Screening questionnaire for selection of sampling sites for assessment of risks from combined exposure to multiple chemicals in indoor air

Supplementary publication to the screening tool for assessment of health risks from combined exposure to multiple chemicals in indoor air in public settings for children

Abstract

This screening questionnaire was developed to facilitate the selection of sampling sites for assessment of risks from combined exposure to multiple chemicals in indoor air in public settings for children. It addresses indoor and outdoor factors relevant to indoor air pollution, and uses a simplified approach to answering questions (yes/no). Public-health workers can use the questionnaire to select sampling sites in schools, kindergartens and day-care centres where indoor air pollution is a concern.

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Screening questionnaire for selection of sampling sites for assessment of risks from combined exposure to multiple chemicals in indoor air Supplementary publication to the screening tool for assessment of health risks from combined exposure to multiple chemicals in indoor air in public settings for children

SCREENING QUESTIONNAIRE FOR SELECTION OF SAMPLING SITES FOR ASSESSMENT OF RISKS FROM COMBINED EXPOSURE TO MULTIPLE CHEMICALS IN INDOOR AIR

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ACKNOWLEDGEMENT ......................................................................................................................v

BACKGROUND ...................................................................................................................................1

SCOPE ................................................................................................................................................2

HOW TO USE THE SCREENING QUESTIONNAIRE ........................................................................3

SCREENING QUESTIONNAIRE ........................................................................................................4

REFERENCES ....................................................................................................................................8

CONTENTS

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ACKNOWLEDGEMENT

The WHO Regional Office for Europe gratefully acknowledges the principal author Alexander Gankin, Scientific Practical Centre of Hygiene, Belarus for preparing this publication.

The Regional Office also highly appreciates the assistance provided by the following national experts in the discussion and development of the questionnaire:

♦ Kristina Aidla, Estonian Health Board, Estonia

♦ Eva Csobod, Regional Environmental Centre for Central and Eastern Europe, Hungary

♦ Sani Dimitroulopoulou, Public Health England, United Kingdom

♦ Marta Sofia Da Fonseca Gabriel, Institute of Science and Innovation in Mechanical and Industrial Engineering, Portugal

♦ Corinne Mandin, Scientific and Technical Centre for Building, France.

The Regional Office gratefully acknowledges the financial support of the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety.

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BACKGROUND

Assessment of exposure to chemicals in indoor air is needed to assess risks from individual chemicals as well as combined exposure to multiple chemicals (1,2). Information about the concentrations of specific chemicals can be obtained from indoor air quality monitoring programmes at national, regional or local levels, as well as from dedicated projects. Since it is unfeasible to sample and analyse chemicals in indoor air in all buildings and rooms, sampling sites need be selected and prioritized. Several examples of approaches to selecting sampling sites are available from scientific studies and projects at both European and national levels (3,4).

Different types of questionnaires have been used in international projects, such as the Schools Indoor Pollution and Health Observatory Network in Europe (SINPHONIE) project (3), and in national projects. For example, starting from 1990, Finland developed a range of indoor air quality assessment questionnaires, including for occupants of workplaces and schools (the MM-40 questionnaire), pupils in secondary schools (MM-60), and parents of primary-school children (MM-80) (4). These questionnaires were used in the framework of the ARIA project conducted in Porto, Portugal, which aimed at characterizing indoor environments and studying links between sources of exposure, chemical concentrations and health effects (5).

In general, locations where higher concentrations of hazardous chemicals in indoor air are anticipated due to different conditions are of particular interest. These concentrations depend upon many factors, including levels of outdoor air pollutants that penetrate indoor spaces, releases from indoor sources and human activities, and the rate of exchange between indoor and outdoor air (6–8).

Outdoor air pollutants penetrate buildings through windows, doors, ventilation systems or gaps in building structures. The higher the concentration of outdoor air pollution from, for example, high-traffic roads, industrial enterprises, small workshops or pesticide application, the higher the expected concentration of chemicals in indoor air. The penetration of outdoor air pollutants into indoor spaces also depends on other factors, including the presence of green spaces, artificial barriers such as other buildings and prevailing wind directions (6–8).

Many indoor sources of chemicals can also affect air quality. These include building materials, furniture, electronic equipment, cleaning products, and human activities that use chemicals and chemical products (9–11). Depending on the combination of these factors and conditions, levels of indoor air pollution can differ significantly.

