Table 1b.

Summary of pathways between excess cold hazards from the HHSRS and health outcomes.

Hazard	Possible health effect	Pathway/cause	Design feature/defect	Value
Excess cold	Below 19 °C: small risk, Below 16 °C: serious health risks for the elderly, Below 10 °C: great risk *Cardiovascular conditions: stroke, heart disease, hypertension *Respiratory disease *Suppressed immune system	*Changes in outdoor temperature *Low energy efficiency ratings (poor insulation) *Absence of central heating/poor inefficient heating systems *Excessive damp which reduces thermal insulation	*Thermal insulation *Appropriate/properly installed or maintained occupant controllable heating system *Appropriate/properly installed or maintained occupant controllable low-level background ventilation *Means for rapid ventilation at times of high moisture production in kitchens/bathrooms *Properly sited/sized permanent openings (e.g. air bricks/open-able windows) *Properly fitting butt-jointed floor boarding/doors/windows	The health impact potential of cold on mortality, sickness absence, and hospital admissions could be valued at £240,500 per 1000 people per year (Upstream, 2018)