Household air pollution, the forgotten health hazard
Health concerns surrounding outdoor air pollution are well-documented, and the EU has grappled with the seriousness of how to tackle the issue for some time.
But one area, where there has been little action, is on the health concerns surrounding indoor air quality.
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Less attention has been given to this issue despite the wide range of indoor pollutants that can affect health such as building materials, furniture or even by activities such as cooking or the use of cleaning products.
In a new report, the World Health Organization (WHO) has shed some light on the issue.
The report reveals that 23 percent or 12.6 million of all global deaths each year are linked to the environment, with nearly two-thirds linked to noncommunicable diseases (NCD). These include ischaemic heart disease (IHD), stroke, chronic obstructive pulmonary disease (COPD) and lung cancer.
4.3 million deaths per year
"The WHO estimates that 4.3 million people a year die from exposure to household air pollution globally, of which almost 120,000 are in the WHO European region," Leen Meulenbergs, the WHO's representative to the EU, told EUobserver.
"While deaths from ambient air pollution occur in all European countries, regardless of their income level, those from household air pollution are over five times greater in low- and middle-income countries than in wealthier ones," Meulenbergs added.
Worldwide, 17 percent of the cardiovascular disease burden can be attributed to household air pollution from cooking with polluted fuels, with almost a third (30 percent) of COPD linked to polluted air at home.
While smoking was described as the most important risk factor for developing lung cancer, almost a fifth (17 percent) of deaths were attributed to household air pollution.
Another major element is the more common ailment of asthma, which is reportedly exacerbated by exposure to dampness, mould, house dust mites and other allergens in homes.
The WHO said that work-related asthma is seen as a frequent occupational disease and could be caused by many factors - including cleaning agents, enzymes, flour, wood dust, latex and metals.
Household air pollution was reported as being responsible for three percent or 56,000 of IHD deaths each year, three percent or 43,000 stroke deaths, two percent or 10,000 lung cancer deaths, and three percent or 8,000 COPD deaths a year.
A wide range of interventions, according to the WHO, would be needed to reduce indoor air pollution and associated health effects. These actions could address the sources of pollution, the living environment, or changes in behaviour.
Concrete action
In the EU, indoor air quality was recently brought into the spotlight with the draft proposal of the Energy Performance of Buildings Directive (EPBD).
The proposal put forward to the European Parliament committee on industry, research and energy (ITRE) on 11 October and passed with an overwhelming majority, suggested a range of changes not only to improve the efficiency of buildings, but also included indoor air quality measures.
The new EU building regulations could see indoor air quality become a mandatory criteria for the first time.
However, health campaigners like the European Federation of Allergy and Airways Diseases Patients' Associations (EFA) argue there is more to be done, as the health implications can be serious. At the European level, there is no real measure to safeguard and improve the quality of indoor air and there is a lack of awareness on the issue, said EFA.
EFA is calling for more action and said it expects the WHO Indoor Air Quality guidelines, which are not legally binding, to be taken into account by policy-makers.
"We think an Indoor Air Quality certificate for new and renovated buildings, can be a good monitoring and information system for citizens. We cannot see what air carries and we cannot choose what not to breathe," Roberta Savli, director of strategy and policy at EFA, told EUobserver.
"There is a policy gap on indoor air quality and that lack of binding rules is leaving Europeans unprotected against dirty air indoors. The European Commission set a working group on indoor air quality in 2006, but nothing has been done since it stopped working in 2012," Savli added.
Overcoming air quality
EFA said it is also concerned, as the seventh Environmental Action Programme, approved in 2013, requires the EU to develop a strategy on indoor air quality. As yet, no proposals have been put forward.
But EFA is not the only organisation raising concern about air quality in the latest EPBD proposal.
Russell Patten, secretary general of the European Ventilation Industry Association (EVIA), raised some other concerns.
"We are pleased to see that the European Parliament recognises the crucial importance of indoor air quality but caution that the upcoming discussions with the Council [of the EU] could result in a lowering of ambitions," Patten warned, referring to the Council, where representatives of the member states meet.
Even the European Builders Confederation has voiced concern that the ITRE committee failed to include regular maintenance of heating and ventilation systems, citing that this was needed to ensure "health, well-being and safety."
Member states
In spite of the slow progress at EU level, some member states have recognised the risk of indoor air pollution and have started their own initiatives to tackle the problem.
In 2015, Finland adopted a decree setting limits for microbial damage, adequate ventilation and concentration of chemicals. According to an estimate by the country's environment ministry, between 600,000 and 800,000 people could be affected by indoor moisture and mould damage alone.
France also has an action plan, and the Italian ministry of health has developed guidelines for indoor air quality in schools.
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