SCREENING QUESTIONNAIRE FOR SELECTION OF SAMPLING SITES FOR ASSESSMENT OF RISKS FROM COMBINED EXPOSURE TO MULTIPLE CHEMICALS IN INDOOR AIR

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SCOPE

This document includes a screening questionnaire developed to facilitate the selection of sampling sites for conducting risk assessments of indoor air pollution. Public-health workers can use the questionnaire to select sampling sites in schools, kindergartens and day-care centres where indoor air pollution is a concern.

Scientific information on sources of chemicals in indoor air and factors influencing levels of pollution were considered throughout the questionnaire’s development. A draft version was discussed during two expert consultations held in Bonn, Germany, in December 2018 (12) and September 2019 (13). The draft questionnaire was piloted during trainings in Budapest, Hungary, in May 2019 and Tallinn, Estonia, in October 2019, and was finalized at a fourth expert consultation held virtually in November 2020 (14).

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HOW TO USE THE SCREENING QUESTIONNAIRE

The questionnaire can be filled in onsite based on visual inspection. Additional information on location, building materials, furniture and other potential sources of chemicals, collected through consultation with the facility’s administration, can complement visual assessments.

The questionnaire is divided into three sections:

♦ Section 1: Selection of buildings: outdoor factors of relevance to the pollution of indoor air by chemicals;

♦ Section 2: Selection of room(s): indoor sources of chemicals; and

♦ Section 3: Other factors.

Questions are compiled with the assumption that users will first select buildings of potential concern for indoor air pollution, and then select specific rooms/places in those buildings. When answering the questions, please insert your answer in the free space on the right side, as demonstrated in Fig. 1.

Fig. 1. Example answer in the screening questionnaire

Are there any industrial facilities, high-traffic roads or agricultural lands treated with pesticides or other pollution sources near the facility?

Yes – 1 No – 0

Once you have answered all the questions, calculate the total score. The higher the score, the higher the likelihood of indoor air pollution by chemicals. If the score in different places is the same and you must select a single site among them, consider your answers to questions on the following factors:

♦ proximity to industrial facilities, high-traffic roads or agricultural lands treated with pesticides (Section 1, questions 4, 5 and 6);

♦ time since renovations/repairs and the installation of new furniture (Section 2, questions 1 and 2); and

♦ complaints made by teachers, pupils or parents about the indoor environment (smell, irritation symptoms, etc.) within the past year (Section 3, Question 9).

Instructions in the questionnaire will also guide you.

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SCREENING QUESTIONNAIRE FOR SELECTION OF SAMPLING SITES FOR ASSESSMENT OF RISKS FROM COMBINED EXPOSURE TO MULTIPLE CHEMICALS IN INDOOR AIR

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SCREENING QUESTIONNAIRE

SECTION 1. Selection of buildings: outdoor factors of relevance to the pollution of indoor air by chemicals1. Please provide general information about the facility for children.

♦ Address, including city and country: ♦ Type of facility (school, kindergarten, day-care centre, other): ♦ Working hours (from xx to xx): ♦ Year of the building’s construction/major renovation:

2. What kind of area is the facility located in? Please circle the most appropriate answer. ♦ Rural ♦ Urban, within built environment ♦ Urban, surrounded by green spaces1

3. Was the building constructed/renovated within the past 3 months?

Yes – 1 No – 0

4. Are there any industrial facilities, high-traffic roads or agricultural lands treated with pesticides (or other pollution sources) near the facility?If the answer is “No”, please move to Question 6.If the answer is “Yes”, please specify below and respond to Question 5 as well.

Yes – 1 No – 0

High-traffic road (less than 100 m) Yes – 1 No – 0

Parking place (including idling) (less than 100 m) Yes – 1 No – 0

Gasoline station (less than 50 m) Yes – 1 No – 0

Power plant (less than 500 m) Yes – 1 No – 0

Waste management plant (less than 500 m) Yes – 1 No – 0

Chemical or metallurgic plant (less than 500 m) Yes – 1 No – 0

Agricultural activity using pesticides (less than 50 m) Yes – 1 No – 0

5. Is the facility located leeward (downwind) in relation to these sources of chemicals?

Yes – 1 No – 0

6. Is there a green zone around the facility or between the facility and possible sources of chemicals?

Yes – 0 No – 1

7. Is the facility’s heating system centralized? Yes – 0 No – 1

8. Does the heating system use clean fuel (natural gas, electricity)?

Yes – 0 No – 1

Total score for Section 1

1 For the purpose of this questionnaire, “green zone” refers to trees, shrubs and vegetation that form a buffer or barrier to airborne pollutants.

