Indoor air quality and health in schools: a critical review for developing the roadmap for the future school environment

Several research studies have ranked indoor pollution among the top environmental risks to public health in recent years. Good indoor air quality is an essential component of a healthy indoor environment and significantly affects human health and well-being. Poor air quality in such environments may cause respiratory disease for millions of pupils around the globe and, in the current pandemic-dominated era, require ever more urgent actions to tackle the burden of its impacts. The poor indoor quality in such environments could result from poor management, operation, maintenance, and cleaning. Pupils are a different segment of the population from adults in many ways, and they are more exposed to the poor indoor environment: They breathe in more air per unit weight and are more sensitive to heat/cold and moisture. Thus, their vulnerability is higher than adults, and poor conditions may affect proper development. However, a healthy learning environment can reduce the absence rate, improves test scores, and enhances pupil/teacher learning/teaching productivity. In this article, we analyzed recent literature on indoor air quality and health in schools, with the primary focus on ventilation, thermal comfort, productivity, and exposure risk. This study conducts a comprehensive review to summarizes the existing knowledge to highlight the latest research and solutions and proposes a roadmap for the future school environment. In conclusion, we summarize the critical limitations of the existing studies, reveal insights for future research directions, and propose a roadmap for further improvements in school air quality. More parameters and specific data should be obtained from in-site measurements to get a more in-depth understanding at contaminant characteristics. Meanwhile, site-specific strategies for different school locations, such as proximity to transportation routes and industrial areas, should be developed to suit the characteristics of schools in different regions. The socio-economic consequences of health and performance effects on children in classrooms should be considered. There is a great need for more comprehensive studies with larger sample sizes to study on environmental health exposure, student performance, and indoor satisfaction. More complex mitigation measures should be evaluated by considering energy efficiency, IAQ and health effects