Rodents

Exposure to rodents can trigger asthma attacks. Studies have shown a linkage between rodent allergy and asthma symptoms.Integrated pest management (IPM) approaches offer effective means of eliminating rodents from a home. IPM methods focus on preventing infestations, trapping rodents, and limited use of lower-toxicity pesticides. However, even after a rodent population is controlled, rodent hair, urine, and fecal matter may remain, which can trigger allergic reactions in some people.

Designing, maintaining, and renovating buildings to minimize rodents is an effective prevention-based approach.

  • Seal holes and cracks in building foundations, utility openings, and joints between materials. Use corrosion-proof materials such as copper or stainless steel mesh. Rodents can chew through many other materials and squeeze through tiny openings.
  • Add rodent barriers to foundation walls to make it more difficult for them to enter a building. For example, heavy-duty wire mesh along the outside of a foundation is an effective barrier.
  • Seal passages through interior floors, walls, ceilings, and kick spaces. If possible, keep kick spaces open to limit places rodents can hide. (Kick spaces are the gaps between the bottom of cabinetry or built-in furniture and the floor.)
  • Keep bushes and trees at least three feet from homes. Bushes and trees near a home provide food, a living place, and sheltered passage for rats and rodents.
  • Ensure trash is stored in secure containers (covered garbage cans and dumpsters).
  • Store food in rodent-proof containers.

Sources and Additional Information:

Asthma and Allergy Foundation of America – www.aafa.org

Asthma Regional Council – www.asthmaregionalcouncil.org

Beyond Pesticides – Integrated pest management to control mice –www.beyondpesticides.org/alternatives/factsheets/MOUSE%20CONTROL.pdf and www.beyondpesticides.org/infoservices/pesticidesandyou/Winter%2000-01/Minimizing%20Mouse%20Madness.pdf

Building Science Corporation – www.buildingscience.com

Environmental Health Coalition – www.environmentalhealth.org/PestControl.pdf

Gumm, Brian, Home Energy, “Integrated Pest Management in the Home,” Vol. 21 Iss. 6 pp. 36-39 (Nov-Dec 2004)

National Academy of Science, Institute of Medicine report Clearing the Air: Asthma and Indoor Air Exposures 2000 – http://books.nap.edu/books/0309064961/html/index.html

Pesticide Action Network – www.pesticideinfo.org

US Centers for Disease Control and Prevention – www.cdc.gov/ncidod/diseases/hanta/hps/noframes/prevent3.htm

US Environmental Protection Agency – www.epa.gov/pesticides

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Mold

Mold is a serious health hazard in the home environment, as it produces allergens, irritants, and in some cases, potentially toxic substances. Further, mold can trigger respiratory problems such as asthma in vulnerable and allergic populations. Therefore, preventing and eliminating mold problems is a crucial part of ensuing quality housing conditions.

Controlling mold problems in the home environment is largely dependent on controlling the level of moisture in the home, because mold cannot grow without moisture. Further, excessive moisture in the home is cause for concern as it can also cause or contribute to structural home damage and other housing hazards to human health such as cockroachesdust mites, and peeling lead paint.

Fortunately, there are ways to prevent and control excessive moisture, and therefore mold growth, in the home environment—both practical measures for residents as well as precautionary measures during construction or renovation. Please visit the “How to Control Moisture” section of this website for additional information such as practical tips, telltale signs, and likely sources of moisture both inside and outside the home.

In addition to preventative measures, visual inspections for mold should be performed periodically for the early detection of potential problems. Mold may be clearly visible or it may be hidden under furniture and carpets, in cabinets, and in crawlspaces or attics. When assessing mold problems in the home environment, it is important to know such potential hiding places and visually inspect all likely areas that are reasonably accessible. In some cases, mold will not be discovered even after searching typical hiding places, but a musty odor or related health problems will indicate a mold problem. In these instances, mold may be hidden on the backside of such materials as drywall, wallpaper, paneling, and carpet pads or inside wall cavities and ductwork. Investigation of such hidden mold problems is more complicated as actions such as peeling off wallpaper may disturb the mold and cause widespread dispersal of mold spores. Expert assistance may be required for such disruptive actions.

The most reliable way to identify a mold problem is through visual inspection. Because all molds should be treated similarly (safely removed, while addressing underlying moisture problems), there is no need to identify mold by type prior to remediation. However, bulk or surface sampling may be helpful in identifying specific mold contaminants in connection with a medical evaluation or in confirming the presence of mold if a visual inspection is unclear. Bulk sampling involves removing and collecting visible mold from surfaces, while surface sampling involves wiping a surface or stripping it with tape to collect specimens.

Airborne fungal testing is rarely appropriate but may be useful if, for example, building occupants are experiencing symptoms that seem to be mold-related, and a visual inspection and sampling have failed to locate mold. Airborne testing does not provide reliable data on the average mold content in a home—instead, it provides a “snapshot” of mold levels, which vary considerably over the course of hours, days, weeks, and months. Airborne fungal tests also are expensive and there currently are no standards for determining whether measured fungal concentrations are safe. Extensive airborne testing should be reserved for specialized cases, such as when health problems persist in a complex building environment with no discernable source of the problem. In such a setting, expert assistance should be engaged.

The New York City Department of Health & Mental Hygiene and the US EPA have developed separate but complementary guidelines for assessing and remediating mold in indoor environments. These guidelines contain detailed recommendations on the appropriate remediation activities for varying sizes and locations of mold contamination in various structures.

The NYC Guidelines contain five levels of mold remediation protocols. The most basic techniques apply to areas of 10 square feet or less, and include training workers on safe cleanup methods; protecting workers with disposable respirators, gloves, and goggles; vacating people from the work area; suppressing dust; removing and disposing of contaminated items that cannot be cleaned; and final cleaning of work areas and work area-egress locations. In addition to containing more protective measures such as containment for larger mold problems, the Guidelines also address remediation of HVAC systems.

EPA advises that if the moldy area is less than 10 square feet in total size, non-professionals can usually manage the cleanup by following some basic precautions and procedures. Larger jobs may require the services of a contractor who should have prior experience cleaning up mold.

When a manageable mold problem is identified in the home environment, the following are some basic steps that individuals, landlords, and homeowners can take to remove the mold:

  • Remediate the moisture source immediately. Mold cannot grow without water; therefore, controlling underlying moisture problems must be an integral part of removing mold.
  • Wear gloves, goggles, and appropriate respiratory protection during all mold remediation activities. Both EPA and New York City recommend the N-95 respirator available on the Internet and at most hardware stores for approximately $12-25.
  • Take photos of the moldy surfaces. These may be useful in the future should the need to document the problem arise.
  • Determine if it is possible to clean the moldy area or not. Non-porous and semi-porous materials (e.g. metals, glass, hard plastics, wood, and concrete) can generally be cleaned and reused. Porous materials (e.g. fabrics, ceiling tiles, insulation, wallboard) may be cleaned, but it is preferable that they be removed and thrown away, as it is extremely difficult to ensure complete removal of the mold.
  • Remove belongings from the clean-up area.
  • Clean the moldy area as soon as possible with either a detergent/soapy water solution or a baking soda and vinegar solution. Thoroughly dry the area and immediately dispose of all sponges or rags used in both the cleaning and drying process. Chemicals such as chlorine bleach are not recommended for routine mold cleanup.
  • When finished cleaning the visible mold area, clean all nearby surfaces and scrub or vacuum the floor.
  • Make sure the area is well ventilated until all surfaces are dry.
  • Regularly check the area for signs of recurring water damage and new mold growth. If the mold returns, it may indicate that the underlying water problem has not been appropriately addressed.

