Quality of School Environments

To assess the benefits of improved air quality in French classrooms on childhood asthma, Santé publique France conducted an EQIS and drew on data from the OQAI’s National Schools Campaign (CNE) conducted between 2013 and 2017, as well as the results of national school health surveys.

The results of this initial assessment showed that tens of thousands of asthma cases among children aged 6 to 11 could be prevented each year by reducing exposure to formaldehyde and mold in classrooms. More specifically:

• approximately 9,000 current cases of asthma based on the target value of 30 µg/m³, corresponding to the regulatory threshold defined for regulatory monitoring and above which further investigations must be conducted, and 30,000 cases based on a scenario in which all elementary schools had formaldehyde concentrations equivalent to those observed in classrooms with good air exchange;
• nearly 12,000 cases of wheezing in the past 12 months, assuming a scenario in which no schools showed signs of mold in classrooms, representing 3% of asthmatic children in this age group.

Since there are still many sources of uncertainty, these initial estimates should be interpreted with caution. This is particularly true for exposures to low concentrations, such as those observed in France, for which data has yet to be collected. Furthermore, it is difficult at this stage to attribute the estimated benefits associated with a reduction in formaldehyde to this single pollutant; these results should be considered as representing the impact of formaldehyde as a marker of pollution from internal sources and thus associated with reduced exposure to various VOCs. Nevertheless, these results reinforce the importance, from a health perspective, of continuing efforts to address indoor air quality issues in schools and illustrate the importance of maintaining ventilation measures beyond the health crisis.

Poor Housing Conditions and Health

In France, there is little research on the relationship between housing and health beyond isolated studies linking a specific pollutant to a specific disease. Studies that integrate multiple health effects or risk factors are rare and are conducted on small samples at the local level.

Two studies were conducted by Santé publique France with the aim of clarifying the links between health and housing conditions, and whose purpose is to assist public authorities in the fight against substandard housing.

• A first study, based on quantitative data from the Health and Social Protection Survey (ESPS) conducted by the Institute for Research and Documentation in Health Economics (Irdes), was launched in 2010 with the objective of measuring the scale of the problem.

• The 2013–2014 Qualisurv-Habitat study, conducted among households living in substandard housing conditions, not only described the direct and indirect interactions between substandard housing conditions and individuals’ perceived health status but also established an action-oriented typology of substandard housing situations.

Based on semi-structured interviews conducted with 32 households residing in Île-de-France, Nord-Pas-de-Calais, and Provence-Alpes-Côte-d’Azur, this study shows that:

• households report effects on their health and quality of life; more than half mention significant health issues such as cancer, lead poisoning, physical disabilities, cardiovascular problems, or mental health disorders, and three-quarters of households report between one and three health problems;

• respiratory health and mental health are, from the participants’ perspective, the two areas most affected by poor housing conditions;

• Dampness and mold, energy poverty, and overcrowding are the most common issues, along with outdated electrical systems and structural instability.

These housing conditions contribute to isolating households that are already facing numerous social challenges. Furthermore, the actions taken by households to remedy their situation are linked to the length of time they have lived in the dwelling and the presence of a supportive family and social network. Actions to consider include repair and maintenance work, as well as taking steps with the landlord and government agencies to assert the right to healthy housing.