Indoor Air Quality and Student Performance

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assist with maintaining the indoor environment of a school facility. School systems should take
advantage of available programs to improve and maintain good indoor environmental quality, and
specifically, good indoor air quality in their schools. Programs can be targeted to the maintenance
of existing school facilities and to new school construction.

The U.S. Environmental Protection Agency has published voluntary guidance that addresses
indoor air quality in schools. By applying no-cost or low-cost approaches outlined in the AQ Tools
for Schools IAQ TfS) Action Kit, schools can find cost-effective approaches toward making the
school environment more conducive to improved health and performance of teachers and students.

The IAQ Tf Kit is free to schools and school districts who make the request on school letterhead.
To order the Kit contact the [AQ Information Clearinghouse:

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Additional Resources

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A searchable bibliography of studies dealing with indoor health and productivity (including
abstracts of many of the references cited below) is available through the Indoor Health and
Productivity (IHP) project. To view, visit http://www.IHPcentral.org

1, Institute of Medicine. Committee on the
Assessment of Asthma and Indoor Air. 2000.
Clearing the Air: Asthma and Indoor Exposures.
‘Washington, DC, National Academy Press.

2. Bornehag, C.G., G. Blomquist, et al. 2001.
“Dampness in buildings and health: Nordic
interdisciplinary review of the scientific evidence
on associations between exposure to ‘dampness?
in buildings and health effects (NORDDAMP).”
Indoor Air: International Journal of Indoor Air
Quality and Climate 11(2):72-86.

3. Platts-Mills, T.A.E. 2000.
Allergens Derived from Arthropods and
Domestic Animals. Indoor Air Quality
Handbook. Eds., J. Spengler, J. M. Samet, and J.
F. McCarthy. New York, MeGraw-Hill:43.1—
43,15.

4, Burr, M.L, 2000.

Combustion Products, In: Indoor Air Quality
Handbook. Eds., J. Spengler and J.M. Samet.

New York, McGraw-Hill:29.3-29.25,

Pilotto, L.S., R.M. Douglas, et al. 1997.
“Respiratory effects associated with indoor
nitrogen dioxide exposure in children.”
International Journal of Epidemiology 26(4):788-
96.

Norback, D., R. Walinder, et al. 2000.
“Indoor air pollutants in schools: Nasal patency
and biomarkers in nasal lavage.” Allergy
55(2):163-70,

Mendell, M.J., G.N. Naco, et al.
“Work-related respiratory symptoms in office
workers: Analyses of standardized dara from
NIOSH Health Hazard Evaluations” (in
preparation).

Sieber, W.K., L.T. Stayner, et al. 1996.
“The National Institute for Occupational Safety
and Health indoor environmental evaluation
experience. Part Three: Associations between.
environmental factors and self-reported health
conditions.” Applied Occupational and
Environmental Hygiene 1(12):1387-92.


Indoor Air Quality and Student Performance

54, Gravesen, S., PB Skoy, et al. H. 1990,
“The role of potential immunogenic components
of dust (MOD) in the sick-building-syndrome.”
Indoor Air 90, 1:9-13. Ottawa, CMHC.

55. Gyntelberg, B, P. Suadicani, et al. 1994.
“Dust and the sick building syndrome.” Indoor
Air 4:223-38.

56. Raw, G..J., M.S. Roys, and C. Whitehead. 1993.
“Sick building syndrome: Cleanliness is next to
healthiness.” Indoor Air 3:237-45,

57. Skyberg, K., K.R. Skulberg, et al. 1999.

“Dust reduction relieves nasal congestion. A
controlled intervention study on the effect of
office cleaning, using acoustic rhinometry.”
Indoor Air 99: The 8th International Conference
on Indoor Air and Climate, Edinburgh, Scotland.

58. Fogarty, R. 2000,
“Bliminating AQ complaints by eliminating
ultrafine particles.” Healthy Buildings 2000.
1:207-11.

59. Wyon, D.P. 2000.
“The effects on health and self-estimated
productivity of two experimental interventions
which reduced airborne dust levels in offfice
premises.” Healthy Buildings 2000. 1:641-6.