Sources and Additional Information:

Affordable Comfort – www.affordablecomfort.org

A Brief Guide to Mold, Moisture, and Your Home – www.epa.gov/iaq/molds/moldguide.html

Community Environmental Health Resource Center – www.cehrc.org

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Asthma, Allergies, and Respiratory Illness

Housing factors can play a significant role in respiratory health and greatly exacerbate or increase susceptibility to asthma, allergies, and other respiratory illnesses. For example, numerous home pollutants—dust mites, pet dander, cockroach debrismold, tobacco smoke, and paint fumes—are known to aggravate asthma. Controlling exposure to these and other triggers in the environment benefits overall respiratory health.Asthma is a chronic disease in which the airways of the lungs become inflamed or narrowed, resulting in disruptions to normal breathing patterns, often called “attacks” or “episodes.” The level of severity of asthma suffered by each individual, and further, the severity of each attack, varies greatly. Symptoms of asthma include wheezing, shortness of breath, a feeling of tightness in the chest, and coughing. According to the Environmental Protection Agency, 8.7 percent of all children (6.3 million) had asthma in 2001. The American Lung Association (ALA) states that asthma accounts for an estimated 3 million lost workdays for adults and 10.1 million lost school days in children annually, making it the leading cause of chronic illness among children. Additionally, ALA ranks asthma among the top ten conditions causing limitation of activity, and the disease costs the United States $16 billion annually.

Scientists do not know exactly what causes the development of asthma in individuals, nor is there a cure for asthma once it has developed. It is generally thought that some people are born with a genetic predisposition toward developing asthma, but environmental (and potentially societal) factors play a role in the actual development of the disease. It is this knowledge that allows scientists to determine ways in which asthma attacks can be prevented or limited. Generally, asthma attacks are “triggered” by something. In relation to the home environment, triggers can be grouped into two primary categories: allergens and irritants. Allergens are typically defined as something that causes an allergic reaction in some people, but not others. Indoor allergens include dust mitescockroach debris, pet dander, and mold. Irritants are substances that irritate the respiratory tract and include tobacco smoke and paint fumes.

Although many people who have asthma have respiratory allergies, not all do. Similarly, not all people who have respiratory allergies have asthma. Symptoms of respiratory allergies include sneezing; watery eyes; coughing; itchy eyes, nose, and throat; and wheezing. In addition to asthma attacks induced by allergens, respiratory allergic diseases include rhinitis (hay fever) and sinusitis. The same indoor allergens that may trigger asthma attacks in asthmatics can be responsible for respiratory allergies in others. The American Academy of Allergy, Asthma, and Immunology (AAAAI) reports that allergic diseases are the sixth leading cause of chronic disease in the United States. Less overwhelming than the statistics for asthma but nonetheless striking, allergies account for $4.5 billion in direct medical costs in the U.S. and 3.8 million lost work and school days per year, according to AAAAI.

Overall, the rates of individuals suffering from asthma and allergies are increasing. Of particular concern, however, is the disparity in the health risks to different populations. For example, data from the Centers for Disease Control and Prevention and the National Institutes of Health document that when compared to whites, African-Americans have higher rates of asthma, higher numbers of emergency room visits and hospitalizations from the disease, and three to four times the number of asthma deaths. Particular attention and concern is also being directed to the disproportional increases in childhood asthma rates (pre-school aged especially), and further, among children in inner city, minority populations.

Housing conditions can play a key role in delaying or preventing the development of asthma and preventing or limiting the occurrence of asthma attacks and allergic reactions. For more information on the housing hazards most often associated with respiratory health and how to control them, see Health Hazards and Ensuring Quality Housing Conditions.

Sources and Additional Information:

American Academy of Allergy, Asthma, and Immunology – www.aaaai.org

American Lung Association – www.lungusa.org

Asthma and Allergy Foundation of America – www.aafa.org

Asthma Moms – www.asthmamoms.org

Centers for Disease Control and Prevention – National Asthma Control Program – www.cdc.gov/asthma/default.htm

Environmental Protection Agency, Indoor Air Quality, Asthma and Indoor Environments – www.epa.gov/iaq/asthma/

National Institute of Environmental Health Sciences – Factsheet: Asthma and its Environmental Triggers – www.niehs.nih.gov/oc/factsheets/asthma.htm

Healthy People 2010 – www.healthypeople.gov

SleepWorkPlaytm – A Resource of the Allergy and Asthma Foundation of America – www.sleepworkplay.com

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Cockroaches

Cockroaches in the home environment are a health hazard not only because of the risks posed by cockroach antigens to asthma sufferers, but also because they can carry disease-causing germs and because some of the methods traditionally used to eliminate them cause additional health hazards.Any home can have cockroaches. However, there are steps you can take to prevent cockroaches from becoming a problem in your home; identify the extent of and solutions to any potential cockroach problem; and reduce or eliminate cockroach problems.

Prevention

General maintenance and cleaning are important because they remove the food, water, and shelter on which cockroaches depend. There are many steps tenants, landlords, and homeowners can take individually and jointly to prevent cockroach infestation of the home environment.

  • Wipe off counters, tables, and stovetops after all meals, snacks, and food preparations.
  • Keep food confined to specific areas of the house and clean any spills immediately.
  • Keep all food and garbage in tightly sealed containers.
  • Do not leave dirty dishes in the sink, on the counter, or in the dishwasher overnight.
  • Remove all piles of boxes, cardboard, newspapers, etc. from both inside and around the home.
  • Fix leaky pipes, faucets, toilets, and other plumbing problems.
  • Use a bathroom fan that vents to the outside after all baths and showers to reduce humidity.
  • Caulk all cracks and crevices throughout the home around systems such as plumbing, electrical, and gas lines, as well as in places like cupboards and walls.

Identification

Generally, determining whether a home has a cockroach problem and the extent of the infestation involves the use of glue traps, which can be purchased at most hardware or grocery stores. The traps are laid out in target areas, where they are left for at least one night. Upon either filling the trap with cockroaches or waiting a predetermined length of time, the number of cockroaches caught on the glue trap is counted to provide an estimate of the extent of the cockroach problem in the home environment. More detailed guidelines on deciding to test for cockroaches and the actual testing itself are available at www.cehrc.org.

If an apartment building is to be sampled, it is best to test more than one unit. If only one unit is tested, the landlord may claim that only that unit is infested and put the blame for the problem solely on that tenant. Most housing codes put responsibility for cockroach control on the landlord if two or more units are infested.

Elimination

The ultimate goal is to keep cockroaches out of a home and when necessary, to eliminate those that are there, while keeping residents safe. Reaching this goal can be difficult, especially in multi-unit housing that is heavily infested. For most apartment buildings, the landlord must take a building-wide approach to controlling cockroaches. Normally, it will take a coordinated effort from the landlords and tenants to eliminate cockroaches. Getting their support takes compelling evidence, such as a trap full of cockroaches coupled with a count of the number of cockroaches.

The initial actions residents and landlords can take are regular cleaning and maintenance to remove the food, water, and shelter for the cockroaches. Not only will this help to prevent a cockroach problem in the first place, it is also crucial to controlling an existing infestation and maintaining a cockroach-free environment.

If a cockroach problem requires remedial action, there are numerous paths of control and products available. Once a cockroach problem has been identified, the landlord or homeowner should call an integrated pest management (IPM) professional to conduct a formal inspection. Care should be taken to avoid residential exposure to pesticides, as these chemicals can be a carcinogenic health hazard in the home. Many pesticides can also trigger asthma attacks and cause developmental disabilities.

