Long-term health and cognitive effects of indoor air quality in occupied public buildings

Indoor air quality (IAQ) in public buildings has traditionally been assessed through short-term measurements that capture immediate pollutant concentrations and ventilation performance. However, emerging evidence indicates that the long-term health and cognitive effects of chronic exposure to suboptimal IAQ are far more consequential, particularly in high-occupancy settings such as schools, hospitals, libraries, and administrative institutions. Poor IAQ characterized by elevated carbon dioxide, volatile organic compounds, particulate matter, and microbial contaminants has been linked to respiratory diseases, weakened immune response, and heightened vulnerability to infections. Yet beyond physical health, chronic exposure to polluted indoor environments affects cognitive function, concentration, memory formation, and emotional regulation. In classrooms, this manifests as learning loss, reduced test performance, and increased absenteeism. In healthcare environments, compromised IAQ can slow patient recovery rates, elevate stress among clinical staff, and increase cross-infection risks. This study situates IAQ as both a public health imperative and a determinant of human productivity and wellbeing, arguing that long-term exposure dynamics must be central to building management policy. It proposes a longitudinal monitoring and evaluation framework that integrates continuous air sensor data, occupant health records, and cognitive performance indicators. By examining multi-year trends, rather than isolated measurement snapshots, this approach captures the cumulative burden of air pollutants and identifies thresholds beyond which cognitive and physiological impairment becomes measurable. The study further emphasizes the need for international policy alignment to support proactive IAQ standards, especially in resource-limited regions where infrastructure upgrades may be incremental. Ultimately, improving IAQ is not only an environmental or engineering concern, but a foundational requirement for healthy learning, healing, and public service environments.