Emerging Trends in Healthy Homes

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Emerging Trends in Healthy Homes

• Tom Neltner
• National Center for Healthy Housing

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Agenda

• Overview of Healthy Homes
• Strategies to Advance Issues
• Hot Topics

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The Link Between Housing Health
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Why Do We Care About Healthy Homes?
Young children spend about 70 of their time
inside their home.

• Housing affects health
• both directly and
• indirectly
• Physical, chemical, biological exposures
• Psychological

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No Place Like Home!
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It may be frail its roof may shake the wind
may blow through it the storms may enter the
rain may enter but the King of England cannot
enter all his forces dare not cross the
threshold of the ruined tenement. William Pitt
One of our deepest needs is to be at home.
Timothy Radcliffe
Home is the place where, when you have to go
there, They have to take you in. Robert Frost
Home is where the heart is.Pliny
Where thou art, that is home. Emily Dickinson
Theres no place like home. Dorothy, Wizard of Oz
The strength of a nation derives from the
integrity of the home. Confucius
He is happiest, be he king or peasant, who finds
peace in his home. Johann Wolfgang von Goethe
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What is Healthy Housing?

• Healthy Housing is
• Designed,
• Constructed,
• Maintained, and
• Rehabilitated
• in a manner that is
• conducive to good
• occupant health.

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The Real World is Complex

• Current knowledge
• Economic factors
• Community
• Family
• Social and cultural
• Affordability
• Political and legal factors
• Do No Harm
• Precautionary principles

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But . . .

• 6.2 million homes had severe or moderate physical
  problems in the U.S. in 2005
• Total does not consider cockroaches, mold,
  dampness and other problems linked to health.

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Why a Holistic Approach?
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Structural Damage
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Structural Damage
Pests
Lead Poisoning
Fire
Injuries
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Pesticide
Pests
Asthma and Allergy Exacerbation
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Pesticide
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Structural Damage
Structural Damage
Moisture
Asthma Exacerbation
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7 Healthy Homes Principles

• Keep It
• Dry
• Clean
• Ventilated
• Pest-Free
• Safe
• Contaminant-Free
• Maintained

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Strategies

• Federal Legislation
• Federal Leadership / Coordination
• Healthy Homes Training
• Healthy Homes Specialist Credential
• American Housing Survey
• Healthy Homes Codes
• Expanding from Lead
• Translating Research
• Expert Panel

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Federal Legislation

• Senator Reed introduced Research, Hazard
  Intervention, and National Outreach for Healthier
  Homes Act of 2008 S 3654
• Funds existing federal housing programs to add
  healthy homes components to their programs.
• Creates voluntary Healthy Homes Seal of
  Approval modeled after the Energy Star program.
• Evaluates health risks and human health effects
  of indoor exposure to chemical pollutants.
• Studies methods for the assessment and control of
  housing-related health hazards.
• Studies indoor environmental quality of existing
  housing.
• Creates a system for monitoring housing related
  hazards.

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Federal Leadership / Coordination

• U.S. Centers for Disease Control and Prevention
  (CDC) National Center for Environmental Health
  (NCEH)
• U.S. Department of Housing and Urban Development
  (HUD) Office of Healthy Homes and Lead Hazard
  Control (OHHLHC)
• U.S. Environmental Protection Agency (EPA)
• Office of Childrens Health
• Office of Air Quality
• Office of Pollution Prevention and Toxics
• Office of Pesticide Programs
• U.S. Department of Agriculture
• Cooperative State Research, Education and
  Extension Network (CSREES)
• U.S. Consumer Products Safety Commission (CPSC)

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Healthy Homes Training

• National Healthy Homes Training Center and
  Network
• Funding by CDC, HUD and EPA
• 20 training partners reaching 40 states

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Healthy Homes Training
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Healthy Homes Training

• www.healthyhomestraining.org
• Courses
• Essentials for Healthy Homes Practitioners
• Launching a Healthy Homes Initiative
• Pediatric Environmental Home Assessment
• IPM in Multi-Family Housing
• Healthy Homes for Community Health Workers
• Clearinghouse

