The use of sustainable assessment methods in the UK is on the rise, emulating the future regulatory trajectory towards zero carbon by 2016. The indisputable influence of sustainable rating tools on UK building regulations conveys the importance of evaluating their effectiveness in achieving true sustainable design, without adversely effecting human health and well-being. This paper reviews the potential trade-offs between human and ecological health in sustainable building design, particularly between building energy conservation and indoor air quality. The barriers to effective adoption of indoor air quality strategies in sustainable assessment tools are investigated, including recommendations, suggestions and future research needs. The consideration of occupants’ health and well-being should be paramount in any sustainability assessment method, particularly indoor air quality, thus should not be overshadowed or obscured by the drive
towards energy efficiency. A balance is essential.