Healthy Housing: It’s Everyone’s Job

Ellen TohnTohn Environmental Strategieswww.tohnenvironmental.com

Are we sick?

Top housing based health hazards

• Asthma/breathing problems

• Lung cancer

• Lead poisoning

• Injuries

• Carbon monoxide

• Allergies/irritation

Annual illness and hospitalization

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

Home Injuries/Falls

Carbon Monoxide Lead Poisoning Asthma

Annual deaths

0

5,000

10,000

15,000

20,000

25,000

Radon -Lung

Cancer

2nd Hand Smoke Lung

Cancer

Home Injuries

Carbon Monoxide

Lead Poisoning

Asthma

Asthma in Maine

Over 8,000 ED visits and 1,000 hospitalizations in Maine each year

Asthma triggers

Dampness and Asthma

Health Outcome Estimated % Increase in Damp Homes

Upper respiratory tract symptoms

52%

Cough 50%Wheeze 44%Current asthma 50%Ever-diagnosed asthma 33%

Most time spent at home

Young children can spend up to 90% of the day at home

Most of us spend 60% of our year at home

Healthy homes principles• Start with people

• Make the house:

– Dry

– Ventilated

– Pest free

– Contaminant free

– Cleanable

– Safe

• Maintain the house

Houses can be fixed

When

• New construction

• Renovation

• Energy upgrades

• Property management

• Refinancing

• Health home visits

By

• Contractors

• Energy auditors & workers

• Health home visitors

• Homeowners

• Property owners/managers

• Tenants

The “One Touch” opportunity

Issue NH Families Touched/Year

Program Provides Home Visits or Repairs

Health 1800 Asthma, Lead Poisoning, Head Start, Home Visiting

Housing <500 Housing Rehab, Lead Hazard Control

Energy 1800(1,000 low income)

Weatherization, Utility-Funded Energy Upgrades

Rural NH county

• 18 units all 100% units FPG• Asthma (8 children, 3 adults)

One family had 10 unscheduled doctor visits & 4 emergency room visits

• Peeling Paint pre -78 (8 units)• Moisture (10 units)• Pest (4 mice, 1 cockroach)• 5 units immediate WX priority;

energy needs & children < 6 yrs.

Manchester, NH

• 27 units

• 32 referrals

• 25% units referred to WX

• 16% units referred for asthma or lead

AA

L

AA

LL A

WXWXWXWXWX

WXL L A

HH repair commitments

• Lead Hazard Control Grant Program --owner 10% match to fund HH work

• Lead Poisoning Prevention, Housing Rehab, MCH -- identify and leverage funds for HH and EE work

• WX to add moisture and pest repairs to audits and work practices, pending state funded IPM project

Tracking water expenses

$-

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Properties

Annual Boston Area Water Expenses per ApartmentIf usage is not available, dollars provide clues about extreme use

5 to 1 ratio in expenses from about $1500/apartment to low of $300/apartment

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Water work orders

Source: Urban Edge Boston MA & The National Center for Healthy Housing

Daily water use targets

* Targets per bedroom assume 1.5 people per bedroom.Sources: American Water Works Association (2010) & Steven Winter Associates

Super Water Conserver:< 44 gallons/person

< 66 gallons/bedroom *

Good Water Conserver:< 55 gallons/person

< 83 gallons/bedroom*

Poor Water Conserver:> 55 gallons/person/day> 83 gallons/bedroom*

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Water opportunities

• Toilets <1.3 gpf;

• Clothes Washer

• Fixtures– Faucets <1.5 gpm

– Bath faucets <1 gpm

• Shower Heads <1.75 gpm

• EPA WaterSense

Water case study: Retrofit timeline

Source: WegoWise

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Water case study: Retrofit costsUnit #Units Cost/Unit Total

1.28 gpf Flapperless Toilets 12 $144.78 $1,737.36

1.5 gpm Kitchen Aerators 6 $2.65 $15.90

.5 gpm Bathroom Aerators 7 $1.25 $8.75

1.5 gpm Showerheads 7 $4.95 $34.65

Source: WegoWise

Total Retrofit Cost $1,796.66

Savings Per Month $1,296.17

Simple Payback 1.4 Months

Consider smoke free housing

Resident Benefits• Improves resident health• Reduces complaints• Reduces unit transfer

requests• Most tenants want smoke

free environments –survey tenants to find out!

Owner Benefits• Reduce maintenance

costs• Reduce complaints• Reduce unit transfer • Reduce unit turnover

costs• Can reduce insurance• Can increase demand • Consistent with HUD

Guidance

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Secondhand smoke is deadly

• Secondhand smoke is the third leading cause of preventable death in US, killing 53,000 nonsmokers/year. For every 8 smokers one non smoker is killed.

• Children exposed to secondhand smoke are 44% more likely to suffer from asthma.

• Exposures increases the risk of SIDS. • 7.3% of persons 65 and older smoke, 70% report a

desire to quit.

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Source: Smoke-Free Housing New England

Source: U.S. Surgeon General (2006), Asthma Regional Council (2006), Smoke Free New England

Smoke free saves owners money

25Source: Source: Smoke Free New England Free Housing New England

Why worry about pests? It costs money

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Annual pest control costs for Boston , MA multi family housing..

$0

$20

$40

$60

$80

$100

$120

$140

$160

$180

1 2 3 4 5 6 7 8Buildings

Use Integrated Pest Management

• Goal: Cost-effectively prevent and address pest problems while minimizing the harm to people, property and the environment.

• Use IPM Certified Workforce: • Green Pro or Greenshield certified; OR

– Demonstrate equivalent IPM training– www.certifiedgreenpro.org,

www.greenshieldcertified.org

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Integrated Pest Management • Monitor pests to understand the problem

• Keep pests out, give them no place to hide– Change surrounding landscape– Block pest entries, passages, hiding places

• Reduce food availability– Practice proper food storage and disposal– No dirty dishes in the sink overnight– Clean crumbs, grease etc.

• Knock down population– Traps– Appropriate pesticides

28

Roach Traps

Seal holes & cracks

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Likelihood lead-based paint

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1. Lead-based paint is paint with >1 mg of lead per square centimeter

Consider testing paint for lead, particularly if property age is 1960-1978. Buildings less likely to have lead based paint and may be exempt from requirements.

Percent of Housing UnitsWithout Lead-based Paint1

Age Interior Exterior AnywhereBefore 1940 21% 28% 13%1940 to 1959 54% 41% 31%1960 to 1977 84% 87% 76%

Healthier property management

1. Unit Turnover Checklists2. Pest Control: Integrated Pest Management 3. Renovation: Lead Safe Work4. Flooring: Smooth & Green; FloorScore resilient

flooring & Green Label Plus carpet 5. Painting: Lead Safe & Low VOC6. Cabinets /Shelving: No urea formaldehyde7. Green Cleaning: Use GreenSeal, Ecologo or Dfe8. Work Order Requests9. Resident Education

Add health to energy upgrades

The necessity – Don’t make it worse

Opportunities – Pest control

Opportunities - Ventilation

• Meet new industry standard -- ASHRAE 62.2, Appendix C

• Kitchens fans

• Bath fans – Energy Star

• Dryer vents

• Whole house

Opportunities - Radon

Short Term Minimum 48 hours $10-$20 If >4 pCi/L recommend mitigation ME pilot