It is estimated that people in the developed world spend more than 85-90% of their time indoors. Of this, most is spent in homes. To minimize health risks from pollutants occurring in homes, exposures should be controlled. The most effective way to achieve this is to control sources of pollutants and to reduce emissions. Often, especially in existing buildings, this strategy is difficult to implement, in which case exposures are controlled by providing sufficient, presumably clean, outdoor ventilation air to dilute and remove the contaminants.
The present paper attempts to find out how much ventilation is needed in existing homes to reduce health risks. This is achieved by reviewing the published scientific literature investigating the association between measured ventilation rates and the measured and observed health problems.
The paper concludes that, generally, there are very few studies on this issue and many of them suffer from deficient experimental design, as well as a lack of proper characterization of actual exposures occurring indoors. Based on the available data, in the reviewed studies, it seems likely that health risks may occur when ventilation rates are below 0.4 air changes per hour in existing homes. No data were found indicating that buildings having dedicated natural ventilation systems perform less well than the dwellings in which mechanical ventilation systems are installed. Newly installed mechanical ventilation systems were observed to improve health conditions. In homes with existing ventilation systems this positive effect was less evident, probably due to poor performance of the system (too low ventilation rates and/or poor maintenance).
Studies are recommended in which exposures are much better characterized (by for example measuring the pollutants indicated by the WHO Guidelines for Indoor Air Quality and improving ventilation measurements). Exposures should also be controlled using different ventilation methods for comparison. Future studies should also advance the understanding of how ventilation systems should be operated to achieve optimal performance. These data would create further input and support to the guidelines for ventilation based on health developed currently in the framework of the HealthVent project (www.healthvent.eu).