Seasonal Variation in Schools’ Indoor Air Environments and Health Symptoms among Students in an Eastern Mediterranean Climate

The indoor air quality (IAQ) in classrooms highly affects the health and productivity of students. This article aims to clarify seasonal variation in indoor environment and sick building syndromes (SBS) symptoms in an Eastern Mediterranean climate. A series of field measurements were conducted during the fall and winter seasons from October 2011 to March 2012 in 12 naturally ventilated schools located in the Gaza Strip. Data on environmental perception and health symptoms were obtained from 724 students by using a validated questionnaire. The results showed that indoor PM₁₀ and PM_2.5 concentrations were 426.3 ± 187.6 μg/m³ and 126.6 ± 94.8 μg/m³, respectively. The CO₂ concentrations and ventilation rate widely exceeded their reference values during the winter season. The prevalence rates of general symptoms were relatively high at baseline assessment in the fall season and increased significantly during follow-up in the winter season. Significant increases in disease symptoms such as mucosal irritation and pre-existing asthma symptoms among students could be related to poor indoor air quality. Five distinct groups of SBS symptoms from factor analysis of students’ related symptoms were significantly correlated with PM₁₀ and PM_2.5, CO₂, ventilation rate, and indoor temperature. As vulnerable children, this situation negatively affects their school performance and health.     

Characterization of Indoor Environmental Quality in Primary Schools in Maia: A Portuguese Case Study

Scientific evidence associates indoor environment pollutants with respiratory effects (asthma and allergies), and children constitute one of most sensitive groups. Indoor air quality (IAQ) in schools may indeed be a significant health factor for children, with effects on school attendance and performance. Our aim was to characterize IAQ of classrooms in Maia County (north of Portugal) for which there was no information available. The study was conducted in 21 of the 40 primary schools, selected by stratified random sampling. Depending on the dimension, one or two classrooms were tested at each school. Walkthrough surveys of school grounds, buildings, and individual classrooms were done. Continuous measurements were taken of temperature, relative humidity, airborne respirable particles, total volatile organic compounds, and carbon dioxide, whereas bioaerosols were counted on Plate Count Agar during regular school activities. The indoor arithmetic mean for PM₁₀, CO₂, TCOV, and bioaerosol concentrations were 0.14 mg/m³, 999 ppm, 0.41 mg/m³, and 4140 UCF/m³, respectively. The values of PM₁₀ and CO₂ were close to their acceptable maximum values, but bioaerosols were much higher. This study supports previous studies conducted in school environments and emphasizes the need for proactive indoor air quality audits in school buildings.     

A Longitudinal Study of Sick Building Syndrome (SBS) among Pupils in Relation to SO2, NO2, O3 and PM10 in Schools in China

There are fewer longitudinal studies from China on symptoms as described for the sick building syndrome (SBS). Here, we performed a two-year prospective study and investigated associations between environmental parameters such as room temperature, relative air humidity (RH), carbon dioxide (CO₂), nitrogen dioxide (NO₂), sulphur dioxide (SO₂), ozone (O₃), particulate matter (PM₁₀), and health outcomes including prevalence, incidence and remission of SBS symptoms in junior high schools in Taiyuan, China. Totally 2134 pupils participated at baseline, and 1325 stayed in the same classrooms during the study period (2010–2012). The prevalence of mucosal symptoms, general symptoms and symptoms improved when away from school (school-related symptoms) was 22.7%, 20.4% and 39.2%, respectively, at baseline, and the prevalence increased during follow-up (P<0.001). At baseline, both indoor and outdoor SO₂ were found positively associated with prevalence of school-related symptoms. Indoor O₃ was shown to be positively associated with prevalence of skin symptoms. At follow-up, indoor PM₁₀ was found to be positively associated with new onset of skin, mucosal and general symptoms. CO₂ and RH were positively associated with new onset of mucosal, general and school-related symptoms. Outdoor SO₂ was positively associated with new onset of skin symptoms, while outdoor NO₂ was positively associated with new onset of skin, general and mucosal symptoms. Outdoor PM₁₀ was found to be positively associated with new onset of skin, general and mucosal symptoms as well as school-related symptoms. In conclusion, symptoms as described for SBS were commonly found in school children in Taiyuan City, China, and increased during the two-year follow-up period. Environmental pollution, including PM₁₀, SO₂ and NO₂, could increase the prevalence and incidence of SBS and decrease the remission rate. Moreover, parental asthma and allergy (heredity) and pollen or pet allergy (atopy) can be risk factors for SBS.     