60. Mendell, M.J., WJ. Fisk, et al. 2002.
“Enhanced particle fileration in a non-problem
office environment: A double-blind crossover
intervention study.” Epidemiology (in press).

61, Green, G.H. 1974.

“The effect of indoor relative humidity on
absenteeism and colds in schools.” ASHRAE
Transactions 80:131-41.

62. McNall, RE., and R.G. Nevins. 1967.
“Comfort and academic achievement in an air-
conditioned junior high school: A summary
evaluation of the Pinellas County experiment.”
ASHRAE Transaction 73:3.1-3.17.

63. Sieber, W.K., L.T. Stayner, et al. 1996.
“The National Institute for Occupational Safety
and Health Indoor Environmental Evaluation
Experience. Part Three: Associations Between
Environmental Factors and Self-Reported Health
Conditions.” Applied Occupational and Hygiene
Journal 11(12):1387-92.

64, Chen, L., B.L. Jenison, et al. 2000,
“Elementary school absenteeism and ait
pollution.” Inhalation Toxicology 12(11):997-
1016.

65. Ransom, M.R., and C.A. Pope, 3", 1992,
“Elementary school absences and PM, pollution
in Utah Valley.” Environmental Research
58(2):204-19,

66. Makino, K. 2000.
“Association of school absence with air pollution
in areas around arterial roads.” Journal of
Epidemiology 10(5):292-9.

67. Gilliland, ED., K. Berhane, et al. 2001.

“The effects of ambient air pollution on school

absenteeism due to respiratory illnesses.”
Epidemiology 12(1):43-54.



Indoor Air Quality and Student Performance

There is also good evidence that moderate changes in room temperature, even within the comfort
Continued zone, affect children’s abilities to perform mental tasks requiring concentration, such as addition,
multiplication, and sentence comprehension. Overall, warmer temperatures tend to reduce
performance, while colder temperatures reduce manual dexterity and speed.TM In general, the need
stress can drain to avoid extreme conditions and to provide for as much individual temperature control as possible

children’s -37:" is strongly supported.>'*?

WIIl Performance Be Affected Even If No One Is Complaining?

Performance can certainly be expected to suffer if conditions are serious enough for people to
complain. The lack of complaints, however, is not an indication that performance cannot be
improved. For example, in the above studies, symptoms were solicited through questionnaires (as
opposed to complaints), and tests were performed on individuals in typical school and office
environments. That is, the reductions in performance were recorded under circumstances that
easily could have gone unnoticed because of the absence of complaints.

. environmental

Filtration, Housekeeping, and HVAC Maintenance

One study in schools and several with adult subjects also suggest relationships between health
symptoms and airborne or surface-level dust’”***> and between health benefits and good
housekeeping protocols that thoroughly remove dust from surfaces.***” Some studies show health
and comfort benefits from efforts to reduce airborne particles. One such study in an office
building showed a statistically significant reduction in mental confusion when 95 percent of
airborne particles between 0.3 and 0.5 microns in size were removed by filtration. The study also
showed reduced fatigue and improved productivity, although these results were not statistically
significant.

Early studies in schools have found that air conditioning is associated with lower absentee rates or
improved performance,” and that schools with humidification systems are also associated with
lower absentee rates. More recent and more rigorous studies in offices, however, show the opposite
to be true. This discrepancy may be explained by the fact that, while air conditioning and
humidification systems are designed to control temperature and humidity (a positive effect), they
may also become contaminated with biological pollutants (a negative effect) if they are not
judiciously maintained. A review of building investigation reports also suggests significant benefits
to health and performance from good HVAC maintenance.® Presumably, these benefits result
because properly maintained HVAC systems can provide consistently good thermal and ventilation
control while also reducing the risk of biological contamination.

Overall, the evidence suggests that good housekeeping designed to control surface dust plus care
and maintenance of the HVAC system, including provisions for good filtration performance, are
important aspects of school operating protocols designed to improve student health and
performance.

