Our latest study is *very cool*: showed link between indoor air quality and lung health, and now also...gut health 🧵 Even though the female participants still cooked with stoves that burn wood or charcoal, switching from traditional lighting to solar lights lowered their exposure to indoor air pollution
--> Our prior study showed switching from kerosene lamps for lighting to solar lights led to a 37%-91% reduction in exposure to indoor pollutants

Fixed it:
--> last year, the U.S. sold more educational services to the rest of the world than it sold in natural gas and coal **combined**
--> every $1 of research funded by NIH generates $2.56 in economic activity
--> more than 1.1M foreign students come to the U.S. each year to study and they contributed over $43 billion to the U.S. economy in foreign currency balances
--> students who came to the U.S. to study founded 55% of America’s 582 start-up companies worth at least $1 billion
--> cutting health research in Texas will cause a loss of 3,698 jobs and cost the economy $856M
--> The University of Alabama is the largest employer in the state
--> shortage of trained occ/env docs set to cost CA $1B

RECEIPTS🧵

https://x.com/j_g_allen/status/1913188677842317492

In @AMJPublicHealth I make an argument that adding in an economic lens is good public health practice, and I leverage an excellent article by @celinegounder and @Craig_A_Spencer.
🧵 In the 1980s and 1990s, the then-new field of IAQ generated research documenting that ventilation rates above this minimum standard were associated with many health benefits.

The triple-digit temps in the southwest are catching headlines ("Record-breaking heat wave expected to extend stay in the West"). Dangerous heat, for sure, but, if you look at wet-bulb, you'll see that the headlines should be about the heat wave in the West **AND** Florida🧵 How we talk about hot weather is seriously flawed. As heat waves become more intense and more frequent because of climate change, we need to change the way we think about outdoor temperatures.

In my Editorial for @AMJPublicHealth on the history of ventilation, I share a story not many people know...

--> In late 2020, the ASHRAE Epidemic Task Force convened a group of experts and gave them an explicit task of making recommendations on ventilation rate targets...
🧵 This team submitted their first recommendations to the ASHRAE Epidemic Task Force in 2021...

...but the recommendations were never released to the public.

The history of ventilation is fraught, indeed. And it hasn't been told through a public health lens. I was invited to write an Editorial for @AMJPublicHealth. My reflections on how we got here, and what needs to happen next.
🧵 We are in the sick building era, ushered in by a historic mistake in the 1970s with the promulgation of a standard that lowered ventilation rates in nearly every building we spend our time, and which represented a gross departure from earlier health-focused higher ventilation targets.

This is bad public health. "Everyone stay indoors after 6pm for the next six weeks" (also happens to be the absolute nicest time of year in Massachusetts...) Totally unrealistic, totally unnecessary, and also will just be ignored, anyway.

https://twitter.com/CBSEveningNews/status/1827120410439098633

(A major contributing problem in Massachusetts is that we have **351** local boards of health...)

NEW from our Harvard Healthy Buildings team

We used CFD modeling to evaluate the effectiveness of portable air cleaners to help remove airborne pathogens and mitigate disease transmission in schools

[tl/dr: portable air cleaners work]

THREAD Portable air cleaners work!

We found that portable air cleaners w a clean air flow rate of 2.6 h−1 reduce mean aerosol intake of all students by up to 66%

On H5N1, milk and this NEJM letter
There are some really important points being missed. It's worth reading the whole letter, including the supplemental info (the authors do a good job of explaining everything); it's not very long...
1/n
nejm.org/doi/full/10.10… Relevant background
There are two main commercial pasteurization approaches: 63C/30min or 72C/15 sec

The Lancet Commission on Lessons for the Future from the Pandemic

The multiple failures of intn'l cooperation include
1. lack of timely notification of initial outbreak
2. costly delays in acknowledging the crucial airborne exposure pathway of SARS-CoV-2
thelancet.com/journals/lance… Do you know how we got this "costly delays in acknowledging the crucial airborne exposure pathway of SARS-CoV-2" into the manuscript? Steady work by this incredible Lancet Task Force (you'll recognize the crew)

Build buildings? Operate buildings? Invest in buildings? Work in buildings? Don’t sleep on this. Consensus that:

1) Current ventilation rates are too low
2) 30 cfm/p is a good target Members of the Lancet Covid-19 Commission Task Force on Safe Work, Safe School, Safe Travel

--> Report citing 30 cfm/p
static1.squarespace.com/static/5ef3652…

"Popcorn Lung" was coined when workers at a microwave popcorn packaging facility developed the disease after inhaling diacetyl, one of the chemicals used to create fake butter flavor. Diacetyl, and its many chemical cousins, create candy flavors, too. Fine to ingest; dangerous to inhale.