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SECTION 2. Selection of room(s): indoor sources of chemicals1. Has the room been renovated2 within the past

2 months? Yes – 1 No – 0

2. Has new furniture been installed within the past 6 months?

Yes – 1 No – 0

3. Is the material used for the floor covering labelled “low-emission”3? Please do not answer if you are unsure or if this information is not available.If there is no answer or the answer is “No”, please specify the type of material below.

Yes – 0 No – 1

Ceramic, stone Yes – 0

Natural wood Yes – 0

Laminate Yes – 1

Rubber Yes – 1

Wall-to-wall carpet Yes – 1

Linoleum Yes – 1

Polyvinyl chloride (PVC) Yes – 1

4. Is the material used for the wall coating/covering labelled “low-emission”? Please do not answer if you are unsure or if this information is not available.If there is no answer or the answer is “No”, please specify the type of material below.

Yes – 0 No – 1

Water-based paint Yes – 0

Solvent-based paint Yes – 1

Oil-based paint Yes – 1

Paper-based wallpaper Yes – 0

Textile-based wallpaper Yes – 1

PVC-based wallpaper Yes – 1

Tiles Yes – 0

Natural wood Yes – 0

Wood veneer/plywood Yes – 1

2 For the purpose of this questionnaire, “renovated” means renewed by repairing or rebuilding.3 Several systems of labelling for low-emission products have been developed at the European level as well as the national

level (for example, in Germany, France).

SCREENING QUESTIONNAIRE FOR SELECTION OF SAMPLING SITES FOR ASSESSMENT OF RISKS FROM COMBINED EXPOSURE TO MULTIPLE CHEMICALS IN INDOOR AIR

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5. Is the material used for the ceiling coating/covering labelled “low-emission”? Please do not answer if you are unsure or if this information is not available.If there is no answer or the answer is “No”, please specify below what type of material is used.

Yes – 0 No – 1

Whitewash Yes – 0

Paint (acrylic) Yes – 1

Gypsum, plaster Yes – 1

Natural wood Yes – 0

Wood veneer/plywood Yes – 1

6. What materials are used for the furniture? Please specify below.

Metal Yes – 0

Natural wood Yes – 0

Wood veneer/plywood Yes – 1Plastic composite furniture Yes – 1

7. What materials are used for the window frames? Please specify below.

Aluminium Yes – 0

Natural wood Yes – 0

Plastic Yes – 1

8. What materials are used for the curtains/sun blinds? Please specify below.

Metal Yes – 0

Natural wood (if treated with flame retardants) Yes – 1

Treated fabric Yes – 1

Synthetic material Yes – 1

No curtains/sun blinds Yes – 0

Total score for Section 2

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SECTION 3. Other factors1. What type of ventilation system is used? Please specify below.

Manual window-opening only Yes – 1

A mechanical ventilation system only Yes – 1

A hybrid of manual and mechanical ventilation Yes – 0

2. Is there electronic equipment in the room (computers, tablets, virtual blackboards, etc.)?

Yes – 1 No – 0

3. Do you notice (or have you noticed in the past) an unusual/chemical odour in the room?

Yes – 1 No – 0

4. How often is the room cleaned without chemical products (wet mopping/wiping or vacuuming of flooring and furniture)? Please specify below.Once or twice a day Yes – 0

Less than once a day Yes – 1

5. When is cleaning without chemical products (wet mopping/wiping or vacuuming of flooring and furniture) commonly done? Please specify below.Before classes Yes – 0

During classes Yes – 0

After classes Yes – 1

6. When is cleaning using cleaning products commonly done? Please specify below.

Before classes Yes – 1

During classes Yes – 1

After classes Yes – 0

7. Are the cleaning products used for maintenance and cleaning in the classrooms labelled “free from toxic chemicals” or “eco-friendly”? Please do not answer if you are unsure or if this information is not available.

Yes – 0 No – 1

8. Is the room used for other activities after class hours (during evenings or weekends)?

Yes – 1 No – 0

9. Have teachers, pupils or parents made any complaints about the indoor environment (smell, irritation symptoms, etc.) within the last year?

