Air Quality of Nursing Homes Affects Residents' Lung Function

Nursing homes’ air quality significantly affects their elderly residents’ lung health, according to research published online on March 11 in the European Respiratory Journal.

Due to the elderly’s longer life expectancy, increased vulnerability to air pollution, and sedentary lifestyle, the authors claimed nursing homes’ air quality is a dire issue, according to a news release by the European Lung Foundation (ELF).

Using 50 nursing homes in 7 European countries, Dr. Isabella Annesi-Maesano, lead author, and her colleagues assessed the levels of PM10, PM0.1, formaldehyde, NO2, and O3 — 5 air pollutants commonly derived from cleaners, cooling systems, and heaters, the ELF release also mentioned.

In addition to detecting the presence of air pollutants, the team conducted a medical examination of the 600 residents, which included a lung function test and an overall health questionnaire.

In doing so, the investigators reported a parallel between air quality and the residents’ lung function, with forced expiratory volume (FEV) in 1s/forced vital capacity (FVC) ratio significantly associated with elevated amounts particles with a 50% cut-off aerodynamic diameter of <0.1 µm (PM_0.1) (adjusted OR 8.16, 95% CI 2.24—29.3) and nitrogen dioxide (aOR 3.74, 95% CI 1.06–13.1).

Furthermore, residents’ coughing and breathlessness associated with higher levels of PM₁₀ (aOR 1.53 (95% CI 1.15—2.07) and aOR 1.73 (95% CI 1.17–10.3), respectively) and nitrogen dioxide (aOR 1.58 (95% CI 1.15–2.20) and aOR 1.56 (95% CI 1.03–2.41), respectively). Their risk of wheezing in the past year was linked to PM_0.1 (aOR 2.82, 95% CI 1.15—7.02). The study also found formaldehyde exposure (aOR 1.25 (95% CI 1.02–1.55) was related to chronic obstructive pulmonary disease (COPD) development.

Alarmingly, the levels found all nursing homes did not exceed regulatory standards for air pollutants.

“Even at low levels, indoor air quality affected respiratory health in elderly people permanently living in nursing homes, with frailty increasing with age,” the authors reported. They also mentioned the trend was exacerbated in nursing homes where the ventilation system is poor and among patients over 80.

“Our findings have shown an independent effect of several indoor air pollutants on the lung health of the elderly living in nursing homes. This is a worrying problem since the body’s ability to cope with harmful air pollutants decreases as we age,” Annesi-Maesano stated. “Nursing homes should do more to prevent indoor air pollution by limiting its sources and by improving ventilation in their buildings. The respiratory health of residents should also be checked on a regular basis.

Advancing their findings, the researchers encouraged the assessment of nursing homes around the world to identify novel prevention methods.