Microbiomes of the
Built Environment
A RESEARCH AGENDA FOR INDOOR MICROBIOLOGY,
HUMAN HEALTH, AND BUILDINGS
Committee on Microbiomes of the Built Environment:
From Research to Application
Board on Life Sciences
Board on Environmental Studies and Toxicology
Board on Infrastructure and the Constructed Environment
Division on Earth and Life Studies
Health and Medicine Division
Division on Engineering and Physical Sciences
National Academy of Engineering
A Consensus Study Report of
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by Grant No. 2014-13628 from the Alfred P. Sloan Foundation, a grant from the Gordon and Betty Moore Foundation, Grant No. NNX16AC85G from the National Aeronautics and Space Administration, Contract No. HHSN263201200074I with the National Institutes of Health, Contract No. EP-C-14-005/0007 with the U.S. Environmental Protection Agency, and with additional support from the National Academy of Sciences Cecil and Ida Green Fund. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-44980-9
International Standard Book Number-10: 0-309-44980-4
Digital Object Identifier: https://doi.org/10.17226/23647
Library of Congress Control Number: 2017952589
Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2017 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2017. Microbiomes of the Built Environment: A Research Agenda for Indoor Microbiology, Human Health, and Buildings. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/23647.
The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.
The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president.
The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.
The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.
Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.
Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.
Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.
For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.
COMMITTEE ON MICROBIOMES OF THE BUILT ENVIRONMENT: FROM RESEARCH TO APPLICATION
Committee Members
JOAN WENNSTROM BENNETT (Chair), Rutgers University
JONATHAN ALLEN, Lawrence Livermore National Laboratory
JEAN COX-GANSER, National Institute for Occupational Safety and Health
JACK GILBERT, University of Chicago
DIANE GOLD, Brigham and Women’s Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health
JESSICA GREEN, University of Oregon
CHARLES HAAS, Drexel University
MARK HERNANDEZ, University of Colorado Boulder
ROBERT HOLT, University of Florida
RONALD LATANISION, Exponent, Inc.
HAL LEVIN, Building Ecology Research Group
VIVIAN LOFTNESS, Carnegie Mellon University
KAREN NELSON, J. Craig Venter Institute
JORDAN PECCIA, Yale University
ANDREW PERSILY, National Institute of Standards and Technology
JIZHONG ZHOU, University of Oklahoma
Project Staff
KATHERINE BOWMAN, Study Director and Senior Program Officer, Board on Life Sciences
ELIZABETH BOYLE, Program Officer, Board on Environmental Studies and Toxicology
DAVID A. BUTLER, Scholar, Health and Medicine Division
ANDREA HODGSON, Postdoctoral Fellow, Board on Life Sciences
JENNA OGILVIE, Research Associate, Board on Life Sciences
CAMERON OSKVIG, Director, Board on Infrastructure and the Constructed Environment
PROCTOR REID, Director, National Academy of Engineering Program Office
FRANCES SHARPLES, Director, Board on Life Sciences
Consultants
RONA BRIERE, Editor
HELAINE RESNICK, Editor
Acknowledgments
This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.
We thank the following individuals for their review of this report:
William P. Bahnfleth, The Pennsylvania State University
Rita R. Colwell, University of Maryland, College Park
Richard Corsi, The University of Texas at Austin
Pieter C. Dorrestein, University of California, San Diego
Peter B. Hutt, Covington & Burling LLP
Susan Lynch, University of California, San Francisco
Janet Macher, California Department of Public Health (retired)
Mihai Pop, University of Maryland, College Park
Joan B. Rose, Michigan State University
Sarah Slaughter, Built Environment Coalition
Martin Täubel, National Institute for Health and Welfare, Finland
Mary E. Wilson, Harvard T.H. Chan School of Public Health
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or
recommendations of this report, nor did they see the final draft before its release. The review of this report was overseen by Michael R. Ladisch, Purdue University, and William W. Nazaroff, University of California, Berkeley. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.
Preface
Ours is a microbial world. Although we cannot see microbes with the naked eye, we all live with microbial consortia. The microbes that are indigenous to our bodies are an essential component of our biology. Moreover, the indoor environments in which we live also harbor a complicated constellation of microbial types. The levels of microbial diversity, and the sheer numbers of organisms, are incongruous with our visual experience, but current microbiome research is changing the way we look not only at ourselves but also at the built environments we have created. DNA sequencing technologies provide a new view of the ubiquity and diversity of microbes in our lives. In looking back on centuries of human experience with buildings, we can see that people have developed many systems that support human comfort and convenience. The vision articulated in this report is that microbiome research can guide improvements to future buildings to enhance human healthfulness.
Do we know enough to rationally manage the microbial communities around us in built environments? The answer is “no.” However, there are provocative hints that in the future, coherent management of the indoor microbiome can help prevent the spread of disease and contribute to human longevity, health, and well-being.
