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New study lays bare the cost of damp, mouldy homes on children's health in NZ

August 15, 2019

Researchers say one in five children hospitalised for respiratory illnesses wouldn’t be there if they lived in warm, dry homes.

Almost a fifth of hospital admissions of young children with acute respiratory infections could be prevented if their houses were free from damp and mould, New Zealand researchers have found.

The University of Otago, Wellington research, published today in the international medical journal Thorax, is said to be the largest ever case-control study of the association between housing quality and hospital admissions for young children with acute respiratory infections.

The researchers conducted the study in two paediatric wards and five general practice clinics in Wellington during winter and spring seasons between 2011 and 2013. 

The quality of their housing was assessed using the Respiratory Hazard Index, a 13-point scale of household quality factors including an eight-item damp/mould subscale.

The researchers studied 188 children who were admitted to hospital with acute respiratory infections and 454 control patients - those who saw their GP either with a respiratory illness which did not require hospitalisation or for a routine immunisation.

They found the children who became ill had significantly higher levels of dampness and mould in their homes, which could be addressed by a number of measures, including better heating, insulation and ventilation. 

Mould on the ceiling and wall of a house.

The study's lead author, senior research fellow Dr Tristram Ingham, says reducing exposure to poor quality housing could cut the number of hospital admissions for the under-twos by 1700, or 19 per cent a year.

Dr Ingham said the study shows the health of children can't be separated from the condition of their housing. The country needs to address respiratory illnesses more seriously, through Government policy, district health board initiatives, GP referrals and awareness, she added.

"Cancer, heart disease, diabetes, the other three top conditions get a lot of air time, a lot of funding. Respiratory health gets very little," he said.

Dr Ingham said he has concerns the Government's new Healthy Homes standards will penalise tenants if landlords' renovations lead to higher rents.

A spokesperson for Associate Housing Minister Kris Faafoi said in a statement the Government isn't convinced landlords will pass on the costs "of meeting these basic standards" to tenants.

"The research released today by Otago University underscores the importance of the Healthy Homes Standards, as the new standards will make rental homes healthier for tenants,' the spokesperson stated.

The latest data from Statistics New Zealand shows a third or Kiwis report living in a damp flat or house, and a third report their home is mouldy.

Upu Ioapo-Peniata, mother of a two-year-old girl who’s been hospitalised from pneumonia and bronchiolitis, has seen the impact of unhealthy homes personally and through her job as a nurse.

"I get to see a lot of young children that come in with preventable illness from their homes and so a lot of things I'm educating my patients about, I’m doing myself, but it’s not 100 per cent proof and has a lot to do with the environment," she said.

With community funding set up to improve the quality of homes in Porirua, Ms Ioapo-Peniata has had a heat pump, thermal curtains and a bathroom extractor installed, but she said her house is still cold and has mould building up.

"It's kind of like you’re going through this cycle of trying to prevent the illness but it’s still recurring," she said.

In 2015, 9003 under-two-year-olds were hospitalised in Wellington for acute respiratory infections out of an estimated population of 118,580, a rate per population of 7.6 per cent.

"If all housing was free from damp and mould, the country could save just under $8 million a year solely in hospital costs," Dr Ingham said.

"Improving housing quality to prevent such hospitalisations is also highly desirable in terms of future costs, with poor housing quality in childhood associated with adverse health outcomes in adulthood."

Acute respiratory infections are a major cause of early childhood illness, and account for 50 per cent of consultations general practitioners have with children under five. 

Upper respiratory tract infections are the most common, but acute respiratory infections also include lower respiratory tract infections, such as bronchitis and bronchopneumonia.

The research was part of a wider Whiti Te Rā Case-Control Study, which examines the broader risk factors for hospitalisation for acute respiratory infection using a kaupapa Māori research framework.

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