#26 - Simon Jones: What is the risk to long term health and productivity in home working?

You have me this week.

Sitting at home on a beautiful day with the window open, I wonder.... 

Could remote working and hybrid working, represent the single largest chronic occupational environmental health risk of this century?

While we've been enjoying the flexibility and comfort of working from home, a new, insidious risk is potentially emerging – one that could have profound implications for our long-term health and well-being. This risk is the deteriorating quality of our indoor environment at home

Imagine this: you're working at your home desk, basking in the convenience of avoiding the daily commute, only to discover that your home environment may be quietly undermining your health and productivity. The potential health risks associated with prolonged remote working conditions might represent the single largest chronic environmental health risk of our century.

The surge in remote and hybrid work, catalyzed by the COVID-19 pandemic, has persisted well into 2024, with nearly 49% of desk workers now splitting their time between home and office, and 17% working fully remote. This could translate to around 900 million people globally who are exposed to home environments that were never designed for full-time work.

Harvard Paper
Ventilation and indoor air quality in new homes
Ventilation provision and use in homes in Great Britain: A national survey

Transcript

Simon: 0:14

Welcome to Air Quality Matters, and you've got me this week. Well, not just me, there's you, of course, and I appreciate that. Otherwise it would just be me talking into the void through a microphone. So, look, really appreciate it.

Simon: 0:29

I'm sat at home here today in my home office with the window open. The air quality outside is great. The air quality inside the room is really good as well, and it got me thinking about air quality and working from home. And it got me thinking about air quality and working from home. I can't emphasize this enough and we talk about it so much on this podcast how important the air quality in our home really is to our long-term health and well-being. I use this figure a lot, but if you're lucky enough to live to 80 years of age, you're going to spend 70 years of that indoors and nearly 55 years of that in your own home.

Simon: 1:12

Now more than ever, with the home hybrid work type environment, more and more of us are spending increasing amounts of our time at work in our own homes and, perhaps interestingly, now this is important for our employers too, who have a stake in the air quality of the environments that our employees work in. Could remote working and hybrid working now represent the single largest chronic occupational environmental health risk of the century. While we've been enjoying the flexibility and comfort of home working, a new insidious risk is potentially emerging, one that could have profound implications for our long-term health and well-being. This risk is the deteriorating quality of our indoor environment at home. Imagine this you're working in your home desk, just like I am right now, basking in the convenience of avoiding that daily commute, only to discover that your home environment may be quietly undermining your health and productivity. The potential health risks associated with prolonged remote working conditions might represent a serious risk for our long-term health and well-being, and something that employers will have to take increasingly seriously. This surge in remote and hybrid working, catalyzed by COVID-19, has persisted well into this year, with nearly 49% of desk workers now splitting their time between home and office and 17% working fully remotely. This could translate to around 900 million people globally who are exposed now to home environments as their place of work.

Simon: 3:18

A study by the Harvard TH Chan School of Public Health reveals quite alarming data about the indoor air quality and its impact on cognitive function amongst remote workers. Researchers found that variations in indoor temperature and CO2 levels could significantly affect cognitive performance, for example, excessively warm or cool indoor temperatures can impair tasks requiring selective attention and creative problem solving. Even moderate increases in CO2 levels can reduce our ability to focus and process information accurately. Given that most homes are not optimised as workspaces, these findings underscore a crucial point. Poor indoor air quality in our home offices can diminish our cognitive abilities, making us less productive and more prone to errors, notwithstanding the potential long-term chronic health implications it has. This brings us to an important question Are employers responsible for the work environment of their remote employees?

