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  • Writer's pictureLeo Tonkin

The Importance of Indoor Air Quality in Senior Living

Updated: Feb 4, 2023

Leo Tonkin, The Chair of the Global Wellness Institute Respiratory Initiative, shares strategies that go beyond preventing pathogen transmission to contributing to resident and staff well-being.


There is a concerted effort of the part of many in senior living design and operations to improve the quality of the air inside their buildings. Senior living residents spend even more time indoors than the average American, who typically spends about 90% of their time inside. The American Lung Association warns that an unhealthy indoor environment can “cause or contribute to infections, lung cancer, and chronic lung diseases such as asthma.”


There are 2 to 5 times more pollutants indoors versus outdoors, according to Dr. Jie Zhao, Executive Vice President at Delos, and lecturer at the University of Pennsylvania. Dr. Zhao has devoted his career to investigating how interactions between the built environment and humans impact health, comfort, and productivity; and how human activity impacts a building’s sustainability and energy. "People don’t realize the dangers of indoor air quality, given how much time we spend inside. If someone were to give you a dirty glass of water, you probably wouldn’t drink it, but the air we breathe is invisible. We breathe 2,000 gallons of air a day, and consume at most a couple gallons of water," said Dr. Zhao.


According to the Global Burden of Disease, the most comprehensive database of epidemiological trends worldwide, the top three risk factors for disease for all 8 billion people on the globe are number one smoking, number two air pollution, and number three high blood pressure. People understand how smoking and high blood pressure impact health and well-being, but most don’t understand that air pollution is detrimental to health.


Increasing awareness of dangerous indoor air quality, and of course, COVID-19, have brought respiratory wellness to the forefront in senior living. This focus on indoor air quality goes well beyond preventing illness or pathogen transmission. There is finally awareness that buildings directly impact overall health and well-being. There is a natural decline in our respiratory system as we age, along with increased susceptibility to COPD, asthma, allergies, and other conditions. A healthy respiratory system is directly connected to aging well.


PM 2.5 The Invisible Enemy


Fine particulate matter (PM 2.5), an air pollutant that is two and one-half microns or less in width, is the primary culprit in dangerous air quality, both indoor and outdoors. As large as the size of a hair or as fine as a virus or bacteria, PM 2.5 not only negatively impacts our respiratory system, it gets into our bloodstream and goes to our heart, making it one of the major contributors to heart disease.


Larger particles will be filtered or blocked by our nose and mouth, but smaller ones will get into our upper respiratory system. The smaller they are, the deeper they go into our system. Below 2.5 is the sweet spot for the maximum size of particles the body will absorb into the lungs and bloodstream.

Steps to Improve Air Quality in Your Senior Living Community


This insight around air-awareness should encourage more spas to implement a system for monitoring indoor air quality – not just to prevent the spread of airborne transmissions, but also to ensure the health and safety of team members to enhance their ability to focus and work efficiently.

  1. Monitor. The first step is to get a baseline of your spa’s indoor air quality. Today there are a lot of air quality monitoring devices, and they are market rate. They provide a relative scale and that's good enough for most of us to know whether the air quality is good or bad.

  2. Ventilate. A ventilation system introduces "fresh" outdoor air and removes the "contaminated" indoor air.

  3. Filter. Filtration goes a step further than ventilation to actually remove pollutants from the air. A lot of buildings, especially older buildings, have ventilation systems that are decades old and not capable or efficient enough to properly purify the environment. Stand-alone air purifiers circulate internally within buildings to deactivate pollutants and microorganisms.

HVAC systems recirculate the same air, which is why you need a dedicated fresh air system in your spa. The “holy grail” of air purification in your spa is a combination of a good ventilation system with localized filtration systems. Localized filtration in your breathing zone is like immediately getting out in the fresh air.


Salt Therapy for Respiratory Wellness


Progressive senior living communities are adding salt therapy to their wellness suites to help residents cleanse the respiratory system and support respiratory conditions such as COPD, asthma, and long-term COVID. Dry salt therapy has been used for centuries to improve respiratory wellness and skin health. Salt rooms and salt booths provide an enclosed space to inhale the micron-salt particles of 99.99% pure-grade sodium chloride (salt). The dry aerosol penetrates deep into the lungs to aid the respiratory system and is absorbed into the skin.


Dry salt therapy acts as an anti-inflammatory. It helps open the airway passages and increases oxygen intake. It literally gives people their breath back. Somebody who could play only a few holes of golf can now play a full round, or walk up and down the stairs, or along the beach. SALT Chamber has designed salt rooms in a dozen senior living communities. We're working with developers, designers, and architects right now for future sites to create additional value in terms of acquiring residents.


Respiratory Wellness Initiatives


Delos created WISE Initiative, Wellness Innovation in Senior Environments, a partnership with senior operators and investors to study environmental conditions in communities and develop cost-effective solutions. “The goal is to advance scientific research, education and innovation that will help meet the growing consumer demand for senior living communities that offer safer, healthier environments for residents and staff. We focus on air quality and lighting—easy fixes that provide a big impact,” said Dr. Zhao.


As Chair of the Global Wellness Institute's Respiratory Wellness Initiative, our goal is to bring attention to the need to improve the quality of the air we breathe. As climate change, air pollution, and COVID-19 continue to impact many millions worldwide, this collaborative, global effort between leading physicians, scientists, and health and wellness business leaders will mobilize people and communities to improve the quality of the air that we breathe.



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