Indoor Air Quality Indoor Air Quality Indoor Air Quality Indoor Air Quality yyfor Medical Professionalsfor Medical Professionals

yyfor Medical Professionalsfor Medical ProfessionalsNorth Carolina Respiratory Forum 2007North Carolina Respiratory Forum 2007North Carolina Respiratory Forum 2007North Carolina Respiratory Forum 2007

Presented By:

Brian K. Kasher, CET

Manager, Environmental Health and Safety

Charlotte Mecklenburg Schools

History of IAQHippocrates noted Pb toxicity in the mining industry in

the Fourth century BC

l h Eld ( l d ( ) Pliny the Elder (Gaius Plinius Secundus, (23–79) – Roman Historian “160 Volume Naturalis Historia”– Noted Asbestos, zinc, sulfer and lead related

illnessDevised Animal Bladder as Respirator– Devised Animal Bladder as Respirator

– Lost Studying Eruption of Mt. Vesuvius at Pompeii

Bernardino Ramazzini, Bernardino Ramazzini, – an 18th-century Italian physician, described

"asthma" in bakers, miners, farmers, gilders, tinsmiths, glass-workers, tanners, millers, grain-sifters, stonecutters, ragmen, runners, riders, porters, farmers, and professors.

l l– outlined health hazards of the dusts, fumes, or gases that such workers inhaled.

– The bakers and horse riders described by Ramazzini would today probably be diagnosed as suffering from allergen-induced asthma. Th l di ff d b t f th th – The lung diseases suffered by most of the other workers would now be classified as "pneumoconiosis," a group of dust-related chronic diseases. NLM De Morbis Artificum

(Diseases of Workers) Padua, 1713

Modern History of IAQ• Florence Nightingale

– Coined the importance of IAQ and Co ned the mportance of IAQ and Ventilation “The First Cannon of Nursing”

• Dr. Alice HamiltonFlorence

• Florence Kelly

• Francis Perkins

F or nc Nightingale

Francis Perkins

• Jane Adams Hull House– Settlement Houses Francis

P kiFlorence

PerkinsKelly

Why IAQ Today?y Q y• Buildings used to be made of brick, stone,

mortar, metal and wood,

• Today thousands of compounds are used in our buildings that did not exist in the pastour buildings that did not exist in the past

• Buildings are much tighter and offer less natural breath ability and fresh airnatural breath ability and fresh air

• Studies have shown poor indoor air quality negatively impacts the performance of negatively impacts the performance of building occupants

IAQ Issue Prerequisite P’sIAQ Issue Prerequisite P s

Poll tant(s) PeoplePollutant(s) People

Pathway

What Causes Poor IAQWhat Causes Poor IAQThe National Institute of Occupational Safety and

Health identified the following frequencies of Poor Health identified the following frequencies of Poor IAQ Root Causation

• Inadequate ventilation 52%• Inadequate ventilation 52%• Contamination from inside building 16%• Contamination from outside building 10% ontam nat on from outs de bu ld ng • Microbial contamination 5%• Contamination from building materials 4%• Unknown sources 13%

Asthma Triggers• Dust mites• Molds & Yeasts • Pollens

• Cockroach particles • Cat hair (dander) & saliva • Dog hair (dander) and saliva

Y t • Viral infection• Certain air pollutants • Exercise• Cold air

• Yeast spores • Metabisulfite, used as a

preservative in many beverages and some foods G d l d k Cold air

• Chemical fumes and other strong-smelling substances like perfumes

• Intense emotions

• Gas, wood, coal, and kerosene heating units

• Natural gas, propane, or kerosene used as cooking fuel S • Intense emotions• Smog

• Wood smoke • Weather changes

#1 Cause of School Absenteeism

Over 500,000 Constituents M Aff t IAQ

• VOC’s • Di-isocyinates

May Affect IAQ

VOC s• Nitrous Oxides• Pesticides

• Di-isocyinates• Perfumes• Metals

• Ozone• Legionella• Mold

• Dusts/Dust Mites• Pollen

Body OdorMold• Bacteria• Insect/Avian/Bat

G

• Body Odor• Formaldehyde• Acids/Bases

Guano

The IAQ ChallengeWhat makes IAQ/MOLD issues a challenge?

