{
  "schema_version": "1.0",
  "title": "Clean Air / Aeritas evidence register",
  "updated_on": "2026-09-24",
  "scope": "Source-linked homeowner education. Not clinical advice, individual home results, or Aeritas outcome validation.",
  "clinical_review": "pending",
  "records": [
    {
      "id": "epa-indoor-time",
      "group": "Everyday exposure",
      "title": "Most of our time is spent indoors",
      "evidence_type": "Agency exposure summary",
      "population": "Americans, across indoor settings",
      "data_period": "Historical exposure research cited by EPA",
      "finding": "EPA estimates that Americans spend about 90% of their time inside buildings.",
      "context": "This includes homes, workplaces, schools, and other buildings. It is not a measure of time at home alone.",
      "homeowner_takeaway": "Pay attention to the places where you spend your day, including your home.",
      "source": {
        "title": "EPA · Report on the Environment: Indoor Air Quality",
        "url": "https://www.epa.gov/report-environment/indoor-air-quality"
      },
      "metrics": [
        {
          "value": 90,
          "unit": "percent of time",
          "qualifier": "approximately"
        }
      ],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    },
    {
      "id": "epa-indoor-pollutants",
      "group": "Everyday exposure",
      "title": "Some pollutants build up indoors",
      "evidence_type": "Agency exposure summary",
      "population": "Indoor versus outdoor concentrations of some pollutants",
      "data_period": "Historical exposure research cited by EPA",
      "finding": "EPA reports that concentrations of some pollutants are often 2 to 5 times higher indoors than outdoors.",
      "context": "The comparison applies to certain pollutants. It is not an overall air-quality score or a finding about your home.",
      "homeowner_takeaway": "Investigate sources, ventilation, and filtration instead of assuming indoor air is clean.",
      "source": {
        "title": "EPA · Report on the Environment: Indoor Air Quality",
        "url": "https://www.epa.gov/report-environment/indoor-air-quality"
      },
      "metrics": [
        {
          "lower": 2,
          "upper": 5,
          "unit": "indoor/outdoor concentration ratio",
          "qualifier": "some pollutants, often"
        }
      ],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    },
    {
      "id": "salo-bedroom-allergens",
      "group": "Everyday exposure",
      "title": "Allergens are common in bedroom dust",
      "evidence_type": "National survey analysis",
      "population": "NHANES participants, dust from nearly 7,000 U.S. bedrooms, eight allergens tested",
      "data_period": "2005–2006 data · published 2018",
      "finding": "At least one allergen was detectable for more than 99% of participants. At least one was classified as elevated for 72.9%.",
      "context": "“Elevated” used study percentile cutoffs, not a universal danger level. Dust measurements do not establish airborne dose, allergy, or illness.",
      "homeowner_takeaway": "Look at relevant sources and personal sensitivities. A general particle monitor cannot identify a specific allergen.",
      "source": {
        "title": "Salo et al. · JACI, 2018",
        "url": "https://pubmed.ncbi.nlm.nih.gov/29198587/"
      },
      "metrics": [
        {
          "value": 99,
          "operator": ">",
          "unit": "percent of participants with detectable bedroom allergen"
        },
        {
          "value": 72.9,
          "unit": "percent of participants with an elevated bedroom allergen"
        }
      ],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    },
    {
      "id": "epa-humidity",
      "group": "Moisture & equipment",
      "title": "Humidity is a useful starting point",
      "evidence_type": "Agency prevention guidance",
      "population": "Indoor spaces",
      "data_period": "EPA guidance checked September 2026",
      "finding": "EPA recommends keeping indoor relative humidity below 60%, ideally between 30% and 50% where possible.",
      "context": "These are moisture-control guidelines. A reading within the range does not rule out a leak, damp material, or condensation on a cold surface.",
      "homeowner_takeaway": "Review persistent humidity changes with moisture sources and HVAC operation.",
      "source": {
        "title": "EPA · A Brief Guide to Mold, Moisture and Your Home",
        "url": "https://www.epa.gov/mold/brief-guide-mold-moisture-and-your-home"
      },
      "metrics": [
        {
          "lower": 30,
          "upper": 50,
          "unit": "percent relative humidity",
          "qualifier": "ideal guidance where possible"
        },
        {
          "value": 60,
          "operator": "<",
          "unit": "percent relative humidity",
          "qualifier": "EPA prevention guidance"
        }
      ],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    },
    {
      "id": "epa-drying",
      "group": "Moisture & equipment",
      "title": "Water damage needs prompt attention",
      "evidence_type": "Agency prevention guidance",
      "population": "Materials made wet or damp by a leak or spill",
      "data_period": "EPA guidance checked September 2026",
      "finding": "EPA advises acting quickly and drying wet or damp materials within 24 to 48 hours to help prevent mold growth.",
      "context": "Start promptly. This is not a safe waiting period or a guarantee that mold will not develop.",
      "homeowner_takeaway": "Address the water source and arrange appropriate drying. Do not wait for a monitoring baseline.",
      "source": {
        "title": "EPA · A Brief Guide to Mold, Moisture and Your Home",
