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. 2021 Feb 14;20(1):14.
doi: 10.1186/s12940-021-00699-x.

The impact of energy retrofits on pediatric asthma exacerbation in a Boston multi-family housing complex: a systems science approach

Koen F Tieskens  1 , Chad W Milando  2 , Lindsay J Underhill  2 , Kimberly Vermeer  3 , Jonathan I Levy  2 , M Patricia Fabian  2
Affiliations

The impact of energy retrofits on pediatric asthma exacerbation in a Boston multi-family housing complex: a systems science approach

Koen F Tieskens et al. Environ Health. .

Abstract

Background: Pediatric asthma is currently the most prevalent chronic disease in the United States, with children in lower income families disproportionately affected. This increased health burden is partly due to lower-quality and insufficient maintenance of affordable housing. A movement towards 'green' retrofits that improve energy efficiency and increase ventilation in existing affordable housing offers an opportunity to provide cost-effective interventions that can address these health disparities.

Methods: We combine indoor air quality modeling with a previously developed discrete event model for pediatric asthma exacerbation to simulate the effects of different types of energy retrofits implemented at an affordable housing site in Boston, MA.

Results: Simulation results show that retrofits lead to overall better health outcomes and healthcare cost savings if reduced air exchange due to energy-saving air tightening is compensated by mechanical ventilation. Especially when exposed to indoor tobacco smoke and intensive gas-stove cooking such retrofit would lead to an average annual cost saving of over USD 200, while without mechanical ventilation the same children would have experienced an increase of almost USD 200/year in health care utilization cost.

Conclusion: The combination of indoor air quality modeling and discrete event modeling applied in this paper can allow for the inclusion of health impacts in cost-benefit analyses of proposed affordable housing energy retrofits.

Keywords: Discrete event model; Energy retrofit; Indoor air quality; Pediatric asthma; Systems science.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Distribution of average annual healthcare utilization costs per asthmatic per year for different combinations of resident behaviors (cooking frequency (1x/day or 3x/day), smoking (yes/no), opening windows in the summer and fall (yes/no)) for a pre-energy-retrofit Baseline scenario and two post energy-retrofit scenarios (Retrofit/min and Retrofit/plus)
Fig. 2
Fig. 2
Average annual healthcare utilization cost differences compared with pre-retrofit Baseline scenario for different combinations of resident behaviors. Negative values indicate average savings
See this image and copyright information in PMC

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