How can a damp home affect your health?

Damp is thought to affect almost one in five homes in the UK,¹ and between 10 and 50% of indoor environments in Europe (depending on the country).²

Damp and mould can have catastrophic consequences on health, as seen in the case of Awaab Ishak, a two-year-old boy who died in 2020 after being exposed to “extensive” mould at his home in Rochdale.³

Awaab Ishak died in 2020 after being exposed to environmental mould pollution

Awaab’s father, Faisal Abdullah, first complained to Rochdale Boroughwide Housing (RBH) about the mould in their home in October 2017. Mr Abdullah was told to paint over the black mould, but it persisted, and by May 2019, he was making frequent complaints to the housing association.

Mr Abdullah eventually pursued legal action, and his case was picked up by solicitors in June 2020. However, RBH refused to carry out work at the property’s condition until the legal complaint had been approved by solicitors.

Awaab had regular coughing fits, his parents said, and just days after his second birthday, he was rushed to the hospital after struggling to breathe. He died the next day after suffering a cardiac arrest brought on by respiratory failure.

Fungus was found in Awaab’s blood and lungs and his throat, windpipe and airways were extremely swollen. The coroner concluded: “I find as a matter of fact that the development of Awaab’s severe respiratory condition, which led to him going into respiratory arrest, was entirely due to the prolonged exposure he had to mould in his home environment.”

In November 2022, Joanne Kearsley, the coroner, ruled that the cause of Awaab’s death was “environmental mould pollution”.

Gareth Swarbrick, chief executive of the housing association, said the association “didn’t recognise the level of risk” Awaab was exposed to. “We must make sure this can never happen again,” he added.

As Ms Kearlsey said at the hearing at Rochdale Coroners Court: “This issue is not simply a Rochdale problem, nor is damp and mould simply a social housing problem, it is a significant issue in private sector too.”

More than half of households predicted to be in poverty by end of the month

Indeed, this issue is much bigger than just one house in Rochdale, and an analysis by HR News found there were more than 12-and-a-half million damp issue queries in the UK between April 2020 and April 2021.⁴

London was found to have the highest rate of complaints, with almost one in seven Londoners experiencing damp, mould or condensation issues. This number is likely to be even higher now considering the rapidly rising cost of energy.

Households on lower incomes, those with children, pregnant women, immunocompromised people, older, frail people and people with diabetes are all at increased risk of health problems caused by damp.⁵

Since mould cannot grow without sufficient moisture, cold, damp, poorly ventilated homes provide the perfect environment for mould to thrive.

With the rising cost of energy, many households across the UK can no longer afford to heat their homes. Indeed, forecasts predict that by the end of this month (January 2023), more than half (55%) of households will be in fuel poverty.⁶

Health professionals are growing increasingly concerned that thousands of families across the UK will be living in cold, damp environments this winter, exposing themselves and their families to a plethora of health problems.

As the Royal College of Paediatrics and Child Health (RCPCH) President, Dr Camilla Kingdon, explains: “The cost of housing is now at an all-time high, meaning low-income families have the least amount of say in where they live. Increasing evidence suggests a rising number of families are living in poor quality accommodation, with detrimental impacts on children’s health.

“Cold and damp housing conditions can lead to increased risk of asthma, respiratory infections, slower cognitive development, and higher risk of disability, mental health problems in children.”

What causes damp and mould?

Damp and mould are caused by excess moisture. If houses are poorly ventilated, excess moisture from day-to-day activities (like cooking, drying clothes and showering/bathing) can’t escape, which can lead to damp inside the home.

Since moisture pools on cold surfaces, heating your home can help prevent condensation from forming. Ventilation and using a dehumidifier can also help to extract moisturiser from the air, but keeping windows open all day in the winter is not a practical solution and dehumidifiers can be expensive to run.

Damp can also be caused by structural issues such as leaking pipes, rising damp or a damaged roof or window frames. Newly built homes can also have damp issues if the plaster isn’t allowed to fully dry out.

