Healthy Homes Practitioner: Overview

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University of Maryland Extension Healthy Homes
Training
EFNEP In-Service October 15, 2009
Ms. Lynn Little, Extension Educator Dr. Lis
Maring, Family Life Specialist
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The connection between housing and health
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Why are healthy homes important to us?
Young children spend as much as 90 of their time
inside their homes

• Homes can affect health both physically and
  mentally.

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Why are healthy homes important to us?
It may be frail its roof may shake the wind
may blow through it the storms may enter the
rain may enter but the King of England cannot
enter all his forces dare not cross the
threshold of the ruined tenement. William Pitt
One of our deepest needs is to be at home.
Timothy Radcliffe
Home is the place where, when you have to go
there, They have to take you in. Robert Frost
Home is where the heart is.Pliny
Where thou art, that is home. Emily Dickinson
Theres no place like home. Dorothy, Wizard of Oz
The strength of a nation derives from the
integrity of the home. Confucius
He is happiest, be he king or peasant, who finds
peace in his home. Johann Wolfgang von Goethe
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Health problems related to housing conditions

• Asthma
• Allergies
• Brain damage
• Behavior learning problems
• Lung cancer
• Injuries
• Poisonings

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Children and seniors are most vulnerable
Children spend a lot of time indoors
Seniors spend a lot of time indoors
Breathing problems are easily triggered.
Children eat and drink more than adults (in
relation to body weight)
Children are still developing
Falls are more common
Children behave differently
Seniors can overheat
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Start with People

• What good are they?
• Whats difficult about people?
• How can you deal with people?

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No Place Like Home!
When asked to rate their homes from 1 to 10
(1-worst and 10-best)

• 53 of people surveyed rated their homes as an 8,
  9 or 10 EVEN THOUGH their houses have severe
  problems.
• 13 of people living below poverty rated their
  home as a 1

Source American Housing Survey (2005)
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Follow These Seven Principles to Make A Home
Healthy

• Key reference Help Yourself to a Healthy Home.
• Key Materials Healthy Homes Toolkits
• A healthy home is one that is dry, ventilated,
  clean, pest-free, safe, contaminant-free and
  maintained.
• Materials in Healthy Homes toolkits provided with
  funds from Healthy Homes Partnership, USDA/HUD

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7 Healthy Homes Principles

• Keep It
• Dry
• Ventilated
• Clean
• Pest-Free
• Safe
• Contaminant-Free
• Maintained

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How does moisture enter a home?
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Where is the moisture?
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There are three ways your house gets wet
Rain through leaks in roof, walls, foundation
Moisture and water leaks inside your home
Condensation
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How does excess moisture affect health?
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Health Problems Associated with Mold and Moisture

• Nose and throat irritation and congestion
• Coughing
• Wheezing
• Asthma symptoms
• Pneumonia (in people particularly sensitive to
  mold)

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Keep It Dry What You Can Do?
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Using Help Yourself to a Healthy Home as a Client
Resource A Keep It Dry Example
Information for clients (page 20)
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Using Help Yourself to a Healthy Home as a Client
Resource A Keep It Dry Example
Information for clients (page 21)
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7 Healthy Homes Principles

• Keep It
• Dry
• Ventilated
• Clean
• Pest-Free
• Safe
• Contaminant-Free
• Maintained

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What does Ventilate Mean?

• Ventilating means that fresh air is circulating
  in the house
• Ventilating means that the house has openings for
  pollution to escape from inside

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Why Well Ventilated?

• Ventilation is necessary to remove humidity and
  reduce or remove indoor air pollution.
• Good ventilation can reduce hazards from
• Moisture
• Smoke from cigarettes, cigars, incense or candles
• Allergens (such as cockroach and mice droppings)
• Mold
• Carbon monoxide
• Volatile organic compounds (VOCs)
• Radon

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Health Problems Associated with Poor Ventilation

• Higher rates of respiratory irritation and
  illness
• Common colds
• Influenza
• Pneumonia
• Bronchitis

and increased rates of absence from school or
work
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Things that need exhaust ventilation

• Bathrooms
• Clothes dryers
• Kitchen ranges
• Boilers, furnaces, hot water heaters
• Fireplaces, wood burning stoves

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Testing an Exhaust FanThe Charmin Method
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Local Ventilation in the Kitchen

• Ventilation in the kitchen removes moisture,
  odors, and grease
• If you have a gas oven or range, it removes
  carbon monoxide
• The gas oven or range must be vented to the
  outside
• If the fan for the gas oven or range is not
  reasonably quiet, many people will not use it.

