Improving the energy efficiency of buildings is a major target in developed countries toward decreasing their energy consumption and CO2 emissions. To meet this target, a large number of countries have established energy codes that require buildings to be airtight. While such a retrofitting approach has improved health outcomes in areas with heavy traffic, it has worsened the health outcomes in Nordic countries and increased the risk of lung cancer in areas with high levels of radon emissions. This review highlights the importance of adapting the characteristics of energy-efficient residential buildings to the location, age, and health of inhabitants to guarantee healthy indoor pollutant levels. The implementation of mechanical ventilation in new energy-efficient buildings has solved some of these problems; however, for others, a decrease in the level of outdoor pollutants was still required in order to achieve a good indoor air quality. A good balance between the air exchange rate and the air humidity level (adapted to the location) is key to ensuring that exposure to the various pollutants that accumulate inside energy-efficient buildings is low enough to avoid affecting inhabitants' health. Evidence of the protective effect of mechanical ventilation should be sought in dwellings where natural ventilation allows pollutants to accumulate to threatening levels. More studies should be carried out in African and Asian countries, which, due to their rapid urbanization, use massive volumes of unproven/unrated building materials for fast-track construction, which are frequent sources of formaldehyde and VOC emissions.
Keywords: health outcomes; human; indoor air quality; mechanical ventilation; natural ventilation; review.