Tebbe Thesis FINAL 4-28-17

A Thesis
entitled
Evaluation of Indoor Air Quality in Four Nursing Home Facilities in Northwest Ohio
by
Hope Tebbe
Submitted to the Graduate Faculty as partial fulfillment of the requirements for the
Masters of Science Degree in
Occupational Health
________________________________________
April Ames PhD, CIH, Committee Chair
________________________________________
Victoria Steiner, PhD, Committee Member
________________________________________
Farhang Akbar-Khanzadeh PhD, CIH, Committee
Member
________________________________________
Sheryl Milz, PhD, CIH, Committee Member
________________________________________
Amanda Bryant-Friedrich, PhD, Dean
College of Graduate Studies
The University of Toledo
May, 2017
Copyright 2017, Hope Marie Tebbe
This document is copyrighted material. Under copyright law, no parts of this document
may be reproduced without the expressed permission of the author.
An Abstract of
Evaluation of Indoor Air Quality in Nursing Home Facilities
by
Hope Tebbe
Submitted to the Graduate Faculty as partial fulfillment of the requirements for the
Masters of Science Degree in
Occupational Health
The University of Toledo
May 2017
Indoor air quality (IAQ) is considered one of the top five environmental risks to
the public’s health. Older adults are more vulnerable to health complications associated
with indoor air contaminants because of their decreased immune system and age-
associated health problems, as well as the fact that they spend up to 95 percent of their
time indoors.
Area air sampling was conducted in the nursing home section of four long term
care facilities, three days at each facility (12 days total). Particle concentrations (PM2.5,
PM10, Total Particulate matter (TPM), Ultrafine Particles (UFP), temperature, and
humidity were measured. Two minute samples were collected during seven Sampling
Sessions. Up to nine indoor locations were sampled, representing the various occupied
spaces in each nursing home, along with an outside location for comparison.
Results of Analysis of Variance (ANOVA) by Facility demonstrated significant
differences (p<0.001) in PM concentrations and UFP counts. One Facility had higher
particulate concentrations at all Sampling Locations which may include contributions
from geographic location, vehicular traffic, or resident clustering. ANOVA by Sampling
iii
Location demonstrated significant differences (p<0.001) in PM concentrations and UFP
counts. In general, the highest UFP and PM concentrations were seen in the kitchen,
satellite kitchen, and hair salon, especially at times when the staff and residents were
active in these rooms. Significant differences were seen in UFP counts (Facilities 1 and
3) and PM2.5 (Facility 2) by Sampling Session. The highest concentrations were found for
the Sampling Sessions in the mid-morning and mid-afternoon which were during peak
times of activity for the residents.
Although maximum temperature measurements exceeded ASHRAE winter
guidelines, this may be appropriate for older residents who prefer a warmer temperature.
While most median particle values were below ASHRAE guidelines, maximum values
did exceed occasionally in the hair salon and kitchen at all facilities. Various indoor
Sampling Location PM concentrations or UFP counts exceeded the outdoor levels at all
four facilities. Although the median PM values did not exceed the ASHRAE standards it
is unknown whether older adults may still experience significant health complications
with these PM concentrations. In addition staff who spend extended amount of times in
the kitchen and hair salon could be exposed to higher levels of PM. IAQ in hospitals and
similar environments, such as nursing homes, may require a higher level of care because
of the vulnerable population.
iv
This thesis is dedicated to my parents: for their endless love, support and encouragement;
and to the memory of my uncle Paul Tebbe.

Acknowledgements
Thank you, Dr. Ames, for your long hours of review, support, and assistance, who
without I never would have pursued my career in Occupational Health and Safety. Your
guidance and encouragement are likely responsible for the completion of this paper and
program.
Thank you, Dr. Steiner, for your assistance in coordinating the facilities and for
your long hours of help and support.
Thank you, Erin Messerly, Sarah Mancuso, and Megan Benner for your assistance
in gathering data.
Thank you to the members of my committee for your participation with this
thesis; Dr. Akbar-Khanzadeh, Dr. Milz, Dr. Valigosky and Dr. Ames, for all the
education leading up to this; you have been a teacher, a motivator, and an inspiration.
Thank you to NIOSH/CDC for the scholarship that provided me with this
education.
v
Table of Contents
Abstract .............................................................................................................................. iii
Acknowledgements .............................................................................................................v
Table of Contents .............................................................................................................. vi
List of Tables ......................................................................................................................x
List of Figures .................................................................................................................. xii
List of Abbreviations ....................................................................................................... xiv
List of Symbols .................................................................................................................xv
1 Introduction .............................................................................................................1
1.1 Overview ...........................................................................................................1
1.2 Significance........................................................................................................2
1.3 Statement of Problem .........................................................................................3
1.4 Hypotheses ........................................................................................................4
1.5 Objectives .........................................................................................................4
2 Literature Review ....................................................................................................6
2.1 Indoor Air Quality .............................................................................................6
2.2 Particulate Matter ..............................................................................................8
2.3 Indoor PM Sources ...........................................................................................9
2.4 Comfort Parameters ..........................................................................................9
2.5 Health Effects ..................................................................................................10
vi
2.6 Control of IAQ ................................................................................................11
2.7 IAQ Guidelines ...............................................................................................12
2.8 Long Term Care Environments .......................................................................14
2.9 IAQ in Long Term Care Facilities ..................................................................15
3 Methods .................................................................................................................18
3.1 Overview .........................................................................................................18
3.2 Sampling Equipment .......................................................................................18
3.3 Facilities .......................................................................................................... 21
3.3.1 Sampling Location ...........................................................................22
3.4 Sampling Sessions ..........................................................................................23
3.5 Sampling Procedures ......................................................................................24
3.6 Facility Observation ........................................................................................25
3.7 Data Analysis ..................................................................................................25
4 Results ...................................................................................................................27
4.1 Overview .........................................................................................................27
4.2 Description of Facilities ..................................................................................27
4.3 Descriptive Statistics All Indoor Locations by Facility ...................................27
4.4 Descriptive Statistics by Sampling Location, all Facilities .............................31
4.5 Descriptive Statistics by Sampling Location and Facility ..............................34
4.5.1 Descriptive Statistics by Sampling Location, Facility 1 ..................34
vii
4.5.5 Comparison by Sampling Location and Facility .............................61
4.6 Descriptive Statistics by Sampling Session .....................................................66
4.6.1 Descriptive Statistics by Sampling Session, All Facilities ..............66
4.6.2 Descriptive Statistics by Sampling Session, Facility 1 .....................67
4.7 ANOVA by Facility ........................................................................................78
4.8 ANOVA by Sampling Location and Facility ..................................................79
4.8.1 ANOVA by Sampling Location, All Facilities ................................79
4.8.2 ANOVA by Sampling Location, Facility 1 ......................................81
4.9 ANOVA by Sampling Session ........................................................................88
4.9.1 ANOVA by Sampling Session, All Facilities ..................................88
4.9.2 ANOVA by Sampling Session, Facilities 1-4 .................................90
4.10 Results Compared to Guidelines ...................................................................93
5 Discussion .............................................................................................................95
5.1 Overview .........................................................................................................95
5.2 Differences between Facilities ........................................................................95
5.3 Differences between Indoor Sampling Locations ...........................................96
5.4 Differences between Sampling Sessions ........................................................97
viii
5.5 Indoor versus Outdoor Comparisons ..............................................................97
5.6 Comparison to Guidelines ...............................................................................99
5.7 Limitations ....................................................................................................102
5.4 Recommendations .........................................................................................102
6 Conclusions .........................................................................................................104
References ........................................................................................................................106
A Facility Descriptions ............................................................................................112
ix
List of Tables
4.1 Descriptive Statistics All Indoor Locations by Facility .........................................31
4.2 Descriptive Statistics by Sampling Location, All Facilities ..................................33
4.3 Descriptive Statistics by Sampling Location, Facility 1 .......................................36
4.7 Descriptive Statistics, All Indoor Locations by Sampling Session .......................67
4.8 Descriptive Statistics, All Indoor Locations by Sampling Session, Facility 1 ......68
4.12 ANOVA by Facility ...............................................................................................78
4.13 Tukey by Facility ...................................................................................................79
4.14 ANOVA by Sampling Location, All Facilities ......................................................79
4.15 Tukey by Sampling Location, All Facilities ..........................................................80
4.16 ANOVA by Sampling Location, Facility 1 ..........................................................81
4.17 Tukey by Sampling Location, Facility 1 ...............................................................82
x
4.20 ANOVA by Sampling Location, Facility 3 ...........................................................85
4.24 ANOVA by Sampling Session, All Facilities ........................................................89
4.25 Tukey by Sampling Session, All Facilities ............................................................90
4.26 ANOVA by Sampling Session Facilities 1-4 ........................................................91
4.27 Tukey by Sampling Session, Facility 1 ................................................................91
5.1 Indoor/Outdoor Median PM by Location and Facility ..........................................98
5.2 Indoor Median and Max PM Compared to Guidelines ........................................101
A.1 Facility Summary ................................................................................................112
A.2 Activity Room Description .................................................................................113
A.3 Resident Room Description ................................................................................113
A.4 Rehab/Exercise Room Description .....................................................................113
A.5 Dining Room Description ....................................................................................114
A.6 Satellite Kitchen Description ..............................................................................114
A.7 Main Kitchen Description ...................................................................................114
A.8 Community Space 1 Description ........................................................................115
A.9 Community Space 2 Description ........................................................................115
A.10 Hair Salon Description ........................................................................................115
xi
List of Figures
3-1 TSI DustTrak DRX ................................................................................................19
3-2 TSI P-Trak Model 8525 .........................................................................................20
3-3 TSI Q-Trak Plus Model 7575 ................................................................................21
4-1 Ultrafine Particles (pt/cm3) by Location, Facility 1 ...............................................37
4-2 PM2.5 Concentration (mg/m3) by Location, Facility 1 ...........................................38
4-3 PM10 Concentration (mg/m3) by Location, Facility 1 ............................................39
4-4 TPM Concentration (mg/m3) by Location, Facility 1 ...........................................40
4-6 PM2.5 Concentration (mg/m3) by Location, Facility 2 ..........................................45
xii
4-17 Ultrafine Particles (pt/cm3) by Sampling Location and Facility ...........................62
4-18 PM2.5 Concentrations (mg/m3) by Sampling Location and Facility.......................63
4-19 PM10 Concentrations (mg/m3) by Sampling Location and Facility .......................64
4-20 TPM Concentrations (mg/m3) by Sampling Location and Facility .......................65
4-21 Median Ultrafine Particles (pt/cm3) by Sampling Session and Facility ................74
4-22 Median PM2.5 Concentration (mg/m3) by Sampling Session and Facility.............75
4-23 Median PM10 Concentration (mg/m3) by Sampling Session and Facility .............76
4-24 Median TPM Concentration (mg/m3) by Sampling Session and Facility..............77
xiii
List of Abbreviations
ACGIH .......................American Conference of Governmental Industrial Hygienists

AHU ...........................Air Handling Units
ANOVA .....................Analysis of Variance
ASHRAE....................American Society (of) Heating, Refrigerating, (and) Air-
Conditioning Engineers
CDC ...........................Centers for Disease Control and Prevention

CMS ...........................Center for Medicare and Medicaid Services
COPD .........................Chronic Obstructive Pulmonary Disease
EPA ............................Environmental Protection Agency
HSD............................Honestly Significant Differences

HVAC ........................Heating, Ventilation, and Air Conditioning
IAQ ............................Indoor Air Quality
NAAQS ......................National Ambient Air Quality Standards

NIOSH .......................National Institute for Occupational Safety and Health
OA ..............................Outside Air
OEL ............................Occupational Exposure Limit
OSHA.........................Occupational Safety and Health Administration
PEL ............................Permissible Exposure Limit

PM ..............................Particulate Matter
RH ..............................Relative Humidity
TLV ............................Threshold Limit Value. Used by ACGIH.

TPM ...........................Total Particulate Matter
UFP ............................Ultrafine Particle

