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Summary of Two Key Institute of Medicine Reports Regarding

1. People can continue offering and taking the HUD and EPA approved eight hour lead safe work practices course People who take or have taken this course will only need to take the four hour certified renovator refresher course instead of the eight hour certified renovator initial training course Go to www epa gov lead pubs renovation htm to download a copy of the new Renovate Right Important Lead Hazard Information for Families Child Care Providers and Schools pamphlet See www healthyhomestraining org References Page 59 of 137 Advance Information Distribution Requirements 40 CFR 745 84 Inside Dwelling Units In Common Areas of Multi In Child Occupied Facilities in Target Housing Unit Target Housing including in target housing When to Notify No more than 60 days before beginning work 7 days if mailing What to Deliver EPA Pamphlet Either EPA Pamphlet 1 Written notice to each affected unit or 2 Post informational signs and EPA Pamphlet Documentation of Delivery to Owner Owner s signature on acknowledgment or certificate of mailing Documentation of Delivery to Adult Occupant Same as above for owner or certify in writing that attempt made but was unsuccessful See Additional Documentation Below If facility is not owner then same as above or certify in writing that attempt made but was unsuccessful Notice to Parents or Guardians
2. is a properly installed fire suppression system Currently few homes are protected by residential sprinkler systems Sprinkler systems can be installed for a reasonable price These systems can be retrofitted to existing construction The final element in escaping from a residential fire is having a fire escape plan 8 The HH Manual does not discuss Principle 24 dwelling construction or 30 traffic See www healthyhomestraining org References Page 47 of 137 16 17 18 19 Protection against danger of electrical shocks and burns P27 Electrical distribution equipment was the third leading cause of home fires and the second leading cause of fire deaths in the U S between 1994 and 1998 38 300 home electrical fires occurred in 1998 which resulted in 284 deaths and 1 184 injuries Electrical fires are one of the leading types of home fires in manufactured homes M any electrical fires in homes are associated with improper installation of electrical devices by do it yourselfers Protection against gas poisonings P28 In 2001 an estimated 130 deaths occurred as a result of CO poisoning from residential sources this decrease in deaths down from about 600 in 1998 is related to the increased use of CO detectors In addition approximately 10 000 cases of CO related injuries occur each year Protection against falls and other mechanical injuries in the home P29
3. Enterprise Community 1CC 700 National Partners Green EPA Indoor Air USGBC Green Building Health Principles Communities Package LEED For Homes Standard DRY A A B C CLEAN D D D D VENTILATED A A A C SAFE D D D D CONTAMINANT FREE A A D D PEST FREE A A B D MAINTAINED A A A A VERIFIED CERTIFIED B A A A OVERALL GRADE B B C D Based on total score across all criteria in comparison to 85 target score Grading Key A gt 100 all NCHH criteria included 90 100 of target score 80 89 of target score 70 79 of target score g O m gt lt 70 of target score See www healthyhomestraining org References Page 77 of 137 See www healthyhomestraining org References Page 78 of 137 U S Department of Health and Human Services U S Department of Housing and Urban Development Healthy Housing Inspection Manual SERVICES ae K y gt 3 ee www healthyhomestraining org References Page 79 of 137 lt oy vara Contents PREFACE A lect ch la A 1 PL VeRO This Manual u u uum o 3 SECTION 1 Healthy Homes Model Resident Questionnaire a a a 4 General Housing Characteristics U U U U rra rr 5 Indoor Pe llutantS uu uu u u uu aun A E E E Eaa AEE 6 Home Sei uu n au sm Qu cme aaa aw Satu AAA daa asa A A ads 7 Voluntary Health Assessment Data ocoooiniinnnniic a a 8 S
4. RESIDENT REPORTED INFORMATION Bolded responses indicate areas of greater concern Type of ownership Age of home Structural foundation Floors lived in check all that apply Fuel used Sources in home 3 E Filters changed Control Cooling Ventilation check all that apply 1 Own house LJ Pre 1950 _J Basement LJ Basement J Natural gas Fi Baseboards Yes Easy to control heat 1 Windows 1 Open windows 1 Market rate rental hsg 1 1950 1978 LI Slab on grade a 4st T Oil 1 Radiators 1 No LJ Hard to control heat Central window AC 1 Kitchen amp bathroom fans 1 Subsidized rental hsg 1 Post 1978 1 Crawlspace a gnd LI Electric LI Forced hot air vents LI HEPA air filter LI Fans LI Central ventilation LI Shelter LJ Don t know LI Don t know 3 or higher LI Wood LI Other LI Don t know 1 None Mold and moisture Presence Pet Management Cockroaches Mice Rats Pests Bedbugs Lead paint hazards Asbestos Radon Health and Safety Alarms Tobacco smoke exposure Other irritants Type of cleaning NOTES 1 Uses dehumidifier A Uses vaporizer or 1 No damage humidifier T No pets Li Cat 1 Kept strictly outdoors 1 Not allowed in patient s bedroom Li None 1 Family reports LI None 1 Family reports LI None 1 Family reports LI None 1 Family reports 1 Tested and passed l Test
5. 12 5 points ICC 700 National Green Building Standard Hot Water Temperature lt 120 F 0 0 0 0 Locked Medicine Storage Cabinets 0 0 0 0 Shower Grab Bars 0 0 0 0 Smoke Detectors 2 2 2 2 Carbon Monoxide Alarms 3 3 3 1 TOTAL 5 40 5 40 5 40 3 24 CONTAMINANT FREE 7 Criteria 17 5 points Low VOC Products 3 0 1 1 Urea Formaldehyde Free Composite 3 3 i i Wood Products or Sealed Low VOC Carpet 3 3 1 1 Garage Isolation 3 3 1 2 Smooth Cleanable Low VOC Floors 1 1 1 1 Combustion Venting 2 3 3 Radon Test and Mitigation System 3 2 2 2 Smoke free Policy optional 0 3 0 1 Use Lead Safe Work Practices optional applicable only to rehabilitation A sie 7 i TOTAL does not include optional scores 18 103 17 97 10 57 9 51 PEST FREE 1 Criterion 2 5 points THIRD PARTY VERIFICATION 1 Criter On Site Inspection 2 ion 2 5 points 3 Rodent Proof Materials 3 3 2 1 TOTAL 3 120 3 120 2 80 1 40 MAINTAINED 2 Criteria 5 points Users Manual for Health Features 3 3 3 3 Homeowners Manual for Equipment ae 3 2 3 2 and Certification TOTAL 6 120 5 100 6 120 5 100 3 3 TOTAL 2 80 3 120 3 120 2 120 See www healthyhomestraining org References Page 76 of 137 Table 2 National Green Program Health Grades
6. 3 Keep all common areas of the premises in a clean and safe condition 4 Maintain in good and safe working order and condition all electrical plumbing sanitary heating ventilating air conditioning and other facilities and appliances including elevators supplied or required to be supplied by him 5 Provide and maintain appropriate receptacles and conveniences for the removal of ashes garbage rubbish and other waste incidental to the occupancy of the dwelling unit and arrange for their removal and 6 Supply running water and reasonable amounts of hot water at all times and reasonable heat between October 1 and May 1 except where the building that includes the dwelling unit is not required by law to be equipped for that purpose or the dwelling unit is so constructed that heat or hot water is generated by an installation within the exclusive control of the tenant and supplied by a direct public utility connection If the duty imposed by paragraph 1 of subsection a is greater than any duty imposed by any other paragraph of that subsection the landlord s duty shall be determined by reference to paragraph 1 of subsection a The landlord and tenant of a single family residence may agree in writing that the tenant perform the landlord s duties specified in paragraphs 5 and 6 of subsection a and also specified repairs maintenance tasks alterations and remodeling but only if the transaction is entered into in go
7. 1 3 1 0 7 9 3 4 2 1 1 0 24 8 0 4 90 0 58 3 44 5 3 7 21 0 West 24 400 1 9 1 1 12 4 3 5 1 9 1 1 11 8 0 2 92 1 57 2 42 8 5 7 19 8 References Page 16 of 137 Total Occupied Units 000 HEATING FUEL Main Heating Equipment Warm air furnace Steam or hot water system Electric heat pump Built in electric units Floor wall or other built in hot air units without ducts Room heaters with flue Room heaters without flue Portable electric heaters Stoves Fireplaces with inserts Fireplaces without inserts Other Cooking stove None Water Heating Fuel Electricity Piped gas Other Clothes Dryer Fuel Electricity Piped gas Other Heating Problems Uncomfortably cold for 24 hours or more last winter Heating Equipment Other causes Utility interruption Inadequate heating capacity Inadequate insulation Cost of heating Other Occupied Units 110 692 62 9 11 5 11 7 4 3 4 5 1 0 1 1 0 9 0 9 0 1 0 0 0 4 0 1 0 4 40 0 51 4 8 5 77 1 21 3 1 6 8 2 2 4 6 0 2 4 1 0 0 8 0 8 1 3 Owner 75 647 67 4 9 9 12 6 2 8 2 7 0 9 1 0 0 6 1 0 0 2 0 1 0 4 0 0 0 3 37 9 53 1 9 0 75 1 23 2 1 8 7 3 2 0 5 5 2 7 0 5 0 5 0 9 1 1 Renter 35 045 53 2 15 0 9 8 7 6 8 4 1 3 1 3 1 7 0 4 0 1 0 0 0 5 0 2 0 7 44 5 48 0 7 5
8. 6 9 0 3 1 2 1 9 3 7 1 2 0 7 1 4 2 0 8 4 8 0 17 5 26 8 12 1 18 3 American Housing Survey National 2007 Selected Elements Related to Healthy Homes Const lt 4 years 5 747 33 0 6 0 3 0 2 0 2 0 0 59 1 0 0 2 0 0 0 4 0 4 0 4 0 1 0 2 0 0 1 4 1 6 8 4 21 2 19 3 43 9 See www healthyhomestraining org 20 392 516 2 5 1 7 0 7 0 1 0 1 580 2 8 0 2 0 1 1 1 1 5 0 5 0 2 0 7 1 0 4 5 5 0 13 0 27 8 15 6 25 292 348 1 4 1 0 0 3 0 1 0 0 715 2 8 0 1 0 2 1 2 1 4 0 5 0 2 0 5 0 9 4 6 4 7 13 0 28 1 16 6 Manuf Severe Moderate Movedin Below Housing Problems Problems Elderly past year poverty Northeast Midwest 6 919 1 806 3 965 22 864 17 904 14 157 113 1 806 300 359 467 1 6 100 0 0 0 1 3 2 0 3 3 1 1 69 7 0 0 1 2 1 4 2 3 0 4 25 6 0 0 0 2 0 5 0 8 0 0 2 7 0 0 0 0 0 1 0 1 0 2 4 3 0 0 0 0 0 1 0 3 216 3 965 697 992 1 087 3 1 0 0 100 0 3 0 5 5 7 7 0 1 0 0 4 7 0 1 0 2 0 3 1 4 0 0 28 7 1 4 1 1 2 3 1 5 0 0 30 4 0 6 1 2 2 3 0 2 0 0 39 4 1 0 3 3 3 0 1 4 4 1 2 6 0 3 0 8 1 6 0 8 1 9 1 5 0 1 0 5 0 4 1 4 3 5 3 2 0 3 0 9 1 5 1 9 3 3 3 9 0 5 1 6 1 9 8 0 11 0 12 2 3 5 6 4 8 9 6 6 8 3 8 7 3 1 6 5 6 5 12 3 13 6 14 9 7 8 16 6 13 4 22 7 25 1 23 2 24 0 27 6 23 5 11 8 10 7 9 4 16 7 14 7 1
9. 85 9 13 6 0 6 10 1 3 3 7 0 1 6 1 9 1 6 0 8 1 8 American Housing Survey National 2007 Selected Elements Related to Healthy Homes Const lt 4 years 5 747 71 7 2 5 21 8 1 2 1 5 0 1 0 0 0 1 0 2 0 1 0 0 0 6 0 0 0 1 43 8 48 2 8 0 78 2 19 5 2 2 4 8 1 3 3 5 2 3 0 3 0 2 0 4 0 4 See www healthyhomestraining org Manuf Severe Moderate Movedin Below Housing Problems Problems Elderly past year poverty Northeast 6 919 1 806 3 965 22 864 17 904 14 157 20 392 75 8 44 3 39 7 60 3 61 7 56 2 42 1 0 3 21 9 11 2 13 0 8 5 12 8 45 8 13 7 7 3 4 5 11 6 13 2 8 5 1 8 1 2 5 1 5 1 5 0 5 8 6 4 5 5 2 1 7 8 4 9 4 3 5 9 6 7 2 1 1 0 1 9 1 4 1 6 1 0 1 9 0 8 1 5 2 8 28 7 1 5 1 1 2 5 0 1 2 3 3 7 2 6 0 8 1 0 1 8 0 1 1 2 3 3 0 7 0 9 0 1 1 1 0 9 0 0 0 2 0 1 0 2 0 1 0 1 0 1 0 2 0 2 0 1 0 1 0 0 0 0 0 0 0 4 0 4 0 4 0 3 0 7 0 9 0 3 0 1 0 6 0 1 0 1 0 1 0 2 0 2 0 1 0 4 0 6 0 3 0 7 0 7 0 1 74 2 35 9 39 9 41 7 46 3 45 9 22 0 18 9 50 0 51 1 48 5 48 8 46 5 49 8 6 9 14 1 9 0 9 7 4 9 7 6 28 2 91 3 75 7 84 3 77 2 83 7 83 3 68 2 6 2 22 6 15 1 21 0 15 5 15 8 28 4 2 4 1 8 0 6 1 8 0 8 0 9 3 4 12 0 37 3 17 1 6 1 7 6 11 8 8 5 3 6 29 5 3 5 1 6 2 2 3 8 3 3 8 6 11 4 13 9 4 6 5 6 8 3 5 4 4 0 2 0 2 1 2 2 1 3 1 7 1 6 1 4 4 2 3 7 0