To produce this Consensus Study Report, the National Academies of Sciences, Engineering, and Medicine brought together a group of experts to discuss the microbial communities inside our built environments and their potential effects on human health. The committee sought to understand indoor microbiome research, a discipline that is dedicated to studying build-
ings, the microbial communities found inside of buildings, and the complex interactions that impact human health and well-being. Of necessity, this report touches on a number of extremely dissimilar areas of research and therefore required a committee with diverse expertise. I am grateful to the informed and insightful group of professionals who so generously shared their time and knowledge during the process of writing this report. Their collective expertise was reflective of the range of subject matter covered during our deliberations. The report also was informed by a number of excellent speakers and other participants who came to our open sessions. We thank all of these contributors for sharing their perspectives and research with us. Their contributions were invaluable in further developing our ideas and filling gaps in our expertise. In addition, we thank the report reviewers who provided insightful and instrumental feedback.
On behalf of the committee, I extend our greatest appreciation to the staff of the National Academies who worked with us throughout the process of creating this report. Without their time and guidance, this report would not have been possible. Finally, we thank the sponsors of the study for their financial support and for their astute vision of what this report could accomplish.
Joan Wennstrom Bennett, Chair
Committee on Microbiomes of the Built Environment:
From Research to Application
Contents
Emerging Tools That Facilitate Analysis
Studying the Intersection of Microbial Communities, Built Environments, and Human Occupants
Prior Efforts on Which This Report Builds
2 MICROORGANISMS IN BUILT ENVIRONMENTS: IMPACTS ON HUMAN HEALTH
Influence of Building Microbiomes on Human Health: Ecologic and Biologic Plausibility
Transmission of Infection in Indoor Environments
Damp Indoor Environments, Indoor Microbial Exposures, and Respiratory or Allergic Disease Outcomes
Nonairway and Nonallergy Effects
Beneficial Effects of Microbes
3 THE BUILT ENVIRONMENT AND MICROBIAL COMMUNITIES
Introduction to Microbial Reservoirs in Commercial and Residential Buildings
The Diversity of Buildings and Its Impact on Their Microbiomes
Indoor Air Sources and Reservoirs of Microbes
Indoor Water Sources and Reservoirs of Microbes
Building Surfaces and Reservoirs of Microbes
Impacts of Microbes on Degradation of Building Materials and Energy Usage
Building Codes and Standards That May Affect the Microbiome
The Influence of Climate and Climate Change on the Built Environment and Microbial Communities
Summary Observations and Knowledge Gaps
4 TOOLS FOR CHARACTERIZING MICROBIOME–BUILT ENVIRONMENT INTERACTIONS
The Built Environment as a Complex Experimental Environment
Characterizing Indoor Microbial Communities
Linking Analysis of Microbial Communities to Building Characteristics and Human Health Impacts
Moving from Research Toward Practice
Summary Observations and Knowledge Gaps
5 INTERVENTIONS IN THE BUILT ENVIRONMENT
Physical Interventions to Reduce Exposure to Hazardous Microbes
Chemical Interventions to Reduce Exposure to Hazardous Microbes
Interventions to Encourage Exposure to Beneficial Microbes
A Framework for Assessing Built Environment Interventions
This page intentionally left blank.
Boxes, Figures, and Tables
BOXES
S-1 Key Terms Used in This Report
S-2 Knowledge Gaps Identified in This Report
S-3 A Research Agenda for Moving to Practical Application
1-2 Modeling Built Environment Ecology
2-1 Transmission of Infectious and Noninfectious Organisms in Hospital Neonates
2-3 Asthma, Early-Life Exposures, and Farm-Type Environments
3-2 Challenges for the Management of Microbes: The International Space Station
FIGURES
1-2 Transport and life cycle of indoor microbes
2-1 Modes of transmission of microorganisms from the airborne environment
3-1 The influence of water chemistry and flow on the microbiome of bulk water pipes
5-1 Physical processes govern the assembly of indoor microbial communities
TABLES
2-2 Associations Between Health Outcomes and Exposure to Damp Indoor Environments
3-1 Buildings and Surfaces Where Viruses Have Been Detected or Survived
3-2 Home High-Touch Surfaces and Bacterial Reservoirs
3-3 Hospital High-Touch Surfaces and Bacterial Reservoirs
3-6 WELL Building Standard Features That Address Microbiome-Related Issues
Acronyms and Abbreviations
ACGIH | American Conference of Governmental Industrial Hygienists |
AHAM | Association of Home Appliance Manufacturers |
AIHA | American Industrial Hygiene Association |
ANSI | American National Standards Institute |
