NIST Technical Note 1882 

Indoor Environmental Issues in 

Disaster Resilience 

Andrew K. Persily 

Steven J. Emmerich 

This publication is available free of charge from:

http://dx.doi.org/10.6028/NIST.TN.1882
NIST Technical Note 1882 

Indoor Environmental Issues in 

Disaster Resilience 

Andrew K. Persily 

Steven J. Emmerich 

Energy and Environmental Division 

Engineering Laboratory 

This publication is available free of charge from: 

http://dx.doi.org/10.6028/NIST.TN.1882 

July 2015 

U.S. Department of Commerce 

Penny Pritzker, Secretary 

National Institute of Standards and Technology 

Willie May, Under Secretary of Commerce for Standards and Technology and Director 
Certain commercial entities, equipment, or materials may be identified in this 

 document in order to describe an experimental procedure or concept adequately. 

Such identification is not intended to imply recommendation or endorsement by the 

National Institute of Standards and Technology, nor is it intended to imply that the 

entities, materials, or equipment are necessarily the best available for the purpose. 

National Institute of Standards and Technology Technical Note 1882 Natl. 

Inst. Stand. Technol. Tech. Note 1882, 36 pages (July 2015) 

CODEN: NTNOEF 

This publication is available free of charge from: http://dx.doi.org/10.6028/NIST.TN.1882
iii

ABSTRACT 

NIST is developing a planning guide to define programs and strategies to increase communitybased resilience in the face of a broad range of natural disasters and other extreme events. Many 

of these events will affect indoor environmental quality. either through the potential for increased 

airborne contaminant levels or due to challenges in providing acceptable indoor environments for 

building occupants during the event and afterwards in the recovery phase. However, the elements 

of indoor environmental resilience (IER) have not been identified and discussed in a systematic 

fashion, which needs to be done to determine the role of these factors in the context of 

community resilience. This report presents a review of existing information, standards, programs 

and other technical resources related to the events that are likely to impact IER in order to 

describe the scope and potential impacts of the problem, current activities that address these 

issues, important gaps requiring research and other technical analyses, and needs for standards 

and related guidance. The conclusions presented in this report include the following needs: 

passive building design approaches that can maintain safe and comfortable conditions during 

extended power outages; definition of short term acceptable ventilation and indoor air quality 

conditions for living and working in buildings temporarily during power outages; development 

of guidance to provide community-wide sheltering in response to heat waves, wildfire and other 

events; tools to help communities identify buildings that may be subject to poor IER conditions 

during disasters; thermal comfort and ventilation standards or guidelines that cover extreme 

conditions; and, guidance for homeowners and volunteers engaged in mold/wet building cleanup 

following large scale flooding events. 

Keywords: disaster; indoor air quality; indoor environmental quality; thermal comfort; resilience; 

ventilation 
1

1. INTRODUCTION

The NIST Community Disaster Resilience Planning Guide (NIST 2015) addresses resilience of 

buildings and infrastructure systems at the community scale and provides guidance on 

establishing long-term goals and plans for recovery following a disaster, with consideration of 

social needs. In addition to the development of the planning guide, the NIST community disaster 

resilience program is pursuing a number of other activities to support the overall program goals. 

This report describes one such activity, an effort to define the role of indoor environmental 

quality (IEQ) in the context of community resilience. This work is motivated by the fact that 

many of the natural and human-caused disasters being considered under the broader program 

will affect IEQ. These effects include both increased airborne contaminant concentrations 

associated with the disaster or its aftermath and challenges in providing acceptable indoor 

environmental conditions during an event or afterwards during recovery. 

In order to examine resilience, particularly recovery of functionality in the context of the indoor 

environment, it is important to consider what the indoor built environment is expected to provide 

for occupants. One key objective is to maintain thermally comfortable conditions, which are a 

function of air temperature, relative humidity, air speed and radiant temperature in the space as 

well as human factors such as the occupants’ level of physical activity, clothing and 

physiological ability to adapt to thermal conditions. In addition, the indoor environment should 

limit concentrations of airborne contaminants to safe and comfortable levels. Contaminants of 

interest include organic and inorganic gases, particulate matter, and bioaerosols. The indoor 

environment, primarily via the building enclosure, is also intended to isolate the building 

occupants from the exterior environment, specifically including precipitation, pests, noise and 

threats to the physical security of the occupants. Finally, the indoor environment is expected to 

provide various amenities such as light, power and food storage to support the intended activities 

for the space in question, including working, learning, or residing.

Additional concepts to consider in the context of indoor environmental resilience (IER) are the

features of the indoor environment that impact occupant health, comfort and productivity, i.e., 

IEQ. The four primary factors of IEQ are indoor air quality (IAQ), thermal comfort, acoustics 

and illumination (ASHRAE 2011). IAQ refers to indoor levels of airborne contaminants as well 

as odors, without specific reference to the compounds causing those odors, and perceived indoor 

air quality, i.e., human perception of indoor air in terms of irritation and other non-specific 

symptoms (Fanger 2006). Thermal comfort describes building occupants’ sense of the warmth or 

coolness and is a function of the parameters mentioned above. Acoustics refers to the levels and 

frequencies of sound and vibration in a space, while lighting concerns the levels and frequencies 

of visible electromagnetic radiation as well as variations among surfaces in the space.

The role of IEQ issues in the context of disasters has been identified in two prominent 

documents. The National Climate Assessment summarizes the impacts of climate change on the 

United States, now and in the future, and highlights several anticipated changes that are relevant 

to IEQ (Melillo et al. 2014). Under extreme weather, the increased frequency of heat waves, 

heavy downpours, floods and hurricanes are all noted. The discussion of human health mentions 

vulnerable people and communities, wildfire smoke, increased levels of pollen, and impacts on 

asthma and allergies. Finally, under infrastructure, disruptions in energy production and delivery 

are noted. The IEQ impacts of these topics, as they relate to disasters, are all reviewed later in 

this report. The Institute of Medicine (IOM) published a study on climate change and indoor 
2

environmental health in 2011, which contained several key findings: poor IEQ is creating health 

problems today, impairing the ability of occupants to work and learn; climate change may 

worsen existing IEQ problems and introduce new ones; and, there are opportunities to improve 

public health while mitigating or adapting to alterations in IEQ induced by climate change (IOM 

2011). This report also noted several problematic indoor exposures including the following: 

indoor contaminants; dampness, moisture and flooding; infectious agents and pests; thermal 

stress; and, building ventilation, weatherization, and energy use. Several of these exposures are 

discussed later in this report.

Fisk (2015) reviewed the potential health consequences of climate changes that affect indoor 

environments including consideration of the IOM report, recent contributions of working groups 

to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change (Smith et al. 

2014, IPCC 2013) and other resources. Fisk discusses the potential health impacts of increases in 

urban airborne ozone concentrations (not considered in this report), as well as increases in the 

frequency and severity of heat waves, flooding associated with severe storms and sea level rise, 

and wildfires, all of which are considered in this report.

This report identifies and discusses the elements of what is referred to here as indoor 

environmental resilience through a review of existing information, programs and other technical 

resources related to events that are likely to impact IER. It reviews such events, describing how 

those events may impact IER and what is known about their impacts. For each event, existing 

standards and guidelines are described, as well as other programs and activities to support 

planning and response strategies. In the discussion that follows, the community resilience 

perspective is employed in presenting each of the events.
3

2. SCOPE OF INDOOR ENVIRONMENTAL RESILENCE

The first step in this effort was to consider the types of extreme events that have the potential to 

impact IEQ and which may merit planning and responses in support of increased community 

resilience. Table 1 contains a list of the events considered in this discussion, along with the 

associated indoor environmental exposures of interest.

Type of event Indoor environmental exposure

Heat waves High indoor temperatures/heat stress

High levels of outdoor pollution

Storms causing power failure Lack of heating, cooling, and ventilation leading to 

heat/cold stress and elevated indoor contaminant levels

Carbon monoxide exposure from portable generators

Floods and mold exposure Microbial growth affecting occupants and remediation 

workers

Wildfires Particulate and other contaminant exposure

Airborne releases of chemical, 

biological or radiological (CBR) agents

Exposure to agent

Table 1 Events relevant to indoor environmental resilience

Each of the events listed in Table 1 was analyzed in terms of what is known about the scenarios 

of interest and the associated impacts. This effort involved examining available information on 

these events and their indoor environmental impacts, technical gaps in understanding these 

impacts, existing standards, and how they are being addressed by various guidance documents. 

An important aspect of the NIST Community Resilience Planning Guide is addressing recovery 

from disasters, which is usually divided into three phases: short term (days), intermediate (weeks 

to months), and long term (months to years). The impacts of the events considered in Table 1 are 

primarily in the short to intermediate phases, though the effects of floods and airborne CBR 

releases could extend into long term recovery phases.