10. Environment Healthy Indoor Air for America s Homes www healtyindoorair org facts_ lead html Community Environmental Health Resource Center CEHRC www cehrc org tools lead leaddust background cfm Alliance for Healthy Homes www afhh org or 202 543 1147 National Center for Healthy Housing www centerforhealthyhousing org Parents Against Lead PAL 773 324 7824 www hud gov offices lead MOLD lll DEN or U S Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control The key to mold control is moisture control U S Environmental Protection Agency Does your home have m Stains or discoloration on your walls ceiling or furniture m A damp or musty smell m Water problems like a leaky roof or water in the basement What is it Molds are alive There are hundreds of thousands of different types of mold They are living organisms that grow naturally particularly in warm damp humid conditions where there is little air movement Often called mildew molds are related to mushrooms and yeast but are much smaller we can only see or smell mold when there is a large quantity Mold can grow almost anywhere on walls ceilings carpets or furniture Humidity or wetness caused by water leaks spills from bathtubs or showers or condensation can cause mold to grow in your home Mold produces spores tiny particles that float through the air These
11. Respiratory and allergic effects Summary Report prepared by National Center for Healthy Housing from the Report on the WHO technical meeting on quantifying disease from inadequate housing Bonn Germany 28 30 November 2005 See www euro who int Document HOH EBD Bonn Report pdf For more information on WHO Regional Office for Europe s work on housing and health see www euro who int Housing 20060519_2 See www healthyhomestraining org References Page 3 of 137 Percentage of Households reporting smoke free home rules by state area Current population Survey United States 1992 93 1998 99 and 2003 change from 1992 State Area 1992 1993 1998 1999 1993 to 2003 69 6 81 1 I Utah 88 8 California 84 4 Arizona 82 4 Oregon a 81 2 Hawaii 79 7 Nevada 79 6 Colorado 79 3 Washington i 79 3 Idaho a 78 8 Texas 78 5 Florida 78 5 Georgia 77 4 Maryland 75 9 Alaska 75 8 Massachusetts 75 5 New Mexico 75 5 New Hampshire 74 6 New Jersey 74 0 Connecticut 73 4 Virginia 72 7 Minnesota 71 5 South Dakota i 71 1 Alabama 70 9 New York E 70 5 Montana 70 0 Rhode Island E 69 8 Delaware 69 7 Mississippi 69 6 Vermont 69 3 Nebraska 69 2 Maine E 69 0 Louisiana 68 6 North Dakota E 68 2 District of Columbia s a 68 1 lowa 68 0 Pennsylvania 67 5 South Carolina 67 5 Kansas 66 9
12. deck attaches to house Check below window amp door E that flashing intact G S F E 2 E L Repair broken cracked glass o Look for signs of leaks at Basement a 1E H F window and door sills No wet surfaces puddles Clean dryer vent Sump pump and check e Check exhaust ducts are clear O valve working Floor drain working Vacuum basement surfaces j Maintenance Checklist continued on next page Check for signs of rodents bats roaches termites Buin 3 BS Wy Healthy homes training Org wincopin Circle st References page 09 9 AS ifryhousing org I a Check washer hoses connections Plumbing Fixtures and Appliances Y Check dishwasher hoses for leaks Check toilet supply shut off valve Clean amp check refrigerator drip pan icemaker connections Check shower tub surrounds for signs of damage Check traps and drains under sinks tubs showers for leaks 00 0 Check hot water heater for leaks Check boiler for leaks Check water main meter or well pump for leaks or sweating Check water main meter or well pump for leaks or sweating Clean septic tank 2 yrs Check drain and supply time for leaks O Check bath and kitchen fans operation bo
13. e Safety standard for entrapment hazards in bunk beds 16 CFR Part 1213 e Ban of unstable refuse bins 16 CFR Part 1301 e Ban of extremely flammable contact adhesives 16 CFR Part 1302 e Ban of lead containing paint and certain consumer products bearing lead containing paint 16 CFR Part 1303 e Ban of consumer patching compounds containing respirable free form asbestos 16 CFR Part 1304 e Ban of artificial emberizing materials ash and embers containing respirable free form asbestos 16 CFR Part 1305 e Self pressurized consumer products containing chlorofluorocarbons 16 CFR Part 1401 e CB base station antennas TV antennas and supporting structures 16 CFR Part 1402 e Cellulose insulation 16 CFR Part 1404 e Coal and wood burning appliances notification of performance and technical data 16 CFR Part 1406 e Requirements for full size baby cribs 16 CFR Part 1508 e Requirements for non full size baby cribs 16 CFR Part 1509 e Requirements for bunk beds 16 CFR Part 1513 e Standard for the flammability of vinyl plastic film 16 CFR Part 1611 e Standard for the surface flammability of carpets and rugs FF 1 70 16 CFR Part 1631 e Standard for the surface flammability of small carpets and rugs FF 2 70 16 CFR Part 1631 e Standard for the flammability of mattresses and mattress pads FF 4 72 amended 16 CFR Part 1632 e Standard for the flammability open flame of mattress sets Eff 7 1 07 16 CFR Part 1633 e Standard for devices
14. m Keep people with asthma out of a room while vacuuming or dusting Get medical advice and follow the doctor s instructions m Get medical attention for breathing problems m Get emergency medical care for bad attacks of shortness of breath or wheezing m Take all prescribed medication either to prevent attacks or to lessen the symptoms m Find out what allergies you have so you can avoid these potential asthma triggers n WWW ag y O e d ASTHMA For more information Visit HUD s website at www hud gow offices lead for more information about addressing health hazards in homes or to leam if HUD has a Healthy Homes program in your community From this website you can download a copy of Help Yourself to A Healthy Home for more practical steps you can take to make your home a healthy home Other Federal Resources US Centers for Disease Control and Prevention www cde gov od oc childhealth US Environmental Protedion Agency www epa gov children Other Resources American Academy of Allergy Asthma and Immunology AAAA www aaaai org Asthma and Allergy Foundation of America www aafa org The Allergy amp Asthma Network Mothers of Asthmatics AANMA Wwww aanma org Ask your doctor or contact your local or state department of health Cockroaches can trigger asthma Use traps gel bait and cleaning to deal with roaches Photo by January E Jones Improving Kids Environment Asthma Prevalence
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16. 4 Carol W Runyan PhD et al January 2005 5 Reference State of Home Safety in America 2002 survey national telephone survey Website of the US Census Bureau American Housing Survey Web site http www census gov hhes www housing ahs ahs html 6 Federal Hazard Substance Act Public Law 86 613 74 Stat 372 July 12 1960 as amended 7 Source Children s Hospital of Pittsburgh website http www chp edu mryuk 05a_mryuk php 8 Arts and Crafts Materials Institute Safety What you Need to Know http www acminet org Safety htm Avoid Contaminants 1 NAS Committee on Toxicity Data Elements 2 US Environmental Protection Agency Last updated February 1 2005 Lead in paint dust and soil Retrieved March 3 2005 from Web site http www epa gov lead index html 3 Jacobs D E Clickner R P Zhou J Y Viet S M Marker D A Rogers J W Zeldin D C Broene P Friedman W 2002 The prevalence of lead based paint hazards in U S housing Environmental Health Perspectives 110 10 A599 606 4 Cunningham J O Connor G T Dockery D W Speizer F E 1996 Environmental tobacco smoke wheezing and asthma in children in 24 communities 4m J Respir Crit Care Med 153 1 218 224 5 Nischke I A Traynor G W Wadach J B et al 1985 Indoor Air Quality Infiltration and Ventilation in Residential Buildings New York State Energy Research and Development Authority NYSERDA
17. A IA 3 1OlIAgu q eBueyo o jasunog Awe UM UNION oq O Ajiwe4 u SUS A IA 3 Proyo a 1y sjuauns9op juajuo9 BJO spmajes esn MMM dH ye von euwJojul jayes a asou 190 ueld jajes lltuej e dojanap se yons sioiAeyaq BuEgu2 o jasunoy O OOO 00 0 0 OO O O oa OL ASYNN s eB 1 ppo L in jei duu 1972M JOH Page 104 of 137 qn ul ayy ynpe ue Aq payojem pitu neces plo sie 9 uey ssa Q u ipli u2 10 Bursa pe 1 E seuo pawysanddns Sujuea 9 spinb1 oH N XJ NO9 u ipiiuS Buno A D D JUBWUOJIAUD 1ol x3 35 e sSi1 uBil pue s y N E gt aoueljdde 18911999135 T Q z uejd de s ouy lluuej NUZINOI Y panuruos jajes jesauay Se jajes p109 Jo suu i Huyoosdpyiyo eseyamg O y9ea S UBIPIIYD JO no spio2 pulg mopuim desy O spienB mopu jjeysuy O a1qe 1eAe saounosed plenB mopuim aJe aJay Jeyleym uluuJ 8 p o WeIBOId uonu A id Anfu eoco jpejuo O deb OU sI 3194 JEU os quo ay o xau Bnus s ss meu quo no yey SINSUW O yjesuJapun Bulppeq yos ou pue ssa peu zey wy UMA quo e u d ls o qeq Ino ing O Od OL ATIINVA Apwe YM uuunio2 odq OL Ajlwe4 u SUIS Mana y jajes p109 JO suu Huljoosdpyjiyo eseyond o pue yoe s u i1pjiuS JO no sp109 pul q mopuim dasy o AjIwWe jesunoo Alles YM uulnio2 odq OL Ajlwe4 u SUIS M H S1qe 1ene seoinosel
18. Arsenic References Chapter 6 Housing Structure Introduction New Housing Terminology Old Housing Terminology Foundation Vapor Barriers Crawl Space Barriers Vapor Barriers for Concrete Slab Homes Wall and Ceiling Vapors House Framing Foundation Sills Flooring Systems Studs Interior Walls Stairways Windows Doors Roof Framing Rafters Collar Beam Purlin Ridge Board Hip Roof Sheathing Dormer Roofs Asphalt Shingle EPDM Asphalt Builtup Roofs Coal Tar Pitch Builtup Roofs Slate Roofs Tile Roofs Copper Roofs Galvanized Iron Roofs Wood Shingle Roofs Roof Flashing Gutters and Leaders Exterior Walls and Trim Putting It All Together References See www healthyhomestraining org Additional Sources of Information Chapter 7 Environmental Barriers Introduction Roof Insulation Siding Fiber Cement Brick Stucco Vinyl Asbestos Metal References Chapter 8 Rural Water Supplies and Waterquality Issues Introduction Water Sources Source Location Well Construction Sanitary Design and Construction Pump Selection Dug and Drilled Wells Springs Cisterns Disinfection of Water Supplies Chlorine Carrier Solutions Routine Water Chlorination Simple Well Water Shock Chlorination Backflow Backsiphonage and Other Water Quality Problems Backflow Backsiphonage Other Water Quality Problems Protecting the Groundwater Supply References Additional Sources of Information Ch
19. Carter M C 1997 Asthma and indoor exposure to allergens New England Journal of Medicine 336 19 1382 4 27 Krieger J W Song L Takaro T K Stout J 2000 Asthma and the home environment of low income urban children preliminary findings from the Seattle King County healthy homes project Journal of Urban Health 77 1 50 67 28 U S EPA 1998 Chemical hazard data availability study Retrieved March 13 2005 from Web site http www epa gov opptintr chemtest hazchem htm 29 Whyatt R M Camann D E Kinney P L Reyes A Ramirez J Dietrich J Diaz D Holmes D Perera F P 2002 Residential pesticide use during pregnancy among a cohort of urban minority women Environmental Health Perspectives 110 5 507 14 30 Jordan E R Ehrlich R I Potter P 1999 Environmental tobacco smoke exposure in children Household and community determinants Archives of Environmental Health 54 5 319 27 31 Faustman E M Silbernagel S M Fenske R A Burbacher T M Ponce R A 2000 Mechanisms underlying Children s susceptibility to environmental toxicants Environmental Health Perspectives 108 Suppl 1 13 21 32 Rivara F P Calonge N Thompson R S 1989 Population based study of unintentional injury incidence and impact during childhood American Journal of Public Health 79 8 990 4 33 Scheidt P C Harel Y Trumble A C Jones D H Overpeck M D Bijur P E 1995 The
