Impacts of the Indoor Air Quality on the Health of the Employee and Protection against These Impacts

Abstract

Workplace indoor factors are among the factor which affect the health of workers most in all sectors. Another important one of these factors is the air quality of the workplace. There are three main groups of workplace indoor pollutants: biological ones, chemical ones and particles (non-biological). They were grouped as asbestos, biological pollutants, carbon monoxide (CO), carbon dioxide (CO2), formaldehyde/pressed wooden products, lead (Pb), nitrogen dioxide, (NO2), Radon (Rn), indoor particle substances, environmental tobacco smoke, volatile organic compounds (VOCs), humidity, odor and wood smoke. The workplace indoor air pollutants are among the primary indoor air pollutants with serious effects on health and the potential to deteriorate the workers’ health. Healthy indoor air quality is defined as the indoor air which does not contain hazardous substances and does not create sense of discomfort in at least 80% of the workers in the workplace. Poor indoor may result in a variety of health problems, from headache, dizziness and nausea, to asthma, cardiovascular diseases, cancer and death.

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
Chapter
Impacts of the Indoor Air Quality
on the Health of the Employee
and Protection against These
Impacts
FerdiTanir and BurakMete
Abstract
Workplace indoor factors are among the factor which affect the health of workers
most in all sectors. Another important one of these factors is the air quality of the
workplace. There are three main groups of workplace indoor pollutants: biological
ones, chemical ones and particles (non-biological). They were grouped as asbestos,
biological pollutants, carbon monoxide (CO), carbon dioxide (CO), formaldehyde/
pressed wooden products, lead (Pb), nitrogen dioxide, (NO), Radon (Rn), indoor
particle substances, environmental tobacco smoke, volatile organic compounds
(VOCs), humidity, odor and wood smoke. The workplace indoor air pollutants
are among the primary indoor air pollutants with serious effects on health and the
potential to deteriorate the workers’ health. Healthy indoor air quality is defined as
the indoor air which does not contain hazardous substances and does not create sense
of discomfort in at least  of the workers in the workplace. Poor indoor may result
in a variety of health problems, from headache, dizziness and nausea, to asthma,
cardiovascular diseases, cancer and death.
Keywords: air quality, worker, health effect, prevention, VOCs
. Introduction
Oxygen is a basic need for the survival of human beings who can stand its
deficiency only for a certain period of time which is shorter when compared with
their other needs. Human beings receive oxygen from air through respiration. It is a
right for them to have clean air around them. Pollution of air have adverse effects on
the health of living things. The relation between health and air quality has been a fact
acknowledged since Hippocrates. Indoor environments may pollute the air with the
outdoor pollutants and indoor pollutants. Indoor air quality is of particular impor-
tance for people who spend  of their time in public or private indoors such as
houses, schools, fitness centers, shopping malls, supermarkets, workplaces and trans-
portation vehicles. The health risks accompanying exposure to indoor air pollution
can be worse for many people when compared with those of the outdoor air pollution.

Air Quality and Health

Unhealthy indoor air may be harmful particularly for risk groups, such as children,
the elderly or the patients suffering chronic disorders. Workplace indoor air quality is
equally important for those spending at least / of their lifetime in workplace [, ].
Workplace indoor factors are among the factor which affect the health of workers
most in all sectors. Another important one of these factors is the air quality of the
workplace. One of the focal points of occupational health is environmental effect on
the workers working in the indoors of workplaces, when compared to those working
in industrial workplaces, such as construction, mining and agricultural workplaces
which are very dangerous or dangerous. Furthermore, workers working indoors are
less prepared or experienced against environment risks in comparison to the ones
working in industrial workplaces. Overview of relevant legislation shows control
mechanisms used in such workplaces are not sufficient []. Workplace indoor air
quality is an optimal indoor requirement which ensures health, comfort and wellbe-
ing of workers and includes minimum air pollutants. Indoor air quality varies accord-
ing to air temperature, relative humidity, air speed and chemicals at workplace [].
In today’s workplaces, materials, equipment, various cleaning products and chemical
and particle emissions determine the indoor air quality. Indoor air quality affect
workers’ health, incidence of occupational accidents, nonattendance and productiv-
ity. For this reason, ensuring that the workplace indoor air quality conforms to the
norms is of particular importance. Indoor air quality affects workers’ health, emer-
gence of occupational accidents, in attendance and productivity []. This article aims
at shedding light on the adverse effects of workplace indoor air quality on the health
of workers and also the measures which need to be taken for preventing such effects.
For this reason, this part covers information on factors deteriorating indoor air pol-
lution, health problems which might develop in workers as a result of the indoor air
quality, workplace indoor air quality assessment criteria stemming from international
and national source data, the measures to be taken to protect workers from indoor air
pollution, indoor air quality and Covid-.
. Factors affecting workplace indoor air quality
Indoor air pollutants originating from environment/outdoor environment:
These are biological factors, industrial pollutants, fire products, ammonia, ozone,
traffic pollutants such as nitrogen dioxide and particles, radon, methane and
humidity.
Indoor air pollutants originating from workplace: They were grouped as
asbestos, biological pollutants, carbon monoxide (CO), carbon dioxide (CO),
formaldehyde/pressed wooden products, lead (Pb), nitrogen dioxide, (NO), Radon
(Rn), indoor particle substances, environmental tobacco smoke, volatile organic
compounds (VOCs), humidity, odor and wood smoke [–]. Workers working in
the workplace indoor environment may be exposed to various air pollutants (both
in gas form and particle form), including organic, inorganic and biological ones.
The workplace indoor air pollutants are among the primary indoor air pollutants
with serious effects on health and the potential to deteriorate the workers’ health.
Indoor air quality is affected by the tobacco and nicotine products, chemicals used
for cleaning purposes, heating, construction materials and humidity. The pollutants
in the indoor air can be present in the form of gas or particle and they may cause
various diseases in the respiration system. The most important indoor air pollutant
is the smoke of cigarette. The smoke produced by smokers includes many hazardous

