Environmental Sensitivities and Multi-Unit Residential
Housing: A Review
Introduction
Environmental sensitivities (ES) refers to a condition or a group of conditions whereby
individuals become sensitive to relatively low levels of substances in the environment.
ES can go by a number of names, including multiple chemical sensitivities,
environmental hypersensitivity, environmental illness, toxicant-induced loss of tolerance,
or idiopathic environmental intolerances. People with ES can become severely ill due to
the presence of contaminants in the air at levels that would not affect individuals without
the condition. Multiple-unit rental housing, where many households live close together
and where residents have limited control over the air quality in their homes, can be
extremely problematic for people suffering from ES. The following is a brief review of
the literature available on ES and housing, and particularly multi-unit housing. We hope
that this review will provide readers with a general understanding of the condition, and
the challenges associated with multi-unit residential housing.
What are Environmental Sensitivities?1
ES is a poorly understood chronic condition that has no single definition or cause, but
describes a “variety of reactions to chemicals, electromagnetic radiation and other
environmental factors at levels commonly tolerated by many people.”2 ES often overlaps
with a variety of other conditions such as fibromyalgia, chronic fatigue syndrome,
anxiety/panic disorder, chronic pain, and can manifest itself with dramatically different
severities depending on the individual: some individuals have mild reactions to chemical
emissions in their environment, while others are completely debilitated, unable to work or
even leave their apartment. It is a condition that can worsen over time with repeated
exposure to contaminants and treatment often focuses on avoiding substances that lead to
symptoms. Like the conditions listed above, ES is not universally recognized by the
medical community, though this is changing.
Because of the lack of a single, simple definition and the fact that people experience ES
at wide range of severities, it is challenging to come to grips with the prevalence of the
condition. That said, Statistics Canada has reported that 1.2 million Canadians aged 12
or older (5% of the population) have been diagnosed with either ES, fibromyalgia or
chronic fatigue syndrome (with 14% of these having at least 2 of the three conditions)3,
1
Much of this section is taken from: Sears, Margaret (2007), The Medical Perspective on Environmental
Sensitivities. (Ottawa: Canadian Human Rights Commission).
2
Ibid, at p. 3.
3
Statistics Canada (2003), 2003 Canadian Community Health Survey, Cycle 2.1 (Ottawa: Statistics
Canada)
Toronto ~ 340 College Street, Suite 101A, Box 23,
Toronto, Ontario M5T 3A9
Tel: 1.416.944.0087 / 1.800.263.1139 (outside Toronto)
Fax: 1.416.944.1803
www.equalityrights.org/cera
Email: cera@equalityrights.org
Ottawa ~
200 MacLaren Street, 2nd Floor,
Ottawa, Ontario K2P 0L6
Tel: 1.613.233.8618
Fax: 1.416.352.5507
Email: leilani@equalityrights.org
and almost 3% of Canadians aged 30 or over have been diagnosed with ES.4 Of course
the actual numbers are likely substantially higher as many people are not formally
diagnosed. It has been estimated that as many as 5 million Canadians may suffer from the
condition.5
ES can affect anyone. However, research has suggested that lower income individuals are
more likely than more affluent people to suffer from “medically unexplained symptoms”,
while highly educated or affluent people are more likely to seek medical treatment for the
condition. ES is also a condition that increases in prevalence with age. Of those people
diagnosed, the overwhelming majority are women.
While there continues to be debate over ES and related conditions in the medical
community, an increasing number of federal and provincial health bodies and
organizations recognize these conditions. For example, Health Canada, the Canadian
Health Network, the Canadian Centre for Occupational Health and Safety, Canada
Mortgage and Housing Corporation, the Ontario Medical Association and the
Environmental Health Committee of the Ontario College of Family Physicians all treat
ES as a medical condition with real impacts on daily living. As will be discussed in
greater detail below, Canadian human rights legislation considers ES and related
conditions to be disabilities protected under the law.
Triggers and Symptoms
For people with ES, exposure to certain substances in the air can “trigger” symptoms
which can lessen or disappear when the person is no longer exposed to the substance.
Common triggers include: Volatile Organic Compounds (VOC’s) released from
substances such as paints, glues, solvents, gasoline, cleaning products and scented
personal care products; vehicle exhaust; pesticides; animal dander; pollens; and moulds.