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Combustion Products
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Carbon Monoxide

• Health Effects from Carbon Monoxide
• Fatigue, headaches, dizziness, confusion
• The Silent Killer
• About 500 deaths a year plus more than 15,000
  healthcare visits per year.

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What Can Be Done to Prevent Carbon Monoxide
Poisoning?

• Do not use ovens and gas ranges to heat your
  home.
• Open flues when fireplaces are in use.
• Make sure stoves and heaters are vented to the
  outside and that exhaust systems do not leak.
• Do not use unvented gas or kerosene space
  heaters in enclosed spaces

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What Can Be Done to Prevent Carbon Monoxide
Poisoning?

• Make sure your furnace has adequate intake of
  outside air.
• Ensure that appliances are properly adjusted and
  working to manufacturers instructions and local
  building codes.
• Obtain annual inspections for heating system,
  chimneys, and flues and have them cleaned by
  a qualified technician.

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What Can Be Done to Prevent Carbon Monoxide
Poisoning?

• Do not burn charcoal inside a home, cabin,
  recreational vehicle, or camper.
• Never leave a car or lawn mower engine running in
  a shed or garage, or in any enclosed space.
• Install a CO Detector

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Carbon Monoxide Alarms

• A carbon monoxide alarm should be placed near
  sleeping area
• Can be put on every level of a home to provide
  extra protection
• Should not be installed directly above or beside
  fuel-burning appliances

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Keep It Ventilated What You Can Do
Landlord Maintenance

• Install exhaust fans in the bathroom and kitchen
  that vent outside.
• Make sure that there are working smoke and carbon
  monoxide alarms installed.
• Maintenance of furnace
• Maintenance of dryers

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What If I Have Carbon Monoxide Poisoning?

• Dont ignore symptoms, especially if more than
  one person is feeling them. If you think you are
  suffering from carbon monoxide poisoning, you
  should
• Get fresh air immediately. Open doors and
  windows. Turn off combustion appliances and leave
  the house. Call 911.
• Go to an emergency room. Be sure to tell the
  physician that you suspect CO poisoning.

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Using Help Yourself to a Healthy Home as a Client
Resource A Keep It Ventilated Example
Information for clients (page 26)
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7 Healthy Homes Principles

• Keep It
• Dry
• Ventilated
• Clean
• Pest-Free
• Safe
• Contaminant-Free
• Maintained

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Health Problems Associated with Cleaning and
Cleanliness

• Dust mites, mold, mice/rats/cockroaches can
  trigger allergy and asthma attacks
• Pesticides can cause skin rashes, headaches,
  dizziness, muscle pain, nausea and vomiting, and
  respiratory problems
• Lead paint and lead paint dust can lead to range
  of health problems including neurological damage

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Dust Mites

• Homes with high humidity can have a lot of dust
  mites.
• Keep it clean Keep it dry

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Dust Control

• Five steps to limit dust
• Hard Surface Walkways
• Outside Grate-Like Mat
• Inside Carpet Pad
• Hard Surface Floor
• Take shoes off

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Healthy Cleaning

• Dont dry dust or dry sweep
• Tips for vacuuming carpets
• Wet cleaning
• Use elbow grease
• Killing dust mites
• Washing machine water should be gt130 degrees
• However, faucet water should be lt120 degrees to
  safely
• avoid burns

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What cleaning measures are problematic?

• Soaps and other products that are anti-bacterial
• Air fresheners
• Carpet cleaning

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Label Reading
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Clutter

• Whats the problem?
• Whats the solution?

