Indoor air quality in day-care centers, kindergartens, and primary schools: a pediatric health-oriented operational framework aligned with European and U.S. IAQ standards
Abstract
Background: Children aged 0-12 spend many hours in day-care and school buildings characterized by high occupant density, synchronized occupancy peaks, intense activity, and frequent transitions. Exposure patterns differ between early childhood settings (day care/kindergarten/preschool) and primary schools due to differences in schedules, floor-level activity, cleaning routines, and staff-mediated operations. However, recent evidence remains heterogeneous and is often interpreted without sufficient differentiation between educational levels or adequate emphasis on operational verification under real-world conditions.
Objectives: This study aims to (O1) synthesize recent in situ evidence on IAQ in day-care, kindergarten/preschool, and primary school settings; (O2) identify determinants explaining exposure patterns (D1, occupancy/use intensity; D2, ventilation strategy and real operation; D3, seasonality and comfort-driven rebound; D4, outdoor pollution context, D5 envelope-moisture pathway); and (O3) translate the evidence into a conceptual, verifiable N1-N3 pathway aligned with European and U.S. normative anchors.
Methods: PRISMA 2020 reporting was followed. Searches in Scopus, Web of Science, and PubMed (2018-2025; last search conducted on 12 September 2025) identified 990 records (Scopus, 345; Web of Science, 456; PubMed, 189). After removing 289 duplicates, 701 records were screened, and 614 were excluded based on title and abstract. Reports assessed for eligibility (n =…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 87 participants or records.
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