Each of the following sections describes the event and its potential impacts, relevant standards 

that currently exist, and a summary of other guidance and activities that might support increased 

resilience. Following the discussion of each of the topics in Table 1, this document discusses two

other issues that are relevant to IER but do not necessarily relate to a particular event in the same 

way as the topics in Table 1. These issues are pandemics and the role of healthcare facilities and 

indoor environmental conditions in safe rooms and shelter-in-place facilities. These discussions 

are followed by a review of existing standards and guidelines relevant to IER.
4

2.1 Heat Waves

Heat waves are prolonged periods of high outdoor temperatures, often accompanied by high 

outdoor humidity levels, typically lasting for two or more days. These events are typically 

associated with high-pressure atmospheric conditions that hold air in place over a limited 

geographic area, preventing cooling from rain and other mechanisms or replacement with air 

from other areas. The human health effects of excessive heat are well understood and include a 

range of health effects from mild, e.g. dehydration and cramps, to severe, e.g. heat exhaustion 

and heat stroke. The elderly, infants and children, overweight individuals, and people with 

chronic medical conditions are more susceptible to heat related health effects. There have been a 

number of heat waves in recent years, with several recent events captured in Table 2. In fact, 

during the period of 1979 to 2003, more people in the U.S. have died from extreme heat than 

from hurricanes, lightning, tornadoes, floods, and earthquakes combined (CDC 2012). As the 

climate warms, longer and more severe heat waves are predicted to result in significant increases 

in heat wave deaths in the U.S. over the next several decades (Wu et al. 2013).

Extreme Heat incident, year Deaths

Philadelphia heat wave, 1993 118

Chicago heat wave, 1995 739

European heat wave, 2003 70 000

California heat wave, 2006 650

Russian heat wave, 2010 11 000 to 50 000

Table 2 Selected extreme heat events (CAT 2013)

There has been a lot of work done on heat stress in occupational settings, primarily to protect 

workers against adverse health effects through a combination of personal protection and limits 

on time in work settings with elevated temperatures (Charmichael et al. 2011). In terms of nonoccupational exposures, there have also been many studies to understand the health risks 

associated with elevated temperatures in the general population (Basu and Samet 2002; Basu 

2009). These epidemiologic studies have identified associations of elevated temperature with 

death and disease and identified vulnerable subgroups including children, infants, the elderly and 

those with pre-existing health conditions. CDC (Berko et al. 2014) recently published an analysis 

of deaths due to heat, cold and other weather events by income level of the affected U.S. county, 

level of urbanization, age, and race, but did not specify whether the exposure occurred indoors or 

outdoors. Table 3 summarizes some of the vulnerabilities to heat illnesses. Of particular note are 

the environmental factors, which relate to how building design, community programs and 

communication could potentially reduce the human health impacts of heat waves.

Fisk (2015) suggests that many and perhaps most heat wave deaths occur indoors, thus, buildings 

and community environments play a key role in these effects and their control. Individuals spend 

most of their time indoors, about 90 % (Klepeis et al. 2001), and as noted in the last column of 

Table 3, the health impacts are associated with several building features. Note that a lack of air 

conditioning may be a feature of the building itself or associated with an event that leads to a 

power outage. Other building and community features not noted in the table are increasing levels 

of insulation in buildings driven by energy efficiency goals, which can contribute to elevated 

indoor temperatures during heat waves when air conditioning is not available. There has been 

renewed attention to passive cooling designs as a means to both save energy and to deal with 

situations in which mechanical cooling is not available. Passive cooling approaches have been 

around for centuries, with increased levels of interest as building energy efficiency has become a 
5

more important design goal. Common passive cooling approaches include natural ventilation, 

use of building mass to dampen outdoor temperature extremes, and building orientation to reduce 

solar loads and shading, again to reduce solar heating. Concerns have been expressed that as 

buildings are designed to use less energy through the use of higher insulation levels, fewer 

operable windows and more reliance on mechanical ventilation, that these buildings will be 

harder to cool during power outages (CCC 2014). Fisk (2015) identified thermal insulation of 

attics, cool roofing materials, external shading, and energy efficient windows as mitigation 

measures for protection against heat waves regardless of climate change.

Pre-existing health conditions Extremes of age Environmental Factors

Obesity 

Poor existing health 

Pre-existing dehydration 

Cardiovascular conditions 

Respiratory conditions 

Low fitness or physical 

disabilities

Uncontrolled diabetes

Medications affecting 

thermoregulation

Alcohol and/or drug abuse

Elderly (particularly > 65 y) 

Children and infants 

Residing in upper floors of 

buildings 

South facing flats 

Lack of adequate ventilation in 

home or air conditioning 

Living alone 

Socially isolated 

Lack of acclimatization 

Urban dwelling 

Care home residents 

Inability to adapt behaviorally 

Alzheimer’s 

Confinement to bed

Disabilities

Table 3 Vulnerabilities to heat illness (Carmichael et al. 2011)

Standards and Guidance

Recommendations exist for mitigating heat stress in occupational settings. The American 

Conference on Government Industrial Hygienists (ACGIH 2014) addresses heat stress using the

wet bulb globe temperature (WBGT), a metric that accounts for air and radiant temperatures, 

humidity, solar exposure and clothing level. The ACGIH provides workplace screening criteria 

for WBGT that depend on the level of activity and whether or not the worker is acclimatized to 

the conditions. For example, an unacclimatized individual engaged in light work is associated 

with a criteria value of WBGT of about 30 °C, assuming their time is evenly split between light

work and rest. Note that these criteria are applicable to healthy workers and not to the susceptible 

populations listed in Table 3. While the Occupational Safety and Health Administration does not 

have a specific standard that covers working in hot environments, they do provide resources for 

employers and workers to reduce worker risk to heat related illnesses (OSHA 2014).

ASHRAE Standard 55, Thermal Environmental Conditions for Human Occupancy, specifies 

indoor environmental factors that will produce conditions that are acceptable to a majority of the 

occupants in a space (ASHRAE 2013a). The factors in this standard include primarily air 

temperature and humidity, but it also speaks to air speed, draft and temperature stratification. 

This standard, which is based on healthy adults, has historically been focused more on 

mechanically ventilated commercial buildings than on residential buildings, though recently it 

has considered naturally ventilated buildings. However, it still focuses on thermal comfort when

buildings are being operated as designed and does not address extraordinary circumstances such 

as power outages and extreme outdoor weather events. Also, it addresses thermal comfort, and 

not physiological concerns such as heat stress. The most familiar information from Standard 55 

is the so-called comfort chart, which shows the range of acceptable operative temperatures and 

relative humidity levels for a specific range of physical activity and clothing levels. Operative 

temperature is a measure that combines air temperature with radiant effects. The maximum 

operative temperature on that chart ranges from about 27 °C to 28 °C depending on humidity.
6

ISO Standard 7933 contains an analytical method for assessing heat stress experienced by an 

individual in a hot environment, including the prediction of sweat rate and internal core 

temperature under working conditions (ISO 2004). As noted in the standard, it only considers 

individuals “in good health and fit for the work they perform” and is intended for evaluating 

“working conditions.” It is not applicable to the general population in non-work environments. 

Local building regulations address minimum indoor temperatures during cold weather but not 

maximum temperatures. However, there are several sources of guidance that address heat waves, 

which could be incorporated into a more comprehensive community resilience approach. Many 

state and local governments, e.g., Wisconsin (Wisconsin Department of Health Services 2014), 

as well as the CDC (2012) and the American Red Cross (2014), have warning and prevention 

plans with guidance on how to prepare for and respond to extreme heat conditions. This guidance 

identifies risk factors for heat-related illness, including age, being overweight, taking medication 

that affects the body’s ability to regulate temperature, and lack of air conditioning. Steps to 

prevent health problems are also highlighted, such as communication with susceptible 

individuals, use of fans, drawing shades and curtains, and drinking fluids. The potential for 

power outages during heat waves is noted, with suggestions of testing alternative power systems 

before such events and communicating with vulnerable individuals. 

Other relevant efforts

In terms of building design, as noted above, passive design approaches that avoid overheating of 

buildings during heat waves and loss of air conditioning are being developed by CIBSE (2014) 

and others. These approaches are focused on window selection, solar shading, operable windows, 

flow-through ventilation, and natural ventilation design principles. In addition, weather data for 

building design is being projected into the future to enable consideration of warmer conditions as 

well as extreme heat events. The impacts of urban planning on heat islands is also being 

considered as a means to reduce localized heating through the use of green spaces, building 

spacing to allow air to flow through urban areas and shading strategies (Hong Kong Planning 

Department 2002, Rosenthal et al. 2008, San Francisco Department of Public Health 2013).

