To ensure better and more inclusive health outcomes, the TCPA has identified 12 Healthy Homes principles that all new housing developments must provide. Each month, this blog series explores one of the principles
Healthy Homes principle: Prevent air pollution
If there’s one thing that the tragic and preventable deaths of nine-year old Ella Adoo-Kissi Debra and two-year old Awaab Ishak have shown us, it’s that where people live, and the quality of our homes, has a fundamental impact on our health and wellbeing.
If homes are located near or alongside major roads and industrial emissions, or they are poorly insulated and poorly ventilated, people are more likely to risk exposure to air pollution. Poor indoor and outdoor air quality is linked to between 28,000 and 36,000 deaths in the UK every year. By 2025, the estimated costs to the NHS and social care from treating air pollution-related illnesses in England alone will exceed £1.6 billion (UK Parliament, 2023).
Research shows that people from lower socio-economic backgrounds are more likely to live in areas with higher outdoor and indoor air pollution due to factors like housing density and quality, further exacerbating health inequalities (UCL, 2021).
By 2025, the estimated costs from treating air pollution-related illnesses in England alone will exceed £1.6 billion.
Outdoor air pollution
Outdoor air quality is fundamental to ensuring public health, with no safe levels of exposure to pollutants. In 2021, the World Health Organization (WHO) updated its air quality guidelines, emphasising the urgency of reducing pollution to protect lives. However, UK government targets in the 2021 Environment Act still allow pollution levels above WHO recommendations, leaving many urban areas exposed to unsafe concentrations of nitrogen dioxide (NO₂) and particulate matter (PM), primarily caused by road traffic (Asthma+Lung UK, 2024).
Outdoor air pollution originates from both natural and human activities, including transport, industrial processes, farming, energy generation, and domestic heating, with road transport being the largest source in urban areas in the UK (TCPA, 2021; Trees and Design Action Group, 2019). And as discussed in our last blog on climate resilience, air quality is also being affected by climate change. Our future homes need to be able to mitigate and adapt to these changes, including increased risks from particulates.
UK government targets in the 2021 Environment Act still allow pollution levels above World Health Organisation recommendations.
Local Authorities are tasked with monitoring air quality and designating Air Quality Management Areas where standards are exceeded. However, the impact of air pollution is not distributed equally across the population. Certain groups are disproportionately affected, including people from minority communities and those living in lower-income areas (Impact on Urban Health, 2019). In England, 13% of people who live in the most deprived neighbourhoods also live in neighbourhoods with the highest levels of air pollution (The Health Foundation, 2024).
Poor housing and indoor air quality
While outdoor air pollution often dominates headlines, the air inside our homes is an equally significant, yet frequently overlooked, threat to health. Poor-quality homes expose millions of people to health risks, contributing to respiratory and cardiovascular diseases. In the private rental sector, nearly one in four fail to meet basic standards (TCPA, 2024).
In countries like the UK, where people spend up to 90% of their time indoors, exposure to indoor air pollutants can have severe and long-lasting health consequences. Unlike workplaces, schools, or hospitals, the air quality in homes is rarely monitored or regulated, leaving people unknowingly vulnerable (National Centre for Atmospheric Sciences, 2023).
The air inside our homes is an equally significant, yet frequently overlooked, threat to health.
Poor indoor air quality arises from a complex mix of factors, including dampness, mould, poor ventilation and energy efficiency, alongside structural issues common in the UK’s ageing housing stock (Holden, A. et al., 2023). Currently, 8 million people in England live in 3.7 million homes that are cold, damp, or in disrepair; conditions that foster respiratory infections and worsen existing lung conditions such as asthma and lung cancer.
8 million people in England live in 3.7 million homes that are cold, damp, or in disrepair
Overall, the health impacts from indoor air pollutants range from dizziness and headaches to heart diseases, strokes and cognitive decline (Asthma+Lung UK, 2024). Vulnerable groups—including babies, children, elderly people—are particularly susceptible. Children, for example, are especially at risk, as poor-quality housing disproportionately affects low-income families (Holden, A. et al., 2023). A recent study involving more than 200,000 people in Scotland also highlighted an increased risk of hospital admission for mental health linked to air pollution (The Guardian, 2024), highlighting its impact beyond physical illness.
