1. Home Environmental Health Hazards: Assessment and Risk Reduction January 13, 2009

2. Indoor Environments and Health

3. Nurses and Home Environmental Health Risks Perez, National Library of Medicine

4. Common Household Exposures Lead Mercury Radon Carbon Monoxide Pesticides

5. Lead Household Exposures Older homes Chipped, peeling, and flaking paint Home renovation products like sanding Old windows, porch,

6. Lead – Effects on Children Affects childrens immune, nervous, and renal systems Linked to developmental disabilities Linked to growth retardation in children, children have short stature and increased BMI (Kim et al., 1995)

7. Lead In adults, low dose cumulative lead exposure is inversely associated with scores on cognitive function tests ( Weisskopf et al, 2004, Shih et al, 2006) In non-occupationally exposed adults, blood and bone lead levels are associated with increased systolic blood pressure (Bener, 2001, Cheng et al 2001, Glenn et al 2003, Martin et al 2006)

8. Mercury Household Exposures Medical thermometers, BP cuffs, thermostats, fluorescent lights. Dietary sources - Fish

10. Mercury – Effects on Children Attention deficits, hearing impairments, vision impairments Linked to damage to the brain, kidneys, and developing fetus Developmental disabilities

11. Mercury Exposure to methylmercury in adults has been associated with neurobehavioral abnormalities in adults ( Yokoo et al, 2003, Carta et al, 2003) Methylmercury exposure in adults has also been associated with increased cardiovascular risks such as acute MI (Salonen et al, 1995, Guallar, 2002)

12. Carbon Monoxide Exposure Source: EPA, 2005

13. Carbon Monoxide Low dose CO exposure is associated with impairment of higher cognitive function such as memory, new learning, attention and concentration (Amitai et al, 1998) CO exposure is associated with myocardial injury, hypo-perfusion of cardiac tissue, EKG changes and cardiac arrest (Raub, 2000, Satran et al, 2005)

14. Long Term Effects Cognitive impairment Dementia, Parkinsons Memory, attention and concentration problems Neuropsychiatric problems: depression, anxiety, irritability personality changes Frequent job loss Loss of IQ

15. Radon

16. Radon – Health Effects Radon is the second leading cause of lung cancer after smoking There is no established safe level of radon Smokers who are exposed to the average household level of radon 1.3pCi/L have a 20 in 1000 chance of dying of lung cancer versus 2 in 1000 for the non-smoker. Source: A Citizen's Guide to Radon The guide to protecting yourself and your family from radon, http://www.epa.gov/radon/pubs/citguide.htmlA Citizen's Guide to Radon

17. Pesticides Household pesticides are designed to kill by being toxic to the nervous or reproductive systems Many commonly available household pesticides can be rapidly absorbed through the lungs and skin

18. Pesticides – Sources Pesticides are used in: Homes, Schools On food crops, In commercial buildings, Gardens, lawns Exposure occurs primarily from ingestion of food products and from residential or commercial use (CDC, 2001)

19. Pesticides – Effects on Children Household exposure doses can result in: Headache Weakness, Dizziness, restlessness, Anxiety, confusion, Skin and respiratory irritation Central nervous system depression, and lowering of the seizure threshold.

20. Amount of Pesticides Used in the U.S. By Pesticide Group, 2000 and 2001 Estimates ( EPA) 1. See Table 3.4 (conventional pesticides) for additional details andTable 3.4 Pesticide Group Total (Mil lbs) 20002001 Conventional Pesticides (1)1926888 Other Pesticides (2)2308315 Specialty Biocides (3)3353363 Chlorine/Hypochlorites (4)42,5322,609 Wood Preservatives (5)5809797 Total4,9284,972

22. Volatile Organic Compounds General short term acute health effects of exposure to these compounds cause respiratory, eye and throat irritation, loss of coordination and dizziness, and exacerbation of asthma and respiratory conditions (EPA, 2006) Long term health effects of some of these VOCs are cancer, liver, kidney and CNS damage (EPA, 2006) In a study of children, home formaldehyde exposure was associated with increased risk of allergic sensitization to other common allergens ( Garrett et al, 1999)

23. Household Products National Library of Medicine Household Product Database National Library of Medicine Household Product Database

26. Other Assessment Tools http://www.neetf.org/

27. Resources for Nurses Environmental Health and Nursing Practice ( 2003) Springer Publishing Company ATSDR Environmental Health Nursing Initiative http://www.atsdr.cdc.gov/EHN/ Pediatric Environmental Health ( 2 nd Ed) available at www.aap.org/bookstorewww.aap.org/bookstore The National Environmental Education and Training Foundation http://www.neetf.org/Health/index.htm http://www.neetf.org/Health/index.htm Physicians for Social Responsibility http://www.psr.org/home.cfm?id=environmenthttp://www.psr.org/home.cfm?id=environment National Library of Medicine – Environmental Health and Toxicology, Specialized Information Services http://sis.nlm.nih.gov/enviro.htmlhttp://sis.nlm.nih.gov/enviro.html

28. Questions