Last month's verdict that 2-year-old Awaab Ishak ‘died as a result of a severe respiratory condition due to prolonged exposure to mould in his home environment’ in 2020 should be a wake-up call to both the housing and healthcare sectors. Are health professionals aware of this important issue in their vulnerable patients?
Exposure to damp and mould can make people more likely to have respiratory problems, respiratory infections, allergies or asthma (NHS, 2022). Babies and older people, and those with pre-existing skin, respiratory and immune system problems are at greatest risk. Senior coroner Joanne Kearsley said: ‘Throughout his life Awaab had recurring cold symptoms such as runny nose, cough, and respiratory tract infections. His GP confirmed that he attended at their surgery more than most children.’ A community midwife had filled in a special circumstances form to children's services highlighting concerns about the mould and the potential impact on his health. However, there is no evidence any action was taken. How can concerned health professionals raise the alarm in future?
Awaab's poorly maintained and ventilated home led to his death and as Ms Kearsley went on to say: ‘In my opinion there is a risk that future deaths will occur unless action is taken.’ While Awaab's family were failed by their housing provider, how many other families are living in dangerous homes, whether this is in social housing or privately rented? Arguably, those living in privately rented accommodation are at greater risk, as they can feel more vulnerable to being forced out if they report problems. Research by the Building Research Establishment (2021) estimated that illness caused by poor housing costs the NHS in England £1.4 billion a year - a shocking amount.
The verdict on Awaab's death comes at a worrying time. With the cost-of-living crisis biting many families, heating homes adequately to avoid condensation - a major cause of mould - is becoming too costly for some. Some patients with conditions that get worse in the cold are being prescribed heating as part of an expanded trial in 150 households in NHS Gloucestershire's area and around 1000 in Aberdeenshire and Teesside (Wearn and Smith, 2022). Social prescribers visit those with long-term conditions and low incomes in their homes to identify those who could benefit. The pilot study aims to see whether it is more cost-effective overall to help pay the heating costs of vulnerable people than it is to pay for their health care if they fall ill.
Joanne Kearsley summed it up perfectly in her verdict: ‘I'm sure I'm not alone in having thought: how does this happen? How, in the UK in 2020, does a 2-year-old child die from exposure to mould in his home?’. Let us hope that this is not the first of many tragic deaths. What are your thoughts on this? We'd love to hear from you at pn@markallengroup.com
‘Practice Nursing provides nurses working in general practice with the tools to reach their full potential and deliver the best possible care to their patients. Our monthly journal informs and inspires by providing up-to-date, evidence-based clinical articles, highlighting key professional issues and promoting the latest research in general practice.’