How do occupants experience the onset and triggering of building-related symptoms in damp Australian housing? An inductive-deductive content analysis

In recent years, occupants’ time spent in dwellings has increased concurrently with an increase in the duration and intensity of extreme weather events and the worsening of housing conditions. Indoor dampness and or mould (D/M) are risk factors for building-related symptoms (BRS), yet little is known about how symptoms start, thus hindering where to focus indoor air quality measurements and improvements in occupant safety. This study describes perceived symptom initiators, triggers and coinciding factors that explain what and how symptoms occurred from the perspectives of occupants living with indoor D/M. This study uses an inductive/deductive qualitative analysis, with purposive sampling (n = 154) from data collected via an online survey. Deductive content analysis utilises a framework driven by the Determinants of Health (DoH). Themes that emerged from the inductive analysis include: 1) when occupants or others interact with D/M; 2) when indoor D/M conditions change; and 3) a home full of D/M problems. From the deductive analysis, perceived exposure relating to D/M conditions differed between the initial onset of symptoms and the later triggering of symptoms. Additional coinciding factors relating to climate, socioeconomic, policy and individual factors along with a lack of knowledge, attitudes and beliefs, emerged. This study highlights the need to raise occupant awareness, enhance housing and occupancy regulations, and introduce safe work practices to address the lack of health awareness and health significance regarding indoor D/M housing conditions. It also outlines the need for targeted research measuring bioaerosol exposure related to actions, proximity-based exposure, and wet and repeatedly wet conditions. • Occupants described situational, proximal and action-based symptomatic exposure. • Differences between the onset and later triggering of BRS in damp housing emerged. • Occupants reported a perceived lack of health awareness regarding indoor mould. • Recommendations for enhancing housing and occupancy regulations are suggested. • Guidelines for safe mould cleaning and standards for safe work practices are needed.