The Burden of Respiratory Disease from Formaldehyde, Damp and Mould in English Housing

Abstract

Quantifying the burden of disease from exposure to poor indoor air pollution can support policy development. In England, there is current regulatory and public attention on the health implications of residential exposure to formaldehyde, damp and mould. However, there is scarce information on these health impacts at the population scale. As such, we assessed the burden of key respiratory diseases from residential formaldehyde, damp and/or mould for the English population aged 0–14 and 15–49. We obtained data on the percentage of dwellings affected by damp and/or mould from the English Housing Survey and estimated the distribution of residential formaldehyde concentrations (annual average (μg/m3)) by pooling data from monitoring studies conducted in England. Exposures were combined with epidemiological relationships and national health data to estimate Population Attributable Fractions (PAFs), disease incidence, and Disability Adjusted Life Years (DALYs) lost associated with residential formaldehyde or damp and/or mould exposure in England. We made estimates for the year 2019 but also looked back several years in time. Exposure to formaldehyde was associated with approximately 4000 new cases of childhood asthma (~800 DALYs lost) in 2019, though the estimates were sensitive to the placement of the lower exposure threshold. Exposure to damp and/or mould was associated with approximately 5000 new cases of asthma (~2200 DALYs) and approximately 8500 lower respiratory infections (~600 DALYs) among children and adults in 2019, though the PAFs were unequally distributed across dwellings based on income and ethnicity. Alternative data sources suggest that the percentage of dwellings affected by damp and/or mould may even be higher, resulting in a possible 3–8-fold greater number of cases and DALYs. Our assessment emphasizes a potential respiratory health burden in England associated with residential formaldehyde as well as damp and/or mould, further highlighting the public health importance of good indoor air quality and good quality housing.

Damp and mould—the big picture. How do we tackle the damp and mould crisis in social housing: lessons from the UK

“…Effects of damp and mould include coughing, wheezing and shortness of breath, increased risk of airway infections, worsening or development of allergic airway diseases, irritation to the eyes, eczema, and fungal infections (3). In the most extreme cases, prolonged exposure to damp and mould can lead to death (4). Living in a home with damp and mould can also lead to worsening mental health, as a result of the stress of living in unpleasant conditions, anxiety related to the physical impacts, belongings being destroyed, the frustration of not having the problem properly dealt with, feeling blamed for the situation, and social isolation stemming from being embarrassed to have guests visit the home (5).…”