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Keep It Clean What You Can Do
If you rent or own, you should
If you rent, your landlord should

• Vacuum or wet clean floors regularly.
• Wash bed linens in hot water.
• Trap dirt and dust outside on a walk-off mat.
• Take shoes off at the door.
• Use damp cloth for dusting and lightly mist a
  floor for broom sweeping. Wash rags used for
  dusting.
• Use cleaning products labeled non-toxic.
• Use a good vacuum with beater bar on bottom.
  Vacuums with HEPA filters are best.
• Reduce clutter.
• Store in plastic boxes.
• Use mattress and pillow covers for family members
  with asthma or allergies.

• Help you deal with pest problems by sealing up
  cracks and holes
• Put in hard surface floors which show dust, can
  be cleaned faster and can be damp mopped.

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Using Help Yourself to a Healthy Home as a Client
Resource A Keep It Clean Example
Information for clients throughout book because
Keep it Clean crosses other topic areas
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7 Healthy Homes Principles

• Keep It
• Dry
• Ventilated
• Clean
• Pest-Free
• Safe
• Contaminant-Free
• Maintained

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What do we mean by pests?

• Rats and mice
• Roaches
• Fleas
• Bedbugs
• House flies
• Mosquitoes
• Dust mites
• Regional pests

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Health Problems Associated with Pests/Pesticides

• Health effects associated with pesticides
  include
• Eye, nose, throat irritation
• Skin rashes, stomach cramps, nausea
• Central nervous system damage
• Kidney damage
• Increased risk of cancers

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Why Pest Free?

• Some pests are associated with asthma or asthma
  symptoms
• Dust mites
• Cockroaches
• Mice dander

• Rat bites are also a problem
• Rats and mice have been associated with a variety
  of diseases.

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Integrated Pest Management (IPM)

• Keep them out and give them no place to hide
• Change what is around a house or building
• Block where they come in, walk through or hide
• Dont leave out food they could eat
• Practice proper food storage and disposal
• No dirty dishes in the sink overnight
• Clean crumbs, grease etc.
• Get rid of the pests that are already in the
  house
• Use traps
• Use less-toxic pesticides when necessary

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See the creature, be the creatureWhat to look
for and where to look
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What To Do About Pests Cleaning

• Get rid of food sources and grease
• Vacuum
• Hard to reach locations and places pests frequent
• Direction of work work from top to bottom
• Wash hard surfaces and floors
• De-grease oven, stove, and counters
• Two-bucket method
• Restrict water distribution
• Spray-bottle application

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What To Do About Pests Better Storage

• Food Store in containers that pests cant get
  into or find it hard to get into
• Other household items Store in an organized
  fashion so that any pest activity can easily be
  seen
• Clutter Reduce or get rid of stored items that
  arent really needed

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Pest proof food storage
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Keep It Pest-Free What You Can Do?
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Using Help Yourself to a Healthy Home as a Client
Resource A Keep It Pest-Free Example
Information for clients (page 43)
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7 Healthy Homes Principles

• Keep It
• Dry
• Ventilated
• Clean
• Pest-Free
• Safe
• Contaminant-Free
• Maintained

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Keep it Safe There are many ways to be injured
in the home
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What are the most common causes of home injury
deaths?

• Falls
• Poisoning
• Fires and burns
• Choking and suffocation
• Drowning
• Guns
• Other

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Which age groups are most at risk?

• Infants are most likely to be injured or die from
  choking and suffocation.
• Children up to 14 years old and seniors are most
  likely to be injured from falls.
• Children from 1 14 years old are most likely to
  be injured by fires and burns.
• Adults who are over 80 years old are most likely
  to die from any injuries in the home.

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Falls
About ½ of households with 2nd floor windows do
not have window locks or safety guards to protect
children.
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Poisoning

• 82 of households keep medicines in unlocked
  drawers or cabinets.
• 69 of homes with young children store household
  chemicals in unlocked areas.

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Pesticides and Poisonings

• Almost half of all households with children
  under five stored pesticides within reach of
  children.
• In 2003, Poison Control Centers reported
  113,000 cases of pesticide poisoning.

