SEVEN PRINCIPLES OF HEALTHY HOMES

Transcription

1 SEVEN PRINCIPLES OF HEALTHY HOMES

2 LINK BETWEEN HOUSING & HEALTH The connection between health and the dwelling of the population is one of the most important that exists. Florence Nightingale 2

3 MASLOW S HIERARCHY OF NEED Self- Actualization Ego Belonging Safety and Security Physiological Needs 3

4 WHY DO WE CARE? Housing impact on health: Physical, chemical, biological exposures Psychological Young children spend about 70% of the time in their home. 4

5 WHY START WITH PEOPLE? What good are they? What s difficult about people? How can you deal with people? 5

6 SPECIAL COMMUNICATION ISSUES Language Cultural Shoes in the Home Men and Women Responding to Problems Hoarding Tolerance for Clutter and Pests 6

7 NO PLACE LIKE HOME! Resident Overall Opinion of Structure, American Housing Survey National 2011 Worst Best Type of resident All 0.6% 2.0% 23.6% 27.2% 16.0% 30.6% Renters 1.1% 3.7% 32.8% 27.8% 12.7% 21.9% Below Poverty 1.5% 4.4% 29.5% 24.4% 11.3% 28.9% 7

8 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 The strength of a nation derives from the integrity of the home. Confucius Home is the place where, when you have to go there, They have to take you in. Robert Frost There s no place like home. Dorothy, Wizard of Oz He is happiest, be he king or peasant, who finds peace in his home. Johann Wolfgang von Goethe 8

9 DIFFERENT APPROACHES HEALTH Primary Prevention Secondary Prevention Epidemiologic Triangle HOUSING Well constructed Well maintained Comfortable Affordable Healthy ENVIRONMENTAL HEALTH Lead Radon Allergens/asthma Combustion products Unintentional Injuries Insects & Rodents Mold & Moisture Pesticides Asbestos 9

10 WHAT IS HEALTHY HOUSING? Healthy Housing is: Designed, Constructed, Maintained, and Rehabilitated in a manner that is conducive to good occupant health. 10

11 BUT million homes had severe or moderate physical problems in the U.S. in 2011* *Total does not consider cockroaches, mold, dampness and other problems linked to health. 11

12 REAL WORLD IS COMPLEX Current knowledge Economic factors Social and cultural Political and legal factors Do No Harm 12

13 Moisture/water intrusion Why a Holistic Mold Approach? Asthma exacerbation 13

14 Moisture/ water intrusion Structural damage 14

15 Structural damage Pests Deteriorated lead paint/ lead poisoning Fire Injuries 15

16 Pesticides Pests Asthma & allergy exacerbation 16

17 Pesticides 17

18 18

19 HEALTHY HOMES PRINCIPLES 1. Keep it DRY 2. Keep it CLEAN 3. Keep it PEST-FREE 4. Keep it VENTILATED 5. Keep it SAFE 6. Keep it CONTAMINANT-FREE 7. Keep it MAINTAINED 19

20 Steps to Healthier Homes KEEP IT DRY 20

21 MOISTURE SOURCES Poorly managed rainwater/groundwater Plumbing leaks Condensation on surface Construction moisture 21

22 INTERIOR WATER LEAKAGE Sources of interior water leakage, 2011 American Housing Survey Source of interior leak 8.5 % Interior Water Leak % among total # of units Leaking pipes 3.6% Fixtures 1.9% Broken water heater 0.8% Other or unknown 2.4% 22

23 EXTERIOR WATER LEAKAGE Sources of exterior water leakage, 2011 American Housing Survey Source of exterior leak 11% Exterior Water Leak % among total # of units Roof 5.7% Basement 2.8% Walls/windows/doors 2.2% Other/unknown 1.2% 23

24 OVERHANGS WORK 24

25 Air conditioner condensate drains into building 25

26 Poorly managed rainwater often causes moisture problems either directly or by humidifying the whole house. Efflorescence is sometimes mistaken for mold. 26