• Each building is different• Building operations differg p• Building maintenance differs• Custodial operations differ• Building locations differ• Building occupants differ• Building Uses Change

IAQ Problem IndicatorsQ m• Odors• Stuffiness• Stuffiness• Headaches

R i t I it ti• Respiratory Irritation• Allergies

Si i i • Sinusitis • Asthma• Red Eyes• Not Feeling Right

IAQ BUZZ WORDSOd Th h ld• Odor Threshold

• Personal Sensitivity• Stack Effect• Volatilization

•Dose Response Relationship

•The Poison is in the Dose

•Dilution is the Solution to Pollution• Fresh Air• Dermatitis• Sinusitis/Upper Respiratory

Irritation

Dilution is the Solution to Pollution

•Health and Safety Based Approach

•Risk Management Based Approach

I d t i l H i i tIrritation • PEL (Personnel Exposure Limit)• STEL (Short Term Exposure

Limit)Ceilin Limit

•Industrial Hygienist

•Occupational Hygienist

•Psychrometer (Sling)• Ceiling Limit• TLV (Threshold Limit Values)• IDLH (Immediately Dangerous

to Life and Health) ( l )

•Passive Diffusion

•Dew Point

•Limit of Detection• LD50 (Lethal Dose 50)• Epidemiology

L m f D

•Baseline

Typical HVAC System

Unintended Air Pathways

Unintended Air Pathways

Building Proximics

IAQ Problem Sources 1Building Systems– HVACHVAC– Plumbing– RoofingRoofing– Landscaping– Electrical

Fresh Air Intake Loaded with Vegetation

HVAC Pipe Insulation With Mold Growth

E ctr ca– Interior Design – Windows– Building Seal

Supply Air Register Supply Air Register

with Mold Filtration

IAQ Problem Sources 2QBuilding Materials– Carpets

Wall Molded

after Flood

Carpets– Sheet Rock– Flooring

Floor destroyed by Mold & Moisture

BookshelfFlooring– Paneling– Surface coating Lab Sink Deteriorated

Bookshelf

Underside Molded

Surface coating– AdhesivesFire Proofing

Lab Sink Deteriorated and Mold

Bookshelf

Wicking Moisture– Fire Proofing– Insulation

g

Wall Molded

IAQ Problem Sources 3Building OperationsBuilding Operations– Custodial/Maintenance Tasks

and ProductsE h ( f h – Exhausts (cafe, shops, bathrooms)

– Occupant Supplies (Art, up upp ( ,Lab, Chemicals)

– Animals/Insects Product Incompatibility

Excessive Dust on Media Cart– Product Incompatibility– Lawn Mowing, Watering– Aquariums/Fountainsq– Change in purpose of space

IAQ Problem Sources 4• Human Factors

– Open Windows/DoorsOpen Windows/Doors– Body Odors– Viruses Tampering with T-statViruses– Perfumes– Individual SusceptibilityIndividual Susceptibility– Psychosomatic responseGroup Hysteria– Group Hysteria

– Carbon Dioxide

Desk With Trash

Carbon Dioxide MeasurementCarbon Dioxide As Indicator Gas

2500

500100015002000

PPM

0500

00 00 00 00 00 00 00

8:00

10:0

011

:00

12:0

0

2:00

4:00

6:00

TimeKey Factors

OutsideCeilingInside

Key Factors•Fresh Air Supply

•Mix Ratio IA/OA

•Population

•Time

IAQ Problem Trends

Mold on the Building Gets into building Through the Air Handing System

Air Goes Into the Building Here

What is Outside Gets Inside

IAQ Problem TrendsThis Air Supply Gets Its Air From the Photo to the Left.