Air quality in permitted development housing
With the health impact of air pollution now well understood, provisions should be made to ensure all new homes, including those produced through permitted development (PD) minimise people’s exposure to air pollution. However, PD housing can be located in unsuitable areas exposed to poor air quality, alongside major roads and active industrial estates.
Local authorities can apply Article 4 Directions to specify unsuitable locations where PD conversion is not allowed. Such directions are highly constrained however by the National Planning Policy Framework in paragraph 54 which states they can only apply if there are ‘wholly unacceptable adverse impacts’, with ‘robust evidence’, and to ‘the smallest geographical area possible’.
What is the way forward?
Building regulations are complicated when it comes to PD conversion and air quality. Approved document C2. Resistance to Moisture (i.e. protection from damp) does not currently apply to existing buildings converted to flats or dwellings – so called ‘material change of use’. Approved F Schedule 1. on Ventilation does appear to apply to buildings converted to residential use. The Manual to Building Regulations (2020) also requires updating to reflect the gap on resistance to moisture.
Improving indoor and ambient air quality is not just a matter of individual wellbeing; it’s a public health imperative. Addressing these challenges requires a dual focus on reducing outdoor pollution and improving indoor air quality through better planning, housing standards and sustainable building practices.
Tackling urban air pollution requires a blend of strategic national and local policies, and thoughtful design. Governments can reduce road transport emissions by promoting active travel like walking and cycling (TCPA, 2021). Urban greening, such as planting trees and incorporating multi-functional green infrastructure, like parks, SuDS, green roofs and walls, can not only help improve air quality but also encourage more attractive, healthier, car-free lifestyles (Trees and Design Action Group, 2019).
Green infrastructure can not only help improve air quality but also encourage more attractive, healthier, car-free lifestyles.
Overall, effective planning and design play a key role in controlling where pollution is generated and how it disperses, making it essential for planners to be able to prioritise air quality in every project (Trees and Design Action Group, 2019). Through effective local planning and development policies we can create an urban environment that promotes complete, compact and connected communities that combined with well-maintained homes, high quality green infrastructure and active healthy travel (TCPA, 2024).
Regarding outdoor air pollution, the upcoming review of the Clean Air Strategy presents a pivotal opportunity to align targets with WHO guidelines and set ambitious ones for pollutants like PM₂.₅ and NO₂, which pose the greatest risk to human health. Achieving this also requires a holistic, cross-departmental approach, integrating health, environment, and public policy sectors (Asthma+Lung UK, 2024).
Policies such as zero-emission zones and incentives for renewable energy in transport and energy production will help to further reduce pollution, alleviate healthcare burdens, and pave the way for a prevention-led NHS (The Guardian, 2024).
We need to see policies such as zero-emission zones and incentives for renewable energy in transport and energy production.
Campaign groups have called for a cross-departmental national strategy to improve housing conditions to transform public health and the economy. The Safe Homes Now campaign estimates that an annual investment of £625 million could upgrade 520,000 homes, create 100,000 jobs, save the NHS £1 billion, and generate £19 billion in health benefits (Asthma+Lung UK, 2024). These numbers highlight the immense potential of prioritising safe, warm, and healthy homes as a cornerstone of public health.
The Campaign for Healthy Homes is seeking a fundamentally different approach to housing quality. We are calling for a Healthy Homes Bill which would create a comprehensive high-level framework for housing standards, with statutory duty on the government to ensure that all new homes minimise exposure to air pollution for residents. This principle, alongside the other Healthy Homes principles, is vital to ensure everyone can live in a home that is designed to promote wellbeing and not merely prevent harm.
Clémence Dye – Projects and policy assistant, TCPA and Rosalie Callway – Projects and policy manager
