Title: In2Air: the impact of ‘net-zero’ household energy intervention on indoor air quality, occupant self-reported general health and wellbeing, and household energy use.
Funder: Department of Health and Social Care

Abstract: Background to the research: Air pollution is one of the main causes of ill health and premature death worldwide. It particularly affects the very young (damages growing lungs), the elderly and those with relevant pre-existing medical conditions (for example asthma). Given we spend a great deal of our time indoors, we need to make sure indoor air is safe to breathe. The UK Government has set challenging targets to reduce our production of greenhouse gases (the ‘net-zero’ challenge) as these gases cause the planet to warm and drive climate change. Homes play a large part in greenhouse gas emissions and so the energy efficiency of homes is of international importance as we work to reduce the impact of climate change. In response, UK housing providers are making changes to homes to reduce household energy use. Our aim: The aim of this study is to collect indoor air quality, energy use and health information from householders for at least a month before any energy efficiency renovations take place. We want to know if renovations to homes designed to improve household energy efficiency, like insulation, reducing draughts and using mechanical air extractors, change the amount of indoor air pollutants (such as dust or gases that can be harmful if we breathe them in), as well as lower the amount of energy used in the home. Design and methods used: Our local authority partner (Newcastle City Council) is undertaking energy efficiency improvements to its homes, starting with 91 bungalows with older residents. This type of home modification is set to increase, so it’s vital that we understand potential effects on indoor air quality, as well as on health and wellbeing and on energy savings. Thirty households will be recruited to take part in this study. These households will work with a researcher to 1) complete a questionnaire survey that will collect information on the home and occupants, 2) have equipment to monitor energy use and indoor and outdoor air quality installed and running for a month or more before the renovations take place. The information we collect will show the baseline (pre-renovation) conditions. We will apply for further funding to undertake repeat monitoring a year after these renovations so that we can see if there have been any changes in indoor air quality, in the household’s energy use and in their general health and wellbeing. This future work will make recommendations to remove or reduce any negative impacts (so called ‘unintended consequences’). Community engagement: Local community representatives have been involved in the design of the study and study materials and will continue to be consulted throughout the project to make sure information is easy to understand and addresses residents’ concerns. Communities participating in the study will benefit by receiving information on sources of air pollution and ways to improve indoor air quality and reduce energy use. Researchers on the project will act as ambassadors for community science, hosting public events to encourage community members to participate and stay engaged, and to share study findings and experiences. Future energy efficiency works are an opportunity to improve residents’ health and wellbeing, in addition to achieving the necessary reductions for climate change through energy savings. Our work will help ensure that the increased energy efficiency of homes does not inadvertently cause health problems from reduced indoor air quality.

Lay abstract: Research question What is the impact of energy efficient retrofit intervention on indoor air quality (AQ), household energy use and self-reported general health and wellbeing in older occupants (> 65 years) living in social housing? Background Energy efficiency renovations have an opportunity to improve the thermal comfort of homes and improve indoor AQ. Both these can have positive outcomes for residents, if appropriately delivered, and reduce GP/hospital visits and NHS costs. It is vital that indoor air quality is not compromised by air sealing of homes. A unique contribution of this primary research study is its focus on the AQ and health effects associated with the energy efficient refurbishment of existing social housing. Aims and objectives 1: To characterise baseline conditions: concentration of indoor air pollutants, household energy consumption, general health and wellbeing, before intervention. 2: To facilitate community involvement and engagement Methods and timeline for delivery The study is a non-randomized natural experiment on Newcastle City Council (NCC) owned homes in the Walker area of Newcastle upon Tyne. Walker is ranked 45 out of 32,844 in England in the latest Index of Multiple Deprivation scores where 1 is the most deprived. During this 6-month study we will collect baseline data on 30 bungalows before these homes undergo a fabric-first intervention. We will measure: i) indoor and outdoor concentrations of PM10,2.5 (primary outcome metric: indoor particulate matter (PM10 and PM2.5) concentrations; exposures to PM are associated with increased risk of allergic and respiratory diseases); indoor CO2 concentrations (elevated levels are regarded as sign of inadequate ventilation and often used as a surrogate measure of the amount of outdoor air introduced into the home); ii) outdoor and indoor temperature and humidity (due to their effect on mould growth and thermal comfort); iii) energy consumption (monitoring and utility bills), and iv) self-reported general health and wellbeing (using SF-36v2 and a modified ICECAP-A survey). Histograms, boxplots and descriptive statistics will be used to summarise these data, identify patterns, with associations investigated using regression modelling. Two key domains will be presented for the general health and wellbeing data: a physical component summary and a mental health component summary. We will host events in the local neighbourhood to enable the community to contribute, participate, share experiences and feedback ideas for increasing engagement. To remove financial barriers to study participation we will provide reimbursements of costs of participating in the study. To remove mobility barriers participants can undertake all elements of the study from their home. Anticipated impact and dissemination This 6-month study will: 1) develop a rigorous scalable protocol for collecting baseline data to facilitate an evaluation of the impact of retrofitting on indoor AQ, household energy use, general health and wellbeing, 2) generate new awareness of indoor conditions and AQ, energy use and health across a previously under-represented community, and 3) provide new insight and learning from research engagement with a previously under-represented community. All of which will be disseminated through stakeholders, website and a capacity building event. Long-term public health impacts will derive from reduced fuel poverty co-delivered alongside improved indoor AQ.

Research activity codes: 3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS
Health categories: GENERIC HEALTH RELEVANCE