Health-related quality of life and radioiodine therapy in thyroid cancer patients: a before-and-after study.

OBJECTIVE: Thyroid cancers are on the rise, but the associated vital prognosis and long-term survival rates are very good. Therefore, treated patients' quality of life and psychological well-being are important considerations. The treatment usually involves surgery and radioactive iodine (radioiodine) ablation. This study aims to investigate potential effects of radioiodine ablation therapy on health-related quality of life, anxiety and depression symptoms, and nutritional status at 6 months post-therapy. METHODS: This study included 136 patients diagnosed with thyroid cancer. Absorbed doses to the salivary glands were estimated from dosimeters worn by patients. Patient health-related quality of life, psychological status and nutritional status were assessed before and 6 months after therapy using standardized questionnaires (including SF-36, Hospital Anxiety and Depression (HAD) scale). Statistical analyses included random-effects logistic and linear regressions adjusted for potential confounders. RESULTS: While no significant association was found between radioiodine exposure and anxiety or depression symptoms, or nutritional status, a significant increase in the SF-36 role physical sub- score was observed in relation with the salivary gland dose (ß= 6.54, 95%CI 2.71;10.36 for a 1-Gy increase). CONCLUSIONS: The findings suggest an improved physical health-related quality of life, namely reduced pain and functional impairment, 6 months after radioiodine therapy in thyroid cancer patients. No significant association was found between radioiodine exposure and mental health-related quality of life, anxiety or depression scores nor nutritional status. This study does not provide any evidence that radioiodine therapy has a potentially adverse effect on patient health-related quality of life.

Use and storage of pesticides at home in France (the Pesti'home survey 2014).

Some epidemiological studies have raised health concerns following the chronic exposure of pregnant women and children to pesticides in the domestic environment. In France very little is known about potential exposure to pesticides at home. An observational study called Pesti'home was carried out in continental France between July and November 2014. The residential use of pesticides was investigated and an inventory of pesticides and active ingredients used and stored at home was drawn up. Plant protection products, biocides, and human and animal external pest control products were listed during face-to-face interviews. A random sample of households including at least one adult (18-79 years old) was selected following a two-stage stratified random sampling method using the national census database. Within each household, an adult was appointed to answer survey questions. Data related to the interviewee's sociodemographic and housing characteristics, the reported use of pesticides at home, and a visual inventory of all stored pesticides were collected. Overall, 1507 households participated. The participation rate was between 36% and 57% according to the definition chosen. Over the previous 12 months, 75% of households declared that they had used at least one pesticide. Households who used and stored at least one product most frequently used an insecticide (84%). The active ingredients most frequently used by these households as insecticides were pyrethroids, namely tetramethrin and permethrin. The Pesti'home survey collected detailed data on the residential use of pesticides for risk assessment at national and European levels.

Assessing Human Exposure to SVOCs in Materials, Products, and Articles: A Modular Mechanistic Framework.

A critical review of the current state of knowledge of chemical emissions from indoor sources, partitioning among indoor compartments, and the ensuing indoor exposure leads to a proposal for a modular mechanistic framework for predicting human exposure to semivolatile organic compounds (SVOCs). Mechanistically consistent source emission categories include solid, soft, frequent contact, applied, sprayed, and high temperature sources. Environmental compartments are the gas phase, airborne particles, settled dust, indoor surfaces, and clothing. Identified research needs are the development of dynamic emission models for several of the source emission categories and of estimation strategies for critical model parameters. The modular structure of the framework facilitates subsequent inclusion of new knowledge, other chemical classes of indoor pollutants, and additional mechanistic processes relevant to human exposure indoors. The framework may serve as the foundation for developing an open-source community model to better support collaborative research and improve access for application by stakeholders. Combining exposure estimates derived using this framework with toxicity data for different end points and toxicokinetic mechanisms will accelerate chemical risk prioritization, advance effective chemical management decisions, and protect public health.

Indoor air pollutant health prioritization in office buildings.

