Air cleaners in energy-efficient buildings: performance, health evidence and implementation challenges
Journal article, 2026
Indoor air quality (IAQ) plays a critical role in human health, yet indoor pollutants frequently accumulate despite improvements in ventilation and building design. Air cleaners are increasingly used as a complementary mitigation strategy, but their real-world effectiveness and clinical relevance remain heterogeneous. This review synthesizes evidence from 36 peer-reviewed studies to evaluate the pollutants targeted by air-cleaning technologies, their removal efficiency under realistic conditions, and their associations with respiratory, cardiovascular and other health outcomes. HEPA-based systems consistently reduce indoor particulate matter (PM), often by 20–80%, and show moderate evidence for short-term cardiopulmonary benefits, including reductions in blood pressure and inflammatory biomarkers. In contrast, evidence for gaseous pollutant removal, long-term health outcomes, cognitive effects and economic impacts remains limited, and some technologies may generate harmful byproducts such as ozone. The review also considers implications for vulnerable populations and energy-efficient buildings where ventilation may be constrained. By critically evaluating multidisciplinary evidence, this work bridges the gap between air-cleaning performance metrics and public-health relevance, supporting informed decision-making for practitioners, policymakers and building professionals.
Indoor air quality
air cleaners
human health outcomes
energy-efficient buildings
HEPA filtration
particulate matter
Author
A Afshari
Aalborg University
A. Aganovic
University of Tromsø – The Arctic University of Norway
Haider Latif
Aalborg University
Arsen Melikov
Technical University of Denmark (DTU)
G. Cao
Norwegian University of Science and Technology (NTNU)
Risto Kosonen
Aalto University
Lars Ekberg
Chalmers, Architecture and Civil Engineering, Building Services Engineering
Martin Thalfeldt
Tallinn University of Technology (TalTech)
Olli Seppänen
Finnish Association of HVAC Societies FINVAC
Pawel Wargocki
Technical University of Denmark (DTU)
Pertti Pasanen
University of Eastern Finland
Svein Ruud
RISE Research Institutes of Sweden
Sasan Sadrizadeh
Royal Institute of Technology (KTH)
Mälardalens university
Advances in Building Energy Research
1751-2549 (ISSN) 1756-2201 (eISSN)
Vol. In PressSubject Categories (SSIF 2025)
Occupational Health and Environmental Health
DOI
10.1080/17512549.2026.2692582