Assessing the Effects of Cool Roofs on Indoor Environments and Health in Tavua, Fiji

A Cluster Randomised Controlled Trial (cRCT) Evaluating the Effects of Cool Roofs on Health, Environmental and Economic Outcomes in Tavua, Fiji

Ambient air temperatures in Fiji are increasing due to climate change. Solutions are needed to build heat resilience in communities and adapt. Sunlight-reflecting cool roof coatings may passively reduce indoor temperatures and energy use to protect home occupants from extreme heat. Occupants living in poor housing conditions in Fiji are susceptible to increased heat exposure.

Heat exposure can instigate and worsen numerous physical, mental and social health conditions. The worst adverse health effects are experienced in communities that are least able to adapt to heat exposure. By reducing indoor temperatures, cool roof use can promote physical, mental and social wellbeing in household occupants.

The long-term research goal of the investigators is to identify viable passive housing adaptation technologies with proven health benefits to reduce the burden of heat stress in communities affected by heat in Fiji. To meet this goal, the investigators will conduct a cluster-randomized controlled trial to establish the effects of cool roof use on health, indoor environment and economic outcomes in Tavua, Fiji.

Increasing heat exposure from climate change is causing and exacerbating heat-related illnesses in millions worldwide - particularly in low-resource settings. Heat exposure can instigate and worsen health conditions, including cardiovascular, metabolic, endocrine and respiratory disease, heat-related illnesses, pregnancy complications, and mental health conditions. Adaptation is essential for protecting people from increasing heat exposure. The built environment, especially homes, is ideal for deploying interventions to reduce heat exposure and accelerate adaptation efforts. However, there is currently a lack of global, empirical evidence guiding the uptake of interventions to reduce heat stress in low-resource settings.

Cities and towns of LMIC are among the most vulnerable to the adverse impacts of climate change and are likely to experience increases in ambient air temperature over the coming decades. People in Fiji are exposed to year-round heat and low humidity. The combined burden of heat and NCDs places Fiji's population at greater risk of adverse health effects from heat extremes.

Sunlight-reflecting cool roof coatings passively reduce indoor temperatures and lower energy use, offering protection to home occupants from extreme heat. The investigators therefore aim to conduct a cluster-randomized controlled trial investigating the effects of cool-roof use on health, environmental and economic outcomes in Fiji.

The trial will quantify whether cool roofs are an effective passive home cooling intervention with beneficial health effects for vulnerable populations in Fiji. Findings will inform regional policy responses to scale cool roof implementation and protect people from increasing heat exposure driven by climate change.

Inclusion Criteria:

• Permanent household resident.

Exclusion Criteria:

• Roof damage, inaccessible or instability of roof adversely affecting cool roof coating application.
• Participant unable to provide written/verbal informed consent.