Indoor Air Quality: Tackling the

Challenges of the Invisible

Prof Dr Juliana Jalaludin
Department Of Environmental and Occupational Health
Universiti Putra Malaysia
[18/11/2023]
Highlights

•Overview of IAQ

•Risk Assessment

•Mitigation Strategies

•Vision for the Future

 What is Indoor Air Quality (IAQ)?

Indoor air quality refers to the quality of

the air inside buildings as represented
by concentrations of pollutants and
thermal (temperature and relative
humidity) conditions that affect the
health, comfort, and performance of
occupants. (EPA)
 Indoor Air Quality (IAQ) is the air quality
within and around buildings and structures
especially as it relates to the health and
comfort of the building’s occupants.

Poor indoor air quality has been linked to sick

building syndrome, reduced productivity, and
impaired learning in schools.
 Indoor Air Quality (IAQ)
.
Factors which impact upon the quality of
the indoor air are the external air, the building
materials and the heating, ventilation and air
conditioning (MVAC/HVAC) systems (through
air temperature, humidity and ventilation
rates); and the interior of the building (layout,
furnishings, fittings and equipment.
Changes in Physical Environmental conditions and
Changes in the work performance
Air tightness of buildings

Poorly designed air conditioning and ventilation

systems

Indoor sources of pollution

Outdoor sources of pollution

 Indoor Air Quality

Teresa et al 2021

IAQ is affected by pollution with various airborne

contaminants such as gaseous compounds, fine
particles , and bioaerosal
Health Risk Assessment of
IAQ
How Indoor Spaces Can Make You Sick—Or Keep You
Well??
 Sick Building Syndrome
.
Buildings often have problems
associated with insufficient air
renewal, issues with the
filtration system and inadequate
maintenance of the air distribution
and treatment systems.

The occupants then begin feeling

unwell at work– a syndrome
known as the "Sick Building
Syndrome".
INDOOR AIR QUALITY
Typical Sources of of
Indoor Air Quality.
Contaminants
 Sick Building Syndrome
A number of health problems are
associated with indoor air pollution, The Occupational Safety and
including Building Related Illness Health Administration
(BRI), Multiple Chemical estimates that the sick
Sensitivity (MCS) and Sick
building syndrome affects 30
Building Syndrome (SBS)
to 70 million US workers!—
Sick Building Syndrome is a from 19% to 80% of workers
condition which affects a significant in studies from North America
number of building occupants but and Europe
which abates when the occupants
leave the building. The World Health
Organization estimates that
The symptoms occur in a higher 30% of new buildings have
proportion of the building
poor air quality
occupants than in the community
generally. SBS is not confined to
office buildings
Health Risk Assessment
of IAQ
Indoor Air Quality in Educational &
Occupational Residential Settings-
Selected Case Studies
Health Risk Assessment
of IAQ in Educational
Instituition
IAQ IN SCHOOLS
Environmental Exposure, Asthma, and
Allergies Among Preschool Children A
strategic Model on Preventive Measure
(Science Fund, 2012-2014)
Juliana J, Nazariah SSN, Abdah MA and Suhaimi NF. Exposure to
PM2.5 and NO2 and Respiratory Inflammation among School
Children in Malaysia. American Journal of Applied Sciences. 1616-
1630.

Tezara Cionita, Nor Mariah Adam, Juliana Jalaludin, Mariani

Mansor and Januar Parlaungan Siregar . (2014). Measurement of
Indoor Air Quality Parameters in the Daycare Centers in Kuala
Lumpur Malaysia Applied Mechanics and Materials ISI/Scopus Vol.
564 (14)

Tezara Cionita., Mariah A., Juliana J and Mariani M. Siregar JP

(2014). Indoor Air Quality in The Day Care Centres in Tropical
Country. International Journal Mechanics Engineering 3(1): 47-52.

Tezara C., Juliana J., Nor Mariah Adam and Januar Parlaungan
Siriger. Assessment of Children’s Health and Indoor Air
Contaminants of Day Care Centre in Industrial Area Iranian Journal
of Public Health 44(3): 81-88.

J Jalaludin, SNS Noh, NF Suhaimi, AM Akim. (2014). Tumor necrosis

factor-alpha as biomarkers of exposure to indoor pollutants among
primary school children in Klang Valley. American Journal of
Applied Sciences 11 (9), 1616.

