In 2020 a two-year-old boy, Awaab Ishak, died after protracted exposure to mould in a house rented from a housing association. His death, and the subsequent release of the coroner’s report two years later, brought to the attention of both the public and politicians the fact that damp houses with severe mould growth are not just unsightly and uninhabitable, they can also be a cause of ill health.
It has been known for some time that dampness increases the risk of asthma, allergic rhinitis, and other respiratory conditions. The World Health Organisation issued a report on the health consequences of dampness and mould in 2009.
Stachybotrys chartarum
A number of fungal species (moulds), whose growth is facilitated by dampness, can trigger allergic reactions, but one particular mould has received increased attention: Stachybotrys chartarum.
Stachybotrys chartarum was first recognised as a cause of disease by Russian scientists in 1938, when they reported a serious and sometimes fatal condition in horses fed with mouldy hay or straw.
In the 1990s 37 cases of pulmonary haemorrhage in infants were reported in Ohio (US), leading to 12 deaths. There was an association with water-damaged buildings and Stachybotrys chartarum was thought to be the likely cause.
Stachybotrys chartarum can cause ill health not just by triggering allergic reactions, but also via the production of toxic products (mycotoxins) which harm our body tissues.
Damp buildings
Although not everybody exposed to damp buildings is adversely affected, the risk to health is real and some individuals (including infants, children, asthmatics and the elderly) are at higher risk.
Tenants are much more likely to be affected by this problem as they do not have the authority to initiate the remedial works that would eliminate dampness. About 3-4% of social homes in England are affected by “notable” mould and damp. There is also a significant problem in the privately rented sector.
Landlords and social housing providers often have been slow to respond to complaints about damp mouldy dwellings, and have sometimes blamed the tenants for causing this problem. Blaming the tenants could be a ploy to avoid the necessary remedial work.
A 2021 report from the Housing Ombudsman Service (HOS), titled It’s Not Lifestyle, has called for an end to this blame culture and has emphasised the need for a more proactive approach by landlords.
The HOS report includes a number of case studies highlighting how difficult it can be to pinpoint the exact cause of the dampness. Landlords would benefit from detailed policies and from ensuring that their staff and contractors have appropriate expertise.
There are a number of websites describing what could be the causes of dampness and the remedial actions that could be undertaken by both landlords and tenants. The websites of the Energy Saving Trust, webmd (Moisture and Mold problems) and the charity Shelter are good starting points.
When there are no structural defects, condensation is usually the problem. In some way it is true that residents are the cause of condensation as it is human activities (breathing, bathing, cooking, drying clothes) that generate much of the humidity. However, blaming tenants is usually wrong, because buildings with adequate insulation and ventilation should not suffer from condensation.
The coroner’s report related to the death of Awaab Ishak pointed out that the mould growth had been incorrectly attributed to “family lifestyle” whereas updated information on the health risks relating to damp and mould was not available to the housing sector. Awaab Ishak’s home was part of an ageing housing stock: it did not seem to have structural defects, but the windowless bathroom did not have an effective extractor fan, whereas the kitchen had no extractor fan at all.
The current high energy costs may encourage many to turn down the heating, but in some buildings this could exacerbate dampness problems as relative humidity increases at lower temperatures.
Health is not just affected by poor housing but also by exposure to pollution, or harmful chemicals, by poor sanitation and by climate change. As much as 24% of all deaths worldwide are attributed to the environment. There are lots of opportunities for prevention, provided there is political will.