Summary

Heat waves are already known to be a serious health issue, with a good understanding of the 

health effects and the large numbers of people being impacted and with concerns noted for the 

potential increase in the frequency and severity of heat waves due to climate change. While the 

data on the health impacts of heat waves has not been parsed to determine the fraction of 

exposures that occur inside buildings, building factors have been identified that contribute to 

overheating. Guidance materials and programs exist describing how to prepare for and respond 

to heat waves, but standards and regulations are limited. Thermal comfort standards for example 

address building design and operation under normal conditions but do not address extreme

conditions that might exist in a building without air conditioning where survivability is more of 

an issue than simply comfort. Also, local building regulations address minimum indoor 

temperatures during cold weather but not maximum temperatures. Building and community 

design guidance is being developed to reduce heat island effects in urban areas and to enhance 

the ability of buildings to be cooled passively, without relying on mechanical cooling. While this 

building design guidance is important and helpful, additional guidance and perhaps standards are 

needed to address the range of climates and different building types. 
7

2.2 Storms causing power failure

Electric power outages are a common occurrence during many types of disasters and, given its 

importance to communities, issues relating to the electric infrastructure are addressed in detail in 

the NIST Community Resilience Planning Guide (CRPG). The CRPG includes a discussion of 

the importance of standby power for continuous operation of critical facilities and considerations 

for safe and reliable operation of onsite standby power, including proper ventilation of 

combustion products. Standby and emergency power issues are also addressed by codes such as 

the National Electric Code (NFPA 2014a) and Life Safety Code (NFPA 2015). The Planning 

Guide discussion focuses largely on larger, permanently installed systems, though it mentions

that small mobile generators can be easily deployed but have shortcomings including the need 

for frequent refueling, risk of theft, potential lack of reliability due to infrequent use and poor 

maintenance, and safety hazards due to inexperienced operators. This section expands on the 

issue of IAQ-related safety hazards due to the use of portable generators and addresses other 

IAQ-related power outage issues, such as cold indoor environments due to loss of heating.

Klinger (et al. 2014) reviewed the potential health-related impacts of international power outages 

during the first three months of 2013, including loss of public health infrastructure, carbon 

monoxide (CO) poisoning, and food safety (see Figure 1 from that reference for a list of services 

lost during power failures). According to Klinger et al., storms, wind and snow accounted for the 

majority of power outages during that period, but many other types of events (such as flooding)

were also responsible to a lesser extent. They concluded that research on the impacts of power 

outages is scarce and that the only area where quantification has been attempted is CO poisoning.

Figure 1 Services lost during power outages (from Klinger et al. 2014)

Recent scientific literature has documented the occurrence of CO-poisoning deaths and injuries 

due to improper use of portable electric generators following a wide range of disasters including 

windstorms (Goldman et al. 2014), coastal storms and flooding (Lane et al. 2013), earthquakes 

(Iseki et al. 2013), winter storms (Klinger et al. 2014) and blackouts (Anderson and Bell 2012). 

The aftermath of superstorm Sandy in October 2012 highlights the potential scope of this 
8

problem for a major event, as this storm resulted in loss of power to over 8.5 million people in 21 

states, caused at least 263 CO poisonings, led to the need to move over 100 patients from New 

York area hospitals, and created other significant issues such as elderly occupants being trapped

in high-rise residences (Manuel 2013).

Hnatov (2013) summarizes non-fire CO incidents associated with engine-driven generators and 

other engine-driven tools reported to the U.S. Consumer Product Safety Commission (CPSC) 

between 1999 and 2012. The CPSC databases contain records of 236 CO poisoning deaths 

involving generator use associated with power outages (in some cases in combination with 

another CO source) for the same 14-year period. The vast majority of these deaths occur when 

consumers use a generator in an enclosed space, though a small percentage occurs when the 

consumer uses the generator outdoors but near a building. The two most common causes of fatal 

CO incidents due to weather-related outages were ice/snow storms (77 incidents, 107 deaths) and 

hurricanes/tropical storms (49 incidents, 71 deaths). The U.S. Centers for Disease Control and 

Prevention (CDC) has reported that 34 % of non-fatal CO poisoning incidents after hurricanes in 

Florida in 2004, and 50 % during Hurricanes Katrina and Rita in 2005, involved generators 

operated outdoors but within 2.1 m of the home (CDC 2006). 

Other IAQ-related issues stemming from disaster-related power outages include the inability to 

operate electric-powered building heating, ventilating and air-conditioning (HVAC) equipment,

which could lead to uncomfortable or even unhealthy indoor environments. While blackouts 

during extreme heat events may be relatively rare in the U.S. (SFDPH 2013), power outages 

during hot weather that does not qualify as a heat wave may still result in increased mortality 

(Anderson and Bell 2012). Lack of power will significantly impact the ability of residents to 

remain in or return to their residences, as described by Kennedy et al. (2012). That paper 

describes a situation in which conditions in tall buildings in Brisbane became “unliveable” due to 

loss of air-conditioning during power outages during and after a major flood event in January 

2011, with some remaining “uninhabitable” for several weeks after the event. Kennedy et al. list 

the livability issues facing residents: “basement inundation without water pumps; vertical access 

and mobility issues without elevators; poor ventilation and air quality issues as apartments 

became overheated and stifling without air-conditioning; loss of potable water for drinking, 

bathing and clothes washing without booster pumps; disruptions to communications phone and 

internet cabling; sanitary issues without flushing toilets; lack of security without electronic 

locking; and lack of fire safety including failure of fire sprinkler systems and alarms.”

Loss of power and utilities can also lead to unacceptably cold indoor temperatures. There were 

over 6600 cold related deaths (twice as many as heat related deaths) in the U.S. between 2006 

and 2010, with age, sex, ethnicity, and income level cited as risk factors (Berko et al. 2014). 

However, the current literature review revealed little study of the building factors affecting cold 

related deaths, though Aylin et al. (2001) reported an association between the lack of central 

heating and mortality. Others have studied the factors involved in cold weather related morbidity 

rather than mortality (e.g., Rudge and Gilchrist 2007). However, no specific study of 

power/utility outage and its impacts on mortality or morbidity was found. Fisk (2015) indicates 

that studies have reached different conclusions on whether and how much climate change may 

reduce cold related deaths.
9

Standards and Guidance

ASHRAE Standards 62.1 and 62.2 specify required ventilation and other building and system

parameters (e.g., particle filtration levels) to achieve acceptable IAQ in nonresidential and 

residential buildings, respectively (ASHRAE 2013b and 2013c). In general, these standards are 

written to address normal conditions when buildings are being operated as designed and do not 

address extraordinary circumstances such as outdoor contamination events, unusual indoor 

contaminant sources, and other than healthy occupants. They primarily rely on mechanical 

ventilation but do contain limited provisions to address natural ventilation. As discussed 

previously, ASHRAE Standard 55 addresses thermal comfort under normal operating conditions 

and, as such, does not contain specific requirements that would be applicable to extreme heat or 

cold during a power outage.

UL Standard 2200 Standard for Stationary Engine Generator Assemblies (UL 2012) covers 

construction and performance of portable generators. Other relevant standards include National 

Fire Protection Association Standards 110 Emergency and Standby Power Systems (NFPA 

2013a) and 111 Stored Electrical Energy Emergency and Standby Power Systems (NFPA 

2013b). The NFPA standards cover installation, maintenance, operation, and testing 

requirements for emergency and standby power systems and stored electrical energy systems 

providing an alternate source of electrical power in buildings and facilities in the event that the 

normal electrical power source fails.

The CDC has published a prevention guide for personal health and safety in extreme cold 

weather that is targeted primarily towards homeowners and addresses alternate methods of 

heating (e.g., kerosene space heaters) and monitoring body temperatures in addition to many 

other issues (CDC 2014a).

Practical guidance for other power outage issues is contained in the New Jersey Department of 

Health Emergency Action Planning Guidance for Retail Food Establishments (NJDPH 2009), 

which assists retail grocery and food service establishments in planning for and responding to 

emergencies that have the potential to create an imminent health hazard. That document includes 

the following guidance:

 “Consider your access to an electrical generator to be used in emergencies. Make certain 

that the generator has the capacity to operate critical equipment such as refrigeration and 

freezer units, pumps, safety lighting, hot water heaters, etc. Make certain that individuals 

are trained to operate the equipment safely. Be sure to consult with a licensed electrician. 

Advise the utility company that you are using a generator as a safety precaution for their 

employees.

 Dry ice should not be used in enclosed spaces (i.e. walk-in cooler) because of the potential 

build-up of carbon dioxide. If used, pack potentially hazardous food in dry ice using 

precautions, such as utilizing insulated gloves to handle and venting the area before 

entering.

 Prepare an “emergency menu” in advance including recipes for food items that do not 

require cooking since the ventilation system will no longer remove smoke, steam, grease 

laden air, etc.”
10

FEMA P-1019 Emergency Power Systems for Critical Facilities: A Best Practices Approach to

Improving Reliability, (FEMA. 2014) provides guidance on how to assess the risks and 

vulnerabilities to the electrical power system, identify performance goals for an emergency 

power system, and the importance of having realistic emergency management policies that 

address emergency power for critical facilities. The critical facilities addressed include hospitals 

and emergency medical treatment facilities; fire, rescue, ambulance and police stations; buildings 

designated as earthquake, hurricane, or other emergency shelters; and emergency preparedness 

and operations centers and other facilities required for emergency response command and 

control. This document is intended as an introduction to the fundamental principles of providing 

emergency power for critical facilities but not to be a comprehensive design manual. While the 

document is not aimed at buildings other than critical facilities, some of the information may be 

useful to consider for other buildings.