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Fires and Burns
75 of households did not know the temperature
setting on their water heaters. 91 were unaware
of the temperature of hot tap water.
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Choke hazards?
Electric shock hazard?
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Keep It Safe What You Can Do
If you rent or own
If you rent, your landlord should

• Prevent Slips, Trips, and Falls
• Keep your floors clear of toys, shoes and other
  things
• Clean up spills right away to prevent slipping.
• If you have rugs, use non-skid mats.
• Poison-Proof Your Home
• Put safety latches on all cabinets with harmful
  products or put products where children cant
  reach.
• Prevent Fires and Burns
• Place working smoke alarm near every sleeping
  area and working fire extinguisher near kitchen
  stove.
• Keep space heaters out of doorways, halls, or
  other busy areas. Keep them at least 3 feet from
  curtains, bedding, or other things that could
  catch fire.
• Put outlet covers over unused electrical outlets.
• Prevent Choking and Suffocation
• Keep young children away from curtains,
  window-blind cords and extension cords.

• Make sure that working smoke alarms are installed
  near every sleeping area.
• Install a carbon monoxide alarm in your apartment
  or house.

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Using Help Yourself to a Healthy Home as a Client
Resource A Keep It Safe Example
Information for clients (page 48-54)
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7 Healthy Homes Principles

• Keep It
• Dry
• Ventilated
• Clean
• Pest-Free
• Safe
• Contaminant-Free
• Maintained

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Contaminant Priorities

• Lead and Lead-Based Paint
• Environmental Tobacco Smoke
• Asbestos
• Volatile Organic Compounds (VOCs)
• Radon

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Sources of Contaminants

• Bring It In
• Building Structure
• Building System
• Living Things

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Lead and Lead-Based Paint

• Peeling, Chipping Paint / Deteriorated Paint
• Dust
• Soil
• Drinking water
• Consumer Products such Pottery, Cribs, Jewelry,
  Candle Wicks
• Cultural Items

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Lead Age of Housing Matters
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Why Avoid Lead?Related Health Effects

• Reduced IQ
• Learning disabilities
• Impaired hearing
• Reduced attention spans, behavior problems
• Anemia
• Kidney damage
• Damage to central nervous system
• Coma, convulsions, death

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Lead and Old Paint Indoors

• Fix peeling paint- Do not dry scrape or dry sand!
• Use damp method to mop, dust.
• Thoroughly clean furniture, carpets, and
  draperies to remove settled dust and dirt
• frequent vacuuming
• Wash kids hands!

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Minimize Exposure to Lead

• Hose off sidewalks, porches, and steps often so
  that lead-containing soil or dust isnt tracked
  into the house

• Periodically clean doormats to reduce tracking
  dirt and soil into the home.

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Available Testing
Trained and certified inspectors can test for
lead in

• Paint chips
• Dust
• Bare soil
• Drinking water

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Letting Buyers and Renters Know About Lead

• Its the law
• Before a lease or sales contract is signed,
  owners must tell the buyer or renter about
  lead-based paint or lead-based paint hazards in
  the house or apartment building.

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Health Problems From Environmental Tobacco Smoke

• Second-hand smoke increases the number of asthma
  attacks that children have and how severe the
  attacks are
• It increases the risk that children will develop
  asthma
• Responsible for 150,000 to 300,000 cases of
  bronchitis, pneumonia and flu symptoms in infants
  and children less than 18 months of age
• Causes lung cancer in non-smokers

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Non-smokers Exposed to Tobacco Smoke Have
Increased Risk of Acute and Chronic Disease

• Respiratory illness (including arrested lung
  development)
• Asthma attacks and development
• Middle ear effusions
• Irritant effects
• Children affected by smoking caretaker

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What Can You Do About Tobacco Smoke in Homes and
Cars?

• Quit, if youre ready theres help
• Dont smoke around children
• Smoke outside
• Exhaust vent the places where people smoke

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Asbestos
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Why avoid asbestos?

• Health effects
• - Lung Cancer
• - Mesothelioma
• - Asbestosis
• Smokers are at greater risk!

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How to handle asbestos

• LEAVE IT ALONE (if in good condition).
• Look for signs of wear or damage such as tears,
  abrasions, or water damage but avoid touching the
  material.
• If damaged or renovation might disturb it, repair
  or removal by a licensed professional is needed.