Mold on the Building Gets in Through the Air Handing

MOLDMold

What is Outside Gets Inside

g gSystem

What is Outside Gets Inside

IAQ Problem TrendsAir Supply

faces Bus Lot

Bus exhaust gases drawn into Bus exhaust gases drawn into classrooms while buses idle

in bus lot

Bus Exhaust Entering Building

IAQ Problem Trends

Clutter Accumulates Dust and Asthma Triggers

Clutter Prevents Proper Custodial Cleaning Operations

Clutter Makes finding an IAQ Problem Much More Difficult

IAQ Problem TrendsMold Growth Condition

Above Ceiling Tile H llin Hallway

Mold May be Hiding Where Visible

H dd M ld

Mold May be Hiding Where Visible Water Damage is found or Where There is no Indication of Growth

Hidden Molds

IAQ Problem Trends

Mobile Without Drainage Results In Water In Results In Water In

Classroom.

Mobile Classroom Installed Over Curb. Curb Blocks Water flow and Water

Accumulates Under and Near Mobile.

Improper Grading Results in Water Flow Into

Building through CMU.

Water Flow Issues Impact IAQ

IAQ Problem TrendsDefective Downspout

Incomplete Downspout

Water Flows to and Then Accumulates Under MCRs

Downspout Spills Under Spills Under

MCR

W t D iImproper Drainage

Improper Drainage

Water Drainage

Water/Mold Deteriorates Building St t d Cl S liStructures and Classroom Supplies

Mold Growth on Wooden Cl ChDeteriorating Wooden Classroom ChairDeteriorating Wooden

Structural Beam

Molds are the Bio in Bio-Degradable. M lds d d n thin ni in l din Molds degrade anything organic including roofing, flooring, sheet rock, and more.

Restricted Air Intakes

Ai S l I t k C d

Air Supply Next to Old Carpet and

RestrictedAir Supply Intake Covered

with Vegetation

Ai S l C d

Air Supply Covered w/ Sheet Metal

Air Supply Covered with Brick and Mortar

IAQ Problem Trends

l Building Design Creates Surfaces out of Reach & Not Accessible With Routine Custodial Tools. Dust, a Known Asthma Trigger Accumulates, and Provides Dust Mites a Home

Mold Impacts

Plume Indicates Moisture Path

Wall and Cover Should Be White as Shown Here

Sample M4 100X Sample M1 400X

The “M” WordThere are over 1000 varieties that grow in the USA and over 100,000 types known on Earth. There are about 100 that grow yp

indoors that are known to be problematic.

Mold in HistoryMold in History

In L iti s Ch pt 14:33 57 In Leviticus Chapter 14:33-57, God is quoted giving the first

known mold clean-up procedure to Arron and Moses.to Arron and Moses.

Mold in HistoryM H y

S l Wi h T i l• Salem Witch Trials• Irish Potato Famine• Curse of the Mummy • Used to produce beer, wine

& h& cheese• Medicines (Penicillium)

What Causes MoldWhat Causes MoldWater Water Mold Food Water Water

Mold needs water or moisture to grow. The t b f l k hi h h idit water can be from a leak, or high humidity,

a flood or even excessive cleaning water left on a kitchen floorleft on a kitchen floor.

If it is dry…mold will not grow!y g

Air Supply Grill Dirty and Molded

What is Mold Food?W M FMold food can be anything like:Paper Wall Board Leather Dead Skin Paper, Wall Board, Leather, Dead Skin,

Dirt, Dust, Wood, Plants, Spilled Soda, Cardboard, Dead Mold, Books…. , ,

Mold GrowthMold begins to grow within 24 hours after a moisture event.– Ever forgot your clothes in the washer Ever forgot your clothes in the washer for a couple of days? Notice an odor develops in the washer?p

– The odor is a sign of the growth cycle well on its way.

Mold GrowthOne mold spore with

mold food and water can generate into a gmillion spores.

Each of the million Each of the million spores can also each turn into a million more more.

And So on and So on and So on and So on…………

First Signs of MoldgThe first sign of mold is usually a spot on the

ceiling floor wall or other material that has ceiling, floor, wall, or other material that has recently become moist.

When mold is hidden inside a wall or under a When mold is hidden inside a wall or under a carpet, for instance, the first sign may be a musty smell or allergy symptoms felt by y gy y p ybuilding occupants.

Mold GrowthIf there is a water event like a flood or

even a cleaning procedure on carpets it is im t t t t th d i d t very important to get the area dried out

as fast as possible to prevent mold growth!growth!