Simon: 4:36

Should they be held accountable for ensuring that home offices are safe and conducive to health and productivity? That home offices are safe and conducive to health and productivity. The chair or CEO of the health and safety executive here in Ireland is on record as saying employers should be under no illusion that they have a responsibility for the health and wellbeing of their employees, no matter where their place of work is. Their employees, no matter where their place of work is. Employers have long been responsible for the work environments in traditional office settings, ensuring proper ventilation, temperature control and overall workplace safety, and as this paradigm shifts, it is imperative for employers to extend these responsibilities to the home office. This could involve providing resources for monitoring and improving indoor air quality, such as air purifiers or ventilation systems, in combination with the actions they're already taking around providing ergonomic furniture and seating, for example. Moreover, policy makers need to develop guidelines and standards for home office setups that include considerations for indoor environmental quality. This is not just about boosting productivity, but safeguarding the health and well-being of the workforce. It's essential to acknowledge and address the long-term health risks posed by inadequate home working environments. The transition to remote work has brought undeniable benefits, but it also comes with hidden costs that we must not ignore. Employers, employees and policy makers must collaborate to make healthier home workspaces. Will we look back at this period with regret for overlooking these risks, or will we take proactive steps to ensure a healthier future for remote work? The choice is ultimately ours, so let's look at some of these points in more detail.

Simon: 6:48

How big a thing is remote working these days? Globally, nearly half of all desk workers that's 49% are engaged in some form of hybrid work, which means they split their time between home and the office. In comparison, 35% of employees work full-time in the office and 17% are fully remote Basic back-of-the-fact packet calculations, of course, but this could mean that close to 900 million workers are either hybrid or fully remote now, and it's unlikely to change. When you look at it, a substantial majority of employees prefer some form of remote work, don't you? Surveys indicate that 98% of employees have a preference to work remotely, at least some of the time. 85% of employees express higher job satisfaction with the flexibility that hybrid work provides. And how does this break down where you live? Well, take the United States, for example. As of September 2023, 14% of full-time employees work fully remotely and 29% have a hybrid work arrangement and 29% have a hybrid work arrangement. So again, nearly half of all employees in the States that are desk workers will have some form of hybrid or fully remote model. That has led to a 30% reduction in office space requirements due to widespread adoption of hybrid working models adoption of hybrid working models.

Simon: 8:29

Let's take the APAC region. Approximately 85% of companies actively promote and embrace the hybrid working model. This marks a significant increase in flexibility compared to pre-pandemic work arrangements. For example, nearly 43% of people in the APAC experienced hybrid working for the first time during the pandemic, reflecting a major shift in the traditional office-based roles. And in Europe, employees also show a strong preference for hybrid models. The flexibility of remote work is highly valued for reducing commute times and improving work-life balance valued for reducing commute times and improving work-life balance. Similar to North America, many European companies have reduced their office space, adjusting to new hybrid work norms.

Simon: 9:21

Think about it If you're in your 20s now, how much of your working life is now going to be based at home or how much of your kids work in life, for that matter, and what impact could it have on their long-term health and well-being, but also their performance and career? And, from an employer's perspective, what could be the compound impact of cognitive performance across your workforce on general productivity and bottom line? It was a few weeks ago now I can't remember exactly when, but there was a study published called Home Indoor Air Quality and Cognitive Function over one year for people working remotely during COVID-19. Over one year for people working remotely during COVID-19. The primary author of the study is Anna Young and she's affiliated with the Department of Environmental Health at the Harvard TH Chan School of Public Health in Boston. The study examined overall the impact of indoor air quality on cognitive function amongst office workers who worked from home during the pandemic period.

Simon: 10:28

The study followed 206 office workers across the US from 2021 to 2022, and participants used two consumer grade environmental monitors to measure CO2, temperature and relative humidity in their home workstations and bedrooms. The participants completed cognitive function tests, including the Stroop test, arithmetic tests and SeaRat, using a custom smartphone app that was developed and there were a couple of key findings. App that was developed and there were a couple of key findings, one of which was that cognitive performance was found to vary with thermal indoor conditions. This means that performance declined both when conditions were too warm and too cold, indicating an optimal thermal range for cognitive function. So what were the impacts of some of these specific tests? Well, with regard to the Stroop test, this test measures cognitive speed, selective attention and inhibitory control. The study found that both excessively warm and cool conditions negatively impact performance. When temperatures were either too high or too low, participants performed worse in terms of both speed and accuracy. With regards to the C-RAT test, that's the compound remote associates task, this test assesses the creative problem solving and remote associative thinking elements of performance. Remote associative thinking elements of performance. Similar to the Stroop test, performance on the C-RAT declined outside of these optimal thermal ranges. The study used the heat index, which combined temperatures and relative humidity to reflect perceived temperature and higher heat indices were associated with worse cognitive performance, particularly in creative, problem solving and inhibitory control tasks. Conversely, with a comfortable range, a slightly higher heat index improved performance in some cognitive areas.

