Dear GP Colleagues,
As medical professionals, we understand that health starts in the home. But how often do we consider the air our patients breathe indoors during the 80 to 90 per cent of time they spend inside buildings?
The Royal College of Physicians’ 2025 report, A Breath of Fresh Air, presents clear evidence that indoor air quality should be treated as a significant and modifiable public health issue, not just an environmental concern.
Outdoor air pollution harms the lungs, heart and brain. What is now becoming clearer is that indoor environments create additional risk. Health is affected by things like poor ventilation, damp, mould, and fumes from heating or cooking.
Damp is a problem in more than 900,000 homes across England. These conditions are more likely to affect older people, lone parents, children, low-income households and some ethnic minority groups. They add to the health inequalities many of our patients already face.
Children, older adults and people with chronic conditions face greater harm from poor indoor air. Awaab Ishak, who died aged two after being exposed to mould at home, reminds us why this matters.
Indoor pollution can bring on asthma, make COPD worse, and increase the risk of heart problems. For people already managing health conditions, poor indoor air adds further risk.
The Royal College of Physicians recommends that clinicians support patients by:
Asking about housing and indoor conditions, especially when seeing patients with respiratory symptoms
Giving clear advice on ventilation and ways to reduce indoor pollution
Helping patients raise housing concerns with landlords and local authorities
Supporting policy change at practice or ICB level to improve housing and air standards
Simple steps like using extractor fans, keeping rooms dry, opening windows, and heating homes properly can all help.
We should treat indoor air quality as part of our role in preventing illness. This matters even more as energy efficiency upgrades are introduced. Improving insulation must not come at the cost of reduced ventilation.
Health professionals remain among the most trusted voices in the UK. This puts us in a strong position to talk about how air pollution affects health and to back changes that could help patients.
The full report is worth reading. It offers ways we can better support people whose health is being harmed by indoor air.
With best wishes,
Dr James Milligan
Medical Doctor and Trustee, Corsi-Rosenthal Foundation UK