FEMA Standard P-361 Design and Construction Guidance for Community Safe Rooms (FEMA 

2008) addresses the need for standby power in both residential and community safe rooms (or 

storm shelters). Other requirements for such spaces, such as ventilation, are discussed later in the 

section on Indoor Environments in Safe Rooms and Shelter-in-Place (SIP) Facilities. In terms of 

standby power, Section 8.10 of this document states:

“Safe rooms designed for tornadoes and hurricanes will have different standby (emergency) 

power needs. These needs are based upon the length of time that people will stay in the safe 

rooms (i.e., shorter duration for tornadoes and longer duration for hurricanes). In addition 

to the essential requirements that should be provided in the design of the safe room, 

comfort and convenience should be addressed. 

For tornado safe rooms, the most critical use of standby power is for lighting. Emergency 

power may also be required in order to meet the ventilation recommendations described in 

Section 8.3. The user of the safe room should set this requirement for special needs 

facilities, but most tornado community safe rooms would not require additional emergency 

power. The ICC-500 (ICC 2008) standard for the design and construction of storm shelters 

requires standby power systems to be designed to provide the required output capacity for a 

minimum of 2 hours and to support the mechanical ventilation system, when applicable.

For hurricane community safe rooms, standby or emergency power may be required for 

both lighting and ventilation by the local building code. This is particularly important for 

safe rooms in hospitals and other special needs facilities. Therefore, a standby generator is 

recommended. Any generator relied on for standby or emergency power should be 

protected with an enclosure designed to the same criteria as the safe room. The ICC-500 

requires the standby electrical system to have sufficient capacity to power all the required 

(critical support) systems and circuits at the same time continuously for a minimum period 

of 24 hours.”

The GSA Climate Change Action Plan (GSA 2014) outlines important actions that GSA has 

taken to better understand and address the risks and opportunities brought on by climate change. 

This includes partnering with customer agencies to determine Climate Protection Levels at the 

site and facility scale for mission-critical sites. Depending on the customer mission, GSA may 

need to provide buildings that maintain livable conditions in the event of extended power 

outages, interruptions in heating fuel, and shortages of water to ensure resilience and 

survivability.
11

Other relevant efforts

NIST has recently conducted a research effort to help understand the building and engineering 

issues involved in CO poisonings due to improper generator use and to help identify and evaluate 

potential solutions. Emmerich et al. (2013) reported measurements of CO emission rates from 

stock portable generators, which ranged from around 400 g/h at near ambient conditions to 

nearly 4000 g/h as the oxygen level reduced when the generators were tested in an enclosed 

chamber. Tests of two different low-emission prototype generators showed the potential for over 

90 % reductions of CO emissions. Tests of the stock generators operated in the attached garage 

of a research house showed that CO levels could quickly reach life threatening levels depending 

on the house and generator configuration. Wang (et al. 2013) conducted a simulation study to 

examine the impact of distance on indoor CO exposure when operating a generator outside a 

house, which also considered the effects of generator location, exhaust temperature and 

discharge velocity, and weather conditions. It was found that in most cases, to reduce CO levels 

for the conditions modeled, it was more effective to direct the generator exhaust away from the 

house and position the generator at a distance of more than 4.6 m from the house.

NIST has developed a draft test method to measure generator emission rates in a chamber at 

reduced O2 levels to support CPSC proposed rulemaking and the potential inclusion of a CO 

emission limit in UL Standard 2201 Standard for Portable Engine-Generator Assemblies (UL 

2013). UL 2201 currently addresses the potential fire and electric hazards associated with 

portable generator use, but does not address CO poisoning. The NIST draft test method was 

developed based on NIST and CPSC testing experience in indoor environments ranging from a 

10 m3chamber to a 90 m3garage (Emmerich and Persily 2014). However, to address the large 

number of units already existing, public health education efforts should be improved by

emphasizing pre-disaster risk communication and tailoring interventions for racial, ethnic, and 

linguistic minorities (Iqbal et al. 2012). Many federal agencies and other organizations publish 

information on portable generator safety directed primarily towards consumers (CDC 2014b, 

CPSC, NFPA 2014b, USFA 2006). 

Summary

Loss of power due to extreme weather events and other disasters have potentially significant IAQ 

and thermal comfort impacts due to loss of building HVAC system functioning. The relevant 

issues that have received attention include deaths and injuries due to CO entry into buildings 

from portable generators, and heat or cold related health impacts after loss of heating and 

cooling. Research and standards are needed to evaluate and define short term acceptable 

ventilation and IAQ conditions for living and working in buildings temporarily during power 

outages and to ensure the safe use of temporary power alternatives like portable electric 

generators.
12

2.3 Mold Exposure Associated with Flooding

The hazards associated with floods due to weather events, failures of levees and dams, and 

spring thaws are serious concerns given the damage they can inflict on buildings and people. 

Much of the discussion of these hazards is focused on the immediate risks to life from drowning 

as well as severe structural damage to buildings and other constructed facilities, and both 

planning and response strategies for these immediate risks are well established (FEMA 2014).

The health risks, both short and long term, associated with the potential for occupant exposure to 

mold and other bioaerosols associated with prolonged wetting of building materials are also 

relevant in preparing for and responding to floods. Mold growth in buildings is generally 

associated with any event or circumstance that leads to prolonged wetting of organic materials 

within buildings, including roof and plumbing leaks, HVAC system design or performance 

problems that lead to poor control of indoor humidity levels, and building envelope designs that 

increase the likelihood of condensation within the envelope.

Concern about indoor exposure to mold has increased in recent years, much of which has been

independent of flooding events. Some of this concern is evidenced in the popular press where 

numerous items about so-called “toxic mold” were published (CDC 2012 and 2014). While 

many of these stories do not contain technically complete descriptions of the issues and risk,

valuable scientific research has been pursued on building moisture and occupant health. The 

Institute of Medicine published a report titled Damp Indoor Spaces and Health in 2004 (IOM 

2004) that characterized the health problems associated with indoor dampness, recommended 

measures to prevent and remediate damp indoor environments based on existing knowledge, and 

identified additional research to answer the numerous remaining questions. This work was 

focused on the linkages between indoor dampness and a wide range of health effects including 

allergic responses, suppression of immune response, and respiratory symptoms and disorders. A 

more detailed presentation of the meta-analysis on which the IOM conclusions are based is 

contained in Fisk et al. (2007), which describes the association between health outcomes and 

damp buildings in detail. The World Health Organization has also published a comprehensive 

review of the associations of health problems with building moisture and biological agents, 

which in effect builds on the earlier report by the Institute of Medicine (WHO 2009). This 

document identifies flooding as one of many sources of indoor dampness.

Additional research has been performed on the health effects following specific flooding events, 

i.e., Hurricanes Katrina and Rita. One study found an increase in mold growth following the 

hurricanes but no increase in adverse health outcomes (Barbeau et al. 2010). The authors 

discussed several potential reasons for the lack of observed health effects, including a lack of 

reporting, people moving to alternate housing, and limited availability of healthcare leading to 

reduced reporting of health effects. Another study measured bioaerosols in three homes before, 

during and after interventions to address flood damage in the aftermath of Hurricane Katrina 

(Chew et al. 2006). The measured levels of mold and endotoxin were quite high, similar to those 

seen in agricultural environments. The authors recommended the development of safe 

remediation techniques for those involved in such cleanup activities.

Fisk (2015) indicates that water entry into buildings through both failures of the envelope and via 

flooding are expected to increase due to climate change impacts such as increased frequency, 

intensity and amount of heavy precipitation and rising sea levels. In the absence of steps to make 

buildings less susceptible, Fisk concludes that the evidence suggests that climate change will 

lead to significant increases in adverse health effects associated with building dampness and 
13

mold. He also identified the following mitigation measures for protection against severe storms 

and sea level rise: building envelope design and construction practices to reduce the potential for 

water entry; improved maintenance of building envelopes; elevating buildings above grade level 

in flood-prone locations; and, locating fewer buildings in flood plains.

Standards and Guidance

Several federal agencies, state and local governments, and other organizations have developed 

guidance on dealing with mold, mostly in terms of clean up, as well as repairing and replacing 

mold damaged materials (CARRI 2008, EPA 2007 and 2008, NYC 2008, OSHA 2006 and 2013, 

University of Minnesota 2010, University of Wisconsin). Some of this guidance is developed 

specifically for cleaning up after floods (EPA 2007, ARC and FEMA 1992). A standard on water 

damage and mold restoration was issued by the Institute for Inspection, Cleaning and Restoration 

Certification (IIRCRC 2006). This standard and the other guidance documents provide 

information on how to clean up mold-contaminated materials and to repair and replace materials 

after the cleanup. Most, though not all, of the guidance on mold cleanup is directed towards 

remediation professionals, rather than homeowners or community volunteers who might be 

engaged in such efforts following a large scale event. This focus is due to the potential for 

significant mold exposures and subsequent health effects from the mold during the cleanup if not 

using personal protective equipment, as well as from chemicals that might be used in the 

cleanup.