Simon: 12:38

When it came to CO2 levels, which is usually a good indicator of ventilation rates, the study was a little bit weaker and I'll come on to that in a minute. But most of the indoor co2 levels in the study were pretty low. But despite these relatively low levels there was still a slight association with higher co2 concentrations and poorer cognitive performance, and this would match very much what we see in traditional workplace settings and higher levels of CO2. So when it came to the specific cognitive impacts the selective attention and inhibitory control, for example, higher CO2 levels were linked to worse performance. On the Stroop test, which involves selective attention and ability to inhibit cognitive interference, participants showed slower response times and reduced accuracy as the CO2 levels increased. Although CO2 levels were not alarmingly high, the findings suggest that even moderate increases in CO2 can negatively impact cognitive functions that are critical for remote work, such as attention to detail and ability to focus amidst distractions.

Simon: 13:53

The study underscores for me the significant impact of indoor air quality on cognitive performance during remote work. Given that many homes are not designed to function as workspaces, the indoor environmental quality of these settings can directly affect workers cognitive abilities. Both excessively warm and cool conditions can impair cognitive functions. I don't know if any of you have ever tried to work in an overly warm or cold office, but I'm sure many can relate to that, and they indicate a need for maintaining a stable and comfortable indoor temperature for optimal performance and when it comes to CO2 or general air quality or ventilation rates, elevated CO2 levels, even if moderate, can hinder cognitive functions such as selective attention and problem solving. This highlights the importance of good ventilation in home environments to ensure that CO2 levels remain low. Enhancing indoor air quality in the home environments can have substantial benefits for cognitive function and productivity, something that employers should be taking note of. This study underscores the need for interventions aimed at improving indoor environmental conditions, such as better ventilation and temperature regulation, to support the cognitive performance of remote workers. So the recommendations from this report were principally threefold One for employees to regularly ventilate the home workspace to keep CO2 levels low and maintain comfortable temperatures. For employers to consider supporting employees with resources and equipment to monitor and improve air quality at home. And for policymakers to develop guidelines and standards for home office setups that include indoor air quality considerations and ensure healthy work environments for remote employees.

Simon: 15:48

The study primarily involved highly educated knowledge workers, many of whom had post-secondary or graduate degrees. This limits the generalizability if I've said that correctly of the findings to the broader population with varying education backgrounds and job types, and the participants were also mostly from a white or Asian race background, with a significant proportion living in relatively high income homes. This demographic limits the applicability of the results to the broader population and, as it notes a little bit further down in the report, also potentially the fact that we're seeing such low levels of CO2 because the homes will be larger and better equipped and better ventilated. Participants also had access to the real-time air quality data. Also had access to the real-time air quality data. This awareness could have influenced their behaviour, potentially leading them to take actions that those that didn't have monitors wouldn't have done.

Simon: 16:52

And some aspects of the study relied on self-reporting of data, which can be subject to biases, such as over-reporting and the desirability of behaviours and under-reporting of undesirable ones. And, as Richard Corzai said in a previous podcast with us, we have almost no contextual information on the performance of the ventilation in the homes, the size of the rooms that people were in, and we've got no idea how those kind of things impacted the air quality results. The study did also use consumer grade environmental monitors, which, although strongly correlated with reference grade instruments, may still have some measurement inaccuracies. This is particularly relevant for parameters like PM2.5, where low concentrations fell below the sensor's accuracy limits. The study's entirely remote nature meant that researchers could not directly measure ventilation rates, inspect ventilation systems or verify other home environmental conditions. This reliance on remote data collection may introduce some inaccuracies or misqualifications of certain indoor air quality assessments. The study focused on objective sensor measurements and did not directly survey participants about their thermal comfort or behaviours that might affect comfort, such as clothing choices. But nonetheless, while the study provides valuable insights into the impact of indoor air quality on cognitive function for remote workers, these weaknesses highlight areas for improvement of future research. Addressing these limitations could enhance the robustness and applicability of findings to a wider range of populations and settings.

