The Importance of Cleaner Indoor Air in Seniors Housing

by Jeff Shaw

Improved circulation and purification methods can help prevent viral spread.

By Jie Zhao, Delos Labs

We now know that SARS-Cov-2 (the virus that causes COVID-19) is primarily spread through the air. There are three main modes of transmission: direct exposure to exhaled droplets and particles in the air; inhalation of fine respiratory droplets and aerosol particles; and touching surfaces where those particles have attached to and then touching your eyes, nose or mouth.

While larger respiratory droplets quickly fall onto surfaces, smaller aerosolized particles containing SARS-CoV-2 can remain suspended in the air indoors for long periods of time (up to several hours) and travel distances beyond six feet. Cleaning indoor air through outdoor ventilation and advanced air purification is key to mitigating and preventing transmission of SARS-CoV-2.

While the pandemic brought to the fore the importance of good indoor air quality, particularly within seniors housing communities, the benefits of cleaner indoor air extend far beyond COVID-19.

Pollution: A quiet killer

In 2019, before the pandemic, air pollution contributed to 60,229 deaths in the United States, caused by chronic respiratory disease, cardiovascular disease and other diseases linked to air pollution. Among these deaths, more than 95 percent (57,607) were age 50 and older.

In the United States, indoor air quality is typically two to five times worse than outdoor air. The biggest pollutant of concern is particulate matter (PM). PM refers to very small particles of solid or liquid matter that can stay suspended in the air and be transported by the wind.

Particles sized 2.5 micrometers or less (PM2.5) have received the greatest attention from scientists and government agencies due to their ability to enter the smallest regions of the lungs and therefore pose serious health concerns. Chronic exposure to PM2.5 has been shown to contribute to diabetes, chronic pulmonary obstructive disorder (COPD), stroke, ischemic heart disease, atherosclerosis, various forms of cancer and lower respiratory infections.

Other pollutants — such as PM10, certain types of volatile organic compounds (VOCs), ozone, high levels of carbon dioxide (CO2), allergens and mold — have also been proven to have negative health impacts. Exposure to unpleasant smells and odors have also been shown to negatively impact mental health and can be indicative of poor indoor air quality.

As we age, our bodies become less able to compensate for the effects of air pollution and airborne particles. Therefore, cleaner indoor air is even more important for senior health and wellbeing.

Keep your air clean

Seniors spend more than 90 percent of their time indoors, many in seniors housing communities. Sources of PM2.5, VOCs, CO2 and other pollutants include everyday activities such as cooking, cleaning, use of personal care products, as well as chemical off-gassing from toxic materials in household items such as furniture.

The need for cleaner air in senior housing has never been more clear, and the good news is the solutions available have been extensively studied and shown to be effective. Below are three strategies to help improve indoor air quality:

  • Improve existing ventilation systems. Increasing the outdoor air percentage when needed, installing higher MERV-rated in-duct filtration systems and increasing air change rate can help existing ventilation systems effectively deliver cleaner air. Of course, increased additional energy cost, system capacity, labor cost and other practical limitations need to be taken into consideration before beginning any retrofit project.
  • Install portable air purifiers. Many portable air purifiers have been tested to effectively filter pollutants such as PMs and VOCs, and some can also deactivate and trap airborne viruses and bacteria. A randomized clinical trial conducted in Michigan found that three-day use of portable air purifiers reduced PM2.5 exposures and systolic blood pressure in older adults living in homes in an urban setting. The caveat of this strategy is that some air purifiers may produce ozone and other harmful by-products in the cleaning process, so be cautious when making purchasing decisions.
  • Install indoor air quality monitors. People cannot “see” if their indoor air quality is good or bad and are thus often unaware of indoor air quality issues in their residences. Indoor air quality monitors help give operators and residents the opportunity to track particulate matter pollution and other air quality parameters in real time. The data can also be used to better control existing ventilation systems or portable air purifiers to help remediate indoor air pollutants with precision. Sensor technology has improved in the past few years and many lower cost sensors are now available on the market.

Cleaner air is essential to protecting the health of our seniors. In addition to the health benefits associated with the indoor air quality solutions above, there are also clear economic benefits for investors, developers and operators.

Investors: Healthy buildings are more valuable than regular buildings. ESG (environmental, social and governance) is a dominating topic in investment today and is likely to be even more important in future. Investing in seniors housing should be no different. Clean air is the foundation of a healthy building and a key component of ESG, so it should be one of the key criteria when you evaluate investment opportunities.

Developers: Whether you are planning for a new development or are considering upgrading existing seniors housing, incorporating clean air strategies may help increase the value of your development and attract more residents. Make sure to prioritize clean air strategies in your technology and engineering budget.

Operators: There are many steps you can take to help make your residents healthier and happier. Delivering cleaner indoor air is scientifically proven to help improve occupant health and requires minimal involvement and maintenance from your team. It is also a good way to demonstrate your commitment to the health, safety and wellbeing of residents, visitors and staff, giving them peace of mind.

Indoor air quality has a significant impact on seniors’ physical and mental health. Fortunately, the strategies to help provide cleaner air in senior housing are straightforward, mature and effective. The healthy building movement can also provide economic benefits for investing, developing and operating healthier senior housing communities.

Even when the COVID-19 pandemic has ended, cleaner indoor air will continue to be more important than ever.


Jie Zhao is the head of Delos Labs and an executive vice president at Delos, a wellness real estate and technology company headquartered in New York City. As the creator of the WELL Building Standard, Delos develops products, programs and solutions that transform environments into vehicles for health, wellbeing, performance and resilience. Zhao leads the research team to support product innovations and market strategies.

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