In response to an Australian governmental inquiry into biotoxin-related illness, the purpose of this integrative review is to bring together the current state of evidence on the prevalence, risk factors and impacts related to mould-affected housing in an Australian context, in order to inform building, housing and health research, practice and policy. The robust integrative review methodology simultaneously sought quantitative and qualitative studies and grey literature from multiple disciplines, identifying only 45 studies directly relating to Australian housing and indoor mould. Twenty-one studies highlight negative health impacts relating to indoor residential mould, with asthma, respiratory, allergy conditions and emerging health concerns for chronic multiple-symptom presentation. The majority of studies reported risk factors for indoor mould including poor housing conditions, poor-quality rental accommodation, socioeconomic circumstance, age-related housing issues and concerns for surface/interstitial condensation and building defects in newer housing. Risks for indoor mould in both older and newer housing raise concerns for the extent of the problem of indoor mould in Australia. Understanding the national prevalence of housing risks and “root cause” associated with indoor mould is not conclusive from the limited existing evidence. Synthesis of this evidence reveals a lack of coverage on: (1) national and geographical representation, (2) climatical coverage, (3) housing typologies, (4) housing defects, (5) maintenance, (6) impact from urbanisation, and (7) occupant’s behaviour. This integrative review was key in identifying emerging housing and health concerns, highlighting gaps in data and implications to be addressed by researchers, practice and policy and acts as a comprehensive holistic review process that can be applied to other countries.

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.