Hamilton Ian, Milner James, Chalabi Zaid, Das Payel, Jones Benjamin, Shrubsole Clive, Davies Mike, Wilkinson Paul
UCL Energy Institute, University College London, London, UK.
Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK.
BMJ Open. 2015 Apr 27;5(4):e007298. doi: 10.1136/bmjopen-2014-007298.
To assess potential public health impacts of changes to indoor air quality and temperature due to energy efficiency retrofits in English dwellings to meet 2030 carbon reduction targets.
Health impact modelling study.
England.
English household population.
Three retrofit scenarios were modelled: (1) fabric and ventilation retrofits installed assuming building regulations are met; (2) as with scenario (1) but with additional ventilation for homes at risk of poor ventilation; (3) as with scenario (1) but with no additional ventilation to illustrate the potential risk of weak regulations and non-compliance.
Primary outcomes were changes in quality adjusted life years (QALYs) over 50 years from cardiorespiratory diseases, lung cancer, asthma and common mental disorders due to changes in indoor air pollutants, including secondhand tobacco smoke, PM2.5 from indoor and outdoor sources, radon, mould, and indoor winter temperatures.
The modelling study estimates showed that scenario (1) resulted in positive effects on net mortality and morbidity of 2241 (95% credible intervals (CI) 2085 to 2397) QALYs per 10,000 persons over 50 years follow-up due to improved temperatures and reduced exposure to indoor pollutants, despite an increase in exposure to outdoor-generated particulate matter with a diameter of 2.5 μm or less (PM₂.₅). Scenario (2) resulted in a negative impact of -728 (95% CI -864 to -592) QALYs per 10,000 persons over 50 years due to an overall increase in indoor pollutant exposures. Scenario (3) resulted in -539 (95% CI -678 to -399) QALYs per 10,000 persons over 50 years follow-up due to an increase in indoor exposures despite the targeting of pollutants.
If properly implemented alongside ventilation, energy efficiency retrofits in housing can improve health by reducing exposure to cold and air pollutants. Maximising the health benefits requires careful understanding of the balance of changes in pollutant exposures, highlighting the importance of ventilation to mitigate the risk of poor indoor air quality.
评估英国住宅为实现2030年碳减排目标而进行的能源效率改造对室内空气质量和温度变化可能产生的公共卫生影响。
健康影响建模研究。
英国。
英国家庭人口。
对三种改造方案进行建模：（1）假设符合建筑法规，进行结构和通风改造；（2）与方案（1）相同，但对通风不良风险较高的房屋增加通风；（3）与方案（1）相同，但不增加通风，以说明法规薄弱和不遵守规定的潜在风险。
主要结果是由于室内空气污染物变化，包括二手烟、室内外来源的PM2.5、氡、霉菌和室内冬季温度，在50年内因心血管疾病、肺癌、哮喘和常见精神障碍导致的质量调整生命年（QALY）变化。
建模研究估计表明，方案（1）在50年随访期间，每10000人净死亡率和发病率产生积极影响，为2241个QALY（95%可信区间（CI）2085至2397），这是由于温度改善和室内污染物暴露减少，尽管直径小于或等于2.5μm的室外产生颗粒物（PM₂.₅）暴露增加。方案（2）在50年内每10000人产生-728个QALY（95%CI -864至-592）的负面影响，原因是室内污染物暴露总体增加。方案（3）在50年随访期间每10000人产生-539个QALY（95%CI -678至-399），原因是尽管针对污染物，但室内暴露增加。
如果与通风措施一起妥善实施，住房的能源效率改造可以通过减少寒冷和空气污染物暴露来改善健康。要使健康效益最大化，需要仔细了解污染物暴露变化的平衡，突出通风对降低室内空气质量差风险的重要性。