20. J T Distribution of pesticides and polycyclic aromatic hydrocarbons in house dust as a function of particle size Environmental Health Perspectives 107 9 721 6 Keep It Pest Free 1 Hirschhorn R B Hodge R R 1999 Identification of risk factors in rate bite incidents involving humans Pediatrics 104 3 e35 2 Source The American Association of Poison Control Centers 3 Source Children s Hospital of Pittsburgh website http www chp edu mryuk 05a_mryuk php Page 5 of 9 See www healthyhomestraining org References Page 117 of 137 4 US EPA Office of Indoor Air Quality 2004 Sources of Indoor Air Pollution Pesticides Retrieved October 6 2004 from Web site http www epa gov iaq pesticid html 5 Community Environmental Health Resource Center Tools for Detecting Hazards http www cehrc org tools webres index cfm 6 US EPA Region 9 2004 Integrated Pest Management for Schools A How to Manual Retrieved March 14 2005 from Web site http www epa gov pesticides ipm schoolipm index html 7 Community Environmental Health Resource Council Revised 2004 May Cockroaches Retrieved July 11 2005 from Web site http www cehrc org tools cockroaches index cfm 8 Safe control Cockroaches and rodents using IPM in your neighborhood Available through U S EPA Keep It Ventilated 1 Wallace L 2000 Real time monitoring of particles PAH and CO in an occupied townhouse App
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22. See www healthyhomestraining org References Page 32 of 137 Table 1 Comparison of Regulatory Approaches to Healthy Homes Housing Property Health Sanitation Landlord Tenant Product Standards Hazard Management Law Maintenance Code Code Law National Yes for federally No Lead disclosure and Yes for specific Yes for specific hazards Requirements assisted housing No fair housing products and such as lead asbestos and for other housing general standards pesticides State Several states Several states Most States Yes for Generally yes for specific Requirements pesticides All hazards in addition to must be consistent federal such as carbon with federal monoxide and radon Local Common except in Common but Common in large Uncommon Larger community for Requirements rural areas limited scope urban areas specific hazards in addition to federal and state Current Yes International No Yes Uniform Industry Federal government and National Property Maintenance Residential Landlord Consensus some associations issue Models Code IPMC and Tenant Act Standards guidelines to address URLTA specific hazards For More Part A Housing e Part C for e PartD URLTA e PartE Page e PartF Page 25 Information Quality Standards American Public Page 19 23 e Part G EPA s Page 4 Part B IPMC Page 9 Health APHA Association 1938 Principles Page 14
23. Two states New York and Virginia and more than 600 local jurisdictions have adopted the IPMC with modifications See Part B on page 9 for more information on the IPMC Health Sanitation Code There is no national health code for housing State and local agencies mostly in the Northeast have adopted health or sanitation codes that address health and safety hazards in housing Many urban areas have also adopted vector control programs generally focused on rodents and mosquito harborage The leading example of a state health or sanitation code is the State Sanitary Code for the State of Massachusetts The only model health or sanitation code was adopted by the American Public Health Association APHA in 1938 and has not been updated The U S Centers for Disease Control and Prevention CDC used this model code as the foundation for its Healthy Homes Reference Manual See Part C on page 14 for more information on the APHA model health sanitation code Building a lead safe and healthy home environment for all children 10320 LITTLE PATUXENT PARKWAY SUITE 500 COLUMBIA MARYLAND 21044 410 992 0712 FAX 443 539 4150 See www healthyhomestraihity Org orealihyhousing References Page 31 of 137 Landlord Tenant Law There is no national landlord tenant law for rental housing The Federal Lead Hazard Disclosure adopted by both the U S Environmental Protection Agency EPA and HUD requires landlords sellers and their agents to disclose
24. Wisconsin E 66 4 Wyoming 65 5 North Carolina a 65 4 Illinois a 3 64 8 Oklahoma i s 64 7 Tennesse 64 2 Missouri 64 0 Indiana 62 7 Ohio 60 8 Michigan 60 7 Arkansas 60 1 West Virginia 57 1 Kentuck 53 4 Minimum 25 7 38 9 53 4 27 6 Maximum 69 6 81 1 88 8 Range 43 9 42 3 35 4 80 2 Median 39 9 58 6 69 8 71 7 Total 43 2 60 2 72 2 67 1 U S Centers for Disease Control and Prevention Morbidity Mortality Weekly Report May 25 2007 56 20 501 504 See www cdc gov mmwr preview mmwrhtmi mm5620a3 htm See www healthyhomestrarainig ary References Page 4 of 137 Midcourse Review HEALIHY PEOPLE Environmental Health Co Lead Agencies Agency for Toxic Substances and Disease Registry Centers for Disease Control and Prevention National Institutes of Health Contents A AN 8 3 INTOdUCION su coria Da aa at io diodo taa 8 3 Modifications to Objectives and Subobjectives o o ooooo 8 3 Progress Toward Healthy People 2010 Targets 8 5 Progress Toward Elimination of Health Disparities 8 7 Opportunities and Challenges 8 8 Emerging ISSUES 462 avi e A AAA AAA 8 11 RGICIENCES 3 oroen iva tad amaa nda ci dd dica 8 45 Related Objectives From Other FOCUS Areas 8 47 See www healthyhomestraining org References Page 5 of 137 Figure 8 1 Progress Quotient for Focus Area
25. drapes U No window curtains poor ventilation Other irritants T Abundant cosmetics and fragrances General Active renovation or remodeling J Yes J No Stairs protective walls railings porches y Yes O No Hallway lighting J Adequate T Inadequate Poison control number 1 Posted by phone QO Not posted by phone Family fire escape plan D None L Developed and have copy available Electrical appliances radio hair dryer space heater LI Not used near A Used near water water 1 Out of child s reach LI Well maintained Matches and lighters stored Q Within child s reach m Abundant trash and 1 Chipping debris peeling paint Exterior environment A Broken window s See www healthyhomestraining org References Page 96 of 137 NURSE OBSERVED INFORMATION continued Young Children Present J Yes LJ No Coffee hot liquids and foods A Out of child s reach U Within child s reach Cleaning supplies stored A Out of child s reach Q Within child s reach Medicine and vitamins stored A Out of child s reach U Within child s reach Child less than six years old been tested for lead 7 within past 6 months Within past year or more No poisoning Result When _ Result _ Child watched by an adult while in the tub O Always AU Most of the time L No Home s hot water temperature J lt 120 F A gt 120 F LI Don t know Non accordion toddler gates used T At top of stairs O At bottom of sta
26. i e removal of load bearing member or structure even if asbestos may not be present and o any renovation that involves removal or disturbance of gt 260 linear feet or 160 ft of RACM e Certified workers remove all RACM a certified supervisor be present and required work practices be followed e g wet methods and no visible emissions e The collection transport and disposal of waste comport with regulatory requirements II Lead based Paint LBP The federal government has several legal authorities pertaining to LBP and LBP hazards e The Disclosure Rule2021 e The Lead Safe Housing Rule LSH Rule e The Toxic Substances Control Act TSCA and regulations thereunder o The Pre renovation Education Rule PRE Rule o The Renovation Repair and Painting Rule RRP Rule issued by EPA on April 22 2008 and fully effective on April 22 2010 and o The Lead based Paint Activities Certification and Training Rule LBP Activities Rule and e The Resource Conservation and Recovery Act RCRA Section 7003 18 NESHAP Fact Sheet for Renovation and Demolition Projects http yosemite epa gov R10 OWCM NSF webpage Asbestos in Demolition and Renovation 40 C F R Part 61 Subpart M 2 24 C F R Part 35 Subpart A HUD and 40 C F R Part 745 Subpart F EPA 21 42 U S C 88 4851 4853a known also as the Residential Lead based Paint Hazard Reduction Act of 1992 2 24 C F R Part 35 Subparts B R The U S Department
27. ka U S Department of Housing and Urban Development Office of Public and Indian Housing SPECIAL ATTENTION OF NOTICE PIH 2007 12 HA Regional Directors State and Area Coordinators Public Housing Hub Issued May 24 2007 Directors Program Center Coordinators Troubled Agency Recovery Center Directors Expires May 31 2008 Special Applications Center Director Administrators Offices of Native American Cross Reference Programs Public Housing Agencies 24 CFR 903 7 e 2 Housing Choice Voucher Section 8 Public This Notice Supersedes Notice Housing Agencies Tribally Designated PIH 2006 11 HA Housing Entities Indian Tribes Resident Management Corporations Subject Guidance on Integrated Pest Management 1 PURPOSE The purpose of this Notice is to inform public housing agencies PHAs and Tribally Designated Housing Entities TDHEs to reference materials on Integrated Pest Management IPM located in Maintenance Guidebook Seven Termite Insect and Rodent Control and reference material located at paragraph 7 of this notice PHAs and TDHEs HAs may choose to share this information with families and property owners participating in their programs 2 APPLICABILITY The information in this Notice may be of interest to HAs property owners property managers and family program participants when they review their pest control efforts The decision to reflect IPM processes in their ongoing pest control efforts rests solely on local manage
28. seek emergency medical attention immediately For more information Visit HUD s website at www hud gov offices lead for more information about addressing health hazards in homes or to learn if HUD has a Healthy Homes program in your community From this website you can download a copy of Help Yourself to A Healthy Home for more practical steps you can take to make your home a healthy home See www healthyhomestraining org Medications Insect Stings Contact and Bites with Skin m antibiotics m bees m plants like Penicillin m wasps like poison ivy anti seizure hornets m cosmetics drugs i m skin care i m yellow jackets anesthetics products m jewelry m latex gloves or condoms Other Federal Resources US Centers for Disease Control and Prevention www cdc gov od oc childhealth US Environmental Protection Agency www epa gov children Other Resources American Academy of Allergy Asthma and Immunology AAAAI Wwww ddaai org Asthma and Allergy Foundation of America www cafa org The Allergy amp Asthma Network Mothers of Asthmatics AANMA www aanma org Ask your doctor or contact your local or state department of health Keeping a clean home can reduce some allergens Source American Academy of Allergy Asthma and Immunology AAAAI The Allergy Report Science Based Findings on the Diagnosis amp Treatment of Allergic Disorders 1996 2001 References Page 123 of 137 www hud gov offices
