Indoor Air Quality
Overview
October 20, 2015
Philip Bouton, Program Manager
Healthy Homes Program
Objectives
• Understand some current trends and research for practitioners dealing
with the indoor environment.
• Identify actions to reduce or eliminate health risks in the home
environment.
• Know where to go for additional information to address indoor
environmental hazards.
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Healthy Housing
Watershed Events
1922 - League of Nations proposes worldwide
Office of Healthy Homes and Lead Hazard
lead paint ban
Control is created
1978 – US bans sale of lead-based paint for
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residential use
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1985 – US bans sale of leaded gasoline in cars
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1992 – Residential Lead Hazard Reduction Act
created and provides training
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1993 - Cleveland cluster of infant cases of
2003 - CDC begins addressing Healthy Homes
issues (in addition to lead) and updates the 1976
Healthy Homes Inspection and Reference
passed (Title X)
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2001 - National Center for Healthy Homes
Manuals
Pulmonary Hemosidorosis
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2004 – IOM Dampness and Mold Report
1996 – Residential Lead-based disclosure
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2007 - IOM Asthma Report 3
becomes law
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2009 - The Community Guide Best Practices for
Asthma Interventions
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1997 - HUD develops HHI
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2000 - Clearing the Air IOM NHLBI Asthma
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2010 - EPA RRP Rules goes into effect
Report
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2012 - CDC lowered the “reference level” for
childhood lead poisoning” to 5 µg/dL
According to the U.S. Surgeon General’s
Call to Action to Promote Healthy Homes
(2009):
“Many of the disparities in health status among
subpopulations may be linked to poor access to
safe and healthy homes, which is most prevalent
among lower income populations, populations
with disabilities, and minority populations”
Healthy and Safe Home
Community Environments
• Create, sustain, and recognize housing that
promotes health and wellness through
prevention
• Health and wellness are also heavily
influenced by the places in which people live
• Environment Plays a Major Role in Children’s
Health—their mental, educational, physical,
and social well-being
Why Do We Care About
Healthy Homes?
• Children suffer disproportionately from Environmental Health
and Safety Hazards
• Most of our non-occupational exposures occur in the home
• Neurological, immunological, digestive, and other systems still
developing
• Eat, drink, and breathe more in proportion to their body weight than
adults do
• Size & weight diminish their protection from std. safety features
• Behavioral patterns make them more susceptible to accidents and
exposures
• Exposures in childhood can cause chronic disease and premature
death later in adulthood
• Who else is at increased risk?
Why do we care: Changing Times
• There has been sustained anxiety and serious concern
about mold, toxins and other housing related health
effects nationwide, and in the developed world (Chinese
Product Syndrome).
• There has been a significant change in the composition of
materials, products and how air tight our home are.
• Rising concerns for energy conservation and
environmental impact have lead to various guidelines and
best practices for building, renovating, and maintaining a
home—some without serious consideration for IEQ.
Specific Types of Contaminants
Associated with Housing Conditions
• Microbiological
– Fungi
– Bacteria
– Viruses
• Environmental
Allergens
• Pests
• VOCs
• Pesticides
• Radon
• Tobacco Smoke
• Combustion ByProducts
• Ozone
• Particulates
• Lead
• Sewer Gas
Why do we care? Known/Suspected Health Effects
Associated with Housing Conditions
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Respiratory Conditions
Asthma
Injuries and Burns
Reactions to extreme cold and heat
Irritations, allergies and rashes
Poisonings, asphyxiation
Neurotoxic Exposures
Cancer
Poor quality of life
Death
Causes of Poor IAQ
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Design
Construction
Building Materials
Appliances/HVAC/OA
Maintenance
Furnishing
Behavior
• Green & Healthy is
Possible
• Negated by behavior
and Chinese product
syndrome
Principles of Healthy &
Sustainable Housing
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Dry
Ventilated
Clean & Uncluttered
Free of Contaminants
– Pest & Pesticide
– Combustion By-products
– Lead Hazards
– Other Contaminants
• Free of Injury Hazards
• Well Maintained
• Affordable
• Universally
Accessible/Aging in Place
• Secure from Intrusion
• Resilient
• In a Health Promoting
Community
• Green (reduced
environmental impact)
Start with the People
• Don’t assume that your clients understand why or how they should
have a clean and healthy home.
• Its important to provide education on how health and housing are
related.
• As a public health professional, you may be the only professional your
clients trust to receive information on how they can help improve their
own health, and who they should speak to for more information and
resources.