        "url": "https://www.epa.gov/mold/brief-guide-mold-moisture-and-your-home"
      },
      "metrics": [
        {
          "lower": 24,
          "upper": 48,
          "unit": "hours after leak or spill",
          "qualifier": "drying guidance, act promptly"
        }
      ],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    },
    {
      "id": "hvac-maintenance",
      "group": "Moisture & equipment",
      "title": "Your equipment feels the effects, too",
      "evidence_type": "Equipment maintenance guidance",
      "population": "Residential heating and cooling equipment",
      "data_period": "ENERGY STAR guidance checked September 2026",
      "finding": "Dirty coils can reduce cooling, increase runtime and energy costs, and shorten equipment life. A blocked condensate drain can cause water damage and affect indoor humidity.",
      "context": "These are equipment conditions that need inspection. A room particle or humidity reading cannot identify a failed component.",
      "homeowner_takeaway": "Check coils, filter condition, drainage, and airflow as part of HVAC care.",
      "source": {
        "title": "ENERGY STAR · Maintenance Checklist",
        "url": "https://www.energystar.gov/saveathome/heating-cooling/maintenance-checklist"
      },
      "metrics": [],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    },
    {
      "id": "dew-point-example",
      "group": "Moisture & equipment",
      "title": "A comfortable room can still have a wet surface",
      "evidence_type": "Physical example in technician training manual",
      "population": "Illustrative air and surface conditions",
      "data_period": "Mainstream Engineering · eighth edition, January 2016 · PDF page 49",
      "finding": "At 80°F and 50% relative humidity, the dew point is approximately 60°F. Surfaces colder than that can collect condensation.",
      "context": "This is a physical example, not a mold detection threshold or a recommended thermostat setting.",
      "homeowner_takeaway": "Look at cold surfaces and insulation as well as the room humidity reading.",
      "source": {
        "title": "Scaringe · Indoor Air Quality and Mold Remediation Service Techniques, p. 49",
        "url": "https://ww2.epatest.com/wp-content/uploads/2019/01/Indoor-Air-Quality-Manual.pdf#page=49"
      },
      "metrics": [
        {
          "value": 80,
          "unit": "degrees Fahrenheit, air"
        },
        {
          "value": 50,
          "unit": "percent relative humidity"
        },
        {
          "value": 60,
          "unit": "degrees Fahrenheit, approximate dew point"
        }
      ],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false,
      "supplied_file": "25-Indoor-Air-Quality-Manual.pdf"
    },
    {
      "id": "cdc-asthma-prevalence",
      "group": "Health research",
      "title": "Asthma is common. Its causes need individual evaluation.",
      "evidence_type": "National health statistics",
      "population": "U.S. adults age 18+ and children under 18",
      "data_period": "2024 estimates",
      "finding": "CDC reports current asthma in 8.6% of U.S. adults and 6.5% of children for 2024.",
      "context": "These figures describe asthma prevalence. They do not show how many cases were caused by home air.",
      "homeowner_takeaway": "Discuss symptoms with a clinician and investigate relevant indoor triggers alongside medical care.",
      "source": {
        "title": "CDC / NCHS · FastStats: Asthma",
        "url": "https://www.cdc.gov/nchs/fastats/asthma.htm"
      },
      "metrics": [
        {
          "value": 8.6,
          "unit": "percent of U.S. adults with current asthma",
          "year": 2024
        },
        {
          "value": 6.5,
          "unit": "percent of U.S. children with current asthma",
          "year": 2024
        }
      ],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    },
    {
      "id": "varga-mold-asthma",
      "group": "Health research",
      "title": "Home mold is associated with childhood asthma",
      "evidence_type": "Meta-analysis of observational studies",
      "population": "11 cohort studies and 21 case-control studies of childhood asthma",
      "data_period": "Published online 2024 · journal issue 2025",
      "finding": "The pooled odds ratio was 1.15 in cohort studies (95% CI 1.01–1.31) and 1.53 in case-control studies (1.42–1.65).",
      "context": "The cohort results varied substantially. Odds ratios are not an individual child’s probability of asthma, and these observations do not diagnose a cause.",
      "homeowner_takeaway": "Take moisture and visible mold seriously while a clinician evaluates health concerns.",
      "source": {
        "title": "Varga et al. · Childhood asthma and mould in homes",
        "url": "https://doi.org/10.1007/s00508-024-02396-4"
      },
      "metrics": [
        {
          "value": 1.15,
          "unit": "pooled odds ratio",
          "design": "cohort",
          "ci95": [
            1.01,
            1.31
          ]
        },
        {
          "value": 1.53,
          "unit": "pooled odds ratio",
          "design": "case-control",
          "ci95": [
            1.42,
            1.65
          ]
        }
      ],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    },
    {
      "id": "morgan-home-intervention",
      "group": "Health research",
      "title": "Comprehensive home action can make a difference",
      "evidence_type": "Randomized controlled trial",
      "population": "937 children ages 5–11 with allergic asthma in seven U.S. cities",
      "data_period": "Published 2004 · one-year intervention",
      "finding": "Children receiving tailored education and home allergen and tobacco-smoke remediation averaged 3.39 symptom days per two weeks, compared with 4.20 in the control group during the intervention year.",
