European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom.
College of Life and Environmental Sciences, University of Exeter, Stocker Road, Exeter EX4 4QD, United Kingdom.
Environ Int. 2015 Jun;79:115-29. doi: 10.1016/j.envint.2015.03.009. Epub 2015 Mar 28.
Fuel poverty affects 2.4 million UK homes leading to poor hygrothermal conditions and risk of mould and house dust mite contaminations, which in turn increases risk of asthma exacerbation. For the first time we assess how fuel poverty, occupants' risk perception and use of mechanical ventilation mediate the risk of mould contamination in social housing.
Postal questionnaires were sent to 3867 social housing properties to collect adult risk perception, and demographic and environmental information on occupants. Participant details were linked to data pertaining to the individual properties. Multiple logistic regression was used to calculate odds ratios and confidence intervals while allowing for clustering of individuals coming from the same housing estate. We used Structured Equation Modelling and Goodness of Fit analysis in mediation analyses to examine the role of fuel poverty, risk perception, use of ventilation and energy efficiency.
Eighteen percent of our target social housing populations (671 households) were included into our study. High risk perception (score of 8-10) was associated with reduced risk of mould contamination in the bedrooms of children (OR 0.5 95% CI; 0.3-0.9) and adults (OR 0.4 95% CI; 0.3-0.7). High risk perception of living with inadequate heating and ventilation reduced the risk of mould contamination (OR 0.5 95% CI; 0.3-0.8 and OR 0.5 95% CI; 0.3-0.7, respectively). Participants living with inadequate heating and not heating due to the cost of fuel had an increased risk of mould contamination (OR 3.4 95% CI; 2.0-5.8 and OR 2.2 95% CI; 1.5-3.2, respectively). Increased risk perception and use of extractor fans did not mediate the association between fuel poverty behaviours and increased risk of mould contamination.
Fuel poverty behaviours increased the risk of mould contamination, which corresponds with existing literature. For the first time we used mediation analysis to assess how this association maybe modified by occupant behaviours. Increased risk perception and use of extractor fans did not modify the association between fuel poverty and mould contamination. This suggests that fuel poor populations may not benefit from energy efficiency interventions due to ineffective heating and ventilation practices of those occupants residing participating households. Our findings may be modified by a complex interaction between occupant behaviours and the built environment. We found that participant age, occupancy, SES, pets, drying washing indoors, geographic location, architectural design/age of the property, levels of insulation and type of heating regulated risk of mould contamination.
Fuel poverty behaviours affected around a third of participating households and represent a risk factor for increased exposures to damp and mouldy conditions, regardless of adult risk perception, heating and ventilation practices. This requires multidisciplinary approach to assess the complex interaction between occupant behaviours, risk perception, the built environment and the effective use of heating and ventilation practices.
Our findings have implications for housing policies and future housing interventions. Effective communication strategies focusing on awareness and perception of risk may help address indoor air quality issues. This must be supported by improved household energy efficiency with the provision of more effective heating and ventilation strategies, specifically to help alleviate those suffering from fuel poverty.
燃料贫困影响了 240 万英国家庭，导致湿热条件不佳以及霉菌和屋尘螨污染的风险增加，进而增加哮喘恶化的风险。我们首次评估了燃料贫困、居住者的风险感知以及机械通风的使用如何在社会住房中引发霉菌污染。
向 3867 处社会住房物业发送了邮寄问卷，以收集居住者的风险感知、人口统计学和环境信息。参与者的详细信息与个人住房的相关数据相关联。使用多变量逻辑回归计算比值比和置信区间，同时允许个体从同一住宅区聚集的情况。我们使用结构方程模型和拟合优度分析进行中介分析，以检验燃料贫困、风险感知、通风和能源效率的使用的作用。
我们研究的目标社会住房人群中有 18%（671 户）被纳入我们的研究。高风险感知（得分 8-10）与儿童卧室（OR 0.5，95%CI；0.3-0.9）和成人卧室（OR 0.4，95%CI；0.3-0.7）中霉菌污染的风险降低有关。居住者对通风和供暖不足的高风险感知降低了霉菌污染的风险（OR 0.5，95%CI；0.3-0.8 和 OR 0.5，95%CI；0.3-0.7，分别）。由于燃料成本而无法供暖和供暖不足的居住者，霉菌污染的风险增加（OR 3.4，95%CI；2.0-5.8 和 OR 2.2，95%CI；1.5-3.2，分别）。高风险感知和使用排气扇并不能调节燃料贫困行为与霉菌污染风险增加之间的关系。
燃料贫困行为增加了霉菌污染的风险，这与现有文献一致。我们首次使用中介分析来评估居住者行为如何改变这种关联。高风险感知和使用排气扇并不能调节燃料贫困行为与霉菌污染风险增加之间的关系。这表明，燃料贫困人群可能不会受益于能源效率干预措施，因为居住在参与家庭中的居住者存在低效的供暖和通风实践。我们的发现可能会受到居住者行为和建筑环境之间复杂交互的影响。我们发现，参与者的年龄、居住状况、社会经济地位、宠物、室内晾洗衣服、地理位置、建筑设计/房屋年龄、绝缘水平和供暖类型调节了霉菌污染的风险。
燃料贫困行为影响了约三分之一的参与家庭，无论成年居住者的风险感知、供暖和通风实践如何，都构成了增加接触潮湿和发霉环境的风险因素。这需要多学科方法来评估居住者行为、风险感知、建筑环境以及供暖和通风实践的有效性之间的复杂相互作用。
我们的研究结果对住房政策和未来住房干预措施具有重要意义。重点关注风险意识和感知的有效沟通策略可能有助于解决室内空气质量问题。这必须通过提高家庭能源效率来支持，提供更有效的供暖和通风策略，特别是为了帮助那些遭受燃料贫困的人。
