Eldercare, nursing homes, and frail care facilities are places for the elderly and infirm to live in comfort and with dignity, and — given the vulnerability of the residents — every care should be made to ensure the safety and hygiene of facilities. However, one hygiene challenge has for too long gone unresolved and until recently, was nearly impossible to overcome — the indoor air quality.
Indoor air quality in nursing homes
While most untreated indoor spaces have high levels of air pollution1, many eldercare and nursing facilities have truly distressing concentrations of harmful airborne pathogens. These concentrations can — and often do — far exceed international standards2 for acceptability and safety. This can be caused, paradoxically, by the pursuit of the comfort of residents. Care homes feature crucial quality-of-life factors in layout, furniture, décor, and temperature control that can, unfortunately, exacerbate the build-up and persistence of indoor air pollutants.
Carpeting and soft furniture can release gases such as benzene, ethylene glycol, or formaldehyde3, which are considered acute hazards or irritants, while in an attempt to keep areas feeling neat and fresh with a coat of paint, polish, or wax, we can introduce potentially harmful VOCs that can cause headaches, eye-watering, dizziness, and breathing problems4. Even worse, regular daily cleaning and hygiene measures can introduce potentially toxic gases and fumes from cleaning products, disinfectants, and floor polishes5.
Temperature control is considered vital for day-to-day comfort in nursing homes, but it can also bring its own set of challenges. Legacy heating, ventilation, and air conditioning systems can introduce outdoor air pollutants and pathogens that can build up and circulate inside where windows are often kept closed, increasing the risk of illness and disease among residents.
Add to this the fact that many residents spend a majority of their time indoors and that by nature the elderly and infirm are particularly vulnerable to the risks associated with indoor air pollution, and you have a truly worrying combination: High pollution concentration, high exposure, and high vulnerability.
1. Respiratory illness
Respiratory muscle strength decreases with age, and together with a reduction in physical activity, this means senior citizens are highly prone to respiratory illness and infections. High concentrations of indoor air pollutants have been linked to increased rates of hospital admissions among the elderly6, and are known to exacerbate or lead to airway inflammation and restriction, asthma, allergies, breathlessness, pulmonary disease, and respiratory infections7.
2. Cardiovascular disease
As the world’s leading cause of death, accounting for nearly one-third of all deaths globally8, cardiovascular disease is a major risk factor for those who are already vulnerable. Exposure to indoor air pollution increases the risk for stroke, heart attack, and coronary artery disease. Multiple studies show 9 that inhaling indoor air pollutants can lead to an increase in blood pressure — the primary cause of heart disease and failure.
3. Airborne viruses and bacteria
Viruses alone are a major threat, but even more so in enclosed spaces where vulnerable people gather and interact with each other. Ultrafine particulate matter can act as a vector for the spread of airborne viruses, making air pollution even more dangerous. Once inhaled, these particulates enter the bloodstream, spreading viruses like COVID-19 and others, and allowing viral infections — such as pneumonia — to develop in the lower respiratory tract.
The threat of pneumonia cannot be overstated. It is the most frequent cause of death in residents in nursing homes and care facilities10around the world and is more common among residents of these facilities than among elderly persons living at home11.
4. Unpleasant odors
Upon entering a nursing home, the way it smells says a lot about the level of cleanliness and sanitation. Age-related hormone changes can lead to increased body odor, known as 2-nonenal12, while incontinence and urinary tract infections can cause embarrassment and even depression among elderly residents — not to mention the build-up of smells in carpets and upholstery from spills, stains, and general wear and tear.
While the use of chemical cleaning agents and air fresheners may help to treat odors in the short term, they emit harmful VOCs that can exacerbate respiratory conditions and lead to long-term health problems. The effective neutralization of odor is critical for not only the dignity and health of residents but for the comfort of visitors and the morale of staff as well. In fact, poor odors are a leading cause of low workplace satisfaction in the care industry13.
5. Poor quality of sleep
The benefits of a good night’s rest are well documented and are linked to the maintenance of a healthy weight, improved immunity against illness, improved attention and concentration, and a healthy heart14. It’s no wonder then that poor quality of sleep can negatively impact the overall health and wellness of the elderly, delaying recovery and increasing their risk of illness and disease.