29. 2to4 5to 9 10 to 19 20 to 49 50 or more Manufactured mobile home or Year Structure Built Post 2000 Post 1980 Pre 1980 Pre 1960 Pre 1940 Foundation 1 unit building excluding With basement under all of With basement under part of With crawl space On concrete slab Other Occupied Units Owner Renter 110 692 75 647 35 045 75 647 75 647 35 045 35 045 68 3 100 0 31 7 100 0 64 5 82 6 25 5 5 5 5 3 5 8 7 9 1 9 21 0 4 8 0 8 13 4 4 2 0 6 12 0 3 3 0 6 9 0 3 5 1 0 9 0 6 3 7 2 4 3 10 6 123 6 8 36 0 39 6 28 3 64 0 60 4 71 7 32 1 30 5 35 6 15 6 13 6 19 9 70 0 88 0 31 3 23 2 30 4 7 5 7 5 9 9 2 2 16 3 19 8 9 0 22 0 26 7 11 9 American Housing Survey National 2007 Selected Elements Related to Healthy Homes Const lt 4 years 5 747 4 710 1 036 82 0 18 0 73 8 8 7 3 2 2 1 2 5 1 6 2 2 5 9 100 0 100 0 0 0 0 0 0 0 82 5 23 5 3 2 13 1 42 3 See www healthyhomestraining org Manuf Severe Housing Problems 6 919 1 806 5 419 729 1 500 1 077 78 3 40 4 21 7 59 6 43 4 5 7 13 2 8 0 8 4 8 1 6 9 100 0 6 3 14 4 3 9 69 4 18 9 0 0 80 9 0 0 48 8 0 0 27 7 0 0 49 1 0 0 15 3 0 0 5 3 0 0 15 2 0 0 11 9 20 392 13 339 7 052 65 4 34 6 54 5 9 0 12 9 4 4 4 1 4 9 7 4 2 7 5 1 20 2 79 8 53 5 33 5 63 5 42 7 11 3 3 5 25 292 18 19
30. 8 Environmental Health HEH Moved away from target Moved toward target m Met target 8 1 8 3 Harmful air pollutants 1997 2001 a Ozone b Particulate matter c Carbon monoxide d Nitrogen dioxide e Sulfur dioxide f Lead g Any criteria pollutant Alternate modes of transportation 1995 2001 110 a Bicycling me b Walking c Transit 11 Cleaner alternative fuels 1997 2004 100 75 50 25 0 25 50 75 100 Percent of targeted change achieved See notes at end of chart continued See www healthyhomestraining org References Page 6 of 137 Figure 8 1 continued Moved away from target 8 5 8 6 See www healthyhomestraining org Safe drinking water community water systems 1995 2003 Waterborne disease outbreaks 1987 96 2002 Elevated blood lead levels 1 5 years 1991 94 1999 2002 Pesticide exposures causing health care visits 1997 2003 Pre 1950s homes tested for lead based paint 1998 2002 Substandard housing units 1995 2003 Global deaths from poor sanitation water or hygiene 1990 2000 Wastewater service provided U S Mexico border 1997 2002 a Ciudad Acuna b Matamoros e Piedras Negras f Reynosa 100 75 EB Moved toward target 50 25 0 25 50 75 B Mettarget 161 360 mmp 200 wy 180 gt 100 Percent of targeted ch
31. Given its urban location you know that the home is connected to a public water system As you go along you make notes and check off any relevant information on the PEHA Survey form Let s get started Welcome and Introductions e View Welcome and Introductions video clip 7 5 MB e View photos of basement conditions e View photos of outside conditions As you talk further the mom reports that she is a Section 8 tenant When she moved in she says the landlord told her that the house was built in 1958 and that lead hazard control work was completed before she moved in 18 months ago She could not remember getting any booklet or warnings about lead when she signed her lease You ask the mom about other general housing characteristics She knows there is a basement but has not been in there She says she has seen the oil truck connect up to the fittings on the side of the house She shows you the unlocked door to the basement in the common area You check out the basement The mom says that the oil heat can be hard to control in the winter Some rooms are too hot and others are too cold She sometimes has to open windows to make the rooms comfortable You observe and the mom reports that there are no pets in the home The mom is focused on the construction dust and mice She says she has not seen any mold You follow along on the PEHA Survey Form and ask about other pests The mom reports no trouble with cockroaches ra
32. H JOJEM POZI EJBUIWAP Jo p linsip esq Of J9 em PjOd ueaja YM Ajlep Jajem ay abueyo O Od OL ATINVS 6 AYAN payed se yolym s y asp O weak e a91m suayy ebuey O SJIOOP A0 SpOOA JO UBBJOS Bde daJy UO je s poof e s aJay zey aunsug O u n q y JOMO u Spio2 uolisu x BHneB y JO Z jUO sn lessagau u yM O qeuuuue J Buiu ue Wo jaa Se9 e ae siejesy 2oeds Guns eW O p sn JOU JO sioop no ay o pajuea ae si e u sussolay SINS YeN O ddd19 e e S YM yNsUOD sju ui uinb uiu pue suonye nBa e9o pue e s uo paseq Wau Iiedas spyezey ose aay O auwoy JNOA ul SpJezey peaj eje 194 Jayjeym uluu1 p o Ju uuss sse YS Jo uono dsul jured pes e Bummae6b Jepisuoy O yy esy jo sjuawyledap jedo pue aje s JINOA ye 4dd 10 wesboid uonu A id Buluosiod pe pooypIiyo ay j9ejuos pjo sie xis uey ss si piyo noA J oO Od OL ATINVd Ae UMA UNOS OQ OL Ajlwe4 u SUS Mana y le o aplAosd pue WY epiInbp OW pjouw AOD ede MAM dp y ye UONCWJOJU aJou 190 yyeoy lltuej uo pjow jo yoeduii y pue Aip sBuiu Buid y jo vueyodw ay jnoge lluuej ajeonpy Ae UA UNOS OQ OL Ajlwe4 u SUIS M H e o SpInoJd pue ujypruny sqnd be nob edo mmm dyy ye a9ueuajuleu J lJIpiuunu jnoqe UO EWIOJU aJou 190 yHesy juaned uo ymolB plow Jo pedu pue soueusj ulew Jal pruny 1aziloden Jado ud jo soueyodu y jnoge lluuej ay josunoo O O oa OL
33. No additional notice No additional notice required Provide EPA pamphlet and renovation information to parents and guardians by either 1 Mail reied 2 Hand delivery or 3 Post informational signs and EPA Pamphlet Notice of Changes to If notice given to each affected Scope Locations None Required unit update notice before None required and Dates of Work initiating work Additional Signed and dated statement of Signed and dated statement of Documentation steps performed to notify all steps performed to notify None Required occupants and provide them parents and guardians and with EPA pamphlet provide them with EPA pamphlet Post Renovation 30 Day Notice to Person Contracting for Renovation e If EPA recognized test kits were used provide manufacturer and model of test kit used description and location of components tested and test kit results e If dust clearance sampling is performed in lieu of cleaning verification provide copy of the dust sampling report EPA s new Renovate Right Important Lead Hazard Information for Families Child Care Providers and Schools The existing Protect Your Family from Lead in Your Home pamphlet can be used before 12 22 08 Must acknowledge receipt of the EPA pamphlet prior to start of renovation and contain the address of unit undergoing renovation name and signature of owner or occupant and the date of signature It must be in same langua
34. P18 Approximately 42 million Americans mostly in rural America get their water from private wells or other small unregulated water systems The presence of adequate water sewer and plumbing facilities is central to the prevention reduction and possible elimination of water related diseases Water related diseases can be organized into four categories Waterborne diseases i e those caused by contamination from chemical human and animal wastes such as cholera typhoid shigella polio meningitis and hepatitis A and E Water based diseases i e from aquatic organisms that become parasites These are rare in the U S Water related vector diseases i e those linked to vectors that breed and live in near water primarily mosquitoes that carry malaria yellow fever etc The West Nile virus is a vectorborne disease In the U S in 2003 there were 9 862 human cases of West Nile virus with 264 deaths Water scarce diseases i e diseases that flourish where sanitation is poor due to a scarcity of fresh water including diphtheria leprosy tuberculosis These conditions are essentially absent from the U S Protection against sewage contamination of interior surfaces P19 and avoidance of unsanitary conditions near the dwelling P20 In 2000 1 4 of U S homes lacked plumbing facilities The containment of household sewage is instrumental in protecting the public from waterborne and vectorborn
35. Sherman Ed Air Change Rate and Airtightness in Buildings ASTM 1067 8 U S EPA Office of Air and Radiation Indoor Environments Division 6609 J 2001 Mold Remediation in Schools and Commercial Buildings EPA Publication 402 K 01 001 Retrieved March 15 2005 from Web site http www epa gov mold mold_remediation html 9 New York City Department of Health and Mental Hygiene Guidelines on Assessment and Remediation of Fungi in Indoor Environments Retrieved May 5 2005 from Web site http www nyc gov html doh html epi moldrpt1 shtml 10 California Department of Health Services 2001 July Mold in my home What do I do Retrieved May 4 2005 from Web site www cal iag org mold 9803 htm 11 American Conference of Governmental Industrial Hygienists 1989 Guidelines for the assessment about aerosols in the indoor environment Cincinnati Ohio Keep It Clean 1 Source Pollutants in House Dust Roberts in Proceedings of Asthma and Allergen Control Healthy Indoors Environments 2000 2 Wallace L A Mitchell H O Connor G T Neas L Lippmann M Kattan M Koenig J Stout J W Vaughn B J Wallace D Walter M Adams K Liu L J 2003 Particle concentrations in inner city homes of children with asthma the effect of smoking cooking and outdoor pollution Environmental Health Perspectives 111 9 1265 72 3 Lewis R G Fortunte C R Willis R D Camann D E Antley
36. These verification and rating services generally require approxi mately 2 to 3 days per home The costs vary depending on the size and location of the homes and the number of green measures to be inspected and tested Mandatory Criteria Yes moderate Third Party Certification Yes Building Performance Testing Yes See www healthyhomestraining org References Page 69 of 137 ICC 700 2008 National Green Building Standard The National Association of Home Builders NAHB the International Code Council ICC and the NAHB Research Center initiated a process in 2007 for the de velopment of a national standard for green home build ing construction practices beyond current rating sys tems following the consensus process of the American National Standards Institute ANSI The standard en titled the ICC 700 National Green Building Standard NGBS is a voluntary green home building standard that can be adopted by local green home building programs as a conformance guide for single family multi family remodeling and site development projects The NGBS builds upon the NAHB Model Green Home Building Guidelines developed by the NAHB Re search Center in 2004 see NCHH s 2006 Comparison of Green Building Guidelines for an analysis of the NAHB Model Green Home Building Guidelines ANSI approved NGBS in January 2009 The NGBS includes a minimum number of mandatory construction practices and a mandatory minimum point score based
37. Water heating facilities Water heating facilities shall be properly installed maintained and capable of providing an adequate amount of water to be drawn at every required sink lavatory bathtub shower and laundry facility at a temperature of not less than 110 F 43 C A gas burning water heater shall not be located in any bathroom toilet room bedroom or other occupied room normally kept closed unless adequate combustion air is provided An approved combination temperature and pressure relief valve and relief valve discharge pipe shall be properly installed and maintained on water heaters 602 2 Residential occupancies Dwellings shall be provided with heating facilities capable of maintaining a room temperature of 68 F 20 C in all habitable rooms bathrooms and toilet rooms based on the winter outdoor design temperature for the locality indicated in Appendix D of the International Plumbing Code Cooking appliances shall not be used to provide space heating to meet the requirements of this section Exception In areas where the average monthly temperature is above 30 F 1 C a minimum temperature of 65 F 18 C shall be maintained 602 3 Heat supply Every owner and operator of any building who rents leases or lets one or more dwelling unit rooming unit dormitory or guestroom on terms either expressed or implied to furnish heat to the occupants thereof shall supply heat during the period from DATE to DATE to maintain a temper
