Lead Hazard Control and Healthy Homes in Southern Nevada ERIN SHEEHY, MPH MELISSA BARTSHE, BS UNIVERSITY OF NEVADA, LAS VEGAS

Lead Hazard Control and Healthy Homes in Southern Nevada ERIN SHEEHY, MPH MELISSA BARTSHE, BS UNIVERSITY OF NEVADA, LAS VEGAS

Outline 1. Importance of the Home Environment 2. Las Vegas Lead Hazard Control and Healthy Homes Program 3. EPA Training Center 4. Healthy Homes Training Center 5. Questions

Importance of the Home Environment

The health impact of housing The health of our housing is related to thousands of deaths and hundreds of thousands of illnesses and injuries requiring medical attention each year. Home health hazards can contribute to: Lead poisoning Respiratory infections Asthma Injury (NCHH, 2014; Krieger & Higgins, 2002) Mental health issues

Why focus on lead hazards? Lead poisoning remains one of the most significant housing-related environmental health hazards to children in the United States. Heath impacts of lead Even children who appear healthy can have dangerous levels of lead in their bodies. Lead poisoning is often not diagnosed until they have moderate or severe symptoms. Moderate exposure: Mental retardation Behavioral problems Severe exposure: Brain damage Nervous system impairment Circulatory system damage 82 Pb 207.2 Lead (CDC, 2013; NCHH, 2014; Agency for Toxic Substances, 2007; Bernard, 2003; Papanikolaou et al., 2005; Lanphear et al., 2000; CDC, 2013; Canfield et al., 2003; Gaitens et al., 2009)

Background on lead Occupational Lead Exposures Adults are more likely to be exposed to lead hazards at their job Examples of these jobs include: manufacturing, contractors, and industrial painters Parents often bring this lead dust home Residential Lead Exposures Children are more likely to be lead poisoned at home Childhood lead poisoning is caused by lead-based paint, lead contaminated dust, lead contaminated soil, and water. (EPA, 2000)

Where do we find lead hazards? Potential sources of lead exposures include: Lead-based paint Lead contaminated dust Lead contaminated soil Drinking water Toys Pottery Cookware Imported hot sauces Imported candy Turf (Gaitens et al., 2009; Berger Ritchie & Gerstenberger, 2013; Maxwell & Neumann, 2008; Van Ulirsch et al., 2010)

Testing children for lead poisoning Testing children is the only way to know if they have been exposed to lead. It is easy and inexpensive Approximately 500,000 children in U.S. have a blood lead levels in excess of 5 µg/dl No safe level of exposure to lead Where can you have your child tested? Pediatrician s office Southern Nevada Health District Other healthcare providers (CDC, 2013; NCHH, 2014; Agency for Toxic Substances, 2007; Bernard, 2003; Papanikolaou et al., 2005; Lanphear et al., 2000; CDC, 2013; Canfield et al., 2003; Gaitens et al., 2009)

Las Vegas Lead Hazard Control and Healthy Homes Program (LVLHCHHP)

Our program: LVLHCHHP The Las Vegas Lead Hazard Control and Healthy Homes Program (LVLHCHHP) is a U.S. Department of Housing and Urban Development (HUD) grant-funded program to identify and control lead-based paint hazards in homes within Las Vegas, Nevada city limits, with priority given to homes with child occupants age five or under.

LVLHCHHP Target Area

LVLHCHHP Process Las Vegas, NV Door-to-door, events, referral, mail, flyers. Certified lead risk-assessors conduct lead-based paint risk assessment and conduct HH visual assessment. Findings reported to CLV. Dust and soil samples collected to ensure no lead hazards remain in work areas. Recruitment Qualification Inspection & Assessment Remediation Clearance Home/homeowners that meet program requirements are enrolled. CLV creates scope of work, which is completed by contractors.