Outdoor Pollution

A major component of an IAQ management plan is the control of pollutants that may enter the
school from the outdoors. Studies provide evidence of increased school absenteeism from outdoor
pollutants such as carbon monoxide® and particles.“” This evidence suggests that particular
attention to potential exposures from school bus exhausts and other vehicle exhausts and that
improved filtration of particles in locations with high levels of outdoor pollution may be advisable.

What You Can Do
Because poor indoor air quality results from failure to follow practices that help create and
maintain a healthy indoor environment, being proactive in managing potential IAQ hazards will



Indoor Air Quality and Student Performance

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9. Menzies, R., R. Tamblyn, et al. 1993.
“The effect of varying levels of outdoor-air
supply on the symptoms of sick building
syndrome.” New England Journal of Medicine
328(12):821-7.

10. Milton, D.K., P.M. Glencross, et al. 2000.
“Risk of sick leave associated with outdoor air
supply rate, humidification, and occupant
complaints.” /ndoor Air 10(4):212-21.

11. Pazdrak, K., P. Gorski, et al. 1993.
“Changes in nasal lavage fluid due to
formaldehyde inhalation.” International Archives
of Occupational and Environmental Health
64(7):515-9.

20. Steerenberg, PA., S. Nierkens, et al. 2001.
“Traffic-related air pollution affects peak
expiratory flow, exhaled nitric oxide, and
inflammatory nasal markers.” Archives of
Environmental Health 56(2):167-74.

21. Douglas, J.W.B, and J.M. Ross. 1965.
“The effects of absence on primary school
performance.” The British Journal of Educational
Psychology 35:28-40.

22. Weitzman, M., L.V. Klerman, et al, 1982.
“School absence: A problem for the pediatrician.
Pediatrics 69(6):739-A6.

23, O’Neil, S.L., N. Barysh, et al. 1985.

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“Determining school programming needs of

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“Exposure to gaseous formaldehyde induces IgE-
mediated sensitization to formaldehyde in
school-children.” Clinical and Experimental
Allergy 26(3):276-80.

13. Smedje, G., D. Norback, et al. 1997.
“Asthma among secondary school children in
relation to the school environment.” Clinical and
Experimental Allergy 27(11):1270-8.

14, Garrett, M.H., M.A. Hooper, et al. 1999.
“Increased risk of allergy in children due to
formaldehyde exposure in homes.” Allergy
54(4):330-7,

15, Franklin, PJ., PW. Dingle, et al. 2000,
“Formaldehyde exposure in homes is associated
with increased levels of exhaled nitric oxide in
healthy children.” Healthy Buildings 2000:
Exposure, Human Responses and Building
Investigations, Espoo, Finland, SIY Indoor Air
Information Oy, Helsinki, Finland.

16. McCoach, J.S., A.S. Robertson, et al. 1999,
“Bloor cleaning materials as a cause of
occupational asthma.” Indoor Air ‘99: The 8th
International Conference on Indoor Air Quality
and Climate, Edinburgh, Scotland, Construction

Research Communications Ltd.

17. Zock, J., M. Kogevinas, et al. 2001.
“Asthma risk, cleaning activities and use of
specific cleaning products among Spanish indoor
cleaners.” Scandinavian Journal of Work,
Environment, and Health 27:76-81.

18. Guo, ¥.L., ¥.C. Lin, et al, 1999,
“Climate, traffic-related air pollutants, and
asthma prevalence in middle-school children in
Taiwan.” Environmental Health Perspectives
107(12):1001-6.

19, Wyler, C., C. Braun-Fahrlandes, et al. 2000.
“Exposure to motor vehicle traffic and allergic
sensitization, The Swiss Study on Air Pollution
and Lung Diseases in Adults (SAPALDIA)
Team.” Epidemiology 11(4):450-6.

children.” The Journal of School Health
55(6):237-9,

24, Silverstein, M.D., J.E. Mair, et al. 2001.
“School attendance and school performance: A
population-based study of children with asthma.”
Journal of Pediatrics 139(2):278-83.