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Impacts of the Indoor Air Quality on the Health of the Employee and Protection against These…
DOI: http://dx.doi.org/10.5772/intechopen.102708
substances, just like the smoldering cigarette. Most of them are carcinogenic. The
people who are exposed to this smoke may develop serious diseases, although they
do not consume these products. All workers are affected by the smoke of cigarette
consumed in the environment. Limiting the act of smoking to particular rooms would
not protect other workers. The particles of tobacco products hang in the air for five
hours. Hookah, warmed up tobacco products and electronic cigarette consumption
have the same effects on environment and people [–]. The construction materials,
equipment and chemicals present in the workplace deteriorates the indoor air quality.
There are sources of pollutants which deteriorates the indoor air quality and health
of workers can be protected only if their effects are eliminated. There are three main
groups of workplace indoor pollutants: biological ones, chemical ones and particles
(non-biological):
Biological factors: They may stem from excessive bacteria, virus, fungus, dust
mite, animal hair, pollen concentrations, insufficient maintenance and cleaning,
water split, insufficient humidity control, condensation or leakages at the building
envelope or water leakage caused by flood.
Chemical Factors: Chemical pollutants (gas and vapor), emissions stemming
from the products used in the building (like floor or walls covering, office equipment,
furniture, insecticide, cleaning products), accidental spillage of chemicals and prod-
ucts used for construction purposes, adhesives, paints and combustion products such
as carbon monoxide, formaldehyde and nitrogen dioxide are included in this group.
Particle-associated factors (non-biological): Particles are substances which are
light enough to hang in the air, in solid or liquid form, and they are non-biological.
The building may extract dust, dirt or other substances. Particles may be produced
by activities such as construction, wooden punching, drywall, printing, duplication,
copying and operation equipment [].
. Health problems associated with workplace indoor air pollution
Healthy indoor air quality (IAQ) is defined as the indoor air which does not
contain hazardous substances and does not create sense of discomfort in at least 
of the workers in the workplace [–]. Poor indoor may result in a variety of health
problems, from headache, dizziness and nausea, to asthma, cardiovascular diseases,
cancer and death. The typical effect of some common indoor air pollutants on the
health and wellbeing of the residents can be seen in Table . Poor air quality may also
have adverse impact on workplace performance, learning at the education/training
institutions and improvement of health services, in addition to being hazardous in
terms of health and comfort. The impact of indoor air pollutants on the health of the
people depends on the concentration of the concerned pollutant, exposure duration,
age and gender of the people exposed to it. As for the industrial workplaces, most
of the primary risks are evaluated in terms of use of personal protection equipment
(PPE), exposure risk and local air conditioning [–].
EU-OFFICER research Project showed the association between the indoor chemi-
cals in the office and sick building syndrome-SBS symptoms. The most expressed
complaints are ocular irritation (dry eyes, watering eyes or itching, burning or
irritation), headache, lethargy, extraordinary tiredness. The researchers also reported
that xylene, ethylbenzene, α-pinene, d-limonene, styrene, formaldehyde, acrolein,
propionaldehyde, hexane and ozone might increase in the incidence of the symptoms.
They concluded by underlining the need for further research in order to better depict