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xylene
benzene
styrene
VOLATILE ORGANIC COMPOUNDS
Tetrachloro- ethylene
P-dicholoro- benzene
Methylene chloride
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VOLATILE ORGANIC COMPOUNDS (VOCs)

• Common sources of VOCs
• Paints
• Strippers and other solvents
• Aerosol sprays
• Cleansers disinfectants
• Moth repellents
• Air fresheners
• Stored fuels
• Automotive products
• Hobby supplies
• Dry-cleaned clothing

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Volatile Organic Compounds

• Environmental Tobacco Smoke
• Carpets
• Pressed wood furniture
• Vinyl floors

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Why Avoid Volatile Organic Compounds?

• Potential health problems from volatile organic
  compounds
• Eye, nose, throat irritation
• Headaches, nausea, coordination
• Liver, kidney, and brain damage
• Some can cause cancers

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Radon A Serious Health Concern

• Radon is a naturally occurring gas that comes
  from the ground.
• 2nd leading cause of lung cancer after smoking
  with more than 20,000 deaths annually
• Leading cause of lung cancer in nonsmokers and
  people who have never smoked.

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Where is radon found?

• It moves up through the ground to the air above
  and into your home through cracks and other holes
  in the foundation.
• Your home traps radon inside, where it can build
  up.
• Any home may have a radon problem new and old
  homes, well-sealed and drafty homes, and homes
  with or without basements.

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How can you check for radon?

• Short-term or long term radon test.
• A long-term test more likely to estimate your
  homes year-round average radon level.
• If the level is above 4 pCi/L, information about
  corrective measures is included with the results.

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How do you fix radon problems?

• Seal cracks in basement floors and walls with
  polyurethane caulk.
• Vent gas through the roof

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Testing for Radon

• Testing Options
• For kits call 1-800-SOS-RADON, purchase retail,
  or from certified company
• Hire a professional

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Keep It Contaminant-Free What You Can Do

• Test children under age 6 for lead exposure.
• If your home was built before 1978 and paint is
  peeling, chipping or flaking, you should have the
  paint tested for lead.
• If any remodeling work will be done on your
  house, find out if work is happening on an area
  that contains lead-based paint.
• Do not smoke in the house.
• If you see damaged insulation or plaster, dont
  disturb it, it may contain asbestos.
• Avoid using products that have volatile organic
  compounds.
• Test your house for radon.

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• If you rent, your landlord should

• Know whether your home has been tested for
  lead-based paint (if built before 1978).
• If there is lead-based paint, take steps to deal
  with it in a safe way.
• Be aware of possible asbestos when working on
  insulation or plaster.

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Using Help Yourself to a Healthy Home as a Client
Resource A Contaminant Free Example
Information for clients (page 29- 32)
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7 Healthy Homes Principles

• Keep It
• Dry
• Ventilated
• Clean
• Pest-Free
• Safe
• Contaminant-Free
• Maintained

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Maintenance

• Plumbing problems (for water leaks)
• Roof, walls, foundation (for water leaks)
• Heating, cooling and humidity
• Cooking
• Ventilation
• Storage and Organization

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One example
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Another example
A clogged furnace filter makes it hard for air to
flow.
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When?
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Keep It Maintained What You Can Do
If you rent or own
If you rent, your landlord should

• Call your landlord or skilled maintenance person
  as soon as you notice moisture, cockroaches,
  mice, or holes in your home.
• Call landlord or skilled plumber if your toilet
  overflows.
• If you own, make sure to replace furnace filters
  on a regular basis.
• Clean grease filter on your stoves range hood
• Check gutters and downspouts in spring and fall
• Watch for freezing pipes that crack and leak. Fix
  if you own. Contact your landlord if you rent.

• Fix water leaks or water damaged areas.
• Fix all cracks and holes.
• Help you to get rid of cockroaches and mice.
• Maintain furnaces and hot water heaters in good
  condition and replace furnace filters on a
  regular schedule.
• Check gutters and downspouts for clogs caused by
  leaves.
• Fix pipes that have frozen, cracked and leaked.