Indoor air pollution has been associated with a wide range of health and respiratory problems, including COPD, allergies, and asthma. Pathogens like mold can lead to nasal inflammation, which can be associated with sleep disorders due to airway obstruction15, while short-term exposure to air pollutants such as NO2, PM, and VOCs has been linked to a higher risk of hospitalization among the elderly due to sleep disorders16.
Complete indoor air safety with VIRUSKILLER™
While some air purifiers may filter the air to some degree, even hospital-grade solutions can fail to effectively tackle the full spectrum of particulates, gases, and organic contaminants required to maintain the level of safety care homes require. VIRUSKILLER™ is an all-in-one solution for indoor air safety, deactivating many of the most harmful pathogens that lead to illness and discomfort of residents and staff. A range of devices suited to bedrooms, common rooms, corridors, and restrooms delivers air that is free from odors, pathogens, and pollutants, and simple plug-and-play operation means easy installation with no messy or disruptive renovations.
Radic8 is committed to providing the most efficient, reliable clean air technology to protect our loved ones and those in need of extended care.
- United States Environmental Protection Agency. “Introduction to Indoor Air Quality.” EPA. https://www.epa.gov/indoor-air-quality-iaq/introduction-indoor-air-quality
- A. Mendes, S. Bonassi, L. Aguiar, C. Pereira, P. Neves, S. Silva, D. Mendes, L. Guimarães, R. Moroni, J.P. Teixeira, Indoor air quality and thermal comfort in elderly care centers, Urban Climate 14 (2015) 486-501.
- Agency for Toxic Substances and Disease Registry. “Formaldehyde and your health.” ATSDR. https://www.atsdr.cdc.gov/formaldehyde/index.html
- National Center for Biotechnology Information. “Occupational Exposure as a Painter.” NCBI. https://www.ncbi.nlm.nih.gov/books/NBK304433/
- P. Wolkoff, T. Schneider, J. Kildesø, R. Degerth, M. Jaroszewski, H. Schunk, Risk in cleaning: chemical and physical exposure, Science of the total environment 215(1-2) (1998) 135-156.
- K.L. Shumake, J.D. Sacks, J.S. Lee, D.O. Johns, Susceptibility of older adults to health effects induced by ambient air pollutants regulated by the European Union and the United States, Aging clinical and experimental research 25(1) (2013) 3-8.
- J. Belo, P. Carreiro-Martins, A.L. Papoila, T. Palmeiro, I. Caires, M. Alves, S. Nogueira, F. Aguiar, A. Mendes, M. Cano, The impact of indoor air quality on respiratory health of older people living in nursing homes: spirometric and exhaled breath condensate assessments, Journal of Environmental Science and Health, Part A 54(12) (2019) 1153-1158.
- E.N. Mahlof, J.D. Bisognano, Reducing cardiovascular risk caused by air pollution: individuals can make a difference, Journal of Human Hypertension 34(12) (2020) 805-806.
- S. Rajagopalan, S.G. Al-Kindi, R.D. Brook, Air pollution and cardiovascular disease: JACC state-of-the-art review, Journal of the American College of Cardiology 72(17) (2018) 2054-2070.
- R.R. Muder, C. Brennen, D.L. Swenson, M. Wagener, Pneumonia in a long-term care facility: a prospective study of outcome, Archives of Internal Medicine 156(20) (1996) 2365-2370.
- O. Henig, K.S. Kaye, Bacterial pneumonia in older adults, Infectious Disease Clinics 31(4) (2017) 689-713.
- S. Haze, Y. Gozu, S. Nakamura, Y. Kohno, K. Sawano, H. Ohta, K. Yamazaki, 2-Nonenal newly found in human body odor tends to increase with aging, Journal of investigative dermatology 116(4) (2001) 520-524.
- Q. Zuo, E.E. MaloneBeach, Assessing staff satisfaction with indoor environmental quality in assisted living facilities, Journal of Interior Design 42(1) (2017) 67-84.
- Centers for Disease Control and Prevention. “1 in 3 adults don’t get enough sleep – A good night’s sleep is critical for good health”. CDC. 2016 https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html
- United States Environmental Protection Agency. “Mold and Health.” EPA. https://www.epa.gov/mold/mould-and-health
- Tang, M. et al. “The association of short-term effects of air pollution and sleep disorders among elderly residents in China”. Science of The Total Environment, vol. 708, 2020: 134846. doi: 10.1016/j.scitotenv.2019.134846