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Relationships between home ventilation rates and respiratory health in the Colorado Home Energy Efficiency and Respiratory Health (CHEER) study

Affiliations

• ¹ Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E 17th Place B119, Aurora, CO, United States. Electronic address: elizabeth.carlton@ucdenver.edu.
• ² Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E 17th Place B119, Aurora, CO, United States.
• ³ Department of Mechanical Engineering, University of Colorado, 427 UCB, Boulder, CO 80309-0427, United States.
• ⁴ Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E 17th Place B119, Aurora, CO, United States; Division of Pulmonary Science and Critical Care Medicine, Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States.
• ⁵ Department of Geography and Division of Epidemiology, The Ohio State University, 1036 Derby Hall, 154 North Oval Mall, Columbus, OH 43210, United States.

• PMID: 30500684
• DOI: 10.1016/j.envres.2018.11.019

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Elizabeth J Carlton et al. Environ Res. 2019 Feb.

• ¹ Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E 17th Place B119, Aurora, CO, United States. Electronic address: elizabeth.carlton@ucdenver.edu.
• ² Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E 17th Place B119, Aurora, CO, United States.
• ³ Department of Mechanical Engineering, University of Colorado, 427 UCB, Boulder, CO 80309-0427, United States.
• ⁴ Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E 17th Place B119, Aurora, CO, United States; Division of Pulmonary Science and Critical Care Medicine, Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States.
• ⁵ Department of Geography and Division of Epidemiology, The Ohio State University, 1036 Derby Hall, 154 North Oval Mall, Columbus, OH 43210, United States.

• PMID: 30500684
• DOI: 10.1016/j.envres.2018.11.019

Item in Clipboard

Background: As societies adopt green building practices to reduce energy expenditures and emissions that contribute to climate change, it is important to consider how such building design changes influence health. These practices typically focus on reducing air exchange rates between the building interior and the outdoor environment to minimize energy loss, the health effects of which are not well characterized. This study aims to evaluate the relationship between air exchange rates and respiratory health in a multi-ethnic population living in low-income, urban homes.

Methods: The Colorado Home Energy Efficiency and Respiratory Health (CHEER) study is a cross-sectional study that enrolled 302 people in 216 non-smoking, low-income single-family homes, duplexes and town-homes from Colorado's Northern Front Range. A blower door test was conducted and the annual average air exchange rate (AAER) was estimated for each home. Respiratory health was assessed using a structured questionnaire based on standard instruments. We estimated the association between AAER and respiratory symptoms, adjusting for relevant confounders.

Results: Air exchange rates in many homes were high compared to prior studies (median 0.54 air changes per hour, range 0.10, 2.17). Residents in homes with higher AAER were more likely to report chronic cough, asthma and asthma-like symptoms, including taking medication for wheeze, wheeze that limited activities and dry cough at night. Allergic symptoms were not associated with AAER in any models. The association between AAER and asthma-like symptoms was stronger for households located in areas with high potential exposure to traffic related pollutants, but this was not consistent across all health outcomes.

Conclusions: While prior studies have highlighted the potential hazards of low ventilation rates in residences, this study suggests high ventilation rates in single-family homes, duplexes and town-homes in urban areas may also have negative impacts on respiratory health, possibly due to the infiltration of outdoor pollutants.

Keywords: Air exchange rate; Asthma; Respiratory health; Urban health; Ventilation.

Copyright © 2018 Elsevier Inc. All rights reserved.

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