@article{3110085,
    title = "Indoor air quality, ventilation and respiratory health in elderly residents living in nursing homes in Europe",
    author = "Bentayeb, M. and Norback, D. and Bednarek, M. and Bernard, A. and Cai, G. and Cerrai, S. and Eleftheriou, K.K. and Gratziou, C. and Holst, G.J. and Lavaud, F. and Nasilowski, J. and Sestini, P. and Sarno, G. and Sigsgaard, T. and Wieslander, G. and Zielinski, J. and Viegi, G. and Annesi-Maesano, I. and GERIE Study",
    journal = "The European respiratory journal",
    year = "2015",
    volume = "45",
    number = "5",
    pages = "1228-1238",
    publisher = "European Respiratory Society",
    doi = "10.1183/09031936.00082414",
    keywords = "carbon monoxide;  formaldehyde;  nitrogen dioxide;  air pollutant;  carbon monoxide;  formaldehyde;  ozone;  particulate matter, aged;  air conditioning;  air pollutant;  air quality;  ambient air;  Article;  chronic obstructive lung disease;  coughing;  dyspnea;  Europe;  female;  forced expiratory volume;  forced vital capacity;  human;  humidity;  male;  nursing home patient;  priority journal;  respiratory tract disease;  risk assessment;  wheezing;  abnormal respiratory sound;  analysis;  chemistry;  clinical trial;  environmental exposure;  environmental monitoring;  frail elderly;  health status;  home for the aged;  indoor air pollution;  multicenter study;  nursing home;  particulate matter;  pathophysiology;  procedures;  questionnaire;  risk factor;  very elderly, Aged;  Aged, 80 and over;  Air Pollutants;  Air Pollution, Indoor;  Carbon Monoxide;  Environmental Exposure;  Environmental Monitoring;  Europe;  Female;  Formaldehyde;  Frail Elderly;  Health Status;  Housing for the Elderly;  Humans;  Male;  Nitrogen Dioxide;  Nursing Homes;  Ozone;  Particulate Matter;  Pulmonary Disease, Chronic Obstructive;  Respiratory Sounds;  Risk Factors;  Surveys and Questionnaires;  Ventilation",
    abstract = "Few data exist on respiratory effects of indoor air quality and comfort parameters in the elderly. In the context of the GERIE study, we investigated for the first time the relationships of these factors to respiratory morbidity among elderly people permanently living in nursing homes in seven European countries. 600 elderly people from 50 nursing homes underwent a medical examination and completed a standardised questionnaire. Air quality and comfort parameters were objectively assessed in situ in the nursing home. Mean concentrations of air pollutants did not exceed the existing standards. Forced expiratory volume in 1 s/forced vital capacity ratio was highly significantly related to elevated levels of particles with a 50% cut-off aerodynamic diameter of <0.1 μm (PM0.1) (adjusted OR 8.16, 95% CI 2.24-29.3) and nitrogen dioxide (aOR 3.74, 95% CI 1.06-13.1). Excess risks for usual breathlessness and cough were found with elevated PM10 (aOR 1.53 (95% CI 1.15-2.07) and aOR 1.73 (95% CI 1.17-10.3), respectively) and nitrogen dioxide (aOR 1.58 (95% CI 1.15-2.20) and aOR 1.56 (95% CI 1.03-2.41), respectively). Excess risks for wheeze in the past year were found with PM0.1 (aOR 2.82, 95% CI 1.15- 7.02) and for chronic obstructive pulmonary disease and exhaled carbon monoxide with formaldehyde (aOR 3.49 (95% CI 1.17-10.3) and aOR 1.25 (95% CI 1.02-1.55), respectively). Breathlessness and cough were associated with higher carbon dioxide. Relative humidity was inversely related to wheeze in the past year and usual cough. Elderly subjects aged ?80 years were at higher risk. Pollutant effects were more pronounced in the case of poor ventilation. Even at low levels, indoor air quality affected respiratory health in elderly people permanently living in nursing homes, with frailty increasing with age. The effects were modulated by ventilation. Copyright © ERS 2015."
}