Pesticide sprays and fogs should not be used to control the problem. Not only will sprays and fogs leave a residue that is hazardous to human health, they also must be applied periodically and are not effective against cockroaches. Baits and boric acid are safer, more preferable forms of treatment that limit the level of human exposure to pesticides. IPM practices to control cockroaches are a healthier way to eliminate the problem than spraying pesticides in your home.

IPM

  • IPM is effective, economical, and environmentally sensitive.
  • IPM uses a combination of common-sense practices, information on the life cycles of roaches and their interaction with the environment, and available pest control methods.
  • IPM presents the least possible hazard to people, property, and the environment.

Sources and Additional Information:

American Lung Association’s Health House – www.healthhouse.org/tipsheets/TS_cockroaches.pdf

Beyond Pesticides – Integrated pest management to control cockroaches – www.beyondpesticides.org/alternatives/factsheets/COCKROACH%20CONTROL.pdf and www.beyondpesticides.org/infoservices/pesticidesandyou/Winter%2001-02/Good%20Riddance%20to%20Roaches.pdf

Canada Mortgage and Housing Corp. – Farewell to Cockroaches Guide – www.cmhc-schl.gc.ca/en/co/maho/gemare/faco/index.cfm

Community Environmental Health Resource Center (CEHRC) – www.cehrc.org

Environmental Health Watch – Cockroach Control Guide – www.ehw.org/Asthma/ASTH_Cockroach_Control.htm

Gumm, Brian, Home Energy, “Integrated Pest Management in the Home,” Vol. 21 Iss. 6 pp. 36-39 (Nov-Dec 2004)

US Centers for Disease Control and Prevention – www.cdc.gov/asthma/children.htm

US EPA – Asthma Triggers – Cockroaches – www.epa.gov/iaq/asthma/pests.html

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Arsenic-Treated Wood

Arsenic-treated wood is the result of a chemical process in which wood is treated with a pesticide/preservative called chromated copper arsenate (CCA) to prevent rotting in lumber designed for outdoor use. CCA contains arsenic, chromium, and copper and was widely used for residential purposes in the United States from the 1970s until EPA phased it out in 2003.

CCA-treated wood can be hazardous to human health because arsenic is classified as a known carcinogen. Exposure to arsenic can cause cancer of the lung, bladder, skin, kidney, prostate, and nasal passage. Data released in November 2003 by the US Environmental Protection Agency (EPA) show that 90 percent of children repeatedly exposed to arsenic-treated wood face a greater than one-in-one million risk of cancer. (One-in-one million is the EPA’s historic threshold of concern about the carcinogenic effects of toxic chemicals.) Arsenic exposure can also lead to nerve damage, dizziness, and numbness. Arsenic has been linked to immune diseases, cardiovascular disease, diabetes, and changes in hormone function. Lung and bladder cancer are the two health effects most often related to exposure to CCA-treated wood. For information on other cancer risks in the home environment, please see Cancer Risks.

CCA-treated wood can be found virtually anywhere outdoor lumber is being utilized. Due to the increased risk to children, the uses currently receiving the most attention are play sets, decks, and picnic tables. Arsenic can leach to the surface of the treated wood, becoming accessible for absorption through exposed hands and skin touching the wood surface and, especially in the case of children, ingestion through normal hand-to-mouth behavior. The arsenic can also leach into the ground surrounding the location of the treated wood, providing yet another exposure pathway for children playing in the area.

Government and public attention to the issue of health hazards from CCA-treated wood, both national and international, has been growing steadily over the past few years. In March 2003, EPA finalized a voluntary agreement with preservative manufacturers to ban the production of CCA-treated wood for most residential uses as of December 31, 2003. However, the ban does not prohibit the sale of CCA-treated wood produced prior to December 31, 2003, nor does the measure address existing structures. With regard to retail sales, a warning label must be displayed in locations where CCA-treated wood is sold. The EPA has also removed chromated copper arsenate from its list of approved chemical pesticides.

The Consumer Product Safety Commission (CPSC) is also involved in the regulation of arsenic-treated wood. The CPSC has officially stated that there is an increased lifetime risk of developing lung or bladder cancer from exposure to arsenic for the individual who plays on CCA-treated wood play sets during early childhood. However, in November 2003, CPSC declined to ban the use of CCA-treated wood in playground equipment, citing the EPA-industry voluntary agreement to phase out the manufacture of CCA-treated wood.

In research that is still underway, the EPA and CPSC are studying whether wood sealants could effectively prevent arsenic from leaching out CCA-treated wood.

Informed individuals need not wait for government action on CCA application. Alternatives do exist to using arsenic-treated wood in new construction, and there are recommendations to reduce exposure from existing structures.

  • When purchasing new materials, some of the available alternatives include wood treated with non-arsenic preservatives; wood that does not require pressure-treatment; and non-wood alternatives such as metal, cement, and plastic. The pros and cons for such alternatives (other potentially hazardous chemical treatments, sustainable harvesting, durability, etc.) should be examined prior to making a purchasing decision.
    • A company called Timber Treatment Technologies announced in April 2006 that a new wood treatment process will replace CCA and other pesticide wood treatments in wood used for decks, porches, fences, and other outdoor home-related structures. The new treatment process, called TimberSil, uses a sodium silicate solution, which is infused into the wood. The solution, which is essentially a type of liquid glass, and the wood are heated, rendering the solution water insoluble. This creates a barrier and makes the wood inedible to insects, microbes, and molds.
  • When dealing with existing structures that cannot be replaced, general recommendations include applying a sealant to the wood at least once a year; washing hands after coming into contact with arsenic-treated wood, particularly before eating; avoiding toy storage under arsenic-treated decks; keeping children and pets away from dirt beneath and surrounding arsenic-treated materials, as rains can transfer leached arsenic to these locations; and not eating at an arsenic-treated picnic table.

Sources and Additional Information:

BANCCA.ORG – The premier online health resource for consumers of CCA Pressure Treated Wood – www.bancca.org

Beyond Pesticides – www.beyondpesticides.org

Children’s Health Environmental Coalition – www.checnet.org/healthehouse/chemicals/chemicals-detail.asp?Main_ID=250

Environmental Working Group – www.ewg.org/issues/arsenic/index.php

Healthy Building Network – www.healthybuilding.net/arsenic/index.html

Safe Playgrounds Project – Center for Environmental Health – www.safe2play.org/

U.S. Agency for Toxic Substances and Disease Registry – ToxFAQ for Arsenic – www.atsdr.cdc.gov/tfacts2.html

U.S. Consumer Product Safety Commission – CCA Fact Sheet and Chairman’s Statement – www.cpsc.gov/phth/ccafact.html and www.cpsc.gov/phth/ccastatement.html

U.S. Environmental Protection Agency – CCA Fact Sheet – www.epa.gov/oppad001/reregistration/cca/

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Lead Poisoning

Exposure to lead in housing poses a significant health risk to young children. Lead is a heavy metal used in many materials and products. When absorbed into the body, it is highly toxic to many organs and systems and seriously hinders the body’s neurological development. Lead is most harmful to children under age six because it is easily absorbed into their growing bodies and interferes with the developing brain and other organs and systems. Pregnant women and women of child-bearing age are also at increased risk, because lead ingested by the mother can cross the placenta and affect the unborn fetus.

Lead poisoning causes irreversible health effects and there is no cure for lead poisoning. At very low levels of exposure in children, lead causes reduced IQ and attention span, hyperactivity, impaired growth, reading and learning disabilities, hearing loss, insomnia, and a range of other health, intellectual, and behavioral problems. At low levels, lead poisoning may not present identifiable symptoms, and a blood test is the only way to know if a child is poisoned. At very high levels of exposure, which are now very rare in the U.S., lead poisoning can cause mental retardation, coma, convulsions, and even death.

