The Assessment of Building Interventions on Student Health

Abstract

For more than thirty years, epidemiological and exposure assessment studies have documented the relationship between indoor environmental quality and student health. However, there is an outstanding need to address immediate and long-term building-related environmental challenges. For this reason, this dissertation provides a quantitative evaluation of strategies that could mitigate current harmful indoor exposures and promote investments in healthy environmental quality in schools. It addresses knowledge gaps around a specific set of current strategies across various scales and settings to mitigate indoor environmental exposures including emerging technologies, building and construction policies, and school-related data collection efforts. First, we examined the effectiveness of ‘smart’, dynamic purifiers compared to continuously running purification in a randomized crossover study. We compared changes in indoor particulate matter (PM2.5) and volatile organic compounds (VOCs) concentrations across three intervention arms: no air purification; dynamic purification responsive to elevated PM2.5 and/or VOC concentrations; and continuous purification with fan speed set to half the purifier’s full capability. Both purification types resulted in significant reductions of VOCs, with higher reductions from a continuous system. Dynamic purification can effectively reduce peak exposures to PM2.5 from indoor sources, but continuous purification may better reduce daily PM2.5 and VOC concentrations. Second, using a cross-sectional analysis, we examined the association between school building conditions and chronic absenteeism in Massachusetts. A systematic assessment of public school buildings provided categorical building quality measures across health-related building and site characteristics. Schools with the greatest need for repair were disproportionately attended by disadvantaged and minority students, and associated with high absenteeism. When analyzing specific building systems, schools needing major repairs or replacement of school roofs, building envelope, and site-related features were significantly associated with higher chronic absenteeism compared to schools in need of general maintenance. Addressing building disrepair may provide another strategy for reducing chronic absenteeism. Lastly, in a multi-year study, we characterized building quality at baseline and evaluated school-level associations between acquiring green building certification (Leadership in Energy and Environmental Design and Collaborative for High Performance Schools) and standardized test performance. No association was observed for green buildings because at baseline, future green-certified schools were already higher-performing and the study population of green-certified buildings did not acquire all indoor environmental quality credits available. Allocation of green-certified schools should account for prior academic performance, health, and building quality with greater prioritization of indoor environmental quality credits.