This work presents an original method to identify priority indoor air pollutants in office buildings. It uses both a chronic risk assessment approach by calculating a hazard quotient, and a hazard classification method based on carcinogenic, mutagenic, reprotoxic, and endocrine disruptive effects. A graphical representation of the results provides a comprehensive and concise visualization of all of the information, including the number of buildings where each substance was measured, an indicator of exposure data robustness. Seventy-one out of 342 substances (20%) for which indoor air concentrations have already been measured in office buildings were identified as priority pollutants. The results were compared to previous prioritization studies in various types of indoor environments to assess the reliability of the method and highlight its advantages. Sensitivity analyses were performed to reduce the geographical scope (OECD countries only), time scope (after 2010 only), and measurement duration (working hours only) and showed little influence on the results. Finally, 123 additional substances that could be present in office indoor air but could not be assessed due to the lack of measurement data are proposed for future monitoring surveys to update the prioritization of indoor air pollutants in offices.

Indoor air quality in shopping and storage areas.

In retail stores, workers are constantly exposed to new manufactured goods. The issue of the exposure of retail workers to volatile organic compounds (VOCs) should clearly be considered. Therefore, this study provides data regarding VOC concentrations in ten French retail stores. The stores were chosen to represent various products: sports goods, shoes and leather, furniture, car equipment, bazaars, online-sales storage, clothes, books, DIY (do-it-yourself), and household appliances. VOCs and aldehydes were actively sampled on the same day in five to seven locations per building and outdoors. Toluene and formaldehyde were omnipresent with indoor concentrations reaching 252 and 53 µg/m3 , respectively. The car equipment store, followed by clothing, shoes, and leather, and DIY stores showed the worst indoor air quality. High concentrations were measured, for example, the maximum α-pinene concentration in the furniture and DIY stores was 364 and 141 µg/m3 , respectively, and the heptane concentration in the car equipment store reached 1,316 µg/m3 . Two VOCs classified as toxic to reproduction were measured: hexane in the car equipment store and the bazaar, and dimethylformamide in the sports goods store. This study shows some disparities in the indoor concentrations among different locations in the same store, particularly between sales and storage areas.

Semivolatile organic compounds in French schools: Partitioning between the gas phase, airborne particles and settled dust.

The indoor environmental quality in classrooms can largely affect children's daily exposure to indoor chemicals in schools. To date, there has not been a comprehensive study of the concentrations of semivolatile organic compounds (SVOCs) in French schools. Therefore, the French Observatory for Indoor Air Quality (OQAI) performed a field study of SVOCs in 308 nurseries and elementary schools between June 2013 and June 2017. The concentrations of 52 SVOCs, including phthalates, polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), synthetic musks, and pesticides, were measured in air and settled dust (40 SVOCs in both air and dust, 12 in either air or dust). The results showed that phthalates had the highest concentrations among the SVOCs in both the air and dust. Other SVOCs, including tributyl phosphate, fluorene, phenanthrene, gamma-hexachlorocyclohexane (gamma-HCH, lindane), galaxolide, and tonalide, also showed high concentrations in both the air and dust. Theoretical equations were developed to estimate the SVOC partitioning between the air and settled dust from either the octanol/air partition coefficient or the boiling point of the SVOCs. The regression constants of the equations were determined using the data set of the present study for phthalates and PAHs.

Association of subjective health symptoms with indoor air quality in European office buildings: The OFFICAIR project.

The aim of this study was to explore the association between the building-related occupants' reported health symptoms and the indoor pollutant concentrations in a sample of 148 office rooms, within the framework of the European OFFICAIR research project. A large field campaign was performed in 37 office buildings among eight countries, which included (a) 5-day air sampling of volatile organic compounds (VOCs), aldehydes, ozone, and NO2 (b) collection of information from 1299 participants regarding their personal characteristics and health perception at workplace using online questionnaires. Stepwise and multilevel logistic regressions were applied to investigate associations between health symptoms and pollutant concentrations considering personal characteristics as confounders. Occupants of offices with higher pollutant concentrations were more likely to report health symptoms. Among the studied VOCs, xylenes were associated with general (such as headache and tiredness) and skin symptoms, ethylbenzene with eye irritation and respiratory symptoms, a-pinene with respiratory and heart symptoms, d-limonene with general symptoms, and styrene with skin symptoms. Among aldehydes, formaldehyde was associated with respiratory and general symptoms, acrolein with respiratory symptoms, propionaldehyde with respiratory, general, and heart symptoms, and hexanal with general SBS. Ozone was associated with almost all symptom groups.

Toward setting public health guidelines for chemicals in indoor settled dust?