As lead poisoning rates have declined nationally, the disparities of this disease have increased. In some communities, the rate of exposure is about five times the national average, which is estimated at 1.6 percent of children aged 1-5. In the U.S., children from poor families are more likely to be poisoned than those from higher income families. African-American children are also at increased risk, when compared with both Hispanic and white children.

National health experts agree that exposure to lead-contaminated dust from deteriorated lead-based paint in older homes is the primary pathway for lead exposure in young children. Lead dust settles quickly, is difficult to clean up, and is invisible to the naked eye. Young children usually are poisoned through normal hand-to-mouth activity, as lead dust settles on their toys and the floor. Children may also be seriously poisoned by eating lead-based paint chips, but this is relatively rare.

Soil in the vicinity of the home can also be contaminated by flaking exterior lead-based paint, previous deposits of leaded gasoline, and exterior sandblasting. In yards where soil is contaminated with lead, children can become exposed to harmful levels of the heavy metal when they get their hands dirty and place their fingers or a dirty or dusty toy in their mouths during normal play activity. Lead-contaminated soil and dust can also be tracked into homes on shoes or by pets or can be blown in through open windows and doors. Vegetables grown in lead-contaminated soil may absorb lead and poison children and adults.

Drinking water may become contaminated with lead from pipes or solder when water corrodes them. Less common sources include workplace exposures to lead where workers may receive doses well above those experienced by the general population. Exposed workers may carry lead particles home on their clothing, shoes, or hair, putting family members at risk. Those who work in construction, demolition, painting, with batteries, in radiator repair shops, lead factories, or with a hobby that involves lead are often exposed to lead. Rare sources of exposure include food and drink stored in leaded crystal, lead-soldered cans, or lead-glazed ceramicware; home remedies and cosmetics that are popular in some cultures; and some consumer products.

Except for severely poisoned children, there is no medical treatment for this disease. While drug therapy can reduce high levels of lead in the body, it does not undo the harm caused to developing organs and systems. A blood lead test is the only way to determine if a child has lead poisoning. The U.S. Centers for Disease Control and Prevention (CDC) defines a blood lead level of 10 µg/dl as a level of concern, indicating that steps should be taken to reduce ongoing lead exposure. Recent research has found adverse health effects, including learning disabilities, at much lower levels of exposure.

Most health department lead poisoning prevention programs postpone action to address lead-based paint hazards until after a child has been identified as lead poisoned. In effect, children are used to detect lead hazards in their homes. Over the past decade, emphasis has shifted to primary prevention to prevent and control lead hazards in housing before a child’s health is harmed.

Sources and Additional Information:

National Safety Council – nsc.org/library/facts/lead.htm

U.S. Centers for Disease Control and Prevention, Third National Report on Human Exposure to Environmental Chemicals (July 2005) – www.cdc.gov/exposurereport/metals/pdf/lead.pdf

U.S. Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control – www.hud.gov/offices/lead/

U.S. Environmental Protection Agency – www.epa.gov/lead/ 

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Lead

The major remaining cause of lead poisoning is lead-based paint in housing, especially housing built before 1950, when lead paint was commonly used. Most children with elevated lead levels are poisoned in their own homes by peeling lead-based paint and the lead dust it generates. The mere presence of lead-based paint in a home is not a hazard, as about 40 percent of all U.S. housing contains some leaded paint, and the vast majority of children live safely in these homes and apartments.

Housing age is an important predictor of risk, because the lead content of paint varied substantially over the past century. During the first half of the twentieth century, the lead content of paint was marketed as a measure of its quality—the more lead the better. Prior to about 1940, leaded paints typically contained high amounts of lead, ranging from 10 percent to as much as 50 percent. Lead was added to make paint durable, so lead paint was frequently used in high-traffic and high-moisture areas, including kitchens and bathrooms, exterior siding and trim, window and door trim, stairs, porches, etc. In the early 1950s, the paint industry began reducing lead content, although many paints still contained harmful amounts of lead. Federal regulations limited lead content in 1972 and effectively banned lead in residential paints in 1978.

Two situations account for the vast majority of poisoning in children. Most commonly, children are poisoned by lead dust from deteriorated paint in poorly maintained older housing. A lesser number of cases—though often more serious—are caused by repainting and remodeling projects that disrupt old painted surfaces without proper safeguards to control, contain, and clean up lead dust. In both scenarios, small amounts of lead dust can create substantial health risks. For example, imagine the amount of sugar in a 1-gram packet. The same amount of lead particles evenly spread over 100 rooms, each measuring 10 feet by 10 feet, would leave dust levels of 100 µg/ft2, an amount of lead that is more than twice the federal standard (40 µg/ft2) for a hazardous level of lead on floors.

Lead in soil can come from many sources, including exterior lead-based paint that is peeling or flaking, dust or paint chips resulting from repainting or renovation projects, deposition from emissions of vehicles that used leaded gasoline, and demolition of buildings with lead-based paint. The U.S. Geological Survey estimates the mean naturally occurring lead in soil concentration to be 16 parts per million (ppm). EPA defines a soil lead hazard as 400 parts per million (ppm) in play areas and a 1,200 ppm average for bare soil in the rest of the yard.

Drinking water may become contaminated with lead from pipes or solder leached out by corrosion. EPA estimates that drinking water accounts for 10 to 20 percent of human exposure to lead. Infants may be put at increased risk from lead in drinking water when contaminated tap water is used to make baby formula. EPA recommends that action be taken if more than 10 percent of tap water samples exceed the action level of 15 parts per billion.

Primary prevention of lead exposure, including testing for lead content in paint, soil, and water; housing maintenance; and remediation of existing hazards is key to protecting children’s health. Lead poisoning is a concrete expression of the affordable housing crisis, more prevalent among poor children, children of color, and those living in older housing. Responsible property management, the need for enforceable housing quality standards that are both practical and cost-effective, and increased resources are needed to protect high-risk communities and preserve the nation’s affordable housing stock.

Sources and Additional Information:

U.S. Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control – www.hud.gov/offices/lead/

Environmental Health Perspectives, The Prevalence of Lead-Based Paint Hazards in U.S. Housing – www.hud.gov/offices/lead/techstudies/LeadPaintHousingSurvey.pdf

U.S. Environmental Protection Agency – www.epa.gov/lead & www.epa.gov/safewater/lead/index.html

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Carbon Monoxide Poisoning

You cannot see, smell, or taste carbon monoxide, which is a poisonous gas. When carbon monoxide (CO) enters the bloodstream, it reduces the amount of oxygen received by the body’s organs and tissues. Unborn babies, children, the elderly, and people with respiratory problems or heart disease are especially sensitive to carbon monoxide. Even at low levels, carbon monoxide causes serious health problems, and the longer the exposure, the more damage that occurs.
Low levels of carbon monoxide can cause flu-like symptoms, headaches, dizziness, and make it difficult to think clearly. Often a family may not realize that their illnesses are related to chronic exposure to carbon monoxide in the home.

At higher levels of exposure, carbon monoxide is related to visual impairment, reduced work capacity, poor learning ability, and difficulty in performing complex tasks. At very high levels, carbon monoxide can also kill. Each year, more than 200 Americans accidentally die from carbon monoxide poisoning in the home, unrelated to fires and engine exhaust (other sources of carbon monoxide poisoning). Seventy-six percent of these deaths are from carbon monoxide released from heating systems. Another eight percent are from gas water heaters. Many victims of carbon monoxide poisoning die in their sleep. An additional 10,200 people visit the emergency room due to accidental carbon monoxide poisoning from consumer products.