Simon: 18:44

What I would say, though, is that there is already strong evidence of the impacts on our long-term health exposure to poor indoor air quality in the home. We've covered it very well on this podcast, I think, and it makes sense to me at at least that, as with workplace studies, the poorer air quality in our home office environment is likely to have an impact on our health as well as our performance. The cost of this is hard to measure in the workplace and presents even bigger challenges in the home. One thing that we can be sure of is whatever about the quality of air quality and ventilation in the workplace often being run to failure and poor overall. And don't get me wrong if you're lucky enough to work in a brand shiny new building, you're probably getting relatively good air quality. But for most of us in the built environment that is not the case. But if you think that's bad, you wait until you start looking at the residential sector. It is the wild west in comparison, and if I was in charge of the overall health and safety of my organization and its employees, that would concern me, and it would concern me a lot. Not only is it likely to represent a significant risk if you apply the risk lens to it. How do you control or mitigate that risk in a meaningful way?

Simon: 20:22

Ventilation is critical for maintaining healthy indoor air quality in homes, significantly impacting comfort and well-being. And if you've been listening to this podcast series, you'll know the evidence from the residential sector can be quite damning on its performance. Recent studies have highlighted the challenges and deficiencies of ventilation. In this case let's talk about UK homes, both old and new, revealing alarming statistics and offering compelling insights into the current state of domestic ventilation. A recent study just released this year that looked at ventilation provision and use in homes in Great Britain was a national survey. I'll put links in the show notes for it. I think it's really interesting. So here's some basic stats from that study.

Simon: 21:18

Number one the prevalence of non-compliant ventilation systems In old homes. Only 22% of homes built before 1991 have ventilation systems that meet minimum standards today established in building regulations. And when it comes to new homes, 41% of them built after the introduction of mandatory ventilation standards still fail to comply, indicating gaps in implementation and enforcement. There's an overall lack of mechanical ventilation, with only 11% of all the respondents to the surveys having mechanical ventilation, trickle ventilations and having received information on how to use those systems. And the outcomes can be pretty stark. It depends what sector you look at, but across the board, approximately 22% of all respondents reported mould or damp on walls or surfaces in their homes a direct consequence of inadequate ventilation.

Simon: 22:25

Poor indoor air quality resulting from insufficient ventilation poses significant health risk, as we've talked about over and over on this podcast. The World Health Organization estimates 3.2 million people die prematurely each year due to illnesses caused by household air pollution. While airtight homes are energy efficient, they often lack adequate ventilation, leading to poor indoor air quality. Effective ventilation systems are essential as we move towards low energy buildings to mitigate these issues without compromising energy savings, and many households lack awareness of how to use their ventilation systems properly. For instance, in this study, 29% of the trickle vents in homes were found to be closed despite occupants understanding of their purpose, posing a real question about how we communicate risk.

Simon: 23:23

And another study, which is one of my favorites and I've probably talked about it ad nauseum, is one that was conducted in 2019 by the ministry of housing, communities and local government, and it was titled ventilation and indoor air quality in new homes. The results were very similar to the last one I was talking about, and they indicated poor indoor air quality in many monitored homes, correlating with failures to meet adf ventilation recommendations. In this particular study, 100 homes were offered by developers new homes, one would assume as their best foot forward, the homes that they would be proudest to put into a study. And of those 100 homes, 95% of them failed to meet even minimum standards. In fact, laughably, the study was to look at natural ventilation and intermittent fans, and a third of those homes were found to have a completely different system in nobody really understood. Many of those homes did not comply with the minimum standard provisions recommended in adf, which was directly linked to poor air quality outcomes. And, as with the previous study, many of those homes I think it was close to 40 percent of them had between zero and 20 percent of their ventilators in the open position. On first visit pointed to a significant failure to communicate the purpose and value of keeping those types of ventilators open. Poor indoor air quality in these homes resulted in various health and comfort issues for occupants and it underlines the importance of proper ventilation to ensure a healthy living environment. And herein lies the challenge for home working. It's people's homes and as an employer, practically what impact can you really have on that environment? And in my opinion, like a lot of pathways to better outcomes in the residential sector, much of this will lie in how we communicate that risk to people, something we just fundamentally don't do very well in this sector.