Nazariah, SSN, Juliana, J, Abdah, MA. 2013. Interleukin-6 via Sputum

Induction as Biomarker of Inflammation for Indoor Particulate Matter
among Primary School Children in Klang Valley, Malaysia . Global
Journal of Health Science; 5(4):1-13.
‘Indoor Air Pollutants Exposure And Eosinophil Cationic Protein
(ECP) As AN Upper Airway Inflammatory Biomarker Among
Preschool Children In Selangor’

IAQ assessment Mould sample

Briefing before nasal

sampling Nasal swab process
Urban Air Pollution and
Biomarker of Inflammation

Rise in the inflammatory cells like

neutrophils and lymphocytes in sputum
of school children in urban area may
suggest a greater prevalence of
pulmonary infection and inflammation
in the city.

27
Indoor Air Pollutants
and Biomarker of
Inflammation

• Biomarkers were used to

understand the physiology of
inflammation of human
respiratory system affected by
inhalation of indoor air
pollutants by school children.

• Rise in eosinophil number in

nasal samples of urban
children may indicate
underlying allergy and
hypersensitivity response.

28
IAQ IN SCHOOLS
 Introduction Methodology Results & Discussion Summary

Factors Influencing FeNO levels among School Children

Table 2 Factors influencing the FeNO levels among school children. 1 B. acaciae, H. aloes, H. multicystidium and H.
Explanatory variable Antilog β 95% CI shearii were not commonly reported in relation
Doctor-diagnosed asthma
to the respiratory illness and generation of NO
PM2.5 0.269 (0.04-0.61)*
pathways.
Aspergillus clavatus 0.992 (0.34-1.68)*
Brycekendrickomyces acaciae 2.887 (2.09-3.76)**
Candida parapsilosis 0.809 (0.14-1.49)*
Hazslinszkyomyces aloes 0.647 (0.36-0.94)** 2 Aspergillus associated with upregulation of T2
Hyphoderma multicystidium 1.442 (0.29-2.61)* cytokines, IL-17, and TNF-α, induced the
Heterochaete shearii 1.757 (0.59-2.87)* expression of iNOS which led to the prolonged
Starmerella meliponinorum 1.092 (0.43-1.75)* release of NO (Sullivan et al. 2020).
Verrucoconiothyrium prosopidis 1.088 (0.51-1.62)**
Non-asthma
Brycekendrickomyces acaciae 0.284 (0.02-0.51)*
Hazslinszkyomyces aloes 0.161 (0.08-0.31)**
3 β-glucan from C. albicans induces
Hyphoderma multicystidium 0.153 (0.02-0.36)*
Heterochaete shearii 0.147 (0.03-0.31)*
neutrophilic airway inflammation and
Toxicocladosporium pseudoveloxum 0.211 (0.02-0.49)* expression of IL-17 and IL-5
Analysis: 2-levels logistic regression; *p < 0.05 ; **p < 0.001 (Ramirez-velazquez et al., 2013).

30
 Introduction Methodology Results & Discussion Summary

Findings

1 The Diversity of Fungi in Dust

The profile of fungi taxa in settled dust
2 Unculturable Fungi Taxa
Rare and unculturable fungi taxa does
samples identified through potentially attributable to the risk of allergic
metagenomic in this study provide a development among school children,
new perspective of intricate connections especially C. halotolerans,
between indoor pollutants and allergic X. ardosiaca and T. asahii.
phenotype.

3 Allergic Diseases
4
Findings suggested that Urban & Suburban
exposure to both biological Urban and suburban
and chemical indoor pollutants
at school micro-environment
school areas, might have
may increase the risk of a similar impact of indoor
allergic reactions among pollutants on the allergy
school children. diseases.
31
 Diversity Analysis of Fungi in Dust Samples

Summary

Figure 4 Relative abundance of fungal identified at the species level in

32 settled dust collected in 32 classrooms.
 Early-Life Exposure

Qihong Deng and Norback et al (2017)

Indoor and outdoor exposures play different roles in allergy onset

and development.
The Impact of Traffic –Related Air Polllution in Schools
PUBLICATIONS
TRAP and DNA
Damage

Cell A (greater tail length indicates greater

DNA damage), while cell B (with intact
head indicate less DNA damage)

Primary school children who went to

schools near high traffic density had
greater DNA damage than the primary
school children who went to schools in
low traffic area, as reflected by a longer
tail length.