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Rodents

Exposure to rodents (mice and rats) has been linked to increased asthma symptoms among laboratory workers who handle rodents and are sensitized to them. Other studies have established links between rodent allergies and asthmatic symptoms in lab workers. Research published in 2004 found similar linkages in residential settings. Rodent allergens are likely from rodent urine, saliva, or skin.

It is clear that many inner-city residents are exposed to and allergic to rodents. A major study on asthma among inner-city children found that nearly 20 percent of asthmatic children had been sensitized to rats and 15 percent were sensitized to mice. This is important to note, as research has found mouse allergen in 82 percent of US homes.

Rodents can also expose humans to diseases such as hantavirus. Exposure to such disease vectors is rare but can cause severe health problems.

Integrated pest management (IPM) approaches offer effective means of eliminating rodents from the home. IPM methods focus on preventing infestations, trapping rodents, and limited use of lower-toxicity pesticides. However, even after a rodent population is controlled, rodent hair, urine, and fecal allergens may remain and can trigger allergic reactions in some people.

Sources and Additional Information:

Asthma and Allergy Foundation of American – www.aafa.org

Asthma Regional Council – www.asthmaregionalcouncil.org

Beyond Pesticides – Integrated pest management to control mice –www.beyondpesticides.org/alternatives/factsheets/MOUSE%20CONTROL.pdf and www.beyondpesticides.org/infoservices/pesticidesandyou/Winter%2000-01/Minimizing%20Mouse%20Madness.pdf

Cohn R PhD, Arbes S, Jr. PhD, Yin M PhD, Jaramillo R MStat, and Zeldin D MD. Journal of Allergy and Clinical Immunology, National prevalence and exposure risk for mouse allergen in US households, June 2004 – http://dx.doi.org/10.1016/j.jaci.2003.12.592 (Abstract only)

Kattan M, H. Mitchell, P. Eggleston, P. Gergen, E. Crain, S. Redline, K. Weiss, R. Evans III, R. Kaslow, C. Kercsmar, F. Leickly, F. Malveaux, H.J., Wedner, Pediatr. Pulmonol, Characteristics of Inner-City Children with Asthma: The National Cooperative Inner-City Asthma Sutdy, 24:253-262, 1997

National Academy of Science, Institute of Medicine report Clearing the Air: Asthma and Indoor Air Exposures 2000 – http://books.nap.edu/books/0309064961/html/index.html

US Centers for Disease Control and Prevention – www.cdc.gov (Search under rodents)

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Pesticides

Pesticides are substances designed to kill, repel, or mitigate pests. They include a number of chemical and biological agents commonly used in and around the home to control a broad range of pests: insecticides (for insects, including cockroaches, ants, and termites), rodenticides (for mice and rats), fungicides (for mold and fungi), herbicides (for plants), and antimicrobials (for bacteria and viruses).

Use and Exposure

Approximately 4.4 billion pesticide applications are made each year to American homes, gardens, and yards. According to surveys by the Environmental Protection Agency (EPA), more than three-quarters of U.S. households use pesticides, with 66 percent treating major living areas in the home one or more times per year. Cockroaches and ants are the most common targets. More than one-third of households used insecticides in the absence of a major insect problem.

Children may be exposed to pesticides in food, water, and their environments. However, pesticide use in the home, lawn, and garden is responsible for most children’s exposures. Children may come into contact with pesticides that have been applied in the home, or they may gain access to pesticides that have not been stored safely. They also can be exposed to pesticides applied outdoors or to pets. Pesticides used outdoors can contaminate the home when pesticide-laden dust is tracked inside on shoes and pets. The number and concentrations of pesticides found in household dust exceed those found in food, soil, or air. To make matters worse, pesticide contamination in the home can persist for years, particularly in carpets, due to the lack of sun, rain, and other factors that help to break down pesticides outdoors.

Health Impacts

Pesticides can cause a wide range of health problems, ranging from acute and persistent injury to the nervous system, injury to reproductive systems, birth defects, and cancer. Of the 28 pesticides estimated by EPA to be most widely used in agriculture, in and around U.S. homes, and by commercial pesticide applicators, more than 40 percent are classified by EPA as likely, probable, or possible carcinogens, according to a review by the Northwest Coalition for Alternatives to Pesticides (NCAP). Use of these pesticides totals 350 million pounds per year. An EPA database summarizing studies of 19 of these commonly used pesticides indicates that 18 of the 19 have caused reproductive problems in laboratory tests. Immediate health impacts can include dizziness; vomiting; headaches; sweating; skin, eye, and respiratory tract irritation; and fatigue. The health effects from exposure to pesticides vary depending upon the level and duration of exposure. As with most environmental toxins, children are at greater risk from exposure than adults.

Regulation

EPA regulates pesticides used for residential purposes under the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA). Under FIFRA, EPA can register the use of pesticides or ban or limit their use if they are found to cause unreasonable risks to human health and the environment. The Food Quality Protection Act (FQPA) establishes a higher standard for pesticides used on food: tolerance levels (the maximum amount of pesticide residue permissible on food) must be safe, taking into account exposures from dietary and other sources, as well as the special vulnerability of children to pesticide exposures. While many pesticides are registered for agricultural use, some are registered only for other uses, such as controlling pests in the home.

Subject to some limited exemptions, a pesticide cannot be used legally in the US unless it has been registered with EPA. Since FIFRA was amended in 1988, EPA has been reviewing the health and environmental effects of pesticides registered prior to 1984 to ensure that they meet current, more stringent standards. The 1996 FQPA also requires EPA to review food tolerance levels to ensure their safety and to review pesticide registrations every 15 years.

These review processes have led to bans and use restrictions on some pesticides widely used in the home. For example, chlorpyrifos (marketed by Dow as Dursban) was the most commonly used insecticide in homes, gardens, schools, hospitals, and day care centers for control of cockroaches, ants, fleas, spiders, and ticks. In addition to acute poisonings, chlorpyrifos was found to cause chronic headaches, blurred vision, fatigue, memory loss, depression, irritability, and low birth weights among infants. EPA banned all residential uses in 2004.

In addition to risks presented by older pesticides, some recently registered pesticides may pose health or environmental hazards. According to NCAP, a survey of 19 pesticides registered since 1997 found that nearly all of them posed hazards, including increased risk of cancer, genetic damage, birth defects, and other serious health problems. Some “inert” ingredients cleared for use by EPA also may be harmful.

States also regulate the use of pesticides. States may register pesticides, restrict their use, and establish certification requirements for pesticide applicators. They also may require notification prior to pesticide use and/or posting of areas where pesticides are applied.

Controlling Pests Safely

Pesticides do not offer a long-term, complete solution to pest problems; they kill pests, but typically need to be re-applied periodically. In order to more effectively eliminate pests, it is necessary to identify the factors that are allowing the pests to thrive and alter them. This typically involves eliminating food and water sources and preventing pests from entering the home. This process is known as integrated pest management, or IPM.