US ..............................United States
WHO ..........................World Health Organization
xiv
List of Symbols
º .................................Degrees
< ................................Less than
% ................................percent
a.m. .............................Morning
C .................................Celsius
F .................................Fahrenheit
L/min ..........................Liter/minute
Max ............................Maximum
mg/m3 .........................Milligrams per Cubic Meter of Air
Min .............................Minimum
n..................................Number
p.m. ............................Evening
pt/cm3 .........................Particles per Cubic Centimeters of Air
μg ...............................Micrometers
μg/m3 ..........................Micrometers per Cubic Meter of Air
xv
Chapter 1
Introduction
1.1 Overview
The Environmental Protection Agency (EPA) defines indoor air quality (IAQ)
as “the air quality within and around buildings and structures, especially as it relates to
the health and comfort of building occupants” (EPA, 2016a). It has been shown that air
pollutants are commonly two to five times higher indoors compared to outdoors and
sometimes 100 times greater than outdoor levels (EPA, 2015). It is estimated that 96
percent of homes in the United States (US) have at least one problem with IAQ.
Approximately 85 percent of homes have high levels of particulates and bioaerosols
(Crowder et al., 2007).
IAQ is a priority environmental health concern due to the fact the US population
spends so much time indoors and the health effects that can arise from exposure to these
pollutants (EPA, 2016). Indoor air contaminants can cause acute or chronic health
problems (Bentayeb et al., 2015; Bentayeb et al., 2013; Maio et al., 2015). Previous
research has associated acute health problems such as headache, nausea and respiratory
infection to the quality of the indoor air (Curtis et al., 2006). Chronic health effects of
poor IAQ may include systemic problems such as anemia, heart problems, decreased
1
lung elasticity, and even cancer (Pecingina & Popa, 2014).
Particulate matter (PM) is a mixture of small particles and droplets in the air that
if inhaled causes health problems. Indoor sources of PM come from incomplete
combustion, use of cleaning products, and biological contaminants such as pollen, dust
and fungi. Common PM include dust, dirt, cigarette smoke, soot, or smoke. PM tends to
be higher on warmer days (Katsouyanni, et al., 1993). Relative humidity (RH) has been
associated with increases in PM (Arundel, Sterling, Biggin, & Sterling, 1986). PM
exposure has been linked to heart attacks, aggravated asthma, decrease in lung function,
irregular heartbeat, premature death in people with heart or lung disease, and increases in
respiratory symptoms such as irritation of the air way, coughing, and difficulty breathing
(Bernstein et al., 2008; Bentayeb et al., 2015; Curtis et al., 2006; Bentayeb et al., 2013).
Populations most sensitive to PM are people with lung disease, children and older adults
(EPA, 2016b).
1.2 Significance
In 2014, older adults over the age of 65 comprised 14.5 percent of the US
population (46.2 million Americans), but are projected to more than double to 98 million
in 2060 (Administration on Aging, 2015). Population aging puts pressure on health
systems, increasing the demand for care, services and technologies to prevent and treat
chronic conditions associated with old age. Older adults spend up to 95 percent of their
time indoors and have reduced outdoor activities. As a result, there is potentially more
exposure to indoor environmental contaminants (Bentayeb et al., 2015; Almedia-Silva,
Wolterbeek, & Almeida, 2014; Bernstein et al., 2008). Older adults are a susceptible
population due to: 1) having a compromised immune system; 2) decreased lung function
2
with a predisposition for respiratory infections; and, 3) age-associated health problems
such as heart disease, cancer, or chronic respiratory diseases including chronic
obstructive pulmonary disease (COPD) and asthma (Almedia-Silva, Wolterbeek, &
Almeida, 2014). Older adults are sensitive to short-term PM exposure with a higher risk
of hospitalization and death (EPA, 2017). Recent studies have found that PM levels may
be elevated in nursing homes and this can cause acute and chronic health effects
(Almedia-Silva, Wolterbeek, & Almeida, 2014; Bentayeb et al., 2013).
1.3 Statement of Problem
Limited studies have been conducted related to the indoor environment and long-
term care facilities. These studies have been performed primarily in other countries or in
large urban areas. The quality of nursing home care has been found to be different
between rural and non-rural nursing homes (Lutfiyya, Gessert and Lipsky, 2013).
Nursing homes are measured on a five-star scale from the Centers for Medicare and
Medicaid Services (CMS) nursing home compare website, a publicly available federal
database containing a number of measures of quality (Medicare, 2017). Quality of care
may have an impact on the quality of the indoor environment. The age of the facility
may also have an effect on indoor contaminants (Kike-Parsis, 2004). Measuring PM
levels in nursing homes can assist in determining the potential exposure of older adults to
indoor air pollutants. Understanding the PM levels in nursing homes may allow
identification of controls to decrease PM levels and reduce potential health effects of
occupants exposed to indoor air pollutants.
3
1.4 Hypotheses
The hypotheses examined in the study included the below.
2. H0: There will be no statistically significant difference in the 3-day median
airborne particle (PM2.5, PM10 and TPM) concentrations and Ultra Fine Particle
(UFP) counts indoors between Facilities (Facility 1, Facility 2, Facility 3,
Facility 4).
3. H0: There will be no statistically significant difference in the 3-day median
airborne particle (PM2.5, PM10 and TPM) concentrations and UFP counts
between indoor Sampling Locations (activity room, rehab/exercise room,
dining room, kitchen, satellite kitchen, community space, hair salon).
4. H0: There will be no statistically significant difference in 3-day median
airborne particle concentrations (PM2.5, PM10 and TPM) and UFP counts
indoors between Sampling Sessions (baseline, morning meal time, mid-
morning activity, mid-day meal time, mid-afternoon, late-afternoon, and early-
evening activity).
1.5 Objectives
The objectives of the study were to:
 Identify four long term care facilities and conduct a walkthrough at each;
 Perform air sampling for airborne particle (PM2.5, PM10 and TPM)
concentrations and UFP counts;
 Examine differences between airborne particle concentrations (PM2.5, PM10 and
TPM) and UFP counts between Facilities, Sampling Locations and Sampling
Sessions;
4
 Determine if indoor airborne particle concentrations (PM2.5, PM10 and TPM)
and UFP counts indoors are below outdoor concentrations and counts; and,
 Compare particle concentrations, temperature and relative humidity to
ASHRAE 2010.
5
Chapter 2
Literature Review
2.1 Indoor Air Quality
The EPA defines indoor air quality as “the air quality within and around buildings
and structures, especially as it relates to the health and comfort of building occupants”
(EPA, 2016a). Air quality testing in homes across the United States estimated that 96
percent of homes had at least one problem with IAQ. Up to 85 percent had high levels of
particulates and bioaerosols and up to 71 percent were filled with odors and potentially
harmful chemicals and gases (Crowder et al., 2007).
The most important environment that relates to human health is the indoor
environment because people spend as much at 90 percent of their time indoors (Sundell,
2004). In addition, air pollutants inside are two to five times higher than outside and
sometimes as high as 100 times greater compared to outside air (Hess-Kosa, 2011; EPA,
2016c). Air pollution is “the presence in the atmosphere of a foreign substance
composition of normal or important change in the proportions of its component, which
can be harmful and/or directly or indirectly induce changes on health (Pecingina & Popa,
2014). According to the World Health Organization (WHO, 2016) polluted air is linked
to a variety of health concerns, ranging from short-term irritation to serious diseases or
6
even death. Poor air quality has been shown to exacerbate chronic respiratory diseases,
which are diseases of the airway and lungs (WHO, 2016).
Over the past few decades there has been a decrease in outdoor pollution but an
increase in indoor pollution (Mendes et al., 2013). As people built shelters for living, they
also brought pollutants into their living space (Perez-Padilla, Schilmann, & Riojas-
Rodriguez, 2010). In the 1950’s, the focus on air quality became prominent in the United
States when dealing with industrial air pollution. In the 1960’s, the term environment
changed to a focus on ambient air and industrial surroundings. This caused a shift from
examining all air quality to IAQ. Awareness of IAQ became a concern in the 1970s after
the energy crisis. New requirements for buildings, such as insulated windows, caused
common air contaminants to become trapped (Kike-Parsis, 2004). Starting in 1980
scientists began to understand that crowded buildings could be causing health problems.
Subsequently, the first ventilation standards were initiated (Lillard, 2005). Research is
lacking in the area of IAQ and the health impacts it has older adults, a vulnerable
population (Anneeis-Maesano et al., 2013).
IAQ problems arise from interactions between the building materials, activities
that occur in the building, climate and the building occupants (Kike-Parsis, 2004). These
problems may arise from inadequate temperature, poor ventilation systems, indoor air
contaminants, or from insufficient outdoor air intake (EPA, 2016a). In general, the types
of pollutants that may affect IAQ are biological, chemical, particles and aerosol
pollutants. Biological pollutants include bacteria, fungi, pollen, and animal dander.
Chemical pollutants include adhesives, cleaners, solvents, combustion by-products and
emissions from floor or wall coverings. Particles and aerosols are solids and liquids
7
suspended in air, from dust, construction, smoking, or combustion (EPA, 2016b). For the
purposes of this study, the stressors discussed will include particulate matter, ultrafine
particles and the comfort parameters temperature and relative humidity.
2.2 Particulate Matter
Particulate matter (PM) is a mixture of small particles and droplets in the air that
can cause health problems if inhaled. Some PM are visible while others are not, except
under a powerful electron microscope. The most common sizes are PM0.1 (< 0.1
micrometers), PM2.5 (< 2.5 micrometers), and PM10 (< 10 micrometers). Total particulate
matter (TPM) is all respirable particles. Smaller particles have the greatest health concern
because they can travel deep in the lungs and cause heart and lung disease (Oberdörster,
2000).
The populations most affected by PM exposure are people with lung disease,
children, and older adults (Liu, et al., 2008). Indoor particle events are elevated PM levels
for short periods of time usually caused by a source such as cooking. Particle events have
been associated with an increase in acute health outcomes (Long, Suh, & Koutrakis,
2000). A study by Schlesinger showed a correlation between PM2.5 and an increase in
mortality and morbidity (2007).
Ultrafine particles are particles that are less than 100 nanometers aerodynamic
diameter in size (Oberdörster, 2000). Ultrafine particles are much smaller than cellular
structures and have been associated with adverse health effects because of how deeply
they can penetrate the lungs (Oberdörster, 2000; Peters, et al., 1997).
8
2.3 Indoor PM Sources
Common PM includes dust, dirt, soot, or smoke. Indoor PM sources include
activities such as cooking, cleaning (sweeping or vacuuming), and burning (candles,
smoking, incense) (Nazaroff, 2004; Williams, Creason, Zweidinger, et al., 2000). In
addition, PM can be from general activities such as walking and flailing one’s arms,
which may recirculate particles (Long, Suh, & Koutrakis, 2000); Diapouli et al., 2011).
Research completed by Monn et al. (1997) showed that human activity accounted for
high indoor levels of PM and that cooking on a gas stove had the largest impact on
elevated PM2.5 and PM10 concentrations.
Fine and ultrafine particles are generated in indoor environments through
cooking, smoking or cleaning (Abt et al., 2000). The main source of UFPs is traffic
(Sajani et al., 2015). A tenfold increase in UFPs has been found with cooking (Wallace et
al., 2004). Higher concentrations have been observed during frying and lower during
boiling (Zhang, Ramirez, & Zhu, 2010). It has been suggested that peak concentrations of
UFPs may be more important for determining health effects than long-term average
concentrations (Garrett et al., 1998). It has been shown that outdoor-generated PM2.5 and
UFPs seem to penetrate indoors but PM10 does not (Diapouri et al., 2011). In the absence
of indoor PM sources, indoor concentrations show temporal variations similar to those
outdoors (Laiman et al., 2014).
2.4 Comfort Parameters
Comfort parameters such as temperature and humidity are important in
maintaining good IAQ (Davis, et al., 2016). Thermal comfort is affected by air
temperature, temperature of the surrounding surfaces, air movement, relative humidity,
9
and the rate of air exchange (Ormandy and Ezratty, 2012). Relative humidity (RH) is the
amount of water vapor that the air is holding compared to the amount it can hold at a
specific temperature (Spengler, Samet, & McCarthy, 2001). Temperature and RH have
been shown to increase concentrations of air pollutants because of the dense air holding
the pollutants (Bentayeb et al., 2015).
2.5 Health Effects
Health effects related to poor IAQ depend upon several factors: the effect of each
contaminant, concentration, duration of exposure, and individual sensitivity (Hess-Kosa,
2010). Indoor air contaminants can cause acute or chronic health problems. Acute health
effects are usually from short-term exposure at higher concentrations, whereas chronic
health effects are often long-term exposure at lower concentrations (EPA, 2016c). Acute
health effects have been correlated with peak particle events (Long, Suh, & Koutrakis,
2000); Diapouli et al., 2011). Acute health concerns of exposure to PM are respiratory
issues such as wheezing and coughing (Bentayeb et al., 2015; Bentayeb et al., 2013; Maio
et al., 2015; Curtis et al., 2006).
Chronic effects of PM exposure have been linked to cardiovascular problems,
increased asthma and COPD (Bentayeb et al., 2013; Saldiva, et al., 2002; Curtis et al.,
2006). PM exposure has been linked to premature death in people with heart or lung
disease, heart attacks, a decrease in lung function, and irregular heartbeat (Bernstein et
al., 2008; Bentayeb et al., 2015; Curtis et al., 2006; Bentayeb et al., 2013). PM exposure
has been linked to an increase in hospital admissions (Bernstein, et al., 2008). Research
by Peters et al. (1997) showed that when there were high levels of UFPs people who had
asthma had a decrease in peak respiratory flow. Early signs of atherosclerosis and
10
systemic oxidative stress have also been associated with exposure to UFPs (Araujo et al.,
2008). Environmental tobacco smoke, which contains particles and chemicals, is
associated with an increased risk of coronary artery disease, asthma, and admissions to
the hospital for respiratory related illnesses (Dales, Liu, & Wheeler, 2008; Bentayeb et
al., 2008).
Aging may lead to a compromised immune system and decreased lung functions,
with a predisposition for respiratory infections. As people age, they also tend to have an
increased incidence of chronic respiratory diseases such as COPD and asthma. Older
adults are sensitive to short-term PM exposure with a higher risk of hospitalization and
death (EPA, 2017). One way to help with the control of these acute and chronic illnesses
is to better understand the health consequences associated with IAQ (Bentayeb, et al.,
2013).
Temperature is a concern in older adults because their bodies do not adjust to
temperature as well as younger, healthy adults and they can have difficulty controlling
body temperature. Older adults tend to prefer it warmer than other individuals, around
25C in the summer and 23C in the winter (Davis, McGregor, & Enfield, 2016). Older
adults also have decreased perspiration making it difficult to cool the body (Klenk,
Becker, & Rapp, 2010). Temperature and RH have been linked to several health issues
including pulmonary disease. An increase in relative humidity has been linked to
wheezing and an increase in hospital admissions among older adults (Davis, et al., 2016).
2.6 Control of IAQ
Poor building ventilation can cause an accumulation of contaminants within the
indoor environment. Ventilation is the process of supplying a building or room with fresh
11
air (EPA, 2016a). The purpose of ventilation in buildings is to provide healthy air by
diluting and removing pollutants from a building (Etheridge & Sandber, 1996). Elements
of building ventilation include ventilation rate and air flow direction and distribution. The
ventilation rate is the amount of outdoor air that is provided into a given area. Airflow
direction is the overall direction the air is flowing in the building, which should be from a
clean to a dirty environment. Air distribution ensures air is distributed evenly, instead of
into only one area (Atkinson, et al., 2009). According to the Occupational Safety and
Health Administration (OSHA), ventilation is the most important engineering control for
maintaining and improving IAQ. Inadequate ventilation and poor maintenance was the
main issue in over 50 percent of IAQ investigations conducted by the National Institute
for Occupational Safety and Health (NIOSH) (OSHA, 1999). Knowing and controlling
common indoor air pollutants can help decrease the risk of indoor health concerns (EPA,
2016a). Other methods of controlling IAQ are to eliminate the source of the pollution,
conserve energy, use energy efficient appliances, and choose environmentally friendly
cleaners (New Hampshire Department of Environmental Services, 2015).
2.7 IAQ Guidelines
There are few established national or mandatory limits for indoor air quality
contaminants in non-industrial environments, however there are guidelines. The
American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE)
has guidelines to help monitor and control a healthy living environment: Standard 55,
Thermal Environmental Conditions for Human Occupancy, and Standard 62, Ventilation
for Acceptable Air Quality.
12
The purpose of ASHRAE Standard 55 is “to specify the combinations of indoor
space environment and personal factors that will produce thermal environmental
conditions acceptable to 80 percent or more of the occupants within a space.” The
operating temperatures recommended by ASHRAE 55 (2010) range from 23 to 28C (74
to 82F) in summer and 20 to 25.5C (68 to 78F) in winter. Clothing selection accounts for
the main difference in temperature ranges between seasons. It is recommended that
indoor relative humidity be between 30 and 65 percent per ASHRAE (2010).
ASHRAE Standard 62 recommends pollutants in indoor air should not exceed the
EPA’s National Ambient Air Quality Standards (NAAQS) levels. The NAAQS are used
to protect the public health from six criteria pollutants, including particulate matter (EPA,
2016a). This equates to a maximum exposure limit for PM10 of 0.15 mg/m3 for a 24-hour
mean. EPA NAAQS for PM2.5 is 35 μg/m3 for a 24-hour mean (EPA, 2016b).
Currently, there are no standards or guidelines for UFPs. While threshold limits
for UFPs are under discussion, a challenge is determining the appropriate exposure
metrics (Lehnert et al., 2012).
While we have OSHA Permissible Exposure Levels (PEL) and American
Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Values
(TLV), those are primarily intended for industrial environments (Burton, 2017). Over the
years, Burton has compiled data suggested by agencies or associations such as OSHA,
ASHRAE, NIOSH, WHO and EPA regarding “typical,” and “trigger” conditions. A
“trigger” suggests a range of actions, from “take note” to “investigate” to “correct”
depending on professional judgement (Burton, 2017). The trigger condition for PM2.5 is
>0.015 mg/m3 and Total Particulate Matter (TPM) is >0.050 mg/m3.
13
2.8 Long Term Care Environments
In many countries, the aging population is a major challenge. In 2014, older adults
over the age of 65 comprised 14.5 percent of the United States population (46.2 million
Americans), but are projected to more than double to 98 million in 2060 (Administration
on Aging, 2015). Population aging puts pressure on health systems, increasing the
demand for care, services and technologies to prevent and treat chronic conditions
associated with old age. Annually, 8,357,100 people receive support from five main long-
term care services; home health agencies (4,742,500), nursing homes (1,383,700),
hospices (1,244,500), residential care communities (713,300) and adult day service
centers (273,200) because of a chronic illness or disabling condition (CDC, 2013). The
average person spends up to 90 percent of their time indoors, but many older adults have
reduced outdoor activities and may spend more time indoors. As a result, they may
potentially be exposed to even more indoor environmental air contaminants (Bentayeb et
al., 2015; Almedia-Silvaet al., 2014; Bernstein et al., 2008).
Research has been completed on how different types of building characteristics
may impact indoor air quality in nursing homes and elderly care centers. Mendes et al.
(2014) completed a study examining how windows, walls and ceiling, type of ventilation,
air conditioner status, and roof lining affected PM, carbon dioxide, temperature, and RH
within elderly care centers. PM10 was affected by the types of window, sealants, and
types of window frames used. PM2.5 was affected by insulation, ventilation type, and
flooring. The number of building occupants, ventilation type, wall insulation type, roof
lining, window types and frames, glass type, and flooring affected temperature. Relative
humidity was affected by building occupancy, wall insulation, roof lining, ventilation
14
type, window types, and flooring. Overall the building design and occupancy greatly
influenced the amount of different pollutants present.
2.9 IAQ in Long Term Care Facilities
Little research has been completed in regards to older adults and their exposure to
IAQ contaminants. The following section will discuss the indoor air quality research that
has been completed in long-term care facilities.
A pilot study done by Williams, Creason, Zweidinger et al. (2000) was conducted
to look at potential PM exposure among elderly subjects living at a retirement facility in
Baltimore, MD. The elderly subjects were sedentary and spent 96 percent of their time
inside. Results suggested PM2.5 was the dominant outdoor size fraction. Findings
indicated elderly subjects were compliant with wearing personal samplers to measure PM
exposure. Daily personal exposures of PM1.5 ranged from 12 to 58 µg/m3. PM
concentrations were suggested to be affected by various activities including crafts, café
dining, travel, cleaning and time spent in a hair salon.
Williams and colleagues completed a two-part study in Baltimore on particulate
matter exposure with an elderly population. Part one examined daily 24-hour integrated
PM2.5 and PM10 from residential central indoor, individual apartment and residential
outdoor and ambient monitoring locations (Williams, Suggs, Zweidinger et al., 2000).
The average daily central indoor and individual apartment PM concentrations were
approximately 10 μg/m3. The mean outdoor and ambient PM2.5 concentrations were 22
μg/m3. Indoor and personal PM2.5 concentrations appeared to be strongly influenced by
outdoor PM penetration rather than typical generating activities such as cooking and
tobacco smoking.
15
Part two of the Baltimore study examined the variability of 24-hr personal PM
exposure among the elderly population (Williams, Suggs, Creason, et al., 2000). Subjects
reported spending 92 percent of their time within the retirement center, 76 percent in their
apartment and 16 percent inside other people’s apartments. The mean of the daily PM2.5
personal concentrations was 12.9 μg/m3. Residents rarely left these facilities because they
offered many internal amenities. This fact, along with the low activity level of the
subjects, influenced personal PM exposures.
A study done by Rhodes et al. (2001) evaluated personal PM2.5 and PM10
exposure and the indoor and outdoor concentrations at three different retirement centers
(one in Baltimore and two in Fresno) over winter and summer months. Overall, the levels
of PM2.5 and PM10 were lower inside compared to levels outside, suggesting the Heating,
Ventilation, and Air Conditioning (HVAC) system was effective in removing particles
from the environment. There were higher concentrations of PM10 indoors compared to
PM2.5. Higher concentrations of PM2.5 were found indoors during the summer, when the
windows were open. However, PM10 levels remained consistent throughout the seasons,
suggesting PM10 does not penetrate through open doors and windows. The most
important factors affecting indoor PM concentrations were particle generation from
activities such as cooking and walking on the carpet, the type of HVAC unit, and how
often the windows or doors were open and closed.
Almeida-Silva, Wolterbeek, and Almeida (2014) completed a study on elderly
exposure to indoor air pollutants in living rooms and bedrooms in elderly care centers.
PM of different sizes (0.3-0.5, 0.5-1, 1-2.5, 2.5-5, and 5-10 µg), carbon monoxide and
carbon dioxide were evaluated. Residents spent approximately 95 percent of their time
16
indoors, with 57 percent in the bedroom and 30 percent in the living room. PM was
significantly higher in the living room compared to the bedroom. It was observed that
older adults performed more tasks that could promote the re-suspension of particles in the
living room. In addition, there were peaks in PM levels in the living room area during
meals. In general, there were higher levels of air contaminants during the winter
compared to summer (Almedia-Silva, Wolterbeek, & Almeida, 2014).
Mendes et al. (2014) examined indoor air pollutants, including PM2.5 and PM10,
and building characteristics in elderly care facilities in Portugal. Monitoring was
conducted in the dining room, drawing room, medical offices, and bedrooms. PM2.5
exceeded EPA NAAQS standards in winter and summer. Among indoor areas, levels of
PM2.5 were highest in the drawing rooms and were affected by ventilation characteristics.
PM10 levels were higher in the dining room and the drawing room. PM10 was affected by
window characteristics, suggesting PM10 can enter the building more readily with open
windows and doors.
Akbar-Khanzadeh, Windom, & Golbabaei (2011) studied the effectiveness of
designated smoking rooms to control environmental tobacco smoke (ETS) in nursing
homes in northwest Ohio. Three locations (a designated smoking room with an
independent ventilation system, the adjacent hallway and outside the building) within
three nursing homes were monitored for carbon monoxide, carbon dioxide, respirable
suspended particulate matter, nicotine and solanesol. Compared to the adjacent hallways
and outdoors, concentrations of air contaminants (except CO2) were significantly higher
in the designated smoking rooms. These results demonstrate the effectiveness of an
independent ventilation systems on reducing ETS associated contaminant levels.
17
Chapter 3
Methods
3.1 Overview
Air sampling was conducted at four long term care facilities in Ohio. The focus of
the air sampling was in the nursing home section of the care facilities. Two of the
facilities selected were older buildings, while two were newer buildings. The sampling
occurred in up to nine indoor Sampling Locations, one outdoor smoking location (if
present) and one outdoor Sampling Location for comparison purposes at each facility.
Measurements were collected during seven time periods (Sampling Sessions) throughout
the day, representing baseline and peak activities. Indoor and outdoor air was sampled for
particulate matter (PM2.5, PM10, and TPM), ultrafine particle counts, temperature and
relative humidity. Concentrations and counts of particles were compared between
Facilities, Sampling Locations and Sampling Sessions. Comparisons were made between
temperature, relative humidity and indoor and outdoor concentrations of particles to
indoor air guidelines.
3.2 Sampling Equipment
Particle concentrations at various sizes were measured using TSI DustTrak DRX
Aerosol Monitor (Model 8533); ultrafine particulate counts were measured with a TSI P-
18
Trak Ultrafine Particle Counter (Model 8525), and temperature and humidity were
measured using a TSI Q-Trak Indoor Air Quality Monitor (Model 7575 (TSI, Inc.,
Shoreview, MN).
The DustTrak DRX (Figure 3.1) simultaneously measures mass and size fraction
corresponding to PM2.5, PM10 and TPM. The instrument uses a 90º light scattering laser
photometer which provides the mass concentration of a photometer and size resolution of
an optical particle counter. The pump flow rate is 3.0 L/min with a flow accuracy of ±5%
of the factory set point, internal flow controlled. The aerosol concentration range is 0.001
to 150 mg/m3 and the particle size range is 0.1 to 15 µm. The resolution of the instrument
is ±0.1% of reading or 0.001 mg/m3, whichever is greater. A zero-calibration check was
performed prior to each use of the instrument using a zero filter.
Figure 3-1: TSI DustTrak DRX.
The TSI P-Trak Plus Model 8525 measured the number of ultrafine particles per
cubic centimeter of air (pt/cm3). An ultrafine particle has a diameter less than 0.1 µm.
The P-Trak provides one second averages of ultrafine particulate matter in pt/ cm3. The
P-Trak’s has a sampling range from 0 to 50,000 pt/cm3. The P-Trak is able to capture and
measure ultrafine particles ranging from 0.02μm - 1μm in aerodynamic diameter. The
19
flow rate for the unit is approximately 100 cm3/min. The unit uses an isopropyl alcohol
wick to grow UFP into larger, easier to count droplets. The instrument was zeroed prior
to each use in accordance with manufacturer’s instructions.
Figure 3-2: TSI P-Trak Model 8525.
The Q-Trak simultaneously measured temperature and relative humidity using an
IAQ probe. Temperature was measured using a thermistor sensor with a range of 32 to
140°F (0 to 60°C). The accuracy was ±1.0°F (0.5°C) and the resolution was 0.1°F
(0.1°C). The response time was 30 seconds. Relative humidity was measured using a
thin-film capacitive sensor with a range of 5 to 95 percent. The accuracy was ±3%
relative humidity and the resolution was 0.1% relative humidity. The response time was
20 seconds. Both temperature and relative humidity affect PM. A dry environment may
allow for more re-suspension of PM and skin becomes drier, which may lead to more
PM.
20
Figure 3-3: TSI Q-Trak Plus Model 7575.
3.3 Facilities
Data were collected at four long term care facilities during fall of 2016. Data
collection occurred at each facility on two days during the week and one day on the
weekend, for a total of three days at each facility. All facilities were located in northwest
Ohio. Facility 1 was a two-story building constructed in 1992 and the nursing home had
32 beds. Data at Facility 1 were collected indoors on the second floor and outdoors at
ground level. Facility 2 was a one-story building constructed in 1966 with 54 beds in the
nursing home. Data at Facility 2 were collected on the first floor. Facility 3 was a two-
story building constructed in 1930, with 29 beds in the nursing home. Data at Facility 3
were collected on both the first and second floor indoors and on the ground level
outdoors. Facility 4 was a one-story building constructed in 2013 and the nursing home
had 60 beds. All indoor and outdoor data were collected on the first floor at Facility 4.
21
3.3.1 Sampling Locations
Each Facility was sampled on 3 separate days for a total of twelve sampling days.
There were multiple fixed Sampling Locations sampled throughout the facilities, nine
indoor and two outdoor, as available:
1. Activity Room: Art and crafts that occur in these rooms, such as ceramics,
have been reported to affect PM concentrations (Williams, Creason,
Zweidinger et al., 2000);
2. Private Resident’s Room: PM has demonstrated to be higher in the
bedroom compared to the living room (Almedia-Silva, Wolterbeek, &
Almeida, 2014) and up to 80 percent of the residents’ time can be spent in
their bedroom (Williams, Suggs, Zweidinger, et al., 2000);
3. Rehabilitation/Exercise Room: PM can be increased due to action taking
place in a room causing the resuspension of particles (Diapouli et al.,
2011). A rehabilitation/exercise space has people constantly moving as
they receive treatment and use exercise equipment;
4. Dining Room: PM has been shown to be higher if there is a door or
window connected to the kitchen (Anneis-Maesano, et al., 2013) and up to
5 percent of the residents’ time may be spent in the dining room areas
(Williams, Creason, Zweidinger, et al., 2000);
5. Kitchen: Cooking is a contributor to indoor air pollution (Broich et al.,
2012; Ozkaynak et al., 1996); PM2.5 and ultrafine particles are both
produced by gas and electric burners and by cooking (Wallace et al.,
2004);
22
6. Satellite Kitchen: Although smaller in size, this location is believed to
have indoor air similar to the kitchen which may be elevated since cooking
is a contributor to indoor air pollution (Broich et al., 2012; Ozkaynak et
al., 1996);
7. Community Space: Almost all of the residents’ time may be spent in the
community rooms/spaces if they are not in their private room (Williams,
Suggs, Zweidinger, et al., 2000);
8. Community Space 2: Some facilities have more than one community
space where residents spend time throughout the day;
9. Hair Salon: Reported to have high PM levels due to the use of hair
products (Williams, Suggs, Creason, et al., 2000);
10. Outdoor smoking area (if available): Environmental tobacco smoke is a
source of PM (Invernizzi et al., 2002; Akbar-Khanzadeh, Windom, &
Golbabaei, 2011); and,
11. Outdoors: Research has shown that as the PM outside increases so does
the PM inside (Williams, Creason, Zweidinger, et al., 2000). This will
serve as the background.
3.4 Sampling Sessions
Sampling times were selected in an attempt to collect data during potential high
activity and a time of minimal activity for the baseline. The seven time windows
(Sampling Sessions) included:
23
1. Baseline: approximately 6:00-7:00 a.m.;
2. Morning meal time: approximately 8:00-9:00 a.m. depending on the
facility; residents getting up, dressed and eating breakfast;
3. Mid-Morning activity: approximately 10:00-11:00 a.m.; residents
participating in activities, therapy or interaction with other residents in
community spaces;
4. Mid-day meal time: approximately 11:30 a.m.-12:30 p.m.; residents eating
in own room or in dining room area;
5. Mid-afternoon: approximately 1:30-2:30 p.m.; residents participating in
activities, therapy or interacting in community spaces.
6. Late-afternoon: approximately 3:00-4:00 p.m.; residents in own room or
community area; and,
7. Early-evening activity: approximately 4:30-5:30 p.m.; residents are eating
in own room or dining room area, visiting with guests, or participating in
activities.
3.5 Sampling Procedures
All equipment calibrations were performed following the manufacturers’
instructions. The DustTrak and P-Trak were zeroed using a zero filter before and after
each sampling event. All instruments were placed on a rolling cart at approximately
breathing height while sitting (3.5 feet). The inlets of all instruments were placed away
from all walls and corners and faced the center of the room where the occupants were
located during sample collection. Each instrument was programmed to collect a 2-minute
average sample, which were displayed on the screens of each instrument. The resulting
24
values were documented on a sampling form and saved in the instrument memory. One
form was used to document all sampling data including location, time, temperature,
relative humidity, UFP, and PM.
The number of individuals present, open windows or doors, presence of carpet in
the area, and activities being performed (cooking, eating, playing games) during sampling
was documented. Outdoor samples were taken outdoors away from doors or traffic. Any
potential contributing sources of contaminants (vehicle emissions, environmental foliage,
dust or gravel from parking lots) were documented. Weather conditions were also
recorded.
3.6 Facility Observation
A walkthrough of each facility was performed to collect information specific to
each indoor location. Information collected included: physical description, primary use,
occupancy, square footage, flooring type, wall construction, number of windows, any
evidence of water damage and any odors. General information about the remodeling,
heating, ventilation and air conditioning at each facility was obtained from each facility
manager.
3.7 Data Analysis
All data were downloaded and exported into excel from TrakPro, the TSI
instrument software. Data were merged into one SPSS file for analysis.
Descriptive statistics were used to summarize the median, minimum and
maximum particle concentration and counts by Facility, Sampling Location and
Sampling Session. The distribution of the particle data was not normally distributed and
this data was log transformed. Analysis of variance (ANOVA), a parametric test, was
25
used to determine whether there were any statistically significant differences between the
means of two or more independent groups (Facility, Sampling Location, Sampling
Session). The Tukey honestly significant difference (HSD) post hoc test, a conservative
test, was performed on significant ANOVA findings to identify statistically significant
pairwise differences between Facilities, Sampling Locations or Sampling Sessions. An
alpha of 0.05 was used for all analyses.
Indoor PM concentrations and UFP counts were compared to outdoor levels.
Resulting data were compared to indoor air quality guidelines related to comfort
parameters and particulate matter.
26
Chapter 4
Results
4.1. Overview
A total of four facilities were sampled three separate days over Fall of 2016. Up to
nine indoor locations were sampled, representing the various occupied spaces in each
nursing home. An Outdoor smoking location was sampled when available. An Outdoor
background location was sampled for comparison purposes.
This chapter will present the results of the sampling, descriptive and statistical
tests by Facility, Sampling Location and Sampling Session. The particle, temperature and
relative humidity levels measured were all within the working range of associated
instruments. The distribution of the particle data was not normally distributed.
Descriptive data presents the median, minimum and maximum. Statistical tests were
performed on the log transformed data.
4.2. Description of Facilities
Facility 1 was a two-story building originally constructed in 1992 and remodeled
in 2015. The facility was located in a suburban area away from major traffic. The nursing
home section was on the second floor with 32 beds. The nursing home was dry wall and
all rooms were carpeted except the kitchen (vinyl tile), rehab/exercise room (hardwood),
27
and hair salon (vinyl tile). The facility allowed pets; however, domesticated animals were
only present one day over one Sampling Session. The housekeeping schedule was 7:00
a.m. to 3:30 p.m. each day and included changing linens, vacuuming, washing dishes,
sweeping, and cleaning the bathrooms.
Facility 1 had twelve air handling units (AHUs) on the roof that operated
continuously. Associated filters are replaced quarterly. The nursing home recirculated air
in all areas except the satellite kitchen, which used 100 percent outside air (OA).
Facility 2 was a one-story building originally constructed in 1966 and a
rehabilitation center was added in 2009. The facility was located in an urban area on a
busy street. The nursing home section had 54 beds. The entire nursing home section of
the facility was dry wall and the flooring was vinyl tile. The facility did not allow
resident pets. The housekeeping schedule was 7:00 a.m. to 4:00 p.m. each day and
included mopping, sweeping, changing linens, washing dishes, and cleaning the
bathrooms.
Facility 2 had 6 AHUs on the roof that were continuously operated using 100
percent OA. Associated pleated filters were changed monthly. A boiler system provided
heat at the facility and was operational during the last two days of sampling.
Facility 3 was a two-story building constructed in 1930. The facility was located
in a urban area away from major streets. The nursing home section was on the second
floor and had 29 beds, while the hair salon, activities room, rehab/exercise space, and
kitchen were located on the first floor. The nursing home section of the facility was dry
wall. Vinyl tile was present in the kitchen, hair salon, rehab/exercise room, and satellite
;kitchen; wood flooring was present in the activities room; while the remainder of the
28
facility was carpeted. Residents were permitted to have pets; however, none were present
during sampling. In addition, birds were present in a glass cage on the first floor and a
resident cat roamed the space on the first floor. The facility was cleaned each day by the
staff and included changing linens, vacuuming, washing dishes, sweeping, and cleaning
the bathrooms.
Facility 3 had rooftop AHUs were continuously operational at Facility 3 using 50
percent OA. Associated two-inch pleated filters were changed quarterly.
Facility 4 was a one-story building constructed in 2013 and the most recent
remodeling event occurred 2015. The facility was located in a rural area surrounded by
agricultural fields. There was a major highway less than a mile away from the facility.
The nursing home section had 60 beds. The facility had an open concept, with the
community space and dining room all in one shared space. Vaulted ceilings were present
in the shared open space. The entire facility was dry wall and carpeted except for the
kitchen. Although the facility does allow pets, none were present during sampling. The
housekeeping schedule was 7:00 a.m. to 3:30 p.m. each day and included changing
linens, vacuuming, washing dishes, sweeping, and cleaning the bathrooms.
Facility 4 had 16 AHUs on the roof using 100 percent outside air. Associated
filters were changed monthly.
Tables summarizing characteristics of the indoor locations sampled and general
ventilation information are included in Appendix A.
29
4.3. Descriptive Statistics All Indoor Locations by Facility
Table 4.1 shows the descriptive statistics for all indoor locations by Facility. The
number of sampling points by Facility ranged from 115 to 155. Differences in sampling
number were due to the number of indoor locations sampled and accessibility. The
temperature ranged from 64.3 to 80.9F in the four facilities, while relative humidity
ranged from 15.5 percent to 74.8 percent. The highest median count of ultrafine particles
(10,546 pt/cm3) was in Facility 2. The median concentration of particulate matter was
highest in Facility 2: PM2.5 (0.012 mg/m3), PM10 (0.013 mg/m3) and TPM (0.02 mg/m3).
30
Table 4.1: Descriptive Statistics All Indoor Locations by Facility
n Median Minimum Maximum