38. and exterior stairs halls porches walkways etc must not present a danger of tripping and falling For example broken or missing steps or loose boards are unacceptable v Elevators must be working and safe h Interior air quality 1 Performance requirement The dwelling unit must be free of pollutants in the air at levels that threaten the health of the occupants 2 Acceptability criteria i The dwelling unit must be free from dangerous levels of air pollution from carbon monoxide sewer gas fuel gas dust and other harmful pollutants 11 There must be adequate air circulation in the dwelling unit 111 Bathroom areas must have one openable window or other adequate exhaust ventilation iv Any room used for sleeping must have at least one window If the window is designed to be openable the window must work i Water supply 1 Performance requirement The water supply must be free from contamination 2 Acceptability criteria The dwelling unit must be served by an approvable public or private water supply that is sanitary and free from contamination j Lead based paint performance requirement The Lead Based Paint Poisoning Prevention Act 42 U S C 4821 4846 the Residential Lead Based Paint Hazard Reduction Act of 1992 42 U S C 4851 4836 and implementing regulations at part 35 subparts A B M and R of this title apply to units assisted under this part k Access performance requirement The dwelling unit mus
39. both outdoors and indoors and include m Cold weather m Pollen m Exercise m Stress m Dust and dust mites m Cockroaches m Mold m Pet dander skin flakes R m Rodents w m Tobacco smoke i m Air fresheners continued on back www hud gow offices lead U S Department of Housing and a Urban Development k E Office of Healthy Homes and 5 Lead Hazard Control Photo by January E Jones Improving Kids Environment What can you do Because there is no cure for asthma it is most important to work on preventing attacks There are three major categories of prevention Keep a clean home m Make sure that your home is free of dust mold smoke and other potential triggers m Vacuum often HEPA High Efficiency Partide Air filters remove dust best m Keep foods stored in tightly sealed containers to avoid attracting cockroaches and rodents by keeping food in tightly sealed containers m Cear crumbs drips spills and dirty dishes immediately m Identify and quickly fix water leaks in your home Keep people with asthma away from dust dust mites and smoke m Use zippered allergen resistant mattress and pillow covers to Keep dust mites out of sleeping spaces m Keep pets outdoors or away from sleeping areas clear hairs from carpets and furniture m Quit smoking or smoke only outside your home and car Always keep tobacco smoke away from children m Change bed sheets often
40. can sometimes cause health problems Mold does not affect everyone and different people are affected differently when mold is breathed or inhaled People who are allergic to mold may get watery eyes runny or stuffed noses itching headaches and may have difficulty breathing Mold can also trigger asthma attacks see Asthma fact sheet Some molds produce toxins poisons that may be hazardous if people are exposed to large amounts of these molds continued on back e WWW as y O E a www hud gov offices lead U S Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control What can you do You cannot eliminate all mold spores from a home but you can take the following steps to prevent and get rid of mold Prevent keep your house clean and dry following steps to prevent and get rid of mold m Fix water problems such as roof leaks wet basements and leaking pipes or faucets m Make sure your home is well ventilated and always use ventilation fans in bathrooms and kitchens m f possible keep humidity in your house below 50 by using an air conditioner or dehumidifier m Avoid carpeting in kitchens bathrooms and basements Dry floor mats regularly Identify find mold that might be growing in your home m Search for areas that have a damp or moldy smell especially in base ments kitchens and bathrooms m Look for water stains or colored fuzzy growth on and around
41. codes affecting health and safety e make all repairs and do whatever is necessary to put and keep the premises in a fit and habitable condition e keep all common areas in a clean and safe condition e maintain electrical plumbing sanitary heating ventilating air conditioning and other facilities and appliances in good and safe working order and condition e provide and maintain appropriate receptacles for removal of garbage and other waste and arrange for their removal and e supply running water and reasonable amounts of hot water at all times and reasonable heat between October 1 and May 1 except where the law does not require the building be so equipped or heat or hot water is generated by an installation controlled by the tenant Under certain circumstances a landlord and tenant may agree to have the tenant perform repairs and maintenance URLTA 2 104 URLTA prohibits rental agreements that allow landlords to receive rent free of the obligation to comply with the code s maintenance obligations URLTA 1 404 2 104 a Tenant Obligations Also URLTA requires that a tenant e comply with all obligations primarily imposed upon tenants by applicable building and housing codes keep the tenant s premises as clean and safe as the condition of the premises permit dispose of garbage rubbish and other wastes from the dwelling unit in a clean and safe manner keep plumbing fixtures in the tenant
42. curtains or insect repellent fans are employed 304 17 Guards for basement windows Every basement window that is openable shall be supplied with rodent shields storm windows or other approved protection against the entry of rodents 305 1 General The interior of a structure and equipment therein shall be maintained in good repair structurally sound and in a sanitary condition Occupants shall keep that part of the structure which they occupy or control in a clean and sanitary condition Every owner of a structure containing a rooming house housekeeping units a hotel a dormitory two or more dwelling units or two or more nonresidential occupancies shall maintain in a clean and sanitary condition the shared or public areas of the structure and exterior property 305 3 Interior surfaces All interior surfaces including windows and doors shall be maintained in good clean and sanitary condition Peeling chipping flaking or abraded paint shall be repaired removed or covered Cracked or loose plaster decayed wood and other defective surface conditions shall be corrected See www healthyhomestraining org References Page 41 of 137 307 1 Accumulation of rubbish or garbage All exterior property and premises and the interior of every structure shall be free from any accumulation of rubbish or garbage 308 1 Infestation All structures shall be kept free from insect and rodent infestation All structures in which insects or rodents ar
43. epidemiology of nonfatal injuries among US children and youth American Journal of Public Health 85 7 932 8 34 Baltrop D 1974 Children and lead American Journal of Disorders in Children 127 2 165 166 35 Environmental Law Institute Improving Indoor Air Quality in Rental Dwellings a Review of Policies in Five U S Localities 2003 Page 3 of 9 See www healthyhomestraining org References Page 115 of 137 36 Mass Sanitary Code 105 CMF 410 504 37 Minimum Standards for Residential Property and Housing Ordinance Marion Co Indiana Section 10 602 b 38 Building Code Stamford Connecticut Section 146 27 A 5 39 Standards for Habitable Buildings Seattle Washington SMC 22 206 160 3 Start with People 1 Wallace L A Mitchell H O Connor G T Neas L Lippmann M Kattan M Koenig J Stout J W Vaughn B J Wallace D Walter M Adams K Liu L J 2003 Particle concentrations in inner city homes of children with asthma the effect of smoking cooking and outdoor pollution Environmental Health Perspectives 111 9 1265 72 2 Cunningham J O Connor G T Dockery D W Speizer F E 1996 Environmental tobacco smoke wheezing and asthma in children in 24 communities Am J Respir Crit Care Med 153 1 218 224 3 Adgate J L Kukowski A Stroebel C Shubat P J Morrell S Quackenboss J J Whitmore R W Sexton K 2000 Pesticide storag
44. head designed to be used with disposable absorbent cleaning pads a reservoir for cleaning solution and a built in mechanism for distributing or spraying the cleaning solution onto a floor or a method of equivalent efficacy See www healthyhomestraining org References Page 62 of 137 Post Renovation Cleaning Verification 40 CFR 745 85 b Activities Windowsills Uncarpeted Floors and Countertops in Work Area Dust clearance testing is an option if contract or other rules require it Permissible alternative to the steps below Work area must meet EPA clearance standards Certified Renovator must personally Required perform all cleaning verification except recleaning Step 1 Visually inspect work area for Required dust debris and residue Step 2 If failed visual have it Required recleaned Step 3 Wipe with wet disposable cleaning cloth Required Cloth must be damp to touch Required Cloth must be damp when used One cloth per 40 square feet Step 4 Compare to cleaning verification card If lighter than card then work passes Required Step 5 If failed have it recleaned Required if failed 1 wipe Step 6 Wipe surface again with new wet disposable cleaning cloth Required if failed 1 wipe Can use clean surface of used wipe Required if failed 1 wipe Step 7 Compare to card If lighter than card then work passes Requ
45. holes in the wall or ripped or torn food containers Water leakage during last 12 months Data on water leakage are shown if the leakage occurred in the 12 months prior to the interview or while the household was living in the unit 1f less than 12 months Housing units with water leakage are classified by whether the water leaked in from inside or outside the building and by the most common areas roof basement walls closed windows or doors or reasons fixtures backed up or over flowed or pipes leaked of water leakage Room heater without flue refers to any room heater that burns kerosene gas or oil and that does not connect to flue vent or chimney See www healthyhomestraining org References Page 20 of 137 American Housing Survey A Healthy Homes Perspective AHS s Rating System for Physical Problems Physical Severe Moderate Problems any one of 5 categories any one of 5 categories but none severe Plumbing Lacking hot or cold piped water or a flush On at least three occasions during toilet or lacking both bathtub and shower all the last 3 months all the flush toilets inside the structure and for the exclusive use of were broken down at the same time the unit unless there are two or more full for 6 hours or more bathrooms Heating 1 Having been uncomfortably cold last winter Having unvented gas oil or for 24 hours or more because the heating equipment broke down and 2 It broke down at leas