Air Quality and Health

the complicated relationship between IAQ and health interaction symptoms [].
A research conducted on the effects of indoor air quality on the health of workers
in Middle East showed that the first most affected part of workers’ bodies is their
respiratory system; the second most affected one is their cardiovascular system, and
the third most affected one is their visual system [].
. Indoor air pollution for health professionals
People living in developed European and American countries are reported to be
more exposed to airborne substances deriving from indoors where they spend most
of their time (>) causing environmentally associated symptoms that should be
evaluated by health professionals. However, this percentage is expected to be higher for
infants and the elderly, chronically ill people and in urban settings []. Many pol-
lutants present with higher concentrations indoor than outdoor, especially in case of
longer and non-intermittent exposure like in the home, workplace and school. It should
be taken into account that some of the signs and symptoms presented in the text may
occur only in the case of significant exposures. However, lower or shorter exposures
with milder or indeterminate symptoms, or atypical presentation (noted in the text)
in younger aged children render the diagnosis more difficult. The cooperation of the
Pollutant Impact on health
Carbon monoxide (CO) Carbon monoxide can cause headaches, dizziness, nausea and at very high
levels, death. Elderly people, pregnant women, young children and people with
heart disease and lung disease are more sensitive to the adverse effects of carbon
monoxide.
Formaldehyde Formaldehyde can cause eye, nose and throat irritation and is considered a
potential human carcinogen.
Nitrogen dioxide (NO)Exposure to nitrogen dioxide can cause inflammation of the airways, respiratory
illnesses and possibly increases the risk of lung infections. Young children and
people with asthma are the most sensitive to NO. It plays a major role in the
development of chronic obstructive pulmonary disease in adults which will affect
more people than heart disease by  (Environmentalist ). Long-term
exposure may also affect lung function and can enhance responses to allergens in
sensitized individuals.
Odor Odorous discharges are subjective and cause nausea and irritation for some
people.
Ozone (O)Ozone exposure can cause asthma, irritation and damage to the eyes, nose and
airways. Prolonged exposure to high levels may result in damage to the lungs and
airway linings.
Particulate matter Inhalable particles have been linked with a number of respiratory illnesses,
including asthma and chronic bronchitis. Long-term exposure to fine particles
can cause premature death from heart disease and lung disease including cancer.
Short-term exposure to higher levels of fine particle concentrations have also been
linked with cardio-vascular problems and increased death rates. Exposure to fine
particles has also been linked to prevalent anxiety and hypertensive disorders.
Volatile organic
Compounds (VOCs)
Key symptoms associated with exposure to VOCs include eye irritation, nose and
throat discomfort, headache and allergic skin reaction.
Table 1.
Typical health impacts of some common pollutants found indoors.

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individual and the health care professional is essential for the correct diagnosis noting
clues suggestive of indoor air pollution, like time patterns or location of occurrence by
the help of a log or diary of symptoms. In the absence of this cooperation, the following
questions in addition to the medical history may be useful.
• Start, duration and periodicity (diurnal, daily, weekly, seasonally) of symptom
or complaints.
• Their relation with location under consideration (cessation when away or reoc-
currence when returning)
• The work type, work place, any change including moving or decoration.
• Exposure to environmental tobacco smoke at work, school, home, etc.
• Place of residence including internal change or moving
• Exposure to a new hobby etc., a new pet.
• Similar problem in anybody in close contact at home or work (Table ).
. Health problems related to environmental tobacco smoke (ETS)
It is the most observed indoor air contaminants. It easily disperses and it is hard
not be inhaled by workers in the workplace.
Key Signs/Symptoms in Adults; conjunctival irritation, headache, persistent
cough, wheezing, rhinitis/pharyngitis, nasal congestion, exacerbation of chronic
respiratory conditions.
Key Signs/Symptoms in Infants and Children; asthma onset, snoring, bronchi-
tis, repeated pneumonia, persistent middle-ear effusion, frequent upper respiratory
infections and/or episodes of otitis media, increased severity of, or difficulty in
controlling, asthma.
ETS is also defined as Group A human carcinogen by the U.S. Environmental
Protection Agency (EPA) and related to three thousand pulmonary cancers per year
among people who do not smoke in the U.S [–]. Among very young children, the inci-
dence of pneumonia, bronchitis, and bronchiolitis is reported to increase two-fold and the
effects to be proportional with the frequency of smoking and smokers at the home [].
The odor of ETS can be eliminated by ventilation, but not meaning that health
risks are also removed as it is not possible to totally remove tobacco smoke []. The
most effective remedy is strict smoking prohibition in the work-place or adapting
special smoking rooms with separate ventilation to the outside [].
. Other combustible products causing health problems
Carbon monoxide is an odorless and colorless asphyxiant due to carboxyhemo-
globin (COHb) resulting from CO binding to Hb, impeding oxygen transport.
Nitrogen dioxide (NO) and sulfur dioxide (SO) particularly irritate ocular, nasal,
pharyngeal and respiratory tract mucosa. Acute bronchoconstriction by sulfur dioxide
can be observed in asthma cases or as a hypersensitivity reaction. Continued exposure
to elevated levels of nitrogen dioxide may result in acute or chronic bronchitis [].

