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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 26-October-2007, Vol 120 No 1264

Home is where the heart is—most of the time
One reason for the considerable public health interest in the home environment, particularly the indoor home environment, is because we spend so much of our lives in this setting. Risk assessment and management principles imply that even relatively low-risk exposures will become important if humans are exposed to them frequently and for prolonged periods and if such exposures are common across the population. Consequently, many countries have carried out time-microenvironment-activity studies to support improved environmental health policy development.1,2
New Zealand has not specifically measured the amount of time that we spend in the indoor home environment. However, it is possible to produce estimates by combining data from several sources.
This brief report provides estimates of the amount of time that New Zealander’s spend in the indoor home ‘microenvironment’ using the most complete available New Zealand data.
Method—We used two data sources that have measured the amount of time that New Zealander’s spend in various locations. These sources are the 1998–99 NZ Time Use Survey and the 1997–98 NZ Travel Survey.
  • The NZ Time Use Survey was conducted by Statistics NZ in 1998–99 and included a sample of 8500 people aged 12 years and over.3 This survey used a 48-hour diary system in which participants recorded activities and locations.
  • The 1997–98 NZ Travel Survey (NZTrS) was conducted by the Land Transport Safety Authority (LTSA).4 It included 14,250 people of all ages. This survey also used a 48-hour diary in which people recorded all journeys from the house. Although it was not primarily established to measure time use, it can be analysed to provide similar information about time spent in various locations.
Neither of these surveys recorded whether the participants were indoors or outdoors. However, specific studies have been carried out overseas that collected such information.
A telephone survey of time and activity patterns has been conducted in the United States. This was the National Human Activity Pattern Survey (NHAPS) based on 9386 participants interviewed over the 1992–94 period.5
A similar survey in Canada, the Canadian Human Activity Pattern Survey (CHAPS) was carried out from 1996–97 and included 2381 participants.6
Findings from these surveys are very similar.7 They show:
  • While at home, people spend about 96.6% of time indoors;
  • At work, school, and other places about 83.9% of time is indoors; and
  • While travelling, about 97.3% of time is indoors.
Results—Findings about place of activity from the NZTUS and NZTrS are shown in Table 1. A key observation is that we spend most of our lives at home (72–73%), followed by our work and study environment (12–13%), and transport environment (5–6%).
Combined with overseas estimates, these data suggest we spend about 70% of our lives in the indoor home environment, and a total of about 94% of out time indoors in buildings or vehicles.
Discussion—Findings from these surveys confirm that the home environment, particularly the indoor home environment, is the one where New Zealanders spend most of their lives. This result is consistent with the findings of time use surveys carried out in other developed countries. One difference is that New Zealanders appear to spend slightly more time at home that in other developed countries.
Estimates of time indoors at home are slightly lower for the US (65% of time indoors at home),7 Canada (66%),7 Germany (65%),8 and United Kingdom (67-68%).9 If the time spent at ‘other peoples houses’ was taken into account, then the time spend in New Zealand homes would be even greater than these estimates suggest.
The relatively large amount of time spent in the indoor home environment has notable public health implications. Hazards in the domestic environment become particularly important because of the long duration of exposure. For example, domestic exposures in New Zealand homes to dust mites,10 endotoxins,11 and mould12 are associated with asthma.
Moreover, the home is an important setting for transmission of some infectious diseases, such as meningococcal disease, where the risk for children is greatly increased by household crowding.13 Because the indoor home environment is unregulated, it remains an important setting for passive smoke exposure.14 15
Cold damp housing is associated with poor health outcomes, and conversely, improving such conditions with home insulation results in significant health improvements.16
The most vulnerable groups of the population also spend more of their time in the home environment. These groups include infants and children, the elderly, and those with disabilities and chronic illnesses such as COPD.17 Such vulnerability, coupled with long periods of exposure to the domestic environment, is reflected in the high rates of home injuries seen in children.18
The time-use findings presented here have several limitations. Probably the most important is our reliance on overseas estimates of the split of indoor and outdoor time. The estimates used here were based on large surveys conducted in the United States and Canada. Despite different methods, the findings for these countries were very similar.7 It seems reasonable to conclude that the indoor-outdoor mix is not markedly different in New Zealand, though that assumption needs to be investigated further.
Statistics New Zealand has developed a proposal for a repeat time-use survey to be carried out in 2008/09. They have consulted widely regarding the content and method for this survey and are considering several important extensions, including broadening it to all age groups, and recording of indoor-outdoor location.
Results from this survey will be useful in providing more precise estimates of the relative importance of environmental exposures for New Zealanders. Ultimately, New Zealand may also need to consider a range of other more specialised approaches to provide time-microenvironment-activity data for specific purposes.19
Competing interests: Two of the authors (MB, MK) have carried out work for Statistics New Zealand on the potential scope of the next NZ Time Use Survey.

