19 August 2019 BMJ Journals: Damp mouldy housing and early childhood hospital admissions for acute respiratory infection: a case control study

“This paper presents the largest ever case–control study of the association between housing quality and hospital admission for young children with ARI. Participants in this housing study comprised children under 2 years of age: 188 cases (children admitted to hospital with ARI) and 454 controls (children attending general practice either with ARI not requiring hospitalisation or for routine immunisation). Independently measured levels of damp, mould and crowding were statistically significantly associated with ARI hospitalisation among this sample of children after adjusting for potential confounders. For each additional housing feature assessed as indicating evidence of damp and mould, there was a 15% increase in the odds of ARI hospitalisation. The RHI did not predict case–control status in a statistically significant way after adjustment.”

“Implications for policy

Given the findings of this study, we predict that 19% of ARI admissions for children under 2 years old would be prevented if all housing were free from damp and mould. This represents savings in costs solely due to hospitalisation (ignoring wider social costs) of just under $8 million NZD (£4.5 million GBP) per annum. Improving housing quality to prevent such hospitalisations is highly desirable also in terms of future costs. Poor housing quality in childhood has also been shown to be associated with adverse health outcomes in adulthood.43 Conversely, improvements in housing contribute to long-term improvements in the health of the occupants, for as long as such improvements remain effective.

The results of the study also highlight the importance that all healthcare professionals are made aware of housing as a risk factor for respiratory illness. This is of particular relevance to primary healthcare, given the high service use generated by childhood respiratory conditions. As an important aspect of the primary and secondary preventions of childhood ARI, we suggest that part of the routine clinical assessment of preschool children should include enquiry about the home environment, particularly regarding the presence of dampness and mould, with referral to appropriate remedial services.”