25. U.S, Centers for Disease Control and Prevention.
2002.
“Surveillance for Asthma—United States, 1980-
1999.” Morbidity and Mortality Weekly Report. 51
(SS01):1-13.

26. Myhrvold, A.N., E.Olsen, and O, Lautidsen 1996,
Indoor Environment in Schools—Pupils’ Health
and Performance in regard to CO,
Concentrations. In Indoor Air ’96, The Seventh
International Conference on Indoor Air Quality
and Climate. Vol 4, pp. 369-371.

27, Smedje, G., D. Norback, et al. 1996.
“Mental performance by secondary school pupils
in relation to the quality of indoor ait.” Indoor
Air '96. The 7th International Conference on
Indoor Air Quality and Climate, Nagoya, Japan.

28, Mrlhave, L., $.K. Kjaergaard, et al. 2000.
“Sensory and other neurogenic effects of
exposures to airborne office dust.” Healthy
Buildings 2000: Exposure, Human Responses and
Building Investigations, Espoo, Finland, SIY
Indoor Air Information Oy, Helsinki, Finland.

29. Otto, D.A., H.K. Hudnell, et al. 1992.
“Exposure of humans to a volatile organic
mixture. I. Behavioral assessment.” Archives of
Environmental Health 47(1):23-30.

30. Wargocki, P, D.P. Wyon, et al. 1999,
“Perceived air quality, SBS-symptoms and
productivity in an office at two pollution loads.”
Indoor Air '99. The Eighth International
Conference on Indoor Air Quality and Climate, Vol
2, pp. 131-136.

31. Wargocki, P,, D.P. Wyon, et al. 2000,
“The effects of outdoor air supply rate in an
office on perceived air quality, Sick Building
Syndrome (SBS) and productivity.” Indoor Air
10(4)222-36.



( 402K03006

a United States Indoor Environments Divisiv.. August 2003
Environmental Protection Office of Radiation and 402-K-03-008
Agency Indoor Air

The Consequences

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e Problem How Does Indoor Air Quality Affect a Child’s Ability to Learn?

Evidence continues to emerge showing that poor indoor air quality (IAQ) can cause illness
requiring absence from school, and can cause acute health symptoms that decrease performance
while at school. In addition, recent data suggest that poor [AQ may directly reduce a person's
ability to perform specific mental tasks requiring concentration, calculation, or memory.

Air in most indoor environments contains a variety of particles and gaseous contaminants. These
contaminants are commonly referred to as indoor pollutants when they affect human health and
performance. Indoor temperature and relative humidity can also affect health and performance
directly, and can affect human performance indirectly by influencing the airborne level of molds
and bacteria.

Most often, poor indoor air quality results from the failure to follow practices that help create and
maintain a healthy indoor environment. Common examples include failure to:

>» control pollution sources such as art supplies and laboratory activities
» control temperature and humidity

» control moisture and clean up spills

> ventilate each classroom adequately

» adequately perform housekeeping and maintenance

> use integrated pest management to minimize the use of pesticides

Schools should be designed, built, and maintained in ways to minimize and control sources of
pollution, provide adequate exhaust and outdoor air ventilation by natural and mechanical
means, maintain proper temperature and humidity conditions, and be responsive to students and
staff with particular sensitivities such as allergies or asthma. Failure to deal adequately with any of
these issues may go unnoticed, but can and often does take its toll on health, comfort, and
performance of teachers and students in school.

Specific Evidence

Ilnesses Resulting from Poor Indoor Air Quality Increase School Absences
Evidence from schools that various environmental conditions are closely associated with the
incidence of objectively measurable adverse health effects is rapidly emerging. Indoor air quality

' Substantial portions of this revised document are based on a literature review funded by the Environmental Protection
Agency. The literature review was conducted by Mark Mendell from Lawrence Berkeley National Laboratory, and Garvin
Heath from the University of California at Berkeley. Evidence of the association between indoor environmental quality
and human performance is taken from school sestings wherever possible, but it is supplemented by similar evidence in
other environments where information from school environments is lacking.


