“Our research has shown the effect of several airborne pollutants in enclosed spaces on the lung health of the elderly living in nursing homes. This is a worrying problem as the body’s ability to react to harmful air pollutants decreases as we age. Nursing homes should do more to prevent indoor air pollution by limiting sources and improving ventilation in their buildings.”

That is what Dr. Isabella Annesi-Maesano explained, principal author of a study published in European Respiratory Journal in 2015 (European Lung Foundation. “Air quality in nursing homes affecting lung health of residents.” 11^th March 2015), in unsuspected times, when the disastrous consequences from the spread of Covid-19 had not yet been seen in care homes around the world.

Unlike outdoor environments, indoor air quality in nursing homes is not regulated by legislation and is rarely monitored. As a result, care homes residents who spend the vast majority of their time indoors and in close contact with each other are exposed to indoor pollutants for long periods of time and this prolonged exposure can adversely affect health, well-being and quality of life. This long exposure to unhealthy air also leads to increased medical costs due to frequent and unplanned acute illness visits and hospitalizations.

We will also discuss this fundamental issue at Exposanità, the international exhibition at the service of health and assistance, in Bologna from 11^th to 13^th May 2022.

What are the sources of indoor pollution in care homes?

The air quality of a closed environment is influenced by numerous factors: the air arriving from outside, the presence of people who can carry viruses and bacteria, as demonstrated by the Covid-19 pandemic, specific internal sources of pollutants (furnishings, construction materials, glues and paints, products for cleaning people and environments); ventilation and air conditioning systems not adequately cleaned and maintained. Some indoor pollutants can reach concentrations from 2 to 5 times higher than outdoor pollutants, with direct consequences on health both from a respiratory and cognitive point of view.

Viruses and bacteria: can cause disease or trigger asthma and allergy symptoms. In addition to being carried by humans, viruses and bacteria can settle in the air conditioning and ventilation system, causing significant problems for residents, visiting relatives and staff.

Lack of ventilation: in a care home it is not always possible to open the windows as long and as many times as necessary to ensure adequate air exchange, also in order not to affect the heating or air conditioning.

Products for the disinfection and care of environments and people: disinfectants, medicines, specific detergents can introduce polluting and allergenic substances into closed environments and contribute to creating strong odours.

Non-certified construction and furnishing materials: dyes, varnishes, adhesives, furniture and furnishings release formaldehyde and other pollutants that are harmful to health.

Presence of many people: in the common rooms and at mealtimes, guests and staff are together even in confined spaces and with a poor ventilation with a considerable deterioration in the quality and healthiness of the air.

Smells: of cooking, of medicines, of personal care products, disinfectants for environments and surfaces.

Mould: If not properly treated and sanitised, mould can hide in surfaces, releasing spores that create significant respiratory problems for residents.

How to intervene on air quality

Environments where people stay for a long time require safe and certified sanitisation systems, which can regenerate the air continuously, without contraindications or side effects for the people themselves. Jonix Non-Thermal Plasma technology responds to these characteristics: it constantly acts on pollutants, including Covid-19, making the air healthier even in the presence of people.

Jonix Non-Thermal Plasma Technology has a vast range of devices, so as to be able to adapt to any environment, satisfying all the needs of the building, based on the size of the spaces, function of use, frequency and number of people present:

• stand-alone devices, light and compact to be moved easily – Cube Line: to sanitise guest rooms, examination rooms, small bathrooms.
• fixed wall-mounted devices for lifts – Jonix up in: can be positioned both on the ceiling and vertical wall for small densely frequented environments
• fixed wall devices for functional environments – Steel Line: to sanitise quickly eliminating even odours and guaranteeing safety and hygiene of preparations, in professional kitchens and in storage environments
• mobile devices with filtering and sanitising action – Mate Line, for the absolute filtration of suspended dust and the elimination of up to -99.9% of bacteria, viruses and moulds in any type of environment, in particular common rooms, dining areas, recreational areas
• double flow centralized ventilation unit with heat recovery with cold plasma technology – vmc 4people: in waiting rooms, corridors, common rooms, for a continuous exchange of air and to prevent the spread of airborne diseases, guaranteeing safety and hygiene without obstacles on the ground.

Bibliography: useful articles and sources

• Indoor environmental quality in social housing with elderly occupants in Spain: Measurement results and retrofit opportunities (here the article)
• Indoor air pollution in old people’s homes related to some health problems: a survey study (here the article)
• European respiratory journal (here the website of the Scientific Journal)
• Indoor air quality, ventilation and respiratory health in elderly residents living in nursing homes in Europe. European Respiratory Journal, March 2015
• Air quality of nursing homes and its effect on the lung health of elderly residents (here the article)
• Improvements in air quality may slow down the rate of age-related cognitive decline (article here)
• The impact of Covid-19 on the LTC sector and the role of policies: evidence from Italy and abroad by Eleonora Perobelli, Sara Berloto, Elisabetta Notarnicola and Andrea Rotolo. Published in “The prospects for the social and health sector beyond the pandemic” 3rd Rapporto Osservatorio Long Term Care, written by Giovanni Fosti Elisabetta Notarnicola Eleonora Perobelli.