Host Factors: Personal
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Age
Gender
Race/ethnicity
Genetics
Immunity
Occupation
Socioeconomic Status
Host Factors:
Behavioral and Lifestyles
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Activity/exercise
Smoking
Diet
Household maintenance
Risk-taking (unhealthy homes)
Violence in home and community
Sanitation and hygiene
Host Factors: Susceptibility
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Children
Elderly
Pregnant and Nursing Women
Medically Underserved
People with Existing Health Conditions
Poorly Nourished People
Indoor pollutants can cause different
reactions in people
SENSITIVE GROUPS include those with:
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allergies
asthma
chemical sensitivities
respiratory disease
suppressed immune system
Immature respiratory system
• Surprise! Surprise! Perhaps You!
Home
Safety
 Keep a working smoke detector on every level
 Keep a CO alarm near the sleeping area first and basement
second (~10’ from combustion appliances).
 Reduce fall & trip hazards
 Keep poisons locked away and out of sight & reach
 Keep the fridge below 420F
 Defrost foods in the fridge
 Refrigerate prepared foods after two hours
 Keep hot water less than 1210F
 Test your home for radon
 Remove Mercury Sources!!!!!!!!!!!
 Ounce of prevention = living and no permanent injuries.
 Ounce of Prevention = Pound of Cure.
Cooking/Combustion
Combustion by-products:
• Ultrafine particulates, sulfur and nitrogen dioxides, VOCs including
acrolein & formaldehyde, and other by-products cause irritation and
can exceed the Clean Air Act—indoors!
• Sources: gas stoves, electric stoves, unvented gas/fuel appliances,
and wood burning appliances.
Management:
• Vent stove to outside (open window if no vent)
• Cook on back burners closest to exhaust vent
• Do not allow unvented combustion appliances
• Don’t allow indoor/outdoor wood burning fireplaces
Exhaust Stove Pollution
-a Serious Issue!
• Recirculating hoods just grease foreheads!
• Exhaust hoods/microwaves vary greatly in
efficiency and use.
• Choose: HVI certified, ≥ 100-250 cfm, with good
front burner coverage, ≤installed according to
specifications,
• Look for high air pressure rating (62.5 Pa) or use
low pressure duct work.
• Look for new standards/ratings in next year+
Volatile Organic Compounds:
Smelly things that may harm you
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Strong odors (perfume, smelly markers, cleaning
chemicals (bleach, quaternary ammonium), paints,
glues, nail polish, solvents, etc.
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Most anything in an aerosol
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Almost no one is 'normal' as to how we react
to volatile organic compounds.
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Those who have been previously sensitized can react to
low levels (10's, hundreds or thousands of times lower
than 'normal' people).
Scented Products Emit a
Harmful Bouquet of VOCs
Tested 25
– air fresheners,
– laundry detergents,
– Fabric softeners, dryer sheets,
– disinfectants,
– dish detergents,
– all purpose cleaners,
– soaps, hand sanitizers,
– lotions, deodorants,
– and shampoos.
Many of the products tested are top sellers in
their category.
Potera C Scented Products
Emit a Bouquet of VOCs. Environ Health Perspect 2011. 119:a16-a16
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Avoiding VOCs
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Apply outdoors
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Ventilate: open windows and run
exhaust fans to air out chemical odors
– our sense of smell becomes desensitized
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Safer products:
– Low/no VOC products
– water-based products
– non-aerosol pump and liquid
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Make your own natural cleaner using
vinegar, water and dish soap or choose
“unscented” or “ecofriendly” products
from the store
Formaldehyde et al
• Study by Francis Offermann, Ventilation and Indoor Air in
New CA Homes (NCHH Conf Call 10-20-2008)
www.healthyhomestraining.org
– Formaldehyde composite products will off-gas for years.
– Can cause irritation below the odor threshold.
– Many homeowners never open home for ventilation; 6% Spring
and 29% Winter; formaldehyde and acetaldehyde elevated.
– 67% of homes had air exchange rates below CBC requirement of
0.35 ach.
– Of homes where carcinogens detected, significant levels found for
formaldehyde (most common), acetaldehyde, benzene, 1,4dicholorobenzene, naphthalene, tetracholoroethene,
tricholoromethane (chloroform).
Formaldehyde et al
• HRV mechanical outdoor air system performed well in increasing the
home outdoor air exchange rates and reducing formaldehyde
concentrations.