Other relevant efforts

While there has been much attention given to mold due to flooding and other causes, including 

the development of useful guidance on remediation and repair, no activities have been identified 

on planning for large scale flooding events and the massive remediation efforts that would likely 

be required to make a community safe and livable after the event is over. Similarly, guidance 

appears to be lacking on how to determine if a building is safe for occupancy after a flooding 

event with respect to the presence of mold. ASHRAE and the Indoor Environmental Standards 

Organization have recently issued a standard for public comment, i.e., BSR/IESO/ASHRAE 

Standard 3210, Standard Guide for the Assessment of Education Facilities for Moisture Affected 

Areas and Fungal Contamination. While this standard, as drafted, deals with assessment only, it 

could serve as a first step in the development of a broader set of standards on mold remediation.

FEMA (2006) provides general guidance on mold remediation including use of containment 

strategies, personal protective equipment, and mold remediation methods (such as wet 

vacuuming, damp wiping, high efficiency particulate vacuuming, and discarding materials). 

Summary

Mold growth and bioaerosol exposure due to floods has the potential for serious health 

outcomes, possibly affecting large numbers of buildings and building occupants. While some 

guidance exists on remediation of mold and repair of water damaged building materials, larger 

scale response efforts have not been addressed and are likely to constitute a significant challenge 

in terms of training sufficient numbers of remediation workers and protecting homeowners who 

might be inclined to do their own remediation work. If climate change does increase the 

frequency and severity of flooding, these concerns are going to become more of an issue. There 

has been limited development of standards in this area, with additional efforts needed in terms of 

remediation and defining criteria to clear buildings for reoccupancy.
14

2.4 Wildfires

It is well-established that smoke from wood and other plants contains significant quantities of 

health-damaging pollutants (e.g., polycyclic aromatic hydrocarbons, benzene, aldehydes, 

respirable particulate matter, carbon monoxide [CO], nitrogen oxides [NOx], and other free 

radicals), some of which are carcinogenic compounds (Naeher et al. 2007). Finlay et al. (2012) 

reviewed numerous studies on the health effects of wildfires and concluded that published 

evidence shows that human health can be severely affected by wildfires. They also described 

specific health effects (dominated by respiratory morbidity but including cardiovascular and 

ophthalmic problems) and vulnerable populations, and identified factors that may reduce public 

health risk from wildfires. Some of those studies have focused on the health impacts of 

firefighter exposure to smoke, but such exposure is outside the scope of this effort. In contrast, 

Fowler (2003) reviewed the literature and found the evidence for human health impacts from 

forest fire smoke to be somewhat equivocal.

In one study, Mott et al. (2002) assessed the health effects of exposure to smoke from a large

wildfire in 1999 and evaluated whether participation in interventions to reduce smoke exposure 

prevented adverse lower respiratory tract health effects among residents of the Hoopa Valley 

National Indian Reservation in northwestern California. They found that an increased duration of

the use of high-efficiency particulate air cleaners and the occupants’ recollection of public 

service announcements were associated with reduced frequency of reporting adverse health 

effects of the lower respiratory tract, but no protective effects were observed for duration of 

mask use or evacuation.

Increased outdoor temperatures, heat waves, and number and severity of droughts due to climate 

change are expected to contribute to increased wildfires, including a significant increase in 

average acreage burned in the western U.S. (Spracklen et al. 2009). Increased wildfires in the 

U.S. may lead to greater exposure to airborne particles, much of which happens while people are 

indoors, and, therefore, potentially increased adverse health effects (Fisk 2015). Fisk also

identified improvements in particle filtration as a mitigation measure for protection against 

particles from wildfires.

To address the need for evidence based guidance for public health decision making during 

wildfire smoke events, the British Columbia Centre for Disease Control (BCCDC) recently 

completed a series of systematic reviews, which has produced several documents addressing

wildfire-related topics: Home and community clean air shelters (Barn 2014), Reducing time 

outdoors (Dix-Cooper 2014), Public health risk (Durán 2014), Filtration in institutional settings 

(Keefe 2014), Health surveillance (Morrison 2014), Use of evacuation (Stares 2014), Using 

masks to protect public health (Sbihi 2014), and Exposure measures for wildfire smoke 

surveillance (Yao 2014). 

Conclusions reached from the BCCDC reviews on measures to mitigate the health effects 

include the following:

 Reviewed air sampling studies suggest that staying indoors can be effective at reducing 

wildfire smoke exposure (using particulate matter (PM) as an indicator) when a building 

has little air infiltration from outdoors, for shorter duration wildfires, when sources of 
15

indoor air pollution are minimal and if effective indoor air cleaners are used (Dix-Cooper 

2014).

 Filtering half facepiece respirators (FHFR), such as N95 masks, provide effective 

protection against PM. FHFRs are cost effective and can be stockpiled for use at the 

population level during wildfire events (Sbihi 2014).

 Filtration is a potentially effective intervention to reduce PM2.5 (particulate matter with 

diameter of 2.5 m or smaller) exposures among community members exposed to wildfire 

smoke. Filtration can be implemented by establishing home clean air shelters (HCAS)

(using portable or in-duct filters) or community clean air shelters (CCAS) (using in-duct 

filters in larger public buildings). (Barn 2014)

 When determining the appropriateness of filtration in smoke-affected communities, several 

things should be considered, including the intensity of the smoke event, timing and 

preparation for and implementation of filtration, and availability of potential CCAS. (Barn 

2014)

 The effectiveness of existing healthcare institutional filtration systems may be enhanced 

with the use of pre-filters or higher MERV rated filters, more frequent change-out of the 

filters, as well as portable air cleaning devices equipped with HEPA filters. (Keefe 2014)

 Those wildfire smoke response guidelines that do consider evacuation to reduce smoke 

exposure recommend it only for those who are vulnerable rather than for entire 

populations. Vulnerable individuals include both those who are particularly susceptible to 

health effects from smoke exposure and those requiring special assistance for evacuation. 

Evacuation decisions (who, how best, and when to evacuate) can be part of a blend of 

interventions for the general population and subpopulations with particular sensitivities and 

vulnerabilities. (Stares 2014)

Other considerations mentioned in the BCCDC reviews include:

 When recommending HCAS (Barn 2014): 

o Poor quality housing, as well as older housing, is expected to have higher infiltration 

rates, making such homes less effective as HCAS. 

o Availability of central air conditioning will encourage residents to remain indoors 

with windows closed. 

o More than one portable air cleaning unit may be required for large rooms or homes 

with high air change rates. 

 When identifying potential community clean air shelters (CCAS) (Barn 2014): 

o Consider whether large air conditioned spaces are available and whether it is feasible 

to use these spaces over the short term (hours) and long term (days to weeks). 

o For communities where wildfire smoke is a frequent seasonal exposure, installation of 

high efficiency filters in community shelters before the fire season may be needed. 

For other communities, establishing an inventory of buildings with sufficient 

conventional in-duct filtration may be a more feasible approach. 

o Upgrades to buildings may be required to provide adequate electrical power, fan 

capacity, or structural support to handle the added airflow resistance of high 

efficiency in-duct filtration. 

 When considering CCAS versus HCAS (Barn 2014)

o The benefits of potentially more effective filtration obtained intermittently at CCAS

should be weighed against less effective but more consistent filtering obtained in 

HCAS for extended periods of time. 
16

o Encouraging individuals to remain in CCAS may be a challenge if extended stays are 

required. If smoke events are expected to persist, HCAS might be a more viable 

option than encouraging prolonged stays at CCAS. 

 Vulnerable populations, including children, the elderly, pregnant women, and those with 

pre-existing respiratory and cardiovascular disease, may be at higher risk of adverse health 

effects related to wildfire smoke, and therefore may benefit most from decreased exposures 

through filtration. Measures to best implement the use of filters among these groups should 

be considered (e.g., high efficiency in-duct filters could be installed in long-term care and 

retirement facilities and schools). Additionally, portable filters could be preferentially made 

available to homes with children or elderly occupants. (Barn 2014)

 Because of its episodic nature, smoke from wildfires can quickly overload filters and 

adversely impact an air cleaner’s ability to function properly. (Keefe 2014)

 It is theoretically possible to set up clean air shelters in areas of institutions with positive 

pressure and higher filtration efficiency (e.g., operating rooms); however, it is not clear 

how the necessary alterations in the HVAC system may affect airflow and filtration in 

other areas of the hospital. Therefore each such alteration should be individually designed

by a qualified professional to ensure that important HVAC functions, including infection 

control, are maintained. (Keefe 2014)

 In the absence of adequate in-duct filtration in an institution, the development of clean air 

shelters using portable HEPA filters is a reasonable approach. (Keefe 2014)

Other international, federal and state agencies, and private organizations have addressed the 

health threats posed by wildfire smoke in various publications (EPA 2003, CDC 2007, CDPH 

2008, PEHSU 2011, WHO). These documents describe the hazards due to wildfire smoke, 

vulnerable populations, acute and chronic health impacts, and steps to mitigate the hazard. 

