Healthy Home = Healthy Healthy Home = Healthy HumanHuman

There is A Link Between There is A Link Between

Housing & HealthHousing & Health

Overview Of A Healthy Overview Of A Healthy Home DiscussionHome Discussion

Describe housing problems and associatedDescribe housing problems and associatedhealth risks .health risks .

Identify populations that may be at higher Identify populations that may be at higher risk for housing-related disease and injury.risk for housing-related disease and injury.

Identify housing systems that contribute to Identify housing systems that contribute to a comfortable living space.a comfortable living space.

Identify codes used to enforce remediation Identify codes used to enforce remediation of housing-based health threats.of housing-based health threats.

What Is A Healthy What Is A Healthy Home?Home?

A healthy home is:A healthy home is: designeddesigned constructedconstructed maintained maintained or rehabilitated or rehabilitated

in a manner that supports the health of in a manner that supports the health of residentsresidents

WHY DO WE CARE ABOUT WHY DO WE CARE ABOUT HEALTHY HOMES?HEALTHY HOMES?

Young children spend Young children spend nearly 80%-90% nearly 80%-90% of their of their time inside.time inside.

Housing affects health both directly and Housing affects health both directly and indirectly:indirectly: Physical, chemical,biological exposuresPhysical, chemical,biological exposures Psychological, security, well-beingPsychological, security, well-being

Known or Suspected Harmful Health Known or Suspected Harmful Health Effects Associated With Housing Effects Associated With Housing

ConditionsConditions Respiratory infectionsRespiratory infections AsthmaAsthma Injuries and burnsInjuries and burns Reactions to extreme cold and extreme heatReactions to extreme cold and extreme heat Irritations, allergy, rashesIrritations, allergy, rashes Poisonings, asphyxiationPoisonings, asphyxiation Neurotoxic exposuresNeurotoxic exposures CancerCancer DeathDeath

So, What Is An So, What Is An Unhealthy HomeUnhealthy Home

Often substandard Often substandard constructionconstruction

Inadequate Inadequate renovationsrenovations

Not adequately Not adequately maintainedmaintained

Place residents at risk Place residents at risk of illness or injuryof illness or injury

Sources of ExposureSources of Exposure

TTypical sources of indoor exposures ypical sources of indoor exposures include: include: dust, dust, insects, and pet allergensinsects, and pet allergens chemicals in wall coatings and chemicals in wall coatings and

furnishingsfurnishings penetrating outdoor toxics; pesticidespenetrating outdoor toxics; pesticides environmental tobacco (smoke)environmental tobacco (smoke) Fungi (mold)Fungi (mold)

Following Statistics From Following Statistics From The American Housing The American Housing

Survey Survey US Census BureauUS Census Bureau

Who Is Affected: Low Who Is Affected: Low Income ResidentsIncome Residents

There are six million substandard housing units There are six million substandard housing units ininthe United States.the United States.

Asthma rates are 40-50% higher among minority Asthma rates are 40-50% higher among minority children living in U.S. cities.children living in U.S. cities.

Children from low-incomeChildren from low-income communities are eight timescommunities are eight times more likely to suffer from leadmore likely to suffer from lead poisoning compared topoisoning compared to moderate and upper incomemoderate and upper income children.children.

Cost of Unhealthy HomesCost of Unhealthy Homes

Annual costs for environmentally Annual costs for environmentally attributable childhood diseases in attributable childhood diseases in the U.S: $54.9 billionthe U.S: $54.9 billion

$43.9 Billion from Lead Poisoning$43.9 Billion from Lead Poisoning $ 9.2 Billion from Neurobehavioral $ 9.2 Billion from Neurobehavioral

DisordersDisorders $ 2.0 Billion from Asthma$ 2.0 Billion from Asthma $ 0.3 Billion from Childhood Cancer$ 0.3 Billion from Childhood Cancer

Health & Safety: Health & Safety: Categories for Residential Categories for Residential

