California
Case Study Documents Human and Economic Costs of Asthma
Researchers at California State University—Fresno’s
Central California Children’s Institute released a report in December
documenting the human and economic costs of childhood asthma. “Struggling
to Breathe: The Epidemic of Asthma Among Children and Adolescents in the San
Joaquin Valley” demonstrates staggering childhood asthma rates in an eight-county
area that includes Bakersfield, Fresno, and Stockton, where 15.8 percent of
children age 17 and under suffer from the disease.
The report estimates that one-third of the children with
asthma in the Valley miss one or two days of school every month because of the
disease, adding up to 800,000 missed school days each year. Because they miss
so much school, asthmatic children have more difficulty with learning and social,
physical, and emotional development, according to the report. These absences
cost Valley school districts some $26 million a year in lost state attendance
money, leading to higher local property taxes and lost educational opportunities.
While the exact causes of rising asthma rates in the San
Joaquin Valley and throughout the world remain unknown, science has demonstrated
that many environmental triggers can cause asthma attacks and make existing
symptoms worse. Many of these triggers are found in the home and are often associated
with substandard housing conditions, including dust mites, certain molds, excessive
moisture, cockroaches, mouse and rat dander and droppings, and pesticide residues.
ARC
Paper Highlights Success of Asthma Interventions in the Home
The Asthma Regional Council of New England released a December
briefing paper that explores the success of addressing environmental triggers
in the home. Improving Asthma Management by Addressing Environmental Triggers:
Challenges and Opportunities for Delivery and Financing describes the rising
incidence of asthma in the United States, looks at the effectiveness of home
interventions on reducing asthma attacks, details the cost effectiveness of
asthma interventions, and includes case studies related to delivering and funding
comprehensive asthma management and intervention services.
The paper’s authors found that the most effective
asthma intervention strategies are those that employ intense, multi-faceted
techniques that target several triggers at once. Single-trigger interventions,
such as supplying special pillow and mattress covers to keep dust mite levels
down, have much more limited impacts. The paper also highlights the importance
to asthmatics of reducing cockroach levels in the home with integrated pest
management (IPM). This lowers levels of cockroach antigen, a significant trigger
for many asthmatics. Combating cockroaches with IPM is an effective control
strategy that uses monitoring, structural repairs, and targeted application
of lower-toxicity chemicals. IPM eliminates the use of high-toxicity pesticides
that are often highly volatile and that can exacerbate asthma and cause neurological
damage, especially in children.
When compared to traditional asthma management methods,
intensive home interventions are also cost-effective. For those with the most
severe asthma, these interventions can even produce cost savings by reducing
the number of urgent care and emergency room visits for asthma attacks.
The paper notes the lack of health insurance coverage for
many asthma home intervention methods because many insurers do not see environmental
interventions as “medical services.” Likewise, many doctors do not
pay as much attention as they could to home intervention possibilities, leading
to less asthma relief and potentially higher costs to patients. According to
the paper’s authors, “Lack of attention to environmental factors
and controls has led thousands of people with asthma to suffer unnecessarily
from the burden of chronic asthma and from acute asthma events, and accordingly,
has resulted in decreases in quality of life of asthmatics and their families,
as well as a substantial increase in avoidable costs from emergency room visits
and hospitalizations.”
CDC Lead
Poisoning Prevention Funding Remains Level in FY05
In late November, Congress decided to maintain level funding
for the Centers for Disease Control and Prevention’s (CDC) Childhood Lead
Poisoning Prevention (CLPP) program in FY 2005. The Consolidated Appropriations
Bill provides funds to CDC to continue its work on developing strategies and
providing assistance to state and local governments for the prevention of childhood
lead poisoning. While CLPP funding was not reduced for FY05, the agency had
requested a modest increase to expand its prevention efforts.
The U.S. Department of Housing and Urban Development (HUD)
has rejected a call from the Natural Resources Defense Council (NRDC), the Alliance,
and other organizations to require local public housing agencies (PHAs) to use
integrated pest management (IPM) in their properties.
HUD asserts that federal law does not force them to require
PHAs to use IPM. Rather, the Federal Insecticide, Fungicide, and Rodenticide
Act (FIFRA) mandates that HUD “promote” IPM in all public housing,
which the agency claims that it does. HUD did acknowledge that it has the authority
to require the use of IPM but stressed that its efforts to promote the pest
management technique are wide-ranging and effective, and its commitment to IPM
is steadfast. For these and other reasons, the Department concluded that a regulation
to require PHAs to use IPM is not necessary.
