Use of Simple Telemetry to Reduce the Health Impacts of Fuel Poverty and Living in Cold Homes

Interventions for cold homes: a rapid review of the health impacts

BACKGROUND

Cold homes are associated with an increased risk of adverse health outcomes for older people. To mitigate this risk, homes need to be heated to an appropriate temperature. This review aims to identify interventions designed to improve heating and temperatures within homes and summarize its impact on health, health service utilization and cost effectiveness.

METHODS

A rapid review was conducted. Studies assessing the effects of structural, financial, or behavioural interventions designed to improve home temperatures of residents aged 18+ years were eligible. Searches were carried out in four databases. A search for grey literature, and backward and forward citation searching were performed. Data were summarized in a narrative synthesis and mapped using EPPI-Reviewer and EPPI-Mapper software.

RESULTS

Eighteen studies reported across 19 publications were included. Structural interventions were associated with better mental health and quality of life, a reduction in health service utilization, and improvements in satisfaction with internal home temperature, social interactions and financial difficulties. The impact on physical health outcomes varied by age, gender and long-term conditions. Evidence about the impact of behavioural interventions was inconsistent.

CONCLUSION

Structural improvements to increase home temperatures may offer the potential to improve some aspects of health. However, the impact on physical health, including which groups are most likely to benefit, is unclear. Key gaps include the lack of evidence about the impact of financial interventions, and the impact of all types of interventions, on quality of life, mortality and costs.

Assessing the impact of energy and fuel poverty on health: a European scoping review

BACKGROUND

The burden of energy and fuel poverty (EFP) in Europe is increasing in the face of the cost-of-living crisis, the Russian invasion of Ukraine, the coronavirus disease 2019 (COVID-19) pandemic and the climate emergency. While the health impacts of EFP are often the driving reason for addressing it, EFP's association with health is poorly delineated. This review aims to scope the evidence of EFP's association with health in Europe.

METHODS

A scoping review based on Arksey and O'Malley's framework was conducted using search terms relevant to EFP, health and Europe. Five databases were searched, in addition to hand searching. Review selection was performed by two independent reviewers, and articles were thematically analyzed.

RESULTS

Thirty-five articles published between January 2000 and March 2022 were included. The literature varied in definitions and measurements of EFP and in the health indicators examined. The review revealed a negative association between EFP and health, specifically, general unspecified poor health (9 articles), excess winter mortality (3 articles), communicable diseases (3 articles), non-communicable diseases (11 articles), mental health (15 articles) and well-being (12 articles). While women were reported to be at a higher risk of EFP than men, children and older adults were identified as particularly vulnerable to EFP's adverse health repercussions.

CONCLUSIONS

This scoping review illustrates a significant and complex association between EFP and various domains of health. Though heterogeneity across research makes it difficult to compare findings, our review supports the use of health as a justification to address EFP and urges public health to be more involved in EFP mitigation.

Cold housing environments: defining the problem for an appropriate policy response

Researchers across disciplines are increasing attention to cold housing environments. Public health, environmental and social sciences, architecture, and engineering each define and measure cold housing environments differently. Lack of standardisation hinders our ability to combine evidence, determine prevalence, understand who is most at risk--and to formulate policy responses. We conducted a systematic, cross-disciplinary review of literature to document the measures used. We examined benefits and limitations of each approach and propose a conceptualisation of cold housing: where temperature is too low to support optimal health and wellbeing of inhabitants, measured using one or a combination of economic, 'objective', or subjective approaches. More accurate data on home temperatures for all population groups, combined with an understanding of factors leading to cold homes, will enable appropriate policy response to reduce adverse health effects and costs. Policies targeting better building standards and energy subsidies both improve temperature conditions in housing environments.

Iot application for energy poverty detection based on thermal comfort monitoring

The development of a datalogger for identifying Energy Poverty (EP) using thermal comfort monitoring is described in this work. There is not a uniform definition of EP, and no global recommendations indicating the thermal comfort characteristics that should be utilized to identify EP. Most Internet of Things (IoT)-based systems designed for EP identification measure energy consumptions (electricity and gas). There is a lack of works that use IoT-based systems to identify EP through the monitoring of thermal comfort parameters. To address the deficiencies discovered in the identification of EP from the perspective of thermal efficiency, an IoT-based monitoring system was designed, developed, and tested. A first pilot was installed in a household in Getafe. A full month of temperature, relative humidity, and CO₂ concentration measurements were utilized to evaluate the system, which was then compared to a commercial system. The results revealed that the new IoT-based approach was very dependable and may be used to accurately monitor EP-related parameters.