ASHRAE | American Society of Heating, Refrigerating and Air-Conditioning Engineers |
ASM | American Society for Microbiology |
ASTM | American Society for Testing and Materials |
aw | water activity |
BASE | Building Assessment Survey and Evaluation |
BOMA | Building Owners and Managers Association |
CADR | clean air delivery rate |
CBECS | Commercial Buildings Energy Consumption Survey |
CDC | U.S. Centers for Disease Control and Prevention |
CHAMPS | Combined Heat, Air, Moisture, and Pollutant Simulation |
CHILD | Canadian Healthy Infant Longitudinal Development |
CHW | community health worker |
CMPBS | Center for Maximum Potential Building Systems |
CNS | central nervous system |
DNA | deoxyribonucleic acid |
DOAS | dedicated outdoor air system |
DOD | U.S. Department of Defense |
DOE | U.S. Department of Energy |
EBI | European Bioinformatics Institute |
ECHO | Environmental Influences on Child Health Outcomes |
ECRHS | European Community Respiratory Health Survey |
EPA | U.S. Environmental Protection Agency |
eQUEST | Quick Energy Simulation Tool |
ERH | equilibrium relative humidity |
ETS | environmental tobacco smoke |
FIFRA | Federal Insecticide, Fungicide, and Rodenticide Act |
GSA | General Services Administration |
HCWH | Health Care Without Harm |
HEPA | high-efficiency particulate air (filter) |
HHS | U.S. Department of Health and Human Services |
HUD | U.S. Department of Housing and Urban Development |
HVAC | heating, ventilation, and air conditioning |
IAPMO | International Association of Plumbing and Mechanical Officials |
IAQA | Indoor Air Quality Association |
IBPSA | International Building Performance Simulation Association |
ICAS | Inner City Asthma Study |
ICC | International Code Council |
ICS | inhaled corticosteroid |
ICU | intensive care unit |
IDA ICE | IDA Indoor Climate and Energy simulation tool |
IES | Illuminating Engineering Society; also Integrated Environmental Solutions |
IgCC | International Green Construction Code |
IICRC | Institute for Inspection, Cleaning and Restoration Certification |
ILFI | International Living Future Institute |
IPM | integrated pest management |
IR | infrared |
ISAAC | International Study of Asthma and Allergies in Childhood |
ISIAQ | International Society of Indoor Air Quality and Climate |
ISS | International Space Station |
ITS | internally transcribed spacer |
IV | intravenous |
IWBI | International WELL Building Institute |
LEED | Leadership in Energy and Environmental Design |
LPS | lipopolysaccharide |
MBARC-26 | Mock Bacteria and ARchaea Community |
MCAN | Merck Childhood Asthma Network |
MERCCURI | Microbial Ecology Research Combining Citizen and University Researchers on ISS |
MERS | Middle East respiratory syndrome |
MERV | Minimum Efficiency Reporting Value |
MIxS-BE | Minimum Information about any (X) Sequence-extension for the Built Environment |
MoBE | Microbiomes of the Built Environment |
mRNA | messenger ribonucleic acid |
MRSA | methicillin-resistant Staphylococcus aureus |
MSSA | methicillin-sensitive Staphylococcus aureus |
MVOC | microbial volatile organic compound |
NASA | National Aeronautics and Space Administration |
NCBI | U.S. National Center for Biotechnology Information |
NCS | National Children’s Study |
NGS | next-generation sequencing |
NHANES | National Health and Nutrition Examination Survey |
NHAPS | National Human Activity Pattern Survey |
NHLBI | National Heart, Lung, and Blood Institute |
NIAID | National Institute of Allergy and Infectious Diseases |
NICU | neonatal intensive care unit |
NIEHS | National Institute of Environmental Health Sciences |
NIH | National Institutes of Health |
NIOSH | National Institute for Occupational Safety and Health |
NIST | National Institute of Standards and Technology |
NSF | National Science Foundation |
OFEE | Office of the Federal Environmental Executive |
OSHA | Occupational Safety and Health Administration |
OTU | operational taxonomic unit |
PAMP | pathogen-associated molecular pattern |
PCR | polymerase chain reaction |
PM | particulate matter |
QOL | quality of life |
qPCR | quantitative PCR |
RCT | randomized controlled trial |
RECS | Residential Energy Consumption Survey |
RH | relative humidity |
RNA | ribonucleic acid |
rRNA | ribosomal ribonucleic acid |
SARS | severe acute respiratory syndrome |
SSCP | single-strand conformation polymorphism analysis |
SVOC | semivolatile organic compound |
TAB | testing, adjusting, and balancing |
TB | tuberculosis |
tRFLP | terminal restriction fragment length polymorphism |
TRNSYS | Transient System Simulation Tool |
USGBC | U.S. Green Building Council |
UV | ultraviolet |
UVGI | ultraviolet germicidal irradiation |
VA | U.S. Department of Veterans Affairs |
VOC | volatile organic compound |
VRE | vancomycin-resistant enterococci |
WHO | World Health Organization |
WUFI | Wärme Und Feuchte Instationär |