      "context": "The difference was 0.81 symptom days per two weeks. This tested a comprehensive program, not a monitor, and does not establish an Aeritas result.",
      "homeowner_takeaway": "Connect identified exposures with appropriate action and follow-up, alongside asthma care.",
      "source": {
        "title": "Morgan et al. · New England Journal of Medicine, 2004",
        "url": "https://pubmed.ncbi.nlm.nih.gov/15356304/"
      },
      "metrics": [
        {
          "value": 3.39,
          "group": "intervention",
          "unit": "symptom days per two weeks"
        },
        {
          "value": 4.2,
          "group": "control",
          "unit": "symptom days per two weeks"
        },
        {
          "value": 0.81,
          "unit": "fewer symptom days per two weeks",
          "derivation": "4.20 - 3.39"
        }
      ],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    },
    {
      "id": "hansel-clean-air",
      "group": "Health research",
      "title": "Filtration research includes mixed results",
      "evidence_type": "Randomized controlled trial",
      "population": "116 former smokers with moderate-to-severe COPD, active HEPA/carbon air cleaners versus sham units",
      "data_period": "Online 2021 · journal issue 2022 · six months",
      "finding": "The trial found no statistically significant difference in its primary overall respiratory quality-of-life outcome. Some secondary symptom measures improved. The moderate-exacerbation rate ratio was 0.32 (95% CI 0.12–0.91).",
      "context": "Report the primary result alongside the secondary findings. Results apply to this population and intervention, not all filters or Aeritas monitoring.",
      "homeowner_takeaway": "Choose equipment for a documented need and evaluate its results without promising a medical outcome.",
      "source": {
        "title": "Hansel et al. · CLEAN AIR trial",
        "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8886948/"
      },
      "metrics": [
        {
          "value": 0.32,
          "unit": "incidence rate ratio for moderate exacerbations",
          "ci95": [
            0.12,
            0.91
          ],
          "outcome": "secondary"
        },
        {
          "value": null,
          "unit": "overall SGRQ primary outcome",
          "result": "no statistically significant between-group difference"
        }
      ],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    },
    {
      "id": "epa-monitor-scope",
      "group": "Measurements & action",
      "title": "A monitor sees only what its sensors measure",
      "evidence_type": "Agency monitor guidance",
      "population": "Low-cost indoor air monitors",
      "data_period": "EPA guidance checked September 2026",
      "finding": "Low-cost monitors measure selected pollutants or environmental conditions. They do not give a complete assessment of indoor air quality.",
      "context": "A room reading cannot establish that a home is free of every hazard, identify every pollutant, or diagnose illness.",
      "homeowner_takeaway": "Confirm supported sensors and placement, then interpret trends alongside inspection findings.",
      "source": {
        "title": "EPA · Low-Cost Air Pollution Monitors and Indoor Air Quality",
        "url": "https://www.epa.gov/indoor-air-quality-iaq/low-cost-air-pollution-monitors-and-indoor-air-quality"
      },
      "metrics": [],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    },
    {
      "id": "epa-source-control",
      "group": "Measurements & action",
      "title": "Start with the source, then choose the solution",
      "evidence_type": "Agency air-cleaning guidance",
      "population": "Homes and indoor pollutant sources",
      "data_period": "EPA guidance checked September 2026",
      "finding": "EPA prioritizes reducing pollutant sources and ventilating with clean outdoor air. Filtration can supplement those measures.",
      "context": "A filter does not remove every pollutant or correct a moisture source. Suitability depends on the home, equipment, and conditions outdoors.",
      "homeowner_takeaway": "Ask what a proposed solution addresses and how the result will be checked.",
      "source": {
        "title": "EPA · Air Cleaners and Air Filters in the Home",
        "url": "https://www.epa.gov/indoor-air-quality-iaq/air-cleaners-and-air-filters-home"
      },
      "metrics": [],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    },
    {
      "id": "epa-radon",
      "group": "Measurements & action",
      "title": "Some concerns need a dedicated test",
      "evidence_type": "Agency national estimate",
      "population": "U.S. homes",
      "data_period": "EPA national estimate, checked September 2026",
      "finding": "EPA estimates that nearly one in 15 U.S. homes has an elevated radon level.",
      "context": "This is a national estimate, not a Jacksonville rate or a result for your home. Radon requires a radon-specific test or sensor.",
      "homeowner_takeaway": "Ask what is included in an assessment. Do not assume a general air monitor measures radon.",
      "source": {
        "title": "EPA · Radon in Homes, Schools and Buildings",
        "url": "https://www.epa.gov/radtown/radon-homes-schools-and-buildings"
      },
      "metrics": [
        {
          "value": 1,
          "denominator": 15,
          "unit": "U.S. homes",
          "qualifier": "nearly, EPA estimate"
        }
      ],
      "publication": "preview_with_context",
      "verification": "primary_source_checked",
      "checked_on": "2026-09-24",
      "production_alert_rule": false
    }
  ]
}