These same chemicals are often found in e-cigs/vapes. I wrote about "Popcorn Lung" and the flavoring chemicals used in e-cigs/vapes a few years ago:
nytimes.com/2018/04/04/opi…

Historic day. For 40 years we've been saddled with bare minimum ventilation standards that were not designed for health. Today, CDC released the 1st ever federal guidance on higher ventilation standards, and ASHRAE also released a doc for public comment🧵
cdc.gov/coronavirus/20… CDC specifies 5 ACHe.🙌 This is exactly in-line with the recommendations from our Lancet Covid-19 Commission. It's smart. It's evidence-based. It's understandable. It's actionable. It's achievable. It will keep people healthier.

https://twitter.com/j_g_allen/status/1640109363447705601?s=20

Current ventilation rates are not designed for Covid-19 (or any other respiratory pathogen)

That's why our Lancet Covid-19 Commission Task Force on Safe Work/School/Travel published this report.
🧵 Task Force had widespread agreement on:

1) current targets too low
2) getting bldgs off current minimums would lead to big gains
3) coalescence around target values, across experts and metrics
4) we want to propose something that moves this convo forward
5) there is urgency

Higher ventilation rates in schools associated with better math test scores.

This study, and many more, in the Harvard Healthy Buildings program report, "Schools for Health": schools.forhealth.org 5% decrement in "power of attention" in poorly ventilated classrooms...researchers equate this roughly to how a student might feel from skipping breakfast. schools.forhealth.org

1/ "It is imperative that orgs like ASHRAE, CDC, WHO, NIOSH create, adopt, and disseminate health-based standards for ventilation.

These orgs cannot continue to tell people to “bring in more air” without answering the critical question: “How much?”
harvardpublichealth.org/environmental-… 2/ Is there an answer to "how much"? Yes! Check out latest article by @dyanilewis. She cites the work of our Lancet @Commissioncovid Task Force that published ventilation targets and other groups.

nature.com/articles/d4158…

1/ Measles spreads through the air. I’m going to take a professional gamble here and, **prior to reading the article** (I swear), am betting that there’s no info on ventilation. Not measured; not discussed. washingtonpost.com/health/2023/03… 2/

Vaccine: ✅ (most important)
Ventilation: ❌

(So close, too, because the article has this: “Measles is a respiratory virus that is spread through the air. “)

Has anyone looked into ventilation here??

The First Four Healthy Building Strategies Every Building Should Pursue, from The Lancet Covid-19 Commission Task Force on Safe Work, Safe School, and Safe Travel 🧵 1/ Commission or Recommission Building Systems

1/ When our Lancet Covid-19 Commission Report came out, it got a lot of positive reviews, with the one exception being the "The Origins of SARS-CoV-2" section, which came under attack. We had it right. Look at the balanced presentation here:
thelancet.com/commissions/co… 2/ "The proximal origins of SARS-CoV-2 are still not known. Identifying these origins would provide greater clarity into not only the causes of the current pandemic but also vulnerabilities to future outbreaks and strategies to prevent them.

1/ This is *really* smart.

“Ms. Guglielmo, 67, was not satisfied. Instead, she paid $900 for an independent contractor to analyze the air in the store, Wristbands America, and was planning to pay to test her inventory of silicone bands.”

nytimes.com/2023/02/19/us/… 2/ Silicone wristbands act as passive chemical samplers (chemicals in the air absorb into them). We use them in our research. 👇

hsph.harvard.edu/healthybuildin…

1/ Everywhere I go these days I see portable air cleaners turned off and/or shoved in the corner. We need to address the noise issue. ANSI standard for background noise in unoccupied classroom is 35 dB(A), but many (most) devices are 55+. The CADR of a device that's off is...0

https://twitter.com/DavidElfstrom/status/1613522890271461386

2/ The ANSI standard also says diff between teacher and student shouldn't exceed 15 dB(A). If device is on in back of room humming at 55 dB(A), a teacher will have to be speaking at >70 dB(A)* or student will have trouble hearing/comprehending speech.