Michael Baker, Michael Keall, Ee Lyn Au, Philippa Howden-Chapman
He Kainga Oranga / Housing and Health Research Programme
Department of Public Health, University of Otago, Wellington
(michael.baker@otago.ac.nz)

References:
  1. McCurdy T, Glen G, Smith L, Lakkadi Y. The national exposure research laboratory's consolidated human activity database. J Expo Anal Environ Epidemiol. 2000;10:566–78.
  2. Schweizer C, Edwards RD, Bayer-Oglesby L, et al. Indoor time-microenvironment-activity patterns in seven regions of Europe. J Expo Sci Env Epid. 2007;17:170–81.
  3. Statistics New Zealand. Around the clock: Findings from the New Zealand Time Use Survey 1998-99. Wellington: Statistics New Zealand; 2001.
  4. Povey LJ, Keall MD. Travel Survey Report 1997/98. Wellington: Land Transport Safety Authority; 2000.
  5. Klepeis NE, Nelson WC, Ott WR, et al. The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants. J Expo Anal Environ Epidemiol. 2001;11:231–52.
  6. Leech JA, Wilby K, McMullen E, Laporte K. The Canadian Human Activity Pattern Survey: report of methods and population surveyed. Chronic Dis Can. 1996;17:118–23.
  7. Leech JA, Nelson WC, Burnett RT, et al. It's about time: a comparison of Canadian and American time-activity patterns. J Expo Anal Environ Epidemiol. 2002;12:427–32.
  8. Brasche S, Bischof W. Daily time spent indoors in German homes—baseline data for the assessment of indoor exposure of German occupants. Int J Hyg Environ Health. 2005;208:247–53.
  9. Briggs DJ, Denman AR, Gulliver J, et al. Time activity modelling of domestic exposures to radon. J Environ Manage. 2003;67:107–20.
  10. Wickens K, Pearce N, Siebers R, et al. Indoor environment, atopy and the risk of the asthma in children in New Zealand. Pediatr Allergy Immu. 1999;10:199-208.
  11. Gillespie J, Wickens K, Siebers R, et al. Endotoxin exposure, wheezing, and rash in infancy in a New Zealand birth cohort. J Allergy Clin Immun. 2006;118:1265–70.
  12. Howden-Chapman P, Saville-Smith K, Crane J, et al. Risk factors for mold in housing: a national survey. Indoor Air. 2005;15:469–76.
  13. Baker M, McNicholas A, Garrett N, et al. Household crowding a major risk factor for epidemic meningococcal disease in Auckland children. Pediatr Infect Dis J. 2000;19:983–90.
  14. Thomson G, Wilson N, Howden-Chapman P, et al. Smoky homes: a review of the exposure and effects of secondhand smoke in New Zealand homes. N Z Med J 2005;118(1213). http://www.nzma.org.nz/journal/118-1213/1404
  15. Gillespie J, Milne K, Wilson N. Secondhand smoke in New Zealand homes and cars: exposure, attitudes, and behaviours in 2004. N Z Med J 2005;118(1227). http://www.nzma.org.nz/journal/118-1227/1782/
  16. Howden-Chapman P, Matheson A, Crane J, et al. Effect of insulating existing houses on health inequality: cluster randomised study in the community.[see comment]. BMJ. 2007;334:460.
  17. Leech JA, Smith-Doiron M. Exposure time and place: do COPD patients differ from the general population? J Expo Sci Environ Epidemiol. 2006;16:238–41.
  18. Gulliver P, Dow N, Simpson J, et al. The epidemiology of home injuries to children under five years in New Zealand. Aust N Z J Publ Health. 2005;29:29–34.
  19. Freeman NCG, Saenz de Tejada S. Methods for collecting time/activity pattern information related to exposure to combustion products. Chemosphere. 2002;49:979–92.
     
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