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8/6/2019 Housing and Healthy Connection-HH Training Center
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Housing and Health Connection:
A Short Summary&
Review of Existing Healthy
Homes Trainings
National Healthy Homes Training Center
and Network MeetingMount Washington Conference Center
January 21-23, 2004
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Focus on the Indoor
Environment
� It¶s where we spend our time: ± Children - up to 80%
± Adults ± up to 90%
� Estimates of the direct impact of housing quality on human health
vary.
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³The connection
between health and
the dwelling of the
population is one of the most important
that exists´.
Florence Nightingale
Cited in Lowry, S. BMJ, 1991, 303, 838-840
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Current Understanding� Housing is under appreciated as a
determinant of health.
� We need to understand the
interaction among hazards.
� Intervention studies are needed.
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How do Hazards Interact?
Deterioratedhousing
PestInfestation
Increased
Asthma Risk
Pesticide
Use
Pesticideexposure
Neurobehavioral risk(cancer risk)
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What are the Health Effects of
Mold?
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Water, Moisture, Humidity,
Leaks� Associated with many other vectors
including:
± Dust mites
± Cockroaches
± Domestic animals
± Bacteria
± viruses
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Combustion Leakage� Combustion appliances
� HVAC systems
� Nitrogen Dioxide and CO
� Strong link to asthma and respiratory
symptoms
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Products Used in the Home� Pressed wood products, paints,
solvents, adhesives
� Volatile organic compounds
� Associated with respiratory
symptoms, rashes, allergies, cancers
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R adon
� Soil gas entering homes through
cracks, sumps, concrete slabs
� Cancer
� No differentiation between adults and
children
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The real world is complex
� Exposures are not single-substance.
� How do different allergens interact to
cause health effects?
� What are the most appropriate
measures of exposure?
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Need Better Exposure
Assessment Tools
� Sampling Location
� Sampling Method
� Personal Exposure
� How can we take advantage of on-
going program opportunities?
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Which Interventions Work?� Control of water
� Allergy Avoidance
� ETS Exposure Avoidance
� Pest Control
� Can we develop a comprehensive,home-based primary prevention
strategy?
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Social Behavioral Issues
� What are the barriers to compliance ?
� How can we increase effectiveness of educational recommendations?
� What will make the difference for the
long-term?
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Summary of Research Needs
� Evidence of the health effects of mold and
moisture
� Studies of mixtures and combined effects
� Better exposure assessment tools
� Evaluations of the efficacy of
interventions to reduce disease� A better understanding of social
behavioral issues
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Implementation Issues� Prevention not reaction
� A combined public health-housingapproach
� Attention to public sector infrastructure issues
� The private sector role� Guidelines and training
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³Until effective standards for the
domestic environment are
devised, it is likely that children
will continue to be employed asbiological indicators of
substandard housing.´
Donald Barltrop
Am. J. Dis. Child 127:165-166 (1974)
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National Healthy Homes
Training Center & Network
Overview of Existing
Healthy Homes Trainings
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Survey of Existing
Trainings
� Questions focused on:
± Names of existing trainings
± Sponsors of the training ± Target audience
± Length of training
± Pre-existing competencies ± Topics of training
± Goals of training
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Types of
Training Identified
� University-based courses
� Public Health Agency Trainings
� Healthy Homes Partnership Projects
� Other types of Trainings
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University Based Trainings
² University of California, Berkeley� Mold: Inspection, Assessment and Control
² Eastern Kentucky University� EHS 460, Control of Housing Environments
� EHS 855 Emergency Preparedness and Shelter
Environments
² University of Georgia� EHS 3260 Shelter and Institutional Environmental
Health
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University-Based Courses
� Target audience ± Symposiums - Contractors, consultants,
industrial hygienists
± Courses - Students in Public health
� Length of trainings ± Symposiums - 3 days
± Courses - 30 to 48 hours of classroom, 96hours preparation
� Focus ± Symposiums ± inspection, assessment andcontrol of molds
± Courses - comprehensive, cover a widerange of healthy housing concepts
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Public Health Agency
Trainings ² Boston Public Health Commission
� Healthy Homes Training
² Alameda County Lead Poisoning
Prevention Program
� Environmental Risk Factors Affecting aHealthy Home
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Public Health AgencyT
rainings� Target audiences:
± Community health workers
± Public health nurses, public healthprofessionals, health educators,contractors, housing agency staff,outreach workers
� Length of trainings - 3 hours
� Focus ± Childhood Asthma andinjuries
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Healthy Homes Partnerships
Alabama ± Conducts 6 multi-county
Healthy Home Environmental Conferences
Arkansas ± Series of workshops on child
safety ³21st Century Families: Challenges
and Opportunities´.
Connecticut ± multi-topic workshops on
Healthy Homes and Indoor Air Quality
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Healthy Homes PartnershipsGeorgia ± ³Help Yourself to a Healthy
Home´ seminars
Kentucky ± Seminars on lead, householdhazardous products, and pesticides
Louisiana ± Healthy Home information is
incorporated into ³Safety First´ and
³Creating a Learning Environment´ lessons
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Healthy Homes Partnerships
Minnesota ± Healthy Homes presentations to
Head Start Program parents
Missouri ± one day training on Health and
Safety Issues in the Home
New Jersey ± developed curriculum and
handout sheet: Environmental Health in
Childcare Facilities
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Healthy Homes PartnershipsNorth Carolina ± in-services on Healthy
Homes for county educators
Rhode Island ± incorporated Healthy
Homes materials into the R hode Island
Home*A*Syst Program
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Healthy Homes PartnershipsTexas ± Train-the-Trainer sessions on
Indoor Air Quality
Utah ± Train-the-Trainer program for
housing professionals
Virginia ± Training that focused on
childcare environments
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Healthy Homes Partnerships
� Target audiences ± Providers, parents, social workers, Health
Department Staff
± Volunteer organizations and general public
± Teachers and childcare providers
� Length of Training
± Seminars or series of seminars
� Focus ± Lead, hazardous products, pesticides
± Asthma
± Disaster preparedness
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Other Trainings� American Lung Association
² Health House Project
� Target audience ± Builders
� Length of Training ± 2 days
� Focus ± Construction issues that can
help create healthier indoor environments
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In Summary - 1
� Current trainings are quite diverse .
� R ange of target audiences is wide.
� Length of trainings range from 3 hours to 2days.
� Most trainings are not based on a set of pre-
existing competencies.
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In Summary - 2� The goals vary but most attempt to provide
basic education to the target audiences
about Healthy Homes issue.
� Availability is unclear: some are done as a
one time event and some may be
continuing.