Clean Indoor Air: A New Frontier in Public Health

In response to growing concerns around the health impacts of indoor air, a two-day roundtable co-led by Dr. Milana Trounce of Stanford University convened experts across disciplines to define and advance scientifically grounded standards for indoor air quality (IAQ). Held in partnership with Lidia Morawska of Queensland University of Technology, the event focused on developing actionable pathways toward cleaner indoor environments as a strategy for improving public health and resilience.

Dr. Trounce, Director of the BioSecurity and Pandemic Resilience program at Stanford Department of Emergency Medicine, framed the forum’s purpose around the need to better integrate indoor air quality into health, building, and climate agendas. She noted, “Amidst the escalating risks of pandemics and climate-related disasters like wildfires, the need for buildings that promote human health and environmental sustainability is more evident than ever. Scientific evidence highlights the crucial role of clean indoor air in bolstering resilience to such challenges and improving overall human well-being.”

Creating New Standards

The roundtable aimed to build consensus around performance-based IAQ standards that are both scientifically sound and feasible. Attendees brought expertise from emergency medicine, public health, aerobiology, engineering, and policy to bridge the gap between research and implementation. Discussions addressed how clean air intersects with infectious disease preparedness, environmental health, and sustainable building design.

The forum also explored the integration of IAQ into precision health strategies. This concept views clean air not only as a response to threats like wildfire smoke or airborne viruses but also as a preventive tool to improve health outcomes.

Role of Emergency Medicine

Emergency medicine played a central role in both framing and hosting the forum. Positioned at the crossroads of clinical care, public health, and disaster response, emergency medicine brings a unique perspective to indoor air.

“We see firsthand the consequences of poor indoor environments—whether it’s respiratory illness from wildfire smoke, infectious disease spread, or chronic conditions from prolonged exposure to pollutants,” said Trounce. “From that vantage point, precision emergency medicine isn’t just about treating disease—it’s about anticipating risk and creating healthier systems upstream.”

Notable Themes and Surprises

A key outcome was the level of alignment among traditionally siloed sectors. Trounce noted, “Whether from industry, government, or academia, participants shared a sense of urgency and purpose. Many in the building and design world are eager to lead—but are asking for consistent, science-based guidance.”

The forum also examined the need to raise public awareness and strengthen the economic case for IAQ improvements, including in retrofits and new construction.

Precision Emergency Medicine

The event continues Stanford Emergency Medicine’s role in advancing public health resilience. “We’re proud that Stanford Emergency Medicine helped convene this effort—and that our department continues to lead in precision emergency medicine, bringing evidence, action, and impact together at a systems level,” Trounce said.

As climate and infectious disease risks grow, clean indoor air is gaining traction as a core public health strategy. The forum’s interdisciplinary approach and emphasis on feasible, measurable standards reflect a shift from technical aspiration to actionable goal.

By placing emergency medicine at the center of this work, the roundtable highlighted the field’s broader role in systems change. Through science, policy, and industry collaboration, the movement toward clean indoor air is advancing with new momentum.

An Interdisciplinary Approach

The invitation-only Clean Indoor Air Roundtable convened diverse leaders, including:

  • Federal agency representatives

  • White House Clean Indoor Air Initiative officials

  • WHO Air Quality Advisory Committee members

  • Scientists from national labs, including Lawrence Berkeley National Laboratory

  • California Department of Public Health officials

  • ASHRAE engineering experts

  • CEOs and senior building design leaders

 

This interdisciplinary mix was intentional. According to event-director Dr. Milana Trounce, “Achieving clean indoor air requires collaboration across science, engineering, health, and policy. No single group can solve this alone—we need shared ownership and mutual understanding to make real progress.”

Key Takeaways

Participants aligned around several findings and recommendations:

  • Performance-based IAQ standards: Measurable, outcome-focused standards are needed beyond design guidelines.

  • Clear and feasible metrics: CO₂ levels, PM2.5, and ventilation rates were identified as practical starting points.

  • Monitoring and verification: Reliable data is essential to enforce and validate standards.

  • Balanced incentives and regulation: Both voluntary and mandatory mechanisms are necessary for adoption.

  • Action-focused implementation: The forum emphasized moving beyond theory to real-world application.

Next Steps

Several initiatives are now underway:

  • Development of industry-led IAQ standards
  • Publication of a policy roadmap and commentary
  • Identification of partners in local government and industry and launch of pilot projects with early adopters
  • Economic and health impact analysis
  • Coordination among national and global stakeholders