Indoor air quality in naturally ventilated primary schools: A systematic review of the assessment & impacts of CO2 levels

Indoor air quality (IAQ) in schools significantly impacts occupant health and academic performance, especially in naturally ventilated (NV) classrooms, where CO2 levels are often elevated. This systematic review synthesises findings from 125 studies, examining CO2 as an indicator of ventilation rates (VRs) and its impact on IAQ, health, and academic performance in NV primary school classrooms. This analysis highlights seasonal and temporal variations in CO2 concentrations, revealing a median CO2 concentration of 1487 ppm across 2444 classrooms, with 81% exceeding the recommended 1000 ppm threshold. Influencing factors include VR, occupant density, generation rates, and occupant behaviours. Increased VRs consistently lowered CO2 levels and enhanced IAQ. CO2 concentrations correlated with particulate matter, volatile organic compounds, bioeffluents, microbial concentrations, and bacteria and fungi levels, but not with traffic-related pollutants like NO2 , which is associated with asthma prevalence. Elevated CO2 levels consistently correlated with fatigue, headaches, respiratory symptoms, reduced academic performance and absenteeism, suggesting potential socio-economic benefits of increased VRs. However, effective IAQ management requires balancing ventilation with considerations of thermal comfort, noise, and outdoor pollutants. The findings highlight the need for standardised IAQ indices and CO2 monitoring protocols, offering insights for future research, intervention design, and investment aimed at enhancing classroom environments.