Some people with ES also react. People with ES can react to triggers in vastly different
ways. Some people will become extremely ill after a single brief exposure to a substance,
while others experience only mild symptoms; symptoms can appear immediately after
exposure, or hours later; once a trigger is removed, symptoms may stop immediately, or
persist for hours or even days. Some people with ES may also experience “habituation”
after ongoing exposure to a trigger, where poor health comes to appear normal. No two
cases of any medical condition are alike – this is particularly true for ES.
The following table lists some of the common symptoms associated with ES.6
Body System
Nervous System
Symptoms
Heightened sense of smell, difficulty concentrating,
difficulty remembering, hyperactivity, feeling
groggy, headaches, depression, insomnia, anxiety,
seizures, tinnitus
4
Statistics Canada (2003), National Population Health Survey (Ottawa: Statistics Canada)
Sine, Debra, Leslirae Rotor and Elizabeth Hare (2005), Accommodating Employees with Environmental
Sensitivities: A Guide for Building Managers.
6
Table reproduced with revisions from Sears, Supra, at p. 19.
5
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Stuffy/itchy nose, sinus pain or infections, blocked
ears
Coughing, wheezing, shortness of breath, asthma,
frequent bronchitis or pneumonia
Red, watery eyes, pain under eyes, blurred vision
Heartburn, nausea, bloating, constipation, diarrhea,
abdominal pain
Fatigue, lethargy, blood sugar fluctuations
Joint and muscle pain, muscle spasms, muscle
weakness
Rapid/irregular heartbeat, cold extremities, high/low
blood pressure
Flushing, hives, eczema and other rashes, itching
Frequent, urgent urination, painful bladder spasms
Upper Respiratory System
Lower Respiratory System
Eyes
Gastrointestinal System
Endocrine System
Musculoskeletal system
Cardiovascular System
Skin
Urinary system
Multiple Unit Housing and ES
Residential environments can be a major source of triggers and can, thus, have significant
health implications for people suffering from ES. In fact, most conventional housing is
not “safe” for people with ES due to conventional building practices, toxicity of building
materials (few building materials do not release chemical emissions), the use of
pesticides and lawn care products, vehicle exhaust and presence of mold and pollens.
Multiple unit housing – whether rental or condominium – can be particularly
problematic. This type of housing puts residents in close proximity to each other – and
each other’s scents and chemical products – and forces them to traverse indoor commonareas maintained by the building management. With the aging stock of multi-unit rental
housing in Ontario, renovations and repairs of common-areas and individual units have
increasingly become a part of everyday life for renters. Also, where there are common
walls, floors and ceilings, there are many places for air – and the pollutants it contains to travel from one unit to another.7 The most problematic aspect of multi-unit housing,
however, involves control, or lack thereof: residents of apartment buildings have limited
control over their indoor living environment and the products and chemicals in it. For
someone with ES, maintaining her health requires the active participation of other
residents and the building’s management. Not surprisingly, getting this participation can
be very difficult.
Air quality problems in buildings
As discussed above, symptoms associated with ES can be triggered by a variety of
substances in the air, including VOC’s, pollens, vehicle exhaust, and mould. Many of
these substances are readily found in apartments and apartment buildings, contaminating
the indoor air. In fact, research shows that air within homes and buildings can be
substantially more polluted than the outdoor air in large metropolitan areas.8 Levels of
approximately one dozen common VOC’s have been found to be two to five times higher
7
Gourd, Francoise and LaVerne Chappell (2006), ES Issues and Pre-Existing Dwellings (accessed online
at http://www.EScanadian.org).