Sources and Additional Information:

Asthma, Children, and Pesticides brochure [PDF] – www.beyondpesticides.org/children/asthma/asthma%20brochure%20high%20res.pdf

Beyond Pesticides – www.beyondpesticides.org

Cox, C., Journal of Pesticide Reform, “EPA Takes Action on Diazinon: Too Little, Too Late” (Winter 2000) – www.pesticide.org/diazinonNEWS.pdf

Cox, C., Journal of Pesticide Reform, “Ten Reasons Not to Use Pesticides” (Winter 2001) – www.pesticide.org/TenReasons.pdf

Environmental Health Watch, Pests and Asthma Resources (includes IPM information) – www.ehw.org/Asthma/ASTH_home1.htm#Pests

Gumm, Brian, Home Energy, “Integrated Pest Management in the Home,” Vol. 21 Iss. 6 pp. 36-39 (Nov-Dec 2004)

Natural Resources Defense Council – www.nrdc.org

Northwest Coalition for Alternatives to Pesticides – www.pesticide.org

Northwest Coalition for Alternatives to Pesticides, Journal of Pesticide Reform, “Does Government Registration Mean Pesticides are Safe?” (Summer 1999) – www.pesticide.org/BasicRegistration.pdf

Our Stolen Future – www.ourstolenfuture.org

Pesticide Action Network – www.pesticideinfo.org

Safer Pest Control Project – http://spcpweb.org/

Silent Spring Institute – www.silentspring.org

U.S. Environmental Protection Agency, Pesticides Program – www.epa.gov/pesticides/index.htm

Zahm, S.H., and Ward, M.H., Environmental Health Perspectives, “Pesticides and Childhood Cancer,” Vol. 106 Suppl. 3, pp. 893-908 (June 1998) – http://ehp.niehs.nih.gov/members/1998/Suppl-3/893-908zahm/zahm-full.html

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Mold

Molds are simple, microscopic organisms that can grow virtually anywhere, both in homes and outdoors. Along with mushrooms, yeasts, and mildew, molds are classified as fungi. Molds typically consist of a network of threadlike filaments that infiltrate the surface on which the mold is growing. Molds reproduce by releasing spores, which are lightweight and small enough to travel through the air. Spores can resist dry, adverse environmental conditions, allowing them to outlive the mold that produced them.Molds play an important ecological role in breaking down dead organic matter and returning nutrients to the environment. They require moisture and food to grow, and they typically thrive in warm, moist environments. Moisture is the key factor determining mold growth in the home, influencing both the types of mold present and the extent of mold colonization. A variety of materials found in the home, including insulation, wallpaper, glues used to affix carpet, backing paper on drywall, dust, and dirt, can serve as a food source for mold. Mold colonies can go dormant under adverse conditions and revive when favorable conditions return.

Mold growth often appears as green, gray, black, brown, or other discoloration. Eventually, mold growth results in the breakdown of the substrate. More than 1,000 types of molds have been found in US homes.

Exposure and Health Impacts

People are exposed to mold on a daily basis. Most exposures in the home occur when occupants inhale spores or mold fragments, which are components of household dust. They also may be exposed when their skin comes into contact with mold-contaminated materials.

Most people are unaffected by exposure to moderate amounts of mold. However, mold exposure can cause allergic reactions in some people. Approximately 6-10 percent of the general population, and 15-50 percent of persons who are genetically prone to develop allergies (atopic individuals), are allergic to mold, according to the National Academy of Sciences. The most common symptoms include runny nose, eye irritation, coughing, congestion, and exacerbation of asthma in persons who have the disease. At this point, it is unclear whether mold can cause individuals to become asthmatic. For more information on asthma and allergies, see Asthma, Allergies, and Respiratory Illnesses.

Some types of mold produce toxic substances known as mycotoxins, which can cause health problems when they are inhaled, absorbed through the skin, or ingested. One mold species may produce a number of different mycotoxins; conversely, one mycotoxin may be produced by several different types of mold. Mycotoxin production varies depending on environmental conditions such as moisture level, temperature, and substrate content. As a general matter, toxin-producing molds have higher water requirements than most household molds, so they thrive indoors only under wet conditions.

Although the health impacts of exposure to mycotoxins in the home are not well studied, adverse health effects have been observed in occupational settings and in animal studies. Of course, health impacts vary depending on the mycotoxin at issue and the nature of the exposure. Skin rashes, fatigue, dizziness, flu-like symptoms, nausea, respiratory and eye irritation, immuno-suppression, birth defects, lung inflammation, and cancer have been associated with exposure to mycotoxins. Persons exposed to high levels of mold toxins, e.g., mold remediation workers or farm workers, may be at risk for organic toxic dust syndrome (OTDS) or hypersensitivity pneumonitis (HP). ODTS may occur after a single, heavy exposure to mycotoxins, and usually carries with it fever, respiratory, and flu-like symptoms. HP is an immunological disease caused by repeated, high-level exposures to the same agent, and can result in permanent lung damage.

Mold exposure also may lead to infections such as fungal pneumonia in persons with compromised immune systems.

Mold Assessment

The most reliable way to identify a mold problem is through visual inspection. According to experts with the Building Science Corporation, “If you see mold or you smell mold, you have mold.” Since mold requires water in order to grow, looking for water or moisture problems is usually the best way to locate mold. This may require looking behind walls or ceilings, under furniture, in crawlspaces and basements, or behind cabinets and toilets. While assessing mold contamination, workers should wear gloves and eye protection and a respirator. They also should take steps to ensure that large amounts of mold are not released into the home from concealed areas, by misting moldy surfaces before disturbing them or using a HEPA vacuum attachment when cutting mold-contaminated surfaces, for example.

Prevention and Control

Although health-based standards for mold currently do not exist, it is generally accepted that no one should live or work in an indoor environment beset by extensive mold growth. Since mold requires moisture to grow, mold problems can be prevented by solving moisture problems quickly and effectively. Moisture in the home may be caused by poor ventilation, excess condensation (due to humidifiers or unvented clothes dryers, for example), water leaks, or floods. In the case of a flood or leak, mold growth can be prevented if water-damaged materials are dried and cleaned and/or removed within 24-48 hours. Additional preventative measures include regularly checking plumbing and promptly repairing leaks; maintaining relative humidity below 60 percent; venting clothes dryers; and installing exhaust fans in kitchens and bathrooms vented to the outside. For more information on addressing moisture problems in the home, see How to Control Moisture.

If mold is obviously present, the first step in controlling the problem is to assess the extent of the contamination. The Environmental Protection Agency (EPA) has developed mold remediation guidelines for schools and commercial buildings, and the New York City Department of Health (NYC) has created assessment and remediation guidelines for fungi in indoor environments. Both of these guidelines recommend remedial measures and precautions calibrated to the amount of mold present.

As a general matter, the goal of mold remediation is to remove or clean contaminated materials in a manner that prevents mold and contaminated dust from escaping the work area, while protecting the workers performing the remediation. The underlying water or moisture problems must be addressed prior to or during remediation; otherwise, mold growth will recur.

Regulation

Despite the flurry of activity around the country to pass laws relating to mold, legislation on the problem remains in the nascent stages. Currently, there are no health-based standards for mold exposure. The EPA and NYC guidelines set forth recommendations for safe assessment and remediation of mold contamination, but they are not legally binding. The laws being considered, and in some cases adopted, address a few common themes. Some laws seek to establish committees or task forces to study the issues surrounding mold. Other laws have sought to implement licensing schemes for mold inspectors and/or remediators. Some laws under consideration have addressed insurance issues, while others have sought to require disclosure of mold during sale or lease transactions. In some cases, legislatures have focused on indoor air quality issues in schools and public buildings.

Several states also have considered adopting more comprehensive mold legislation, modeled in some cases on California’s Toxic Mold Protection Act, which requires the state’s Department of Health Services (DHS) to convene a task force to consider the feasibility of adopting exposure limits to mold in indoor environments (and to adopt standards if feasible). The Act also directs DHS to adopt practical standards to assess the health threat posed by mold, develop remediation guidelines, and assess the need for standards covering mold assessment and remediation professionals. Landlords are required to provide written disclosure of known mold contamination to tenants prior to entering into a lease and to provide a DHS brochure on mold. However, these requirements do not become effective until after the standards are adopted and DHS creates a brochure. City attorneys, as well as code enforcement and public health officials, are authorized to enforce the Act, which has gone largely unimplemented due to lack of funding. In New York State, two bills have been introduced that mirror the California Act.