Yes – 1 No – 0

10. Are there any signs of mould in the room(s)? Yes – 1 No – 0

11. Are there any signs of humidity in the room(s)? Yes – 1 No – 0

12. Are there any signs of pests in the room(s)? Yes – 1 No – 0

13. Are air fresheners used in the room(s)? Yes – 1 No – 0

Total score for Section 3

TOTAL SCORE FOR THE QUESTIONNAIRE

Combined scores of sections 1, 2 and 3

SCREENING QUESTIONNAIRE FOR SELECTION OF SAMPLING SITES FOR ASSESSMENT OF RISKS FROM COMBINED EXPOSURE TO MULTIPLE CHEMICALS IN INDOOR AIR

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REFERENCES

1. International Programme on Chemical Safety (IPCS). WHO human health risk

assessment toolkit: chemical hazards. Geneva: IPCS, WHO; 2010 (https://www.who.int/ipcs/methods/harmonization/areas/ra_toolkit/en/, accessed 6 February 2021).

2. Assessment of combined exposure to multiple chemicals [webpage]. Geneva: WHO; 2021 (https://www.who.int/ipcs/methods/harmonization/areas/aggregate/en/, accessed 6 February 2021).

3. Csobod E, Annesi-Maesano I, Carrer P, Kephalopoulos S, Madureira J, Rudnai P et al. SINPHONIE – Schools Indoor Pollution and Health Observatory Network in Europe. Final report. Luxembourg: Publications Office of the European Union; 2014 (https://ec.europa.eu/jrc/en/publication/eur-scientific-and-technical-research-reports/sinphonie-schools-indoor-pollution-and-health-observatory-network-europe-final-report, accessed 6 February 2021).

4. Kati Järvi, Vornanen-Winqvist C, Mikkola R, Kurnitski J, Salonen H. Online questionnaire as a tool to assess symptoms and perceived indoor air quality in a school environment. Atmosphere. 2018;9(7):270–90. doi:10.3390/atmos9070270.

5. ARIA – How indoor air quality can affect childhood allergies and asthma. Porto: Institute of Science and Innovation in Mechanical and Industrial Engineering; 2016 (http://www.scienceportugal.com/en/institutions/inegi-institute-of-science-and-innovation-in-mechanical-and-industrial-engineering/aria-how-indoor-air-quality-can-affect-children-allergies-and-asthma/, accessed 6 February 2021).

6. Leung DYC. Outdoor–indoor air pollution in urban environment: challenges and opportunity. Front Environ Sci. 2015;2. doi:10.3389/fenvs.2014.00069.

7. Zupancic T, Westmacott C, Bulthuis M. The impact of green space on heat and air pollution in urban communities: a meta-narrative systematic review. Vancouver: David Suzuki Foundation; 2015 (https://davidsuzuki.org/science-learning-centre-article/impact-green-space-heat-air-pollution-urban-communities/, accessed 6 February 2021).

8. Hitchins J, Morawska L, Gilbert D. Concentrations of submicrometre particles from vehicle emissions near a major road. Atmos Environ. 2000;34(1):51–9. doi:10.1016/S1352-2310(99)00304-0.

9. Yura A, Iki M, Shimizu T. Indoor air pollution in newly built or renovated elementary schools and its effects on health in children. Nihon Koshu Eisei Zasshi. 2005;52(8):715–26 [in Japanese].

10. Willem H, Singer B. Chemical emissions of residential materials and products: review of available information. Oak Ridge: United States Department of Energy – Office of Scientific and Technical Information; 2010 (https://www.osti.gov/biblio/988998-WBVO5T/, accessed 6 February 2021).

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11. Wilke O, Jann O, Brödner D. VOC- and SVOC-emissions from adhesives, floor coverings and complete floor structures. Berlin: Federal Institute for Materials Research and Testing; 2004 (https://www.isiaq.org/docs/papers/1D5o1.pdf, accessed 6 February 2021).

12. Towards a tool for assessment of cumulative risks from indoor air pollutants in public settings for children: the first expert consultation. Meeting report. Copenhagen: WHO Regional Office for Europe; 2019 (https://www.euro.who.int/__data/assets/pdf_file/0020/410780/Indoor-air-pollutants-public-children-first-consulation-report.pdf, accessed 6 February 2021).

13. Towards a tool for assessment of cumulative risks from indoor air pollutants in public settings for children: the second expert consultation. Meeting report. Copenhagen: WHO Regional Office for Europe; 2020 (https://www.euro.who.int/__data/assets/pdf_file/0009/459306/cumulative-risks-indoor-air-pollutants-children.pdf, accessed 6 February 2021).

14. Development of a screening tool for assessment of risks from combined exposure to multiple chemicals in indoor air: expert consultations and pilot testing. Copenhagen: WHO Regional Office for Europe; 2020 (https://apps.who.int/iris/handle/10665/337975, accessed 6 February 2021).

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