Facility 1
3
UFP (pt/cm ) 128 2,769 362 93,790
3
PM2.5 (mg/m ) 128 0.005 0.001 0.160
3
PM10 (mg/m ) 128 0.008 0.001 0.403
3
TPM (mg/m ) 128 0.015 0.001 0.595
Temperature (F) 128 76.2 64.3 80.9
Relative Humidity (%) 128 35.0 15.5 54.4
Facility 2
3
UFP (pt/cm ) 154 10,546 1,186 314,083
3
PM2.5 (mg/m ) 154 0.012 0.003 0.101
3
PM10 (mg/m ) 154 0.013 0.001 0.142
TPM (mg/m3) 154 0.02 0.005 0.188
Temperature (F) 154 75.4 69.6 79.0
Facility 3
3
UFP (pt/cm ) 155 2,698 625 315,108
PM2.5 (mg/m3) 155 0.005 0.002 0.055
3
PM10 (mg/m ) 155 0.008 0.002 0.105
3
TPM (mg/m ) 155 0.013 0.002 0.188
Temperature (F) 155 74.3 69.2 79.9
Facility 4
UFP (pt/cm3) 115 3,963 420 222,691
3
PM2.5 (mg/m ) 115 0.008 0.001 0.027
3
PM10 (mg/m ) 115 0.009 0.001 0.033
3
TPM (mg/m ) 115 0.012 0.001 0.066
Temperature (F) 115 73.2 69.9 79.0
4.4. Descriptive Statistics by Sampling Locations, All Facilities
Descriptive statistics were calculated separately for each Sampling Location. The
median, minimum and maximum values for each location and all facilities are presented
in Table 4.2. The highest indoor median of ultrafine particles in all facilities was seen in
the Satellite Kitchen (14,101 pt/cm3; min-max 1,493-315,108 pt/cm3), followed by the
31
Community Space (9,099 pt/cm3; min-max 2,978-49,641 pt/cm3) and Hair Salon (8,711
pt/cm3; min-max 2,627-51,026 pt/cm3). The lowest indoor median UFP was seen in the
Activity Room (2,421 pt/cm3; min-max 366-18,807 pt/cm3).
The Hair Salon had the highest indoor median concentration of PM2.5 (0.021
mg/m3; min-max 0.003-0.16 mg/m3), PM10 (0.024 mg/m3; min-max 0.006-0.403 mg/m3)
and TPM (0.032 mg/m3; min-max 0.010-0.595 mg/m3), followed by the Community
Space, PM2.5 (0.013 mg/m3; min-max 0.001-0.032 mg/m3), PM10 (0.016 mg/m3; min-max
0.001-0.04 mg/m3) and TPM (0.025 mg/m3; min-max 0.016-0.051 mg/m3). The
Rehab/Exercise Room had the lowest indoor median concentration of PM2.5 (0.005
and TPM (0.009 mg/m3; min-max 0.001-0.083 mg/m3). The Outdoor median
concentrations of PM2.5, PM10 and TPM were 0.011 mg/m3, 0.014 mg/m3, and 0.015
mg/m3 respectively, which were lower than the highest median indoor concentrations.
The indoor median temperature ranged from 73.3F in the kitchen to 77.2F in the
Community Space and the indoor median relative humidity ranged from 33.1 percent in
the Satellite Kitchen to 50.7 percent in the Community Space. The median Outdoor
temperature was 53.3F, while the median Outdoor relative humidity was 53.6 percent.
32
Table 4.2: Descriptive Statistics by Sampling Location, All Facilities
Rehab
Activity Private Dining Satellite Community Community Hair Outdoor
/Exercise Kitchen Outdoors
Room Room Room Kitchen Space Space 2 Salon Smoking
Room
n 63 73 78 83 63 62 83 20 27 82 42
UFP (pt/cc)
Median 2,421 2,529 2,603 4,764 5,234 14,101 3,413 9,099 8,711 5,167 5,547
Min 366 399 362 440 517 1,493 410 2,978 2,627 773 1,671
Max 18,807 57,945 17,099 93,790 314,083 315,108 75,521 49,641 51,026 66,849 39,739
PM2.5 (mg/m3)
Median 0.006 0.007 0.005 0.008 0.010 0.01 0.007 0.013 0.021 0.011 0.014
Min 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.006 0.003 0.001 0.001
Max 0.101 0.028 0.025 0.034 0.028 0.117 0.033 0.032 0.160 0.078 0.082
PM10 (mg/m3)
Median 0.010 0.010 0.006 0.010 0.011 0.012 0.009 0.016 0.024 0.014 0.016
Min 0.002 0.001 0.001 0.001 0.001 0.001 0.001 0.001 0.006 0.001 0.002
Max 0.142 0.037 0.028 0.038 0.039 0.162 0.038 0.040 0.403 0.126 0.100
TPM (mg/m3)
Median 0.016 0.016 0.009 0.015 0.015 0.014 0.014 0.025 0.032 0.015 0.018
Min 0.003 0.001 0.001 0.002 0.001 0.001 0.001 0.016 0.010 0.001 0.002
Max 0.153 0.052 0.053 0.051 0.068 0.169 0.046 0.051 0.595 0.129 0.102
Temperature (F)
Median 75.6 76.4 74.5 74.7 73.3 74.2 74.4 77.2 75.8 53.3 62.2
Min 69.9 69.9 69.6 70.1 69.2 64.3 71.2 76.5 71.9 29.3 26.8
Max 80.4 79.9 78.8 79.0 77.2 78.8 78.4 79.0 80.9 77.5 77.4
Relative Humidity (%)
Median 39.2 34.9 35.4 35.6 40.3 33.1 34.2 50.7 47.0 53.6 56.0
Min 16.6 16.3 15.5 18.3 22.1 19.2 17.7 39.2 25.7 27.6 40.5
Max 57.5 55.9 74.8 57.9 56.4 53.7 56.1 57.4 55.0 85.1 89.0
33
4.5. Descriptive Statistics by Sampling Location and Facility
Descriptive statistics were calculated by Sampling Location for each Facility. The
tables and figures by Sampling Location and Facility are summarized in Sections 4.5.1 to
4.5.4.
4.5.1. Descriptive Statistics by Sampling Location, Facility 1
The median, minimum and maximum values for each Sampling Location at
Facility 1 are presented in Table 4.3. Figures 4-1 to 4-4 present boxplots graphically
illustrating the UFP counts and PM concentrations by Sampling Location for Facility 1.
Outliers are values that are 1.5 times the interquartile range and extreme values are values
that are 3 times the interquartile range. The number of sampling points by room ranged
from 3 to 21. Differences in sampling number were due to accessibility.
The highest indoor median counts of ultrafine particles in Facility 1 were in the
Satellite Kitchen (12,663 pt/cm3; min-max 2,723-57,120 pt/cm3), followed by the Dining
Room (4,764 pt/cm3; min-max 440-93,970 pt/cm3) and Hair Salon (4,607 pt/cm3; min-
max 2,950-4,819 pt/cm3). The lowest indoor median count for ultrafine particles was in
the Private Room (1,781 pt/cm3; min-max 399-9,338 pt/cm3). The Outdoor median UFP
was 3,628 pt/cm3.
The Hair Salon had the highest indoor median concentrations of PM2.5 (0.026
and TPM (0.044 mg/m3; min-max 0.037-0.595 mg/m3), followed by the Satellite Kitchen,
PM2.5 (0.017 mg/m3; min-max 0.002-0.117 mg/m3), PM10 (0.021 mg/m3; min-max 0.002-
0.162 mg/m3) and TPM (0.023 mg/m3; min-max 0.002-0.169 mg/m3). The Activity
Room, Private Room, Rehab/Exercise Room and Community Space had the lowest
34
median concentration of PM2.5 (0.004 mg/m3; min-max 0.001-0.025 mg/m3). The
Rehab/Exercise Room and Community Space had the lowest median concentration of
PM10 (0.005 mg/m3; min-max 0.001-0.027 mg/m3), while the Rehab/Exercise Room had
the lowest median concentration of TPM (0.006 mg/m3; min-max 0.001-0.029 mg/m3).
The Outdoor median concentrations of PM2.5 (0.003 mg/m3; min-max 0.001-0.029
mg/m3), PM10 (0.006 mg/m3; min-max 0.002-0.031 mg/m3) and TPM (0.006 mg/m3; min-
max 0.002-0.033 mg/m3) were lower than the highest and lowest median indoor
concentrations at Facility 1.
The indoor median temperature at Facility 1 ranged from 73.5F in the Satellite
Kitchen to 80.1F in the Hair Salon. The indoor median relative humidity ranged from
34.2 percent in the Activity Room to 51.7 percent in the Hair Salon. The median Outdoor
35
Table 4.3: Descriptive Statistics by Sampling Location, Facility 1
Rehab/
Activity Private Dining Satellite Community Outdoor
Exercise Hair Salon Outdoors
Room Room Room Kitchen Space Smoking
Room
n 21 21 21 21 20 21 3 21 21
UFP (pt/cm3)
Median 1654 1781 3254 4764 12663 2521 4607 3628 5203
Min 366 399 362 440 2723 410 2950 1656 2215
Max 9084 9338 12271 93790 57120 42852 4819 7354 15829
PM2.5 (mg/m3)
Median 0.004 0.004 0.004 0.006 0.017 0.004 0.026 0.003 0.004
Min 0.001 0.001 0.001 0.001 0.002 0.001 0.025 0.001 0.001
Max 0.015 0.015 0.025 0.034 0.117 0.017 0.16 0.029 0.025
PM10 (mg/m3)
Median 0.008 0.006 0.005 0.008 0.021 0.005 0.032 0.006 0.005
Min 0.003 0.001 0.001 0.001 0.002 0.001 0.031 0.002 0.002
Max 0.019 0.023 0.027 0.038 0.162 0.018 0.403 0.031 0.029
TPM (mg/m3)
Median 0.018 0.012 0.009 0.018 0.023 0.012 0.044 0.006 0.006
Min 0.009 0.001 0.001 0.002 0.002 0.001 0.037 0.002 0.002
Max 0.038 0.038 0.029 0.051 0.169 0.024 0.595 0.033 0.032
Temperature (F)
Median 77.1 77.3 76.1 76.1 73.5 75.8 80.1 50.1 49.0
Min 72.9 72.7 72.1 72.6 64.3 71.2 79.3 29.3 26.8
Max 80.4 79.8 78.8 78.6 76.1 78.4 80.9 74.0 76.4
Median 34.2 34.3 35.0 34.8 42.4 36.1 51.7 61.4 61.2
Min 16.6 17.1 15.5 18.3 19.2 17.7 51.1 27.6 40.5
Max 50.8 50.0 48.9 50.5 52.8 54.4 52.5 85.1 89.0
36
o
= outliers; * = extreme values
Figure 4-1: Ultrafine Particles (pt/cm3) by Location, Facility 1
37
o
Figure 4-2: PM2.5 Concentration (mg/m3) by Location, Facility 1
38
o
Figure 4-3: PM10 Concentration (mg/m3) by Location, Facility 1
39
o
Figure 4-4: TPM Concentration (mg/m3) by Location, Facility 1
40
Facility 2 are presented in Table 4.4. Figures 4.5 to 4.8 graphically illustrate UFP counts
and PM concentrations by Sampling Location for Facility 2. The number of sampling
points by room ranged from 12 to 21, based on accessibility.
The highest indoor median UFP count in Facility 2 was in the Kitchen (70,790
pt/cm3; min-max 5,466-314,083 pt/cm3) followed by the Dining Room (16,647 pt/cc;
min-max 5,063-89,107 pt/cm3). The lowest indoor UFP was in the Rehab/Exercise Room
(2,294 pt/cm3; min-max 1,186-17,099 pt/cm3). The Outdoor median UFP was 6,369
pt/cm3.
mg/m3; min-max 0.009-0.056 mg/m3), PM10 (0.024 mg/m3; 0.011-0.120 mg/m3) and
TPM (0.03 mg/m3; min-max 0.014-0.188 mg/m3), followed by the Kitchen and
Community Space for PM2.5 (0.013 mg/m3; min-max.0.006-0.033 mg/m3), Community
Space for PM10 (0.016 mg/m3; min-max 0.001-0.040 mg/m3) and Community Space for
TPM (0.025 mg/m3; min-max 0.016-0.051 mg/m3). The Rehab/Exercise Room had the
lowest indoor median concentration of PM2.5 (0.005 mg/m3; min-max 0.003-0.013
mg/m3), PM10 (0.006 mg/m3; min-max 0.005-0.015 mg/m3), and TPM (0.009 mg/m3;
min-max 0.005-0.029 mg/m3). The outdoor median concentrations of PM2.5, PM10 and
TPM were 0.014 mg/m3, 0.015 mg/m3, and 0.016 mg/m3 respectively, which were lower
than the highest median indoor concentrations.
The indoor median temperature ranged from 72.8F in the kitchen to 77.2F in
Community Space and the indoor median relative humidity ranged from 47.4 percent in
41
the Dining Room to 50.8 percent in the Private Room. The median Outdoor temperature
was 65.5F, while the median Outdoor relative humidity was 54.0 percent.
42
Rehab/
Activity Private Dining Community Community Outdoor
Exercise Kitchen Hair Salon Outdoors
Room Room Room Space 1 Space 2 Smoking
Room
n 21 19 20 21 21 20 20 12 21 21
UFP (pt/cm3)
Median 4794 10645 2294 16647 70790 16298 9099 13395 6369 6543
Min 2320 2721 1186 5063 5466 5020 2978 4016 1714 1671
Max 18807 57945 17099 89107 314083 75521 49641 51026 10403 39739
PM2.5 (mg/m3)
Median 0.010 0.011 0.005 0.012 0.013 0.013 0.013 0.021 0.014 0.017
Min 0.005 0.006 0.003 0.008 0.007 0.006 0.006 0.009 0.003 0.002
Max 0.101 0.028 0.013 0.033 0.028 0.033 0.032 0.056 0.033 0.082
PM10 (mg/m3)
Median 0.011 0.013 0.006 0.014 0.015 0.015 0.016 0.024 0.015 0.018
Min 0.006 0.009 0.005 0.009 0.008 0.006 0.001 0.011 0.005 0.004
Max 0.142 0.037 0.015 0.035 0.039 0.038 0.040 0.120 0.041 0.100
TPM (mg/m3)
Median 0.019 0.020 0.009 0.020 0.020 0.020 0.025 0.030 0.016 0.019
Min 0.011 0.012 0.005 0.009 0.010 0.008 0.016 0.014 0.005 0.004
Max 0.153 0.047 0.029 0.038 0.068 0.046 0.051 0.188 0.049 0.102
Temperature (F)
Median 75.8 76.0 75.0 75.0 72.8 74.0 77.2 76.0 65.5 67.0
Min 72.5 74.7 69.6 71.7 70.6 71.2 76.5 75.6 44.6 48.3
Max 76.9 77.0 76.5 77.5 74.7 75.3 79.0 78.2 77.5 77.4
Median 48.7 50.8 50.7 47.4 50.4 49.0 50.7 48.5 54.0 49.0
Min 43.1 36.3 40.6 37.1 40.3 38.5 39.2 39.5 38.7 42.7
Max 57.5 55.9 74.8 57.9 56.4 56.1 57.4 55.0 74.7 69.8
43
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Facility 3 are presented in Table 4.5. Figures 4.9 to 4.12 present boxplots graphically
illustrating Facility 3 UFP counts and PM concentrations by Sampling Location. The
number of sampling points by room ranged from 3 to 21, based on accessibility.
The highest indoor median UFP count in Facility 3 was in the Satellite Kitchen
(8,525 pt/cm3; min-max 1,493-315,108 pt/cm3), followed by the Dining Room (3,148
pt/cm3; min-max 1,387-88,232 pt/cm3). The lowest indoor median UFP was in the Private
Room (2,330 pt/cm3; min-max 798-4,251 pt/cm3). The Outdoor UFP was 6,840 pt/cm3.
The Hair Salon had the highest median concentration of PM2.5 (0.020 mg/m3; min-
max 0.003-0.055 mg/m3), PM10 (0.023 mg/m3; min-max 0.006-0.105 mg/m3) and TPM
(0.039 mg/m3; min-max 0.010-0.188 mg/m3) followed by the Satellite Kitchen: PM2.5
(0.011 mg/m3; min-max 0.003-0.033 mg/m3), PM10 (0.014 mg/m3; min-max 0.004-0.042
mg/m3) and TPM (0.016 mg/m3; min-max 0.004-0.051 mg/m3). The Rehab/Exercise
Room had the lowest median concentration of PM2.5 (0.003 mg/m3; min-max 0.002-0.025
mg/m3), PM10 (0.004 mg/m3; min-max 0.002-0.028 mg/m3), and TPM (0.005 mg/m3;
min-max 0.002-0.035 mg/m3). The outdoor median concentrations of PM2.5, PM10 and
TPM were 0.007 mg/m3, 0.009 mg/m3, and 0.010 mg/m3 respectively.
The indoor median temperature ranged from 72.6F in the Activity Room to 77.2F
in the Private Room. The indoor median relative humidity ranged from 21.0 percent in
the Rehab/Exercise Room to 37.2 percent in the Hair Salon. The median Outdoor
48
Rehab/
Activity Private Dining Satellite Community
Room Room Room Kitchen Space
Room
n 21 20 21 21 21 21 21 9 21
UFP (pt/cm3)
Median 2384 2330 2395 3148 2957 8525 2499 7359 6840
Min 892 798 625 1387 1309 1493 992 2627 2996
Max 9509 4251 8283 88232 47826 315108 9215 29661 66849
PM2.5 (mg/m3)
Median 0.004 0.006 0.003 0.005 0.008 0.011 0.005 0.020 0.007
Min 0.002 0.002 0.002 0.002 0.002 0.003 0.002 0.003 0.003
Max 0.019 0.026 0.025 0.028 0.027 0.033 0.025 0.055 0.049
PM10 (mg/m3)
Median 0.006 0.010 0.004 0.008 0.011 0.014 0.007 0.023 0.009
Min 0.002 0.004 0.002 0.003 0.003 0.004 0.004 0.006 0.004
Max 0.021 0.031 0.028 0.030 0.028 0.042 0.026 0.105 0.054
TPM (mg/m3)
Median 0.008 0.018 0.005 0.013 0.013 0.016 0.013 0.039 0.010
Min 0.003 0.007 0.002 0.005 0.004 0.004 0.007 0.010 0.004
Max 0.035 0.052 0.035 0.033 0.039 0.051 0.035 0.188 0.057
Temperature (F)
Median 72.6 77.2 74.1 74.8 73.6 74.0 75.3 73.6 53.3
Min 69.9 73.8 71.0 71.1 69.2 70.9 72.2 71.9 32.0
Max 75.6 79.9 75.5 77.9 77.2 78.8 77.9 74.6 62.8
Median 24.3 22.4 21.0 29.6 36.1 31.0 25.1 37.2 47.0
Min 19.1 16.3 15.9 18.4 22.8 24.0 18.2 25.7 27.7
Max 49.8 46.2 50.2 54.7 55.1 53.7 47.0 49.5 70.4
49
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4.5.4. Descriptive Statics by Sampling Location, Facility 4
Facility 4 are presented in Table 4.6. Figures 4.13 to 4.16 present boxplots that
graphically illustrate UFP counts and PM concentrations by location for Facility 4. The
number of sampling points by room ranged from 3 to 21, based on accessibility.
The highest indoor median UFP in Facility 4 was in the Satellite Kitchen (20,706
pt/cm3; min-max 3,742-222,691 pt/cm3) followed by the Rehab/Exercise Room (4,312
pt/cm3; min-max 524-5,792 pt/cm3) and Kitchen (3,847 pt/cm3; min-max 517-56,937
pt/cm3). The lowest indoor median UFP was in the Private Room (2,142 pt/cm3; min-max
420-7,478 pt/cm3). The Outdoor median UFP was 4,573 pt/cm3.
and TPM (0.022 mg/m3; min-max 0.018-0.066 mg/m3), followed by the Rehab/Exercise
Room, PM2.5 (0.010 mg/m3; min-max 0.001-0.020 mg/m3), PM10 (0.018 mg/m3; min-max
0.001-0.022 mg/m3) and TPM (0.022 mg/m3; min-max 0.001-0.053 mg/m3). The Satellite
Kitchen and Community Space had the lowest indoor median concentration of PM2.5
(0.007 mg/m3; min-max 0.001-0.026 mg/m3), the Community Space had the lowest
median concentration of PM10 (0.007 mg/m3 min-max 0.001-0.016 mg/m3), and the
Satellite Kitchen had the lowest median concentration of TPM (0.005 mg/m3; min-max
0.001-0.028 mg/m3). The outdoor median concentrations of PM2.5, PM10 and TPM were
0.015 mg/m3, 0.015 mg/m3, and 0.016 mg/m3 respectively.
The indoor median temperature ranged from 71.6 F in the Private Room to 74.5F
in the Satellite Kitchen. The indoor median relative humidity ranged from 24.5 percent in
54
the Community Space to 39.1 percent in the Hair Salon. The median Outdoor
55
Rehab /
Private Dining Satellite Community
Room Room Kitchen Space
Room
n 13 16 20 21 21 21 3 19
UFP (pt/cm3)
Median 2142 4312 3758 3847 20706 3718 3321 4573
Min 420 524 519 517 3742 622 2822 773
Max 7478 5792 6284 56937 222691 38734 8711 11041
PM2.5 (mg/m3)
Median 0.008 0.010 0.008 0.008 0.007 0.007 0.015 0.015
Min 0.001 0.001 0.001 0.001 0.001 0.001 0.015 0.001
Max 0.020 0.020 0.015 0.022 0.026 0.016 0.027 0.078
PM10 (mg/m3)
Median 0.008 0.011 0.008 0.009 0.008 0.007 0.018 0.015
Min 0.001 0.001 0.001 0.001 0.001 0.001 0.015 0.001
Max 0.023 0.022 0.016 0.028 0.027 0.016 0.033 0.126
TPM (mg/m3)
Median 0.013 0.019 0.011 0.014 0.010 0.011 0.022 0.016
Min 0.003 0.001 0.002 0.001 0.001 0.002 0.018 0.001
Max 0.043 0.053 0.031 0.034 0.028 0.018 0.066 0.129
Temperature (F)
Median 71.6 73.0 72.5 73.3 74.5 73.4 72.8 46.8
Min 69.9 72.6 70.1 70.8 73.2 72.1 72.8 36.7
Max 73.9 73.9 79.0 74.6 76.9 73.9 72.9 60.1
Median 27.5 25.1 26.2 26.1 28.5 24.5 39.1 52.3
Min 24.0 21.6 22.3 22.1 23.7 19.5 38.5 29.5
Max 42.3 38.8 43.4 41.1 40.8 38.2 39.1 77.5
56
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4.5.5. Comparison by Sampling Location and Facility
Figures comparing the median particulate matter by Sampling Location for each
Facility are presented in Figures 4.17 to 4.20. In general, the median UFPs were highest
in Facility 2, with the highest counts being in the Kitchen or Satellite Kitchen in each
Facility. In all four Facilities, indoor PM2.5, PM10, and TPM were highest in the Hair
Salon. Indoor concentrations of PM were not consistently below Outdoor concentrations.
61
Figure 4-17: Ultrafine Particle (pt/cm3) by Sampling Location and Facility
62
Figure 4-18: PM2.5 Concentrations (mg/m3) by Sampling Location and Facility
63
Figure 4-19: PM10 Concentrations (mg/m3) by Sampling Location and Facility
64
Figure 4-20: TPM Concentrations (mg/m3) by Sampling Location and Facility
65
4.6. Descriptive Statistics by Sampling Session
A total of seven Sessions were sampled daily at each Facility and Sampling
Location. The Sampling Sessions are generalized below:
 Session 1: baseline;
 Session 2: morning meal time;
 Session 3: mid-morning activity;
 Session 4: mid-day meal time;
 Session 5: mid-afternoon;
 Session 6: late-afternoon; and,
 Session 7: evening-meal time and early-evening activity.
4.6.1. Descriptive Statistics by Sampling Session, All Facilities
The indoor median, minimum and maximum values for each Sampling Session,
all Facilities are presented in Table 4.7. At all Facilities, Session 1, the baseline, had the
lowest median concentrations across all particulate sizes. Indoor median UFP counts
were lowest in Sampling Session 1 (2,934 pt/cm3; min-max 362-264,716 pt/cm3) and
highest in Sampling Session 3 (4,682 pt/cm3; min-max 632-263,316 pt/cm3).
The lowest indoor median concentrations of particulate matter were during
Sampling Session 1: PM2.5 0.007 mg/m3 (min-max 0.001-0.024 mg/m3); PM10 0.008
mg/m3 (min-max 0.001-0.026 mg/m3); and TPM 0.013 mg/m3 (min-max 0.001-0.039
mg/m3). The highest indoor median particle concentrations for PM2.5 were during
Sampling Session 6 (0.01 mg/m3; min-max 0.001-0.16 mg/m3); PM10 during Sampling
Session 5 (0.013 mg/m3; min-max 0.001-0.118 mg/m3); and, TPM during Sampling
Session 3 and 5 (0.018 mg/m3; min-max 0.001-0.13 mg/m3).
66
The median indoor temperature was lowest during Sampling Session 1 (73.6F)
and highest during Sampling Session 7 (75.2F). The median indoor relative humidity was
lowest in Session 1 (33.7 percent) and highest in Session 6 (41.3 percent).
Table 4.7: Descriptive Statistics, All Indoor Locations by Sampling Session
Session 1 Session 2 Session 3 Session 4 Session 5 Session 6 Session 7

