Conference Agenda

Bioaerosols include airborne compounds such as fungi, bacteria, spores, pollen, mites, and viruses, but also can include cell membrane components, metabolites, and byproducts of cells that may or may not be viable. International interest in bioaerosols has increased rapidly since the SARS-CoV-2 pandemic, but the assessment and control of bioaerosols is a much broader discipline than just mold and viruses. This presentation is a general overview of the topic of bioaerosols that begins with a review of potential health effects, a discussion on hazard and risk assessment, the establishment of a hypothesis regarding the potential presence or absence of bioaerosols, purpose and development of a sampling plan, an overview and limitations of interpretation of environmental sampling data, and controls.

This presentation will summarize the information needed to (a) understand when and why bioaerosols are important, (b) recognize sources of bioaerosols, (c) assess the environment to qualitatively or quantitatively determine if biological agents are present, and (d) apply controls to minimize or mitigate bioaerosols exposures. Far too often EHS practitioners automatically turn to sampling for bioaerosols without understanding variations and limitations of source/generation, temporal and spatial variation, limitations of interpretation, and the lack of correlation to health effects. Often, reasons for the presence of biological agents and potential occupant exposure thereto may be obvious in some situations, and investigators may proceed to formulate recommendations without having to sample anything at all. Other situations may be less clear, more than one explanation may be plausible, or substantiating evidence may be needed to warrant repairs or remediation.

One of the core outcomes of the COVID-19 pandemic was a heightened awareness of the connection between indoor air quality and health. Despite this awareness, many building owners and operators still face challenges in implementing indoor air quality policies and protocols. Informed by observations and conversations with stakeholders across the real estate sector, the Center for Active Design team developed and disseminated a survey aimed at better understanding current decision-making processes, implementation challenges, and knowledge gaps in Indoor Air Quality (IAQ) management across the real estate sector. Our analysis of survey results focuses on who drives decision-making, how IAQ is prioritized in relation to energy efficiency, and the tools and technologies stakeholders use to address IAQ concerns. The survey was conducted between September and November 2023, using the Alchemer platform, and included both multiple-choice and open-ended questions to capture quantitative and qualitative data. It was distributed via Fitwel channels, including its network of ambassadors, and through the HERO Health newsletter. 258 professionals participated in the survey, representing real estate investors, developers, facility managers, engineers, and sustainability professionals. Findings revealed both missed opportunities as well as key challenges or barriers to implementing comprehensive indoor air quality policies and protocols. While high-efficiency filtration systems such as MERV13 and HEPA filters have become commonplace management practices, lower-tech solutions like moisture control and regular housekeeping are underutilized —a missed opportunity. Two key barriers identified in the survey are the fragmented landscape for decision-making and the balance of indoor air quality and energy efficiency priorities. Further research is needed to clarify stakeholder roles and responsibilities, improve communication, and develop educational materials that address the financial benefits and return on investment of IAQ improvements to further incentivize the implementation of effective policies and protocols. Aligning IAQ standards with energy efficiency practices will also be critical for future progress.

Poor indoor air quality (IAQ) is one of the world’s largest unmet public health threats. Although we spend 90% of our time indoors, building codes base IAQ requirements on comfort and harm prevention rather than health and wellness. Post-construction, there is little regulation of IAQ. The cost of unhealthy indoor air is massive, with US healthcare spending of >$45B for respiratory infections and >$39B for allergies and asthma. Moreover, health risks from unhealthy indoor air are increasing due to increasing wildfire frequency, longer allergy seasons, and new respiratory viruses.

The paper will begin by summarizing the current situation. We will:

1) Explore historical and recent precedents to inform the development and implementation of health-based IAQ standards, including food and water safety regulations, ventilation reforms post-1918 influenza pandemic, and the Clean Air Act;

2) Analyze the current state of health-based IAQ standards at the local, state, national and international levels; and

3) Review key obstacles to the advancement of health-based IAQ standards.

Then, we will propose a policy and regulatory roadmap to achieve health-based IAQ standards that addresses identified obstacles. We will outline key guiding principles to undergird these standards including health-centricity comprehensiveness, coherence, simplicity, design- and operations-focused, performance-based, measurability, verifiability, and applicability to all buildings. Then, we will define a clear endgame, including detailed model health-based IAQ standards.

Additionally, we will advance a multi-layered approach including:

1. Federal legislative reform, including EPA authority to regulate indoor air, fiscal incentives, and defining IAQ standards in critical infrastructure through DoD

2. Executive agency actions, including DOE and/or EPA to lead development of model IAQ national code, GSA to publish best practice guidelines

3. State and local-level reforms, including codification of health-based IAQ standards

4, Key stakeholder and public engagement, including advocates across public health, biosecurity, and climate, as well as ordinary citizens