Indoor settled dust may result in substantial human exposure to chemicals, especially by ingestion following hand-to-mouth or hand-to-object-to-mouth contact. As with other environmental media related to exposure, dust may thus be subject to regulation. An international scientific workshop was convened in Paris in September 2019 firstly to assess the relevance for public health of setting guidelines for indoor settled dust, and secondly to discuss scientific and technical challenges related to such guidelines. The main discussions and conclusions, with consensus achieved, are reported herein. Discussions concerned general considerations, objectives and definitions, relevance for a health-based guideline, units of measure, and finally derivation of the guideline. These points should be addressed when considering an indoor settled dust guideline as part of a policy to reduce exposure indoors to a given chemical or group of chemicals.

Indoor gaseous air pollutants determinants in office buildings-The OFFICAIR project.

The aim of this study was to identify determinants of aldehyde and volatile organic compound (VOC) indoor air concentrations in a sample of more than 140 office rooms, in the framework of the European OFFICAIR research project. A large field campaign was performed, which included (a) the air sampling of aldehydes and VOCs in 37 newly built or recently retrofitted office buildings across 8 European countries in summer and winter and (b) the collection of information on building and offices' characteristics using checklists. Linear mixed models for repeated measurements were applied to identify the main factors affecting the measured concentrations of selected indoor air pollutants (IAPs). Several associations between aldehydes and VOCs concentrations and buildings' structural characteristic or occupants' activity patterns were identified. The aldehyde and VOC determinants in office buildings include building and furnishing materials, indoor climate characteristics (room temperature and relative humidity), the use of consumer products (eg, cleaning and personal care products, office equipment), as well as the presence of outdoor sources in the proximity of the buildings (ie, vehicular traffic). Results also showed that determinants of indoor air concentrations varied considerably among different type of pollutants.

Machine learning and statistical models for predicting indoor air quality.

Indoor air quality (IAQ), as determined by the concentrations of indoor air pollutants, can be predicted using either physically based mechanistic models or statistical models that are driven by measured data. In comparison with mechanistic models mostly used in unoccupied or scenario-based environments, statistical models have great potential to explore IAQ captured in large measurement campaigns or in real occupied environments. The present study carried out the first literature review of the use of statistical models to predict IAQ. The most commonly used statistical modeling methods were reviewed and their strengths and weaknesses discussed. Thirty-seven publications, in which statistical models were applied to predict IAQ, were identified. These studies were all published in the past decade, indicating the emergence of the awareness and application of machine learning and statistical modeling in the field of IAQ. The concentrations of indoor particulate matter (PM2.5 and PM10 ) were the most frequently studied parameters, followed by carbon dioxide and radon. The most popular statistical models applied to IAQ were artificial neural networks, multiple linear regression, partial least squares, and decision trees.

Relationships between socioeconomic and lifestyle factors and indoor air quality in French dwellings.

BACKGROUND: To date, few studies have analyzed the relationships between socioeconomic status (SES) and indoor air quality (IAQ). OBJECTIVE: The aim of this study was to examine the relationships between socioeconomic and other factors and indoor air pollutant levels in French homes. METHODS: The indoor air concentrations of thirty chemical, biological and physical parameters were measured over one week in a sample of 567 dwellings representative of the French housing stock between September 2003 and December 2005. Information on SES (household structure, educational attainment, income, and occupation), building characteristics, and occupants' habits and activities (smoking, cooking, cleaning, etc.) were collected through administered questionnaires. Separate stepwise linear regression models were fitted to log-transformed concentrations on SES and other factors. Logistic regression was performed on fungal contamination data. RESULTS: Households with lower income were more likely to have higher indoor concentrations of formaldehyde, but lower perchloroethylene indoor concentrations. Formaldehyde indoor concentrations were also associated with newly built buildings. Smoking was associated with increasing acetaldehyde and PM2.5 levels and the risk of a positive fungal contamination index. BTEX levels were also associated with occupant density and having an attached garage. The major predictors for fungal contamination were dampness and absolute humidity. CONCLUSION: These results, obtained from a large sample of dwellings, show for the first time in France the relationships between SES factors and indoor air pollutants, and believe they should be considered alongside occupant activities and building characteristics when study IAQ in homes.

Semivolatile organic compounds in indoor air and settled dust in 30 French dwellings.