46. housing IL EPA Pesticide Registration The U S Environmental Protection Agency sets product standards for pesticides A pesticide is broadly defined as any substance or mixture of substances intended for preventing destroying repelling or mitigating any pest Pests are living organisms that occur where they are not wanted or that cause damage to crops or humans or other animals Therefore a pesticide includes herbicides insecticides and fungicides Products which contain certain low risk ingredients such as garlic and mint oil have been exempted from Federal registration requirements although State regulatory requirements may still apply No pesticide can be sold without first being registered by EPA pursuant to the Federal Insecticide Fungicide and Rodenticide Act FIFRA For a pesticide to be registered EPA must affirmatively determine that the product does not pose an unreasonable risk to human health and the environment when used consistent with the label The label becomes the law that must be followed when used the pesticide Anyone even a consumer who does not follow the product label are violating the law Through the registration process EPA can restrict the sale or use of a pesticide including its use in housing It can require that only licensed pest control operators use the pesticides by classifying it as a restricted use pesticide During the past few years EPA has removed once common pesticides such as chlorpyr
47. included in all green and healthy programs All the programs except NGBS specifically reference ASHRAE 62 2 as the ventilation performance standard The evaluation indicates greater consistency across green programs for the Pest Free and Maintained categories All of the programs included criteria to minimize pest infestations following the least toxic methods and to educate homeowners about proper maintenance of their green homes In contrast all of the programs in cluded in the analysis overlooked safety e g preventing trips falls and poisonings even though the home is the predominant source of unintentional injuries for children in the United States In addition the programs missed opportunities to incorporate building finishes that are easy to keep clean e g smooth cleanable floor ing which help owners reduce allergens and contaminants that may accumulate in a home Finally in this analysis we examined the extent to which the programs incorporate third party veri fication All of the programs except Enterprise Green Commuities require third party verification However Green Communities does require its participants to certify compliance with the program criteria It also conducts inspections nad performance testing of a sampling of units See www healthyhomestraining org References Page 75 of 137 Enterprise Community Partners Green Communities ENERGY STAR Indoor Air Package USGBC LEED Homes SAFE 5 Criteria
48. it is built on concrete that has been poured on the ground The other category refers to a house built on stilts or pilings for example beach houses boats and motor homes housing unit is still too cold for the occupants Inadequate insulation refers to air drafts through window frames electrical outlets or walls that are cold Cost of heating refers to the occupants turning down their thermostat or turning the equipment off altogether to save money This category includes utilities fuels that are unavailable due to unpaid bills Holes in floors Respondents were asked about holes in the interior floors of the unit The holes may or may not go all the way through to a lower floor or to the exterior of the unit The holes are only counted if large enough for someone to trip in Light fixtures in public halls These statistics are presented for housing units in two or more unit structures Data include whether or not there are light fixtures in the public halls and whether or not some none or all of the light fixtures are in working order Light fixtures include wall lights ceiling lights or table lamps in the public halls of the building Public halls are used by the occupants and guests to get to their apartment doors Open cracks or holes interior Statistics are presented on open cracks or holes in the interior wall or ceilings of the housing unit Included are cracks or holes that do not go all the way through to the next room
49. on construction practice options under each principle There are no maximum limits For single family homes for example projects reach a threshold by reaching specific point scores 222 points for Bronze 406 for Silver 558 for Gold and 697 for Emerald In the indoor environmental quality category the minimum score is 36 for Bronze 65 for Silver 100 for Gold and 140 for Emerald Mandatory Criteria Yes limited mandatory minimum points Third Party Certification Yes Units Certified NA See www healthyhomestraining org References Page 70 of 137 U S Environmental Protection Agency Energy Star with Indoor Air Package Pilot Specifications The U S Environmental Protection Agency EPA developed the ENERGY Star with Indoor Air Package IAP Pilot Specifications to recognize homes equipped with a comprehensive set of indoor air quality measures IAP is targeted to production builders which according to EPA are the most rapidly growing sector of the home building industry and are highly influential in home building trends Homes that comply with these specifica tions can use Indoor Air Package as a complementary label to ENERGY STAR for homes As a prerequisite for this label a home must first be ENERGY STAR qualified ENERGY STAR is a performance based program which requires qualified homes to be at least 15 more energy efficient than homes built to the 2004 International Residential Code IRC and include additional
50. or to the exterior of the housing unit Hairline cracks or cracks that appear in the walls or ceilings but are not large enough to insert the edge of a dime are not counted Very small holes caused by nails or other similar objects are also not counted Plumbing facilities The category With all plumbing facilities consists of housing units that have hot and cold piped water as well as a flush toilet and a bathtub or shower For units with less than two full bathrooms the facilities are only counted if they are for the exclusive use of the occupants of the unit Plumbing facilities need not be in the same room Lacking some plumbing facilities or having no plumbing facilities for exclusive use means that the housing unit does not have all three specified plumbing facilities hot and cold piped water flush toilet and bathtub or shower inside the housing unit or that the toilet or bathing facilities are also for the use of the occupants of other housing units See also the definitions Complete bathrooms Flush toilet and flush toilet breakdowns and Sewage disposal and sewage disposal breakdowns Signs of mice or rats The statistics on signs of mice or rats refer to respondents who reported seeing mice or rats or signs of mice or rats inside the house or building during the 3 months prior to interview or while the household was living in the unit if less than 3 months Signs of mice or rats include droppings
51. order it by mail There are two types of tests short term tests take 2 days while long term tests take around 90 days but give results that are slightly more accurate Follow all the instructions that come with your test kit If possible during the test keep your windows closed to keep air from escaping Place your test kit in a room on the lowest level of your home that you use regularly probably on the first floor or in the basement When the test is done send it to a lab to process your results Instead of doing the testing yourself you can hire a professional tester to do it for you Contact your state s radon office for a list of qualified testers Fix It It is possible to lower the levels of radon and the risk of lung cancer in your home Most of the time this will involve removing radon gas from underneath your concrete floor crawlspace or foundation before it can enter your home This will require special knowledge and skills and you will need to hire a professional contactor to help you reduce the levels of radon in your home If you are considering fixing your home s radon problem yourself you should first contact your state radon office for guidance and assistance A few more things you can do 1 Stop smoking and discourage smoking in your home Smoke increases the risk of lung cancer from radon 2 Increase air flow in your house by opening windows and using fans and vents to circulate air Natural ventilation in any
52. pienB MopulMm aJe 3194 Jayjeym SUILUI9 Op o we 5Bo1d uoyuanald Anfu jeoo 1pe uoo jes MOPUIM jnoge Jltuej j sunoo Aue UMA uwnjos oq O Awe u SUIS A IA 3 ss nieuu y 2 d 1 jeyeipeuwu 0 lluuej ey jesunoo u y quo ey pue ss neu y u wqg q pasejd aq ued siaBul pe OM y de6 ou sl aJey 1ey os quo ay 0 xau A 6nus yy pinoys ss njeui quo yeu lluuej jesunoo Oo OO Od OL ASYNN References Page 105 of 137 Sp109 puljq MOPuImM ining org spienB MOpulM ss n eui quo See www healthyhomestra NYUJINOI uaipjiug BunoA See www healthyhomestraining org References Page 106 of 137 National Center for Healthy Housing Pediatric Environmental Home Assessment Scenario The scenario is fictional The photos are taken from a variety of homes to highlight key issues For the sake of the exercise take on the role of a public health nurse conducting a pediatric environmental home visit It is a warm summer day and you are going out on a home visit to see a family The family has a six year old child who has and is being treated for asthma The mom has concerns about recent exacerbations in her child s asthma and the need for more frequent use of rescue inhalers You note that the family lives in a multi family building in an urban neighborhood The building appears to have been built in the late 1950s That is consistent with other buildings in the neighborhood
53. potential and known lead hazards in housing built before 1978 HUD also enforces the Fair Housing Law which requires reasonable accommodations for people with disabilities Most states and in the absence of state action many urban jurisdictions have adopted laws establishing minimum roles and responsibilities for landlords and tenants in rental housing These codes typically require both parties to comply with the applicable health or housing code The parties can enforce this requirement through the courts in a private civil suit The nation s model landlord tenant law is the Uniform Residential Landlord and Tenant Act URLTA managed by the Uniform Law Commission Twenty one states have adopted URLTA See Part D on page 19 for more information on the URLTA Product Standards The federal government is primarily responsible for setting standards for products in commerce that may impact health and safety These standards reduce the dangers posed by these products by banning their use in housing requiring safer designs or specifying label requirements EPA regulates pesticides and does not allow them to be sold or used with prior approval The Consumer Product Safety Commission CPSC regulates most other consumer products related to housing but requires only compliance with general requirements In response to specific problems CPSC adopts specific standards to address the problem such as banning lead containing paint HUD sets standards for
