Intended for healthcare professionals

Letters Home insulation and hospital admission

Home insulation also saves lives by reducing wood stove pollution

BMJ 2021; 372 doi: (Published 09 February 2021) Cite this as: BMJ 2021;372:n388
  1. Dorothy L Robinson, adjunct senior research fellow
  1. University of New England, Armidale, NSW 2351, Australia
  1. drd.robinson{at}

As well as creating warmer, healthier homes,1 improved insulation saves lives by reducing wood heater pollution, which is responsible for 56% of the health costs of man made air pollution in New Zealand—NZ$4425 (£2322; €2643; $3200) per wood heater per year.2

Nick Hopkinson, medical director of the British Lung Foundation and Asthma UK, warning of similar problems emerging in the UK, said, “To protect yourself and others, especially children, avoid buying a wood burning stove or using an open fire if you have another source of fuel.”3

The strictest wood stove standards in the world didn’t solve NZ’s problem. The Growing up in NZ study reported a 7% increased risk of non-accidental hospital emergency presentations in children under 3 for every additional wood heater per hectare.4 Real life emissions of new wood stoves average eight times more than laboratory test measurements.2

Current UK proposals (dry fuel, new standards) are unlikely to make any difference. Emission limits for eco-design stoves are worse than those required since 2005 in NZ’s urban areas.

In 2018, the UK’s PM2.5 pollution was associated with 32 900 premature deaths, much more than nitrogen dioxide (6000) or ozone (1000).5 Domestic wood burning represented 2.5% of all PM2.5 emissions in 1990, surging to 38% in 20186 despite only 7.5% of UK households using wood heating (2.3% as sole heating).7 Wood smoke contains similar toxic chemicals to cigarette smoke. Researchers recommended health warnings on new Defra approved wood stoves because they “nearly tripled harmful indoor pollution.”3

Consequently, health professionals should back Asthma UK and support policies including no new stoves and subsidies to remove existing wood stoves.

PM2.5 pollution increases the risk of covid-19. Alternatives such as electric heat pumps have lower running costs and also help to slow global warming.8