Shared Air: A Renewed Focus on Ventilation for the Prevention of Tuberculosis Transmission

Background

Despite an improvement in the overall TB cure rate from 40–74% between 1995 and 2011, TB incidence in South Africa continues to increase. The epidemic is notably disquieting in schools because the vulnerable population is compelled to be present. Older learners (age 15–19) are at particular risk given a smear-positive rate of 427 per 100,000 per year and the significant amount of time they spend indoors. High schools are therefore important locations for potential TB infection and thus prevention efforts.

Methods and Findings

Using portable carbon dioxide monitors, we measured CO₂ in classrooms under non-steady state conditions. The threshold for tuberculosis transmission was estimated using a carbon dioxide-based risk equation. We determined a critical rebreathed fraction of carbon dioxide () of 1·6%, which correlates with an indoor CO₂ concentration of 1000 ppm. These values correspond with a ventilation rate of 8·6 l/s per person or 12 air exchanges per hour (ACH) for standard classrooms of 180 m³.

Conclusions

Given the high smear positive rate of high-school adolescents in South Africa, the proposal to achieve CO₂ levels of 1000ppm through natural ventilation (in the amount 12 ACH) will not only help achieve WHO guidelines for providing children with healthy indoor environments, it will also provide a low-cost intervention for helping control the TB epidemic in areas of high prevalence.     

Rhinitis,Ocular, Throat and Dermal Symptoms,Headache and Tiredness among Students in Schools from Johor Bahru,Malaysia: Associations with Fungal DNA and Mycotoxins in Classroom Dust

There are few studies on rhinitis and sick building syndrome (SBS) among students in tropical countries. We studied associations between levels of five fungal DNA sequences, two mycotoxins (sterigmatocystin and verrucarol) and cat allergen (Fel d 1) levels in schools and rhinitis and other weekly SBS symptoms in the students. Fungal DNA was measured by quantitative PCR and cat allergen by ELISA. Pupils (N = 462) from eight randomly selected schools in Johor Bahru, Malaysia participated (96%). Dust samples were collected by cotton swabs and Petri dishes exposed for one week. None of the schools had a mechanical ventilation system, but all classrooms had openable windows that were kept open during lectures and indoor CO₂ levels were low (mean 492 ppm; range 380–690 ppm). Weekly nasal symptoms (rhinitis) (18.8%), ocular (11.6%), throat (11.1%), dermal symptoms, headache (20.6%) and tiredness (22.1%) were common. Total fungal DNA in swab samples was associated with rhinitis (p = 0.02), ocular symptoms (p = 0.009) and tiredness (p = 0.001). There were positive associations between Aspergillus versicolor DNA in Petri dish samples, ocular symptoms (p = 0.02) and tiredness (p = 0.001). The level of the mycotoxin verrucarol (produced by Stachybotrys chartarum) in swab samples was positively associated with tiredness (p = 0.04). Streptomyces DNA in swab samples (p = 0.03) and Petri dish samples (p = 0.03) were negatively associated with tiredness. In conclusion, total fungal contamination, measured as total fungal DNA) in the classrooms, Aspergillus versicolor and verrucarol can be risk factors for rhinitis and SBS symptoms among students in the tropical country Malaysia.     

Cat (Fel d 1) and dog (Can f 1) allergen levels in cars,dwellings and schools

Pets are an important source of indoor allergens. The aim of the study was to compare cat and dog allergen levels in cars, schools and homes. The study was carried out in 17 cars, 14 classrooms and 19 dwellings located in the highly industrialized and urbanized region of Poland. Dust and air samples were analyzed for Fel d 1 and Can f 1 using a double monoclonal ELISA assay. The highest amounts of cat and dog allergens (Fel d 1: 1169 μg/g; Can f 1: 277 μg/g) were found in dwellings with pets. Allergen concentrations were correlated with the number of animals kept at home. Although concentrations on automobile seats were lower, Fel d 1 levels exceeded 8 μg/g in 23.5 % of cars and high levels of Can f 1 (>10 μg/g) were found in 17.6 % of cars. The study revealed that cars of pet owners may be reservoirs of cat and dog allergens even when animals are not transported in them. In schools, concentrations of pet allergens did not reach high levels, but the moderate levels of Fel d 1 (≥1–8 μg/g) and Can f 1 (≥2–10 μg/g) were detected in 42.9 and 7.1 % of the investigated classrooms. Concentrations of cat and dog allergen in schools were higher than in homes without pets. While airborne Fel d 1 and Can f 1 levels were found low, residential allergen concentrations in settled dust and air were correlated. The study results suggest that classrooms and cars of pet owners may be important sites of exposure to cat and dog allergens, though the highest concentrations of Fel d 1 and Can f 1 are found in homes of pet owners.     