See Action Agenda for more information about legislation and regulations.

Sources and Additional Information:

Affordable Comfort – www.affordablecomfort.org

Building Science Corporation – www.buildingscience.com/

Canada Mortgage and Housing Corporation – www.cmhc-schl.gc.ca

Environmental Health Watch, Moisture Audit of Residential Structures – www.ehw.org/Healthy_House/HH_Moist_Audit.htm

Environmental Protection Agency, Mold Remediation in Schools and Commercial Buildings – www.epa.gov/iaq/molds/images/moldremediation.pdf

T. Platts-Mills, J. Vaughan, M. Carter, and J. Woodfolk, Journal of Allergy and Clinical Immunology, “The Role of Intervention in Established Allergy: Avoidance of Indoor Allergens in the Treatment of Chronic Allergic Diseases,” pp. 787-804 (November 2000).

US Dept. of Housing and Urban Development, Healthy Homes Issues: Mold, External Review Draft, Version 2, October 2, 2001 – www.hud.gov/offices/lead/hhi/Mold_v2_12-01.pdf

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Dust Mites

Dust mites are microscopic creatures that belong to the same class (Arachnida) as spiders and ticks (they have eight legs, not six like insects). They feed primarily on dead skin cells regularly shed by humans and animals. Dust mites thrive in places where their primary food source is most likely to be found: on mattresses, pillows, bedcovers, carpets, upholstered furniture, stuffed toys, clothes, or other fabric items in the home.Unlike insects such as cockroaches, mites are not capable of ingesting water; in order to obtain water, they must absorb it from the air. For this reason, they thrive in humid environments, ranging from 55% to 75% relative humidity. Ideal temperatures for dust mites are between 68º and 77º F. The growth of dust mites can vary on a seasonal basis, or from room to room within a house, depending largely on variations in relative humidity, availability of food sources, and temperature. Mites take about one month to develop from an egg into an adult and have an adult life span of about two to four months. A single adult female may lay up to 100 eggs.

Mite waste products contain an allergen (a substance that causes an allergic immune reaction) that, according to the Asthma and Allergy Foundation of America, adversely affects about 20 million Americans. Sensitive individuals become exposed to this allergen when they inhale household dust, which contains dust mites and their waste products. Exposure to dust mites can trigger an attack in an asthmatic who is sensitive to the dust mite allergen. (Other asthmatics may not be affected by dust mites.) For persons allergic to dust mite allergen, exposure can cause allergic rhinitis (hay fever), which is characterized by nasal congestion, itching, and sneezing. In addition, exposure to dust mites may cause children who are predisposed to develop asthma to do so. (This predisposition is not fully understood, but appears to depend upon a combination of hereditary and environmental factors.) For more information on asthma and allergies, see Asthma, Allergies, and Respiratory Illnesses.

A combination of measures is often most effective in reducing exposure to dust mite allergens. Because dust mites thrive in the bedroom, this is a good place to begin interventions. One important strategy for controlling dust mites includes reducing moisture and maintaining a low relative humidity in the home, although it may not be feasible to completely eliminate dust mites from homes in moderately humid climates. In addition to killing dust mites, steps should be taken to reduce exposure to dust mite waste products. Weekly hot-water (minimum 130ºF) laundering of bedding (including sheets, bedcovers, and blankets) will kill dust mites and reduce allergen levels. Covering pillows and mattresses with allergen-impermeable covers will contain dust mites and their waste products and reduce exposure to dust mite allergen. Additional measures include washing stuffed toys and vacuuming and steam cleaning carpets.

Sources and Additional Information:

Asthma and Allergy Foundation of America – www.aafa.org

T. Platts-Mills, J. Vaughan, M. Carter, and J. Woodfolk, Journal of Allergy and Clinical Immunology, “The Role of Intervention in Established Allergy: Avoidance of Indoor Allergens in the Treatment of Chronic Allergic Diseases,” pp. 787-804 (November 2000).

University of Nebraska Cooperative Extension In Lancaster County, “House Dust Mites,” – http://lancaster.unl.edu/enviro/pest/resources/DustMites311.shtml

P. Vojta, S. Randels, J. Stout, M. Muilenbert, H. Burge, H. Lynn, H. Mitchell, G. O’Connor, and D. Zeldin, Environmental Health Perspectives, “Effects of Physical Interventions on House Dust Mite Allergen Levels in Carpet, Bed, and Upholstery Dust in Low-Income, Urban Homes,” 815-819 (August 2001) – http://ehp.niehs.nih.gov/docs/2001/109p815-819vojta/abstract.html

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Essential Maintenance Practices

The concept of “essential maintenance practices” (EMPs) was developed to deal with lead-based paint in older housing in recognition that “an ounce of prevention is worth a pound of cure.” While some homes need dedicated “lead abatement projects” by certified contractors, in most cases, hazards can be avoided in the first place through good maintenance and common sense safeguards. Some EMPs are specific to lead safety, such as avoiding paint removal practices that generate and spread dangerous lead dust. Others address conditions that can cause multiple problems. For example, water leaks, water damage, and excessive moisture can encourage the growth of mold, mildew, and pests, which can cause asthma and other health problems, in addition to causing paint to deteriorate. Periodic visual inspections can identify clues to and causes of water leaks and moisture problems so that low-cost repairs “nip problems in the bud.” The concept of “enlightened maintenance practices” is at the foundation of healthy homes. The EPA/HUD five-hour training course in lead-safe work practices (LSWP) offers a model for conveying practical information to existing trades and can benefit all those whose work encounters painted surfaces in older housing.

Essential Maintenance Practices to Reduce Lead Hazards

In 1995, a broad-based national task force chartered by Congress reached almost unanimous consensus on recommendations for controlling lead-based paint hazards in private housing. As part of its comprehensive recommendations, Putting the Pieces Together: Controlling Lead Hazards in the Nation’s Housing (July 1995), the Task Force on Lead-Based Paint Hazard Reduction and Financing called for six Essential Maintenance Practices by owners of pre-1978 rental properties that may contain lead-based paint. These Essential Maintenance Practices are relatively inexpensive initial steps property owners need to take to reduce the chances that hazards will develop, avoid the inadvertent creation of hazards, and provide an early warning system to alert owners to deteriorating paint.

It is important to understand that Essential Maintenance Practices are a “floor,” not a “ceiling,” as these practices were not designed to control lead hazards in units that are judged to be higher-risk based on their age or condition (e.g., construction before 1950, extensive deteriorated paint, deferred maintenance, etc.).

Essential Maintenance Practices for Property Owners

1. Use safe work practices during work that disturbs paint that may contain lead to avoid creating lead-based paint hazards. Do not use unsafe paint removal practices, including:

  • Open flame burning;
  • Power sanding or sandblasting (unless a special vacuum attachment is used to contain dust);
  • Water blasting; and
  • Dry scraping more than a de minimis surface area (for example, more than one square foot per room).

Use good work practices and take precautions to prevent the spread of lead dust (for example, limit access to the work area to workers only; cover the work area with six mil polyethylene plastic or equivalent; protect workers; protect occupants’ belongings by covering or removing them from the work area; wet painted surfaces before disturbing; and wet debris before sweeping).

Perform specialized cleaning of the work area upon completion of work using methods designed to remove lead-contaminated dust.