Standards and guidance

While there are no standards on protecting building occupants from airborne contaminant 

exposure associated with wildland urban interface (WUI) fires, there are several guidance 

documents. In addition to describing the hazard and health impacts related to vegetation fires, the 

WHO/UNEP/WMO Health Guidelines for Vegetation Fire Events - Guideline Document 

(WHO/UNEP/WMO 1999) discusses mitigation measures in detail including remaining indoors, 

use of air cleaners, use of respirators (but not dust or surgical masks), outdoor precautionary 

measures, and evacuation to emergency shelters. Many of the recommendations are fairly 

general such as taking action to “reduce infiltration” and installing and maintaining “effective 

filters.” While moving susceptible individuals to emergency shelters with effective particle 

filtrations is a protection strategy option, the emergency evacuation of whole populations to other 

geographical locations in response to smoke haze is not recommended as a mitigation measure. 

Similar guidance is available in documents published by the EPA (2003) and the CDC (2007). 

The California Department of Health and others (CDPH 2008) provide similar guidance but also 

warn of the potential increased risk of heat stress for at-risk individuals when staying inside 

without air-conditioning, since fire season typically occurs during the hottest part of the year. 

Such individuals may be advised to seek shelter with others or go to a community Clean Air 

Shelter. General recommendations for identifying and setting up Clear Air Shelters are provided. 

The CDPH document also discusses reducing occupant activity and other sources of indoor air 
17

pollution, considering residential air cleaners (but not ozone generators), and possibly using 

humidifiers in arid climates.

The BCCDC recently published preliminary guidelines for British Columbia public health 

decision-making during wildfire smoke events based on recommendations from an international 

working group (Elliott 2014). This guidance describes wildfire smoke hazards and identifies 

health effects associated with wildfire smoke exposure and susceptible populations. It provides 

BC-specific guidance about tools for situational awareness, including smoke and health 

surveillance. It then summarizes the evidence for effectiveness of intervention measures to 

protect public health. A consideration raised in the guidance is that most current guidelines use 

PM concentration thresholds as the basis to recommend various public health intervention 

measures. However, it is not clear whether these thresholds are appropriate for wildfire smoke 

because they are derived from studies based on urban PM health effects not wildfire smoke. As 

with the other guidance, recommendations address public communications, staying indoors, 

wearing N95 respirators, using home clean air shelters, providing community clean air shelters, 

increasing air filtration in institutions and evacuation.

There are numerous programs and activities in place that address smoke from wildfires. These 

include documents published by the EPA (2003), the CDC (2007), and WHO (1999), as well as 

guidance from many states (e.g., CDPH 2008 and CDPHE 2006). This guidance addresses 

monitoring, public notification and education, and mitigating public exposure. 

The International Wildland-Urban Interface Code (ICC 2012) and the NFPA Fire Code (NFPA 

2015a) contain provisions addressing wildfire issues such as fire spread, accessibility, defensible 

space, and water supply for buildings constructed near wildland areas, but do not address the 

threat from exposure inside buildings associated with smoke from wildfires. The NFPA has 

proposed NFPA 1616, Standard for Mass Evacuation and Sheltering, whose purpose is to 

establish a common set of criteria for the process of organizing, planning, implementing, and 

evaluating programs for mass evacuation, sheltering, and reentry (NFPA 2015b). Wildland fires 

are among the many hazards to be considered in such programs, but there is not specific 

guidance related to addressing indoor exposure to smoke from such fires.

Other relevant efforts

The BCCDC review identified several knowledge gaps, which could support future guidance 

efforts, including the following:

 Evidence that staying indoors reduces smoke exposure would be strengthened by studies 

with improved personal exposure assessment and those that examine populations living in a 

wide range of housing types and geographical areas (Dix-Cooper 2014).

 The effectiveness of respirators as a public health intervention has not been fully evaluated 

(Sbihi 2014).

 Most studies of portable air cleaners report on “best case” scenarios and do not take into 

consideration variations in usage, indoor activities, or housing characteristics. (Barn 2014) 

 Effectiveness of portable air cleaners over longer use periods (e.g., months) has not been 

well studied. (Barn 2014)

 There is a lack of research on the impact of in-duct filters in reducing infiltration of PM 

from wildfire smoke. (Barn 2014)
18

 There is a dearth of evidence on the effectiveness of filtration to reduce wildfire smoke 

exposures in healthcare institutional settings. (Keefe 2014)

 There is no literature specifically examining the issue of infiltration of wildfire smoke 

particles into healthcare institutional settings. (Keefe 2014)

 It is not clear how best to use existing filtration capacity within healthcare facilities’ HVAC 

systems to create clean air shelters. (Keefe 2014)

 It is not clear how to use portable filtration to establish clean air shelters within healthcare 

facilities. (Keefe 2014)

 A blend of targeted mandatory and voluntary evacuation, clean air shelters and other 

measures may be used to reduce smoke exposures across a population. However, it is not 

clear how best to combine these measures to maximize benefits and minimize harm. (Stares 

2014)

Summary

The health impacts of wildfire smoke entry on building occupants is well recognized and 

guidance addressing monitoring, public notification and education, and mitigating public 

exposure has been available from state, federal, and international agencies for more than a 

decade. However, this guidance could be more specific such as providing specific levels of 

filtration or air cleaning device ratings needed to provide significant reductions in particle 

concentrations. A recent systematic review of the evidence-based guidance for public health 

decision making during wildfire smoke events identified many important gaps in knowledge that 

could be addressed by future research. These gaps include studies of the effectiveness of portable 

air cleaner usage that consider real-world variations in usage and housing characteristics and 

development and evaluation of guidance on how to establish clean air shelters in healthcare 

facilities using either existing HVAC system filtration capacity or portable air cleaners.
19

2.5 Airborne releases of chemical, biological, or radiological agents

Exposures to airborne chemical, biological, and radiological (CBR) releases have been of interest 

for many years, with increased attention since the terrorist attacks of 2001. In the context of 

community resilience, outdoor CBR releases, whether intentional or not, are most relevant to 

indoor exposures. Unintentional releases include a range of events such as industrial plant 

accidents, releases associated with accidents involving the transportation of hazardous 

substances, and earthquakes and other disasters damaging chemical facilities, water treatment 

plants and other facilities. These types of releases have the potential for generating large airborne 

plumes of hazardous substances that can impact the occupants of buildings downwind from the

release site. The release of a CBR agent in urban areas has been identified as a homeland security 

threat of particular concern (GAO 2008), and the Department of Homeland Security has pursued 

a number of strategies to plan for and respond to such releases (DHS 2009). In the event of such 

a release, hundreds, even thousands, of buildings and building occupants could be affected, 

leading to large economic costs and other disruptions (Judd, et al. 2009; Franco and Bouri 2010). 

The resilience issues related to outdoor CBR releases include approaches to warning building 

occupants and recommending either evacuation or sheltering in place, identification of buildings 

impacted by such releases, building decontamination, and clearing buildings for reoccupancy.

Standards and guidance

While there are no standards on protecting building occupants from outdoor CBR agent releases, 

there are several guidance documents. The National Institute of Occupational Safety and Health 

(NIOSH) issued two such guidance documents early in the 2000s. The first (NIOSH 2002) 

provides general guidance on protecting building environments from airborne CBR agents, 

including how to modify existing buildings, how to design new buildings that are more secure, 

and plans for building managers to prepare in advance for a potential CBR incident. While this 

was a relatively short document, it provided sound guidance. NIOSH followed a year later with 

another document specific to the roles of particle filtration and gaseous air cleaning in protecting 

buildings against potential CBR releases (NIOSH 2003).

Several years later, ASHRAE published Guideline 29, Guideline for the Risk Management of 

Public Health and Safety in Buildings (ASHRAE 2009). This document provides guidance 

beyond just CBR incidents on how to design, operate and maintain buildings using a general risk 

management approach. It contains specific guidance on building CBR protection related to 

building airtightness, HVAC systems, and air cleaning and filtration. It does not address building 

decontamination and reoccupancy or other such issues that fall under community resilience.

FEMA and other groups within DHS have also issued guidance on protecting buildings against 

potential CBR attacks. Of particular relevance are FEMA 430, Site and Urban Design for 

Security Guidance Against Potential Terrorist Attacks (FEMA 2007), and BIPS 06, Reference

Manual to Mitigate Potential Terrorist Attacks Against Buildings (DHS 2011). The former 

document contains information relevant to the design of building sites, including discussion of 

CBR issues and both protection and response strategies. The latter document contains more 

information specific to CBR threats including strategies to reducing building vulnerability using 

a range of engineering approaches and plans for responding to emergencies including training, 

decision-making and building restoration. These and other FEMA documents also address 

shelter-in-place approaches, but these approaches are discussed later in this report. 
20

Other relevant efforts

There are several programs and activities in place to address CBR releases that have the potential 

to impact indoor environments. 