Indoor air quality in schools: exposure to fungal allergens

This study examined indoor air quality within schools in Kansas City, Spokane, Santa Fe, and Orlando. Air sampling was undertaken with both Andersen Single Stage Samplers and Burkard Personal Air Samplers. The data show a wide range of indoor exposures ranging from less than 100 colony forming units (CFU/m³) for viable fungi and 100 spores/m³ for total spores in Spokane and Santa Fe to concentrations over 6000 CFU/m³ for viable fungi and 15 000 spores/m³ for total fungi in Orlando and Kansas City, respectively. In the majority of sites the indoor airspora reflected the outdoor taxa withCladosporium the most abundant genus identified; however, several indoor locations had elevated levels ofPenicillium andAspergillus indicating possible sources of indoor contamination. Airborne basidiospores and smut spores were also fairly abundant in the schools and were among the top five taxa identified. The data also indicated that the airborne concentrations vary significantly during the day and between classrooms within each school. Continued studies in schools are needed to fully assess both the exposure levels and the clinical significance to atopic children allergic to these spores.     

Carbon Dioxide Concentrations and Temperatures within Tour Buses under Real-Time Traffic Conditions

This study monitored the carbon dioxide (CO₂) concentrations and temperatures of three 43-seat tour buses with high-passenger capacities in a course of a three-day, two-night school excursion. Results showed that both driver zones and passenger zones of the tour buses achieved maximum CO₂ concentrations of more than 3000 ppm, and maximum daily average concentrations of 2510.6 and 2646.9 ppm, respectively. The findings confirmed that the CO₂ concentrations detected in the tour buses exceeded the indoor air quality standard of Taiwan Environmental Protection Administration (8 hr-CO₂: 1000 ppm) and the air quality guideline of Hong Kong Environmental Protection Department (1 hr-CO₂: 2500 ppm for Level 1 for buses). Observations also showed that high-capacity tour bus cabins with air conditioning system operating in recirculation mode are severely lacking in air exchange rate, which may negatively impact transportation safety. Moreover, the passenger zones were able to maintain a temperature of between 20 and 25°C during travel, which effectively suppresses the dispersion of volatile organic compounds. Finally, the authors suggest that in the journey, increasing the ventilation frequency of tour bus cabin, which is very beneficial to maintain the travel safety and enhance the quality of travel.     

教室空气污染分析及其解决方案研究

分别采用气相色谱法和分光光度法对某大学五间教室内空气中苯、甲醛含量进行了测定。根据测定结果,参照国家有关室内环境质量指标,对上述教室内的空气质量进行了评价。分析教室中空气污染的来源,提出相应的解决方案,对于提高教室空气质量具有一定的指导作用。     

Heat and PAHs Emissions in Indoor Kitchen Air and Its Impact on Kidney Dysfunctions among Kitchen Workers in Lucknow,North India

Indoor air quality and heat exposure have become an important occupational health and safety concern in several workplaces including kitchens of hotels. This study investigated the heat, particulate matter (PM), total volatile organic compounds (TVOCs) and polycyclic aromatic hydrocarbons (PAHs) emissions in indoor air of commercial kitchen and its association with kidney dysfunctions among kitchen workers. A cross sectional study was conducted on 94 kitchen workers employed at commercial kitchen in Lucknow city, North India. A questionnaire-based survey was conducted to collect the personal and occupational history of the kitchen workers. The urine analysis for specific gravity and microalbuminuria was conducted among the study subjects. Indoor air temperature, humidity, wet/ dry bulb temperature and humidex heat stress was monitored during cooking activities at the kitchen. Particulate matter (PM) for 1 and 2.5 microns were monitored in kitchen during working hours using Hazdust. PAH_S in indoor air was analysed using UHPLC. Urinary hydroxy-PAHs in kitchen workers were measured using GC/MS-MS. Higher indoor air temperature, relative humidity, PM₁ and PM_2.5 (p<0.001) was observed in the kitchen due to cooking process. Indoor air PAHs identified are Napthalene, fluorine, acenaphthene, phenanthrene, pyrene, chrysene and indeno [1,2,3-cd) pyrene. Concentrations of all PAHs identified in kitchen were above the permissible OSHA norms for indoor air. Specific gravity of urine was significantly higher among the kitchen workers (p<0.001) as compared to the control group. Also, the prevalence of microalbuminuria was higher (p<0.001) among kitchen workers. Urinary PAH metabolites detected among kitchen workers were 1-NAP, 9-HF, 3-HF, 9-PHN and 1-OHP. Continuous heat exposure in kitchens due to cooking can alter kidney functions viz., high specific gravity of urine in kitchen workers. Exposure to PM, VOCs and PAHs in indoor air and presence of urinary PAHs metabolites may lead to inflammation, which can cause microalbuminuria in kitchen workers, as observed in the present study.     

