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Evidence-based public health, policy and practice
More effective home heating reduces school absences for children with asthma
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  1. S Free,
  2. P Howden-Chapman,
  3. N Pierse,
  4. H Viggers,
  5. the Housing, Heating and Health Study Research Team*
  1. Housing and Health Research Programme, University of Otago, Wellington, Wellington South, New Zealand
  1. Correspondence to Professor Philippa Howden-Chapman, He Kainga Oranga/Housing and Health Research Programme, University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand;philippa-howden-chapman{at}otago.ac.nz

Abstract

Background New Zealand homes are underheated by international standards, with average indoor temperatures below the WHO recommended minimum of 18°C. Research has highlighted the connection between low indoor temperatures and adverse health outcomes, including social functioning and psychological well-being. Both health effects and social effects can impact on school absence rates. The aim of this study was to determine whether more effective home heating affects school absence for children with asthma.

Methods A single-blinded randomised controlled trial of heating intervention in 409 households containing an asthmatic child aged 6–12 years, where the previous heating was an open fire, plug-in electric heater or unflued gas heater. The intervention was the installation of a more effective heater of at least 6 kW before the winter of 2006 in half the houses. Demographic and health information was collected both before and after the intervention. Each child's school was contacted directly and term-by-term absence information for that child obtained for 2006 and previous years where available.

Results Complete absence data were obtained for 269 out of 409 children. Compared with the control group, children in households receiving the intervention experienced on average 21% (p=0.02) fewer days of absence after allowing for the effects of other factors.

Conclusion More effective, non-indoor polluting heating reduces school absence for asthmatic children.

  • Asthma
  • indoor environment
  • nitrogen dioxide
  • heating
  • school absence
  • child development
  • deprivation
  • environmental health
  • trials

https://doi.org/10.1136/jech.2008.086520

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    Footnotes

    • ↵* Housing, Heating and Health Study Team P Howden-Chapman, N Pierse, S Nicholls, J Bennett, H Viggers, C Cunningham, R Phipps, M Boulic, P Fjällström, R Chapman, S Free, D Shields, B Lloyd, K Wickens, C Cunningham, A Woodward, M Baker, C Bullen, J Crane. S Nicholls, He Kainga Oranga/Housing and Health Research Programme, University of Otago, Wellington, PO 7343, Wellington South, New Zealand. J Gillespie-Bennett, He Kainga Oranga/Housing and Health Research Programme, University of Otago, Wellington, PO 7343, Wellington South, New Zealand. M Cunningham, BRANZ Ltd, Moonshine Rd, Porirua City, New Zealand. R Phipps, School of Engineering and Advanced Technology, Massey University, Private Bag 11 222, Palmerston North, New Zealand. M Boulic, School of Engineering and Advanced Technology, Massey University, Private Bag 11 222, Palmerston North, New Zealand. P Fjällström, School of Engineering and Advanced Technology, Massey University, Private Bag 11 222, Palmerston North, New Zealand. R Chapman, School of Geography, Environment and Earth Sciences, Victoria University of Wellington, New Zealand. B Lloyd, Energy Studies, Physics Department, University of Otago, Dunedin, New Zealand. K Wickens, Wellington Asthma Research Group, University of Otago, Wellington, PO 7343, Wellington South, New Zealand. D Shields, He Kainga Oranga/Housing and Health Research Programme, University of Otago, Wellington, PO 7343, Wellington South, New Zealand. M Baker, He Kainga Oranga/Housing and Health Research Programme, University of Otago, Wellington, PO 7343, Wellington South, New Zealand. C Cunningham, Research Centre for Māori Health & Development, Massey University, Wellington, New Zealand. A Woodward, School of Population Health, University of Auckland, New Zealand. C Bullen, School of Population Health, University of Auckland, New Zealand. J. Crane, He Kainga Oranga/Housing and Health Research Programme, University of Otago, Wellington, PO 7343, Wellington South, New Zealand.

    • Funding Health Research Council of New Zealand, Auckland; Contact Energy Limited, The Terrace, Wellington; Ministry for the Environment, Wellington; Energy Efficiency and Conservation Authority, Wellington; Hutt Valley District Health Board, High Street, Lower Hutt; Capital and Coast District Health Board, Wellington South; LPG Association of New Zealand, Wellington.

    • Competing interests None.

    • Ethics approval This study was conducted with the approval of the Multi-Region Ethics Committee (NZ).

    • Provenance and peer review Not commissioned; externally peer reviewed.