InspectionInspection

Allergens/asthmaAllergens/asthma AsbestosAsbestos Combustion Combustion

productsproducts LeadLead Mold and MoistureMold and Moisture

Insects and Insects and RodentsRodents

WeatherizationWeatherization PesticidesPesticides RadonRadon Fire Fire

New Trend: Integrate New Trend: Integrate ApproachApproach

Integrated approach considers:Integrated approach considers: People living in the homePeople living in the home The structureThe structure Potential health hazardsPotential health hazards

Result is more efficient and effective Result is more efficient and effective prevention system.prevention system.

Health Vs. HousingHealth Vs. Housing

Epidemiologic TriangleEpidemiologic Triangleofof

DiseaseDisease//InjuryInjury

Terms of The Terms of The Epidemiological TriangleEpidemiological Triangle

The HOST or PERSON is the The HOST or PERSON is the who.who.

The AGENT is the SOURCE or The AGENT is the SOURCE or what, what, that that can bring about changes in a person’s can bring about changes in a person’s health. health.

The ENVIRONMENT is The ENVIRONMENT is where where one lives.one lives.

The TRANSPORT MECHANISM is any The TRANSPORT MECHANISM is any mechanism by which an agent is spread mechanism by which an agent is spread from the environment to the host.from the environment to the host.

Transport Mechanisms A transport mechanism ties the HOST, AGENT A transport mechanism ties the HOST, AGENT

and ENVIRONMENT together.and ENVIRONMENT together.

A TRANSPORT MECHANISM is either a VECTOR A TRANSPORT MECHANISM is either a VECTOR or a FOMITE.or a FOMITE.

a. A VECTOR is an insect or any living carrier a. A VECTOR is an insect or any living carrier which transports a pathogenic microorganism which transports a pathogenic microorganism from the sick to the wellfrom the sick to the well

b. A FOMITE is an inanimate object that b. A FOMITE is an inanimate object that transports the agent to the host.transports the agent to the host.

You Decide:You Decide:

HostHostAgentAgentVectorVectorFomiteFomite

You Decide:You Decide:

HostHostAgentAgentVectorVectorFomiteFomite

You Decide:You Decide:

HostHostAgentAgentVectorVectorFomiteFomite

You Decide:You Decide:

HostHostAgentAgentVectorVectorFomiteFomite

You Decide:You Decide:

HostHostAgentAgentVectorVectorFomiteFomite

You Decide:You Decide:

A 56 year old woman presents A 56 year old woman presents with a severe sinus infection and with a severe sinus infection and bronchial congestion. She has bronchial congestion. She has been seen 4 times for the same been seen 4 times for the same symptoms over the course of a 5 symptoms over the course of a 5 month period. Medical month period. Medical specialists suspect exposure as specialists suspect exposure as the source of her recurring the source of her recurring

illness.illness.

Upon returning home, she contacts her son Upon returning home, she contacts her son to assist her in the investigation of potential to assist her in the investigation of potential exposures. She reports to her son that the exposures. She reports to her son that the first floor toilet holding tank has been first floor toilet holding tank has been leaking for sometime now, but she can’t leaking for sometime now, but she can’t image that would cause her any health image that would cause her any health issues. After all, it’s CLEAN water that is issues. After all, it’s CLEAN water that is leaking from the holding tank!leaking from the holding tank!

James, her son, enters the basement below James, her son, enters the basement below which is sealed-off to save on heating.which is sealed-off to save on heating.

He finds the ceiling in the finished area in He finds the ceiling in the finished area in the following condition:the following condition:

List the Following:List the Following:

a. Environmenta. Environment

b. Agentb. Agent

c. Hostc. Host

d. Transport d. Transport MechanismMechanism

Factors Effecting The Host

It is know that personal factors impact health.