In such instances, damp is much harder to prevent and will persist until the water problem is identified and eliminated (for example, through fixing a leak or replacing damp plaster).

It is important to note that the coroner’s report following Awaab’s inquest highlights that housing professionals often place too much emphasis on tenants’ lifestyle choices as a cause for mould.

Landlords and other housing professionals often blame a tenant’s habits (such as bathing or cooking without opening any windows or running a fan) rather than looking at ways they can improve ventilation in the property itself.

This can cause damp issues to go untreated for long periods of time, therefore exposing the residents to mould problems for prolonged periods of time and increasing the risk of chronic illnesses developing.

What effect does a damp environment have on health?

Respiratory issues

Mould releases tiny particles called spores which, when breathed in, can cause various health problems including respiratory issues, which often presents with symptoms such as coughing and wheezing.

It can also cause an allergic reaction, including symptoms such as sneezing, fever, a blocked and/or runny nose, a sore throat and pain or pressure behind the face. These symptoms are often mild, but can become chronic if the occupant is exposed to mould spores over a long period of time.

Those with asthma and other underlying respiratory issues often experience flare ups more frequently and more severely, while some may develop aspergillosis, a condition caused by inhaling mould particles.⁷

While this condition is rare in healthy people, it can affect those with a weakened immune system or lung conditions such as asthma, cystic fibrosis and COPD. Symptoms include shortness of breath, coughing up blood or lumps of mucus, wheezing, a high temperature and weight loss.

Skin conditions

Touching mould spores can cause your skin to become irritated and inflamed. Those who are already prone to skin breakouts, such as those with eczema, are more likely to experience an allergic reaction, but it can affect who do not have underlying skin conditions too.

Skin rashes caused by mould are known as ‘mould rash’. Common symptoms of these rashes include itchiness, dry and scaly skin, raw and sensitive skin, brown or pink skin, and small raised bumps that may leak fluid.⁸

It is unlikely physicians will be able to diagnose mould rash just by looking at it, but tests (such as a blood test or skin prick test) should be able to identify whether you have the condition.

It is therefore crucial that those with skin conditions wear protective garments when removing mould, or seek professional help.

Mental health

Living in a mouldy home can also impact mental health. Personal possessions can become damaged, clothes can begin to smell, and you may become anxious about its impact on your family’s health.⁹

Damp and mouldy housing can therefore impact both physical and mental health, further stretching NHS resources.

Improving housing standards

Those in rented accommodation are particularly vulnerable to damp housing, with around 11% of privately rented homes having problems with damp and 4% of social lettings, compared with just 2% of owner-occupied homes.¹⁰

This leaves people with a lower socioeconomic status more vulnerable to mould and the health issues that are associated with it. It is therefore vital that landlords and social housing providers act quickly to prevent damp and mould from occurring in homes.

While housing associations are responsible for keeping homes in line with the Decent Homes Standard, chronic underinvestment has meant that social housing is often poorly maintained, poorly insulated and poorly ventilated.¹¹

As an editorial published in eClinicalMedicine states: “These widespread failings of substandard housing leading to severe health problems cannot be met with feeble responses of ‘lessons will be learnt’.”¹¹

The author instead calls for the implementation of new laws to protect tenants from damp and mould, otherwise the NHS will continue to face increasing pressure as a result of the health issues caused by cold, damp homes.

Dr Kingdon has similarly called for the government to invest more time and energy into ensuring housing is safe for children and their families. She also encourages paediatricians and other health professionals dealing with respiratory issues to consider the individual’s home environment during assessments.

She said: “We are continually encouraging paediatricians to specifically ask about a family’s living situation whenever they are reviewing a child with a respiratory condition as this is now a crucial issue for child health. However, the responsibility to provide children with warm and dry housing cannot solely rest with parents and guardians.

“Different professions and parts of government must work together to make sure that buildings and homes are fit for purpose. We call on the UK Government establish a process for people in rented and social housing to report indoor air quality problems and to help with necessary improvements. It is essential that all children and young people have a base standard of living that promotes health and wellbeing.”

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