Simon: 25:41

Communicating risk related to indoor air quality is crucial for ensuring the health and well-being of people in their homes. This involves effectively conveying information about potential indoor air hazards, such as cooking pollutants, dampness and mould, and general air quality issues, in a manner that people or employees can understand and act upon. To achieve this, we need to understand and lean on the key principles and elements that make risk communication effective. In this context, we have to deal and acknowledge with risk perception. Residents' perception of indoor air quality risks can vary wildly based on personal experience, health conditions and knowledge levels. For instance, individuals with asthma or allergens may be far more sensitive to mold pollutants than those that aren't. Fear and anxiety about potential health impacts can amplify the perceived severity of certain indoor air quality risks.

Simon: 26:50

Effective communication needs to address these emotions constructively as well, and we have to understand the cultural context. Different cultural backgrounds can influence how residents perceive and respond to information about indoor air quality. Understanding these cultural nuances is essential for effective communication, and we really need to nail message clarity, simplifying complex information, distilling complex scientific information about pollutants, mould and air quality into simple, understandable messages is crucial. Avoiding technical jargon and using plain language helps ensure that the information is accessible, something that we just don't do very well. Visual tools like diagrams, infographics and videos can help convey complex data more clearly, for example, showing how cooking pollutants spread in a kitchen or how mould develops in damp areas.

Simon: 28:00

And a big one is consistent messaging. Ensuring consistency in messaging across different communication platforms and sources prevents confusion and builds trust. Inconsistencies in messages about air quality risks undermining credibility, so we have to start relying on first principles of communication in air quality. Let's look at a few of them. One transparency. Openness about uncertainty. Being transparent about what we know and what is not known and what is being done to improve air quality is crucial. For example, explaining the limitations of current air quality measurements and ongoing efforts to improve ventilation and ongoing efforts to improve ventilation and detailed information sharing. Providing information about the sources of indoor air pollution, health impacts and mitigation strategies helps people in homes understand the situation better.

Simon: 29:00

Two timeliness Early communication and providing information about potential indoor air quality issues should be communicated as early as possible, even if all the details aren't yet known. Early warnings about potential mould growth and cooking pollutants can help residents take precautionary measures, and regular updates as more information becomes available are essential. This keeps residents informed about the status of air quality and the improvements in ongoing investigations. We've seen that from, in the UK, the housing ombudsman. How often has the breakdown in communication been around not providing ongoing updates?

Simon: 29:43

Three consistency three consistency uniform messages is so important in this sector. Ensuring that all communications about indoor air quality are consistent across different media and different sources helps prevent confusion. This includes alignment amongst housing authorities, health departments and environmental organizations and your workplace and reinforcement constantly of the key messages. Repetition of key messages across different platforms ensure that important points about maintaining good indoor air quality are understood and remembered by residents. And one last one empathy, please.

Simon: 30:29

Empathy Acknowledging concerns of people, recognising and addressing the fears and concerns of people in homes about air quality is critical. Empathy helps in building a connection with our audience and enhances the effectiveness of the communication that we provide. Providing reassurance and support and guiding people in homes on how to deal with air quality issues can reduce anxiety and promote positive actions, which is what we need. So we need to start introducing strategies for risk communication on indoor air quality. Allowing and encouraging feedback from people in homes helps to identify areas of confusion or concern early. This interaction makes the communication process more dynamic and responsive.

