The UK government has committed to an 80% reduction in carbon emissions by 2050, with housing accounting for 27% of total current emissions. There are several drivers both to reduce emissions from homes and to reduce fuel poverty, promoting a range of building and behavioural measures in homes. The health benefits of warmer homes in winter have been described, but there has been less consideration of the potential negative impacts of some of these measures. We examine the changes in UK homes, and the possible consequences for health. The main concerns for health surround the potential for poor indoor air quality if ventilation is insufficient and the possible risks of overheating in heatwave conditions. This paper notes a limited evidence base and the need for further research on the health effects of energy-efficient homes, particularly with regard to ventilation.
health; homes; energy efficiency; indoor air quality; heatwave
The indoor environment is a significant determinant of population health. People in industrialized countries spend approximately 80% of their time indoors.1,2 Those at extremes of age or in poor health are likely to spend considerably more time at home than others; they may be particularly affected by changes to the indoor environment. The health sector has an important role in ensuring healthy indoor environments for all.
Three main drivers are promoting the building and refurbishing of homes to make them more energy efficient. First, housing accounts for 27% of current carbon dioxide (CO2) emissions in the UK.3 Home energy efficiency is seen as a key part of the UK government's commitment to an 80% reduction in carbon emissions from 1990 levels by 2050.4 Second, the national Fuel Poverty Strategy incorporates home energy efficiency as part of its framework to eradicate fuel poverty in vulnerable households by 2010.5 Third, the current financial crisis may encourage householders to contain energy costs by making their homes more energy efficient. Given the impact of the recent recession on the building industry, now is an opportune time to examine whether there is sufficient information on the impact on occupant health of existing building policy, guidance and practice.
The UK has one of the highest rates of excess winter mortality in Europe, with currently about 25,000 excess winter deaths each year.6 These deaths are at least partially related to poor housing.7 Much of the research and policy emphasis to date has been on exploring how energy-efficiency measures may benefit health through improved indoor temperatures in winter. However, it is important to also consider and mitigate any potential hazards to health. Chief among these concerns is the impact on indoor air quality (such as levels of radon; products of combustion; pollutants released by furnishings, building materials and consumer products; environmental tobacco smoke; mould and house dust mites), and the potential risk of overheating during heatwave conditions. Both hazards may have a significant impact on occupant health and wellbeing.
CHANGES IN OUR HOMES
Traditional UK housing has low thermal performance and high levels of air permeability. An estimated 15% of all UK homes (3.4 million) fail the thermal comfort criteria for a 'decent home'.8 The changes recommended to save energy and improve the thermal comfort of our homes include improved standards of insulation and air tightness, high-efficiency boilers, double glazing and behaviour change (e.g. switching appliances off at the wall).
In the UK, new-build and structural change in existing homes must comply with Building Regulations to ensure the health and safety of those in and around the building. The Building Regulations set out the requirements with which individual aspects of building design and construction must comply. There are 14 parts that cover aspects such as structure, access, fire safety, electrical safety, waste disposal, energy use, ventilation etc. …