title: A ventilation intervention study in classrooms to improve indoor air quality: the FRESH study.
abstract: BACKGROUND
  Classroom ventilation rates often do not meet building standards, although it is considered to be important to improve indoor air quality. Poor indoor air quality is thought to influence both children's health and performance. Poor ventilation in The Netherlands most often occurs in the heating season. To improve classroom ventilation a tailor made mechanical ventilation device was developed to improve outdoor air supply. This paper studies the effect of this intervention.
  
  
  METHODS
  The FRESH study (Forced-ventilation Related Environmental School Health) was designed to investigate the effect of a CO2 controlled mechanical ventilation intervention on classroom CO2 levels using a longitudinal cross-over design. Target CO2 concentrations were 800 and 1200 parts per million (ppm), respectively. The study included 18 classrooms from 17 schools from the north-eastern part of The Netherlands, 12 experimental classrooms and 6 control classrooms. Data on indoor levels of CO2, temperature and relative humidity were collected during three consecutive weeks per school during the heating seasons of 2010-2012. Associations between the intervention and weekly average indoor CO2 levels, classroom temperature and relative humidity were assessed by means of mixed models with random school-effects.
  
  
  RESULTS
  At baseline, mean CO2 concentration for all schools was 1335 ppm (range: 763-2000 ppm). The intervention was able to significantly decrease CO2 levels in the intervention classrooms (F (2,10) = 17.59, p < 0.001), with a mean decrease of 491 ppm. With the target set at 800 ppm, mean CO2 was 841 ppm (range: 743-925 ppm); with the target set at 1200 ppm, mean CO2 was 975 ppm (range: 887-1077 ppm).
  
  
  CONCLUSIONS
  Although the device was not capable of precisely achieving the two predefined levels of CO2, our study showed that classroom CO2 levels can be reduced by intervening on classroom ventilation using a CO2 controlled mechanical ventilation system.
authors.forename: Jeannette T M
authors.initials: JT
authors.lastname: Rosbach
authors.affiliation: Department of Environmental Health, Municipal Health Services Groningen, P,O, Box 584, 9700 AN, Groningen, The Netherlands. machiel.vonk@ggd.groningen.nl.
authors.forename: Machiel
authors.initials: M
authors.lastname: Vonk
authors.forename: Frans
authors.initials: F
authors.lastname: Duijm
authors.forename: Jan T
authors.initials: JT
authors.lastname: van Ginkel
authors.forename: Ulrike
authors.initials: U
authors.lastname: Gehring
authors.forename: Bert
authors.initials: B
authors.lastname: Brunekreef
mesh_terms: D000393:Air Pollutants / Q000032:analysis*; D016902:Air Pollution, Indoor / Q000032:analysis*; D002245:Carbon Dioxide / Q000032:analysis*; D002648:Child; D018592:Cross-Over Studies; D006801:Humans; D008137:Longitudinal Studies; D009426:Netherlands; D012574:Schools; D012621:Seasons; D014691:Ventilation / Q000379:methods*
chemical_list: D000393:Air Pollutants; D002245:Carbon Dioxide