According to attendees at Stanford’s first-ever Forum on Sustainable and Healthy Buildings, clean and well-ventilated indoor air should be considered as essential to public health as clean water. From March 30 to April 1, the conference served as a rare cross-sector convention focused on advancing national indoor air quality (IAQ) by minimizing indoor pollutants.
Over two days, 24 stakeholders from institutions like the California Department of Public Health, U.S. Green Building Council and the International WELL Building Institute debated the most effective actions to implement IAQ guidelines that could soon be monitored in commercial and residential buildings.
Milana Trounce MBA ’08, an emergency medicine professor and a co-organizer of the forum, said that the forum emerged from more than a decade of personal teaching and engagement around pandemic preparedness. Trounce added that the COVID-19 pandemic, along with worsening wildfire smoke events in the western U.S., underscored the need to address air quality as an important public health intervention.
“Through those conversations [with a pilot group], we discovered a lack of consensus — even among leading design engineers — on how best to achieve buildings that are simultaneously ‘clean and green,’” Trounce wrote to The Daily. “We identified a gap and an opportunity: the need for a high-level convening to bridge knowledge from science/aerobiology/public health, engineering, policy, and industry and chart a path forward.”
The meeting modeled their agenda after a 2024 Science publication by Lidia Morawska, a co-organizer and health director of Queensland University of Technology’s International Laboratory for Air Quality. Conversations surrounding IAQ metrics focused on maintaining low indoor levels of particulate matter (PM2.5) and carbon dioxide (CO2), though attendees also discussed other pollutants.
During a roundtable evaluating existing buildings, new construction projects and IAQ costs, attendees noted that there is currently no IAQ enforcement manual to which policymakers and building owners can refer to.
While the group reached a consensus on the urgent need for an IAQ performance standard model in new construction and existing infrastructure, they also acknowledged that widespread adoption faces several challenges.
For Georgia Lagoudas, a senior fellow at the Brown University Pandemic Center, an ongoing lack of public demand for IAQ policies has slowed meaningful advances.
“Demand needs to come from building occupants, or students or teachers or workers, asking for clean indoor air,” Lagoudas said. “In the absence of that demand, there needs to be a path to incentivize or require it. Just like we have required fire safety codes.”
Multiple speakers agreed that national reporting was crucial in driving interest and investments for IAQ. Some proposed the creation of a public, anonymous IAQ database for future early adopters, which could include schools and government buildings.
Corey Metzger, a board member for the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), supports Lagoudas’ perspective. Still, he believes that the reality of inserting new IAQ technology into existing infrastructure remains the primary hurdle.
“The logistics of implementing solutions to achieve the recommendations and requirements of a guidelines or standard is the single biggest challenge,” Metzger said. “If, and it’s a big if, we can get nationwide acceptance of a standard, or anything close, the scale needed for personnel and materials to implement solutions will be enormous.”
While a national framework with clear quantitative standards is key, Trounce feels that this alone will not be enough. She told The Daily that both community-driven and legislative decisions will be necessary to build long-lasting interest in IAQ — the “demand” that Lagoudas referred to.
“Grassroots action from parents, teachers, small business owners and others who care deeply about their communities will be key in building public awareness and demand,” Trounce said. “The sweet spot is when bottom-up and top-down efforts reinforce one another. That’s what we’re aiming to help catalyze.”
Metzger’s perspective shifted during the forum. While he previously emphasized regulation, he now sees greater promise in these bottom-up approaches.
“Empowering the public to advocate for better IAQ by providing tools — sensors or other methods — and information seems to be the best path for driving meaningful and positive change,” Metzger said.
Lagoudas agreed, calling this dual-approach a “no-brainer.” She said the roadmap from the conference offers building owners and design firms a chance to include IAQ features in new office projects nationwide.
After the forum, participants formed working groups tasked with drafting IAQ performance standards, launching pilot projects, publishing commentary and coordinating outreach with policymakers and industry leaders.
According to Trounce, virtual communication is ongoing and a second summit, possibly at Stanford again, is under discussion. She hopes that the momentum from this initial forum will drive sustained collaboration from attendees and broader industries.
“This work is essential — not only to pandemic resilience — but to precision health, equity and climate adaptation,” Trounce said.