8
Office of Air and Radiation, The Inside Story: A Guide to Indoor Air Quality (Washington, D.C.: USEPA)
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in homes than outside.9 Some of the more common air quality issues are listed in the
table below10:
Carpets
Flooring
Paints/Varnishes
Kitchen Cabinets/Bathroom Vanities
Operations and Maintenance
Lighting
Ventilation/infiltration
Parking areas/garages
Common laundry rooms
Carpet fibres, latex binder on backing,
underpadding and anti-static/stain
treatments emit toxic chemicals; collect
dust, mould and mites; absorb pollutants
Vinyl tiles and adhesive materials emit
VOC’s
Contain VOC’s; solvent-based particularly
problematic
Typically made from particleboard or
plywood which contain urea-formaldehyde
resins
Cleaning products frequently emit toxic
substances; pesticides; dust, debris and
chemical emissions associated with
renovations
Some people with ES experience reactions
when exposed to fluorescent lighting
Inadequate ventilation leading to excessive
humidity, lingering odours and stuffiness is
common in buildings; corridor
pressurization systems often do not
adequately control air transfer between
apartments or provide adequate fresh air;
infiltration of air throughout buildings is
common due to leaks between units and
floors, and in the building envelope;
kitchen and bathroom exhaust fans can
draw in unwanted air from other parts of
the building
Vehicle exhaust; “stack effect” can move
vehicle exhaust from parking garage
through the building
Scented cleaning products used by other
residents
9
USEPA, An Introduction to Indoor Air Quality (accessed online at: http://www.epa.gov/iaq/voc.html).
Much of this table is based on information provided in: Canada Mortgage and Housing Corporation
(1997), Healthy High-Rise: A Guide to Innovation in the Design and Construction of High Rise Residential
Buildings (Ottawa: Canada Mortgage and Housing Corporation); CMCH (2004) Solving Odour Transfer
Problems in Your Apartment. About Your Apartment – General Series (Ottawa: Canada Mortgage and
Housing Corporation).
10
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Strategies for creating “safer” environments
Unfortunately, it is unlikely that any living environment, particularly one in a multi-unit
building, will ever be entirely safe for someone living with ES (it has been suggested the
it is often extremely difficult to make apartment building environments even tolerably
safe11). As a result, it is probably most realistic to consider strategies which will make
these housing environments “safer”. For all of the issues raised above, there are
approaches housing providers can take to minimize residents’ exposure to contaminants.
They range from minor, inexpensive changes to cleaning and maintenance procedures, to
costly repairs or renovations. Canada Mortgage and Housing Corporation suggests that
there are four key components to achieving adequate indoor air quality:
 Reduction and elimination of pollutants
 Exhausting pollutants that are generated
 Sealing units/providing adequate air pressure to eliminate transfer of odours and
pollutants
 Supply an adequate quantity of fresh clean air12
Of these four components, the first – reducing or eliminating pollutants – should be the
priority. While it will be impossible for a housing provider to remove all contaminants,
the table below13 provides some suggestions for ways to minimize toxic emissions in
living environments.
Carpets
Flooring
Paints/varnishes
Cabinets/vanities
Appliances
Lighting
Avoid carpeting; where carpets used,
specify low emission materials (e.g. natural
fibres, nylon), affix by nailing, avoid foam
or rubber underpads, vacuum frequently
with HEPA vacuum cleaner, steam clean
once every four months; hardwood,
ceramic tile, brick floors best
Avoid vinyl flooring; hardwood, ceramic
tile, marble, brick floors better
Zero or Low VOC water-based paints
Solid wood, glass or metal best; next best:
materials with formaldehyde-free glues;
where particleboard/plywood used,
surfaces and edges should be sealed with
low toxicity sealer
Avoid unvented, natural gas appliances
Use near or full-spectrum lighting
11
Gourd, Francoise and LaVerne Chappell, Supra.
CMHC (1997), Supra.
13
Sources: Collette, Stephen (2008) “Health Housing Resources for Multiple Chemical Sensitivity” in
MCSA News, Volume 3, Issue 9; Gourd, Froncoise and LaVerne Chappell (2006), Supra; CMHC (1997),
Supra; Sine, Debra, Leslirae Rotor and Elizabeth Hare (2005), Supra; Gibson, Pamela Reed (2002 ),
Understanding & Accommodating People with Multiple Chemical Sensitivity in Independent Living
(Houston: Independent Living Research Utilization).
