School building energy efficiency and NO2 related risk of childhood asthma in England and Wales: Modelling study.

BACKGROUND: Climate change legislation will require dramatic increases in the energy efficiency of school buildings across the UK by 2050, which has the potential to affect air quality in schools. We assessed how different strategies for improving the energy efficiency of school buildings in England and Wales may affect asthma incidence and associated healthcare utilization costs in the future. METHODS: Indoor concentrations of traffic-related NO2 were modelled inside school buildings representing 13 climate regions in England and Wales using a building physics school stock model. We used a health impact assessment model to quantify the resulting burden of childhood asthma incidence by combining regional health and population data with exposure-response functions from a recent high-quality systematic review/meta-analysis. We compared the effects of four energy efficiency interventions consisting of combinations of retrofit and operational strategies aiming to improve indoor air quality and thermal comfort on asthma incidence and associated hospitalization costs. RESULTS: The highest childhood asthma incidence was found in the Thames Valley region (including London), in particular in older school buildings, while the lowest concentrations and health burdens were in the newest schools in Wales. Interventions consisting of only operational improvements or combinations of retrofit and operational strategies resulted in reductions in childhood asthma incidence (547 and 676 per annum regional average, respectively) and hospital utilization costs (£52,050 and £64,310 per annum regional average, respectively. Interventions that improved energy efficiency without operational measures resulted in higher childhood asthma incidence and hospital costs. CONCLUSION: The effect of school energy efficiency retrofit on NO2 exposure and asthma incidence in schoolchildren depends critically on the use of appropriate building operation strategies. The findings from this study make several contributions to fill the knowledge gap about the impact of retrofitting schools on exposure to air pollutants and their effects on children's health.

Effects of thermal sensation and acclimatization on cognitive performance of adult female students in Saudi Arabia using multivariable-multilevel statistical modeling.

In the hot climate of Saudi Arabia, people living year-round in air-conditioned spaces are likely to develop high expectations for homogeneity and cool temperatures, becoming potentially more sensitive if thermal conditions deviate from the comfort zone they expect. This paper presents the results from a field intervention investigating the association between participants' thermal sensations with cognitive performance in a female university in Saudi Arabia. The climatic context plays a key role in choosing Saudi Arabia, whereas the total reliance on air-conditioners (AC) for cooling is believed to have significant effects on occupants' perceptions of the comfort temperature. Results reveal discrepancies in the actual thermal sensations between the Saudi and non-Saudi participants which affected their performances. "Cool" and "Slightly Cool" sensations versus neutral were associated with significant lower percentage of errors and significant higher speed for all participants independently of any association with ethnicity and acclimatization. The estimates remained significant even after adjusting for ethnicity and the number of years spent in the country and the set temperature of AC at home. Implications of the study suggest a preference for staying cool when working independently of acclimatization status.

Combined effects of ventilation rates and indoor temperatures on cognitive performance of female higher education students in a hot climate.

Impairment in mental functions attributed to the effects of indoor air quality and thermal conditions has received considerable attention in the past decade, particularly for educational buildings where students' cognitive performance is essential to foster learning. This study explores the combined effects of indoor temperatures and CO2  levels as markers for ventilation rates on cognitive performance among female students (16-23 years old) in Saudi Arabia. The longitudinal experiments involved nine conditions combining three CO2 concentration levels (achieved via changes in ventilation) and three temperature levels involving 499 participants, all exposed to the nine conditions. The study implemented a computer-based cognitive performance battery with "9Button" keyboards. Univariable and multivariable multilevel regression models explored the association of indoor temperature and CO2  levels (as markers for ventilation rates) with cognitive performance after adjusting for potential confounders. Potential benefits were found on speed and accuracy of tasks of cognitive performance when indoor temperature was set between 20 and 23ºC and at CO2  levels of 600 ppm compared to higher temperatures and poorer ventilation rates and that both ventilation and thermal environmental control are important and need to be improved for achieving optimum learning conditions. Nevertheless, the results are relevant for short-term exposures lasting no more than 2 h.

Perceived indoor air quality in naturally ventilated primary schools in the UK: Impact of environmental variables and thermal sensation.

Indoor air quality (IAQ) in classrooms has a significant impact on children's academic performance, health, and well-being; therefore, understanding children's perception of IAQ is vital. This study investigates how children's perception of IAQ is affected by environmental variables and thermal sensation. In total, 29 naturally ventilated classrooms in eight UK primary schools were selected and 805 children were surveyed during non-heating and heating seasons. Results show that air sensation votes (ASVs) are more correlated to CO2 levels than to operative temperatures (Top ) during non-heating seasons and more correlated to Top than CO2 levels during heating seasons. The impact of Top on ASVs decreases with an increase in CO2 levels, and the effect of CO2 levels on ASVs decreases with increase in Top . The most favorable ASVs are given when children feel "cool" and have "as it is" preference. By keeping CO2  < 1000 ppm and Top within children's thermal comfort band, ASVs are improved by 43%. The study recommends that standards should consider the impact of both temperature and CO2 levels on perceived IAQ. Perception of IAQ also affects children's overall comfort and tiredness levels; however, this influence is more significant on tiredness level than that on overall comfort level.

The economic benefits of reducing the levels of nitrogen dioxide (NO2) near primary schools: The case of London.

Providing a healthy school environment is a priority for child health. The aim of this study is to develop a methodology that allows quantification of the potential economic benefit of reducing indoor exposure to nitrogen dioxide (NO2) in children attending primary schools. Using environmental and health data collected in primary schools in London, this study estimates that, on average, 82 asthma exacerbations per school can be averted each year by reducing outdoor NO2 concentrations. The study expands upon previous analyses in two ways: first it assesses the health benefits of reducing children's exposure to indoor NO2 while at school, second it considers the children's perspective in the economic evaluation. Using a willingness to pay approach, the study quantifies that the monetary benefits of reducing children's indoor NO2 exposure while at school would range between £2.5 k per school if a child's perspective based on child's budget is adopted up to £60 k if a parent's perspective is considered. This study highlights that designers, engineers, policymakers and stakeholders need to consider the reduction of outdoor pollution, and particularly NO2 levels, near primary schools as there may be substantial health and monetary benefits.