**3. The Italian Situation**

Among the Member States of the EU, Italy plays an important role, as evidenced by the 10.4% of publications in the IAQ field during the last two decades (Figure 1). The Italian situation is particularly interesting because, unlike the other countries, in the Italian legislation, there is no specific reference relating to residential IAQ, even if pre-regulatory initiatives have multiplied.

In relation to IAQ, in almost all European countries, a legislative delay has been compulsorily and quickly filled. This delay has to be covered, with the issue of specific acts containing suitable references for chemical and biological pollutants, in line with those developed by the WHO, with the most recent and user-friendly specific protocols and procedures provided by the ISO 16000 indoor air standard in its various parts. For these reasons, in 2010, the National Study Group (GdS) on Indoor Air Pollution was established at the Italian Institute of Health (IIS), in which the various ministerial components are represented (Ministry of Health, Ministry of the Environment and Protection of the Territory and the Sea, Ministry of Labor and Social Policies), regions, local authorities and research institutes (IIS, National Research Council (CNR), Italian National Agency for New Technologies, Energy, and the Sustainable Economic Development (ENEA), Italian Institute for Environmental Protection and Research (ISPRA), National System for Environmental Protection (SNPA), and the National Institute for Insurance against Accidents at Work (INAIL). The GdS-ISS is working to provide shared technical–scientific documents in order to allow harmonized actions at national level in order to improve the correct assessment of indoor air pollution. The documents of the GdS-ISS, published as Rapporti ISTISAN, or dissemination documents, include recommendations to prevent indoor air pollution, to improve behavior, cultural awareness, training, to reduce exposure and effects on health, and to increase economic competitiveness.

The GdS-ISS has developed eight reference documents for the monitoring strategies of the main indoor chemical and biological pollutants, the role of the different sources, the energy efficiency activities, and the different indoor combustion [38–48]. Table 3 shows the list of ISTISAN reports already published by the GdS-ISS. Some of the technical indications can already be used for the definition of a national plan on indoor air quality and constitute an important reference for the country.


**Table 3.** Rapporti ISTISAN just published by the National Study Group (GdS) on Indoor Pollution.

<sup>1</sup> This publication is not authored by the GdS, but it contains issues related to the IAQ.

The results of this activity have been included in the Directive of the President of the Council of Ministers 1 June 2017 published in the Official Journal on 17 July 2017, among the mandatory training activities that the employer must provide to workers. Such activities of the GdS-ISS have also been taken up in the Air Pollution Strategy of the WHO Country Profile for Italy. In this way, an informative booklet entitled "Air in our home: how to improve it" was prepared, which illustrates the origin of indoor air pollution, the role of sources (household cleaning products, construction products, furniture, fabrics, incense sticks, scented candles, stoves, etc.), and the contribution of individual behaviors, providing specific recommendations to reduce indoor pollution levels.

Work is currently in progress for the preparation of two new documents on indoor air quality in office environments and on contaminated sites. On the other hand, ISTISAN reports are being published that address the problems of indoor air quality in school and health facilities, with the identification of specific environmental detection methodologies and possible sanitary implications.

In 2018, Pierpaoli and Ruello published a paper on the bibliometric study on the IAQ [49]: the authors asked the question "What are the actual trends in Indoor Air Quality (IAQ), and in which direction is academic interest moving?" Starting from that, the authors analyzed the worldwide literature from 1990 to 2018, using the Web of Science as a database. They identified past trends and current advances in IAQ, as well as the issues that were expected to be pertinent in the future. In this section, we would like to show state-of-the-art research in the IAQ sector in Italy from previous years, considering what is shown in Figure 1: 243 scientific papers in specialized journals have been published in Italy since 2015. The topics cover different subjects, i.e. environmental science, engineering, medicine, social sciences, energy, physics and astronomy, biochemistry, genetics and molecular biology, materials science, chemistry, chemical engineering, earth and planetary sciences, agricultural and biological sciences, immunology and microbiology, pharmacology, toxicology and pharmaceutics, computer science, mathematics, business, management and accounting, economics, econometrics and finance, arts and humanities, decision sciences, multidisciplinary, and nursing. This means there is a large interest by the scientific community in this field.

Most papers are addressed to investigate the IAQ in schools. Such topics are important because, based on the subpopulation interested, such as suggested by Manigrasso et al. [50], which estimated the particle regional respiratory doses for both combustion and non-combustion aerosol sources currently encountered in microenvironments, with special regards to the age of subjects. Recent papers on school environments are related to monitoring PM, NOx, VOCs, and CO2, with regard to the ventilation efficiency and the energy consumption [51–56]. As to the radon exposure, according to two papers, the schools are vulnerable targets due to the long daily childhood presence, and the radon risk could be reduced by low-cost interventions (e.g., implementation of natural air ventilation and school maintenance) [57,58]. Over the last five years, several papers were published on residential IAQ: the authors would like to highlight the main papers of interest. Different research groups dealt the problems related to wood or biomass burning, evidencing the emissions and the related risk assessment [59–61]. Particular attention has been addressed to hospitals and healing places for defining protocol for inpatient rooms, to understand the state-of-the-art research and for suggesting design and management strategies for improving process quality [62,63]. Indoors, there are different combustion and non-combustion sources. Manigrasso et al. revised all of the possible sources and investigated the ultrafine particle emissions and relative doses deposited in the human respiratory tract [64–66]. The importance of the micro-climatic parameters was discussed by Zanni et al., which monitored the IAQ in the airport of Bologna (Italy) as a prototypal example of a large regional airport [67]. Siani et al. applied the cluster analysis on a long time series of temperature and relative humidity measurements for identifying the thermo-hygrometric features in a museum [68]. Cincinelli et al. characterized the IAQ in libraries and archives in Florence (Italy), evidencing that benzene, toluene, ethylbenzene, and xylenes (BTEXs) are the most abundant VOCs, along with cyclic volatile methylsiloxanes, aldehydes, terpenes, and organic acids. In particular, the authors detected presence of acetic acid, which is a chemical that can oxidize books and other exposed objects, and furfural, which is a known marker of

paper degradation [69]. Tirler and Settimo discussed the increasing use of incense, magic candles, and other flameless products that may represent a health risk for humans. Pollutants, such as benzene and PM10 are mainly affected when these products are used indoors (for instance, the benzene concentration ranged from background levels to over 200 μg m−<sup>3</sup> after the incense sticks had been tested) [70].

As can be seen, one of the main focal points of the authors is the relationship between IAQ and energy consumption, which is very important. However, it should be considered that the plans and/or interventions of restructuring or renovation cannot be only oriented to the theme of insulation, containment, and energy efficiency, which can alter or worsen air quality, microclimatic conditions, and natural ventilation. They should follow approaches allowing an overall improvement in air quality, with criteria to promote and guarantee health, primarily, to offer all of the maximum benefits of the most current quality educational and training models, and to obtain savings in management costs. Similarly, the same approach should be followed in cases of complete plant adaptations or restructuring (water, electricity, heat, fire, etc.).