Air Quality and Health

Key Signs/Symptoms; nausea/emesis, dizziness, headache, fatigue, ocular and upper
respiratory tract irritation, tachycardia, chronic cough, confusion wheezing, hypercar-
boxyhemoglobinemia, increased frequency of angina in cardiovascular patients.
Diagnostic Leads
• Types of heating, cooking or similar equipment and used combustion material
(especially charcoal).
• Similar findings/symptoms among households in heating season.
Signs and
symptoms
Environmental
tobacco smoke
Other
combustion
products
Biological
pollutants
Vo la ti l e
organics
Heav y
metals
Sick
building
syndrome
Respiratory
Rhinitis, nasal
congestion
Yes Yes Yes Yes No Ye s
Epistaxis No No No YesNo No
Pharyngitis, cough Yes Yes Yes Yes No Ye s
Wheezing,
worsening asthma
Yes Yes No Ye s No Ye s
Dyspnea YesNo Yes No No Yes
Severe lung disease No No No No No Yes
Other
Conjunctival
irritation
Yes Yes Yes Yes No Ye s
Headache or
dizziness
Yes Yes Yes Yes Yes Yes
Lethargy, fatigue,
malaise
No YesYe s Ye s Yes Ye s
Nausea, vomiting,
anorexia
No YesYe s Ye s Yes No
Cognitive
impairment,
personality change
No YesNo Ye s Yes Ye s
Rashes No No Ye s Ye s Ye s No
Fever, chills No No Yes No Ye s No
Tachycardia No Ye s No No Ye s No
Retinal hemorrhage No YesNo No No No
Myalgia No No No YesNo Yes
Hearing loss No No No Yes No No
1Associated especially with formaldehyde.
2In asthma.
3Hypersensitivity pneumonitis, Legionnaires’ Disease.
4Particularly associated with high CO levels.
5Hypersensitivity pneumonitis, humidifier fever.
6With marked hypersensitivity reactions and Legionnaires’ Disease.
Table 2.
Diagnostic quick reference.

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• Odor felt during heating or any damage in the equipment, if they undergo
periodic professional inspection.
Remedial Action.
All equipment should be periodically checked by specialized services, especially
before each cold season. The ventilation of equipment (including kitchens) is
required to be connected to the outdoor environment.
Health Problems Caused By Volatile Organic Compounds (VOCs).
Even at room temperature certain solids or liquids may emit VOCs like formal-
dehyde, benzene, perchloroethylene for different length of time. They have been
observed indoors than outdoors up to  times in six locations of the United States as
reported by the EPA, even where there were petrochemical plants in use [].
Key Signs/Symptoms; conjunctival irritation, headache, dyspnea, allergic skin
reaction, nausea, emesis, fatigue, epistaxis (formaldehyde), nose, throat discomfort,
dizziness, declines in serum cholinesterase levels.
Diagnostic Leads
• Presence and quantity of pressed wood products at the resident.
• Exposure to VOCs at work, home, school.
• Exposure to pesticides, paints, or solvents.
Formaldehyde.
Formaldehyde is a possible human carcinogen (EPA). It may irritate ocular (burning
or tingling sensations) or respiratory mucosa (dyspnea or wheezing). Formaldehyde
vapor may result in hypersensitivity reactions including asthmatics [].
Pesticides.
They are used in daily life as pesticides and harmful when inhaled or exposed to
their vapors or contaminated dusts. Cephalgia, dizziness, muscular weakness, and
nausea are the main symptoms. Some of them are considered possible human car-
cinogens [].
Remedial Action.
A forced ventilation is required when such products are used. Avoid storage of
opened containers of unused paints etc. at home or workplace and similar materials
within home or office.
Health Problems Caused By Heavy Metals: Airborne Lead And Mercury Vapor.
Key Signs/Symptoms.
Lead Poisoning.
In Adults; headache, hearing loss, fatigue, weakness, personality changes, gastro-
intestinal discomfort/constipation/anorexia/nausea, tremor, coordination loss.
In Young Children; abdominal pain, irritability, seizures/loss of consciousness,
ataxia, hyperactivity, reduced attention span, (chronic) learning deficits.
Key Signs/Symptoms of Mercury Poisoning; headache, tachycardia, muscle
cramps or tremors, acrodynia, intermittent fever, neurological dysfunction, personal-
ity change.
Diagnostic Leads
• Housing or working in old or restored buildings or nearby busy highway or
industrial area.