n 70 81 80 83 81 80 77
UFP (pt/cm3)
Median 2934 4749 4682 3851 4568 4376 2970
Min 362 584 632 524 798 420 1067
Max 264716 315108 263316 195100 314083 233300 86127
PM2.5 (mg/m3)
Median 0.007 0.009 0.009 0.007 0.009 0.010 0.009
Min 0.001 0.001 0.002 0.001 0.001 0.001 0.001
Max 0.024 0.034 0.106 0.083 0.086 0.160 0.056
PM10 (mg/m3)
Median 0.008 0.011 0.011 0.009 0.013 0.012 0.011
Min 0.001 0.001 0.003 0.001 0.001 0.001 0.001
Max 0.026 0.038 0.125 0.085 0.118 0.403 0.120
TPM (mg/m3)
Median 0.013 0.014 0.018 0.014 0.018 0.016 0.016
Min 0.001 0.001 0.003 0.001 0.001 0.001 0.001
Max 0.039 0.053 0.130 0.090 0.128 0.595 0.188
Temperature (F)
Median 73.6 74.6 74.3 74.8 75.1 75.0 75.2
Min 69.6 70.1 68.4 68.8 70.7 64.3 69.9
Max 78.5 80.4 79.6 79.7 79.3 80.9 80.1
Median 33.7 34.9 37.1 37.5 39.7 41.3 39.0
Min 15.5 16.5 17.1 16.9 15.9 16.4 16.3
Max 74.8 56.2 55.2 53.7 56.4 53.2 55.1
4.6.2. Descriptive Statistics by Sampling Session, Facility 1
The indoor median, minimum and maximum values for each Sampling Session, at
Facility 1 are presented in Table 4.8. Session 1, the baseline, had the lowest median
concentrations across all particulate sizes. Indoor median UFP counts were lowest in
Sampling Session 1 (1,756 pt/cm3; min-max 362-14,627 pt/cm3) and highest in Sampling
Session 3 (5,504 pt/cm3; min-max 2,226-49,134 pt/cm3).
67
Sampling Session 1: PM2.5 0.003 mg/m3 (min-max 0.001-0.009 mg/m3); PM10
0.004mg/m3 (min-max 0.001-0.015 mg/m3); and TPM 0.007 mg/m3 (min-max 0.001-
0.038 mg/m3). The highest indoor median particle concentrations for PM2.5 were during
Sampling Session 5 (0.007 mg/m3; min-max 0.001-0.077 mg/m3); PM10 during Sampling
Session 5 (0.011 mg/m3; min-max 0.002-0.118 mg/m3); and, TPM during Sampling
Session 3 (0.018 mg/m3; min-max 0.006-0.13 mg/m3).
Table 4.8: Descriptive Statistics, All Indoor Locations by Sampling Session, Facility 1

