarised as follows:
 Ventilation is increasingly becoming recognised as an impor-
tant component of a healthy dwelling.
 Ventilation is the ultimate strategy to control IAQ. However,
modest improvements in construction practice and living
conditions, should aim to eliminate first the potential risk of
exposure to pollutants due to indoor sources (e.g. to environ-
mental tobacco smoke, to traffic related pollutants that pene-
trate indoors, to dampness in homes with visible moulds, to
volatile and semi-volatile organic compounds due to renova-
tion, painting activities and floorings and to phthalates and
chlorine due to the frequent use of cleaning chemical agents)
and supply simultaneously with adequate ventilation.
 Few conclusive studies were found regarding residential
ventilation and its direct association to health effects of
vulnerable groups (children and elderly people).
 In the studies reviewed here, the value of 0.5 air changes per
hour (h
1), which is frequently used in national standards/
regulations in Europe, is reported as a threshold below which
associations may occur. However, this value should not be
considered as a recommendation for the minimum ventilation
level, based on health criteria. On-going European research
(HealthVent project) aims at developing health-based ventila-
tion guidelines, considering both health and energy impacts.
 Studies in the Nordic countries showed that at ventilation rates
greater than 0.5 h
1, there is no direct association between air
change rates and asthma or allergy among children. However,
at low ventilation rates (lower than 0.5 h
1), allergic symptoms
were reported as well as rhinitis and bronchial obstruction. No
association was found between ventilation rates and doctor-
diagnosed asthma. The results from these studies should be
seen under the light that there is no commonly accepted set of
criteria to identify asthma in epidemiological studies. Studies
on asthma, especially in early life (<6 years old), have a high
risk of misclassification, since a reliable diagnosis cannot be
achieved then.
 Certain types of buildings (e.g. relatively new apartments and
houses with crawl space/concrete slab foundation) may result
in lower ventilation rates and have been reported to be asso-
ciated with recurrent wheezing in very young children.
 Low ventilation can be considered as a risk factor for irritation.
Decreased ventilation increases indoor air humidity and
 C. Dimitroulopoulou / Building and Environment 47 (2012) 109e125
therefore the risk for dampness in dwellings and the risk of
infestation with house dust mites. According to WHO guide-
lines, remediation of dampness can reduce adverse health
impacts.
 Ventilation requirements receive major attention in building
regulations, across Europe. The ventilation standards tend to
cluster around common values for recommended ventilation
rates.
 The Nordic countries adopted the minimum requirement of
0.5 h
1 for the whole building ventilation rates. Rates greater
than 0.3 h
1 have also been adopted in some countries (e.g.
Switzerland and Italy).
 Ventilation in practice is often poor, resulting in increased
concentration of pollutants and hence exposure to health risk.
 The ventilation measurements in the Nordic countries showed
that a large percentage of the monitored dwellings did not fulfil
the minimum requirement of 0.5 h
1 (up to 60% in Denmark,
about 50% in Finland, 30%e40% in Norway). In Sweden,
different samples of dwellings showed contrary results,
although the large national study reported 55% of multiple and
85% of single dwellings having ventilation rates lower than
0.5 h
1. The Norwegian dwellings seem to be better ventilated
than the other Scandinavian ones.
 Ventilation rates greater than 0.5 h
1 were reported in the
Netherlands as well as in the Mediterranean countries (Greece
and Portugal), which had rates greater than 0.5 h
1 and up to
1.5 h
1 in Greece and 1.2 h
1 in Portugal.
 The naturally ventilated British dwellings were better venti-
lated in summer (70% > 0.5 h
1) than in winter (68% < 0.5 h
1),
showing that the occupants behaviour (window opening in the
warmer months) affects the whole building ventilation.
 Higher ventilation rates were measured in the mechanically
ventilated dwellings compared to the naturally ventilated
dwellings in a number of countries (e.g. Netherlands, Portugal,
Sweden).
 There is an international effort to reduce CO2 emissions by
using less energy in the domestic sector. As a result, low energy
houses have been built according to the German PassivHaus
standard for energy efficient design and construction for cold-
climate houses. Surveys in some houses showed that the
occupants should be educated to use properly the ventilation
system, whereas measurements are needed to demonstrate if
the buildings built under this standard perform as good as
indicated by the modelling studies.
 The residents play an important role in the ventilation level in
their own homes. Surveys of occupants showed that people
generally think ventilation is important, but their under-
standing of the ventilation systems in their houses is low. The
chain of activities from design through execution to use and
maintenance, especially of mechanical ventilation systems,
shows weak links. Higher set points required to achieve
adequate ventilation are not often used due to the noisy fans.
Thus, poor use and lack of knowledge from the occupants
seem to be the main problems for the under-ventilated
homes.
Acknowledgements
This work was carried out as part of the EPHECT project. EPHECT
is a European collaborative action, which has received funding from
the European Union, in the framework of the Health Programme.
The author would like to thank Prof. Peder Wolkoff, NCRWE,
Denmark, for his constructive comments and for providing material
for this review and Prof. Eduardo de Oliveira Fernandes, IDMEC-
FEUP, Portugal, for his valuable comments.
123
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