Improving Health By Adapting
Energy Conservation Residential
Mohamed Abrar Haneef
Memorial University

Introduction Various diseases like sinusitis, bronchitis, asthma, hypertension, overweight, hay fever, allergies such as rhinitis, eczema and other respiratory diseases are caused by numerous factors such as inadequate ventilation system, chemicals, inefficient heating and Colling system, dampness due to leakage, moulds, pollen grain, smoke and other pollutants. The World Health Organization (WHO) estimated that 30% of excess winter deaths in Europe are due to cold homes. Energy conservation can be related to health because it often involves repairing or replacement of heating and cooling equipment to increase efficiency and reduce the generation of pollutants such as carbon monoxide improvement of ventilation to remove contaminants air sealing and improvement of building envelopes, which can often reduce moisture leaks from the exterior, and reducing moisture from the dwellings (Wilson et al., 2014).

We spend our most of the time indoors and a study on indoor risk factors for asthma and allergies in the home environment among adults and children have focused mainly on building dampness and indoor mould and environmental tobacco smoke. Another sources of indoor contamination is associated with adult asthma includes storage of household waste for several days. Chemical indoor factors at home associated with adult asthma include formaldehyde, volatile organic compounds and emissions from indoor paint and household cleaning sprays, leakage of gasoline emissions from garages, plastic wall materials and recent use of floor levelling plaster. And also the use of air cleaners and air humidifiers at home has been associated with adult asthma (Norbäck et al. 2014). Children with asthma are particularly sensitive to a wide variation of indoor temperature even small change in the temperature have the potential to reduce lung function or increase respiratory symptoms, To support this claim two random community trials have shown an improvement in wheeze and cough symptoms with improved home insulation and improved home heating (Pierse N, Arnold R et al. 2013). Colder houses can cause more physiological stress on older people, babies, and sick people, who have less robust thermoregulatory systems and are also likely to spend more time indoors. Houses that are cold are also likely to be damp, and this can lead to the growth of moulds, which can cause respiratory symptoms. Several international reports have related between inadequate heating, damp, cold, and mouldy houses and poor health (Howden-Chapman et al., 2007).

A Canadian study that examined new energy efficient homes, showed significant self-reported health improvements in throat irritation, cough, fatigue, and irritability. A New Zealand study showed that improved insulation was associated with improvements in health, wheezing, more school and work days, and fewer visits to the doctor and hospital. All the above results were self-reported by the residents. Most of the experiments are done on the low-income housing is particularly important because several studies have found asthma rates 2 to 4 times higher among public housing residents than the general population. Asthma triggers mostly due to moisture and pests such as rodents and roaches. It was also found that depression, hyper tension, diabetes, stroke, obesity were significant in public housing (Jacobs et al., 2015)

Discussion

Renovations were done in few house in various cities such as New York, Chicago, and Boston whose household income were less than 60% of the state median income. Insulation and dryer vents were installed in Boston and upgraded heating Chicago provided heating upgrades and air sealed units and New York upgraded heating, installed windows and bath fans, fixed doors and added door weather stripping, and repaired roof leaks, but added no insulation or air sealing. The residents of the renovated buildings were interviewed about their health before the renovation and also a follow up interview was done after 2-18 months after renovations. The health interview was adapted from the U.S. Centers for Disease Control’s, annual National Health Interview Survey, CDC’s Behavioral Risk Factor Surveillance System and the U.S. Department of Housing and Urban Development /National Institute of Environmental Health Sciences National Survey of Lead and Allergens in Housing (Wilson et al., 2014).

Among the 384 household only 248 completed the follow up interview. Prior to energy conservation work, 64% households reported that that the temperature in their dwelling was uncomfortable in the summer and 55% found uncomfortable in the winter. 52% Households reported that their homes had water leaks or dampness and 23% frequently had a mildew odor or musty smell. Pest problems were less common, but households reported rodent problems in 27 % of houses and cockroach problems in 11 % of houses. 57% of households reported smoke in their home with 39% of the smoke coming from candles/incense and 22% from tobacco smoke. More than half of households did not use the exhaust fan over their stoves regularly when cooking, while 69 % did not use bath fans at least sometimes during showers or baths. After the renovation was completed the Dwelling temperature was more comfortable in both the winter and summer, there were also fewer problems with water leaks and dampness, bath fan usage increased, and the presence of smoke in the home declined. There was no significant change in musty odors, use of stove fans, or rodent and cockroach problems. For all the locations the mean adult general health improved by 0.29 points from baseline to follow-up (Wilson et al., 2014).