27 GROUND SLOPES TOWARD HOUSE BELOW GRADE 27

28 Crawlspaces may contain: Mold Pests Pesticides Asbestos Lead paint Sewer gas Radon Bad Crawlspace What looks like a dry crawlspace can add excess water vapor

29 Good Sealed Crawlspace 29

30 Plumbing problems 30

31 31

32 Leaky refrigerator drip pan causes mold 32

33 Mold in the air conditioner? 33

34 CONDENSATION WHEN COLD OUTSIDE Mold around window where there is no insulation. Mold due to poor insulation or wind blowing through insulation. 34

35 Unsealable recessed light allows warm, moist air into the unheated attic. 35

36 Steps to Healthier Homes KEEP IT CLEAN 36

37 WHY IS CLEAN AND EASILY CLEANABLE IMPORTANT? Reduce exposure to: Chemical contaminants Allergens Pest droppings and urine Pesticides Heavy metals such as lead and arsenic Reduced harborage for pests 37

38 Dust mites in humid and dry buildings 38

39 WHERE DOES HOUSE DUST COME FROM? Brought-In Home-Grown Lead Dust Dust Mites Resident-Made Garbage Clutter 39

40 MAKE BUILDINGS MORE CLEANABLE Dust walk-off systems at entryways Dust-creating activities away from people. Smooth, cleanable surfaces Effective storage space Flooring that is easy to clean Vacuums with good filtration and easy to use 40

41 ISOLATE PROBLEMS Keep pets off beds and out of the bedroom. 41

42 CLEANABLE FLOORING 42

43 WHAT TO LOOK FOR IN A VACUUM? Beater Bar Vacuum Strength Filter Type Dirt Sensor 43

44 HOW CLEAN IS CLEAN? Clearance testing for lead 40 micrograms of lead per square foot on floors 250 micrograms of lead per square foot on window sills. Standards for allergens? Standards for dust? 44

45 PROBLEMATIC CLEANING MEASURES Carpet cleaning Overuse of anti-microbials Sanitizers Air fresheners 45

46 DUCT CLEANING EPA recommends duct cleaning when: Substantial visible mold Ducts infested Ducts clogged Ducts release particles 46

47 Steps to Healthier Homes KEEP IT PEST-FREE 47

48 HEALTH EFFECTS OF PESTS Asthma Infectious diseases Health effects greater on children 48

49 PEST TRIANGLE Water Conducive Conditions Food Nest/ Hide The Pest Triangle 49

50 HOW COMMON ARE PESTS? American Housing Survey (2011) All Housing 1.0% Rats 11.1% Mice 0.6% Rodents, unsure of type Below Poverty 1.8% Rats 12.5% Mice 1.0% Rodents, unsure of type Rat feces in insulation 50

51 HOW DO WE CONTROL THEM? Prevention Sanitation Physical controls Ongoing monitoring 51

52 INTEGRATED PEST MANAGEMENT Best practice Multiple tactics Effective control Least risk to the environment Least exposure of nontarget organisms Economic sustainability 52

53 REDUCE PESTICIDE USE Pest pressure can drive people to unsafe use of pesticides. Too much Too many Wrong kind unsafe & Illegal 53

54 IPM: STEP-BY-STEP Inspection & Identification Exclusion & Denial Education Sanitation Physical control Monitoring 54

55 1. INSPECTION & IDENTIFICATION Thorough inspection Identification of pests found 55

56 2. EXCLUSION AND DENIAL Stoppage Inspection Holes filled Stuff-It Silicone Caulk Spackle, etc 56

57 3. EDUCATION Understand pests Control what, how, and when Safe vs. unsafe practices Educating residents Choosing PCO s Training PCO s 57

58 4. SANITATION Food Water Harborage Photo: City of Houston Bureau of Children s and Environmental Health 58

