Healthy Home = Healthy Human
There is A Link Between
Housing & Health
Overview Of A Healthy Home
Discussion

Describe housing problems and associated
health risks .

Identify populations that may be at higher risk for
housing-related disease and injury.

Identify housing systems that contribute to a
comfortable living space.

Identify codes used to enforce remediation of housingbased health threats.
What Is A Healthy Home?

A healthy home is:
designed
 constructed
 maintained
 or rehabilitated

in a manner that supports the health of residents
WHY DO WE CARE ABOUT
HEALTHY HOMES?

Young children spend nearly 80%-90% of their time inside.

Housing affects health both directly and indirectly:


Physical, chemical,biological exposures
Psychological, security, well-being
Known or Suspected Harmful Health Effects
Associated With Housing Conditions









Respiratory infections
Asthma
Injuries and burns
Reactions to extreme cold and extreme heat
Irritations, allergy, rashes
Poisonings, asphyxiation
Neurotoxic exposures
Cancer
Death
So, What Is An Unhealthy Home




Often substandard
construction
Inadequate renovations
Not adequately maintained
Place residents at risk of
illness or injury
Sources of Exposure

Typical sources of indoor exposures include:
dust,
 insects, and pet allergens
 chemicals in wall coatings and furnishings
 penetrating outdoor toxics; pesticides
 environmental tobacco (smoke)
 Fungi (mold)

Following Statistics From The
American Housing Survey
US Census Bureau
Who Is Affected: Low Income
Residents

There are six million substandard housing units in
the United States.

Asthma rates are 40-50% higher among minority children living
in U.S. cities.

Children from low-income
communities are eight times
more likely to suffer from lead
poisoning compared to
moderate and upper income
children.
Cost of Unhealthy Homes

Annual costs for environmentally attributable
childhood diseases in the U.S: $54.9 billion




$43.9 Billion from Lead Poisoning
$ 9.2 Billion from Neurobehavioral Disorders
$ 2.0 Billion from Asthma
$ 0.3 Billion from Childhood Cancer
Health & Safety: Categories for
Residential Inspection





Allergens/asthma
Asbestos
Combustion products
Lead
Mold and Moisture





Insects and Rodents
Weatherization
Pesticides
Radon
Fire
New Trend: Integrate Approach

Integrated approach considers:




People living in the home
The structure
Potential health hazards
Result is more efficient and effective prevention
system.
Health Vs. Housing
Epidemiologic Triangle
of
Disease/Injury
Terms of The Epidemiological
Triangle

The HOST or PERSON is the who.

The AGENT is the SOURCE or what, that can bring
about changes in a person’s health.

The ENVIRONMENT is where one lives.

The TRANSPORT MECHANISM is any mechanism
by which an agent is spread from the environment to
the host.
Transport Mechanisms

A transport mechanism ties the HOST, AGENT and
ENVIRONMENT together.

A TRANSPORT MECHANISM is either a VECTOR or a
FOMITE.
a. A VECTOR is an insect or any living carrier which
transports a pathogenic microorganism from the sick to the well
b. A FOMITE is an inanimate object that transports the agent
to the host.
You Decide:
Host
Agent
Vector
Fomite
You Decide:
Host
Agent
Vector
Fomite
You Decide:
Host
Agent
Vector
Fomite
You Decide:
Host
Agent
Vector
Fomite
You Decide:
Host
Agent
Vector
Fomite
You Decide:
A 56 year old woman presents with a severe
sinus infection and bronchial congestion.
She has been seen 4 times for the same
symptoms over the course of a 5 month
period. Medical specialists suspect exposure
as the source of her recurring illness.

Upon returning home, she contacts her son to assist
her in the investigation of potential exposures. She
reports to her son that the first floor toilet holding tank
has been leaking for sometime now, but she can’t image
that would cause her any health issues. After all, it’s
CLEAN water that is leaking from the holding tank!

James, her son, enters the basement below which is
sealed-off to save on heating.
He finds the ceiling in the finished area in the following
condition:

List the Following:
a. Environment
b. Agent
c. Host
d. Transport Mechanism
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. Biologic
2. 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