n 17 18 18 18 19 19 19
UFP (pt/cm3)
Median 1756 4938 5504 3237 2673 3021 2570
Min 362 1308 2226 831 1031 704 1067
Max 14627 93790 49134 53042 14860 20646 46186
PM2.5 (mg/m3)
Median 0.003 0.006 0.006 0.004 0.007 0.003 0.005
Min 0.001 0.002 0.003 0.001 0.001 0.001 0.001
Max 0.009 0.034 0.106 0.083 0.077 0.16 0.031
PM10 (mg/m3)
Median 0.004 0.01 0.007 0.007 0.011 0.006 0.008
Min 0.001 0.004 0.004 0.001 0.002 0.002 0.001
Max 0.015 0.038 0.125 0.085 0.118 0.403 0.036
TPM (mg/m3)
Median 0.007 0.015 0.018 0.017 0.014 0.017 0.016
Min 0.001 0.005 0.006 0.003 0.004 0.002 0.001
Max 0.038 0.051 0.13 0.09 0.128 0.595 0.04
Temperature (F)
Median 75.5 76.1 75.8 75.7 76.8 76.7 75.9
Min 72.1 72.3 68.4 68.8 71.5 64.3 70.8
Max 78.5 80.4 79.6 79.7 79.3 80.9 80.1
Median 33.1 33.15 35.4 34.9 35.9 34.3 36.2
Min 15.5 16.5 17.1 18.4 17.7 20.1 18.8
Max 41.8 44.1 49.7 47.7 52.8 52.5 54.4
68
Facility 2 are presented in Table 4.9. Indoor median UFP counts were lowest in Sampling
Session 1 (6,276 pt/cm3; min-max 2,300-264,716 pt/cm3) and highest in Sampling
The lowest indoor median concentrations of PM2.5 (0.011 mg/m3; min-max 0.005-
0.024 mg/m3) and PM10 (0.013 mg/m3; min-max 0.005-0.026 mg/m3) were seen during
Sampling Sessions 1, 3, and 4, while the lowest indoor median TPM was during
Sampling Session 1 at 0.017 mg/m3 (min-max 0.005-0.032 mg/m3). The highest indoor
median particle concentrations were observed during Sampling Session 6 for all particles
sizes: PM2.5 (0.019 mg/m3; min-max 0.004-0.101 mg/m3); PM10 (0.022 mg/m3; min-max
0.005-0.142 mg/m3); and, TPM (0.031 mg/m3; min-max 0.007-0.153 mg/m3).
69
n 20 22 21 23 23 23 22
UFP (pt/cm3)
Median 6276 11887 8144 10569 9298 15871 12452
Min 2300 1536 1602 1186 1537 1346 1588
Max 264716 89107 263316 195100 314083 233300 86127
PM2.5 (mg/m3)
Median 0.011 0.012 0.011 0.011 0.014 0.019 0.012
Min 0.005 0.003 0.004 0.004 0.004 0.004 0.005
Max 0.024 0.022 0.024 0.024 0.086 0.101 0.056
PM10 (mg/m3)
Median 0.013 0.013 0.013 0.013 0.018 0.022 0.014
Min 0.005 0.005 0.005 0.005 0.001 0.005 0.006
Max 0.026 0.029 0.027 0.039 0.092 0.142 0.12
TPM (mg/m3)
Median 0.017 0.02 0.02 0.019 0.02 0.031 0.019
Min 0.005 0.006 0.008 0.008 0.005 0.007 0.007
Max 0.032 0.04 0.035 0.068 0.097 0.153 0.188
Temperature (F)
Median 74.4 75.2 74.7 75.2 75.3 75.9 76.4
Min 69.6 72.1 71.2 71.3 71.8 71.6 71.3
Max 77.4 77.5 77.2 77.5 79 78.1 78.2
Median 50.5 51.8 52.3 49.5 49.2 48.7 48.2
Min 36.3 37.1 38.4 39.5 41.4 41.8 41.1
Max 74.8 56.2 55.2 53.7 56.4 52.8 54
Facility 3 are presented in Table 4.10. Indoor median UFP counts were lowest during
Sampling Session 4 (1,955 pt/cm3; min-max 625-53,268 pt/cm3) and highest in Sampling
mg/m3). The highest indoor median particle concentrations were observed during
Sampling Session 3 for all particles sizes: PM2.5 (0.009 mg/m3; min-max 0.002-0.03
70
mg/m3); PM10 (0.013 mg/m3; min-max 0.003-0.042 mg/m3); and, TPM (0.021 mg/m3;
min-max 0.003-0.056 mg/m3).
and highest during Sampling Sessions 6 and 7 (74.8F). The median indoor relative
humidity was lowest in Session 7 (24.0 percent) and highest in Session 1 (32.6 percent).

