Air is everywhere, and we take it for granted. According to a recent study funded by the European Commission, poor indoor air quality (IAQ) is responsible for the loss of 2 million healthy years of life every year in the European Union (1). And this data does not even include the impact second-hand smoke has on people’s health in indoor environments. With Europeans spending 60-90% of their life inside, patients, children and the elderly are particularly vulnerable when breathing dirty air indoors.

The World Health Organisation has recognised since 2000 the right to breathe good IAQ (2), but this right is constantly breached. There is growing evidence that several indoor air pollutants are causing or exacerbating respiratory diseases, allergies, intoxication and certain types of cancer. For instance, 1 in 4 premature deaths from chronic obstructive pulmonary disease (COPD) are attributable to household air pollution (3).

The EU has taken very seriously the protection of our health from outdoor sources of air pollution passing legislation to reduce the emissions of the most harmful pollutants to health in the coming decades. However, we are still lacking legislation granting not only protection but also information to the public about indoor pollutants.

One of the reasons is that indoor air quality is mistakenly believed to be mostly affecting people in the developing world. But our buildings in Europe can make us sick too. More than 900 compounds harmful to health have been detected in indoor air (4). Furthermore, IAQ requires a health and prevention approach across policies, but the EU is lacking a strong health focus within its institutions, to the point that health organisations have just launched the #EU4Health campaign (5).

Indoor air quality can be modified today by addressing other variables such as, the building emissions (construction, surface and finishing materials) and the indoor equipment (furnishing, heating and ventilation). Emissions and particles from cleaning products, from cooking and other occupant actions such as smoking and even the opening and closing of windows, can be shaped to reduce harmful impacts in the quality of the air.

As patient advocates, we are approaching the EU institutions to include IAQ in policies that have a threshold in the issue. It is the case of the recently revised Energy Performance of Buildings Directive (EPBD), which did not even mention the links and benefits of energy consumption reduction and health. At EFA, we took this legislative piece as an opportunity to bring the patients’ perspective to the building renovation and construction sector. We called on the European Parliament to include a compulsory Indoor Air Quality Certificate in its EPBD revision, to prevent respiratory diseases, reduce premature deaths and guarantee the right to have clean air in indoor spaces for everyone.

Although several forward-thinking MEPS proposed to set up the certificate as an obligatory and reliable source of information and control of indoor air quality in the EU, to match energy certificate, the IAQ certificate was not adopted. As a first step, the final EPBD though includes IAQ considerations, such as establishing inspections for air conditioning and ventilation systems in European buildings and encouraging healthy indoor climate conditions in buildings under renovation (6).

Given that the EU is committed to the WHO action plan for the prevention and control of non-communicable diseases, by promoting clean air and reducing premature deaths by 25% by 2025, we are awaiting policy developments to improve the quality of the air we are breathing in closed spaces, as foreseen by the EU 7th Environmental Health Programme (7). People with allergy, asthma and COPD are your radars!

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