36
TRAP and Micronuclei
Frequency

It can be deduced that long term

exposure to high concentrations of
air pollutants could contribute to
cumulative chromosomal
damages which might elevate the
cancer risk among children living in
proximity to polluted area.

37
 Indoor air quality analysis in naturally
ventilated university training laboratories: a
health risk assessment

Susana et al., 2022

it is important to consider the carcinogenic risk Results from this study show natural
posed by acute short-term exposure to certain ventilation is not enough to get an adequate
chemical contaminants, such as VOCs. IAQ.
IAQ in Occupational
Setting
On average, a working person spends 8-9 hours of his/her time in the office
environment inhaling indoor air particles that can cause a number of health issues.
IAQ in Office Building
 Comparison of the level of indoor air pollutants in both buildings
Variables
Median (IQR)
Old building New building z p
(n=65) (n=55)
CO2 (ppm) 288.00 290.50
-1.044 0.297
(292.20-301.18) (288.48-298.67)
TVOC (ppm) 15.43 2.69
-11.969 <0.001*
(15.46-19.02) (5.15-5.94)
UFP (pt/cm3) 6740 1250
-11.970 <0.001*
(6628-7569) (1354.01-1588.47)
PM2.5 (µg/m3) 80 60
-9.579 <0.001*
(80-90) (60-70)
PM10 (µg/m3) 120 20
-9.498 <0.001*
(120-125) (20-30)

1. The median value for TVOC in the old building exceeded the acceptable range;
TVOC=3ppm. High reading of TVOC came from the newly painted wall, new furniture,
cleaning agents, VOCs from the chemistry lab, and office partitions that made up
from wood.
2. High concentration of UFP in the old building was due to the frequent of the
photocopying activities which located in opened-area and closed to the workers and
insufficient ventilation system.
3. The source of particulates matter came from tobacco smoke and combustion
processes at the chemistry lab which located near to the sampling point.
Indoor Air Quality and
Prevalence of Sick Building
Syndrome Among A
Sample of Staff from Selected
Wards In a Government
Hospital

Results showed that 43.43%

from total of nurses had SBS.
Ventilation rate, temperature
and UFP in naturally
ventilated wards were
significantly higher than in
mechanically ventilated
wards.

The results revealed that low

ventilation rate and high
UFP level in hospital ward
increase the risk of SBS.
 IAQ in Green Building

Cognitive
function scores
were better in
green building
conditions
compared to
the
Conventional
building
conditions

Source : Harvard T.H. Chan School of Public Health’s Center for Health and the Global Environment
IAQ in Residential
Setting
IAQ in Residential Setting
Association of indoor renovation with early childhood ear
infection in China

Qihong Deng et al (2017)

Combined exposure to indoor and

outdoor air pollution significantly
increased Otitis Media risk.
 IAQ and Health in Newly Constructed
Apartments : A Case Study of Surabaya,
Indonesia

Asthma,
eczema, and
allergy
prevalence
were found to
be worse in
residents

IAQ in apartment units appears to be poorer than in other countries

Sophia et al, (2019)

Formaldehyde and TVOC concentrations in apartments are especially critical and

exceed standards in many units. Owing to the hot, humid climate
This study attempted to be inclusive and raise awareness of the complex nexus
between sustainable development of buildings with regard to residential indoor air
quality, energy efficiency, and the health of occupant
IAQ AFTER PANDEMIC

COVID-19 Brings Indoor

Air Quality Monitoring
Upfront
Airborne Transmission of COVID-19
 Note that droplets cannot be inhaled. They are projectiles.