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Healthy Homes Specialist

• Partnership with National Environmental Health
  Association
• 350 people have applied
• Application fee - 205
• Endorsed by American Society of Home Inspectors
• 5 years of health or housing experience
• Exam and visual survey exercise
• Essentials for Healthy Homes Practitioners course
  as good prep
• www.healthyhomestraining.org/credential

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American Housing Survey

• National Survey Every 2 Years
• Metropolitan Areas
• Indianapolis
• Chicago
• Cincinnati
• 7-page Summaries
• 1 page Profiles
• Interior-Exterior Relationship
• www.healthyhomestraining.org/ahs

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American Housing Survey
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Healthy Homes Profile for Indy 2004
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American Housing Survey
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American Housing Survey
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Healthy Homes Codes

• Housing Codes
• Health Codes
• Landlord-Tenant Law
• Product Standards
• Hazard Management Standards
• Disclosure Laws
• www.healthyhomestraining.org/codes

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Healthy Homes Codes

• International Property Maintenance Code
• International Residential Code
• National Conference of State Legislatures
• Federal Lead-Based Paint Benchbook

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Healthy Homes Codes

• Partnership with National Conference of State
  Legislatures
• Healthy Homes Wiki
• Marion County Health Department as Model
• Enforcement
• Getting beyond complaints
• Highlighting compliance problems

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Expanding from Lead

• Conference Calls 1st Monday at 300 ET
• Featuring models making the transition from lead
  to healthy homes
• Marion County in July 2008
• Houston in December 2008
• www.healthyhomestraining.org/transitions

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Translating Research

• Conference Calls 1st Monday at 300 ET
• Discussion of latest research to translating
  research into healthy homes improvements
• Pest control in November 2008
• Lead dust in December 2008
• www.healthyhomestraining.org/research

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Expert Panel

• Met in December 2008
• Final report due soon
• Assessed research in
• Interior Biologic Agents (Toxins)
• Interior Chemical Agents (Toxics)
• External Exposures (Water and Waste)
• Structural Deficiencies
• Categories
• Sufficient Evidence
• Needs More Field Evaluation
• Needs Formative Research
• No Evidence or Ineffective

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Interior Biologic Agents

• Sufficient Evidence
• Multi-faceted tailored asthma interventions
• Integrated Pest Management (allergen reduction)
• Moisture intrusion elimination
• No Evidence or Ineffective
• Bedding encasement alone
• Sheet washing alone
• Upholstery cleaning alone
• Air cleaners releasing ozone

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Interior Chemical Agents

• Sufficient Evidence
• Radon air mitigation through active subslab
  depressurization
• Integrated Pest Management (pesticide reduction)
• Smoking bans
• Lead hazard control
• No Evidence or Ineffective
• Portable HEPA air cleaners to reduce
  environmental tobacco smoke
• Air cleaners using or releasing ozone

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Water and Waste

• Sufficient Evidence
• Voluntary drinking wastewater treatment
  standards for small systems private wells
• Training for small system personnel
• Guidelines for immuno-compromised individuals
• No Evidence or Ineffective
• UV/point of filtration research for systems that
  already comply with standards

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Structural Deficiencies

• Sufficient Evidence
• Installation of working smoke alarm
• Isolation 4-sided pool fencing
• Pre-set safe temperature hot water heaters
• Air condition during heat waves
• No Evidence or Ineffective
• Advise to elderly on fall prevention
• Give away smoke alarm programs
• 3-sided pool fencing

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Hot Topics

• EPAs RRP Rule
• Lead from Childrens Products
• Phthalates from Childrens Products
• Formaldehyde from Wood Products
• Air Fresheners
• Mercury from Consumer Products
• Pest Control

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EPAs RRP Rule

• EPAs Renovation, Repair and Painting Rule
• Published April 22, 2008
• Effective April 22, 2010
• Changes Pre-Renovation Notice
• December 22, 2008
• Must use Renovate Right Pamphlet
• Extended to Child-Occupied Facilities
• Impacts
• 8.4 Million Renovation Events Annually
• 235,000 Renovators to Certify
• 210,000 Renovation Firms to Change
• 35 Additional Cost Per Renovation

