1. Discussion #2: Healthy Homes

2. Review Of Epidemiologic Triangle of Disease

3. 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

4. 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

5. 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).

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

7. 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

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

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

10. 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.

11. 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

12. 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.

13. 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

14. 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.

15. 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

16. 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

17. 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

18. 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. 

19. Peeling lead-based paint on exterior

20. 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

21. Chemical Agents: Radon (2006 Statistics)

22. 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” .

23. 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.

24. 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.

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