NRDC, the Alliance, and the other organizations are concerned
that PHAs across the country continue to use outdated pest control methods,
including hazardous pesticides, to control insect and rodent infestations. While
some chemical pesticide use may be necessary to combat certain short-term infestations,
more widespread use of IPM among PHAs would constitute a more effective, long-term
pest management strategy—and the use of lower-toxicity pesticides would
further safeguard residents’ health.
IPM utilizes a variety of strategies to combat pests, such
as installing physical barriers to pest entry, removing sources of food and
water, and using low-volatility, lower-toxicity pesticides, usually in the form
of baits that are not accessible to residents. Wider adoption of IPM would minimize
resident exposure to dangerous pesticides and their residues that can be potent
asthma triggers, cause neurological damage in children, and lead to a variety
of cancers.
MI Enacts Penalties
for Renting Properties With Lead Hazards,
Creates Lead-Safe Housing Registry
In November, the Michigan Legislature passed SB 757, a
bill that sets criminal penalties for property owners and managers who rent
units that contain known lead hazards. To be found criminally liable under the
new law, a property owner or manager must have at least 90 days prior knowledge
of the lead hazard and refuse to act in “good faith” to control
the hazard.
Property owners and managers who violate the provisions
of SB 757 are guilty of a misdemeanor. First offenses can draw up to 93 days
in jail and up to $5,000 in fines; all subsequent offenses result in the same
jail time but can also bring a fine of up to $10,000.
One other important lead poisoning prevention bill also
passed in the closing days of the 2004 legislative session. SB 756/HB 5116 creates
a statewide lead-safe housing registry in Michigan that will include both single-family
homes and multi-family rental housing. The registry will be posted on the Department
of Community Health’s website. Governor Jennifer Granholm (D) signed both
bills into law on December 21.
Office of Thrift
Supervision Takes Aim at Community Reinvestment Act
The federal Office of Thrift Supervision (OTS) has issued
a proposal that would severely and negatively impact the the Community Reinvestment
Act (CRA). This move comes on the heels of a related FDIC proposal issued in
late summer that would exclude most banks from most CRA requirements by changing
the definition of a “small bank” [see www.afhh.org/res/res_alert_archives_sept04.htm#fdic
for details on the FDIC proposal].
The proposed changes would reduce lending, investments,
and banking services in low- and moderate-income communities where thrifts have
traditionally focused on home lending.
The OTS proposal would allow large thrifts with more than $1 billion in assets
to choose which community needs they will meet. Under the proposal, all thrifts
could earn CRA points by providing community development financing and services
to affluent neighborhoods while neglecting low- and moderate-income ones in
rural areas and areas impacted by natural disasters. Such allowances would dilute
CRA's original purpose: meeting the credit needs of low- and moderate-income
communities.
OTS also wants to permit large thrifts to design their
own watered-down CRA exam. Currently, large thrifts have lending, investment,
and service tests in their CRA exam. Instead, OTS would allow thrifts to eliminate
their investment and service tests or make them insignificant. The "design
your own watered down exam” option will lead to fewer investments, less
accessible basic banking services, and a smaller number of thrift branches in
low- and moderate-income communities.
OTS is accepting public comment on this proposal until January 24, 2005. You
can fax your comments to OTS at 202-906-6518 or e-mail them to regs.comments@ots.treas.gov.
Be sure to include the OTS docket number, No. 2004-53, in the subject line of
your e-mail or on the coversheet of your FAX, and include your full name and
telephone number in the body of your E-mail or FAX. For those who prefer to
comment using a standardized form and letter, the National Community Reinvestment
Coalition’s online OTS letter is available at www.ncrc.org/letters/ots_letter.php.
DC Appleseed
Center Recommends District Take-Over of
Drinking Water Regulation
The DC Appleseed Center released a report to the Washington,
DC City Council in December that urges the District to take over responsibility
for regulating city tap water, specifically to address high lead levels found
in some drinking water in DC. The report recommends that the city create an
environmental quality agency that would implement District water regulations
and suggests that the DC Water and Sewer Authority (WASA) operate two water
treatment plants currently run by the U.S. Army Corps of Engineers. The report
also suggested that the District would be better able to combat high lead levels
in water if WASA were to accelerate its current six-year program to replace
lead service lines.
The report, commissioned by the City Council, states that
federal regulations on lead in drinking water are too weak to be protective.
The Appleseed Center asserts that the District, if it passes a tougher standard
and adequately enforces it through a new Department of Environmental Protection,
could more effectively manage drinking water quality locally, rather than rely
on officials from the U.S. Environmental Protection Agency (EPA). Appleseed
also urged EPA to strengthen its current drinking water regulations covering
lead, and Senator James Jeffords (I-VT) said that the report points out “flaws
not only with the District of Columbia’s drinking water system, but with
federal regulations and oversight” related to lead in drinking water.