A Systematic Review of Associations between Energy Use, Fuel Poverty, Energy Efficiency Improvements and Health

Energy use in buildings can influence the indoor environment. Studies on green buildings, energy saving measures, energy use, fuel poverty, and ventilation have been reviewed, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The database PubMed was searched for articles published up to 1 October 2020. In total, 68 relevant peer-reviewed epidemiological or exposure studies on radon, biological agents, and chemicals were included. The main aim was to assess current knowledge on how energy saving measures and energy use can influence health. The included studies concluded that buildings classified as green buildings can improve health. More efficient heating and increased thermal insulation can improve health in homes experiencing fuel poverty. However, energy-saving measures in airtight buildings and thermal insulation without installation of mechanical ventilation can impair health. Energy efficiency retrofits can increase indoor radon which can cause lung cancer. Installation of a mechanical ventilation systems can solve many of the negative effects linked to airtight buildings and energy efficiency retrofits. However, higher ventilation flow can increase the indoor exposure to outdoor air pollutants in areas with high levels of outdoor air pollution. Finally, future research needs concerning energy aspects of buildings and health were identified.

Associations between indoor temperature, self-rated health and socioeconomic position in a cross-sectional study of adults in England

OBJECTIVE

Excess winter deaths are a major public health concern in England and Wales, with an average of 20 000 deaths per year since 2010. Feeling cold at home during winter is associated with reporting poor general health; cold and damp homes have greater prevalence in lower socioeconomic groups. Overheating in the summer also has adverse health consequences. This study evaluates the association between indoor temperature and general health and the extent to which this is affected by socioeconomic and household factors.

DESIGN

Cross-sectional study.

SETTING

England.

PARTICIPANTS

Secondary data of 74 736 individuals living in England that took part in the Health Survey for England (HSE) between 2003 and 2014. The HSE is an annual household survey which uses multilevel stratification to select a new, nationally representative sample each year. The study sample comprised adults who had a nurse visit; the analytical sample was adults who had observations for indoor temperature and self-rated health.

RESULTS

Using both logistic and linear regression models to examine indoor temperature and health status, adjusting for socioeconomic and housing factors, the study found an association between poor health and higher indoor temperatures. Each one degree increase in indoor temperature was associated with a 1.4% (95% CI 0.5% to 2.3%) increase in the odds of poor health. After adjusting for income, education, employment type, household size and home ownership, the OR of poor health for each degree temperature rise increased by 19%, to a 1.7% (95% CI 0.7% to 2.6%) increase in odds of poor health with each degree temperature rise.

CONCLUSION

People with worse self-reported health had higher indoor temperatures after adjusting for household factors. People with worse health may have chosen to maintain warmer environments or been advised to. However, other latent factors, such as housing type and energy performance could have an effect.

Environmental Comfort as a Sustainable Strategy for Housing Integration: The AURA 1.0 Prototype for Social Housing

The AURA 1.0 prototype is a sustainable social housing proposal, designed by the University of Seville and built for the first Latin American edition of the prestigious Solar Decathlon competition. Different conditioning strategies were integrated into this prototype, optimized for a tropical climate, and focused on contributing positively to the health of the most humble people in society. In this moment, in which a large part of the world population is confined to their homes due to the Covid-19 pandemic, we have the opportunity (and the obligation) to reconsider the relationship between architecture and medicine or in other words, between the daily human habitat and health. For this reason, this analysis of aspects derived from the interior conditioning of the homes is carried out. The main objective of the Aura proposal is to be able to extract data through a housing monitoring system, which allows us to transfer some design strategies to the society to which is a case study, in order to promote environmental comfort and, therefore, people’s health. The AURA 1.0 prototype develops flexible and adaptable living spaces, with a high environmental quality, in order to maintain the variables of temperature, relative humidity and natural lighting within a range of comfort required by the rules of the event. To achieve this end, the prototype develops an architectural proposal that combines passive and active conditioning strategies, using construction qualities and typical costs of social housing. These strategies allowed the project to achieve the first prize in the Comfort Conditions test. So, this paper presents an appropriate and tested solution that can satisfy comfortability and health of residents who live in social housing while maintaining low energy consumption.