1.2
%8 01/2005 %XLimited research is available on potential adverse effects of school environments on academic performance, despite strong public concern. We examine the scientific evidence relevant to this relationship by reviewing available research relating schools and other indoor environments to human performance or attendance. As a primary focus, we critically review evidence for direct relationships between indoor environmental quality (IEQ) in buildings and performance or attendance. As a secondary focus, we summarize, without critique, evidence on potential connections indirectly linking IEQ to performance or attendance: relationships between IEQ and health, between health and performance or attendance, and between attendance and performance. The most persuasive direct evidence showed increases in indoor concentrations of nitrogen dioxide and outdoor concentrations of several specific pollutants to be related to reduced school attendance. The most persuasive indirect evidence showed indoor dampness and microbiologic pollutants to be related to asthma and respiratory infections, which have in turn been related to reduced performance and attendance. Furthermore, a substantial scientific literature links poor IEQ (e.g., low ventilation rate, excess moisture or formaldehyde) with respiratory and other health effects in children and adults. Overall, evidence suggests that poor IEQ in schools can influence the performance and attendance of students, primarily through health effects from indoor pollutants. Also, inadequate IEQ in schools seems sufficiently common to merit strong public concern. Evidence is available to justify (1) immediate actions to protect IEQ in schools and (2) focused research on exposures, prevention, and causation, to better guide policies and actions on IEQ in schools.