A Mixed Methods Study to Determine the Sources and Impact of Indoor Air Pollution in Patients With Chronic Respiratory Disease

Patients with chronic respiratory diseases are significantly affected by indoor air pollution, yet their understanding of specific exposures and mitigation methods remains limited. This mixed methods study explored the perceptions of COPD and asthma patients regarding indoor air quality and practical improvement strategies through interviews with 14 participants and an online survey with 332 respondents. Both patient groups expressed an awareness of indoor air quality concerns and linked pollutants such as dust, mould, animal hair and cleaning products to respiratory symptoms like breathlessness and coughing. Survey data revealed that 90% of participants associated poor indoor air quality with chest-related symptoms, and 84% with coughing. Both groups highlighted the impact of environmental conditions, such as seasonal changes and humidity, on symptom severity. When addressing indoor air quality, participants consistently highlighted window opening as their primary method of ventilation, with 89% of survey respondents employing this strategy. Interviewees similarly emphasised opening windows or using extractor fans to reduce pollutant levels, particularly during activities like cooking. The survey further revealed that while more than half of respondents used extractor fans in kitchens, only 26% employed air purifiers. Financial barriers were a significant constraint, with 43% of survey participants citing cost as a key reason for not purchasing or operating air purifiers. Interviewees echoed these concerns, emphasised affordable, low-cost solutions over high-tech interventions and reflected a preference for accessible, practical strategies in managing indoor air quality. Although participants demonstrated general awareness that poor IAQ is associated with respiratory symptoms, this understanding was not always consistently applied to specific environmental triggers. This suggests a need for clearer, targeted guidance within self-management approaches to support patients in identifying and reducing exposure to indoor pollutants.