Health effects of home energy efficiency interventions in England: a modelling study.
OBJECTIVE
To assess potential public health impacts of changes to indoor air quality and temperature due to energy efficiency retrofits in English dwellings to meet 2030 carbon reduction targets.


METHODS
Health impact modelling study.


METHODS
England.


METHODS
English household population.


METHODS
Three retrofit scenarios were modelled: (1) fabric and ventilation retrofits installed assuming building regulations are met; (2) as with scenario (1) but with additional ventilation for homes at risk of poor ventilation; (3) as with scenario (1) but with no additional ventilation to illustrate the potential risk of weak regulations and non-compliance.


RESULTS
Primary outcomes were changes in quality adjusted life years (QALYs) over 50 years from cardiorespiratory diseases, lung cancer, asthma and common mental disorders due to changes in indoor air pollutants, including secondhand tobacco smoke, PM2.5 from indoor and outdoor sources, radon, mould, and indoor winter temperatures.


RESULTS
The modelling study estimates showed that scenario (1) resulted in positive effects on net mortality and morbidity of 2241 (95% credible intervals (CI) 2085 to 2397) QALYs per 10,000 persons over 50 years follow-up due to improved temperatures and reduced exposure to indoor pollutants, despite an increase in exposure to outdoor-generated particulate matter with a diameter of 2.5 μm or less (PM₂.₅). Scenario (2) resulted in a negative impact of -728 (95% CI -864 to -592) QALYs per 10,000 persons over 50 years due to an overall increase in indoor pollutant exposures. Scenario (3) resulted in -539 (95% CI -678 to -399) QALYs per 10,000 persons over 50 years follow-up due to an increase in indoor exposures despite the targeting of pollutants.


CONCLUSIONS
If properly implemented alongside ventilation, energy efficiency retrofits in housing can improve health by reducing exposure to cold and air pollutants. Maximising the health benefits requires careful understanding of the balance of changes in pollutant exposures, highlighting the importance of ventilation to mitigate the risk of poor indoor air quality.
UCL Energy Institute, University College London, London, UK.
Ian
http://orcid.org/0000-0003-2582-2361
I
Hamilton
Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK.
James
J
Milner
Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK.
Zaid
Z
Chalabi
UCL Institute for Environmental Design and Engineering, University College London, London, UK.
Payel
P
Das
Department of Architecture and Built Environment, University of Nottingham, Nottingham, UK.
Benjamin
B
Jones
UCL Institute for Environmental Design and Engineering, University College London, London, UK.
Clive
C
Shrubsole
UCL Institute for Environmental Design and Engineering, University College London, London, UK.
Mike
M
Davies
Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK.
Paul
P
Wilkinson
D000393:Air Pollutants / Q000032:analysis*; D016902:Air Pollution, Indoor / Q000032:analysis* / Q000517:prevention & control; D002274:Carcinogens, Environmental / Q000032:analysis*; D004739:England / Q000453:epidemiology; D004781:Environmental Exposure; D004784:Environmental Monitoring; D006078:Government Programs; D006798:Housing / Q000592:standards*; D006801:Humans; D008962:Models, Theoretical; D052638:Particulate Matter; D011634:Public Health; D014691:Ventilation / Q000592:standards
D000393:Air Pollutants; D002274:Carcinogens, Environmental; D052638:Particulate Matter
EPIDEMIOLOGY; PUBLIC HEALTH