The Chemical Stockpile Emergency Preparedness Program (CSEPP) is a partnership between 

FEMA and the U.S. Department of the Army that provides emergency preparedness assistance 

and resources to communities surrounding the Army’s chemical warfare agent stockpiles. At this 

point, most of the Army stockpiles have been destroyed, but this program has generated a range 

of useful materials for planning and responding to incidents involving one of the remaining 

stockpiles that would also be potentially applicable to other chemical incidents. Available 

CSEPP resources include a shelter-in-place guide book on planning and implementing temporary 

SIP in response to airborne chemical hazards (Yantosik 2006) and detailed guidance on 

conducting exercises (U.S. Army/DHS 2012). CSEPP is currently developing a public affairs 

workbook on community education and emergency public information programs for government 

public affairs offices, and a guidance document for public alert and warning systems. 

The National Institute for Chemical Studies (NICS, www.nicsinfo.org/SIPcenter.asp) is a nonprofit organization that works mainly through federal, state, county and local government 

agencies as well as businesses on a broad range of projects related to chemical risks in 

communities. Examples of NICS projects include research, education, training, and consultation 

on various topics related to chemical accidents and releases. One of their more relevant efforts is 

the development of information on SIP as a strategy to reduce exposure during chemical releases 

(NICS 2001).

The U.S. EPA’s Emergency Management website (http://www.epa.gov/emergencies/index.htm) 

describes a range of activities related to responding to various environmental emergencies, 

including responding to hazardous releases in coordination with federal, state, and local 

agencies. These activities fall under the National Response System 

(http://www2.epa.gov/emergency-response/national-response-system), which is set up to respond 

to environmental releases. While the material available under these and related programs cover 

the response processes, they do not focus on specific exposure scenarios such as those associated 

with the indoor environment. EPA’s National Homeland Security Research Center 

(http://www.epa.gov/nhsrc/) is another part of the agency that performs research into ways to 

decontaminate buildings and public areas. This work includes determining whether an attack has 

happened, characterizing the extent of its impacts, controlling contamination, assessing and 

communicating risks, getting useful information to first responders, and safely disposing of 

cleanup materials. 

Two studies at NIST provide useful information for reducing occupant exposure to potential 

CBR releases. The first was a study of retrofit options to increase building protection, which 

included detailed discussion of when these options are most applicable and their advantages and 

disadvantages (Persily et al. 2007). The options relevant to outdoor CBR releases included 

enhanced particle filtration, gaseous air cleaning, envelope airtightening, building pressurization, 

relocation of outdoor air intakes, SIP, and HVAC system responses. Another NIST effort was 

focused on the development of a systematic approach to identify which buildings are more or 

less likely to be contaminated by an outdoor CBR release and to what level (Persily 2011). This 

approach, in which the design and operational characteristics of specific buildings are used to 

estimate contamination levels, is referred to here as “building triage” and is intended to assist in 
21

allocating resources for sampling and decontamination, and for facilitating the clearance of 

buildings for reoccupancy. The referenced report constitutes a first step in the development of 

the triage approach, specifically an initial description of the concept, the development of an 

associated building classification system, and the definition of generic building models. 

Summary

Outdoor CBR releases have been the focus of much discussion, research and guidance in recent 

years, with the focus being more on intentional attacks than on accidental releases. However, 

much of the guidance on protecting against and responding to intentional releases also applies to 

unintentional CBR release events. This guidance addresses how to make a building less 

vulnerable to outdoor releases through a range of engineering controls such as filtration and air 

cleaning and HVAC system controls using active sensing in some cases, but these strategies may 

be harder to justify economically in buildings other than high-profile facilities that may be more 

likely targets for intentional attack. There has also been important work in the area of building 

decontamination after a release but important questions remain such as identifying the most 

appropriate decontamination strategy in a given building for a given agent, how to deal with 

large numbers of buildings that might be affected, and finally how to determine when a building 

is clean enough for reoccupancy. 
22

3. OTHER ISSUES

In addition to the events discussed above, this section discusses two additional topics that are 

relevant to IER. These include the role of healthcare facilities in responding to pandemics and 

indoor environmental conditions in safe rooms and shelter-in-place facilities.

3.1 Pandemic response

The fact that healthcare facilities play a key role in community-based disaster resilience is well 

recognized, and the need for these facilities to be operational following disasters is addressed in 

the NIST CRPG. However, the response to a pandemic infection is not specifically addressed. 

Nevertheless, it constitutes a need for preparation and response on both the individual building

and community levels. This topic is reviewed briefly in this paper and is an important candidate 

for follow-up work.

The Centers for Medicare & Medicaid Services (CMMS) recently published a proposed rule that 

would establish national emergency preparedness requirements for Medicare- and Medicaidparticipating providers and suppliers to ensure that they adequately plan for both natural and 

man-made disasters, and coordinate with federal, state, tribal, regional, and local emergency 

preparedness systems (CMMS 2013). Previously, the CDC published guidance on public health 

preparedness capabilities including surge management (CDC 2011). One hazard planning 

scenario in the CMMS proposed rule’s scope is biological disease outbreak, including pandemic 

influenza. One key issue to be addressed is establishing the capacity to address a surge in 

patients seeking treatment. ASHRAE (2014) recommends that new health-care facilities 

incorporate infrastructure to quickly respond to a pandemic: such as HVAC systems that separate 

high-risk areas, physical space and HVAC system capacity to upgrade filtration; the ability to 

increase ventilation to 100 % outdoor air; the ability to humidify air; and, receptacles to enable 

air cleaning using upper-room ultra-violet germicidal irradiation (UVGI). Mead et al. (2012) 

evaluated expedient methods for surge airborne isolation space in existing healthcare facilities

during response to a natural or manmade epidemic, noting that further research is needed to 

evaluate the options. A tool such as the NIST CONTAM model could be used for such a study, 

as has been done previously to evaluate airflow and infectious agent transport in healthcare

facilities (Emmerich et al. 2013).

ASHRAE Standard 170-2013 Ventilation of Health Care Facilities contains ventilation system 

design requirements that provide environmental control for comfort, asepsis, and odor in health 

care facilities. It does not address emergency situations, such as accommodating pandemics in 

the community or functioning with emergency power. An infectious disease management manual 

published by the Minnesota Department of Health (MDH 2013) provides guidance on providing 

temporary negative pressure isolation space in healthcare facilities.

3.2 Indoor Environments in Safe Rooms and SIP Facilities

Safe rooms and shelter-in-place (SIP) facilities are discussed in the context of community 

resilience for providing temporary protection against the hazards associated with many different 

events. These discussions often focus on tornados and other severe weather events, as well as 

many of the indoor environmental events discussed in this report such as heat waves, loss of 

power, wildfires, and CBR releases. FEMA has published several guidance documents on safe 

rooms for sheltering from storms. The first document (FEMA 2008a) focuses on tornadoes and 

hurricanes and the design of such facilities in terms of location in a building, size, and structural 

issues. FEMA P-361 (2008b) addresses the need for ventilation in both residential and 
23

community safe rooms, making reference to the ventilation requirements in building codes The 

ventilation requirements contained in this FEMA document do refer to ICC 500, ICC/NSSA 

Standard for the Design and Construction of Storm Shelters (ICC 2008). If mechanical 

ventilation is provided, it should be connected to a standby power system and, for single-use safe 

rooms, 7.5 L/s per person is the recommended minimum ventilation rate in the FEMA document. 

The ICC standard refers to applicable building code provisions for mechanical ventilation rates, 

which as noted earlier in this report are developed for application under normal building 

occupancy. The FEMA and ICC documents both specify that hurricane safe rooms designed for 

occupancy by more than 50 people must use mechanical ventilation at a minimum rate 

determined in accordance with applicable building code provisions for the normal use of the 

space. These documents also contain ventilation opening areas per occupant for both residential 

and community tornado and hurricane shelters. Neither the FEMA nor the ICC documents 

consider air conditioning or heating as part of the design criteria for safe rooms due to the 

expected short duration of occupancy.

FEMA 453 addresses shelters and safe rooms for protection against terrorist attacks, including 

outdoor CBR agent releases (FEMA 2006). This document recommends a minimum ventilation 

rate of 7.5 L/s per person based on the International Mechanical Code (IMC). These documents 

also contain minimum floor areas per person depending on the age and position of the occupants 

(e.g., standing, seated or bedridden), and the duration of the sheltering event. In terms of 

temperature control, this document states that safe rooms do not require heating or cooling, but 

acknowledges that conditions can become intolerable without heating or cooling. The U.S. 

military has design guidelines for collective protection shelters against CBR agents, which 

contain target outdoor air ventilation requirements consistent with ASHRAE Standard 62-99

(U.S. Army Corps of Engineers 1999).

While these documents recognize the need for adequate ventilation, the issue remains as to how 

these spaces will be ventilated in the event of power failures and whether the design ventilation 

rates are sufficient if extended sheltering times are necessary, since these spaces are typically 

intended for short term sheltering only. The ventilation requirements contained in ASHRAE 

Standard 62.1 and 62.2, building codes and other such documents are intended for normal 

operation and usage and do not address extreme conditions of extended sheltering and 

overcrowding or occupants with pre-existing health conditions. Similarly, the control of 

temperature and humidity levels is not dealt with in these guidance documents and not under 

conditions of power outages, extended sheltering periods, and recognizing the needs of sensitive 

populations.