Air Quality and Health

• Working with lead material (automobile radiators, solder etc.)
• Lead poisoning among people in close contact.
• Exposure to mercury in latex paints or in religious or cultural activities
Remedial Action.
The possible lead dust should be cleaned by wet-mopping. Professional interven-
tion should be sought when handling paints containing lead and adequate protective
gear and good-ventilation provided in work areas.
Health Problems Caused By SICK BUILDING SYNDROME.
Key Signs/Symptoms; headache, dizziness, nausea, sensitivity to odors, lethargy
or fatigue, mucosal irritation.
Diagnostic Leads
• Temporal ceasing or aggravation of problems in relation to exposure frequency
to suspected building, or seasonality
• Similar complaints in co-workers or peers.
Remedial Action.
The building, HVAC systems or possible conditions should be investigated and
examined appropriately.
. Health problems caused by two long-term risks: asbestos and radon
Asbestos and radon are among the most publicized indoor air pollutants. Both are
known as carcinogens. Their carcinogenic effects are not immediate after prolonged
exposure.
Asbestos.
Materials containing asbestos can lose its integrity with time releasing microscopic
fibers into the environment. If they remain present in the lungs for many decades as in
the case of heavy occupational exposure, they may lead to asbestos-caused pulmonary
fibrosis, pulmonary, pleural or peritoneal (including gastrointestinal) carcinoma, or
mesothelioma [].
Radon.
• Radon is a naturally occurring radioactive gas resulting from the decay of
radium, itself a decay product of uranium, follows smoking for causing pulmo-
nary malignancies due to the emitted alpha-particles during the decay. It has no
odor, color, and taste. Tobacco smoke has a synergistic effect to radon exposure
putting smokers and ex-smokers in increased risk.
. Health problems caused by animal dander, molds, dust mites, other
biologicals
Every home, school, and workplace are subject to biological air pollutants. Some
reside outdoor or in human (viruses and bacteria), some in animals or insects (aller-
gens), and some indoor and in water reservoirs (fungi and bacteria), such as humidifi-
ers. High relative humidity is the most important factor contributing to the growth and

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dissemination of biological agents like house-dust mite populations or fungal growth
on damp surfaces. They may cause infections by invading human tissues; hypersensi-
tivity by activating the immune system; and toxicosis by direct effects of toxins [].
Key Signs/Symptoms; rhinitis, dyspnea, cough, chest tightness, recurrent fever,
recognized infectious disease, malaise, conjunctival inflammation, exacerbation of
asthma.
Diagnostic Leads.
Infectious disease:
• Mounting evidence regarding the workplace, home, etc. as a source place (although
very difficult) like presence of a reservoir or disseminator of biologicals
• Evidence of mold growth (visible growth or odors)?
Hypersensitivity disease:
• Relative humidity consistently above .
• Presence of humidifiers or other water-spray systems, proper maintenance.
• History of flooding or leaks or other sources of surface wetting.
• Pets, cockroaches or rodents in the place.
Toxicosis and/or irritation:
• Appropriate ventilation with fresh air.
• Relative humidity consistently above  or below .
• Presence of humidifiers or other water-spray systems.
• Evidence of mold growth (visible growth or odors)?
• Presence of bacterial odors (fishy or locker-room smells)?
Remedial Action
• Adequate outdoor air ventilation.
• Cleaning of water reservoirs and chlorination of potable water systems
• Repairing of leaks and seepage.
• Keeping relative humidity below 
• Controlling exposure to pets.
• Regular vacuuming of carpets and furniture.

Air Quality and Health

• Covering of mattresses. Washing in hot water (>.°C to kill dust mites in soft
materials)
Distinguishing whether indoor air pollution originates from the home or workplace.
Some information may help to determine the presence of an indoor air quality
problem at workplace:
• Symptoms observed to occur at workplace and to disappear when leaving the
workplace, their temporal or locality pattern (day, season or location at work)
• Similar complaint in co-workers.
• Any diagnosis related to IAQ by a physician [].
. Criteria for workplace indoor air quality
There are some international guiding principles set for indoor air quality. The
recommended guidelines define indoor air quality issues with legal standards. These
guidelines are prepared and updated by professionals. There is limited information
in the World, particularly on concentration guidelines and standards proposed for
indoor air pollutants. Only in the United Kingdom and USA, there are concentration
guidelines and standards proposed for indoor air pollutants.
• World Health Organization: WHO issued various guidelines aiming at protecting
the public health from risks arising from some indoor pollutants such as benzene,
carbon monoxide, formaldehyde, nitrogen dioxide, polycyclic aromatic hydro-
carbon (PAH), benzo [α] pyrene, radon, trichloroethylene, tetrachloroethylene.
Reference values offer basic information allowing assessor to decide whether
lifelong exposure to these pollutants or exposure to them for a certain approximate
period of time impose a significant risk for the health and wellbeing of people [].
• Committee on the Medical Effects of Air Pollutants (COMEAP) issued “Report on
the Impact of Air Pollution on Health for public institutions and agencies. It deter-
mined allowed amounts of indoor air pollutants (COMEAP-); formaldehyde,
benzene, PAHs (as the equivalent of benzo[α]piren), NO ve CO for indoors. Air
Quality Strategy for England, Wales and Northern Ireland (DETR, ; Defra,
) sets out policies for the management of indoor air quality. These include air
quality targets for ten basic air pollutants for protecting the health of people and the
environment, without bearing unacceptable “economic and social costs. These are
Particles (PM and PM.), NO, O, Sulfur dioxide (SO), PAHs, benzene, , buta-
diene, carbon monoxide (CO) and lead. Health and Safety Executive (HSE) supports
the regulatory framework for the workplace health and safety in England, Wales and
Scotland, in line with the Occupational Health and Safety Law (HSE, ).
• Regulation on Control of Substances Hazardous on Health  (HSE, ) set
out Official Workplace Exposure Limits (WELs) for  substances which are
listed in the EH document (HSE,  and the following revisions), as an action
against specific pollutants. These limits include maximum concentrations for short
term (minutes) and long term (hours) exposure in any period of hours.