Appleseed’s report to the Council is the latest development
in an ongoing controversy sparked in January 2004, when a series of Washington
Post articles disclosed that high lead levels in the drinking water of thousands
of District homes had existed since 2002.
Researchers
Find Health Benefits from Energy and Water Conservation in Housing
Preliminary research presented at the Second World Health
Organization International Housing and Health Symposium documents improved living
conditions and positive health impacts from energy and water conservation measures
implemented in public housing developments in Boston.
The findings, documented by researchers from Tufts University,
Harvard University, and the University of Texas, demonstrate that several structural
problems related to energy and water usage, such as water leaks, excessive moisture,
and lack of ventilation led to poor indoor air quality, which can exacerbate
asthma and allergies. When repairs to correct roof, wall, and water pipe problems
were conducted in a Boston public housing project, the living conditions and
health of occupants improved.
The researchers cautioned that some improvements noted
in their study were small, and the health measures were gathered using self-reporting
surveys, meaning that residents themselves reported on improved or worsened
health conditions. The researchers concluded that while their study shows important
trends on the impact of renovations on housing and health conditions, further
studies are needed.
In an article published by the Journal of the American
Medical Association (JAMA) in December, researchers found a link between lead
exposure and the development of cataracts in older men. The study analyzed lead
levels in the men’s shin bones, which can harbor the heavy metal for up
to 20 years. The study did not look for similar associations in women.
Men with the highest levels of lead in their bones were
2.7 times more likely to develop cataracts at some point in their lives than
men with the lowest bone lead levels. Scientists think that over time, lead
exposure can contribute to a change in the cells in the lens of the eye, resulting
in a cataract.
This study adds cataracts to a list of adult health problems
associated with lead that includes high blood pressure, dementia, peripheral
artery disease (PAD), and premature death.
In December, the National Center for Healthy Housing and
the Enterprise Foundation published a follow-up report on a Healthy Homes Symposium
the organizations co-hosted in Washington, DC, in June. The Symposium convened
a group of healthy housing leaders from the public health, housing, academic,
and research worlds; community-based organizations; and national policy and
advocacy organizations to initiate development of a healthy housing public policy
agenda. The report looks at the Symposium’s success in establishing high
priority policies that a broad cross section of healthy housing stakeholders
can and will endorse, advocate and work to achieve, both individually and in
coalition with others.
CDC has released a new video entitled "CDC Guidelines
for Collecting and Handling Blood Lead Samples—2004." This video
demonstrates the proper technique for obtaining a high quality blood lead sample.
The overall goal of this video is to improve the quality of specimens collected
for blood lead screening. This training video is appropriate for nurses, laboratory
technicians, medical assistants, and field workers. It is recommended that anyone
involved with the collection of blood lead samples view this video prior to
performing blood lead testing. If you would like either a free VHS videotape
or CD-ROM copy of the video, please send an E-mail with your name and address
to LeadInfo@cdc.gov.
EPA Revamps
Asthma Website
EPA's new asthma website contains up-to-date information
about the science linking indoor environments and asthma, indoor asthma management
techniques, and a wide variety of tools and resources that EPA developed to
help people recognize and manage asthma triggers. All of EPA's asthma materials
and resources are available at no cost. For more information, see www.epa.gov/asthma.
Investigative
Reporter and Childhood Lead Poisoning Prevention Champion Dies
Investigative reporter and columnist Jack Newfield, who
had worked for New York newspapers including the Village Voice, the New York
Daily News, the New York Post, and the New York Sun, died December 20. He was
66.
Newfield was well-known for highlighting childhood lead
poisoning in New York City. In 1969 and 1970, he wrote an influential series
of articles on the “silent epidemic” of childhood lead poisoning
for the Village Voice, and in later articles and columns, he focused on the
racial and class disparities associated with lead poisoning. Newfield’s
passion and insight on this issue will be missed.
Funding Opportunities
The EPA has released a Request for Applications
(RFA) for Radon Communications, Education, Outreach, and Risk Reduction Projects.
National nonprofit organizations are eligible to apply for awards that will
range in size from $30,000 to $70,000 for 2-year projects. EPA is seeking proposals
that will increase public awareness of the health risks of radon exposure, the
number of homes tested and mitigated for elevated levels of radon, and testing
and mitigation of multi-family dwellings in low-income communities, among other
outcomes. Initial proposals are due to EPA by January 17, 2005. To view the
full RFA, visit www.epa.gov/air/grants/04-16.pdf.