Indoor Air Quality and Student Performance

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32. Sundell, J., T. Lindvall, and B. Stenberg, 1991.
“Influence of type of ventilation and outdoor
airflow rate on the prevalence of SBS symptoms.”
JAQ ‘91. Conference of the American Society of
Heating, Refrigerating, and Air-Conditioning
Engineers, Inc. Washington, DC.

33. Sundell, J. 1994.
“On the association between building ventilation
characteristics, some indoor environmental
exposures, some allergic manifestations and
subjective symptom reports.” International
Journal of Indoor Air Quality and Climate
Supplement No. 2/94.

34. Mendell, M, 1993.
“Non-specific symptoms in office workers: A
review and summary of the epidemiologic
literature.” Indoor Air 3:227-36.

35. Seppanen, O.A., WJ. Fisk, et al. 1999.
“Association of ventilation rates and CO,
concentrations with health and other responses
in commercial and institutional buildings.”
Indoor Air—International Journal of Indoor Air
Quality and Climate 9(4):226-252.

36. Apte, M., W, Fisk, and J. Daisey. 2000.
“Associations between indoor CO, concentrations
and sick building syndrome symptoms in U.S.
Office buildings: An analysis of the 1994-1996
BASE study data.” Indoor Air 10:246-57.

37. Myatt, T.A,, et al. 2002,
“An intervention study of outdoor air supply
rates and sick leave among office workers.”
Indoor Air 2002. The 9th International
Conference on Indoor Air and Climate, Monterey,
CA, 1:778-83.

38. Leyten, J.L., and A.C. Boerstra. 2002.
“Two distinet causal paths from indoor air
problems to sickness absenteeism.” Indoor Air
‘2002. The 90h International Conference on Indoor
Air and Climate, Monterey, CA. 1:820-1,

39. California Energy Commission. 1995
i ny in non-residential buildings in
California. California Energy Commission,
40. Daisey, J.M., WJ. Angell, et al.
“Indoor air quality, ventilation and health
symptoms in schools: An analysis of existing
information.” Indoor Air (in press).

41. Myhrvold, AN, E. Olsen, et al. 1996.
“{ndoor environment in schools — Pupils’ health
and performance in regard to CO,
concentrations. Indoor Air ‘96. The 7th
International Conference on Indoor Air Quality
and Climate. Vol 4, pp.369-371.

42. Bartlett, K.H., S.M. Kennedy, et al, 1999.
“Predictors of exposure to indoor CO2 and
bioaerosols in elementary school classrooms.”
Indoor Air '99: The 8th International Conference
on Indoor Air and Climate, Edinburgh, Scotland.

43, Braganza, E., C, Fontana, et al. 2000.
“Baseline measurements of indoor air quality
comfort parameters in eight United States
elementary and secondary schools.” Healthy
Buildings 2000: Exposure, Human Responses and
Building Investigations, Espoo, Finland, SITY
Indoor Air Information Oy, Helsinki, Finland.

44, Smedje, G., and D. Norback 2000.
“New ventilation systems at select schools in
Sweden—effects on asthma and exposure.”
Archives of Environmental Health 55(1):18-25.

45. U.S. EPA. 2002.
School Advanced Ventilation Engineering
Software (SAVES). Indoor Environments
Division. On the Web ( 3/2/03) at hetp://
www.epa.gov/iag/schooldesign/saves. html.

46. Raw, G.J., M.S. Roy, and A, Leaman. 1990.
“Further findings from the office environment
survey: Productivity.” Indoor Air 1990. The Fifth
International Conference on Indoor Air Quality
and Climate. Vol 1, pp. 231-36.

47, Fang, L., G. Clausen, and P.O. Fanger, 1998,
“Impact of temperature and humidity on the
perception of indoor air quality.” Indoor Air
8(2):80-90.