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Although it is mostly related about indoor emissions, exposure limits determine
the indoor values which should not be exceeded, no matter what the source is. HSE
does not set limits for continuous (hours) exposure. For this reason, WELs are
not considered as safe concentrations for periods longer than those specified [].
• A research conducted in Europe in  collected formaldehyde, CO, NO,
benzene and naphthalene under “Group : High Risk Chemicals”, as they can form
in high concentration and impose a significant risk for the health of residents of
the building (INDEKS, ). “Group ” included acetaldehyde, toluene, xylene,
styrene as the chemicals of second highest risk. These compounds may occur in
high concentrations in indoors, but they require less urgent action under risk man-
agement practice []. Leading institutions regulating the national official rules
are American Conference of Governmental Industrial Hygienists (ACGIH) and
American Society of Heating and Air-Conditioning Engineers (ASHRAE) [–].
The focus point of EPA air quality is to protect the human health against outdoor
air. The objective of this Standard is to control emissions of six pollutants during the
release of large amounts of vehicle exhaust gas and industrial waste. These standards
can be used for the indoor air quality researches as outdoor air quality offer potential
contribution to the indoor exposure (Table ) [–].
OSHA claims that it has jurisdiction in all workplace environments. These
standards are concerned about indoor air quality at office buildings, industrial
and construction workplaces. However, OSHA standards have limitations in terms
of knowledge of pollutants and limited exposure limits, as OSHA’s standards are
based on old limits issued by ACGIH in . Original OSA exposure limits were
developed out of ACGIH recommendations dated . Up to now, only limits
for some chemical pollutants (for example, asbestos and benzene) have been
updated. For this reason, general tendency of industrial hygienists to prefer ACGIH
Instructions to OSHA limits. Although backed up by federal laws, OSHA limits are
rarely exceeded in office environments where one or more pollutant substances are
correctly defined. The complicated nature of the indoor air quality is not supported
by the OSHA limits [–].
Indoor air pollutants Permissible concentrations
Carbon monoxide (CO) < ppm
Carbon dioxide (CO)< ppm
Mold Indoor and outdoor values should be the same
Formaldehyde (CHO) < μg/m*
Total volatile organic compounds (VOC) < μg/m*
-Phenyl Cyclohexane (-PC) < μg/m
Total particles (PM) < μg/m
Regular pollutants < National indoor standard
Other pollutants <  of the limit value
*Above outdoor air concentrations.
Table 3.
EPA maximum indoor air standards.