54. provisions in the 2003 International Property Maintenance Code 2003 IPMC and e additional resources links to environmental sampling methods and to more information about substances or issues related to healthy housing Healthy Housing Inspection Manual Page 3 See www healthyhomestraining org References Page 86 of 137 Visual Survey Report Resident Visual Conducted by Alternate Contact Address Date Unit Unique ID Resident Phone Make a checkmark Y if the problem appears in the room or area For deteriorated paint and water damage indicate the extent of the problem see instructions Use the extra rows to identify any other hazards you notice Put an asterisk above any room s where a child sleeps or plays Circle O where you photograph a problem ROOM OR AREA PROBLEM Exterior Living Room Dining Room Bedroom Bedroom 2 Bedroom 3 Bathroom Bathroom 2 Basement Deteriorated Walls paint Windows door or trim Paint chips on floor Cockroaches tT TT TT TT TT Cockroaches Mold Obvious source of moisture Mildew No obvious source of moisture Water Damage walls wet newly stained Strong musty smell Natural gas sewer gas smell Unvented gas oven dryer heater Worn out carpeting If renting received lead hazard disclosure information from landlord Yes No Follow up visit scheduled for Date Ti
55. s dwelling unit as clear as their condition permits and use in a reasonable manner all electrical plumbing sanitary heating ventilating air conditioning and other facilities and appliances URLTA 3 101 See www healthyhomestraining org References Page 50 of 137 III URLTA Provisions Related to Property Maintenance 1 102 Purposes Rules of Construction a b This Act shall be liberally construed and applied to promote its underlying purposes and policies Underlying purposes and policies of this Act are 1 to simplify clarify modernize and revise the law governing the rental of dwelling units and the rights and obligations of landlords and tenants 2 to encourage landlords and tenants to maintain and improve the quality of housing and 3 to make uniform the law with respect to the subject of this Act among those states which enact it 1 404 Separation of Rents and Obligations to Maintain Property Forbidden A rental agreement assignment conveyance trust deed or security instrument may not permit the receipt of rent free of the obligation to comply with Section 2 104 a 2 104 Landlord to Maintain Premises a b c d A landlord shall 1 Comply with the requirements of applicable building and housing codes materially affecting health and safety 2 Make all repairs and do whatever is necessary to put and keep the premises in a fit and habitable condition
56. sooOA JNoge uopeuJojul Jou 99 O E qissod ISA u UuA sjonpold esau PIOAY lt euuu se 198661 uSIuA DOA spunodulo9 z SlueBio a ejoA aAeY sieusysa Je Kuey O 1uinodjod sjuaos uuou VO si u us uj ie aow y SMO OJ Se ajeonpa juasaud sieusysaJIey J sjuey14 J9UIO od OL ATINVA Od OL ASYHNN NYIINOI g Apwe YM uwnjoo oq OL Ajlwe4 u sway MaIAeYy O p1O pue 1184 U IM 418 O way I sunoo u u aewoy sjuas Alley j J SUONPIOIA apoo lqissod Jo yeay Jo pseog eso ay siolAeu q Buljeo sapisuo sedas p p u jnoqe pJojpue INOA yym yle u y Jajual J O eBueyo o jesunos Ua auoy sumo lluueJ y O suredas lessegau eyew Udy seumoauloy Y J ebewep o ajejal u se sysi pjow jnoge ajeonp3 O Apwe UA UNIO oq OL Ajlwe4 u sway maoy O uuou Jo no inlsiouu 2348 0 SI 206 au sjem o u sn Jou episino ay o JUBA Usyoyy pue uuoouuleq ul SUBJ asns axe O Aoqe Aoq e suoepuawwooa JOPO JSNIA PUE pow 99S H suonepu ululo5 1 JOPO JSNIA pue pow ees H Ajlwey YM uwnjoo oq OL Ajlwe4 Ul sway manoy O Sqe Jo eEMajeS AOD eda MMM ye Buns Jajem noqe uoneuuoju BOW aH O spunoduloo oS ueBio a ejon se yans sjueulwejuos jesiuayo JO Buysa puswwose s J jddns Jajem Jesu yea 1ds jan Jo eo1uayo e u q SJB seH O 1es e Suo uey aJOW Hulse pu uuuuo5 1 pjoyasnoy y ul SI JUBJUI JO uewoMm jueuBaldd JI Aljeloadsa 3889 SIU Ul
57. stabilization by oxidation are exempt from this requirement 304 5 Foundation walls All foundation walls shall be maintained plumb and free from open cracks and breaks and shall be kept in such condition so as to prevent the entry of rodents and other pests 304 6 Exterior walls All exterior walls shall be free from holes breaks and loose or rotting materials and maintained weatherproof and properly surface coated where required to prevent deterioration 304 7 Roofs and drainage The roof and flashing shall be sound tight and not have defects that admit rain Roof drainage shall be adequate to prevent dampness or deterioration in the walls or interior portion of the structure Roof drains gutters and downspouts shall be maintained in good repair and free from obstructions Roofwater shall not be discharged in a manner that creates a public nuisance 304 14 Insect screens During the period from DATE to DATE every door window and other outside opening required for ventilation of habitable rooms food preparation areas food service areas or any areas where products to be included or utilized in food for human consumption are processed manufactured packaged or stored shall be supplied with approved tightly fitting screens of not less than 16 mesh per inch 16 mesh per 25 mm and every swinging door shall have a self closing device in good working condition Exception Screens shall not be required where other approved means such as air
58. the family All of the equipment must be in proper operating condition The equipment may be supplied by either the owner or the family A microwave oven may be substituted for a tenant supplied oven and stove or range A microwave oven may be substituted for an owner supplied oven and stove or range if the tenant agrees and microwave ovens are furnished instead of an oven and stove or range to both subsidized and unsubsidized tenants in the building or premises See www healthyhomestraining org References Page 35 of 137 ii The dwelling unit must have a kitchen sink in proper operating condition with a sink trap and hot and cold running water The sink must drain into an approvable public or private system ii1 The dwelling unit must have space for the storage preparation and serving of food iv There must be facilities and services for the sanitary disposal of food waste and refuse including temporary storage facilities where necessary e g garbage cans d Space and security 1 Performance requirement The dwelling unit must provide adequate space and security for the family 2 Acceptability criteria i Ata minimum the dwelling unit must have a living room a kitchen area and a bathroom 11 The dwelling unit must have at least one bedroom or living sleeping room for each two persons Children of opposite sex other than very young children may not be required to occupy the same bedroom or living sleeping room 111 D
59. windows 3 6 Foundation crumbling or has 2 5 open crack or hole None of the above 82 5 Water Leakage in Last 12 With leakage from outside 10 3 Roof 4 7 Basement 3 5 Walls closed windows or 1 7 Other or unknown 1 0 Owner 75 647 1 8 4 3 1 2 2 0 1 0 0 7 2 8 3 4 2 2 84 0 10 8 4 8 4 3 1 4 1 0 Renter 35 045 4 4 6 2 3 3 5 1 3 5 2 2 7 3 4 9 4 7 74 1 9 1 4 3 1 8 2 3 1 2 American Housing Survey National 2007 Selected Elements Related to Healthy Homes Const lt 4 years 5 747 0 4 1 9 0 5 0 6 0 5 0 3 1 1 0 6 0 9 93 8 5 6 2 6 1 7 1 0 0 7 See www healthyhomestraining org Moved in Below Housing Problems Problems Elderly past year poverty Northeast Manuf Severe Moderate 6 919 1 806 3 965 22 864 4 5 8 2 13 9 1 3 4 2 11 2 15 6 3 9 3 0 10 8 12 2 1 4 3 3 12 7 13 0 1 6 2 6 8 4 8 8 1 1 1 8 5 5 5 6 0 7 6 7 15 3 15 2 2 2 0 8 6 4 9 0 4 5 1 4 8 6 12 5 1 9 80 5 61 9 53 3 84 6 10 8 18 9 27 9 8 1 7 8 10 9 17 2 3 7 0 1 3 8 5 7 2 9 2 6 5 4 5 7 1 0 0 9 1 6 2 4 0 7 17 904 2 8 4 4 2 0 3 1 2 3 1 1 5 1 2 7 3 0 82 0 8 7 3 9 2 2 1 9 1 2 14 157 20 392 4 9 2 4 7 3 4 7 3 3 1 4 5 4 2 5 3 0 1 1 2 9 0 5 7 6 3 0 6 3 2 8 4 1 2 9 72 0 82 3 9 6 16 3 5 2 5 8 2 1 8 1 2 0 2 1 1 1 1 5 Midw
60. 1 6 28 6 16 7 17 9 39 7 21 1 25 4 26 9 27 1 South 40 609 553 1 4 1 0 0 3 0 0 0 1 2 000 4 9 0 2 2 5 1 2 1 1 0 6 0 4 0 7 1 0 5 0 4 8 12 8 27 0 14 9 28 9 West 24 400 388 1 6 1 1 0 4 0 0 0 1 670 2 7 0 1 0 1 0 7 1 8 0 4 0 2 0 7 1 1 4 8 5 0 14 6 28 3 17 3 24 4 References Page 18 of 137 American Housing Survey A Healthy Homes Perspective Overview The survey is conducted by the Bureau of the Census for the Department of Housing and Urban Development HUD The results and details are available at www census gov hhes www housing ahs The American Housing Survey AHS collects data on the Nation s housing including apartments single family homes mobile homes vacant housing units household characteristics income housing and neighborhood quality housing costs equipment and fuels size of housing unit and recent movers National data are collected in odd numbered years and data for each of 47 selected Metropolitan Areas are collected currently about every six years The national sample covers an average 55 000 housing units Each metropolitan area sample covers 4 100 or more housing units The AHS returns to the same housing units year after year to gather data therefore this survey is ideal for analyzing the flow of households through housing Key Definitions Related to Healthy Homes 1 Broken plaster or peeling paint
61. 1 800 55RADON 1 800 557 2366 Radon Fix it Hotline 1 800 644 6999 Spanish Language Radon Hotline 1 800 725 8312 American Lung Association www lungusa org Radon test kits are available at hardware stores or by mail U S Environmental Protection Agency Indoor Air Radon www epa gov radon August 25 2004 211 5 Environmental Protection Agency Assessment of Risks from Radon in Homes www epa gov tadon risk_assessment html August 25 2004 References Page 135 of 137 www hud gov offices lead SAFE PEST CONTROL 2 DEN oo U S Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control For years cockroaches have defeated our best efforts to get rid of them We sprayed and sprayed but they always came back Now we under stand there are better methods and products that really work Environmental Health Watch Did you know m Many pesticides for home use are toxic m There are alternative pest management methods that limit the use of toxic substances m Mice cockroaches and cockroach dust can trigger asthma attack What is it Integrated pest management IPM is a way to remove pests like cock roaches mice and rats from a home IPM is a common sense approach that m Denies pests food water shelter and a way to enter the home m Uses baits and powders such as gel baits traps and borate powder Why use IPM m PM is safer IPM does not u
62. 2008 Honolulu AY yo Miami Fort Lauderdale Miami Bez Centers for Disease Control and Prevention CDC Behavioral Risk Factor Surveillance System Survey Data Atlanta Georgia U S Department of Health and Human Services Centers for Disease Control and Prevention 2007 See http apps nccd cdc gov gisbrfss map aspx See www healthyhomestraining org References Page 28 of 137 EPA Map of Radon Zones i OA ISA AA my M Sa ca e The purpose of this map is to assist National State and local organizations to target their fesoures and lo radon resistant bulding codes This map is not intended lo be used do determine a home in a given zone should be tested for radon Homes wilh elevated levels of radon have been found in all three zones All homes should be tested regardless of IMPORTANT Consut the EPA Map of Radon Zones document EPA 402 R 93 071 below using tis map This document contains information on radon variations within counties EPA abo recov Pa P map be Supper AA any 2 available loca data Kay putu nd ont span the radon potential of a speciic area See www healthyhomestraining org References Page 29 of 137 See www healthyhomestraining org References Page 30 of 137 National Center for Healthy Housing Laws Rules and Codes for Healthier Homes Review of Approaches Impacting Existing Homes The National Center for Healthy Housing has identified five different complementary regulatory approa
