ADVANCING THE CONVERSATION ON HEALTHY HOMES

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ADVANCING THE CONVERSATION ON HEALTHY HOMES Mariela Lopez, MPH Regional Asthma Coordinator Jacquelyn Menghrajani, MPH, CPH Regional Children's Environmental Health Coordinator

Overview Why are we here? What are Healthy Homes Principles? How can we keep homes: Contaminant-Free? Pest-Free? Clean? Well-Ventilated? What resources are available to advance the conversation about healthy homes? Small Group Discussions Problem-Solving Scenarios Exchange of Expertise, Experience, Lessons Learned, Best Practices

Learning Objectives Name at least two Principles of Healthy Housing and explain why they are important for health. Identify at least two sources of information or assistance to help address concerns about environmental asthma triggers and lead. 3

WHY ARE WE HERE?

HOUSING AFFECTS HEALTH www2.census.gov/programs-surveys/ahs/2015/infographs/2015%20housing%20profile%20healthy%20homes.pdf 5

HOUSING AFFECTS HEALTH IN CALIFORNIA Excerpt from: National Center for Healthy Housing. California 2017 Healthy Housing Fact Sheet: Retrieved from http://www.nchh.org/portals/0/contents/healthy-housing-fact-sheet_ca.pdf 6

CHILDREN ARE VULNERABLE TO HEALTH AND SAFETY HAZARDS Children are more vulnerable to environmental hazards than adults. Unique activity patterns and behaviors. Windows of susceptibility during early life stages. Physiological differences. Children depend on adults to ensure their environment is safe. 7

ENVIRONMENTS INFLUENCE OUTCOMES Educational, social, and financial impacts Increased risk of adverse health outcomes Environmental exposures 8

WHAT ARE HEALTHY HOMES PRINCIPLES?

A holistic approach to addressing health and safety hazards in homes. Mold Allergens Indoor Air Pollution Lead Carbon monoxide Pesticides Radon Home safety A healthy home is a home sited, designed, built, maintained, and renovated in ways that support the health of its residents. - The Surgeon General s Call to Action to Promote Healthy Homes, 2009

Keep It Dry Keep It Contaminant-Free Keep It Thermally Controlled Keep It Pest-Free Keep It Safe Keep It Clean Keep it Maintained Keep It Well-Ventilated

Keep It Dry Keep It Contaminant-Free Keep It Thermally Controlled Keep It Pest-Free Keep It Safe Keep It Clean Keep it Maintained Keep It Well-Ventilated

KEEP IT WELL VENITLATED

WHY DO WE NEED PROPER VENTILATION? Proper ventilation plays an important role in health. If we do not ventilate, then we can see higher rates of: Common Colds Flu Pnuemonia Bronchitis (which can all lead to missed school and work days) Necessary to remove humidity and dilute or remove contaminants Local exhaust ventilation (cook tops/bathrooms) remove contaminants from point sources

TALKING POINTS Ventilate bathrooms, kitchens and other appliances. Proper ventilation can reduce moisture, which can cause mold growth. Use whole house ventilation for supplying fresh air to reduce the concentration of contaminants in the home. 15

KEEP IT CONTAMINANT-FREE

Radon Asbestos Particulate Matter Volatile Organic Compounds Carbon Monoxide Lead Mercury Pesticides COMMON ENVIRONMENTAL HAZARDS 17

Radon Asbestos Particulate Matter Volatile Organic Compounds Carbon Monoxide Lead Mercury Pesticides COMMON ENVIRONMENTAL HAZARDS 18

Why Keep It Contaminant-Free? Volatile organic compounds (VOCs) can be found in many household products, such as cleaners, pesticides, air fresheners, paint, wood polish, and even some drycleaned clothing. VOCs can result in various health effects, such as headaches, dizziness, fatigue, and irritation. Some can exacerbate asthma. www.epa.gov/indoor-air-quality-iaq/volatile-organic-compounds-impact-indoor-air-quality

Why Keep It Contaminant-Free? Lead is a very toxic metal that has been used in lead-based paint, old water pipes and plumbing fixtures, and other products. Low levels of lead in children can affect health and development (behavioral problems, learning difficulties, lower intelligence, hyperactivity, and hearing problems). Exposure to lead during pregnancy can increase the risk of miscarriage and preterm birth, and can affect the fetus. www.epa.gov/lead/learn-about-lead www.cdc.gov/nceh/lead/tools/are_you_pregnant.pdf

Why Keep It Contaminant-Free? Carbon monoxide (CO) can be produced when fuel is burned in cars, trucks, small engines, stoves, grills, fireplaces, gas ranges, or furnaces. CO is an odorless, colorless, and toxic gas that can cause: Fatigue Confusion Headaches Nausea Death at very high levels www.epa.gov/indoor-air-quality-iaq/carbon-monoxides-impact-indoor-air-quality www.cdc.gov/co/faqs.htm

Why Keep It Contaminant-Free? Mercury is very toxic and can be found in contaminated seafood and consumer products such as batteries, light bulbs, thermometers, and imported skin creams. Mercury can harm the brain, heart, kidneys, lungs, and immune system of people of all ages. Exposure during pregnancy can harm the developing nervous system affecting a child s ability to think and learn. www.epa.gov/mercury www.atsdr.cdc.gov/dontmesswithmercury 22

TALKING POINTS Many chemicals found in products we use or in building materials can affect our health. Chemicals may be released if homes or appliances are not well-maintained. Chemicals are all around us, BUT WE CAN TAKE ACTION to reduce our exposure to them AND maintain healthier home environments. 23