48. Fang, L., G. Clausen, and P.O. Fanger. 1998.
“Impact of temperature and humidity on
perception of indoor air quality during
immediate and longer whole-body exposures.”
Indoor Air 8(4):276-84.

49. Fang, L., P. Wargocki, et al. 1999.
“Field study on the impact of temperature,
humidity and ventilation on perceived air
quality.” Jndoor Air 99. The Eighth International
Conference on Indoor Air Quality and Climate. Vol
2, pp. 107-112.

50. Levin, H. 1995.
“Physical factors in the indoor environment.”
Occupational Medicine: State of the Art Reviews
10(1):59-94,

51. Wyon, D.P, LB, Andersen, and G.R. Lundqvist.
1979.
“The effects of moderate heat stress on mental
performance.” Scandinavian Journal of Work,
Environment, and Health 5:352-61

52. Wyon, D.P. 1991.
“The ergonomics of healthy buildings:
Overcoming bartiers to productivity.” IAQ ‘91:
Post Conference Proceedings. American Society of
Heating, Refrigerating, and Air-Conditioning
Engineers, Inc. Atlanta, pp. 43-6.

53. Skov, P, and O. Valbjorn. 1987.
“The ‘sick’ building syndrome in the office
environment: The Danish Town Hall study.”
Environment International 13: 339~49.



Indoor Air Quality and Student Performance

problems can result in increased absences because of respiratory infections, allergic diseases from*

Recent data. biological contaminants, or adverse reactions to chemicals used in schools. Building factors or
suggest that pollution in buildings most frequently and consistently associated with respiratory health effects
poor A 1Q can are the presence of moisture, water damage, and microbiological pollutants; animal and other
biological allergens;? and combustion products,‘ including nitrogen dioxide.** Other risk factors
reduce a for respiratory health effects include: moisture or dirt in HVAC systems;”* low ventilation rates;”!°
person's ability formaldehyde;*""* chemicals in cleaning products;'*” and outdoor pollutants or vehicle
to perform exhaust.'®?°
specific mental Children’s overall performance decreases due to sickness or absence from school.’!4 Building-
tasks requiring associated health effects can increase student or teacher absences from school and degrade the
concentration, performance of children or teachers while in school. Respiratory health effects, such as respiratory
calculation or infections and asthma, are the illnesses most closely associated with increased absenteeism. In fact,

asthma-related illness is one of the leading causes of school absenteeism, accounting for over 14
million missed school days per year.”*

Measured Loss in Performance from Indoor Pollution Sources or Inadequate Ventilation
Recent studies relate direct performance measurements to changes in indoor air quality. For
example, a European study of 800 students from 8 schools provides data on indoor air quality,
health symptoms, and students’ ability to concentrate.” In the study, carbon dioxide measurements
were taken in the classrooms and students were given a health symptom questionnaire. A
computer-based program scored their ability to concentrate. The main source of carbon dioxide in
buildings is exhaled breath. Carbon dioxide itself is not a health threat at levels typically found
indoors, but when outdoor air ventilation rates are low, carbon dioxide levels and other pollution
levels are not diluted as much and therefore also tend to be high. In the study, student scores on
the concentration test were lower and their health symptom responses to the questionnaire were
inferior when carbon dioxide levels increased. This finding, which was statistically significant,
suggests that reduced ventilation rates (and higher indoor pollution) is associated with a decreased
ability to concentrate along with increased adverse health symptoms. Another study” of students
shows similar results when using subjective reports of performance, while laboratory studies of the
effects of a mixture of VOC on adults shows that elevated volatile organic compounds (VOCs) can
decrease performance of sensitive adults,” though not necessarily on those that are not sensitive.”