Gas Production by Intestinal Microflora of Lactose Maldigesters

To investigate whether the gas produced by faecal contents of lactose maldigesters is traceable to symptoms of intolerance we analysed by gas chromatography faecal extracts of frozen stool samples for their gas composition. The samples were taken from 21 patients with biopsy-proven hypolactasia, 10 with severe and 11 with mild symptoms (cumulative score), and were incubated in three different carbohydrate broths. After incubation, H₂, CO₂, air and methane contents were analysed in triplicate. Differences between patient groups with mild and severe symptom scores were found, but they did not reach statistical significance. Substantial intragroup variations in gas production among patients with severe (range of H₂in galactose: 0.9–8.3%, and range of CO₂: 5.9–15.9%) as well as with mild symptoms (H₂: 0–8.3%, and CO₂1.4–14.5%) were recorded. Two patients with severe and one with mild symptoms produced detectable amounts of methane. The individual symptoms, i.e. flatulence or abdominal pain, did not directly correlate with gas production, but abundant gas production had a tendency to associate with a greater difference in waistline measurements before and after lactose provocation. Preliminary comparisons between faecal H₂and CO₂production and bacterial groups isolated from the samples showed that high concentrations of Escherichia coli tended to be more often associated with high gas production. Numbers of lactobacilli and H₂concentrations showed a trend towards negative correlation.     

In China, students in crowded dormitories with a low ventilation rate have more common colds: evidence for airborne transmission

Objective

To test whether the incidence of common colds among college students in China is associated with ventilation rates and crowdedness in dormitories.

Methods

In Phase I of the study, a cross-sectional study, 3712 students living in 1569 dorm rooms in 13 buildings responded to a questionnaire about incidence and duration of common colds in the previous 12 months. In Phase II, air temperature, relative humidity and CO₂ concentration were measured for 24 hours in 238 dorm rooms in 13 buildings, during both summer and winter. Out-to indoor air flow rates at night were calculated based on measured CO₂ concentrations.

Results

In Phase I, 10% of college students reported an incidence of more than 6 common colds in the previous 12 months, and 15% reported that each infection usually lasted for more than 2 weeks. Students in 6-person dorm rooms were about 2 times as likely to have an incidence of common colds ≥6 times per year and a duration ≥2 weeks, compared to students in 3-person rooms. In Phase II, 90% of the measured dorm rooms had an out-to indoor air flow rate less than the Chinese standard of 8.3 L/s per person during the heating season. There was a dose-response relationship between out-to indoor air flow rate per person in dorm rooms and the proportion of occupants with annual common cold infections ≥6 times. A mean ventilation rate of 5 L/(s•person) in dorm buildings was associated with 5% of self reported common cold ≥6 times, compared to 35% at 1 L/(s•person).

Conclusion

Crowded dormitories with low out-to indoor airflow rates are associated with more respiratory infections among college students.     

The phytoremediation of indoor air pollution: a review on the technology development from the potted plant through to functional green wall biofilters

Poor indoor air quality is a health problem of escalating magnitude, as communities become increasingly urbanised and people’s behaviours change, lending to lives spent almost exclusively in indoor environments. The accumulation of, and continued exposure to, indoor air pollution has been shown to result in detrimental health outcomes. Particulate matter penetrating into the building, volatile organic compounds (VOCs) outgassing from synthetic materials and carbon dioxide from human respiration are the main contributors to these indoor air quality concerns. Whilst a range of physiochemical methods have been developed to remove contaminants from indoor air, all methods have high maintenance costs. Despite many years of study and substantial market demand, a well evidenced procedure for indoor air bioremediation for all applications is yet to be developed. This review presents the main aspects of using horticultural biotechnological tools for improving indoor air quality, and explores the history of the technology, from the humble potted plant through to active botanical biofiltration. Regarding the procedure of air purification by potted plants, many researchers and decades of work have confirmed that the plants remove CO₂ through photosynthesis, degrade VOCs through the metabolic action of rhizospheric microbes, and can sequester particulate matter through a range of physical mechanisms. These benefits notwithstanding, there are practical barriers reducing the value of potted plants as standalone air cleaning devices. Recent technological advancements have led to the development of active botanical biofilters, or functional green walls, which are becoming increasingly efficient and have the potential for the functional mitigation of indoor air pollutant concentrations.     