12
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Operations and maintenance
Use no or low VOC, scent-free cleaning
products; no air fresheners or carpet
fresheners; steam clean carpets or use well
tolerated laundry or other soap; pesticidefree; chemical fertilizer-free; avoid gas
lawnmowers;
Besides reducing the levels of pollutants emitted into living environments, building
managers need to ensure that those pollutants that do exist are effectively removed and
that residents have access to fresh air. Strategies to remove existing pollutants include:
sealing individual residential units to prevent contaminants from moving from unit to
unit; ensuring that corridor air supply systems are operating properly; maintaining and
cleaning ventilation filters and ducts; depressurizing parking garages and installing an air
barrier system; ensuring apartment exhaust fans are working properly; pressurizing units
by having individual ventilation units to the outside of the building; providing HEPA
room air filters for residents.14
Where the housing provider is making significant repairs or renovations to the building or
individual units, special precautions should be taken to reduce the spread of dust and
chemicals. These include installing vapour/dust barriers around the renovation work,
having fans in the containment area exhausting to the outside, and creating a safe path
around the work area to the door of the building. In winter, it will be important to seal off
duct work in the area where the work is being done to ensure that dust and odours do not
get into the heating system and travel through the building.15 Residents with ES will also
need adequate notice before any renovations/repairs take place so that they can put in
place their own contingency plans, such as finding alternate accommodation during the
renovation period if necessary. Housing providers should establish a mandatory period
after repairs/renovation for off-gassing of materials during which the work area continues
to be sealed and extra ventilation is used.16
ES and the Law
Besides human, environmental and business reasons for wanting to create healthy living
spaces for their residents, housing providers have an additional motivation: it’s the law.
Ontario’s Human Rights Code (the “Code”) requires private and public housing providers
across the province to address the needs of their residents that arise from a disability. For
example, if a resident, due to a disability, requires a housing provider to install a ramp
leading to the front of the building and automatic doors, it is the housing provider’s
responsibility to make these modifications. The landlord can only avoid this
responsibility if he/she can prove that making the necessary changes would constitute and
“undue hardship” – i.e. be unaffordable, or result in an unreasonable health or safety risk.
14
Collette, Stephen (2008), Supra; CMHC (1997), Supra; CMHC (2004), Supra.
Collette, Stephen (2009), “Beginning Work on a House with MCS” in MCSA News, Volume 4, Issue 1.
16
Debra Sine, Leslirae Rotor and Elizabeth Hare (2005), Supra.
15
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The same would be true for a resident who has ES and requires the housing provider to
take certain steps to ensure that she has a “safer” living environment.
The definition of disability found in the Code, as in human rights legislation across the
country, is very broad: “any degree of physical disability, infirmity, malformation or
disfigurement that is caused by bodily injury, birth defect or illness”17 While there have
yet to be any cases before the Human Rights Tribunal of Ontario that explicitly consider
the question of whether ES falls within the definition of disability (though there have
been decisions which appear to make the assumption that it does), other courts and
Tribunals in Canada have found the condition to constitute a legally protected disability.
There is little doubt that the same would apply in Ontario. In fact, the Ontario Human
Rights Commission includes ES in a definition of disability used on its website.18
This means that if a resident with medically verifiable ES requests modifications to her
living environment, such as those discussed above, a housing provider will in all
likelihood have to act on these requests. Canadian courts or tribunals have rarely found
requests related accommodating the needs of individuals with ES to constitute and undue
hardship.19For example, it would be difficult for a housing provider to claim that using
no/low-VOC cleaning and building materials would be unaffordable.
In addition to the Code, the Accessibility for Ontarians with Disabilities Act (AODA)
seeks to create a barrier-free Ontario by 2025. The accessible built environment standard
is currently in draft form and undergoing public consultation. The proposed standard has
a specific section on air quality, which includes requirements related to, among other
things, building materials, cleaning products, ventilation, kitchens, maintenance, parking
and air filters. When in place, the accessible built environment standard will apply to new
and existing public and private residential buildings. Housing providers operating
buildings existing at the time the standard comes into effect will have 12 years to make
the changes necessary to be in compliance.20 Thus, while the Code requires housing
providers to make modifications “as needed”, it is ultimately in their best interest to
proactively address indoor air quality issues.
17
Human Rights Code, R.S.O. 1990, Chapter H.19.
Ontario Human Rights Commission, Disability and the Duty to Accommodate: Your Rights and
Responsibilities (accessed online at: http://www.ohrc.on.ca/en/issues/disability/index_html/view).
19
Wilkie, Cara and David Baker (2007), Accommodation for Environmental Sensitivities: Legal
Perspective (Ottawa: Canadian Human Rights Commission).
20
Standards Development Committee (2009), Initial Proposed Accessible Built Environment Standard
(Toronto: Ministry of Community and Social Services).
18
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