59 5. PHYSICAL CONTROL Identify & assess problem Same strategy Different tactics pest specific Photo: City of Houston Bureau of Children s and Environmental Health 59

60 REDUCE EXPOSURE Roach baits Gels Dusts Glueboards and Snap Traps 60

61 6. MONITORING Keep looking for pests Spot reinfestations Place in corners Behind appliances Under sink Under cover! Do date & mark Don t disturb 61

62 COCKROACH CONTROL Habitat modification Monitors Dust and caulk Baits and gels Insect growth regulators Sticky traps 62

63 RODENT CONTROL Rodents are mammals like us Think like a rodent Not all rodents are the same Mice curious & persistent Rats cautious & smart Squirrels - outdoors 63

64 BED BUGS - DON T PANIC Can be avoided and eliminated Every skin irritation or bite is not bed bugs You can see them. Do not cause or spread diseases. Heat and/or steam can kill them. Protocols and communication key to control 64

65 BEDBUGS - CONTROL Exclusion Preparation Traps interceptors 65

66 BED BUG - TREATMENT Inspection Vacuum Heat or cold Pesticides by PCO only Re-inspection & retreatment Encasements & interceptors 66

67 Steps to Healthier Homes KEEP IT VENTILATED 67

68 WHY WELL VENTILATED? Pollutants found in concentrations 2-5 times higher indoors than outdoors. Proper ventilation can reduce hazards of: Volatile organic compounds, moisture, environmental tobacco smoke, particulate matter, allergens, mold, carbon monoxide, Formaldehyde 68

69 HEATING PROBLEMS 9.1% were uncomfortably cold for more than 24 hours 12.5% for renters 13.7% for residents below poverty level 1.1% were uncomfortably cold for at least 24 hours due to inadequate heating capacity 2.0% for renters 2.2% for residents below poverty level 1.1% were uncomfortably cold for at least 24 hours due to inadequate insulation 1.8% for renters 2.0% for residents below poverty level From American Housing Survey

70 COMBUSTION CONTAMINANTS? HEALTH EFFECTS Carbon Monoxide Fatigue, headaches, dizziness, confusion The Silent Killer Nitrogen Dioxide Eye, nose, and throat irritation Shortness of breath 70

71 SOURCES OF COMBUSTION CONTAMINANTS Oven as heater Spillage from furnace, water heater, fireplace Ventless heater or fireplace Car exhaust from attached garage 71

72 WHY VENTILATED Approximately 500 carbon monoxide deaths plus more than 15,000 non-fire related healthcare visits per year. 72

73 CARBON MONOXIDE ALARMS Consumer Product Safety Commission (CPSC) recommends: Place near sleeping area Put on every level of a home to provide extra protection Do not install directly above or beside fuel-burning appliances Combination smoke and CO alarm 73

74 Multi-family dwellings should have planned fresh air supply because: Neighbors are closer together Stack effect- this dominates in cold weather

75 Find the exterior exhaust 75

76 Filter Heated and Cooled Air Poorly sealed access panel Well sealed panel 76

77 Steps to a Healthier Home KEEP IT SAFE 77

78 WHAT ARE THE MOST COMMON CAUSES OF HOME INJURY DEATHS? Drowning 3.0% Firearms 1.0% Other 5.0% Falls 43.0% Choking & Suffocation 5.0% Fires & Burns 9.0% Poisoning 34.0% 78

79 KEEP IT SAFE 12 79

80 SAFETY-RELATED HOUSING ISSUES Holes big enough to trip on Electrical wiring problems Lack of alarms Source: American Housing Survey

81 WHICH AGE GROUPS ARE MOST SUSCEPTIBLE? Age Group Infants Birth age years old Older adults Adults 80+ years Susceptibility Choking/suffocation is the highest rate of injury death Nonfatal falls at home Highest rate of home injury death is fires and burns Nonfatal falls at home 20 times higher risk for death from injury than younger individuals 81

