Cold is not the whole story – what the health services need to know about housing

An AECB consultation response

This document was written in response to a NICE (National Institute for Health and Care Excellence) 2014 consultation on producing guidelines for health authorities on tackling excess winter deaths and illnesses. It was written (mainly) by me, on behalf of the AECB, teaming up with Severn Wye Energy Agency and the STBA (Sustainable Traditional Buildings Alliance) – who also contributed information.

While at the time of this consultation the deleterious impact of cold living conditions on health were well known – prompting the consultation – poor indoor air quality was less discussed.

Yet of course, air quality can be very poor in cold homes: people will block out any draughts they can – including the intended fresh air supply from a ventilation fan or vent – especially if they are in fuel poverty. This only increases the risk of condensation and mould – already high in a dwelling with cold, uninsulated surfaces. And more and more evidence is piling up of just how bad mould in particular is for people’s health and wellbeing. Continue reading

A look at the evidence on mechanical ventilation

Natural ventilation often fails – but what is the evidence that mechanical ventilation succeeds? – Investigation for Passive House Plus

There have been a number of studies showing that natural ventilation, dependent as it is on random gaps in the building fabric and the vagaries of wind and weather, is not a reliable source of fresh indoor air. (see here for my article on this)

In theory, mechanical ventilation is under more control, and should work more reliably. But does the evidence bear this out? Does mechanical ventilation deliver good air quality in practice?

I looked into the research to find out whether MVHR, in particular, lived up to the ideal. Continue reading

Electric Heating – time to come in from the cold?

While there are well-established technologies to produce electricity without fossil fuels, decarbonisation of heat is struggling to get under way. Recommended strategies include expansion of low carbon networked heat and possibly the decarbonisation of gas – though these are still only happening at a scale (and with dubious carbon credentials, see PH+ Iss 15 – district heating). However, the commonest proposed means for decarbonising heat is via electrification.

Electrification of heat raises a number of questions about the ability of our power systems to produce enough low carbon electricity and their capacity to transmit it.  But it also represents something of a u-turn in building services design. Continue reading

District Heating – does it work with Passivhaus?

Cost effective district heating schemes need a nice dense energy demand. They also involve a lot of circulating hot water, which with the best will in the world, is going to involve continuous heat loss. Highly-insulated low energy buildings need very little heat – and in the summer, heat gains can be a positive menace.

So can the two work together? I explored the question a bit in this article for Passive House Plus – downloadable here as a pdf.

District Heating – does it work in Passivhaus?

Risks of Retrofit

A well-designed and well-executed retrofit will not only save energy, it should offer a more comfortable, healthier indoor environment, and protect the building fabric as well. However, there have been a number of warnings about what might go wrong – sometimes, even suggestions that in some instances retrofit measures should not be undertaken at all.

Are these warnings justified? What might go wrong? What is the evidence in practice? In this article, first published in Green Building in 2015, I look at some of the concerns, examine the reasons behind them, and suggest ways to protect building and occupants so retrofit really delivers.

Risks of retrofit – article from Green Building Magazine


Deep retrofit – the big prize?

Simple home energy efficiency improvements (such as new boilers, cavity wall insulation etc) can bring valuable comfort and health benefits to the occupants of inefficient homes – especially those in fuel poverty – as the last article revealed (see here). However, energy, carbon and bill savings tend to be modest, rarely topping 15% or 20% – and sometimes energy use actually increases!

If housing is to contribute its share of the 80% cuts in carbon emissions this country is committed to, in order to play is part in tackling climate change, retrofits will need to go deeper – a lot deeper. But will occupants benefit from the extra work? And is it affordable?

In the first part of this article we looked at the damage fuel poverty and cold homes do to occupants’ health, and found good evidence that when these twin evils were tackled, occupants could enjoy measurable improvements in their health. Encouragingly, some local health bodies are recognising this and investing in home retrofit to help improve people’s health.

Continue reading

Fixing fuel poverty – is there a healthier way?

Fuel poverty causes misery and ill-health – and alleviating fuel poverty by retrofitting homes could potentially offer valuable savings to the health services. However, different approaches to retrofit are likely to have different impacts on health.

The first in this two-part series, published in Green Building in December 2014, looks at how cold, damp homes can harm people’s heath, and at the evidence to date that retrofit can improve matters.  It also explores some pioneering efforts by concerned health organisations to tackle the ill health of their vulnerable patients where it starts – by fixing their cold homes.

The second part, due to be published in Spring 2015, will look a little more closely at different retrofit strategies, and the risks and benefits to occupants – and to the buildings themselves.

PDF download: Fuel poverty and health – Part 1

Continue reading

Prescribing healthy homes

The National Institute for Health and Care Excellence (NICE) recently ran a consultation on the guidance they give to health bodies and local authorities on reducing the burden of winter deaths and illnesses from cold homes.

The AECB (Association for Environment Conscious Building) along with the STBA (Sustainable Traditional Buildings Alliance) and Severn Wye Energy Agency submitted a  response, which I helped to draft.

The response welcomed the idea that health professionals should be involved in identifying and tackling unhealthy homes. It also emphasised that excess winter deaths and illnesses were almost certainly due to a combination of low indoor temperatures and poor indoor air quality (exacerbated by cold surfaces in uninsulated homes, and by occupants restricting ventilation to keep out cold draughts), and that an emphasis on low temperatures alone could miss significant causes of ill-health – and valuable remedies.

You can download the response here: NICE excess winter deaths and illnesses consultation response

You can also find out more about the original NICE consultation on the AECB website here


Ventilation – presentation for AECB

Slides from my presentation to the 2014 AECB annual conference on ‘Natural ventilation – does it work?’.

Download pdf – Natural Ventilation – talk for AECB 2014

Cold bridging, condensation & mould CSE

Failure of ventilation? Photo courtesy of the Centre for Sustainable Energy

For my article on the same subject, see this link:

Natural Ventilation: Does it Work? Article for Passive House Plus magazine


Overheating – how can we avoid it?

Jump straight to article in html Overheating – how can we avoid it?

There is a lot of concern that modern, airtight, well-insulated buildings might be more prone to overheating than older, leakier ones. However, the worst-offending buildings for overheating (and there are some shockers) are as often old as they are new. Overheating buildings just tend to be all-round bad buildings: often cold in winter, as well as hot in summer.

It looks as though buildings with too little insulation, too much glazing, not enough shading, and inadequate provision for purge ventilation are at risk of overheating – as are buildings with badly designed and inadequately insulated heating/hot water/community heat systems. Extravagant use of glazing, in particular, seems to have a great deal to answer for. Continue reading