Outreach and Recruitment Community Events UNLV Public Health Association Events Project Sunrise Safe Summer Night Celebrations Dissemination of Program Information WIC Clinics Head Start Community Centers YMCA Boys & Girls Clubs Easter Seals Positively Kids Food Pantries Las Vegas Fire and Rescue Preschools, Day Cares, and other Learning Centers Door-to-Door Neighborhood Canvassing Targeted areas including Hewetson, McWilliams, and Meadows Presentations Family to Family

Outreach and Recruitment Outreach challenges: Building trust Reaching vulnerable groups Low literacy levels Reluctance to share personal information Home is home Denial Fears Extreme weather conditions

LVLHCHHP Qualifications To be a participant in LVLHCHHP: Live in Las Vegas, NV Live in a home built before 1978 Residents must meet HUD income guidelines Owner-occupied must have a child under the age 6 living/visiting the home or expectant mother living in the home Rental property owners must give priority to families with child under 6 years old for at least 3 years Zero bedroom units must have a child under the age 6 or expectant mother living in the home

Lead Inspection and Risk Assessment Purpose: To identify all lead-based paint hazards present in the home. All painted surfaces tested using a Niton TM XRF device Dust and soil samples collected and analyzed by a NLLAPaccredited lab LIRA visit to Case #136

Lead Inspection and Risk Assessment Exterior windows: a common component for lead-based paint White window: 6.6 µg/cm 2 Brown window: 1.4 µg/cm 2 Green window: 5.0 µg/cm 2

Lead Inspection and Risk Assessment Exterior siding: a common component for lead-based paint Tan siding: 8.4 µg/cm 2 White siding: 7.7 µg/cm 2

Lead Inspection and Risk Assessment Interior/exterior doors: a common component for lead-based paint White door: 2.2 µg/cm 2 White door: 1.4 µg/cm 2 Green door: 1.3 µg/cm 2

Change to Risk Assessment Action Levels Surface EPA Lead Dust Hazard Standards HUD s New Lead Dust Action Levels Floors 40 µg/ft 2 10 µg/ft 2 Windowsills 250 µg/ft 2 100 µg/ft 2

Healthy Homes Visual Assessment Purpose: To identify health and safety issues present in the home. Ranks hazards using the Healthy Homes Scoring System Considers 29 hazards and the likelihood they will cause harm Electrical hazards Structural collapse hazard Volatile organic compounds

Health and Safety Hazards Physiological Psychological Safety 1. Dampness & mold growth 2. Excess cold 3. Excess heat 4. Asbestos & man-made fibers 5. Biocides 6. Carbon monoxide 7. Lead-based paint 8. Radiation 9. Uncombusted fuel 10. Volatile organic compounds 11. Crowding and space 12. Entry by Intruders 13. Lighting 14. Noise Infection 15. Domestic hygiene 16. Food safety 17. Personal hygiene 18. Water supply 19. Falls in baths 20. Falls on level surfaces 21. Falls on stairs 22. Falls between levels 23. Electrical hazards 24. Fire hazards 25. Hot surfaces 26. Collision and entrapment 27. Explosions 28. Position, operability of amenities 29. Structural collapse

Examples of Residential Hazards Hot surfaces Electrical hazards Improperly stored food and volatile organic compounds

Domestic hygiene Dust and mold Pests and food safety

Lead hazard control process

Clearance After remediation is complete, CLV conducts a Pre-Clearance Inspection to ensure work was completed. UNLV team follows up and performs clearance testing, which includes sample collection in work areas: o Dust sampling of floors o Dust sampling of windowsills o Soil samples CLV Monitoring Visits after 1 year to ensure controls for lead-based paint are intact interim Clearance Dust Sampling

Lead clearance standards Surface EPA Standard HUD s New Action Level Floors <40 µg/ft 2 <10 µg/ft 2 Windowsills <250 µg/ft 2 <100 µg/ft 2 Window Troughs <400 µg/ft 2 <100 µg/ft 2 Porch Floors NA <40 µg/ft 2

Training Centers

EPA Lead Training Center EPA Accredited Training Provider Courses available: Lead Paint Supervisor Lead Risk Assessor Lead Inspector Lead Abatement Worker Lead Dust Sampling Technician Renovate, Repair, and Painting *All courses available in Initial and Refresher Source: https://www.epa.gov/lead

Healthy Homes Training Center Healthy Homes Training Partner Courses available: Code Inspection for Healthier Homes Eco-Healthy Child Care Essentials for Healthy Homes Practitioner Healthy Home Evaluator Healthy Homes: Assessment and Interventions Healthy Homes Assessment for Community Health Workers Healthy Homes Assessment: Principles and Practice Healthy Homes for Community Workers Healthy Homes Essentials for Environmental Professionals Health Opportunities in Energy Audits and Upgrades Healthy Homes Rating System Integrated Pest Management in Multifamily Housing

Questions?