2. Perform visual examinations for deteriorating paint (unless the paint is found not to be LBP):

  • At unit turnover; and
  • Every 12 months (unless the tenant refuses entry).

3. Promptly and safely repair deteriorated paint and the cause of the deterioration. If more than a de minimis amount of paint (for example, more than one square foot per room) has deteriorated (unless the paint is found not to be LBP):

  • Follow Essential Maintenance Practice #1 (above) when repairing the surface.
  • Diagnose and correct any physical conditions causing the paint deterioration (for example, structural and moisture problems causing substrate failure or conditions causing painted surfaces to be crushed).
  • When there is extensive paint deterioration (for example, more than five square feet per room), the procedures for dust testing after Standard Treatments apply.

4. Provide generic LBP hazard information to tenants per Title X, including the EPA-developed educational pamphlet and any information available about LBP or LBP hazards specific to the unit.

5. Post written notice to tenants asking tenants to report deteriorating paint and informing them whom to contact. Promptly respond to tenants’ reports and correct deteriorating paint, with accelerated response in units occupied by a child under age six or a pregnant woman. In no case should owners take longer than 30 days to respond. Do not retaliate against tenants who report deteriorating paint.

6. Train maintenance staff. At a minimum, maintenance supervisors need to complete a training course based on the HUD/EPA operations and maintenance/interim control activities curriculum. The maintenance supervisor must ensure that workers either take the training course or have a clear understanding of LBP hazards, unsafe practices, occupant protection, and dust cleanup methods (by such means as on-the-job training and video instruction). The maintenance supervisor needs to provide adequate oversight of workers who have not taken the training course.

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Cockroaches

Cockroaches in homes are a health hazard to many children and families because of the risks cockroach antigens pose to asthma sufferers. Traditionally, cockroaches were controlled because they are offensive, leave behind an awful smell, and cause gastrointestinal and respiratory illness. However, research shows that cockroach debris (old shells, saliva, body parts, and droppings) triggers asthma attacks in people who are sensitized to cockroach antigen (proteins found in the debris). In homes where several allergens are present, including dust mites, mold, furry pets, tobacco smoke, and certain chemicals, children may experience severe and frequent asthma attacks from high airborne concentrations of these allergens.

Any home with food or moisture can have cockroaches. Kitchens and bathrooms typically have the highest number of cockroaches due to the presence of food products and moisture from plumbing fixtures. Apartment buildings often have the worst infestations. The goal is to keep cockroaches out of the home and to eliminate existing pests. Reaching this goal is not always easy, especially in multi-unit housing that is already infested. For most apartment buildings, the landlord must take a building-wide approach to controlling these pests. Moreover, a coordinated effort by the landlord and all tenants is required to eliminate cockroaches.

Integrated pest management techniques that control cockroaches through moisture control and other interventions can also help to minimize exposure to other environmental hazards, including lead and mold. Moisture from leaky roofs, plumbing fixtures, spills, damp areas in the kitchen and bathroom, and other sources should be minimized, along with access to food, accumulation of trash, and holes and cracks in the walls. Safe and effective pest management techniques must be utilized, as some chemicals used to treat pests are toxic, may exacerbate asthma symptoms, and are not successful at ridding homes of cockroaches.

Because children spend more time indoors, allergens found in homes and other buildings pose a significant health risk for asthma sufferers. With asthma rates growing at a startling rate, the hazard posed by the presence of any cockroaches must be addressed.

Sources and Additional Information:

Beyond Pesticides – Integrated pest management to control cockroaches – www.beyondpesticides.org/alternatives/factsheets/COCKROACH%20CONTROL.pdf and www.beyondpesticides.org/infoservices/pesticidesandyou/Winter%2001-02/Good%20Riddance%20to%20Roaches.pdf

Environmental Health Watch – www.ehw.org/Asthma/ASTH_Cockroach_Control.htm

National Institute of Environmental Health Sciences – www.niehs.nih.gov/airborne/prevent/roach.html

US Environmental Protection Agency – www.epa.gov/iaq/asthma/pests.html

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Asbestos

Asbestos is the general name used to describe several types of fibrous minerals. These minerals occur naturally and have been mined since the late 1800s for use in modern commercial industries. As asbestos fibers are strong, heat resistant, chemical resistant, and useful in providing heat insulation, their most common uses include addition to building products, insulation materials, and products intended for use in high friction areas (e.g. vehicle brake parts). Although there are six types of asbestos, the most common type found in buildings is chrysotile, also known as white asbestos. The US Environmental Protection Agency (EPA) estimates that approximately 90-95 percent of all asbestos contained in buildings throughout the United States is chrysotile.Asbestos is a known carcinogen, and inhalation of asbestos fibers is known to cause respiratory problems and lung diseases such as asbestosis, mesothelioma, and lung cancer. Asbestosis is a lung disease in which inhaled fibers become stuck in the lung tissue, eventually causing scarring. Mesothelioma is a cancer of the membranes lining the chest and lung cavity and/or the abdominal cavity. Lung cancer is cancer of the lung tissue itself. A combination of smoking and asbestos exposure is known to greatly increase an individual’s risk of lung cancer. All three of these diseases experience delayed development and the diseases may not manifest for 10-40 years after the initial asbestos exposure. Further, there is some indication that exposure to asbestos through inhalation and possibly ingestion may also be related to other cancers of the respiratory and gastrointestinal tracts. For information on other cancer risks in the home environment, please see Cancer Risks.

In the home environment, asbestos can be found in numerous locations. Some of the most common areas are floor and ceiling tiles, plasters, insulations, adhesives, wallboard, joint compound, roofing materials, fireproofing materials, and cement products. Asbestos materials in the piping that transports drinking water can also be another source of exposure. Asbestos that is intact, undisturbed, and in overall good condition does not necessarily pose a problem to human health. Deterioration and damage releases fibers into the air. Asbestos fibers can enter the home environment as a result of infiltration of airborne asbestos from mines or factories; improper renovation or demolition of a building containing asbestos; and dust brought home on the skin or clothing of individuals exposed at work.

The federal government recognizes asbestos as a health hazard and treats asbestos as a regulated substance. However, the use of asbestos is not banned. Various voluntary agreements have been reached with manufacturers to eliminate the use of asbestos in some materials (i.e. crayons and liners for hand-held hairdryers). Additionally, the Consumer Product Safety Commission (CPSC) enacted a policy in 1986 which required the labeling of all consumer products that contain intentionally added asbestos and are likely to release fibers under reasonable conditions of handling and use. In 1989, EPA established a ban on all new uses of asbestos but allowed for the continuation of uses established before this date. The majority of this ban was stopped from taking effect by a 1991 ruling from the U.S. Court of Appeals. Today, EPA encourages people to inquire about the presence of asbestos in a product from its dealers, suppliers, and manufacturers and suggests laboratory testing in some instances.

It is not possible to unquestionably determine if a material contains asbestos without performing laboratory tests. However, materials labeled as containing asbestos and materials suspected as such should be monitored in the home to prevent potential exposure. In general, if the known or suspected asbestos-containing material is in good condition, it is usually best to leave it alone. The material should be checked regularly for signs of deterioration and/or damage without disturbing it. A professional is needed to remove or repair asbestos-containing materials that are damaged or will be disturbed during a home improvement project.

Sources and Additional Information:

Agency for Toxic Substances and Disease Registry (ATSDR) – ToxFAQ for Asbestos – www.atsdr.cdc.gov/tfacts61.html

American Lung Association – www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35368

CPSC, EPA, and American Lung Association – Asbestos in the Home – www.cpsc.gov/cpscpub/pubs/453.html

Environmental Protection Agency – www.epa.gov/asbestos

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