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Home Rx: The Health Benefits of Home Performance

The home performance industry supports whole-house solutions to improve home energy use and enhance indoor air quality and environmental conditions. Numerous studies have evaluated the effects of a range of residential energy efficiency and green renovation work on indoor environmental quality and occupant health. However, there has not been a systematic review of such studies to summarize current knowledge and identify research gaps.

The purpose of this review is to address the question:

"What are the occupant health and indoor environmental outcomes resulting from energy efficiency or home performance upgrades, and how indoor environmental conditions can affect health?

In all home repair and home performance work, there is some potential for unintended consequences and negative health outcomes due to improper design, inadequate installations, insufficient maintenance, and/or equipment failures. 

1. Base energy efficiency work, can create healthier living environments. Health-related outcomes include improved general health, reductions in some asthma symptoms, fewer cases of hypertension and upper respiratory risks, and some improvements in indoor air quality contaminants. One New Zealand study showed significant healthcare savings when uninsulated homes received energy upgrades.

2. Enhanced energy efficiency upgrades have been shown to reduce indoor air contaminants linked to chronic illnesses, control environmental contaminants (dust mites, mold/moisture) that can trigger respiratory symptoms, and improve symptoms of asthma and other respiratory health conditions.

The studies also found reductions in other indoor air pollutants and reported improvements in blood pressure and fatigue. One small study of low-income clients also showed a reduction in healthcare costs among U.S. residents. The enhanced practices most closely match common practices in the home performance industry.

3. Green new construction research includes four studies that have documented observed reductions in healthcare utilization. Multiple studies of green renovation and new construction also found reductions in indoor air pollutants, other asthma triggers such as pests and mold, and, ultimately, asthma symptoms.

Although green building and maintenance practices are more extensive than the activities of most home performance contractors, this research offers information to frame the potential benefits of energy efficiency/home performance when coupled with other home renovations.

4. Studies of enhanced ventilation strategies have documented reduced indoor air quality contaminants that have been linked with chronic illnesses or respiratory risks; fewer respiratory risks among people with asthma; and reduced allergens. These studies offer promise for positive health benefits when whole house ventilation is incorporated into home performance measures.

5. Several stand-alone home services/upgrades have been shown to improve occupant health and could be incorporated into home performance work specifications.

These include: in-room HEPA (high-efficiency particulate air) air cleaners, replacement of gas stoves with electric stoves, and upgrades from older wood stoves to cleaner burning models. These upgrades help to reduce respiratory risks by reducing air contaminants (e.g., nitrogen dioxide; fine particulate matter).

Additional studies are needed to build upon existing research that demonstrates improved indoor air quality and reported health symptoms to also document reductions in healthcare utilization -- the extent to which a given group uses particular healthcare services in a specified period, and/or costs. 

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