Abstract
Disparities in outdoor air pollution exposure between individuals of differing socio-economic status is a growing area of research, widely explored in the environmental health literature. However, in developed countries, around 80% of time is spent indoors, meaning indoor air pollution may be a better proxy for personal exposure. Building characteristics - such as build quality, volume and ventilation - and occupant behaviour, mean indoor air pollution may also vary across socio-economic groups, leading to health inequalities. Much of the existing literature has focused on inequalities in exposure to outdoor air pollution, and there is thus a lack of an evidence base reviewing data for indoor environments. In this study, a scoping review of the literature on indoor air pollution exposures across different socio-economic groups is performed, examining evidence from both monitoring and modelling studies in the developed world. The literature was reviewed, identifying different indoor pollutants, definitions for socio-economic status and pre- and post- housing interventions. Based on the review, the study proposes a modelling methodology for evaluating the effects of environmental policies on different socio-economic populations. Using a sample size calculation, obstacles in obtaining sufficiently large samples of monitored data are demonstrated. A modelling framework for the rapid quantification of daily home exposure is then outlined as a proof of concept. While significant additional research is required to examine inequalities in indoor exposures, modelling approaches may provide opportunities to quantify exposure disparities due to housing and behaviours across populations of different socio-economic status.
Highlights
The presence of harmful substances such as gases, particulates or biological molecules in the Earth’s atmosphere is known as air pollution (Loomis et al, 2013)
While there is a significant body of international research highlighting evidence of the association of areas of low socio-economic status (SES) with high levels of outdoor air pollution (Clark et al, 2014; Milojevic et al, 2017; Pinault et al, 2016; Fairburn et al, 2019), there is little on equivalent exposures to indoor air pollution, despite populations in developed countries spending the majority of their time indoors
Whilst acknowledging that indoor air pollution is a critical concern in developing nations, especially in homes with solid fuel use (e.g. Bruce et al, 2000; Smith and Mehta, 2003; Goldemberg et al, 2018), the current review focuses on developed countries only
Summary
The presence of harmful substances such as gases, particulates or biological molecules in the Earth’s atmosphere is known as air pollution (Loomis et al, 2013). Human exposure to air pollution has serious implications for health: Short term exposure may exacerbate asthma and be responsible for hospital admissions (Zheng et al, 2015), whilst long term exposure to ambient air pollution is repeatedly associated with a higher incidence of cardiovascular and respiratory diseases (Pope et al, 2011; Atkinson et al, 2016; COMEAP, 2018a), birth defects (Padula et al, 2013) and neuro-degenerative disorders (Moulton and Yang, 2012). While there is a significant body of international research highlighting evidence of the association of areas of low socio-economic status (SES) with high levels of outdoor air pollution (Clark et al, 2014; Milojevic et al, 2017; Pinault et al, 2016; Fairburn et al, 2019), there is little on equivalent exposures to indoor air pollution, despite populations in developed countries spending the majority of their time indoors. Understanding variations in population exposure to air pollution across socio-economic groups, in both indoor and outdoor environments, is critical in reducing existing and future health inequalities
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