Semivolatile organic compounds (SVOCs) are ubiquitous contaminants in indoor environments, emanating from different sources and partitioning among several compartments, including the gas phase, airborne particles, and settled dust. Nevertheless, simultaneous measurements in the three compartments are rarely reported. In this study, we investigated indoor concentrations of a wide range of SVOCs in 30 French dwellings. In settled dust, 40 out of 57 target compounds were detected. The highest median concentrations were measured for phthalates and to a lesser extent for bisphenol A, synthetic musks, some pesticides, and PAHs. Di(2-ethylhexyl)phthalate (DEHP) and diisononyl phthalate (DINP) were the most abundant compounds. A total of 34 target compounds were detected both in the gas phase and airborne particles. The highest concentrations were measured for diisobutyl phthalate (DiBP), diethyl phthalate (DEP), dibutyl phthalate (DBP), and synthetic musks in the gas phase and for DEHP, DiBP, DBP, and DINP in the airborne particles. This is the first study on the indoor concentrations of a wide range of SVOCs in settled dust, gas phase, and airborne particles collected simultaneously in each dwelling.

Radon exposure and potential health effects other than lung cancer: a systematic review and meta-analysis.

Context and objective: To date, lung cancer is the only well-established health effect associated with radon exposure in humans. To summarize available evidence on other potential health effects of radon exposure, we performed a comprehensive qualitative and quantitative synthesis of the available literature on radon exposure and health effects other than lung cancer, in both occupational and general populations. Method: Eligible studies published from January 1990 to March 2023, in English and French languages, were identified in PubMed, ScienceDirect, Scopus, ScieLo and HAL. In the meta-analysis, we estimated average weighted standardized incidence ratios (metaSIR), standardized mortality ratios (metaSMR), and risk ratio (metaRR) per 100 unit (Bq/m3 or Working level Month) increase in radon exposure concentration by combining estimates from the eligible studies using the random-effect inverse variance method. DerSimonian & Laird estimator was used to estimate the between-study variance. For each health outcome, analyses were performed separately for mine workers, children, and adults in the general population. Results: A total of 129 studies were included in the systematic review and 40 distinct studies in the meta-analysis. For most of these health outcomes, the results of the meta-analyses showed no statistically significant association, and heterogeneity was only present among occupational studies, especially between those included in the metaSIR or metaSMR analyses. However, the estimated exposure-risk associations were positive and close to the statistical significance threshold for: lymphohematological cancer incidence in children (metaRR = 1.01; 95%CI: 1.00-1.03; p = 0.08); malignant melanoma mortality among adults in the general population (metaRR = 1.10; 95%CI: 0.99-1.21; p = 0.07); liver cancer mortality among mine workers (metaRR = 1.04; 95%CI: 1.00-1.10; p = 0.06); intestine and rectal cancer mortality combined among mine workers (metaRR = 1.02; 95%CI: 1.00-1.04; p = 0.06). Conclusion: Although none of the exposure-risk associations estimated in the meta-analyses reached statistical significance, the hypothesis that radon may have other health effects apart from lung cancer could not be ruled-out and call for additional research. Larger and well-designed studies are needed to further investigate this question. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023474542, ID: CRD42023474542.

Biocide and other semi-volatile organic compound concentrations in settled indoor dust of CRESPI daycare centers and implication for public health.

This study investigates the presence of biocides and other semi-volatile organic compounds (SVOCs) in cleaning products used in daycare centers and health impact through ingestion of settled dust by young children. In Paris metropolitan area, 106 daycares area were investigated between 2019-2022. Fifteen substances were analyzed in settled indoor dust by gas chromatography-tandem mass spectrometry. Detection rates and concentrations ranged from 5 to 100%, and

Indoor exposure to ultrafine particles related to domestic activities: A systematic review and meta-analysis.