Mold Hidden Between Sheetrock and Joint Compound Below a Plumbing Leak

Where Molds Growld ll l k d k d h Mold especially likes dark damp areas with poor ventilation and may be located in hard to reach places like:

•Behind Bookcases•Under Sinks•Behind Cabinets

•Under Desks•Behind Shelves•Damp AreasBehind Cabinets

•Under Carpets•Under Flooring•Under Tables

Damp Areas•Closed in areas•Above Ceilings•Behind Wall Paperp

Hidden Mold on a Library Book Shelf Support Exposed After a Flood in an Adjacent Area

Mold SamplingNot generally recommended by EPA

for initial assessment

R di ti t h i d – Remediation techniques and personnel protection same for bad and not bad species

– Spend money fixing problem Spend money fixing problem

If air sampling is conducted inside of building, sampling outside should be conducted for should be conducted for comparison

– Little value to air samples if no environmental benchmarkenv ronmental benchmark

MOLD SamplingMOLD Sampling

Do Not Use Bleach on MoldBleach brightens but does not eradicate the

mold which is growing into not just on the mold, which is growing into…not just on the surface being cleaned.

The chlorine in bleach is very dilute– The chlorine in bleach is very dilute.– The chlorine volatilizes and does not generally

penetrate the surface being cleaned.p g– Molds grow into and under the surface and must

be reached to be killed or they will grow againBl h d l b h f l ll – Bleach residuals can be harmful especially to children

Mold Health EffectsM H EffMicrobial Volatile Organic Compounds

– Produced by Molds and released directly into the airStrong unpleasant odors– Strong unpleasant odors

– Linked to headaches, nasal irritation, dizziness, fatigue and nausea, g

– mVOC– Presently Under Research

MOLD Health EffectsMicotoxins

Over 200 micotoxins identified many still to be identifiedOver 200 micotoxins identified many still to be identifiedSome on exterior of mold spores other interior of sporeSome Have Carcinogenic Effect (Liver, Lung Cancer)S C M M b I it ti Ch i Li Some Cause Mucous Membrane Irritation, Chronic Liver

Damage, Central Nervous System DamageMicotoxins exposure occurs by inhalation, ingestion or skin

t tcontactMicotoxins are defense/offense mechanism for MoldPresently under Government and Private Study

IAQ ResponseQ pCMS uses a product called BETCO 256 for

disinfecting and mold response An EPA disinfecting and mold response. An EPA registered fungicide and disinfectant.

h b d d bl d l d ll This bio-degradable product is located in all but approximately 15 schools at CMS, pre mixed and ready to use!pre-mixed and ready to use!

IAQ Tools For SchoolsQ•National Program to Provide Schools with Tools to Identify and Resolve Existing IAQ Problemsand Resolve Existing IAQ Problems

•IAQ Teams for Each School MadeUp of Teachers, Administrators, Custodians, Students and Parents

•Action Checklists Used to IdentifyProblems that may lead to or already Problems that may lead to or already lead to Poor IAQ

•Auxiliary Services Support to P tl R d C t IPromptly Remedy Current Issues

In 2004 CMS was awarded with the USEPA Excellence Award or Our IAQ Management Plan. Our goal now is to ward or Our I Q Management lan. Our goal now s to Achieve a National Award For How We Respond District-

wide to potential and actual Problems in the Schools!

Further Research Portals• National Library of Medicine• National Institute of Occupational Safety and Health• United States Environmental Protection Agency• US Department of Energy• Centers for Disease Control• Centers for Disease Control• Agency for Toxic Substances and Disease Registry• IAQ Clearinghouse• Technical University of Denmark• Lawrence Berkley National Laboratory• Oakridge National Laboratory• American Society for Heating, Refrigeration and Air Conditioning Engineers • American Industrial Hygiene Association• American Conference of Industrial Hygienists• Consumer Product Safety CommissionConsumer Product Safety Commission• National Safety Council • IAQ Councils• National Center for Environmental Health• National Allergy Bureau

A i L A i ti• American Lung Association

Keyword Search: Mold, Indoor Air Quality (IAQ), Indoor Environmental Quality (IEQ), Indoor Air Pollution, Ventilation, HVAC, Bioaerosols,