Air Quality and Health

ACGIH is a professional institution which revises and recommends user manuals
used for evaluation of Professional workplace exposure by industrial hygienists every
year. There are approximately  chemicals that are listed with exposure limits of
minutes and hours. These directives were prepared to treat the workplace expo-
sure. Professional exposure is generally limited with a period of hour exposure for
healthy individuals aged between  and . For this reason, ACGIH exposure rules
do not apply for house exposure for which exposure parameters are different [–].
ASHRAE issued a revised mechanical ventilation standard namely “Ventilation
for Acceptable Indoor Air Quality Standard” in . ASHRAE developed consensus
principles for the indoor air quality in public buildings. The Standard aims at “stat-
ing minimum ventilation rates and indoor air quality”. Health effects and acceptable
exposure limits are based on specific authorized people and their recommendations.
For this reason, ASRAE Standard “Ventilation for Acceptable Indoor Air Quality” has
become the guideline which is most widely used for the evaluation of indoor air qual-
ity in commercial facilities and enterprises. ASHRAE previously issued Standard 
which is a ventilation standard. This Standard was revised a few times in the following
years. The amount of fresh air was specified for smokers and non-smokers separately
in . This value was ,L/s foreseen for non-smokers and L/s for smokers,
which is four times higher than the one for nonsmokers. Cigarette monopolies
prevented the recognition of this Standard by American National Standards Institute
(ANSI) and its integration to the building regulations, by conducting intensive propa-
gandas. Application of this Standard will increase the ventilation cost by four times in
the buildings where smokers work. In , the acceptable fresh air was accepted to be
the amount for which  of the people did not express dissatisfaction. The dissatis-
faction rate was increased to  of the people in the place.
ASHRAE’s Standard numbered – introduced the limit of ppm
carbon dioxide for office workers. OHSA in USA defined a limit of ppm, on the
condition that it does not exceed hours a week. ASHRAE’s Standard  recognized
that carbon dioxide is not a pollutant by itself, but it is one of the indicators of air pol-
luted by people. This CO amount was ppm before the industrial revolution and
it has been continuously increasing due to the combustion of fossil fuel. As a result,
global warming caused by greenhouse effect has become a very important public
problem. The rate of carbon dioxide in today’s air is around ppm and it increases
by ppm every year [–]. Workplace Exposure Limits (WELs) apply to healthy
people who are at working age and directly exposed to pollutants at their workplaces.
Generally lower exposure limits are imposed for people who are not healthy or of
working age or those who are older than the working age. These lower limits apply
even if a person is exposed to a pollutant for a period which is significantly longer
than hours or even if the work activities do not directly include pollutant [–].
Attention should be paid to the selection of air quality standards applicable to a
particular workplace during the selection of the most appropriate air quality standard
and guideline. In schools and hospitals which are open to public Access, imposition of
the targets set by the World Health Organization’s guidelines and the targets intro-
duced by the United Kingdom Air Quality Strategy are more appropriate. As for the
industrial environments, Health and Safety Executive (HSE) and Workplace Exposure
Limits (WELs) are most appropriate (HSE, ) [, ]. HSE WELS defines official
exposure limits for physically healthy people who are exposed for a nominal period of
eight hours a day, five day a week in industrial workplaces. For this reason, the elderly,
the young and the disabled who are sensitive to some pollutants should be excluded,


Impacts of the Indoor Air Quality on the Health of the Employee and Protection against These…
DOI: http://dx.doi.org/10.5772/intechopen.102708
when the limits are determined. The people who work in the office environment
including the ones who are physically less in form and talented, represent a wider
proportion of society, when compared to the workers in the industrial environments.
Furthermore, workers may not be aware of the fact that they are exposed to a pollut-
ant, if they are not in contact with it as a direct part of the work they perform, and
thus they may not take any measure to protect themselves. Her Majesty’s Inspectorate
of Pollution (MHIP) recommended that a part of the guidelines given in HSE WELs
for the exposure of the general society (). In the light of this, it is more appropri-
ate to apply lower outdoor air quality guidelines set by the World Health Organization
and United Kingdom Air Quality Strategy (Defra ) for exposure of the general
population also for the indoor environments. The limits determined by HMIP ()
may be used for the pollutants which do not fall under this scope [–, ].
. Protection from indoor air pollution at workplaces
An employer should use a systematic approach is needed when treating the air
quality at the workplace. The systematic approach to indoor air quality (IAQ) com-
prise commitment of the management, training, participation of employees, hazard
definition, control and program inspection. A management coordinator needs to be
assigned for IAQ and a management plan needs to be developed.
. IAQ control methods
There are three main control methods used to decrease the concentration of the
indoor air pollutants:
. Source Management
It includes eliminating the pollutant or replacement of pollutant with a less hazard-
ous one. It is the most effective control method in practice. For example, an employ-
er may install temporary barriers in order to prevent pollutants during construction
activity or impose negative pressure on the field in Ref. to the adjacent fields.
. Engineering Controls
A. Local exhaust: Use of local exhaust, such as shading and fume hood are effec-
tive in eliminating pollutants which are very concentrated.
B. General ventilation: When designed, operated, maintained properly, general
ventilation is a measure which control air pollutants of normal amount. A well
designed and operating HVAC system ensures comfort, by controlling tem-
perature and relative humidity levels, distributes the amount of air sufficient
to meet the needs of ventilation for the building habitants and alleviate and
eliminates odors and other pollutants.
C. Air cleaning: Firstly, it requires elimination of particles in the air when they
pass through HVAC equipment. Generally, HVAC system filtering is used to