Experiment results for Chicago, Boston, New York | | | Baseline % | Follow-up% (improved) | P value | Temp.-uncomfortable in winter | 55% | 39% | <0.001 | Temp-uncomfortable in summer | 64% | 45% | <0.001 | dampness | 52% | 42% | <0.001 | sinusitis | 16% | 9% | <0.038 | hypertension | 47% | 18% | <0.001 | overweight | 41% | 17% | <0.001 | Asthma symptoms | 17% | 21% | <0.031 |

There was a significant improvements in sinusitis, hypertension and overweight status for both the long-term and short-term follow-up observation. There were no significant changes in the quality of the indoor air between baseline and follow-up sampling.it was reported that at least 34% of the children at baseline had eczema or skin allergy at baseline and 14% at the follow-up among them 19% of the children had improvement in the condition or go away whereas 73% remained the same or never had the condition and 8% of them developed the condition. The difference in eczema or skin allergy in children improving compared to getting worse after energy retrofits was marginally significant. For the 75 children in the study, their caregivers reported no significant change in their general health and for asthma, the results were mixed. On the other hand, significantly more people worsened than improved in asthma severity (Wilson j, Dixon et al. 2014). However one study in New Zealand found that by installing heaters the average indoor temperature can be elevated slightly and therefore it reduces the children’s respiratory symptoms. The theory to support the above claim is that when the children are exposed to low temperatures, it could reduce their lung function either directly by reflex Broncho constriction. The viruses which impair the normal function of the lungs have longer survivability in cold environments. Houses which had Inefficient home heaters such as 2 kW plug in electric heaters, unflued gas heaters or no heaters were enrolled in the Housing Heating and Health study. One child with asthma was studied in each household and new heaters >6 kW were installed in half of the households. Piko meters were used to determine the Lung function every morning and evening throughout the winter of 2006. The children were instructed in the use of Piko meters, which were used to self-record forced expiratory volume1 (FEV1) peak expiratory flow rate (PEFR).The highest valid FEV1 and PEFR from each set of five blows were used as outcome measures in this study. This study proved that for every 1°C increase in temperatures below the threshold of 9°C there was an improvement in PEFR by 0.010 L/s in the morning and 0.008 L/s in the evening. And it was estimated that there will be an improvement in FEV1 by 10.06 mL for every 1°C increase in temperatures below 12°C in the morning and 12.06 mL in the evening for every 1°C increase in temperatures below 10°C. it was found that mean bedroom temperature was 14.4°C and the mean living room temperature was 16.53°C.The who have stated that the most efficient way for secondary prevention of acute infection is by improvement of the indoor climate of the homes (Pierse et al., 2013).

Asthma was significantly improved in Minnesota where similar green renovations were done in multifamily housing were carried out during 2006-2007 such as installation of geothermal heating and cooling system, install high performance windows, add insulation to exterior walls and roof. It was reported that people living in the green renovated housing felt that homes were easy to clean, more comfortable, neighborhood was safe and the children played outside more often. The houses were more energy efficient and the overall cost on health was reduced by avoiding illness (Breysee et al., 2011).

The study performed at Stockholm, Sweden confirms the conclusions from other studies suggesting that building dampness and moulds in homes are associated with asthma and to some extent allergies and eczema. Humid air was associated with doctor’s diagnosed asthma, pollen allergy and eczema, and reports on mould odour showed associations with doctor’s diagnosed allergy, hay fever and eczema. Formaldehyde and volatile organic compounds are emitted by the new building material and indoor. Various renovations such as change of floor materials, wall papers and indoor painting. Indoor painting is a common type of redecoration in dwellings. It was found that there was an association between recent indoor redecoration and doctor’s diagnosed allergy. Furry pet keeping is associated with hay fever, rhinitis and eczema due to pet dander. However, it has also been demonstrated that furry pet keeping may be associated with increased levels of endotoxin in house dust and endotoxin may be protective against allergy, but the protective effect is mainly considered to occur in early childhood (Norbäck et al., 2014).