Ultrafine particles (< 100 nm) are of increasing concern because of their toxicological potential. Emission processes suggest their presence in all environments, including at home, where particularly at-risk populations may be exposed. However, knowledge of their impact on health is still limited, due to difficulties in properly assessing exposure in epidemiological studies. In this context, the objective of this study was to provide a complete summary of indoor exposure to ultrafine particles in highly industrialised countries by examining the domestic activities that influence such exposure. We conducted a systematic review, according to PRISMA guidelines using PubMed, Web of Science and Scopus up to and including 2021. We carried out a qualitative and quantitative analysis of the selected studies with a standardised template. Exposure circumstances, measurement methods, and results were analysed. Finally, a meta-analysis of the measured concentrations was performed to study exposure levels during domestic activities. The review included 69 studies resulting in the analysis of 346 exposure situations. Nine main groups of activities were identified: cooking, which was the most studied, smoking, the use of air-fresheners, cleaning, heating, personal care, printing, do-it-yourself activities, and others. Over 50 different processes were involved in these activities. Based on available particle number concentrations, the highest average of mean concentrations was associated with grilling (14,400 × 103 cm-3), and the lowest with wood stove (18 × 103 cm-3). The highest average of peak concentrations was that for the use of hair dryers (695 × 103 cm-3), and the lowest for the use of air cleaners (11 × 103 cm-3). A hierarchy of domestic activities and related processes leading to ultrafine particle exposure is provided, along with average exposure concentrations at home. However, more extensive measurement campaigns are needed under real-life conditions to improve assessments of indoor exposure to ultrafine particles.

Exposure to Disinfectants and Cleaning Products and Respiratory Health of Workers and Children in Daycares: The CRESPI Cohort Protocol.

Although cleaning tasks are frequently performed in daycare, no study has focused on exposures in daycares in relation to respiratory health. The CRESPI cohort is an epidemiological study among workers (n~320) and children (n~540) attending daycares. The purpose is to examine the impact of daycare exposures to disinfectants and cleaning products (DCP) on the respiratory health of workers and children. A sample of 108 randomly selected daycares in the region of Paris has been visited to collect settled dust to analyze semi-volatile organic compounds and microbiota, as well as sample indoor air to analyze aldehydes and volatile organic compounds. Innovative tools (smartphone applications) are used to scan DCP barcodes in daycare and inform their use; a database then matches the barcodes with the products' compositions. At baseline, workers/parents completed a standardized questionnaire, collecting information on DCP used at home, respiratory health, and potential confounders. Follow-up regarding children's respiratory health (monthly report through a smartphone application and biannual questionnaires) is ongoing until the end of 2023. Associations between DCP exposures and the respiratory health of workers/children will be evaluated. By identifying specific environments or DCP substances associated with the adverse respiratory health of workers and children, this longitudinal study will contribute to the improvement of preventive measures.

The burden of disease attributable to indoor air pollutants in China from 2000 to 2017.

BACKGROUND: High-level exposure to indoor air pollutants (IAPs) and their corresponding adverse health effects have become a public concern in China in the past 10 years. However, neither national nor provincial level burden of disease attributable to multiple IAPs has been reported for China. This is the first study to estimate and rank the annual burden of disease and the financial costs attributable to targeted residential IAPs at the national and provincial level in China from 2000 to 2017. METHODS: We first did a systematic review and meta-analysis of 117 articles from 37 231 articles identified in major databases, and obtained exposure-response relationships for the candidate IAPs. The exposure levels to these IAPs were then collected by another systematic review of 1864 articles selected from 52 351 articles. After the systematic review, ten IAPs with significant and robust exposure-response relationships and sufficient exposure data were finally targeted: PM2·5, nitrogen dioxide, sulphur dioxide, ozone, carbon monoxide, radon, formaldehyde, benzene, toluene, and p-dichlorobenzene. The annual exposure levels in residences were then evaluated in all 31 provinces in mainland China continuously from 2000 to 2017, using the spatiotemporal Gaussian process regression model to analyse indoor originating IAPs, and the infiltration factor method to analyse outdoor originating IAPs. The disability-adjusted life-years (DALYs) attributable to the targeted IAPs were estimated at both national and provincial levels in China, using the population attributable fraction method. Financial costs were estimated by an adapted human capital approach. FINDINGS: From 2000 to 2017, annual DALYs attributable to the ten IAPs in mainland China decreased from 4620 (95% CI 4070-5040) to 3700 (3210-4090) per 100 000. Nevertheless, in 2017, IAPs still ranked third among all risk factors, and their DALYs and financial costs accounted for 14·1% (95% CI 12·3-15·6) of total DALYs and 3·45% (3·01-3·82) of the gross domestic product. Specifically, the rank of ten targeted IAPs in order of their contribution to DALYs in 2017 was PM2·5, carbon monoxide, radon, benzene, nitrogen dioxide, ozone, sulphur dioxide, formaldehyde, toluene, and p-dichlorobenzene. The DALYs attributable to IAPs were 9·50% higher than those attributable to outdoor air pollution in 2017. For the leading IAP, PM2·5, the DALYs attributable to indoor origins are 18·3% higher than those of outdoor origins. INTERPRETATION: DALYs attributed to IAPs in China have decreased by 20·0% over the past two decades. Even so, they are still much higher than those in the USA and European countries. This study can provide a basis for determining which IAPs to target in various indoor air quality standards and for estimating the health and economic benefits of various indoor air quality control approaches, which will help to reduce the adverse health effects of IAPs in China. FUNDING: The National Key Research and Development Program of China and the National Natural Science Foundation of China.