If can be inhaled, they are aerosols. Travel around the room per the laws of physics. - Dr
Butler by CDC
 COVID-19
DELTA VARIANT

• The B.1.617.2 variant is highly

transmissible in indoor settings and
households, which might lead to
increased attack rates
• Multicomponent prevention strategies
including vaccination remain important
to reduce the spread of SARS-CoV-2 in
indoor.
In the aftermath of the COVID-19 pandemic, scientists say it's time to rate
indoor air quality and clean it to prevent the spread of airborne illnesses.
1- Recognising the potential for the airborne
transmission of SARS-CoV-2

2- Engineering controls to reduce the potential

airborne transmission of SARS-CoV-2

3- Avoid air recirculation

4- Air cleaning and disinfection devices may be

beneficial
 Engineering level controls to reduce the
environmental risks for airborne transmission

https://doi.org/10.1016/j.envint.2020.105832
Wonderful guidance from
WHO on ventilation. for non-residential settings.
minimum 10 L/s/person, open doors & windows for
cross-ventilation, use exhaust fans, filtration.
VENTILATION DURING THE COVID-19
PANDEMIC
"The pandemic has also shown that
insufficient attention was previously
paid to the design and management
of ventilation and filtration systems
for healthy indoor environments,
including safe workplaces, safe
schools, and safe public transport."
 ASHRAE approves groundbreaking
Standard to safeguard indoor spaces
from disease transmission.

The new ASHRAE Standard 241- Control

of Infectious Aerosols is a major step
forward in reducing the risk of
infectious disease spread
https://www.omnicalculator.com/ecology/co2-breathing-emission

61
ASHRAE’s publication of its highly anticipated
airborne infection risk mitigation standard for
buildings is now available.

ASHRAE Standard 241 establishes minimum

requirements to reduce disease transmission
through infectious aerosols, benefiting
occupants and promoting healthier
environments.

www.ashrae.org/241.
The Lancet COVID-19 Commission Task Force
on Safe Work, Safe School, and Safe Trave

63
The Lancet COVID-19 Commission Task Force
on Safe Work, Safe School, and Safe Trave
● The First Four Healthy Building Strategies
Every Building Should Pursue to Reduce
Risk from COVID-19 JULY 2022
●
● 1-Commission Or Recommission Building
Systems
● 2-Maximize Outdoor Air
● 3-Upgrade Air Filters To Minimum
Efficiency Reporting Value (Merv) 13
● 4. Supplement With Portable Air Cleaners,
Where Needed

65
CURRENT IAQ MANAGEMENT IN
MALAYSIA
 IAQ control measures
➢ Public awareness ??

➢ Government policy ??

➢ Standards / Guidelines ??

➢ IAQ Management Tools ??

INDUSTRY CODE OF PRACTICE ON INDOOR AIR
QUALITY 2010

The purpose of this industry code of practice

is to provide guidance on improving the
IAQ and to set minimum standard for
selected parameters that will avoid
discomfort and/or adverse health effect
among employees and other occupants of
an indoor or enclosed environment served
by a mechanical ventilating and air
conditioning (MVAC) system including
aircooled split unit.

It is one of the general duties as prescribed

under the Occupational Safety and Health
Act 1994 [Act 514] for the employer and an
occupier (including building owner and
building management) to provide a safe
workplace to their employees or other
person than his employees (occupant).
 STANDARDS OR GUIDELINES BASED ON
INDUSTRY CODE OF PRACTICE ON INDOOR
AIR QUALITY (ICOP-IAQ) BY DOSH MALAYSIA
(2010)
Indoor Air Contaminants Acceptable Limit
Formaldehyde 0.1 ppm
Total volatile organic compounds 3 ppm
Carbon dioxide C = 1000 ppm
Carbon monoxide 10 ppm
Respirable particulates (PM10) 0.15 mg/m3
Ozone 0.05 ppm
Biological Contaminants Acceptable Limit
Total Bacterial Counts 500 Cfu/m3
Total Fungi Counts 1000 Cfu/m3
In addition, the following
IAQ parameters were also
recorded:
Parameter Acceptable range based on DOSH
Guidelines for Office
Temperature 23 - 26 degree Celsius

Relative Humidity 40 - 70%

Air Movement 0.15-0.50 m/s

Guidance Notes For Ventilation And Indoor Air Quality
For Residential, Non Residential, Healthcare Facilities
And Public Area Established By Majlis Keselamatan
Negara (MKN To Minimize Air-borne Transmission Of
Covid-19 Viruses.
IAQ MANAGEMENT IN THE
FUTURE
It's time to clean up indoor air - the
benefits of ventilation reach far beyond
Covid-19
IAQ MANAGEMENT IN FUTURE
 CO2 monitoring recommended to manage
COVID-19 spread in schools and offices

Scientists have created a new model for predicting COVID-19

infection risk in offices and classrooms, which uses CO2 to
assess ventilation efficacy

The model demonstrates that by managing the ventilation and

occupancy levels of shared spaces we can manage the risk of
airborne infection by a virus like SARS-COV-2, which causes
COVID-19.

