HIPPY for Healthy Homes ProjectPartners:

Alesia Ferguson. Ilias Kavouras, Desiree Burroughsray UAMS College of Public Health,

Barbara Gilkey of HIPPY

Sponsored by Environmental Protection Agency

Delivery Pre-Survey:

Outline• Pre-survey: Everyone• Grant description: Dr. Ferguson• Indoor contaminants: Dr. Ferguson

– Chemical Hazards Found in Homes: Carbon Monoxide– Biological Hazards Found in Homes: Mold– Physical-Natural Hazards Found in Homes: Radon

• Ventilation: Dr. Kavouras• Fun Exercise-Desiree Burroughsray

– What you recall– What’s your opinion– Give us your email, respond to online survey– Arrange training in your region

Health effects of an unhealthy home

Sickness (varies) Allergies Asthma (15% of children

mostly non-Hispanic Blacks) Respiratory illnesses CO poisoning Cancer Gastrointestinal diseasesFatigue

Causes and Triggers for Asthma

Development of asthma Asthma “attacks”

House dust mitesSecond(third)-hand tobacco smokeCockroachesRespiratory Syncytial Virus

House dust mitesSecond(third)-hand tobacco smokeCockroachesPets (cats and dogs)Air pollutionFungi and moldsRhinovirusFormaldehydeFragnancesDomestic birdsRSV and “pneumoniae” bacteria

Clearing the Air: Asthma and Indoor Air Exposures, Institute of Medicine of National Academy of Sciences, 2000, ISBN: 0-309-51861-X; Available online: https://download.nap.edu/catalog.php?record_id=9610

2011 American Housing Survey Study

• Out of 131 million units, 81 million built before 1979 (median age:1974)

• Median sq. footage, 1700• 85 million units have central heating• 50 million use gas stoves• 9 million units say primary source of water is not safe to

drink• 1.5 million units lacking some or all plumbing facilities• 2 million units with severe physical problems (plumbing,

heating, electric, upkeep) (4 million moderate

Sponsored by HUD and the US Census Bureau

Housing Survey Data, in 1000’s

Deficiencies Northeast Midwest South West

Total (per million units) 21,066 25,682 42,584 25,575

Signs of rats in last 12 months 161 78 558 374

Signs of mice in last 12 months 3,809 3,081 3,917 1,937

Signs of rodents, not sure which kind in last 12 months 83 79 379 153

Signs of cockroaches in last 12 months 1,445 781 8,353 2,578

Holes in floors 273 208 500 192

Open cracks or holes (interior) 1,285 1,252 2,287 1,125

Broken plaster or peeling paint (interior) 629 536 764 440

No electrical wiring 40 23 76 22

Exposed wiring 302 402 694 422

Rooms without electric outlets 158 132 322 153

Grant objectives

• Build capacity in the state for education and health protection from hazards in the home.

• Development of materials for parents and children • Training of HIPPY coordinators and home-based

outreach educators in 6 regions of the State • Address specific hazards of radon, mold and carbon

monoxide safety • Address other factors in the home that contribute to

asthma and other respiratory illnesses • Provide simple methods and links to resources to

address these hazards

Activities Fall2012

Winter 2012

Spring 2013

Sum.2013

Fall2013

Winter 2013

Spring 2014

Sum.2014

Compilation of learning materials, creating of workshop program for coordinators, home-based educators and parents

x x x

Contribution to resource booklet x x x x x x Workshop and discussion of healthy program with HIPPY coordinators (potential 47) at State conference

x X

Workshops for home based educators and delivery of pre-post assessments (potential 246) at State conference

X x

Analysis of pre and post assessments from home-based educators, coordinators and parents

X x x x x x

Parent Workshops and Meeting Across State x x x x x x X

Communication with Other children programs (share ideas and materials)

x x

Report of Activities x x x x

Grant timeline

Objectives

Biological Hazards Found in Homes Mold

Chemical Hazards Found in Homes Carbon Monoxide

Physical Hazards Found in Homes Radon

Ventilation

Biologic Pollutants/Hazards

CockroachesHouse Dust MitesOther InsectsPetsPlantsHuman skin (highest source of bacteria)Mold/Fungi

Toxins and Irritants

Mold

Mold is found in the natural environment: breaks down dead organic matter.Mold reproduces using spores: found in both indoor and outdoor air.In order to survive spores need a surface that has water and a food source.Mold is an immediate problem when it overgrows in the indoor environment.

