DOI: https://doi.org/10.58248/PB54
Background
Poor air quality has negative health impacts. Air pollution was the theme of the Chief Medical Officer's 2022 annual report. People spend the majority of their time inside, and are exposed to a wide range of pollutants in the air that they breathe indoors whether at home, at work or in other public spaces including schools and hospitals.
Some groups are particularly vulnerable to the health effects of poor air quality; many of these people are the least likely to be least able to influence the quality of the air that they are exposed to indoors. Recent coroners' inquests have highlighted the direct contribution of air pollution to the deaths of two children.
A range of interventions to improve indoor air quality can be put in place. They include methods to control sources of pollution, improving ventilation and using air cleaning technologies, increasing public awareness and strategies to influence behaviour change. There is a range of legislative and regulatory instruments to improve air quality but few directly address the quality of indoor air. Criticisms include a the lack of legally enforceable standards for what would constitute acceptable limits for indoor pollutant levels, and a lack of an integrated policy approach.
Overview of key points
- People spend 80-90% of their time indoors (homes, schools, workplaces, other public spaces and on transport). The effects of poor indoor air quality on health are less well understood than those due to poor outdoor air quality.
- The indoor environment is more complex and variable than outdoors. Sources and concentrations of pollutants can vary greatly between as well as within buildings. Several research projects are underway to address a range of knowledge gaps.
- Indoor pollutant sources include building materials, cooking and heating appliances, consumer products, occupant activities, damp, and the land on which buildings are sited. Concentrations of certain pollutants are higher indoors, and can be exacerbated by poor ventilation. Indoor pollutant concentrations are also affected by the infiltration of air from outdoors.
- There is strong evidence for associations between certain individual pollutants, and overall poor air quality, with an increased risk of respiratory and cardiovascular illness, cognitive impairment and certain cancers.
- There are inequalities in risk for some groups in the population. Vulnerable groups include those who are young, elderly or pregnant, or those who have respiratory disease; other demographic characteristics associated with an increased health risk from poor air quality include socio-economic status and ethnicity.
- Indoor air pollution can be tackled in several ways including removing pollutant sources, improving ventilation, air cleaning, increasing public awareness and legislative changes. There is a trade-off between improving ventilation while reducing the energy consumption of buildings.
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The Government has established a cross-department working group and pledged to tackle aspects of indoor air quality in its 2019 Clean Air Strategy. This included several commitments to reduce emissions in the home such as prohibiting the sale of the most polluting fuels and stoves, improving consumer awareness, and giving new powers to local authorities to take action to minimise air pollution.
Acknowledgements
POSTbriefs are based on literature reviews and interviews with a range of stakeholders and are externally peer reviewed. POST would like to thank interviewees and peer reviewers for kindly giving up their time during the preparation of this briefing, including:
- Members of the POST Board*
- Asthma and Lung UK
- Dr Suzanne Bartington, University of Birmingham*
- Professor Nicola Carslaw, University of York*
- Matthew Clark, Hertfordshire County Council and Chartered Institute of Environmental Health*
- Professor Martin Clift, Swansea University
- Cross-Government Indoor Air Quality Working Group*
- Dr Derrick Crump, Indoor Air Quality Consulting
- Dr Andy Dengel, Building Research Establishment*
- Dr Hywel Davies, Chartered Institution of Building Services Engineers
- Professor Sani Dimitroulopoulou, UK Health Security Agency*
- Dr Robert Ferguson, University of Essex*
- Dr Gary Fuller, Imperial College London
- Global Action Plan
- Professor Rajat Gupta, Oxford Brookes University*
- Dr James Heydon, University of Nottingham*
- Professor Sir Stephen Holgate, University of Southampton*
- Dr Peter Ka Hung Chan, University of Oxford
- Professor Frank Kelly, Imperial College London*
- Professor Alastair Lewis, University of York
- Dr Emma Marczylo, UK Health Security Agency*
- Professor Jim McManus, Hertfordshire County Council and Association of Directors of Public Health
- Dr Ian Mudway, Imperial College London
- Professor Catherine Noakes, University of Leeds*
- Chris Rush, Institute of Air Quality Management*
- Dr Sarah West, Stockholm Environment Institute and University of York
- Professor Corinne Whitby, University of Essex
- Dr Tom Woolley, Rachel Bevan Architects*
*Denotes people and organisations who acted as external reviewers of the briefing.