n 20 23 23 23 23 22 21
UFP (pt/cm3)
Median 2616 3769 3742 1955 2579 2558 2604
Min 1938 2020 632 625 798 1389 1570
Max 4981 315108 75735 53268 12008 19893 45481
PM2.5 (mg/m3)
Median 0.003 0.006 0.009 0.005 0.006 0.005 0.005
Min 0.002 0.002 0.002 0.002 0.003 0.002 0.002
Max 0.023 0.028 0.03 0.045 0.02 0.055 0.016
PM10 (mg/m3)
Median 0.005 0.008 0.013 0.007 0.009 0.007 0.007
Min 0.002 0.003 0.003 0.004 0.004 0.002 0.003
Max 0.024 0.031 0.042 0.053 0.023 0.105 0.017
TPM (mg/m3)
Median 0.007 0.014 0.021 0.011 0.015 0.011 0.011
Min 0.003 0.005 0.003 0.004 0.004 0.002 0.003
Max 0.039 0.043 0.056 0.062 0.039 0.188 0.026
Temperature (F)
Median 73.1 74.2 74.2 74.4 74.5 74.8 74.8
Min 70.4 71.4 72.2 71.6 70.9 69.2 69.9
Max 75.5 78.2 78.2 78.0 78.8 79.5 79.9
Median 32.6 31.1 31.0 27.0 25.9 25.3 24.0
Min 18.6 18.2 17.7 16.9 15.9 16.4 16.3
Max 37.0 42.6 47.1 50.0 52.6 53.2 55.1
Facility 4 are presented in Table 4.15. Indoor UFP median counts were lowest in
Sampling Session 7 (2,970 pt/cm3; min-max 1,518-56,359 pt/cm3) and highest in
Sampling Session 5 (5,209 pt/cm3; min-max 1,774-222,691 pt/cm3).
71
mg/m3). The highest indoor median particle concentrations were observed during
Sampling Session 5 for all particles sizes: PM2.5 (0.012 mg/m3; min-max 0.001-0.027
mg/m3); PM10 (0.014 mg/m3; min-max 0.001-0.033 mg/m3; and, TPM (0.016 mg/m3;
min-max 0.001-0.066 mg/m3).
and highest during Sampling Sessions 4-6 (73.4F). The median indoor relative humidity
was lowest in Session 3 (25.5 percent) and highest in Session 5 (31.4 percent).

n 13 18 18 19 16 16 15
UFP (pt/cm3)
Median 5092 5008 4401 3840 5209 4126 2970
Min 517 584 858 524 1774 420 1518
Max 9949 92608 17287 38700 222691 85070 56359
PM2.5 (mg/m3)
Median 0.008 0.009 0.008 0.007 0.012 0.007 0.005
Min 0.002 0.001 0.002 0.001 0.001 0.001 0.001
Max 0.011 0.018 0.016 0.02 0.027 0.026 0.02
PM10 (mg/m3)
Median 0.008 0.01 0.009 0.008 0.014 0.008 0.007
Min 0.002 0.001 0.003 0.001 0.001 0.001 0.001
Max 0.012 0.022 0.018 0.021 0.033 0.027 0.02
TPM (mg/m3)
Median 0.009 0.012 0.013 0.011 0.016 0.012 0.009
Min 0.002 0.001 0.003 0.001 0.001 0.001 0.002
Max 0.029 0.053 0.024 0.026 0.066 0.043 0.025
Temperature (F)
Median 72.1 73.2 73.2 73.4 73.4 73.4 73.2
Min 70.1 70.1 69.9 70.7 70.7 71.2 71.5
Max 74.5 79.0 76.9 75.9 75.9 75.0 75.2
Median 27.8 26.0 25.5 26.1 31.4 27.5 27.5
Min 20.6 19.5 22.6 22 23.7 23.2 22.8
Max 35.3 38.0 43.4 41.8 41.2 42.3 41.5
72
Figures 4.21 to 4.24 present the particulate matter by Facility for all indoor
locations over the Sampling Sessions. The UFPs were highest at Facility 2 over all
Sampling Sessions. In general, all PM sizes were higher at Facility 2, over all Sampling
Sessions. Facilities 1-3 generally start with the lowest UFP counts and PM values with
peaks and valleys over the sampling day.
73
Figure 4.21: Median Ultrafine Particles (pt/cm3) by Sampling Session and Facility
74
Figure 4.22: Median PM2.5 Concentration (mg/m3) by Sampling Session and Facility
75
Figure 4.23: Median PM10 Concentration (mg/m3) by Sampling Session and Facility
76
Figure 4.24: Median TPM Concentration (mg/m3) by Sampling Session and Facility
77
4.7. ANOVA by Facility
The distribution of the particle data was not normally distributed and the data
were log transformed. While the Shapiro-Wilk test suggested the transformed data were
not normally distributed, the standard deviation of the data was less than half of the
mean. As such, the transformed data were analyzed by parametric statistics. An alpha of
0.05 was used for all analyses.
Table 4.12 shows the results of the ANOVA by Facility. There was a statistically
significant difference between facilities for UFP (p<0.001), PM2.5 (p<0.001), PM10
(p<0.001) and TPM (p<0.001). Therefore, for each of the particle sizes, at least two of
the Facilities were significantly different from each other.
Table 4.12: ANOVA by Facility
Particle Size p-value

3
UFP (pt/cm ) < 0.001
PM2.5 (mg/m3) < 0.001
3
PM10 (mg/m ) < 0.001
3
TPM (mg/m ) < 0.001
Bold=statistically significant
Tukey post hoc was performed to identify pairwise differences by Facility for
UFP and PM. Table 4.13 presents the Tukey post hoc between Facilities. Facility 2 was
significantly different from Facility 1, Facility 3 and Facility 4 for UFPs and all PM sizes.
78
Table 4.13: Tukey by Facility
UFP (pt/cm3) PM2.5 (mg/m3) PM10 (mg/m3) TPM (mg/m3)

Facility
p-value p-value p-value p-value
Facility 1 vs Facility 2 < 0.001 < 0.001 < 0.001 < 0.001
Facility 1 vs Facility 3 0.918 0.777 0.618 0.914
4.8. ANOVA by Sampling Location and Facility
The following sections present the results of ANOVA by Sampling Locations and
Facilities.
4.8.1. ANOVA by Sampling Location, All Facilities
Table 4.14 shows the results of the ANOVA by Sampling Location at all
Facilities. There was a statistically significant difference between Sampling Location at
all Facilities for UFP (p<0.001), PM2.5 (p<0.001), PM10 (p<0.001) and TPM (p<0.001).
Therefore, for each of the particle sizes at least two of the Sampling Locations at all
Facilities were significantly different from each other.
Table 4.14: ANOVA by Sampling Location, All Facilities

3
UFP (pt/cm ) < 0.001
3
PM2.5 (mg/m ) < 0.001
PM10 (mg/m3) < 0.001
TPM (mg/m3) < 0.001
Tukey post hoc was performed to identify pairwise differences by Facility for
UFP and PM. Table 4.15 presents the Tukey post hoc by Sampling Location at all
Facilities. In general, many significant pairwise differences were found between indoor
locations and the Hair Salon for PM. In addition, the Rehab/Exercise space was
79
significantly different from Community Space 2 for all PM sizes. UFPs had the most
pairwise differences by location.
Table 4.15: Tukey by Sampling Location, All Facilities

UFP PM2.5 PM10 TPM
Location 1 Location 2 (pt/cm3) (mg/m3) (mg/m3) (mg/m3)
Private Room 1.000 1.000 1.000 1.000
Rehab/Exercise Room 1.000 1.000 0.503 0.017
Dining Room 0.001 0.966 1.000 1.000
Kitchen <0.001 0.810 1.000 0.999
Satellite Kitchen <0.001 0.510 0.992 1.000
Activity Room
Community Space 1 0.206 1.000 1.000 0.990
Community Space 2 <0.001 0.094 0.575 0.274
Hair Salon <0.001 <0.001 <0.001 <0.001
Outdoors 0.033 0.525 0.964 0.964
Outdoor Smoking 0.011 0.772 0.979 0.998
Dining Room 0.007 0.951 1.000 1.000
Kitchen <0.001 0.764 0.998 1.000
Private Room Community Space 1 0.572 1.000 1.000 0.999
Community Space 2 0.001 0.079 0.401 0.157
Hair Salon <0.001 <0.001 <0.001 <0.001
Outdoors 0.156 0.453 0.832 0.993
Outdoor Smoking 0.050 0.730 0.905 1.000
Dining Room <0.001 0.667 0.399 0.052
Kitchen <0.001 0.383 0.154 0.179
Community Space 1 0.057 1.000 0.851 0.222
Rehab/Exercise Room
Community Space 2 <0.001 0.025 0.013 <0.001
Hair Salon <0.001 <0.001 <0.001 <0.001
Outdoors 0.005 0.136 0.009 0.368
Outdoor Smoking 0.002 0.388 0.050 0.490
Kitchen 0.065 1.000 1.000 1.000
Community Space 1 0.811 0.956 1.000 1.000
Dining room Community Space 2 0.693 0.504 0.522 0.090
Hair Salon 0.681 <0.001 <0.001 <0.001
Outdoors 0.995 0.998 0.938 0.999
Outdoor Smoking 1.000 1.000 0.967 1.000
Satellite Kitchen 0.458 1.000 1.000 1.000
Community Space 1 <0.001 0.772 0.973 1.000
Community Space 2 1.000 0.787 0.836 0.074
Kitchen
Hair Salon 1.000 0.003 <0.001 <0.001
Outdoors 0.003 1.000 1.000 1.000
Outdoor Smoking 0.276 1.000 1.000 1.000
80
Table 4.15: Tukey by Sampling Location, All Facilities (continued)
UFP PM2.5 PM10 TPM

Community Space 1 <0.001 0.445 0.774 1.000
Community Space 2 0.812 0.927 0.961 0.087
Satellite Kitchen Hair Salon 0.536 0.013 0.001 <0.001
Outdoors <0.001 1.000 1.000 1.000
Outdoor Smoking <0.001 1.000 1.000 1.000
Community Space 2 0.090 0.080 0.248 0.031
Hair Salon 0.058 <0.001 <0.001 <0.001
Community Space
Outdoors 1.000 0.450 0.564 1.000
Outdoor Smoking 0.914 0.741 0.736 1.000
Hair Salon 1.000 0.897 0.433 0.884
Community Space 2 Outdoors 0.270 0.874 0.974 0.020
Outdoor Smoking 0.828 0.915 0.992 0.077
Outdoors 0.221 0.005 <0.001 <0.001
Hair Salon
Outdoor Smoking 0.841 0.019 0.004 <0.001
Outdoors Outdoor Smoking 0.998 1.000 1.000 1.000
4.8.2. ANOVA by Location, Facility 1
Table 4.16 shows the results of the ANOVA by Sampling Location at Facility 1.
There was a statistically significant difference between Sampling Location at Facility 1
for UFP (p<0.001), PM2.5 (p<0.001), PM10 (p<0.001) and TPM (p<0.001). Therefore, for
each of the particle sizes at least two of the Sampling Locations at Facility 1 were
significantly different from each other.
Table 4.16: ANOVA by Sampling Location, Facility 1

3
UFP (pt/cm ) < 0.001
PM2.5 (mg/m3) < 0.001
3
PM10 (mg/m ) < 0.001
3
TPM (mg/m ) < 0.001
Table 4.17 presents the Tukey post hoc by Sampling Location at Facility 1. In
general, many significant pairwise differences were found between indoor locations and
81
the Hair Salon and indoor locations and the Satellite Kitchens for PM. UFPs
demonstrated significant differences between indoor locations and the Satellite Kitchen
and the Activity Room and Private Room compared to the Dining Room.
Table 4.17: Tukey by Sampling Location, Facility 1
UFP PM2.5 PM10 TPM

Private Room 1.000 1.000 0.969 0.344
Dining Room <0.001 0.959 1.000 0.998
Activity Room
Community Space 0.381 1.000 1.000 0.489
Hair Salon 0.507 0.016 0.010 0.071
Outdoors 0.013 0.999 1.000 0.144
Outdoor Smoking <0.001 0.999 1.000 0.124
Dining Room 0.001 0.711 0.905 0.823
Private Room Community Space 0.778 1.000 1.000 1.000
Hair Salon 0.711 0.006 0.001 0.002
Outdoors 0.078 0.936 0.981 1.000
Outdoor Smoking <0.001 0.936 0.995 1.000
Dining Room 0.566 0.990 0.948 0.675
Community Space 0.999 1.000 1.000 1.000
Rehab/Exercise Room
Hair Salon 1.000 0.024 0.002 0.001
Outdoors 0.999 1.000 0.993 1.000
Outdoor Smoking 0.317 1.000 0.998 1.000
Community Space 0.172 0.954 0.995 0.918
Dining Room Hair Salon 1.000 0.092 0.016 0.024
Outdoors 0.924 1.000 1.000 0.552
Outdoor Smoking 1.000 1.000 1.000 0.507
Community Space <0.001 0.009 0.025 0.113
Hair Salon 0.310 0.772 0.398 0.189
Satellite Kitchen
Outdoors <0.001 0.074 0.095 0.018
Outdoor Smoking 0.016 0.074 0.060 0.015
Hair Salon 0.991 0.015 0.004 0.002
Outdoor Smoking 0.067 0.998 1.000 0.998
Outdoors 1.000 0.045 0.009 0.001
Hair Salon
Outdoor Smoking 1.000 0.045 0.007 0.001
82