4. STANDARDS

In reviewing the events and issues related to IER, this effort also considered existing standards 

and guidance documents related to post-event conditions. As part of this review, standards 

development needs were identified. 

As noted earlier, ASHRAE has several standards related to indoor environmental conditions in 

buildings. These include Standards 62.1 and 62.2, which cover ventilation and IAQ. The scope 

of Standard 62.1 includes commercial, institutional, and high-rise residential buildings, while 

Standard 62.2 covers low-rise residential. (Note that the scopes of both standards are in the 

process of being revised such that Standard 62.2 will include all residential occupancies.) Both of 

these standards focus primarily on design and construction of new buildings or significant 
24

renovations. While they can be useful in evaluating existing buildings, they do not address 

operation of existing buildings to any significant degree. They also do not address extraordinary 

circumstances such as power outages, extreme weather events or conditions, or unusual outdoor 

pollutant events (such as outdoor chemical releases). The required ventilation rates (and other 

requirements such as filtration) are defined to support occupant health and comfort under normal 

circumstances and were not developed to serve as minimums to provide a tolerable environment 

for shorter-term human occupancy during or after an extreme event. Nor do they specifically 

speak to susceptible populations, who might be more vulnerable to some of the extreme 

circumstances relevant to this discussion.

ASHRAE Standard 170, Ventilation of Health Care Facilities, is also focused on design and 

construction of new buildings or significant renovations and does not address operation of 

existing buildings to any significant degree. It does have requirements for ventilation under loss 

of electrical power for several critical space types, such as airborne isolation rooms. It also has 

heating and cooling requirements when the primary systems break down or are under 

maintenance. Other than that, it does not address extraordinary circumstances such as power 

outages, extreme outdoor weather events or conditions, or unusual outdoor pollutant events, nor 

does it speak to emergency situations such as accommodating pandemics in the community. The 

required ventilation rates are defined to support occupant health and comfort under normal 

circumstances, as well as to reduce hospital-acquired infections, but do not serve as absolute

minimums that humans can tolerate.

ASHRAE Standard 55, Thermal Environmental Conditions for Human Occupancy, specifies 

indoor environmental conditions (e.g., air temperature, relative humidity, and air speeds) that 

will be acceptable to a majority of the occupants within the space. This standard has historically 

been focused more on mechanically ventilated commercial buildings than on residential, though 

more recently it has addressed the issue of naturally ventilated buildings. But it is still about 

thermal comfort when buildings are being operated as designed and does not address 

extraordinary circumstances such as power outages and extreme outdoor weather events or 

conditions. Also, it is about comfort, not physiological concerns such as heat stress.

ASHRAE/IES/USGBC Standard 189.1, Standard for the Design of High-Performance Green 

Buildings (except low-rise residential), contains IEQ requirements consistent with its goal of 

supporting high-performance buildings. In terms of IEQ, it references the requirements of 

ASHRAE Standards 55, 62.1 and 170, with some additional requirements addressing ventilation 

monitoring, filtration and air cleaning, volatile organic compounds emissions from building 

materials, and other items. While it is aiming for a higher level of performance, Standard 189.1 

does not address extreme conditions and other aspects of resilience.

ASHRAE has also published two guidelines of interest in the context of IER. The first, Guideline 

10 Interactions Affecting the Achievement of Acceptable Indoor Environments, describes how 

different indoor environmental factors interact to determine occupancy acceptability of a space. 

While this document recognizes the complex interactions of these various factors, for example 

how air temperature impacts perception of chemical odors, it is focused on normal conditions, 

not extreme events or occupancy when heating, cooling, and ventilation may be severely limited. 

The other ASHRAE Guideline, Guideline 29 for Risk Management of Public Health and Safety 

in Buildings, has already been discussed in this report. As noted earlier, this document provides a 

very general framework on moving from threat assessment to risk categorization, then using the 
25

“decision makers” evaluation criteria to define interventions. It speaks to a broad range of threats 

including natural disasters, accidents, and intentional acts including both criminal and terrorism. 

It speaks to a broad range of issues and offers some general recommendations on each. These 

issues include building siting, utilities, the building envelope, HVAC, food service, fire 

protection, communications, etc. The treatment of each is rather uneven, with a lot of detail on 

air filtration, for example, and much less on many others. It has material on operation and 

maintenance of existing buildings as well as training of staff and occupants.

The U.S. Department of Housing and Urban Development (HUD) Manufactured Home 

Construction and Safety Standards (24 CFR Part 3280, 1994) contains a broad range of 

requirements related to the design and construction of manufactured homes. The HUD regulation 

contains ventilation requirements as well as heating and cooling system requirements, but it is 

focused on normal conditions of occupancy and not extreme events. 
26

5. DISCUSSION AND FOLLOW-ON ACTIVITIES

This report has reviewed existing technical information related to disaster events that are likely 

to impact IER with a focus on post-event IAQ. The purpose of the review was to describe the 

scope and potential impacts of these events, current activities that are addressing these issues, 

important gaps requiring research and other technical analyses, and needs for standards and 

related guidance. The primary events reviewed in detail include heat waves, power outages, 

floods and mold exposure, wildfires, and airborne releases of chemical, biological or radiological 

agents. Other issues discussed include sheltering-in-place and responses to pandemic infection 

events. While the amount and detail of available technical information varies across these events, 

it is clear that these topics have received growing interest in recent years due to high profile 

events, such as heat waves, hurricanes and major storms, wildfires, and terrorist attacks, as well 

as government initiatives in response to these events. Despite the attention given to these areas, 

their impact on indoor environment resilient issues is not fully appreciated in many discussions. 

This review has identified important knowledge gaps requiring research as well as the need for 

improved and more relevant standards and guidance. Additionally, much of the existing 

knowledge needs to be better integrated into a more comprehensive community resilience 

approach, such as the one being established in the NIST Community Resilience program, to 

maximize its impact.

The important research gaps identified include the following, organized by the type of event:

 Heat waves: Development and evaluation of passive design approaches and building retrofit 

measures to avoid overheating during heat waves. Such research needs to consider a variety 

of building types (i.e., single family and high-rise residential, institutional) and building 

occupants (i.e., beyond only healthy adults).

 Power outages: Definition of short term acceptable ventilation and IAQ conditions (beyond 

thermal comfort) for living and working in buildings temporarily during power outages 

which impact HVAC system function.

 Floods: Coupled thermal/airflow simulation tools to better predict conditions that will lead to 

the potential for mold growth.

 Wildfires: The BCCDC review of evidence based guidance for public health decision making 

during wildfire smoke events identified a number of research topics relating to the infiltration 

of smoke into buildings and the use of air cleaning to create clean air shelters in buildings.

 Airborne CBR releases: Building protection approaches based on design and system 

operation in new and existing buildings. Tools to identify buildings most likely to be 

impacted by outdoor releases. Determination of how clean is clean enough following 

decontamination. Tools to support deciding between evacuation and sheltering in place.

 Pandemic response in healthcare facilities: Evaluation and comparison of options to create 

surge airborne isolation space and temporary negative pressure isolation space and the 

impacts on overall building operation. 

 Sheltering in place and safe rooms: Development of detailed coordinated guidance to deal 

with community-wide sheltering in response to events such as heat waves, CBR releases, 

wildfires, and power outages.

 Metrics and tools to help communities identify building classes that may be subject to poor 

IER conditions, and to support planning for improved performance.
27

Several topics for potential standards development were identified during this effort and are 

summarized below. Some are motivated by the fact that most published standards and guidance 

relevant to indoor environmental quality consider only normal operating conditions for buildings, 

e.g., ASHRAE Standards 55, 62.1 and 62.2, which cover thermal comfort and ventilation. A

need exists to develop standards and guidance to address these requirements during or following 

a disaster, when indoor conditions may not be consistent with normal operation and occupancy. 

Specific standard and guidance needs identified in this effort include the following:

 A thermal “comfort” standard or guideline that covers conditions outside the current scope of 

Standard 55. Such a document should define conditions that are safe for both residential 

occupants (including other than healthy adults) and non-industrial occupants during heat 

waves and power outages.

 Ventilation standards or guidelines that cover extreme conditions, which are currently 

beyond the scopes of Standards 62.1 and 62.2. Such documents might include separate 

requirements for safe rooms and shelter-in-place facilities.

 Current efforts underway at CPSC and UL to address CO emission limits from portable 

generators should be continued.

 Guidance should be developed and provided for homeowners and volunteers engaged in 

mold/wet building cleanup following large scale flooding events.

 Specific guidance to support deciding between evacuation and sheltering-in-place in response 

to wildfires and CBR releases.

 Standards for portable air cleaner performance to reduce indoor particulate exposure during 

wildfires, and guidance on system selection.

As efforts to increase community disaster resilience continue, the indoor environmental impacts 

need to be considered and their proper role identified. This report provides the background to 

support these discussions.
28

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