82 CPSC PRINCIPAL DISPLAY PANEL Signal word Affirmative statement of principal hazard Statement to read other cautions on another panel if all labeling is not on Principal Display Panel 82

83 Time to Scalding (sec) SCALDING Temperature (F) 83

84 Steps to a Healthier Home KEEP IT CONTAMINANT-FREE 84

85 CONTAMINANT BUYING DECISIONS INTENTIONALLY BRING IN: Tobacco Smoke Pesticides Volatile Organic Comp. Mercury Asbestos Meth Labs ALONG FOR THE RIDE: Bedbugs and Mice Cockroaches Mice Formaldehyde Lead 85

86 WHY AVOID SECOND-HAND SMOKE: Children s Health Effects Adult Health Effects 60% of US population has biological evidence of exposure 86

87 SMOKE-FREE HOME RULES: STATE PERFORMANCE % Increase Total 43.2% 60.2% 72.2% 67.1% Max. 69.6% 81.1% 88.8% 107.9% Min. 25.7% 38.9% 53.4% 27.6% 87

88 WHAT CAN YOU DO ABOUT TOBACCO SMOKE IN HOMES AND CARS? Quit, if you re ready there s help Don t smoke around children Smoke outside Exhaust vent the places where people smoke 88

89 VOLATILE ORGANIC COMPOUNDS Air Fresheners Cleaning Products Sprays & Coatings Formaldehyde Carpets Vinyl Floors Drywall Hobbies Home Maintenance 89

90 VOLATILE ORGANIC COMPOUNDS Concentration of VOC s can be 2-5 times greater in the home. During or immediately after paint stripping activities, VOC levels can be 1,000 times higher than outdoors. 90

91 WHY AVOID VOCS? Potential health effects of VOCs: Eye, nose, throat irritation Headaches, nausea, coordination Liver, kidney, and brain damage Some can cause cancers Child development 91

92 STEPS TO CONTROL VOCS Don t use it if you don t have to Substitute a better product Control the source Ventilate 92

93 Steps to a Healthier Home KEEP IT MAINTAINED 93

94 KEEP IT MAINTAINED What Inspect Clean Lubricate Replace Repair Organize When On-going Seasonally Annually 94

95 95

96 WHY AVOID LEAD? Reduced IQ Learning disabilities Impaired hearing Reduced attention spans, behavior problems Anemia Kidney damage Damage to central nervous system Coma, convulsions, death 96

97 LEAD AND LEAD-BASED PAINT Peeling, Chipping Paint / Deteriorated Paint Dust Soil Drinking water Consumer Products such Pottery, Cribs, Jewelry, Candle Wicks Cultural Items Contaminated Sites 97

98 98

99 Peeling paint outside 99

100 LEAD: AGE OF HOUSING MATTERS Year House Was Built Before 1940 Percent of Houses with Lead-Based Paint 87 percent percent percent All US Housing Stock 40 percent 100

101 LEAD DISCLOSURE For property transfers For rentals 101

102 ASBESTOS

103 WHY AVOID ASBESTOS? Health effects: - Lung Cancer - Mesothelioma - Asbestosis Smokers are at greater risk! 103

104 RADON Naturally occurring gas 2nd leading cause of lung cancer after smoking Leading cause of lung cancer in nonsmokers and people who have never smoked. 104

105 Lung Cancer Cases Non-Smokers Smokers 4 pci/l 8 pci/l 10 pci/l Radon Exposure 105

106 TESTING FOR RADON Short Term Long Term If result is 4 pci/l or higher take a followup test OR fix the home 106

107 TESTING FOR RADON Testing Options: Kits Hire a professional 107

108 RADON MITIGATION COSTS New Construction Passive only Active system Average Costs $350 - $500 $650 - $800 Existing Homes $800-$2,

109 SEWER GAS Mixture of gases Source 109