Air Quality and Health

keep the dirt away from adjustable surfaces during the process of ensuring
heat transfer effectiveness.
. Management Controls
A. Working Chart: Managers may significantly decrease the amount of exposure
to pollutants in their respective buildings, by using charts. For example, they
can take the following actions:
. Eliminate or decrease the duration in which one worker is exposed to a
pollutant (in other words, programming the maintenance or cleaning
work in the absence of inhabitants)
. Decrease the amount of chemical substances used by workers or used
near to workers (limit the amount of chemicals used by workers for
maintenance or cleaning activities during the activity).
. Control the place where the chemicals are used (conduct maintenance
on moving equipment in a maintenance workshop or place equipment-
printers, copy machines to a separate room).
B. Training: It is important to give IAQ training to workers. Workers need to
informed about the sources and effects of pollutants under their control and
smooth operation of ventilation system. Employers can make warnings and/or
take measures to decrease personal exposure.
Cleaning: Cleaning practices should contain preventing entry of dirt to the
environment (using walking doormats), cleaning it when it enters the workplace,
discharging the litter, storing the food properly and using minimum amount of
cleaning products [–, ].
. Indoor air and coronavirus (COVID-)
COVID- spreads through particles and droplets in the air. Individuals infected
by COVID may release particles and droplets of inspiration liquids containing SARS
CoV- virus to the air (by breathing, talking, singing, exercising, coughing and
sneezing). Droplets- particles may continue to disseminate and accumulate indoors of
workplaces. Infection may happen in case of inhaling the COVID- virus from air in
a distance shorter than six feet. The particles from an infected person may move along
all room or closed area. The particles may hang in the air for hours even after the
person leaves the room. A worker may be exposed to it, if respiration liquids directly
jump to the mucosa membrane and if it is sprayed on him or her. The following cases
may increase the infection risk:
a. Spending time indoors where the amount of outdoor air and ventilation is poor
b. Performing activities which increases emission of respiration liquids, such as
talking loudly, singing, exercising
c. Long term exposure (longer than a few minutes)


Impacts of the Indoor Air Quality on the Health of the Employee and Protection against These…
DOI: http://dx.doi.org/10.5772/intechopen.102708
d. Spending time in crowded areas (especially without proper mask
protection).
Measures to decrease the infection potential of COVID-:
. Layout, design of a building, occupancy state, heating, ventilation and acclima-
tization (HVAC) system may affect the spread potential of virus through air.
Although improvements made on ventilation and air cleaning do not alone elimi-
nate of risk of spread for the SARS-CoV- virus, EPA recommends that physical
distance should be maintained and ventilation should be improved by using
outdoor air and air filtering, as the important components of a strategy which
includes hygiene and clothing.
. Cloth masks, face guards or masks should be used. Attention should be paid to sur-
face cleaning, hand washing, disinfection, personal and environment hygiene [, ].
. Conclusion
• WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury
(–: Global Monitoring Report) revealed that approximately .
workers’ deaths were associated with air pollution (particle substances, gas,
smoke, etc.). This association was reported to be the second most important
factor which comes after the factor of working for long hours among the risk fac-
tors causing death of workers. Workplace indoor air pollution can significantly
increase the health risks of workers, including asthma, allergenic reactions, lung
cancer and death as a result of occupational accident [, ].
•  EPA Report showed that improved indoor air quality may result in higher
productivity and less working day loss. EPA stated that the poor indoor air qual-
ity may bring a cost of tens of million dollars to the respective country, employer
and the enterprise every year, due to the loss of productivity and medical care
cost [].
• Further research is needed to detect new indoor pollutants which are increas-
ing in number and control their effects. Lifelong awareness, elimination of
potential indoor hazards, increased awareness of health service providers and
professionals are reported to be important to encourage long term lung health
and wellbeing [].
• Indoor air quality can be defined as an optimal indoor requirement specifying
the possible minimum amount of air pollutants to ensure the health, comfort and
wellbeing of majority of the workers in any closed workplace, at any given time.
Temperature at the workplace depends on relative humidity and flow of air in
industry. In addition, indoor air at industrial facilities is associated with the tech-
nological processes conducted and contents of the chemicals used. Workplace
risk assessment is a means which helps creation of a safer environment and it
is a process allowing determination of potential adverse effects imposed on the
health of workers. The obligation to determine risk assessments which are both
correct and simple led to the development of approaches to asses and control

Air Quality and Health

Author details
FerdiTanir* and BurakMete
Department of Public Health, Çukurova University, Adana, Turkey
*Address all correspondence to: ftanir@gmail.com
risks, including COSHH (Control of Substances Hazardous to Health) and
“Chemical Control Kit” designed to assess chemical risks. Enterprises developed
Process Route Healthiness Index (PRHI) to analyze new processes which are not
yet in implementation [].
• It was seen that some people had health symptoms although concentrations of
indoor air pollutants are below the indoor air quality guidelines. For this reason,
further research is needed to better understand and explain the complicated
relationships between IAQ and health symptoms [].
• A multidisciplinary team comprising experts of occupational medicine, IAQ,
building physics and toxicology is recommended for evaluation and management
of IAQ problems [].
©  The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of
the Creative Commons Attribution License (http://creativecommons.org/licenses/by/.),
which permits unrestricted use, distribution, and reproduction in any medium, provided
the original work is properly cited.

Impacts of the Indoor Air Quality on the Health of the Employee and Protection against These…
DOI: http://dx.doi.org/10.5772/intechopen.102708

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