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EPAs RRP Rule

• Legal Challenge to Rule
• Excludes Public and Commercial Buildings other
  Child-Occupied Facilities
• Exemption for Owner-Occupied Housing with no
  children or pregnant woman
• Post-Renovation Notice to Owner and Occupant
• White-Glove Test
• Legislation Boxer and Clinton Bill S3495

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EPAs RRP Rule

• Focus on Training
• Accredited Training Providers
• Photo on Certificate
• NCHHs Approach to Facilitating Network of
  Trainers
• Spot Test Kits
• State Delegation
• Paint Retailers Indianas Leadership
• Relationship to
• HUD Lead-Safe Housing Rule
• EPA/HUD Disclosure Rule

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Lead from Childrens Products

• Consumer Products Safety Improvement Act of 2008
  8/14/08
• Lead in Childrens Products
• 600 ppm 6 months
• 300 ppm 12 months
• 100 ppm 36 months unless not technologically
  feasible

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Lead from Childrens Products

• Consumer Products Safety Improvement Act of 2008
  July 2008
• Testing and enforcement improvements
• Lead in childrens products
• 600 ppm 6 months
• 300 ppm 12 months
• 100 ppm 36 months unless not technologically
  feasible
• 5 year review
• Cadmium as a substitute for lead??

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Lead from Childrens Products

• Exemptions
• No absorption into the body considering
  reasonable use and abuse based on peer-reviewed
  science.
• Inaccessible component parts
• CPSC guidance in one year
• Paint or plating not enough
• Electronic devices Schedule unless not
  technologically feasible.

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Lead from Childrens Products

• More Stringent Lead Paint Ban
• 90 ppm 12 months
• 5-year review Lowest amount of that lead that
  is technologically feasible to achieve
• X-ray fluorescence
• Screen for small paint
• Study of methods 12 months
• Rulemaking and 5-year review

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Phthalates in Childrens Products

• Consumer Products Safety Improvement Act of 2008
  8/14/08
• Ban in 6 months
• Childrens toys or child care article
• 1 cutoff
• Two Categories
• Banned
• Interim Ban Process to remove ban

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Phthalates in Childrens Products

• Two Categories
• Banned in 6 months
• di-(2-ethylhexyl) phthalate (DEHP)
• dibutyl phthalate (DBP)
• benzyl butyl phthalate (BBP)
• Interim ban in 6
• diisononyl phthalate (DINP)
• diisodecyl phthalate (DIDP)
• di-n-octyl phthalate (DnOP).

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Formaldehyde

• FEMA trailers in response to Hurricanes Katrina
  and Rita in 2005
• Resident complaints
• Sierra Club testing
• Humidity Heat
• CDC emergency action in January 2008
• FEMA set 16 ppb standard
• Formaldehyde from Composite Wood Products
• Particle Board
• Medium Density Fiberboard
• Plywood

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Formaldehyde

• California Air Resources Board Rule
• Finalized April 2008
• Two phases starting January 2009
• Quality control and product testing
• Imports
• Petition to EPA to make CARB rule national
• EPAs indirect acceptance ANPR Planned
• Potential legislation

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Air Fresheners

• Asthma and Respiratory Sensitization
• No Public Health Benefits
• Petition to EPA
• Reporting
• Testing
• Labeling
• EPA Denial but Voluntary Request to Seven
  Manufacturers
• Fragrance ingredients
• Litigation underway

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Mercury from Consumer Products

• Indianas Leadership on Issue
• EPA planning rulemaking
• Switches and relays
• Thermometers
• Novelty items
• Compact fluorescent lamps
• Risk from cleanup
• Solid State Lighting

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Pest Control

• Cockroaches
• Rats
• Mice
• Bedbugs
• Integrated Pest Management

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Pest Control

• IPM in Multi-Family Housing Training
• HUD, CDC, EPA, and USDA Coordination
• QualityPro Green Greenshield
• HUD Mark-to-Market
• Inspection Facilities and management
• Integrate pest management plan if funded

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Tom NeltnerNational Center for Healthy
Housingtneltner_at_nchh.org443-539-4160
www.nchh.org www.healthyhomestraining.org