KEEP IT CLEAN and cleanable 24

WHY KEEP IT CLEAN? Dust can contain allergens, lead, pesticide residues, and other chemicals Dust mites can trigger asthma Crumbs and spills can attract pests Clutter can serve as shelter for pests 25

TALKING POINTS Many chemicals and allergens can be found in dust in our homes. Clutter, crumbs, and spills can attract pests. WE CAN TAKE ACTION to reduce our exposure dust, allergens, and pests through regular housekeeping and maintenance. 26

Tips to Keep It Clean and Contaminant-Free

Tips to Keep It Contaminant-Free

Tips to Keep It Contaminant-Free National Lead Information Center 1-800-424-5323 Safe Drinking Water Hotline 1-800-426-4791 29

Tips to Keep It Contaminant-Free 30

Tips to Keep It Contaminant-Free Regularly check the Consumer Product Safety Commission recall list: www.cpsc.gov/recalls Regularly check the FDA recall list: www.fda.gov/safety/recalls. Product images from CPSC recall list. 31

Tips to Keep It Contaminant-Free 32

ADDITIONAL TIPS Ensure a healthy diet high in iron, calcium, and vitamin C. Keep children from eating soil. Have your child tested for lead. 33

PUTTING IT INTO PRACTICE SCENARIO 1: Maria has 4-year-old daughter and 2-year-old son. She is also 5 months pregnant with her third child. Her family rents an old home in Los Angeles. Maria shares that she saw a recent news story about lead poisoning in California children, and is concerned about her family possibly being exposed to lead. Maria wants to learn more about sources of lead exposure. Maria asks you about what you know about this issue and whether you have any advice for her. What would you tell Maria? SCENARIO 2: Jack is a father of two young children. His 5-year-old son has asthma. Jack shares with you that he is very stressed. He had to take his son to the emergency room two days ago because his son had a severe asthma attack while playing at home. Jack was told to check his home for asthma triggers. He wants to learn more about what asthma triggers are and how to keep them under control. What would you tell Jack? 34

KEEP IT PEST-FREE Use Integrated Pest Management Practices

WHY KEEP IT PEST-FREE? Pests, their dander, and their excrement function as allergens that can trigger asthma. Adverse health effects of pesticide exposure may range from mild symptoms to more serious health conditions depending on the pesticide and amount and frequency of exposure. Acute exposure to pesticides may lead to short-term effects Headaches Dizziness Muscle twitching Weakness Tingling sensations Nausea Long-term exposure to pesticides may lead to serious health effects Birth defects Learning disabilities Behavioral changes Organ damage Cancer Asthma symptoms 36

TIPS TO PREVENT PEST PROBLEMS Keep pests out by eliminating entry points. Remove food and water. Keep food in sealed containers. Keep kitchen and dining areas clean. Keep lids on waste bins. Fix and prevent leaks. Eliminate clutter. Monitor for pests. Treat existing pest problems. www.epa.gov/safepestcontrol/do-you-really-need-use-pesticide 37

TIPS TO ADDRESS PEST PROBLEMS Preventing pest problems is best! Try non-chemical methods first. If pesticides are needed to address a pest problem: Choose the least toxic pesticide available. Use baits or crack/crevice treatments instead of spray, if possible. Read and follow directions on the label carefully. Keep children and pets away from areas where pesticides are being applied and store out of their reach. Keep pesticides in original containers. Never use outdoor pesticides indoors. Never use illegal pesticides, such as tres pasitos. www.epa.gov/safepestcontrol/dos-and-donts-pest-control 38

TALKING POINTS Seal cracks and openings throughout the home will help eliminate entry points for pests. Addressing overgrown vegetation at our homes and schools that can prevent harborage areas. WE CAN TAKE ACTION to monitor our homes for pests and take measures based on Integrated Pest Management principles. 39

PUTTING IT INTO PRACTICE SCENARIO 3: You are hosting your monthly parent education session, and you decide to focus on Safety. After your session, a parent comes to you, and lets you know that every time his son gets in the car, it seems to trigger coughing and wheezing. He works harvesting produce and wonders if somehow pesticides might be linked. What questions would you ask to help him figure out why his son is getting sick, and tips for how to avoid a future episode? 40

ADDITIONAL RESOURCES AND WRAP UP Technical Assistance Educational Materials Seminars 41

Healthy Homes Programs Lead Poisoning Prevention Programs Asthma Programs Vector Control Programs IPM Programs Code Enforcement Non- Governmental Organizations Community Organizations State and Local Housing, Public Health, and Environmental Agencies NGOs and Community Organizations 42

Healthy Homes App www.hud.gov/healthyhomes 43

PUTTING IT INTO PRACTICE SCENARIO 4: You are planning a seminar to teach your colleagues about Healthy Homes. You conduct a pre-training survey to see what questions your colleagues have about Healthy Homes. There are many similar questions, and you summarize the results of the pre-training survey into 5 questions. 1. What is Healthy Homes? 2. How can housing affect health? 3. What are the Healthy Homes Principles? 4. Are there resources or brochures that I can share with the families I work with? 5. A family I work with is concerned about the condition of the home they are renting. Who can I refer the family to? 44

THANK YOU! Jacquelyn Menghrajani menghrajani.jacquelyn@epa.gov 415-972-3259 Mariela Lopez lopez.mariela@epa.gov 415-972-3771