Lead contamination in French children's homes and environment.

Lead in homes is a well-known source of childhood lead exposure, which is still of concern due to the health effects of low lead doses. This study aims to describe lead contamination in the homes of children aged 6 months to 6 years in France (without overseas). Between October 2008 and August 2009, 484 housing units were investigated. Lead in tap water and total and leachable lead levels from floor dust, outdoor soils and paint chips were measured. X-ray fluorescence measurements were carried out on non-metallic and metallic substrates. Nationwide results are provided. The indoor floor dust lead (PbD) geometric mean (GM) was 8.8 µg/m² (0.8 µg/ft²) and 6.8 µg/m² (0.6 µg/ft²) for total and leachable lead respectively; 0.21% of homes had an indoor PbD loading above 430.5 µg/m² (40 µg/ft²). The outdoor play area concentration GM was 33.5 mg/kg and 21.7 mg/kg in total and leachable lead respectively; 1.4% of concentrations were higher than or equal to 400 mg/kg. Outdoor floor PbD GM was 44.4 µg/m² (4.1 µg/ft²) that was approximately 3.2 times higher than the GM of indoor PbD. Lead-based paint (LBP) was present in 25% of dwellings, LBP on only non-metallic substrates was present in 19% of homes and on metallic substrates in 10% of dwellings. The GM of lead concentrations in tap water was below 1 µg/L; 58% of concentrations were lower than 1 µg/L and 2.9% were higher than or equal to 10 µg/L. The age cut-off for homes with lead would be 1974 for paint and 1993 for indoor floor dust. This study provides, for the first time, a look at the state of lead contamination to which children are exposed in French housing. Moreover, it provides policy makers an estimate of the number of French dwellings sheltering children where abatement should be conducted.

Impact of Climate Change on Indoor Air Quality: A Review.

Climate change can affect the indoor environment due to heat and mass transfers between indoor and outdoor environments. To mitigate climate change impacts and adapt buildings to the changing environment, changes in building characteristics and occupants' behavior may occur. To characterize the effects of climate change on indoor air quality (IAQ), the present review focused on four aspects: (1) experimental and modeling studies that relate IAQ to future environmental conditions, (2) evolution of indoor and outdoor air concentrations in the coming years with regard to temperature rise, (3) climate change mitigation and adaptation actions in the building sector, and (4) evolution of human behavior in the context of climate change. In the indoor environment, experimental and modeling studies on indoor air pollutants highlighted a combined effect of temperature and relative humidity on pollutant emissions from indoor sources. Five IAQ models developed for future climate data were identified in the literature. In the outdoor environment, the increasing ambient temperature may lead directly or indirectly to changes in ozone, particle, nitrogen oxides, and volatile organic compound concentrations in some regions of the world depending on the assumptions made about temperature evolution, anthropogenic emissions, and regional regulation. Infiltration into buildings of outdoor air pollutants is governed by many factors, including temperature difference between indoors and outdoors, and might increase in the years to come during summer and decrease during other seasons. On the other hand, building codes in some countries require a higher airtightness for new and retrofitted buildings. The building adaptation actions include the reinforcement of insulation, implementation of new materials and smart building technologies, and a more systematic and possibly longer use of air conditioning systems in summer compared to nowadays. Moreover, warmer winters, springs, and autumns may induce an increasing duration of open windows in these seasons, while the use of air conditioning in summer may reduce the duration of open windows.