Predictive and retrospective modelling of

airborne infection risk using monitored
carbon dioxide’ by Henry C. Burridge,
Shiwei F an, Roderic L. Jones, Catherine J.
Noakes and P. F. Linden is published in
Indoor and Built Environmen
 Flexible ventilation systems, dependent on the building’s purpose.
Ventilation airflow rates must be controlled by the number of occupants in
the space and their activity.
Air Sensor Technology and Indoor Air
Quality
What is a Healthy Building? In the
simplest of terms, a healthy building is
one with an indoor environment that is
optimized to positively impact the
health, well-being and productivity of its
occupants.
Healthy Building Foundation
The nine foundations include ventilation, air quality and
moisture, for example, proper ventilation is important
because otherwise the concentration of pollutants indoors
can exceed that of outdoor air
Research shows poor ventilation is associated with increased
sickness absence, reduced productivity and higher respiratory
infection.
There is growing evidence that indoor pollutants – including
nitrogen oxides, particulates and volatile organic compounds
(VOCs) from office equipment, paints and furnishings – are as
harmful as outdoor ones.
Poor air quality can cause effects such as irritation and
asthma, and can reduce productivity through reduced
cognitive function (Harvard TH Chan School of Public Health,
2017).
ALL AIR RISK MUST BE CONSIDERED!
 CONCLUSION
Indoor air quality is a key determinant of individual and
population health.

Although the COVID-19 pandemic has sharpened the

urgency around improving indoor air quality,
IAQ improvements are also necessary to address public
health issues related to contaminated urban
environments, sick building syndrome, climate
resilience (haze transboundary air pollution) and
improving productivity and occupant satisfaction
generally.
 The Vision for Future
National comprehensive IAQ standards must be developed,
promulgated, and enforced by all countries. Some countries
around the globe have IAQ standards, but none of them are
comprehensive enough to include airborne pathogens.

In most countries that have IAQ standards, there are no

enforcement procedures in place. Most countries do not have
any IAQ standards. Comprehensive ventilation standards
must be developed by professional bodies.
 INDOOR AIR AWAKENING
The health impacts of poor IAQ are likely to worsen as
climate change gives rise to increasingly severe and
frequent wildfires and extreme weather conditions, and
airborne pathogens will continue to spread indoors.

Let’s learn from the past and take action to build a healthier
future
 Indoor Air Quality (IAQ)
Management Tools for Schools :
Preventive Maintenance Guidance
IAQ MANAGEMENT IN SCHOOL

SCHOOL INDOOR AIR QUALITY

GUIDENCE BOOK
School Indoor Air Quality Strategic
Management Tool Kit
 Comprehensive Covid-19 Workplace
Risk Assessment tool

The Tool could help employers and government regulators

in identifying Covid-19 flare-up points in a workplace
setting.
 Our team’s effort in devising a COVID-19 Risk
Assessment tool based on international best
practices, to help employers assess, control and
manage COVID-19 transmission risks at their
workplaces.
 To formulate strategies and actions that need to
01 be implemented by all agencies involved and
relevant stakeholders in ensuring air quality in
the country can be improved.

These measures will be formulated based

RMK-12 PROJECT: 02 on the target time period and year in the
“A STUDY ON form of short, medium and long term from
DEVELOPMENT OF 2020 to 2030.
NATIONAL CLEAN AIR
MASTER PLAN
TOWARDS BLUE SKY”
• Guidance Document on Indoor Environmental
Quality (IEQ) for Educational Institutions in
• Malaysia, NEHAP MOH
89
Improving IAQ is not the
responsibility of the individuals,
one industry, one profession or
one government department we
must work together to make safe
air for children a reality

Air pollution dirties every organ in your

body.
Thank you very much for your attention

THANK YOU

You can reach me at juliana@upm.edu.my