Discussion #2: Healthy Homes

Review Of Epidemiologic Triangle of Disease

Factors Effecting The Host It is know that personal factors impact health. Low socio-economic populations are disproportionately exposed to: Air pollution & related illness Lead (paint or pipes) Household pests & pesticides

Host: Varied Exposures Residents of the same household will experience varied exposures due to individual behaviors: Time and activity patterns Smoking Diet/exercise Personal hygiene Personal sanitation practices

Host Susceptibility Some household members may experience greater susceptibility to health hazards: ie. Age (children & elderly) Pregnant or nursing women Pre-existing health conditions Poorly nourished individuals Medically under-served people Children are especially vulnerable: Stage of growth and development and their behaviors (e.g. hand-to-mouth activity). Also children spend 80%-90% of their time indoors, which increases their exposure. Older Americans are vulnerable Their immune systems are often weakening They are more likely to be affected by physical hazards Adults 80+ years of age are at 20 times higher risk for injury-related death than younger individuals. Pregnant women are also at risk because toxics such as lead pass through the placental barrier. Malnutrition is another risk factor. For example, children whose diets lack calcium are more likely to uptake lead and suffer from lead poisoning. (Calcium deprived diet will create craving for paint chips).

Agents: Exposure Inside the Home We will discuss three major exposures: 1. Biologic 2. Chemical 3. Physical

Biologic Agents: Infectious Disease Infections often spread due to: Overcrowding inadequate water supplies Inadequate waste disposal Inadequate ventilation Examples: Tuberculosis, rhinovirus, strep, E. coli, salmonella, influenza

Biologic Agents: Allergens Respiratory Illness & Asthma are often precipitated by exposure to: Dust mites Pet dander Mouse droppings Mold & plants

Biologic Agents: Mold Damp/wet houses provide an environment for mold growth

Chemical Agents Many materials used in homes contain chemicals that have known/suspected health effects. Sources of chemical exposure include building materials, consumer products, and combustion processes.

Chemical Agents Indoor combustion appliances release a wide range of compounds that affect health, including: nitrogen dioxide sulfur dioxide carbon monoxide fine particulate matter (PM). Appliances include: Water Heaters (Gas) Clothes Dryers (Gas) Ventless Heaters Gas stoves/ovens Furnaces/room heaters Fireplaces

Chemical Agents Second Hand Smoke (ETS=Env. Tobacco Smoke) Contains 4000 substances 40 of them cause cancer, ie: Acetone Ammonia Benzene Carbon Monoxide Formaldehyde Lead Nicotine Tar Cyanide ETS is estimated by to cause approximately 3,000 lung cancer deaths in nonsmokers each year. Exposure to secondhand smoke increases the severity of symptoms of asthma.

Chemical Agents Pesticides: Greater than 75% of households report use of pesticides. Many are know to affect human health: Respiratory systems Nervous system Immune & reproductive systems

VOC’s Volatile organic compounds Emitted by: Emitted as gasses from solids or liquids Have adverse health effects Emitted by: Paints, lacquers, paint strippers Cleaning supplies, pesticides Building materials, adhesives Generally, any Organic Solvent will emit VOC Office equipment such as copiers and printers, correction fluids and carbonless copy paper, graphics and craft materials including glues and adhesives, permanent markers, and photographic solutions. Fuels are made up of organic chemicals and can release organic compounds while you are using them and when they are stored.

VOCs Are A Group of Chemicals Benzene, formaldehyde, toluene, choloride, xylene Indoors, VOCs are often emitted by: new carpeting & furniture Fresh paint jobs New plastics & electronic devices

Health Effects of VOCs Symptoms: Can lead to chronic problems: Eye/nose irritation Headache Vomiting Dizziness Can lead to chronic problems: Cancer Asthma Liver damage Central nervous system damage

Chemical Agents: Lead Lead-based paint is the most significant source of lead exposure in the U.S. today Exposures: Air, drinking water, food, contaminated soil, deteriorating paint, and dust

Symptoms of Lead Poisoning High levels can cause convulsions, coma & death. Lower levels can cause adverse health effects: Central nervous system Kidneys Blood cells Blood lead levels as low as 10 micrograms per deciliter can impair mental and physical development. 

Peeling lead-based paint on exterior

Chemical Agents: Radon What is Radon? Naturally occurring odorless cancer-causing, radio-active gas Derived from the breakdown of uranium (radio-active) in soil, rock and water Permeates air we breath Can be found in any type of building

Chemical Agents: Radon (2006 Statistics)

How Radon Gets In Several methods of removing radon from the home have proven effective. The methods include installing vent pipes and fans to remove the radon from beneath the home and vent it to the outside. Further measures include sealing exterior cracks, openings & joints. For further information, see EPA’s “Consumer’s Guide to Radon Reduction” .

Chemical Agents: Asbestos Asbestos is a mineral that was frequently used in homes built between 1920 and 1972 Many building products contained asbestos: furnace ducts steam pipes floor tiles Shingles Insulation textured ceilings and siding Inhalation of asbestos fibers can lodge in the lungs and cause disease including lung cancer and asbestosis.

Agents: Physical Electrical Shock Burns: Slip/Fall Hazards Improperly installed wiring Improper childproofing. Burns: hazards include stoves, ranges, exposed steam pipes & portable heaters Slip/Fall Hazards Fire & Explosion The majority of injuries among children occur in the home. Some alarming statistics: • Falls are the most frequent cause of residential injuries to children and the elderly. • Risk is increased by slippery surfaces, breakable window glass, and poorly designed stairs with inadequate • The highest rate of injury death for infants is choking and suffocation The highest rate of injury death for 1-14 year olds is fires and burns.

Electrical Shock Hazard Here is an example of a physical hazard. This is a picture showing drainage around a house trailer’s electrical box.