3
UFP (pt/cm ) < 0.001
PM2.5 (mg/m3) < 0.001
3
PM10 (mg/m ) < 0.001
3
TPM (mg/m ) < 0.001
general, significant pairwise differences for PM were found between all indoor locations
and the Rehab/Exercise Room. UFP had the most pair wise differences by location.
83
UFP PM2.5 PM10 TPM

Private Room 0.098 1.000 1.000 1.000
Dining Room <0.001 1.000 1.000 1.000
Kitchen <0.001 1.000 1.000 0.999
Activity Room Community Space 1 <0.001 1.000 1.000 1.000
Community Space 2 0.364 1.000 1.000 0.999
Hair Salon 0.007 0.682 0.645 0.693
Outdoors 1.000 0.985 0.999 0.557
Outdoor Smoking 1.000 1.000 0.999 1.000
Rehab/Exercise Room <0.001 0.017 0.012 0.005
Dining Room 0.607 1.000 1.000 1.000
Kitchen <0.001 1.000 1.000 1.000
Community Space 1 0.643 1.000 1.000 1.000
Private Room
Community Space 2 1.000 1.000 1.000 0.980
Hair Salon 0.968 0.519 0.590 0.443
Outdoors 0.159 0.999 1.000 0.870
Outdoor Smoking 0.362 1.000 0.998 1.000
Dining Room <0.001 0.001 0.004 0.003
Kitchen <0.001 0.003 0.010 0.011
Community Space 1 <0.001 0.003 0.006 0.004
Rehab/Exercise Room Community Space 2 <0.001 0.006 0.023 0.000
Hair Salon <0.001 <0.001 <0.001 <0.001
Outdoors 0.005 0.119 0.053 0.310
Outdoor Smoking 0.001 0.001 <0.001 0.005
Kitchen <0.001 1.000 1.000 1.000
Community Space 1 1.000 1.000 1.000 1.000
Community Space 2 0.196 1.000 1.000 0.984
Dining Room
Hair Salon 1.000 0.858 0.700 0.454
Outdoors <0.001 0.910 0.998 0.818
Outdoor Smoking 0.001 1.000 1.000 1.000
Community Space 1 <0.001 1.000 1.000 1.000
Community Space 2 <0.001 1.000 1.000 0.895
Kitchen Hair Salon <0.001 0.756 0.528 0.251
Outdoors <0.001 0.967 1.000 0.960
Outdoor Smoking <0.001 1.000 0.996 1.000
Community Space 2 0.222 1.000 1.000 0.984
Hair Salon 1.000 0.781 0.657 0.455
Community Space 1
Outdoors <0.001 0.964 0.999 0.839
Outdoor Smoking 0.001 1.000 0.999 1.000
Hair Salon 0.741 0.675 0.423 0.963
Outdoor Smoking 0.775 1.000 0.984 0.961
Outdoors 0.012 0.140 0.251 0.013
Hair salon
Outdoor Smoking 0.037 0.854 0.947 0.362
84

3
UFP (pt/cm ) < 0.001
PM2.5 (mg/m3) < 0.001
3
PM10 (mg/m ) < 0.001
3
TPM (mg/m ) < 0.001
general, many significant pairwise differences were found between indoor locations and
the Hair Salon at Facility 3. UFPs showed significant differences between the Satellite
Kitchen and all other indoor locations except the Hair Salon, as well as, the Activity
Room, Private Room and Rehab/Exercise Room and the Hair Salon.
85
UFP PM2.5 PM10 TPM

Private Room 0.999 0.985 0.715 0.022
Dining Room 0.515 0.888 0.933 0.392
Kitchen 0.470 0.558 0.578 0.457
Activity Room
Community Space 1.000 0.990 0.964 0.240
Hair Salon 0.033 0.003 <0.001 <0.001
Outdoors 0.001 0.088 0.154 0.366
Dining Room 0.158 1.000 1.000 0.954
Kitchen 0.136 0.989 1.000 0.928
Private Room Satellite Kitchen <0.001 0.553 0.982 0.998
Community Space 0.998 1.000 1.000 0.990
Hair Salon 0.006 0.041 0.028 0.165
Outdoors <0.001 0.617 0.991 0.962
Dining Room 0.204 0.922 0.547 0.042
Kitchen 0.177 0.624 0.170 0.055
Rehab/Exercise Room
Community Space 1.000 0.995 0.639 0.018
Hair Salon 0.009 0.004 <0.001 <0.001
Outdoors <0.001 0.112 0.022 0.037
Kitchen 1.000 1.000 0.999 1.000
Dining Room Community Space 0.569 1.000 1.000 1.000
Hair Salon 0.741 0.092 0.008 0.011
Outdoors 0.297 0.848 0.891 1.000
Community Space 0.523 0.981 0.997 1.000
Kitchen
Hair Salon 0.772 0.247 0.040 0.008
Outdoors 0.335 0.989 0.998 1.000
Community Space <0.001 0.485 0.768 1.000
Satellite Kitchen Hair Salon 0.979 0.762 0.217 0.033
Outdoors 0.959 1.000 1.000 1.000
Hair Salon 0.039 0.033 0.005 0.021
Community Space
Outdoors 0.001 0.550 0.831 1.000
Hair Salon Outdoors 1.000 0.718 0.180 0.012
86
Table 4.22 presents the results of the ANOVA by Sampling Location for Facility
4. There was a statistically significant difference for UFP (p<0.001) and PM2.5 (p=0.032).

3
UFP (pt/cm ) < 0.001
3
PM2.5 (mg/m ) 0.032
3
PM10 (mg/m ) 0.070
TPM (mg/m3) 0.171
Table 4.23 presents the Tukey post hoc by Sampling Location at Facility 4 for
UFP and PM2.5. Significant pairwise differences were found between indoor locations
and the Satellite Kitchen at Facility 4. Although a significant difference was indicated by
ANOVA for PM2.5, no pairwise differences were found by Tukey post hoc test.
87
UFP PM2.5
Location 1 Location 2 (pt/cm3) (mg/m3)
p-value p-value
Rehab/Exercise Room 0.968 0.929
Dining Room 0.978 1.000
Kitchen 0.693 1.000
Private Room Satellite Kitchen <0.001 1.000
Community Space 0.877 0.995
Hair Salon 0.927 0.750
Outdoors 0.802 0.598
Dining Room 1.000 0.776
Kitchen 0.998 0.799
Satellite Kitchen <0.001 0.537
Rehab/Exercise Room
Kitchen 0.993 1.000
Dining Room Community Space 1.000 0.999
Kitchen
Community Space <0.001 1.000
Satellite Kitchen Hair Salon 0.051 0.500
Outdoors <0.001 0.139
Community Space
Hair Salon Outdoors 1.000 0.999
4.9. ANOVA by Sampling Session
The following sections present the results of ANOVA by Sampling Sessions at
the Facilities, for indoor measurements.
4.9.1. ANOVA by Sampling Session, All Facilities
Table 4.24 shows the results of the ANOVA by Sampling Session for all
Facilities. Statistically significant differences were found for ultrafine particles (p=0.015)
88
and TPM (p=0.007) which indicates at least two of the Sampling Sessions were
significantly different from each other for UFPs and TPM.
Table 4.24: ANOVA by Sampling Session, All Facilities

3
UFP (pt/cm ) 0.015
3
PM2.5 (mg/m ) 0.304
3
PM10 (mg/m ) 0.101
PM Total (mg/m3) 0.007
Table 4.25 presents the Tukey post hoc by Sampling Session at all Facilities for
UFP and TPM. Significant pairwise differences were found between Sampling Session 1
and Sampling Session 2 (p=0.003) for UFPs and Sampling Session 1 and Sampling
Sessions 3 (p=0.008) 5 (p=0.009) and 6 (p=0.037).
89
Table 4.25: Tukey by Sampling Session, All Facilities
UFP TPM
Location 1 Location 2 pt/cm3 mg/m3
p-value p-value
Session 2 0.003 0.142
Session 3 0.191 0.008
Session 4 0.716 0.540
Session 1
Session 5 0.651 0.009
Session 6 0.446 0.037
Session 7 0.584 0.334
Session 3 0.767 0.951
Session 4 0.198 0.986
Session 2 Session 5 0.256 0.956
Session 6 0.448 0.998
Session 7 0.339 1.000
Session 4 0.968 0.544
Session 5 0.984 1.000
Session 3
Session 6 0.999 0.999
Session 7 0.994 0.798
Session 5 1.000 0.558
Session 7 1.000 1.000
Session 6 1.000 0.999
Session 5
Session 7 1.000 0.810
4.9.2. ANOVA by Sampling Session, Facilities 1-4
Table 4.26 shows the results of the ANOVA by Sampling Session and Facility.
There was a statistically significant difference between Sampling Sessions for UFP at
Facility 1 (p<0.001) and at Facility 3 (p=0.024). There was a statistically significant
difference between Sampling Sessions at Facility 2 (p<0.001) for PM2.5.
90
Table 4.26: ANOVA by Sampling Session Facilities 1-4
Facility 1 Facility 2 Facility 3 Facility 4

Particles
3
UFP (pt/cm ) <0.001 0.838 0.025 0.514
3
PM2.5 (mg/m ) 0.828 0.027 0.286 0.644
3
PM10 (mg/m ) 0.317 0.101 0.106 0.700
3
TPM (mg/m ) 0.072 0.250 0.064 0.502
Table 4.27 presents the Tukey post hoc by Sampling Session at Facility 1 for
UFP. Significant pairwise differences were found between Sampling Session 1 and
Sampling Session 2 (p<0.001) and Sampling Session 1 and Sampling Sessions 3
(p=0.001) for UFPs.
Table 4.27: Tukey by Sampling Session, Facility 1
UFP
Location 1 Location 2 pt/cm3
p-value
Session 2 <0.001
Session 3 0.001
Session 4 0.101
Session 1
Session 5 0.262
Session 6 0.359
Session 7 0.137
Session 3 0.992
Session 4 0.230
Session 2 Session 5 0.071
Session 6 0.044
Session 7 0.153
Session 4 0.653
Session 5 0.330
Session 3
Session 6 0.236
Session 7 0.528
Session 5 0.999
Session 7 1.000
Session 6 1.000
Session 5
Session 7 1.000
91
Table 4.28 presents the Tukey post hoc by Sampling Session at Facility 2 for
PM2.5. No significant pairwise differences were found between Sampling Sessions using
Tukey.
PM2.5
Location 1 Location 2 mg/m3
p-value
Session 2 0.999
Session 3 0.999
Session 4 1.000
Session 1
Session 5 0.950
Session 6 0.260
Session 7 0.866
Session 3 1.000
Session 4 1.000
Session 6 0.068
Session 7 0.534
Session 4 1.000
Session 5 0.747
Session 3
Session 6 0.087
Session 7 0.587
Session 5 0.768
Session 7 0.608
Session 6 0.845
Session 5
Session 7 1.000
Table 4.29 presents the Tukey post hoc by Sampling Session at Facility for UFPs.
Significant pairwise differences were found between Sampling Session 2 and Sampling
Session 5 (p=0=026) for UFPs.
92
UFP
Location 1 Location 2 pt/cm3
p-value
Session 2 0.081
Session 3 0.871
Session 4 1.000
Session 1
Session 5 1.000
Session 6 0.996
Session 7 1.000
Session 3 0.676
Session 4 0.055
Session 6 0.281
Session 7 0.106
Session 4 0.829
Session 5 0.681
Session 3
Session 6 0.995
Session 7 0.920
Session 5 1.000
Session 7 1.000
Session 6 0.966
Session 5
Session 7 0.999
4.10. Results Compared to Guidelines
ASHRAE recommends indoor air pollutant concentrations should not exceed
NAAQS levels. The PM10 maximum exposure limit for a 24-hour mean is 0.15 mg/m3
and PM2.5 is 0.035 mg/m3 for a 24-hour mean (EPA, 2016). In general, the median PM
levels were not above the ASHRAE recommended concentrations. However, maximum
PM concentration all four facilities exceeded the recommended levels. The maximum
PM2.5 and PM10 concentration in the hair salon exceeded the ASHRAE recommended
concentrations at all facilities. The maximum PM2.5 and PM10 concentration exceeded
ASHRAE recommended concentrations in the Satellite Kitchen and Hair Salon at Facility
1 and Facility 2. At Facility 2 the maximum PM2.5 concentration exceeded ASHRAE

93
recommended concentrations in the Activity Room and the maximum PM10 concentration
in the Activity Room, Kitchen, and Community Space.
The operating temperatures recommended by ASHRAE 55 (2010) range from 23
to 28C (74 to 82F) in summer and 20 to 25.5C (68 to 78F) in winter. Indoor relative
humidity is recommended to be between 30 and 65 percent (ASHRAE, 2010). The
median temperatures were within ASHRAE winter guidelines in all facilities and
locations except at Facility1 in the hair salon. There were numerous occasions that the
maximum temperature exceeded guidelines. The median and maximum temperatures
never exceeded ASHRAE summer guidelines in all Facilities and Sampling Locations.
94
Chapter 5
Discussion
5.1 Overview
Data were collected at four facilities over three separate days during Fall of 2016.
PM (PM2.5, PM10, TPM, and UFP), temperature, and RH were measured in up to nine
indoor locations and an outdoor location for comparison. The data analyses showed that
there were significant differences between Facilities, Sampling Locations, and Sampling
Sessions. This section will discuss those results in more depth.
5.2 Differences Between Facilities
Results showed that there were significant differences between Facilities. Overall,
Facility 2 had higher UFP and PM levels compared to the other three Facilities. This was
consistent in all rooms except the rehab/exercise room which was constructed in 2009
and included a brand-new HVAC system. This Facility was the only one without any
recent remodeling.
One possible reason for the higher particles at Facility 2 is that this facility had a
higher number of residents who tended to be younger and more mobile. This is consistent
with a study by Monn et al. (1997) which showed that one of the highest contributors to
increased PM levels was human activity. In addition, Facility 2 had the poorest ratings on
95
the Center of Medicare and Medicaid Services nursing home compare website (Medicare,
2017).
Only Facility 2 had outdoor smoking permitted by the residents. A prior study in
Ohio found ETS related air contaminants, including respirable suspended particulate
matter, were significantly higher in designated indoor smoking rooms (Akbar-
Khanzadeh, Windom, & Golbabaei, 2011). Outdoor PM concentrations in the smoking
area were above outdoor concentrations and most indoor location concentrations.
The geographical location of Facility 2 also could be a contributing factor to
elevated UFP and PM concentrations. This Facility is located in a more urban setting and
near a road with higher counts of vehicular traffic, compared to the other facilities.
Vehicle exhaust is a common source of PM and UFP. Indoor PM and UFP levels have
been correlated with outdoor levels and this Facility uses 100 percent outdoor air.
5.3 Differences Between Indoor Sampling Locations
Differences between indoor Sampling Locations were found for UFP and all PM
sizes in Facilities 1, 2, and 3. In Facility 4, differences between locations were only
significant for UFP and PM2.5. In general, the highest UFP and PM concentrations were
found in the kitchen, satellite kitchen, and hair salon. Wallace et al. (2004) showed that
there was a tenfold increase in UFP concentrations when cooking occurred and a study by
Williams, Creason, Zweidinger, et al. (2000) showed that hair products and cooking
increase PM levels.
In general, the bedroom had lower levels of PM than the activities room,
community space, and dining room. Other studies have found that the bedroom had lower
96
PM levels due to decreased movement and activity (Almeida-Silva, Wolterbeek, and
Almeida, 2014).
Finally, the lowest UFP and PM concentrations were seen in the rehab/exercise
room. This could because it was used the least compared to the other indoor locations.
5.4 Differences Between Sampling Sessions
Facility 2 had the highest UFP and PM concentrations across Sampling Sessions
or different times of the day. As expected, the lowest concentrations tended to occur
during Sampling Session 1 which was a baseline measurement before residents awoke
and started their day. PM levels were highest during Sampling Session 3 (10:00 to 11:00
a.m.) and Sampling Session 5 (1:30-2:30 p.m.) which were peak times of activity for the
residents. During these times cooking and cleaning also occurred by facility staff.
5.5 Indoor versus Outdoor Comparisons
The UFP counts and PM concentrations for the indoor locations were compared to
the counts and concentrations outdoors. Table 5.1 presents the indoor mean UFP counts
and PM concentrations by location compared to the outdoor mean counts and
concentrations. Facility 1 had the most indoor locations whose levels exceeded the
outside air. This could be because it is the only facility that did not use any outdoor air to
supply air to the facility but rather recirculated the air.
Research has not consistently shown that indoor or outdoor PM levels are higher
in nursing homes. However, all other studies looked a fewer indoor locations (patient
room, activities room, and dining room). This research study had varied results
comparing indoor and outdoor UFP counts and PM concentrations.
97
Table 5.1: Indoor/Outdoor Median PM by Location and Facility
Indoor Median Concentration ≥ Outside Median Concentration
Indoor Location
UFP (pt/cm3) PM2.5 (mg/m3) PM10 (mg/m3) TPM (mg/m3)
Facility 1
Activity room    
Private room    
Rehab/Exercise room    
Dining Room    
Satellite kitchen    
Community Space  
Hair Salon    
Facility 2
Activity room    
Private room    
Rehab/Exercise room  

