National and regional story (Belgium) - Indoor air pollution as a human health concern
Indoor pollution constitutes an appreciable environmental problem in the Brussels-Capital Region due to its highly urban character
The change in our way of living has led, in particular, to an increase in the average amount of time people pass in confined spaces (estimated at 80-90 % in industrialised countries) as well as changes in modes of production and consumption (use of numerous products for renovation, maintenance, cleaning, manufacture of furniture and particle board, carpets, etc.). Moreover, current concerns with saving energy and combating climate change are leading to increased insulation of buildings and, most often, a reduction in aeration, especially in winter. Several scientific studies have shown, however, that living in inadequate housing can have a significant impact on health. One study indicates that people who live in inadequate housing have approximately a 25 % greater risk of encountering serious health problems (Marsh et al., 1999 & 2000).
Indoor pollution constitutes an appreciable environmental problem in the Brussels Region due to its highly urban character, its generally rather old building stock , the precarious living conditions of a significant portion of its population and its relatively severe climate. Over the last decade, the Brussels Region has gradually put in place a series of resources aiming to improve the quality of indoor air.
The Regional Indoor Pollution Intervention Unit [Cellule Régionale d’Intervention en Pollution Intérieure] (CRIPI, commonly called the ‘green ambulance’) is an important resource in this respect. This service aims to aid the physician in his medical diagnosis when he suspects that his patient’s health problem could be related to exposure to indoor pollution in the patient’s residence. Upon a physician’s request, a multidisciplinary team (analysts, public health nurse) visits the patient to carry out chemical and biological sampling, fill in a questionnaire together with the resident (way of life, health problems, general information on the housing), and to advise on how to prevent indoor pollution. The results are sent to the physician and explained to the patient by the public health nurse. After 12 to 18 months, an evaluation of the improvement in the patient’s health is made with the patient and his physician. According to an assessment carried out for the 2000-2007 period, 56 % and 66 % respectively of physicians and patients who have had recourse to the’green ambulance’ have concluded that there were improvements.
Since its establishment in 2000, this service has had increasing success. Approximately 1270 families used the services of the green ambulance, one or more times. In brief, the data collected in this context reveal the following:
The investigations involve mainly respiratory problems, but symptoms can also be cutaneous or more general (headaches, chronic fatigue, etc.);
One-third of the requests for intervention involve children from zero to six years old, and 12 % are under two years old;
Many residences have microbiological contamination (moulds, mites, etc.) and chemical contamination at the same time;
The concentration of many pollutants is generally much higher in indoor air than in outdoor air. Moreover, pollutants not present in outdoor air are detected;
The measured concentrations are often worrying (for example, for total volatile organic compounds or benzene, for which concentrations close to the threshold values set for outdoor air are measured in almost 45 % of the housing analysed);
The chemical pollutants most often identified are benzene (originating from tobacco, some paints and adhesives, ambient fragrances, traffic emissions, etc.), various organic compounds emitted principally by solvents (paints, adhesives, maintenance products), terpenes (mainly maintenance and deodorising products), formaldehyde (particle board, construction materials, cosmetic products, etc.), pesticides (use of some maintenance products, wooden furniture, rugs, etc.), lead-based paint, carbon monoxide and microparticles (tobacco smoke, cooking, wood fires, etc.).
- Documented files on CRIPI, on some pathologies related to indoor pollution and on certain indoor pollutants:
in French (select ‘Santé et environnement’): http://www.ibgebim.be/Templates/etat/informer.aspx?id=3040&langtype=2060
in Dutch (select ‘Gezondheid en leefmilieu’): http://www.ibgebim.be/Templates/etat/informer.aspx?id=3040&langtype=2067
- ‘Health and environment’ chapter from the 2003-2006 Report on the State of the Environment:
Other resources act as a complement to the ‘green ambulance’, namely:
- The ‘Who is SQuAtting your patient’s residence’ resource?
The objective of this resource (available online and in paper format) is to facilitate the job of physicians in relating a health problem to the presence of indoor pollutants.
- Brussels ‘Housing and health’ network
Since 2008, the various parties in Brussels who in one way or another work in the field of ‘the indoor environment, housing and health' have been inventoried and contact information has been collected. The information is accessible online via an interactive map, thematic lists and a database.
- Guide to aeration and natural ventilation of housing
This guide provides information on the health impact of lack of aeration and ventilation and practical ways to remedy it according to the situation and the types of rooms.
Other projects and activities are also conducted by the Brussels Region: assessment of the quality of the indoor environment in child care centres, partnership with physicians carrying out research activity on the relation between health and housing, organisation of training courses, forums, awareness and information activities for associations and professionals, distribution of files (indoor pollutants, eco-construction, and so forth), etc.