Indoor Environment and Emergency Response Health Outcomes

EPA Grant Number: R835749
Title: Indoor Environment and Emergency Response Health Outcomes
Investigators: Uejio, Christopher K , Tamerius, James D
Institution: Florida State University , University of Iowa
EPA Project Officer: Chung, Serena
Project Period: May 1, 2015 through April 30, 2018 (Extended to April 30, 2020)
Project Amount: $500,000
RFA: Indoor Air and Climate Change (2014) RFA Text |  Recipients Lists
Research Category: Air Quality and Air Toxics , Climate Change , Air


The objectives of this study are 1) to quantify the relationship between indoor and outdoor temperature and humidity and the built environment; 2) find actionable thresholds linking indoor temperature, humidity, and the built environment to extreme heat (summer) and influenza-like-illness (winter) emergency distress calls; 3) project future extreme heat disease burdens or influenza risk related to climatic and demographic changes.


This innovative study design observes indoor environment conditions of people receiving care for emergency distress calls i.e., 911 in two climatologically-distinct study cities: New York, NY and Jacksonville, FL. Beneficially, this study design 1) directly observes indoor exposures that may precedes distress calls and 2) targets vulnerable individuals. Small temperature and humidity sensors will accompany paramedics into patient households and monitor indoor conditions. Generalized Linear and Mixed Effects Models will relate outdoor weather conditions, sociodemographics, and the built environment, to indoor conditions (Objective #1). Next, a case-control study determines if extreme heat cases have more hot and humid indoor conditions compared to controls (summer). Other sub-objectives investigate how indoor humidity may affect the survivability of influenza and modulate the timing and incidence of influenza-like-illness (winter) distress calls (Objective #2). Finally, we use the delta method to project the future extreme heat disease burden and influenza risk using climatic and demographic scenarios (Objective #3). The projections consider short-term adaptations and quantify excess indoor conditions that long-term adaptations can address.

Expected Results:

Our anticipated results are that 1) the built environment and sociodemographic characteristics modify the relationship between outdoor and indoor conditions; 2) a higher proportion of extreme heat distress calls will experience hot and humid indoor conditions compared to controls; 3) influenza virus survival will be significantly greater in drier households; 4) a greater proportion of influenza-like-illness distress calls will be made from inside buildings with anomalously dry conditions; 5) projected demographic and climatic changes will increase total extreme heat distress calls. However, long-term built environment adaptations can limit future morbidity. The study results should improve the current health status of vulnerable populations inform adaptation strategies to projected changes.

Publications and Presentations:

Publications have been submitted on this project: View all 16 publications for this project

Journal Articles:

Journal Articles have been submitted on this project: View all 6 journal articles for this project

Supplemental Keywords:

air, ambient air, indoor air, exposure, health effects, human health, vulnerability, sensitive populations, elderly, age, race, viruses, epidemiology, climatology, modeling, monitoring, analytical, climate models, Northeast, Southeast, NY, FL

Progress and Final Reports:

  • 2015 Progress Report
  • 2016 Progress Report
  • 2017 Progress Report
  • 2018 Progress Report
  • Final Report