The EPA is also soliciting grant proposals to conduct activities
to prevent childhood lead poisoning in vulnerable populations, including projects
to: (1) address areas with high incidences of elevated blood-lead levels; (2)
identify and address areas with high potential for undocumented elevated blood-lead
levels; (3) develop tools to address unique and challenging issues in lead poisoning
prevention; and (4) identify tools that are replicable and scalable for other
areas. Activities eligible for funding include outreach and public education,
data gathering, monitoring, training, inspections and assessments, demonstrations,
and new, innovative approaches for identifying or reducing lead poisoning. EPA
is awarding a total of approximately $750,000 in individual grants of $25,000
to $100,000. This grant program is open to a wide range of applicants, including
state governments, local governments, federally recognized Indian Tribes, nonprofit
organizations, and public and private colleges and universities. Grant proposals
are due by January 31, 2005. More information can be found at http://frwebgate6.access.gpo.gov/cgi-bin/waisgate.cgi?WAISdocID=936429319425+2+0+0&WAISaction=retrieve.
The Centers for Disease Control and Prevention (CDC) and
the Agency for Toxic Substances and Disease Registry (ATSDR) have announced
the pending availability of FY 2005 funds for a grant program for Public Health
Conference Support. This funding may be used by organizations and agencies to
hold conferences in the "Healthy People 2010" focus areas, including
Educational and Community-Based Programs and Environmental Health. Eligible
conferences can include education, disease prevention, and applied research
components. The grant program will not fund the same conference conducted more
than once during the grant period, but applicants can apply for funding for
more than one different conference during the project period. Applications may
be submitted by public and private nonprofit organizations and by governments
and their bona fide agents, such as private nonprofit organizations, universities
and colleges, foundations and civic groups, and federally recognized tribal
governments. Applications for ATSDR support may be submitted by the official
public health agencies of the States and the District of Columbia, or their
bona fide agents. Letters of Intent are due February 3, 2005, and the full application
deadline is April 6, 2005. More details are available at http://fr.cos.com/cgi-bin/getRec?id=20041102a107.
The National Institute of Environmental Health Sciences
(NIEHS) and its parent agency, the National Institutes of Health, are calling
for proposals for Community-Based Participatory Research (CBPR) Grants. These
projects should further the goal of reducing the burden of environmentally associated
diseases and health conditions by 1) providing the scientific basis for understanding
the impact of the environment on human health; 2) translating this information
into prevention and intervention strategies; 3) evaluating the efficacy of prevention
and intervention strategies; and 4) communicating the results to the public
and improving public health. All projects must be conducted in communities and
must allow community members, affected persons, and other key stakeholders the
opportunity to be full participants in each phase of the project, including
grant proposal development. FY 2005 grant proposals are due May 17, 2005. More
details are available at http://grants.nih.gov/grants/guide/pa-files/PAR-05-026.html#PartI.
Upcoming Conferences
The Surgeon General's Workshop: Healthy Indoor Environment
will take place on January 12 and 13 at the National Institutes of Health campus
in Bethesda, Maryland. The workshop is intended to enhance the understanding
of the public health consequences of the non-industrial indoor environment (homes,
schools, office buildings). The public, members of the medical and public health
communities, and the building design, construction, and ownership communities
will benefit from this workshop. There is no registration fee, but pre-registration
is strongly encouraged as space is limited, and registrations are accepted on
a first-come, first-served basis. For more information, visit http://infoventures.com/sgworkshop2005/.
The 4th Annual New Partners for Smart Growth: Building
Safe, Healthy and Livable Communities Conference will be held in Miami Beach,
January 27-29, 2005. The conference will offer several plenaries and dozens
of concurrent sessions focused on connecting healthy community design, affordable
housing, and Smart Growth. The conference will draw a multidisciplinary audience
of local elected officials, city and county staff, landscape architects, developers
and builders, planners, transportation professionals and traffic engineers,
public health professionals, architects, bankers, crime prevention professionals,
realtors, urban designers, parks and recreation professionals, environmentalists,
advocates for older adults and youth, bicycle and pedestrian advocates, advocates
for social equity and affordable housing, labor representatives, and others
committed to building safer, healthier, and more livable communities everywhere.
See www.outreach.psu.edu/C&I/SmartGrowth/
for more information, or contact Mark Bernhard at 814-863-5100 or mvb8@outreach.psu.edu.
The Indoor Environmental Health & Technologies Conference
and the Lead and Healthy Homes Grantees Conference will be held as a joint conference
in New Orleans, April 4-7, 2005. The conference will examine new findings in
the environmental health field; the need to close the gap between research findings
and formulating public policies; available resources on children’s health
and the environment; collaboration between public agencies and community groups;
primary prevention strategies in housing, schools, and daycare facilities; low-cost
lead hazard control methods; funding opportunities apart from federal grants;
updates on state and federal legislative efforts that can impact the future
of lead hazard control and healthy homes programs; and more. For more information,
visit www.leadmoldconferences.com
or call the conference hotline at 1-800-590-6522.
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