Polluted air in schools, hospitals, train stations and workplaces has become the leading environmental cause of preventable illness and premature death, doctors and scientists have warned.
Australia’s lack of indoor air regulation has been labelled a critical public health gap, raising the risk of stroke, heart attack and dementia, said oncologist Dr Bronwyn King, ahead of an unprecedented meeting of politicians, health and environmental leaders in Canberra on Wednesday to demand the federal government implement a National Healthy Air Strategy.
“When we measure indoor air quality in Australia, we routinely find all sorts of pollutants in the air: Particulate matter, vehicle emissions, airborne viruses, toxic chemicals … even microplastics,” said King, who previously took on big tobacco and funnelled $1.3 trillion away from the industry.
“Everyone should be breathing healthy air; it’s as basic as eating food that’s hygienic, drinking water that’s safe.”
Outdoor air quality has been regulated for decades, but indoor air has gone unchecked, despite Australians spending 90 per cent of their time indoors.
Plum Stone has come to call this the “invisible threat” after she developed long COVID during the pandemic, and her daughter Alice, who was three at the time, was hospitalised.
She said children constantly returning from school or childcare with viruses should not be an inevitable part of family life, given transmission is preventable.
“We can monitor the air quality, we can use air purifiers, we can improve ventilation,” she said.
Stone founded The Safer Air Project in 2024, an inclusion and patient advocacy group which has become integral to the growing body of doctors, scientists, politicians and concerned parents pushing for change.
This coalition of 85 medical colleges, universities, charities and research groups wants the federal government to develop nationally consistent and enforceable indoor air quality standards.
Among them is Queensland University of Technology Distinguished Professor Lidia Morawska. The physicist spent decades advocating for clean air regulation with little traction, which she credited to political fragmentation because schools, hospitals, housing and transport all fall within separate government portfolios.
Morawska, the 2025 Prime Minister’s Prize for Science winner, said the pandemic had prompted a renewed push for mandated air standards, but failing to take urgent action would be a missed opportunity.
“Once the momentum is gone, we are unlikely to come back to this until the next disaster … we cannot wait,” she said.
A cross-party NSW parliamentary inquiry into clean indoor air last week handed down its final report with 38 recommendations, including sweeping changes in schools, appointing a specialised indoor air quality minister, introducing monitoring systems, and a program to retrofit existing public buildings.
Greens spokesperson for health and inquiry chair Dr Amanda Cohn said NSW Parliament House was among the few public buildings with “gold standard” air quality after a recent renovation introduced sophisticated technology, including pathogen-killing UV light in air ducts.
“There was no rollout of similar air quality improvements to every other public building, and there’s no reason we should have better air quality than the rest of the state,” Cohn said.
A study published in June found almost a third of NSW public school classrooms have carbon dioxide levels that are not optimal for students’ learning most of the time, prompting the inquiry recommendation that low-cost indoor air monitors be rolled out in classrooms across the state.
Taken to NSW parliament by her mother when the inquiry report was tabled, Alice said she supported the inquiry’s recommendations for schools.
“[Right now], you have to ask for the windows and doors to be open, and everybody’s a bit sniffly, [so] you have to stay away from people who are sick,” the 10-year-old said, while a stuffy classroom “makes it a lot harder to think and concentrate”.
The inquiry found indoor air quality is not monitored in NSW public hospitals, which have experienced outbreaks of mould and COVID-19 in recent years, leaving immunocompromised patients exposed to airborne hazards.
The report found indoor air pollution can also reach “very high levels” on public transport. A 2024 investigation by this masthead revealed air pollution in Sydney’s underground train platforms was more than double safe daily limits.
NSW Health Minister Ryan Park said the government would consider the report’s findings and recommendations.
The CSIRO is assessing the economic costs of poor indoor air quality, including lost productivity and increased demand on health services, expected to total tens of billions. A federal government spokesperson said this costing would inform policy decisions.
Existing analyses found every dollar invested in cleaner indoor air delivered a return of between $3 and $30 a year.
The Commonwealth spokesperson said the Australian Centre for Disease Control provided advice on indoor air quality, and was working with states and territories to better understand its health effects and inform practical, proportionate approaches to reducing them.
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