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• Regulations to control outdoor air pollution work in two ways. They may target the source (such as requiring cleaner cars and transport vehicles), or set concentration limits for the pollutants in our air – although it is difficult to say what levels are really safe. • Increased road traffic, and higher energy use to heat and cool our buildings because of climate change, could make the problem worse. • According to 2012 figures, indoor air pollution may have caused or contributed to 99,000 deaths in Europe. • There are few regulatory controls on indoor pollution, apart from building regulations. The drive to reduce energy costs, by creating homes with tighter ventilation, could be making the situation worse. • Indoors, tobacco smoke is probably the most serious cause of harm. • Carbon monoxide from faulty boilers and heaters can be fatal. • Volatile organic compounds (VOCs) are chemicals that start off as solids or liquids, but readily evaporate. They can arise from many common items, including air fresheners and some personal care, DIY and cleaning products. Although they are very common in the air, their health effects are generally minor. • Formaldehyde vapour can be emitted by certain furniture, furnishings, fabrics, glues and insulation, and can cause irritation of the lungs. • Asbestos was used as a building material in the 20th century, peaking in the 1960s. It can cause serious damage to the lungs if it is disturbed, which is most likely to happen during maintenance work. • Particulates and nitrogen oxides from heating and cooking appliances can damage the lungs and/or heart. • Biological materials that can harm health include house-dust mites, mould and animal dander. © Royal College of Physicians 2016 17 2 Summary

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