• Roof leakMold on crawl space ceiling

Mold - Why Today?•Always outside “background” levels of mold

•Excessive Building Tightness?– (reduced infiltration, reduced ventilation)

• Poor construction practices

• Improper use of building materials

• More media and public awareness

• High rates of asthma and allergies

Spores (concentration), fragments, proteins Mycotoxins Microbial volatile organic compounds People can react if mold is living or dead

Health Effects –People React to:

Chemical Pollutants

• Carbon Monoxide • Pesticides• Cigarette smoke• Lead-Based Paint in old Home• Ozone• Volatiles (e.g., formaldehyde, sulfides)

– From paints, varnishes, waxes, cleaning, disinfecting, degreasing, and hobby products, dry cleaning clothes

– Pressed wood products (check ANSI approved products, get laminated or coated )

– Avoid UF glues, lumber or metal

Carbon Monoxide

• Leads to over 500 deaths each year• Is released by combustion appliances, cars, and

cigarettes• Is odorless, colorless, and tasteless• Prevents a person’s blood from delivering oxygen

to tissue and organs• Is often released in high levels

• unvented space heaters, improperly functioning gas ranges, leaky wood stoves, and back-drafting vented space heaters and furnaces

Carbon Monoxide Exposure

p. 9Trainee Resource Book Source: SE Field Guide

Carbon Monoxide– Different organizations publish varying maximum

exposure limits for CO:

• OSHA = no more than 50 ppm for 1 hour • NIOSH = no more than 35 ppm for 1 hour• The U.S. National Ambient Air Quality Standards for CO = 9

ppm for 8 hours and 35 ppm for 1 hour• The Consumer Product Safety Commission = levels not to

exceed 15 ppm for 1 hour or 25 ppm for 8 hours

– Most CO detectors go off when CO levels reach 70 ppm

Preventing Carbon Monoxide Poisoning

• Have gas appliances professionally installed, vented outside, and checked annually for carbon monoxide leaks.

• Run cars and trucks only outside the garage and away from any openings into the house to prevent carbon monoxide poisoning

• Never run lawnmowers and other combustion devices inside the garage or near any windows

• Don’t use a gas range or oven for heating because CO can build up quickly inside a home

• Put carbon monoxide monitors near bedroom(s) and low to the ground

Radon

• Radon is a gas from the earth that can get in through floors and basements, water supply.

• Cannot see it or smell it.• Dust particles are involved• Causes cancer, especially in smokers • Level between 2-4- pCi/L (picocuries of radon per liter),

take some simple steps• If levels are above the U.S. Environmental Protection

Agency action level 4 pCi/L, install a radon mitigation system, from simple to more complex

Controlling Radon

• We are likely to have low levels here-varies• Test your home for radon gas (Home-depot $25-

include send off)• Mitigation

– vapor barrier in crawl space– sealing cracks and leaks (lower level), –house pressurization, soil suction, ventilator–Costs $100 to $10,000

• Test your home for radon gas

Radon Mitigation

Ventilation

• Open windows in the morning (cool air) (Natural)• Air pollution, safety and 1970’s energy crisis

– Closed windows, tight buildings/homes• Warmer climate and markets promoted mechanical

ventilation (A/C) (Mechanical or forced)

• Ventilation is the process of replacing air to provide high indoor air quality (i.e. replenish oxygen, remove moisture and contaminants).

Ventilation today• Existing home A/C units

“refresh” and circulate existing indoor air using a “filter” to remove air contaminants

• Easily maintained T and humidity levels

• Insufficient removal of contaminants

• Home contaminant levels may be higher than outdoor levels• The “cleaning” efficiency of filters depends on their quality and

regular replacement and more importantly, they do not remove gases.

Steps to improve ventilationIf A/C is regularly used If A/C is not regularly used

• Keep a “normal” temperature (winter: 66-70; summer: 80-86).

• Use high quality filters, inspect and replace them.

• Open windows for 1-2 hrs/day (in the morning or evening)

• Open multiple windows for 1-2 hrs/day (in the morning or evening) (screens on windows may be used)

• Use fans to move air in the home.• May use de-humidifiers in humid days• Air purifiers (check before you use)

• Perform regular maintenance and performance testing of the A/C system

• Perform a thorough home evaluation and fix leaks

• Perform a thorough home evaluation and improve natural ventilation efficiency

Questions?

Fun Activities and Post Survey Information

– What you recall– What’s your opinion– Give us your email, complete post survey– Arrange training in your region for coordinators

and home based educators

Fun Activity

Microstructures & Designs (small groups -> large groups)Scenario #1• Divide the group into 5 large groups based on each

pamphlet/brochure that will be given to families (Healthy Homes, Allergies and Asthma, Mold, Radon and Carbon Monoxide).

• Have individuals work in pairs from a prompt (What can you do to make a home healthy?) brainstorming ideas for how home based educators can help create a healthier home. What would be the best methods/approaches for engaging families? (5 min)

• Then have the 5 large groups re-form and discuss their ideas. Each group will present 3 of their best ideas to the large group (5-10min).

Second Fun ActivityMicrostructures & Designs (small groups -> large groups)Scenario#2• Divide the group into 5 large groups based on pamphlet/brochure

that will be given to families (Healthy Homes, Allergies and Asthma, Mold, Radon, and Carbon Monoxide).

• Have individuals work in pairs from a prompt (What are problems you have seen visiting homes? What do you think could be done to make a home healthy?) brainstorming ideas regarding needs that they have identified in the homes they visit.

• Then have the 5 large groups re-form and discuss their ideas. Are any of the groups ideas included in the tips section of the brochure? Each group will present 3 problems w/ solutions to the large group (5-10min).