Simon: 31:25

Utilising things like social media, community meetings and other interactive platforms that you might have available in your workplace, for example, can help facilitate two-way communication. These platforms allow real-time engagement and clarity of doubts. And, importantly, we need to tailor messages. Importantly, we need to tailor messages. Audience specific communication is so critical. Different segments of the residential population may require different types of information and communication styles. Is it any surprise? Tailoring the message to suit the specific needs and understanding levels of different groups can help enhance effectiveness and localising information. Providing localised information relevant to specific housing areas, such as the presence of mould in particular buildings or building typologies, or the risk of cooking pollutants in certain communities or housing units, makes risk communication far more relevant and actionable.

Simon: 32:28

And, of course, in the modern world of communication, we have to deal with combating misinformation. Addressing myths and rumours is key. Actively addressing and correcting misinformation about indoor air quality issues is crucial. Providing accurate information and debunking false claims can prevent panic and misinformed actions. And, of course, then that helps you build credibility. Establishing credibility through consistent, honest and transparent communication helps in combating misinformation effectively. And we have to manage uncertainty Effectively, communicating the inherent uncertainties of indoor air quality assessment without causing undue alarm is a delicate balance, and we've all seen that both succeed and fail through the COVID pandemic. Clear explanation of the reasons for uncertainty and the steps being taken to reduce it is necessary. Preparing people for the possibility of changing information as new data becomes available helps in managing expectations and maintaining trust. Understanding and implementing principles and strategies is essential for effective communication about indoor air quality. By focusing on clarity and transparency, timeliness, consistency and empathy, communicators can enhance workers, homeowners and tenants understanding and enable better decision making in the face of potential indoor air hazards, ultimately leading to healthier and safer living environments and, as we've been talking on this podcast, working environments.

Simon: 34:17

As we've described, nearly half of all desk workers are now engaged in some form of hybrid work. This shift, while offering undeniable benefits such as flexibility and reduced commuting time, also brings forth hidden danger the potential deterioration of our home environments, specifically indoor air quality, and its profound implications for health and productivity. How many people are going about their work day-to today in the tiny little box room in the house because of lack of space, or even at the end of the bed or in the bedroom that they sat in last night, and how many of those spaces aren't ventilated properly in the first place, even for residential settings, never mind workplace settings. And again I go back to my scenario you're working from the comfort of your home, avoiding this daily commute, only to find that your home environment may be quietly undermining your health and productivity. Most homes and I repeat, most homes were never designed to serve as full-time workspaces.

Simon: 35:25

This inadequacy could be diminishing our cognitive abilities, making us less productive and more prone to errors, never mind illness and long-term health and well-being. And this raises the important question again should employers be responsible for ensuring the quality of the work home environment? Traditionally, employers have been accountable for these spaces, but as the work paradigm shifts, it's crucial for employers to extend these responsibilities to the home office, and this might have to include the provision of resources for people to monitor air quality and improve it in their homes, for people to monitor air quality and improve it in their homes, and policymakers are going to have a critical role to play here. They need to develop guidelines and standards for the home office setup that consider the indoor air quality. This is not just about boosting productivity, but safeguarding the health and well-being of the workforce as a whole.

Simon: 36:28

In essence, this transition to remote work has brought both benefits and hidden costs for us, and as we enjoy this flexibility of home working, as I'm doing today, we must not ignore the long-term health risks posed by inadequate home working environments. Employers, employees and policy makers must collaborate to create healthier home work spaces. The question is will we look back at this period with regret for overlooking these risks, or will we take proactive steps to ensure a healthier future remote working environment? The choice is ultimately ours.

Simon: 37:08

Effective risk communication is crucial here. I think this involves conveying information about indoor hazards in a way and in a manner that people can understand and act upon. Key elements of effective risk communication include understanding individual risk perception, simplifying complex information using visual aids and ensuring message consistency. Enhancing indoor air quality in the home work environment can have substantial benefits at a population level, never mind the cognitive function and productivity. To employers directly, employers should support employees with resources to monitor and improve indoor air quality, and policy makers should develop standards for home offices, and employees us should take proactive steps to ensure their home workspaces are healthy. By working together, we can create a future where remote work is not only flexible and convenient, but safe and conducive to long-term health and wellbeing. Thanks, as always, for listening. I'm Simon Jones and this is Air Quality Matters.