Indoor climate and air quality

 In industrialized countries about 90% of the time is spent indoors. The ambient parameters affecting indoor thermal comfort are air temperature and humidity, air velocity, and radiant heat exchange within an enclosure. In assessing the thermal environment, one needs to consider all ambient parameters, the insulating properties of the occupants’ clothing, and the activity level of the occupants by means of heat balance models of the human body. Apart from thermal parameters, air quality (measured and perceived) is also of importance for well-being and health in indoor environments. Pollutant levels are influenced by both outdoor concentrations and by indoor emissions. Indoor levels can thus be lower (e.g. in the case of ozone and SO₂) or higher (e.g. for CO₂ and formaldehyde) than outdoor levels. Emissions from cooking play an important role, especially in developing countries. The humidity of the ambient air has a wide range of effects on the energy and water balance of the body as well as on elasticity, air quality perception, build-up of electrostatic charge and the formation or mould. However, its effect on the indoor climate is often overestimated. While air-handling systems are commonly used for achieving comfortable indoor climates, their use has also been linked to a variety of problems, some of which have received attention within the context of ”sick building syndrome”. Received: 27 October 1997 / Accepted 26 November 1997     

The effect of store conditions on the rotting of apples, cv. Bramley's Seedling, by Nectria galligena

The log of the time interval between inoculation with Nectria galligena in October and the onset of rotting in apples held in air was proportional to the deficit between the temperature of incubation and 25°C, but temperature did not affect the rate of subsequent rot expansion. Rots expanded equally fast whether apples were held in dry or moist air. The quantity of rotted tissue obtained after incubating inoculated apples in atmospheres containing up to 12.5% CO₂ increased with increasing concentrations of CO₂ greater than 2.5%. The quantity of rotted tissue obtained in apples incubated in 10% CO₂ was three times as great as that obtained after incubation in air. The incidence of natural rots was lower in apples stored at 4% CO₂ than in those stored in air and rotting increased with increasing concentrations of CO₂ higher than 4%. Colonies of N. galligena grew faster on malt agar plates incubated in 5% CO₂ than in air, but growth was slower in 10% CO₂ than in air. The quantity of benzoic acid per mg hyphae accumulated in developing lesions was similarly related to the CO₂ concentrations up to 2.5% but decreased at higher concentrations, and the quantities found in apples stored in CO₂ concentrations >5.0% CO₂ were less than in those stored in air.     

Relation of CO(2) Compensation Concentration to Apparent Photosynthesis in Maize

Significant differences in CO₂ compensation concentration measured in the field among varieties of the species Zea mays L. are reported for the first time. CO₂ compensation concentrations were significantly (P≤ 0.01) and negatively correlated with apparent photosynthesis at 300 μl CO₂/liter air. The Michaelis constant (as defined) for a leaf was significantly (P≤ 0.01) and positively correlated with apparent photosynthesis among varieties. While the first correlation is similar to behavior of CO₂ compensation among species of different photosynthetic efficiency, the latter correlation is the converse of the behavior of Km among species.     

Effects of Air Pollution and the Introduction of the London Low Emission Zone on the Prevalence of Respiratory and Allergic Symptoms in Schoolchildren in East London: A Sequential Cross-Sectional Study

The adverse effects of traffic-related air pollution on children’s respiratory health have been widely reported, but few studies have evaluated the impact of traffic-control policies designed to reduce urban air pollution. We assessed associations between traffic-related air pollutants and respiratory/allergic symptoms amongst 8–9 year-old schoolchildren living within the London Low Emission Zone (LEZ). Information on respiratory/allergic symptoms was obtained using a parent-completed questionnaire and linked to modelled annual air pollutant concentrations based on the residential address of each child, using a multivariable mixed effects logistic regression analysis. Exposure to traffic-related air pollutants was associated with current rhinitis: NOx (OR 1.01, 95% CI 1.00–1.02), NO₂ (1.03, 1.00–1.06), PM₁₀ (1.16, 1.04–1.28) and PM_2.5 (1.38, 1.08–1.78), all per μg/m³ of pollutant, but not with other respiratory/allergic symptoms. The LEZ did not reduce ambient air pollution levels, or affect the prevalence of respiratory/allergic symptoms over the period studied. These data confirm the previous association between traffic-related air pollutant exposures and symptoms of current rhinitis. Importantly, the London LEZ has not significantly improved air quality within the city, or the respiratory health of the resident population in its first three years of operation. This highlights the need for more robust measures to reduce traffic emissions.     