The above graph shows that there was a improvement in asthma and general health of the residents (Breysee J et al., 2011).

Another study was carried out in three Chicago housing developments which consisted of 325 apartments and 803 individuals dwelled in those apartments.it was self-reported by the residents that the Housing conditions and physical and mental health improved significantly in the green healthy housing when compared to their old homes. It was also noticed that hay fever, headaches, sinusitis, angina, respiratory allergy and asthma and various other symptoms related to it improved significantly. It was also seen that the mental health of the residents improved such sadness, nervousness, restlessness, and child behavior. Adults reported that children in the green healthy homes were better-behaved and more likely to do what adults requested. (Jacobs et al., 2015).People from insulated houses were less likely to be admitted to hospital due to respiratory conditions such as pulmonary disease and obstructive airways diseases (Howden-Chapman et al., 2007).

Conclusion

There were certain limitation to all the above experiments such as Very less sample data was studied and generally people were in good health when they took up the experiment, another limitation was that one adult answered the health questions for children and other adults in the apartment, potentially introducing bias. The contractor had not address well to the damping problems. A complete and timely follow up couldn’t be made. Some ventilation systems did not perform to design specifications, likely due to limited equipment choices/ sizing options, budgetary constraints, and existing building characteristics. But it cannot be denied that by enhancing and renovating the residence the quality of living of the residents significantly improved. Various diseases such as sinusitis, bronchitis, Asthma, hypertension and overweight saw a significant improvement and also due to improved mechanical ventilation and kitchen and bathroom fans carbon monoxide and various other pollutants were under control. There were fewer moisture and dampness issues, little or no pest problems, and less smoke indoors. It was noted from Stockholm study that asthma allergies and eczema were more common in buildings which utilized less energy for space heating therefore by utilizing better insulations and more energy efficient heaters and ventilation system asthma and other related symptoms can be prevented/cured. The mental health of the residents improved significantly and there were less stressful as their sleep pattern improved and less medication were used. However there was no significant improvement in asthma in Chicago, Boston and New York but where as in Minnesota and New Zealand there was significant improvement in asthma in both children and adults just by elevating the indoor temperature by using more efficient heaters and ventilation system. The residents reported that their homes were much cleaner, comfortable, safe and children went outside to play more. The houses were more energy efficient and the overall cost on health was reduced by avoiding illness.

References

Wilson, J., Dixon, S. L., Jacobs, D. E., Breysse, J., Akoto, J., Tohn, E., ... & Hernandez, Y. (2014). Watts-to-Wellbeing: does residential energy conservation improve health?. Energy Efficiency, 7(1), 151-160.

Breysse, J., Jacobs, D. E., Weber, W., Dixon, S., Kawecki, C., Aceti, S., & Lopez, J. (2011). Health outcomes and green renovation of affordable housing. Public Health Reports, 126(Suppl 1), 64.

Norbäck, D., Lampa, E., & Engvall, K. (2014). Asthma, Allergy and Eczema among Adults in Multifamily Houses in Stockholm (3-HE Study)-Associations with Building Characteristics, Home Environment and Energy Use for Heating. PloS one, 9(12), e112960.

Jacobs, D. E., Ahonen, E., Dixon, S. L., Dorevitch, S., Breysse, J., Smith, J., ... & Levavi, P. (2015). Moving Into Green Healthy Housing. Journal of Public Health Management and Practice, 21(4), 345-354. Pierse, N., Arnold, R., Keall, M., Howden-Chapman, P., Crane, J., Cunningham, M., & Heating Housing and Health Study Group. (2013). Modelling the effects of low indoor temperatures on the lung function of children with asthma. Journal of epidemiology and community health, 67(11), 918-925. Howden-Chapman, P., Matheson, A., Crane, J., Viggers, H., Cunningham, M., Blakely, T., ... & Davie, G. (2007). Effect of insulating existing houses on health inequality: cluster randomised study in the community. Bmj, 334(7591), 460.