Congress should delineate the roles and responsibilities
of the appropriate federal agencies, including Housing and Urban Development
(HUD); Environmental Protection Agency (EPA); Centers for Disease Control
and Prevention (CDC) and National Institute for Environmental Health
Sciences (NIEHS) within Health and Human Services (HHS); and Department
of Energy (DOE).
HUD’s Office of Healthy Homes
and Lead Hazard Control should serve as the center for investigating,
demonstrating, and disseminating tools and techniques for
assessing, correcting, and preventing housing-related health
hazards.
Expand Scientific Knowledge
Congress should create an interagency
task force chaired by CDC and HUD to coordinate research
among the federal agencies.
The National Institute of Environmental
Health Sciences should conduct research to identify mechanisms
of disease for housing-related health hazards and dose-response
relationships; increase scientific understanding of indoor
environmental factors that sensitize children to asthma
and other respiratory problems and trigger attacks; evaluate
the health risks of chronic indoor exposure to carbon monoxide;
and conduct clinical trials to document the health benefits
of preventing and controlling health hazards in housing.
HUD’s Healthy Homes Grant Program
should fund studies to test, evaluate, and validate low-cost
tools and methods to detect housing-related health hazards;
fund demonstration projects of cost-effective integration
of healthy homes safeguards into housing programs; and identify
and validate effective healthy homes practices for private-sector
housing.
The Environmental Protection Agency
should conduct monitoring studies to compare the relative
risks of indoor and outdoor exposure to environmental health
hazards and fund basic research to develop low-cost monitoring
and detection technologies for housing-related health hazards.
Establish Health-Based Protective Practices
EPA should aggressively promote integrated pest
management (IPM) as the standard of care for controlling pests in residential
settings, and EPA should issue guidelines for the remediation of cumulative
residues of pesticides, including any needed interventions for serial
applications of multiple toxic pesticides.
EPA should ban the sale of unvented
gas appliances and educate consumers about the importance
of adequate ventilation and the danger of carbon monoxide
from automobiles in attached garages.
State and local governments should
incorporate health-based standards into building and housing
codes.
Assure Housing Quality
HUD programs that provide housing
assistance should give consistent attention to decent housing
quality and serve as models for integrating health considerations
into housing programs and practice by
issuing and implementing preemptive
good building and maintenance practices to prevent hazards;
incorporating inspections for and
disclosure of health hazards into homebuyer assistance
programs; and
requiring that public housing authorities
and other providers of federally assisted housing meet
health-based standards.
Rental property owners, the building
industry, and painting and construction trades should embrace
and implement these models throughout the US housing stock.
Congress should require property owners
to disclose potential health hazards to tenants and purchasers.
State and local governments should
consolidate or closely link agencies that have enforcement
responsibilities for health and housing standards.
State and local code enforcement agencies
should give priority to enforcing provisions that protect
against health hazards.
Mortgage lenders and underwriters
should require radon testing for all home purchases.
Coordinate Health and Energy Improvements
DOE’s Weatherization Assistance Program
should incorporate safeguards to ensure that energy efficiency measures
do not compromise health and should revise management and accountability
systems to encourage state programs to address health hazards in homes
undergoing weatherization treatment.
EPA’s Energy Star program should
be expanded to encompass the Voluntary IAQ standard and
other healthy homes measures and address rehab programs
and low-income housing in addition to new home construction.
Strengthen Local and State Capacity
Local and state agencies' goals and
strategies should evolve beyond responding to sick children
to screening high-risk housing and prevention of hazards
before exposure occurs.
State and local governments should
take advantage of federal funding and invest local resources
to prevent and correct health hazards in low-income and
very low-income housing, commit to reduce health hazards
in their Consolidated Plan, and prioritize using CDBG and
HOME funds to rehab housing for low- and moderate-income
families with children.
The CDC should provide technical assistance
and grants to equip state and local health departments to
prevent, identify, and correct housing-related health hazards.
Integrate Medical and Housing Treatments
The Center for Medicare and Medicaid
Services, Medicaid agencies, managed care organizations,
and private insurance providers should pay for low-cost
home investigations as part of case management for lead
poisoning and asthma patients, and reimburse for Community
Health Workers providing patient education and home assessment
services for asthma.
Providers should factor housing condition
and other environmental circumstances into determining cause
and treatment of patients with asthma, allergies, and other
respiratory illnesses as well as lead poisoning, and advocate
and make referrals to motivate control of causative hazards
in the home.
Build Community Capacity
HUD, in collaboration with CDC and
EPA, should ensure the development and delivery of training
for
health departments and code enforcement
agencies in the assessment of health hazards in housing;
the building trades (architects,
builders, contractors, and housing providers on healthy
homes practices, including construction, rehab and maintenance
practices; and
code inspectors and home inspectors
in assessment, remediation, and prevention of housing-related
health hazards.
HUD, EPA, and CDC should provide funding,
training, and technical assistance to community- and faith-based
organizations to build local capacity to prevent and address
housing-related health hazards.
State and local governments should
implement cross-training of health, housing, and code enforcement
agency personnel.
Ensure Tenants’ Rights
Rental property owners should adopt
and apply preemptive maintenance practices that prevent
health hazards while improving durability and energy efficiency.
Governments should require rental
property owners to identify and remedy any potential health
hazards at unit turnover.
Governments should require that workers
doing repairs, repainting, or renovations in buildings built
prior to 1978 are trained in and use lead-safe work practices.
Local governments should require a
warranty of habitability for all rental properties and local
code enforcement agencies should conduct periodic inspections
of all rental units.
