Indoor air pollution: The invisible killer inside our homes

By - Integrated Care Journal

The World Health Organisation (WHO) has defined air pollution as the public health challenge of our time, the cause of approximately seven million deaths every year. This is supported by a growing body of evidence about the impact of poor air quality upon health.

“Who is responsible? I keep asking myself how seven million people can die and yet nothing is done about it? ” asked Rosamund Adoo-Kissi-Debrah at the Public Policy Projects (PPP) Annual Conference.

Rosamund’s daughter, Ella, was diagnosed with rare and life-threating asthma before her seventh birthday. Ella passed away at the age of nine. Since then, Rosamund has Co-founded the Ella Roberta Family Foundation, where she dedicates her time to raising awareness of the true dangers of asthma and air pollution.

The damage begins before birth. A recent study by the Hasselt University in Belgium discovered particulate matter (PM) on the foetal side of the placenta, indicating that black carbon breathed in by pregnant women impacts unborn children. Meanwhile, researchers at the Beijing Normal University found that those exposed to higher levels of air pollution had an increased risk of miscarriage.

“I keep asking myself how seven million people can die and yet nothing is done about it? ”

- Rosamund Adoo-Kissi-Debrah, Co-Founder of the Ella Roberta Family Foundation

So far, the policy debate surrounding air pollution has mostly, if not entirely, focused on outdoor environmental air pollution. Yet, Professor Stephen Holgate, Clinical Professor of Immunopharmacology at the Medical Research Council, argued that poor indoor air quality can be just as dangerous. To this end, PPP organised a panel session, in partnership with Dyson, to discuss: Applying Innovation to the Social Determinants of Health - Improving our air quality at home.

The big picture

While the health risks associated with poor air quality are well documented, the UK has a long way to go before being able to tackle them fully. “We need to consider that we only spend around five-to-ten per cent of our time outside, with 90 per cent indoors,” said Professor Holgate. “What are we breathing there? Does anybody know? No, because as soon as you go in through your front door, that's your house. What goes on behind that door is not the Government’s or anybody else’s business,” he added.

The statistics are worrying. The National Human Activity Pattern Survey shows that people inhale more pollutants indoors than outside. The United States Environmental Protection Agency (EPA) reported that the concentration of pollutants found indoors is two-to-five times higher than typically found outdoors. Despite this evidence, the UK Government has thus far omitted to put forward legislation to seriously tackle the issue.

“We need to make air pollution everyone’s problem,” said Juliette Price, Solutions Architect for the Social Determinants of Health at Helgerson Solutions Group. Juliette stressed that as long as it is just the people who have asthma or know someone who has asthma championing this issue, it will not be enough. Widespread engagement along with outside-of-the-box thinking is required to truly mitigate this growing problem.

Innovating a solution

Fortunately, novel solutions are on the horizon. In March 2019, Dyson collaborated on the Breathe London project. The experiment, conducted by King’s College London and the Greater London Authority sought to monitor pollutants children are exposed to during the commute to and from school. Data gathering sits at the heart of understanding air pollution.

To this end, Dyson has around 1.7 million machines in 39,000 different sites around the world collecting data about indoor air quality every six seconds. Dyson hopes to use this data to paint a comprehensive picture of air quality across the globe. “Measurement and visualisation of the problem really help drive change and hopefully gives people the power to take positive steps,” said Paul Dawson, former Vice President of Health at Dyson.

As well as monitoring air quality at a range of sites around the world, Dyson is also focused on designing and testing new technologies to purify air indoors. “Understanding the problem is really important to driving change,” said Paul. In 2016, Dyson engineers launched their first purifying fan. More recently, in 2019, Dyson released a fan that can simultaneously heat or cool the user while purifying the room and removing pollutants including formaldehyde, one of the key sources of indoor air pollution.

However, due to cost and accessibility limitations, technology alone does not provide a comprehensive solution. So far, argued Professor Holgate, poor air quality has been regarded as “somebody else’s responsibility” and neither government nor healthcare providers have taken a lead in addressing it. According to Rosamund, we should all treat air pollution as a “major crisis,” especially those directly involved in the health sector.

“Air pollution affects everything from stillbirths to miscarriages. We all have a responsibility, so what are you going to do about it? ” she challenged delegates. From local authorities and national government to the healthcare providers and the general public, we need to collectively embrace this challenge and work to find a solution.


Key recommendations to local authorities and health professionals by the National Institute for Health and Care Excellence (NICE)

  • Prioritise indoor air quality in local strategies or plans by emphasising the need for a balanced approach to ventilation, insulation and heating for good indoor air quality
  • Encourage collaborations between local authority departments and local health and social care providers to improve air quality in people's homes
  • Ensure the general population is aware of the cause of poor air quality and how health is affected by indoor air pollution, particularly among people with pre-existing health conditions such as asthma
  • Advise the general population on specific pollutants and their sources, as it can help them reduce the pollution levels in their homes and improve their health
  • Advise private and public sector landlords about the health risks associated with poor indoor air quality
  • Ensure homes have suitable and efficient heating and ventilation
  • Encourage home visits by health professionals in order to help prevent or reduce indoor air pollution

Full NICE Guideline on Indoor Air Quality at Home report available here

PPP video session on Indoor Air pollution available here

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