Characterization of metal(loid)s in indoor and outdoor PM2.5 of an office in winter period

The characterization of indoor (a naturally ventilated office) and outdoor (adjacent courtyard) metals in PM_2.5 during a winter period in Xi'an, China were carried out. The results indicated that the average mass concentrations of PM_2.5 in indoor and outdoor environments all exceeded the daily average limit of 75 µg m^–3 set by the Chinese government. The dominant metals in PM_2.5 were Ca, Al, Zn, Mg, Fe, and Pb in both indoor and outdoor air. Concentration of As was much higher than the standard of 6 ng m^–3 issued by the government. Enrichment factor analysis showed that anthropogenic emissions might be the primary sources of As, Cd, Pb, and Zn, while crust was the main origin of Co. A majority of indoor-to-outdoor concentration ratios of metal were lower than 1 indicating mostly the contribution of outdoor sources rather than indoor ones. As and Cr in both indoor and outdoor air posed the highest noncarcinogenic and carcinogenic risks, respectively. The noncarcinogenic and carcinogenic risks were 2.74 and 2.54 × 10^?4 indoor and 4.04 and 3.87 × 10^?4 outdoor, which suggested that possible adverse health effects should be of concern.     

Preliminary comparison of atmospheric CO2 enhancement to photosynthesis of Pyropia yezoensis (Bangiales,Rhodophyta) leafy thalli and filamentous thalli

Intertidal macroalgae are submerged in seawater at high tide and exposed to air at low tide. When they are exposed to the air, CO₂ is the main inorganic carbon source. In this study, the photosynthetic performances of PSI and PSII were measured in different generations of Pyropia yezoensis (leafy thalli and filamentous thalli) that had been exposed to air containing different CO₂ concentrations. Changes in photosynthesis during dehydration and salt treatment under the different CO₂ concentrations were also analyzed. The results showed that in leafy thalli, the effective photochemical quantum yield of PSII (YII) was enhanced as CO₂ increased, which suggested that CO₂ assimilation was enhanced and that they can utilize CO₂ in the air directly, even when they are subjected to moderate stress. These findings could explain why, in P. yezoensis aquaculture, moderate exposure to air does not lead to a decrease in crop yield. However, in filamentous thalli, there were no significant differences in YII at the CO₂ concentrations tested. The expression of genes involved in the Calvin cycle in leafy thalli was higher than that in filamentous thalli. CO₂ uptake and biomass of P. yezoensis leafy thalli is larger than filamentous thalli, which may be due to its different carbon utilization mechanism and the adaptation of intertidal environment in the evolutionary process.     

Indoor Air Pollution Aggravates Symptoms of Atopic Dermatitis in Children

Most of researches on the impact of indoor air pollutants on atopic dermatitis (AD) have been based upon animal models, in vitro experiments and case-control studies. However, human data to elucidate the role of indoor air pollution on worsening symptoms of pre-existing AD from a longitudinal study are scarce. The objective of this prospective study was to evaluate the effect of indoor air pollution on AD symptoms in children. We surveyed 30 children with AD in a day-care centre, which moved to a new building during the study. These children stayed there for 8 hours a day Monday through Friday, and their daily symptom scores were recorded. Indoor and outdoor air pollutant levels were continuously measured 24 hours a day for 12 months (Period 1 to 4). Data were analyzed using a generalized linear mixed model. Compared to the period before moving (Period 1), concentrations of indoor air pollutants mostly increased after moving (Period 2) and decreased by natural ventilation and bake-out (Periods 3 and 4). The rate of positive AD symptom increased from 32.8% (Period 1) up to 43.8% (Period 2) and 50.5% (Period 3), then decreased to 35.4% in Period 4 (P < 0.0001). When the delayed effects of indoor air pollutants on AD symptoms 2 days later were evaluated, AD symptoms significantly increased by 12.7% (95% CI: -0.01 to 27.1) as toluene levels increased by 1 ppb (P = 0.05). In conclusion, indoor air pollutants increase the risk of AD aggravation in children and toluene in the indoor environment might act as an aggravating factor.