• The DOA systems did not perform well as a result of a combination of
the low outdoor air flow rates and low fan operation times.
• Recommended installation of mechanical outdoor air ventilation systems
in new single family residences to provide dependable and continuous
supply of outdoor air to residences.
• California Air Resource Board adopted an airborne toxics control
measure in 2007 to reduce formaldehyde emissions in composite wood
products.
• US EPA review of formaldehyde was a failure
Avoid VOCs and Formaldehyde
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When purchasing pressed wood products (particleboard, MDF, or hardwood plywood),
look for products that carry a CARB 93120.2 or ANSI label -American National
Standards Institute (ANSI). The following standards indicate lower formaldehyde
emission levels: (Particleboard should conform to ANSI A208.1-1993. For
particleboard flooring, look for ANSI grades "PBU", "D2", or "D3". MDF should comply
with ANSI A208.2-1994; and hardwood plywood with ANSI/HPVA HP-1-1994).
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Use Low/No VOC products
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Increase ventilation in the home by opening doors and windows and installing exhaust
fan(s).
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Install continuous exhaust or supply fan for the entire unit—timed exhaust allows
unhealthy build-up of contaminants.
CPSC - AN UPDATE ON FORMALDEHYDE http://www.cpsc.gov/PageFiles/121919/AN%20UPDATE%20ON%20FORMALDEHYDE%20final%200113.pd
CARB - http://www.arb.ca.gov/toxics/compwood/compwood.htmf
Indoor Air Quality
Control Devices
Room Air Cleaners:
• Some scientific support for use of fan driven room HEPA filter correctly sized
for room if cleaning the room regularly is not effective or near busy roadway
– Other factors: noise, cost for maintenance/replacement parts
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Electronic air purifiers and ion generators may produce ozone
– No sound scientific support for ozone generators showing a health
benefit—health threat to asthmatics and others—follow CA standard
Duct cleaning is not a normal part of routine ventilation maintenance
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Duct cleaning for disaster events, and older homes 1x
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Routine ventilation cleaning and maintenance should include:
– cleaning drain pans and cooling coils;
– 1 to 3 month filter changes with MERV 8 filters disposable filters with
cursory visual inspection;
– cleaning and inspections 1/year for gas furnaces/ 2-3 years for electric.
More information at www.epa.gov/iaq/ or www.nchh.org
EHP: Polyurethane foam & polybrominated
diphenyl ethers (PBDEs)PBDEs
Rental environmental disclosure
Montana Code § 70-16-703 MT Requires sellers, landlords or their agents
to inform buyers or renters of the known presence of mold in a building and
to provide buyers or renters with the results of any mold tests that have
been conducted. Authorizes sellers, landlords, agents, and property
managers to provide buyers or tenants with a mold disclosure statement
specified in the statute. Provides for relief from liability in certain cases for
sellers and landlords who comply with these provisions.
Healthy Home Rating System (HHRS)
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HHRS uses a risk-assessment methodology and is a system (not a standard)
developed to enable risks from hazards to health and safety in dwellings to be
removed or minimized for all current and future occupants.
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The HHRS provides an analysis of just how hazardous a dwelling is and
provides evidence and statistical methods to assist assessors in making their
judgments.
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Each of the 29 hazards are assessed separately.
Healthy Home Rating System
29 Hazards
The simplified formula is: Risk (likelihood) x Outcome = Numerical Score
IAQ Resources
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Columbus Public Health Smoke-Free Housing Tool Kit www.columbus.gov/publichealth
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CDC Healthy Housing Reference Manual (technical, but not too!)
www.cdc.gov/nceh/publications/books/housing/housing.htm
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Environmental Health Perspectives www.ehp.niehs.nih.gov
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Healthy Indoor Air for America’s Homes www.healthyindoorair.org
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Healthy Indoors Magazine www.iaq.net
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IAQradio.com
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Lawrence Berkeley Laboratory IAQ Scientific Findings Research Bank www.iaqscience.lbl.gov/topics
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National Healthy Homes Training Center and Network
www.healthyhomestraining.org
-Pediatric Environmental Home Assessment
-Essentials of Healthy Homes Practitioner's Course
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Ohio ALA Asthma Educator Institute and more www.ohiolung.org
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US EPA Indoor Air Quality Info and asthma checklist www.epa.gov/asthma or IAQ
Questions?
Phillip Bouton
614-645-6226
pbouton@columbus.gov