Low socio-economic populations are disproportionately exposed to: Air pollution & related illness Lead (paint or pipes) Household pests & pesticides Injurious conditions

Host: Varied Exposures

Residents of the same household will experience varied exposures due to individual behaviors: Time and activity patterns Smoking Diet/exercise Personal hygiene & sanitation practices

Host Susceptibility Some household members may

experience greater susceptibility to health hazards: ie.

Age (children & elderly) Pregnant or nursing women Pre-existing health conditions Poorly nourished individuals Medically under-served people

Agents: Exposure Inside the Home

We will discuss three major exposures:1. Biologic2. Chemical

3. Physical

Biologic Agents: Infectious Disease

Infections often spread due to: Overcrowding Inadequate water supplies Inadequate waste disposal Inadequate ventilation

Examples: tuberculosis, rhinovirus, strep, E. coli, salmonella, influenza

Biologic Agents: Allergens

Respiratory illness & asthma are often precipitated by exposure to:

Dust mites Pet dander Mouse droppings Mold & plants

Biologic Agents: Mold

Damp/wet houses provide an environment for mold growth

Chemical Agents

Many materials used in homes contain chemicals that have known/suspected health effects.

Sources of chemical exposure include building materials, consumer products, and combustion processes.

Chemical Agents Indoor combustion appliances release a wide range of

compounds that affect health, including: nitrogen dioxide sulfur dioxide carbon monoxide fine particulate matter (PM).

Appliances include: Water Heaters (Gas) Clothes Dryers (Gas) Ventless Heaters Gas stoves/ovens Furnaces/room heaters Fireplaces

Chemical Agents

Second Hand Smoke (ETS=Env. Tobacco

Smoke) Contains 4000 substances 40 of them cause cancer,

ie:

Acetone Ammonia Benzene Carbon Monoxide Formaldehyde Lead Nicotine Tar Cyanide

Chemical Agents

Pesticides: Greater than 75% of households report use of pesticides.

Many are know to affect human health: Respiratory systems Nervous system Immune & reproductive systems

VOC’s Volatile organic compounds

Emitted as gasses from solids or liquids Have adverse health effects

Emitted by: Paints, lacquers, paint strippers Cleaning supplies, pesticides Building materials, adhesives

Generally, any organic solvent will emit VOC

VOCs Are A Group of Chemicals

Benzene, formaldehyde, toluene, xylene

Indoors, VOCs are often emitted by:

new carpeting & furniture Fresh paint jobs New plastics & electronic devices

Health Effects of VOCs Symptoms:

Eye/nose irritation Headache Vomiting Dizziness

Can lead to chronic problems: Cancer Asthma Liver damage Central nervous system damage

Chemical Agents: Lead

Lead-based paint is the most significant source of lead exposure in the U.S. today

Exposures: Air, drinking water, food, contaminated soil, deteriorating paint, and dust

Symptoms of Lead Poisoning

High levels can cause convulsions, coma & death.

Lower levels can cause adverse health effects: Central nervous system Kidneys Blood cells

Blood lead levels as low as 10 micrograms per deciliter can impair mental and physical development in children.

Peeling lead-based paint on exterior

Chemical Agents: Radon

What is Radon? Naturally occurring odorless cancer-causing,

radio-active gas Derived from the breakdown of uranium

(radio-active) in soil, rock and water

Permeates air we breath Can be found in any type of building that

bears on the earth.

Chemical Agents: Radon (2006 Statistics)

How Radon Gets In

Chemical Agents: Asbestos

Asbestos is a mineral that was frequently used in homes built between 1920 and 1972

Many building products contained asbestos: furnace ducts steam pipes floor tiles Shingles Insulation textured ceilings and siding

Inhalation of asbestos fibers can lodge in the lungs and cause disease including lung cancer and asbestosis.

Agents: Physical Electrical Shock

Improperly installed wiring Improper childproofing.

Burns: hazards include stoves, ranges, exposed steam

pipes & portable heaters

Slip/Fall Hazards

Fire & Explosion

Electrical Shock Hazard