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It is well accepted that there is an intimate relationship between housing and residents’ physical and mental health and wellbeing. However, epidemiological and longitudinal studies are few and far between. This is mostly due to the multitude and dynamism of housing factors – and of course non-housing factors – that can affect health and the resultant difficulty in isolating factors to assess housing dose-response relationships. The majority of studies in this area have based their research on residents’ self-reporting of their housing-related health status. Consequently, it has so far not been possible to quantify the contributions that energy efficiency improvements can make to residents’ health.
The WHO has recognised the need for stronger and consistent evidence of the links between housing and health and has been undertaking a study involving eight countries with the aim of developing measurable housing and health indicators . The results of a pilot survey of housing and health in panel block buildings – i.e. large multi-family, in some cases high-rise buildings – in former East Germany, Lithuania and Slovakia were published in 2003 . The survey comprised 259 flats and 601 residents, assessing their perception of their own health. It surveyed both unrefurbished and refurbished situations, including control groups of residents for the latter. In line with previous experiences, it proved difficult to identify any aspect of the housing conditions having a clear overall effect on residents’ health, although the fact that it found residents’ satisfaction to have improved with refurbishments “raised expectations that housing improvements can lead to better health” . Given the area it covered, its findings are particularly important to this project.
The key issues identified in panel block buildings with the ability to adversely affect residents’ comfort and wellbeing were small dwelling size, air quality, temperature and draught, noise exposure and the use of harmful building materials. Energy efficiency measures and improvements can directly improve three of these. First, air quality can be improved through a combination of improved building air tightness and an appropriate ventilation strategy. Second, comfortable and consistent temperatures can be more easily achieved and draughts eliminated through a combination of heating (control), building fabric and ventilation improvements. Third and finally, insulation measures and window replacements reduce noise exposure.
As stated above, the WHO survey asked residents whose panel block dwellings had undergone refurbishment their subjective views of their comfort and wellbeing. This methodology meant meaningful associations could be inferred, but not that causal links between refurbishment and stated improved comfort and wellbeing could be established. The table below illustrates the WHO’s statistically significant findings yielded by the survey data.
WHO survey: statistically significant results (**=highly significant, *=significant)
|
|
Existence of ventilation system
|
Satisfaction with ventilation system
|
Suffering from chronic disease
|
Mould growth
|
|
Air quality perception
|
**
|
**
|
*
|
**
|
|
|
Temperature problems in transient season
|
Gas stove/oven
|
No exhaust system in kitchen
|
Room without adjustable heating
|
|
Mould growth
|
**
|
**
|
**
|
**
|
|
|
Temperature problems in transient season
|
Temperature problems in summer season
|
Condensation signs at windows
|
Problems with humidity
|
|
Asthma/allergic symptoms
|
**
|
*
|
**
|
*
|
|
|
Temperature problems in transient season
|
Air quality perception
|
Draught problems
|
Mould growth
|
|
Acute respiratory diseases
|
**
|
**
|
**
|
**
|
|
|
Exposure to ETS in bedrooms
|
Air quality perception
|
Satisfaction with noise conditions
|
Temperature problems in winter season
|
|
Health perception
|
**
|
**
|
**
|
**
|
|
|
Good sound insulation quality
|
Less problems to fall asleep
|
Frequency of noise exposure
|
Temperature problems in winter season
|
|
Good mental health
|
**
|
**
|
*
|
*
|
It is clear that the survey results show a wide range of associations that between self-reported health and living conditions in panel block buildings can be reliably made. While the identified associations are not causal, it is clear that energy saving measures, in combination with appropriate ventilation strategies, contribute directly to (improving the) issues illustrated by the shaded cells in the table, and so clearly have the potential to contribute to improving residents’ comfort and wellbeing.