Air contaminants in the indoor environment may be more hazardous to respiratory health than pollutants found in the outdoor air. Much of the current attention to the health effects of indoor air pollution has resulted from energy-conservation ef-forts. For example, insulation of homes has reduced fresh-air exchanges with the outdoors, thus preventing dilution of air contaminants. In addition, alternative heat-ing devices such as kerosene heaters have recently been recognized as a major source of indoor pollution. Although innumerable gases and particulates contami-nate the indoor environment, respiratory effects can be attributed to only a few pollutants that may reach high concentrations indoors. These agents include oxides of nitrogen, carbon monoxide, formaldehyde, particulates, and even sulfur dioxide. We discuss the sources of these contaminants and provide a review of their pul-monary health effects. The respiratory care practitioner should be aware of the potential for these indoor pollutants to cause acute and chronic respiratory prob-lems. (Witek TJ, Schachter EN, Leaderer BP. Indoor Air Pollution and Respiratory Health. Respir Care 1984;29:147-154.
National Academy of Sciences. Indoor pollutants. National Academy Press, 1981.
2.
LevinL, PurdomPW. A review of the health effects of energy conserving materials. Am J Public Health1983;73:683–690.
3.
RussellMAH, ColePV, BrownE.Absorption by nonsmokers of carbon monoxide from room air polluted by tobacco smoke. Lancet1973;1:576–579.
4.
RussellMAH, FeyerabendC.Blood and urinary nicotine in nonsmokers. Lancet1975;1:179–181.
5.
RepaceJL, LowreyAH. Indoor air pollution, tobacco smoke, and public health. Science1980;208:464–472.
6.
ColleyJRT. Respiratory symptoms in children and parental smoking and phlegm production. Br Med J1974;2:201–204.
7.
WeissST, TagerIB, SpeizerFE, RosnerB.Persistent wheeze. Its relation to respiratory illness, cigarette smoking, and level of pulmonary function in a population sample of children. Am Rev Respir Dis1980;122:697–707.
8.
TagerIB, WeissST, RosnerB, SpeizerFE. Effect of parental cigarette smoking on the pulmonary function of children. Am J Epidemiol1979;110:15–26.
9.
DodgeR.The effects of indoor pollution on Arizona children. Arch Environ Health1982;37:151–155.
10.
HasselblandV, HumbleCG, GrahamMG, AndersonHS. Indoor environmental determinants of lung function in children. Am Rev Respir Dis1981;123:479–485.
11.
SchillingRSF, LetaiAD, HuiGH, BeckGJ, SchoenbergJB, BouhuysA.Lung function, respiratory disease, and smoking in families. Am J Epidemiol1977;106:274–283.
12.
LebowitzMD, BurrowsB.Respiratory symptoms related to smoking habits of family adults. Chest1976;69:48–50.
13.
HirayamaT.Nonsmoking wives of healthy smokers have a higher risk of lung cancer. A study from Japan. Br Med J1981;282:183.
14.
GarfinkelL.Time trends in lung cancer mortality among nonsmokers and a note on passive smoking. JNCI1981;66:1061–1066.
15.
WhiteJR, FroebHF. Small airways dysfunction in nonsmokers chronically exposed to tobacco smoke. N Engl J Med1980;302:720–723.
16.
DahmsTE, BolinJF, SlavinRG. Passive smoking. Effects on bronchial asthma. Chest1981;80:530–534.
17.
WiedemannHP, VirgultoJA, SnyderP, . Lung function and airway reactivity in stable asthmatics after passive exposure to cigarette smoke (abstract). Am Rev Respir Dis1983;127:92.
18.
MeliaRJW, FloreyC du V, ChinnS.The relation between respiratory illness in primary schoolchildren and the use of gas for cooking. I. Results from a national survey. Int J Epidemiol1979;8:333–338.
19.
FloreyC du V, MeliaRJW, ChinnS, . The relation between respiratory illness in primary schoolchildren and the use of gas for cooking. III. Nitrogen dioxide, respiratory illness and lung infection. Int J Epidemiol1979;8:347–353.
20.
SpeizerFE, FerrisBJr, BishopYMM, SpenglerJ.Respiratory disease rates and pulmonary function in children associated with NO2 exposure. Am Rev Respir Dis1980;121:3–10.
21.
ComstockGW, MeyerMB, HelsingKJ, TockmanS.Respiratory effects of household exposures to tobacco smoke and gas cooking. Am Rev Respir Dis1981;124:143–148.
22.
LeadererBP. Air pollutant emissions from kerosene space heaters. Science1982;218:1113–1115.
23.
OrehekJ, MassariJP, GayradP, GunandC, ChapinG.Effect of short term low level nitrogen dioxide exposure on bronchial sensitivity of asthmatic patients. J Clin Invest1976;57:301–307.
24.
AhmedT, MarchetteB, DantaI, . Effect of 0.1 ppm NO2 on bronchial reactivity in normals and subjects with bronchial asthma abstract. Am Rev Respir Dis1982;125S:152.
25.
WitekTJ, SchachterEN, BeckGJ, . Interaction between SO2 and exercise in asthmatic and healthy subjects (abstract). Chest1982;82:216.
26.
SheppardD, SaishoA, NadelJA, BousheyHA. Exercise increases sulfur dioxide-induced bronchoconstriction in asthmatic subjects. Am Rev Respir Dis1981;123:486–491.
27.
SwenbergJA, KernsWD, MitchenRI, GrallaEJ, PavkovKL. Induction of squamous cell carcinomas of the rat nasal cavity by inhalation exposure to formaldehyde vapor. Cancer Res1980;40:3398–3402.
28.
HarringtonJM, ShannonHS. Mortality study of pathologists and medical laboratory technicians. Br Med J1975;4:329–332.
29.
MasterKM. Air pollution in New Guinea. Cause of chronic pulmonary disease among stone-age natives in the Highlands. JAMA1974;228:1653–1655.
30.
HendrickDJ, RandoRJ, LaneDJ, MorrisMJ. Formaldehyde asthma: Challenge exposure levels and fate after 5 years. J Occup Med1982;24:893–897.
31.
CockcroftDW, HoeppnerVH, DolovichJ.Occupational asthma caused by cedar urea formaldehyde particle board. Chest1982;82:49–53.
32.
FrigasE, FilleyWV, ReadCE. Asthma induced by dust from urea-formaldehyde foam insulating material. Chest1981;79:706–707.
33.
SchoenbergJB, MitchellCA. Airway disease caused by phenolic (phenolformaldehyde) resin exposure. Arch Environ Health1975;30:574–577.
34.
AlexanderssonR, Kolmonden-HedmanB, HedenstiernaG.Exposure to formaldehyde: Effects on pulmonary functions. Arch Environ Health1982;37:279–284.
35.
DallyKA, HanrahanLP, WoodburyMA, KanarekMS. Formaldehyde exposure in nonoccupational environments. Arch Environ Health1981;36:277–284.
36.
SardinasAV, MostRS, GiuliettiMA, HoncharP.Health effects associated with urea-formaldehyde foam insulation in Connecticut. J Environ Health1979;41:270–272.
37.
LefcoeNM, AshleyMJ, PedersenLL, KeaysJJ. The health risks of passive smoking. The growing care for control measures in enclosed environments. Chest1983;84:90–95.
38.
AndrewsJLJr. Reducing smoking in the hospital. An effective model program. Chest1983;84:206–209.