Dining Room    
Kitchen    
Community Space    
Community Space 2    
Facility 3
Activity room    
Private room    
Rehab/Exercise room    
Dining Room  

Kitchen    
Satellite kitchen    
Community Space    
Facility 4
Private room    
Rehab/Exercise room    
Dining Room    
Kitchen    
Satellite kitchen    
Community Space    
Hair Salon    
98
5.6 Comparison to Guidelines
There are few established national or mandatory limits for indoor air quality
contaminants, however, there are guidelines. All median PM levels were compared to the
ASHRAE Standard 62 which recommends that levels do not exceed the EPA standard in
order to protect public health. This equates to a maximum exposure limit for PM2.5 of
0.035 mg/m3 for a 24-hour mean and PM10 of 0.15 mg/m3 for a 24-hour mean (EPA,
2016b).
While we have OSHA PEL and ACGIH TLV values, those are primarily intended
for industrial environments (Burton, 2017). The standard of care for IAQ in hospitals and
similar environments, such as nursing homes, should be at a higher level because of the
vulnerable population. Residents at nursing homes are more susceptible to potential
health effects (Gunderson, 2016). Burton has compiled data for “typical” or “trigger,”
conditions (Burton, 2017). The trigger condition for PM2.5 is >0.015 mg/m3 and TPM is
>0.050 mg/m3.
Table 5.2 compares all Sampling Locations to the ASHRAE recommendation for
PM2.5 and PM10 and the trigger conditions for PM2.5 and TPM. Overall, the median PM
levels did not exceed the ASHRAE recommendations. The PM2.5 maximum
concentrations exceeded ASHRAE guidelines in the satellite kitchen, hair salon, and
activities room. The PM10 maximum concentrations exceeded ASHRAE guidelines in the
satellite kitchen and hair salon. This can be attributed to salon/hair products and the
cooking that occurs in these locations, both of which are known to be sources of PM.
The maximum concentrations for PM2.5 met the recommended trigger conditions
in every indoor location. In addition, the TPM maximum concentrations met the trigger
99
conditions in all facilities in various locations. This indicates that even though PM levels
do not exceed the ASHRAE recommendations, there are conditions that suggest further
investigation may be warranted.
Median and maximum temperature measurements never exceeded ASHRAE
summer guidelines, while numerous maximum temperature measurements exceeded
ASHRAE winter guidelines. Thermal comfort normally differs for staff and elderly with
the staff generally comfortable in cooler temperature and the elderly in warmer
temperature (Gunderson, 2016).
100
Table 5.2: Indoor Median and Max PM by Location and Facility
Compared to Guidelines and Trigger Levels
ASHRAE Trigger Conditions ASHRAE Trigger
Indoor Location PM2.5 PM2.5 PM10 ConditionsTPM
0.035 mg/m3 >0.015 mg/m3 0.15 mg/m3 >0.05 mg/m3
Facility 1
Median Max Median Max Median Max Median Max
Activities room 
Private room 
Rehab/Exercise room 
Dining Room 
Kitchen  
Satellite Kitchen     
Community Space 
Hair Salon     
Facility 2
Activities room   
Private room 
Rehab/Exercise room
Dining Room 
Kitchen  
Community Space 1 
Community Space 2  
Facility 3
Activities room 
Private room  
Rehab/Exercise room 
Dining Room 
Kitchen 
Satellite Kitchen  
Community Space 
Hair Salon  
Facility 4
Private room 
Rehab/Exercise room  
Dining Room 
Kitchen 
Satellite Kitchen 
Community Space 
Hair Salon   
101
5.7 Limitations
The two minute Sampling Sessions are a limitation of this study. However, Long,
Suh, and Koutrakis (2000) showed that when long periods of sampling occur, peak levels
of PM are often missed suggesting that short sampling periods can be beneficial. Their
research showed that peak PM levels have been related to an increase in acute health
effects.
In addition, area sampling was conducted instead of personal sampling. While
personal sampling is a better indicator of exposure in the industrial hygiene field, a
previous study in nursing homes and PM exposure showed that area sampling resulted in
essentially the same value as personal sampling (Williams, Creason, Zweidinger et al.,
2000).
Another limitation was that indoor and outdoor locations were sampled in a fixed,
rather than random order. While the initial intent was to sample in random order for each
Sampling Session, it was not conducted due to the fact that locations were far apart from
each other and could not all be sampled in the time allotted.
There were only 3 days of sampling per facility which provides limited data.
Another limitation is that samples were only collected during one season of the year (i.e.
fall). Prior research has shown that there are different levels of PM during different
seasons (Rhodes et al., 2001).
5.8 Recommendations
This research shows that there are differences in PM concentrations and UFP
counts between facilities, location, and time of day. This research study provided pilot
data of what occurs in the nursing home section of four long term care facilities. It is
102
recommended that integrated sampling be performed in a smaller number of locations,
which are suggested problem areas such as the hair salon, kitchen, satellite kitchen, and
activities room. Future research should also consider the importance of sampling PM
levels during different seasons of the year.
In addition, it is recommended that personal sampling be conducted due to the
fact the staff might be present in the locations that have higher PM concentrations. This
may offer a better understanding of particle levels throughout the day. Finally, it is
recommended to examine the association between different building and occupant
characteristics such as flooring type or number of people and PM concentrations.
103
Chapter 6
Conclusions
The results showed that the highest median PM concentrations and UFP counts
were in Facility 2. A statistically significant difference between Facilities was seen for all
PM levels (PM2.5, p<0.001); PM10, p<0.001); and TPM, p<0.001) and UFP counts
(p<0.001). The null hypothesis “there will be no statistically significant difference in the
3-day median airborne particle (PM2.5, PM10 and TPM) concentrations and Ultra Fine
Particle (UFP) counts indoors between Facilities (Facility 1, Facility 2, Facility 3, Facility
4)” is rejected.
The results showed that the highest median indoor PM concentrations and UFP
counts were in the hair salon and kitchen at all Facilities. A statistically significant
difference between indoor Sampling Locations was seen for all PM levels (PM2.5,
p<0.001); PM10, p<0.001); and TPM, p<0.001) and UFP counts (p<0.001) at all
Facilities. The null hypothesis “there will be no statistically significant difference in the
3-day median airborne particle (PM2.5, PM10 and TPM) concentrations and UFP counts
between indoor Sampling Locations (activity room, rehab/exercise room, dining room,
kitchen, satellite kitchen, community space, hair salon)” is rejected.
104
The results showed PM concentrations and UFP counts were highest during
Sampling Session 3 (10:00 to 11:00 am) and Sampling Session 5 (1:30-2:30 pm). A
statistically significant difference between Sampling Sessions was seen for all TPM
(p=0.015) and UFP (p=0.007) at all facilities, while no significant difference between
Sampling Sessions was seen for PM2.5 (p=0.304) or PM10 (p=0.101). The null hypothesis
“there will be no statistically significant difference in 3-day median airborne particle
concentrations (PM2.5, PM10 and TPM) and UFP counts indoors between Sampling
Session (baseline, morning meal time, mid-morning activity, mid-day meal time, mid-
afternoon, late-afternoon, and early-evening activity)” is partially rejected.
105
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Appendix A
Facility Description
Table A.1: Facility Summary

Pets Permitted Yes No Yes Yes
Most recent
2015 2009 2016 2016
remodeling
Any new Furniture by nurse’s
No No No
furniture station
7:00 a.m. to 4:00 Constantly have 7:00 a.m. to 3:30
Housekeeping 7:00 a.m. to 3:30
p.m. 7 days a staff cleaning the p.m. 7 days a
Schedule p.m. 7 days a week
week facility week
Yes exercise/ rehab
Any new HVAC room summer of No No No
2016
Number of AHUs
12 6 7 16
for facility
System operation Continuous Continuous Continuous Continuous
Percent outdoor Nursing home uses
100% 50% Outside air 100%
air recirculated air
2” pleated filter
Type of filters Pleated Pleated Air guard
with a bag
Filter
Quarterly Monthly Quarterly Monthly
replacement
Outdoor intake
Roof Roof Roof Roof
location
Number of beds 32 93 20 60
112
Table A.2: Activity Room Description

Crafts, games, and Crafts, games, and
Primary use Crafts and games
cooking aroma therapy
Flooring type Carpet Tile Wood
Wall Construction Dry Wall Dry Wall Dry Wall
Number of
3 2 None
Windows Not present
Evidence of water
None None None
Damage
Number Supply 2 3 2
Number Returns 2 1 4
Floor Level 2 1 1
Table A.3: Resident Room Description

Sleeping and Sleeping and Sleeping and Sleeping and
Primary use
watching tv watching tv watching tv watching tv
Flooring type Carpet Tile Carpet Carpet
Wall
Dry wall Dry wall Dry wall Dry wall
Construction
Number of
1 1 1 1
Windows
Evidence of water Potential small
None None None
Damage area on ceiling
Number Supply 1 0 1 1
Number Returns 0 0 1 1
Floor Level 2 1 2 1
Table A.4: Rehab/Exercise Room Description

Primary use Therapy Therapy Therapy Therapy
Flooring type Wood Tile Tile Carpet
Wall Dry wall and a
Dry Wall Dry Wall Dry Wall
Construction glass wall
Number of
4 0 0 7
Windows
Evidence of water
None None Yes None
Damage
Floor Level 2 1 1 1
113
Table A.5: Dining Room Description

Primary use Eating Eating Eating Eating
Carpet, wooden
Flooring type Tile Wood Wood
floor by kitchen
Wall
Dry wall Dry wall Dry wall Dry wall
Construction
Number of
8 7 5 6
Windows
Evidence of water
None None None None
Damage
Other Smoking area is
Observations attached
Floor Level 2 1 2 1
Table A.6: Satellite Kitchen Description

Hold food to
Primary use Cooking Serve food not cooking
Serve
Flooring type Tile Tile Tile
Wall Construction Dry wall Dry wall Dry wall
1 to dining room not to 1 to dining room not to
Number of Windows Not 0
outside outside
Evidence of Water Present
None Yes, in corner None
Damage
Number Supply 2 2 1
Floor Level 2 2 1
Table A.7: Main Kitchen Description

Primary use Cooking Cooking Cooking
Flooring type Concrete Tile Tile
Wall Construction Brick Dry way Dry Wall
Number of Windows 3 7 0
Not Present
Evidence of water damage None Yes on ceiling None
Number Supply 6 14 6
Floor Level 1 1 1
114
Table A.8: Community Space 1 Description

Watching TV and Watching TV and Watching TV and Watching TV and
Primary use
visiting visiting visiting visiting
Flooring type Carpet Wood Wood Carpet
Wall Construction Dry wall Dry wall Dry wall Dry wall
Number of
0 0 1 2 glass doors
Windows
Evidence of water
None None None None
damage
Floor Level 2 1 2 1
Table A.9: Community Space 2 Description
Facility 2
Primary use Watch TV or sleep
Flooring type Tile
Wall Construction Dry wall and 1 glass wall
Number of Windows 1
Evidence of water damage None
Number Supply 0
Number Returns 0
Floor Level 1
Table A.10: Hair Salon Description

Primary use Hair Styling Hair Styling Hair Styling Hair Styling
Flooring type Wood Tile Tile Tile
Wall Construction Dry wall Dry wall Dry wall Dry wall
Number of Windows 1 0 0 0
Evidence of water damage None Yes, on ceiling None None
Number of Windows 2 1 1 1
Floor Level 2 1 1 1
115

Tebbe Thesis FINAL 4-28-17

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Tebbe Thesis FINAL 4-28-17

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A Thesis

Masters of Science Degree in

The University of Toledo

Evaluation of Indoor Air Quality in Nursing Home Facilities

The University of Toledo

Results of Analysis of Variance (ANOVA) by Facility demonstrated significant

particulate concentrations at all Sampling Locations which may include contributions

from geographic location, vehicular traffic, or resident clustering. ANOVA by Sampling

times of activity for the residents.

Although maximum temperature measurements exceeded ASHRAE winter

of the vulnerable population.

and to the memory of my uncle Paul Tebbe.

your long hours of help and support.

Abstract .............................................................................................................................. iii

Table of Contents .............................................................................................................. vi

List of Tables ......................................................................................................................x

List of Figures .................................................................................................................. xii

List of Abbreviations ....................................................................................................... xiv

List of Symbols .................................................................................................................xv

1.1 Overview ...........................................................................................................1

1.3 Statement of Problem .........................................................................................3

1.4 Hypotheses ........................................................................................................4

1.5 Objectives .........................................................................................................4

2 Literature Review ....................................................................................................6

2.1 Indoor Air Quality .............................................................................................6

2.2 Particulate Matter ..............................................................................................8

2.3 Indoor PM Sources ...........................................................................................9

2.4 Comfort Parameters ..........................................................................................9

2.5 Health Effects ..................................................................................................10

2.7 IAQ Guidelines ...............................................................................................12

2.8 Long Term Care Environments .......................................................................14

2.9 IAQ in Long Term Care Facilities ..................................................................15

3.1 Overview .........................................................................................................18

3.2 Sampling Equipment .......................................................................................18

3.3 Facilities .......................................................................................................... 21

3.3.1 Sampling Location ...........................................................................22

3.4 Sampling Sessions ..........................................................................................23

3.5 Sampling Procedures ......................................................................................24

3.6 Facility Observation ........................................................................................25

3.7 Data Analysis ..................................................................................................25

4.1 Overview .........................................................................................................27

4.2 Description of Facilities ..................................................................................27

4.3 Descriptive Statistics All Indoor Locations by Facility ...................................27

4.4 Descriptive Statistics by Sampling Location, all Facilities .............................31

4.5 Descriptive Statistics by Sampling Location and Facility ..............................34

4.5.1 Descriptive Statistics by Sampling Location, Facility 1 ..................34

4.5.2 Descriptive Statistics by Sampling Location, Facility 2 ..................41

4.5.3 Descriptive Statistics by Sampling Location, Facility 3 ..................48

4.5.4 Descriptive Statistics by Sampling Location, Facility 4 ..................54

4.6 Descriptive Statistics by Sampling Session .....................................................66

4.6.1 Descriptive Statistics by Sampling Session, All Facilities ..............66

4.6.2 Descriptive Statistics by Sampling Session, Facility 1 .....................67

4.6.3 Descriptive Statistics by Sampling Session, Facility 2 .....................69

4.6.4 Descriptive Statistics by Sampling Session, Facility 3 .....................70

4.6.5 Descriptive Statistics by Sampling Session, Facility 4 .....................71

4.7 ANOVA by Facility ........................................................................................78

4.8 ANOVA by Sampling Location and Facility ..................................................79

4.8.1 ANOVA by Sampling Location, All Facilities ................................79

4.8.2 ANOVA by Sampling Location, Facility 1 ......................................81

4.8.3 ANOVA by Sampling Location, Facility 2 ......................................83

4.8.4 ANOVA by Sampling Location, Facility 3 ......................................85

4.8.5 ANOVA by Sampling Location, Facility 4 ......................................87

4.9 ANOVA by Sampling Session ........................................................................88

4.9.1 ANOVA by Sampling Session, All Facilities ..................................88