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Studies of adults in office settings generally support these associations. In a controlled study of 30
female adults working in an office environment, a 20-year old used carpet, which served as a
pollution source, was periodically introduced on racks behind a screen so that subjects had no way
of knowing when the carpet was present.*” The subjects were tested in typing, arithmetic, logical
reasoning, memory, and creative thinking during several trials with and without the carpet present.
These tasks are similar to the kinds teachers and students perform in school. During the trials
without the carpet, the subjects’ performance improved in all tasks by 2 — 6 percent. When the
carpet was present, the prevalence of headaches during tasks requiring concentration increased,
suggesting that at least part of the effect on performance was from pollution-related adverse health
effects. In a later study using the same procedure, increasing ventilation rates with the carpet
present resulted in statistically significant improvements in performance.?!

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In a similar although more limited study of typing performance and perceptions of air quality,
computers were used as the pollution source. Computers can emit a variety of VOCs as internal
temperatures of various components rises. In this study, the air was perceived to be fresher and
typing performance improved in the absence of the computers.

Evidence is increasing that health, comfort, and performance of adults improve at higher
ventilation rates.” In addition, a recent controlled study in office buildings found that short-



Indoor Air Quality and Student Performance

PePH a sereteet term sick leave, often associated with respiratory illness, was significantly associated with low

ss related. ventilation rates,'° A subsequent study to test the hypothesis that the sick leave reflected increased
respiratory illness failed.” The latter study, however, examined a much narrower range of ventilation
rates, and related ventilation rates only with sick leave taken during the following week. An
alternative explanation supported by sick leave data from this and other studies is that poor indoor
air quality increases the probability that individuals will take sick leave even for minor ailments, and
delay returning to work during recovery.**

Ventilation rates in most schools are below recommended levels, both in the United States and in
Europe.” In fact, in a California study, one third of the schools had ventilation rates that were
less than half the recommended levels. Thus, the prevalence of low ventilation rates, combined with
the continually growing evidence of the positive impact that outdoor air ventilation has on health
and human performance, suggests a clear opportunity for improving IAQ design and management
of school facilities. The availability of energy recovery technology in ventilation systems, and the
availability of software tools to evaluate the financial implications of this technology,” may facilitate
acceptance of higher ventilation rates.

Thus, the evidence is increasing in studies of both schools and other settings that indoor pollution
or inadequate ventilation can decrease student and teacher performance. These studies reinforce
others that relate degradation in indoor air quality with increased frequency of adverse health
symptoms or absenteeism. IAQ management in schools, including pollutant source control and
provisions for adequate ventilation, appears to provide a healthy indoor environment conducive to
improved student and teacher health, higher school attendance, increased school funding, and
improved student performance. Furthermore, the pervasive problem of inadequate ventilation in
schools provides a significant opportunity to improve school conditions that leads to improved
performance of teachers and students.

Effects from Mild Symptoms of Distress

What about people who do not have a diagnosable illness, but simply do not feel well? People may
report feeling lethargic, having headaches, having a mild sore throat or itchy eyes, or they may have
a sense that the air is “stale,” “stuffy,” or “too dry.”

Motivation can often overcome small burdens of environmental stress so that children’s
demonstrated performance may not decline. Evidence from adults, however, suggests that continued
environmental stress can drain a person's physical and mental resources and ultimately affect their
performance. For example, evidence from office workers suggests that, when individuals experience
just two symptoms of discomfort (e.g., dry eyes, itchy or watery eyes, dry throat, lethargy, headache,
chest tightness), they begin to perceive a reduction in their own performance. That perception
increases as the number of symptoms increases, averaging a 3-percent loss with three symptoms, and
an 8-percent loss with five symptoms.** This suggests that when large numbers of students and staff
experience signs of discomfort related to the air inside their school, teaching and learning
performance will degrade over time.

Effects of Temperature and Humidity

In addition to indoor pollution and ventilation, studies suggest that various activities such as typing
or driving a vehicle are diminished when people are demonstrably too cold or too hot. Maintaining
temperature at the warm end of the comfort zone tends to increase adverse health symptoms, while
temperatures at the cool end of the comfort zone tend to reduce symptoms. Similarly, individuals
perceive the quality of the indoor air to be better when humidity is at the low end of the comfort

zone.”