63. 3 9 3 1 3 4 3 9 7 7 13 9 8 9 15 6 ee SINE OM outstde is 0 5 2 8 65 27 28 37 53 8 3 7 9 9 7 Broken windows 2 947 8 2 7 2 5 6 0 2 8 3 1 3 3 5 4 13 2 8 1 7 0 Boarded up windows 806 6 1 9 2 3 8 3 2 8 2 8 4 5 6 4 11 8 10 3 9 5 Poundanon Cnuubling Or Nas open 2 147 4 2 1 3 5 5 2 2 7 2 8 23 73 11 9 7 5 8 2 crack or hole One or more ext problem 10 086 0 2 3 2 9 4 2 2 6 2 6 2 7 5 9 11 8 7 4 7 5 Two or more ext problem 3 250 9 2 5 3 8 6 3 3 2 3 5 3 9 8 3 15 3 10 9 11 5 Three or more ext problem 1 434 1 2 9 4 4 9 0 3 7 3 9 4 9 9 9 20 3 14 6 18 8 Four or more ext problem 656 6 3 0 42 142 41 4 5 5 7 10 5 22 6 17 1 21 7 Five or more ext problem 364 7 3 1 3 6 12 3 4 3 4 8 5 8 10 0 23 6 19 7 24 8 Six or more ext problem 2025 3 0 3 3 13 4 3 5 4 5 5 9 9 8 24 6 18 4 28 7 Seven or more ext problem 1272 2 1 2 8 15 1 4 1 3 5 5 6 7 1 23 7 13 1 20 5 Eight or more ext problem 64 1 5 7 4 3 3 6 13 2 72 8 2 A home is L times as likely to have a specific interior problem column heading if the exterior problem is reported row heading than if the exterior problem is not reported For example a home is 2 7 times as likely to have a leak from the interior if it has a sagging roof than if it does not have a sagging roof See www healthyhomestraining org References Page 11 of 137 Relationship Between Interior Problems and Exterior Problems The National Center for Healthy Housing developed the table to help communities make hom
64. 4 0 6 2 5 0 8 9 0 0 5 0 1 1 0 1 1 25 292 1 0 5 4 2 0 7 9 2 1 3 2 0 7 2 0 0 1 5 9 0 2 0 1 0 7 1 4 Manuf Severe Moderate Movedin Below Housing Problems Problems Elderly past year poverty Northeast Midwest 6 919 1 806 3 965 22 864 17 904 14 157 2 5 8 7 9 7 0 6 1 5 2 7 6 2 19 1 31 3 3 0 5 7 8 0 1 7 10 4 19 3 1 6 1 9 3 7 8 7 17 6 25 4 4 9 9 6 10 0 1 6 4 4 7 3 1 1 2 7 2 8 5 0 9 1 11 6 2 2 4 4 4 7 1 5 1 1 1 9 0 6 0 6 0 7 1 1 4 3 6 7 1 1 2 2 2 4 1 0 4 8 3 3 0 5 0 6 1 4 9 0 12 1 12 0 5 0 4 3 8 1 0 4 2 5 1 3 0 2 0 5 0 6 0 0 2 4 0 0 0 0 0 0 0 1 0 6 3 0 1 9 1 0 1 4 1 5 1 2 5 4 3 1 1 0 2 1 2 3 8 1 15 0 15 8 5 6 10 2 7 6 9 4 10 3 South 40 609 1 1 4 8 2 0 7 9 1 9 3 5 0 9 2 0 0 9 4 8 0 4 0 0 1 1 1 3 8 0 West 24 400 0 7 4 0 1 4 7 6 2 2 3 4 0 8 1 6 0 9 3 2 0 4 0 0 1 1 1 3 9 3 References Page 15 of 137 Total Occupied Units 000 SANITATION WATER Lacking complete kitchen Lacking some or all plumbing facilities Water not safe to drink With water stoppage in last 3 No flush toilets working some time in last 3 months With sewage disposal breakdown in last 3 months Septic tank cesspool or chemical toilet Septic tank or cesspool breakdown in last 3 months SAFETY EQUIPMENT Working smoke detector Smoke detector b
65. 4 7 097 71 9 28 1 69 8 4 3 8 0 4 4 3 6 2 4 2 9 4 6 9 0 30 0 70 0 39 0 21 3 74 1 43 6 12 9 10 1 Moderate Movedin Below Problems Elderly past year poverty Northeast Midwest 3 965 22 864 17 904 14 157 1 565 18 271 5 501 5 566 2 401 4 594 12 403 8 591 39 5 79 9 30 7 39 3 60 6 20 1 69 3 60 7 45 3 68 7 40 6 41 3 3 0 5 1 6 8 5 4 16 0 5 4 14 9 14 4 10 1 2 7 11 3 9 7 7 5 2 0 10 0 6 0 7 0 2 7 6 7 6 3 5 8 6 7 4 4 6 9 5 4 6 7 5 3 10 1 3 8 6 5 17 1 6 1 20 0 27 9 40 4 26 6 80 0 72 1 59 6 73 4 49 2 35 6 28 6 37 2 28 1 14 6 15 3 19 3 48 3 73 8 47 4 46 6 7 6 24 2 12 2 12 5 5 0 8 3 3 6 3 8 23 5 18 6 123 13 9 9 9 21 3 18 7 15 2 5 5 6 7 South 40 609 28 508 12 101 70 2 29 8 67 0 4 8 5 3 4 5 4 4 2 4 2 0 9 7 13 6 45 7 54 3 21 0 7 2 71 8 9 6 4 0 23 6 33 2 West 24 400 15 607 8 794 64 0 36 0 63 4 4 9 8 0 5 9 4 8 4 4 3 3 5 3 11 7 39 4 60 6 25 6 8 7 68 3 8 3 4 4 21 5 33 1 References Page 13 of 137 Occupied Units Total Occupied Units 000 110 692 EXTERIOR External Building Conditions excluding multiunit Sagging roof 2 2 Missing roofing material 4 6 Hole in roof 1 5 Missing bricks siding or other 2 5 outside wall materials Sloping outside walls 1 4 Boarded up windows 1 0 Broken windows 3 5 Bars on
66. 6 1 2 1 8 1 1 1 0 2 4 3 4 0 3 1 2 1 8 0 7 1 1 1 3 2 5 0 5 0 8 1 4 1 0 1 5 3 2 3 3 1 1 1 4 2 1 1 3 Midwest 25 292 81 1 8 2 2 8 4 4 1 6 0 5 0 2 0 1 0 6 0 1 0 0 0 2 0 0 0 1 28 8 65 9 5 3 68 5 29 6 1 9 10 6 2 6 8 2 4 1 0 9 1 0 0 8 1 6 South 40 609 59 9 1 4 25 8 2 2 3 0 1 4 2 6 1 8 0 7 0 1 0 1 0 6 0 1 0 2 64 3 32 2 3 5 92 4 6 8 0 7 5 9 2 1 3 9 1 1 0 8 0 6 0 7 0 9 West 24 400 66 2 3 2 5 9 6 9 12 1 1 1 0 2 1 0 1 3 0 3 0 1 0 4 0 0 1 4 26 5 69 8 3 8 65 9 32 9 1 2 9 3 2 0 7 6 3 2 1 2 1 0 1 1 1 6 References Page 17 of 137 Total Occupied Units 000 SELECTED PHYSICAL PROBLEMS Severe physical Severe physical problems Plumbing Heating Electric Upkeep Moderate physical problems 000 Moderate physical problems Plumbing Heating Upkeep Kitchen Overall Opinion of Structure 1 worst 2 3 4 5 6 7 8 9 1 0 best Occupied Units 110 692 1 806 1 6 1 1 0 4 0 0 0 1 3 965 3 6 0 2 1 0 1 1 1 4 0 5 0 3 0 6 1 0 4 8 4 9 13 3 27 7 16 0 27 1 Owner 75 647 729 1 0 0 7 0 2 0 1 0 0 1 565 2 1 0 1 1 0 0 7 0 3 0 2 0 1 0 3 0 5 3 1 3 4 11 3 28 1 17 7 31 2 Renter 35 045 1 077 3 1 2 0 0 9 0 0 0 2 2 401
67. ASYNN Ae UA UNOS oq OL Ajlwe4 u SUIS A IA 93H QOUBUSJUIEW Jay JedoJd op 0 jituej j sunoo IUe YM UNOS OQ OL Ajlwe4 u SUS Mana y Ape 0 apinold pue uyy ysnquioo bei nob ede MMMd e auoy ayy ul sas1nos uosnquoo pue Ayyjenb 4e soopul noqe uogewoyu ajo 8O Ayyenb Je soopul pue jejes aly JO sua u sesnos Sunesy yons jo si Buep y ynoge Ajiwey jasunoy Ae YM uwnjoo OQ OL Ajlwe4 u SUS Mana y Aue 0 Sprinold pue pes Aob eda mam ye Buysa peaj noqe UOHeWJOJUI ajou 385 spJezey pea Jo 3sa 0 jueyioduu SI y uay plo sued xis uey ss pliyo e sey wez yy o Ju uido A p pue yeay S USIP IYO BunoA oy njuuey aq ued spuezey pea o juled pea aney o Ajay SI WOoH SMO OJ SE SJEINPI 8 61 1oJ q YINA Jl O O O Oo OO O O Od OL 3SYNN S913511939818y9 Bulsnoy e 19uas Jopo JSNIN PIOIN References Page 99 of 137 SJ9PIUIN H SISZLIOdBA NINO sjue mod 100pu S19M14 Org S8A0 S poom BD sooe daiy si9 e uw aoeds s19 e9y BUISOJOY 19y30 991nos Buljeay Y ealthyhomest uuou jo oby E NY3INOO Muol 32p aanoa1109 Buipu uuuio3 1 pue uonesnp juened 104 pinB e se siy sn Ju uiss ssep ay Bune duoo 104V O NV Id NOILOV WO y u uiss ssv uuoH e UsWUOJIAUY 91 1J21p9g SBDIAJOS vo esses Bunouus e20 Joe UO pue SeJjeyOWS AOD ede MMM ayisqem abBpajd swoH aaljeyous Yag 0 Jajay Burjows dojs o dey 99 O u
68. Bathroom Basement Living Room Laundry area 14 Public water system T No soiling 14 Functioning stove exhaust fan vent 4 Functioning exhaust fan vent window LI None No Access T No soiling 1 None T Household Well 1 Trash or garbage sealed LJ Mold growth present LI Mold growth present T Mold growth present LI Mold growth present 1 Well maintained Trash or garbage not sealed 11 Broken stove exhaust fan vent U Needs cleaning and maintenance U Needs cleaning and maintenance I Needs cleaning and maintenance 1 Dryer not vented QO Wall ceiling floor damage OQ No stove exhaust fan vent A Wall ceiling floor damage Oj Wall ceiling floor damage A Wall ceiling floor damage 41 Hang clothes to dry Patient s sleep area Beds Allergen impermeable encasings on beds Pillows Bedding Flooring Dust mold catchers L Own room 30 LI On mattress and boxspring zippered 1 Allergen proof 1 Washable 1 Hardwood Tile Linoleum 1 Stuffed animals washable 1 Shared in room 1 1 On mattress only zippered Ll Washable L Small area rug LJ Non washable LJ Wool not washable LJ Other 2 1 On mattress not zippered 1 Feather down J Feather down 1 Large area rug 1 Plants 1 More than 2 1 No mattress covers QO Wall to wall carpet A Other toys toys 1 No clutter Window T Washable shades A Washable blinds A Curtains
69. CHH conser vatively rated optional criteria as a 1 thereby reducing the LEED H score ett all a criteria The NGBS re lies substantially on optional criteria with a minimal set of mandatory standards As such the program received the lowest rating One reviewer suggested that optional criteria receive greater credit because the flexibility in scoring enables greater program participation The reviewer also noted that several of the optional healthy homes criteria are pursued by the majority of program participants The reviewer suggested multiplying the percentage of proj ects that incorporate the optional measure by the score a measure would have received it were mandatory as an alternative scoring system For example if landscaping away from a building would receive a score of 3 as a mandatory element it would receive a 2 7 if 90 of the program participants selected it as an optional criterion Although such a nuanced system may reflect a more precise view of the actual compliance with a programs criteria in a prior year because programs cannot predict the optional criteria that future projects will select NCHH felt that these programs could not be scored as highly as those based on mandatory criteria In addition NCHH believes that the healthy homes criteria are practical and cost effective e g avoiding install ing carpets in wet areas and so it is sensible to include them as prerequisites Across all the green programs ther
70. Conservation Code International Existing Building Code International Fire Code International Fuel Gas Code International Mechanical Code ICC Performance Code International Plumbing Code 10 International Private Sewage Disposal Code 11 International Residential Code 12 International Urban Wildland Interface Code and 13 International Zoning Code O OA AS D bo Y All but three other states have adopted one or more of these model codes most likely the International Building Code II IPMC s Provisions Related to Healthy Homes EXTERMINATION The control and elimination of insects rats or other pests by eliminating their harborage places by removing or making inaccessible materials that serve as their food by poison spraying fumigating trapping or by any other approved pest elimination methods HABITABLE SPACE Space in a structure for living sleeping eating or cooking Bathrooms toilet rooms closets halls storage or utility spaces and similar areas are not considered habitable spaces INFESTATION The presence within or contiguous to a structure or premises of insects rats vermin or other pests 302 1 Sanitation All exterior property and premises shall be maintained in a clean safe and sanitary condition The occupant shall keep that part of the exterior property which such occupant occupies or controls in a clean and sanitary condition 302 2 Grading and drainage All premises shall be graded
71. ECTION 2 Healthy Homes Visual Assessment Data Collection Form 10 Instructions for Visual Assessment Observations T aaa 11 Sl SMS TEL u u ua maak khunu AAA AAA AAA 12 FFOMCING ANG GALCS inuit A ma AE E bad 12 Grounds Or Pavement esm u u uu u usa yaaa akaqa E E Eana a E EEEE ENERE 12 Children s Play Areas icri aii 14 A O un saa sata Nn unas usan u Santas usa 15 COMMENTS Site SOCUON aio acid 17 Building Exterior Items 30D A a A teasers 18 DO iio da ina 18 Fire Es aBeS uu a u uu a a a A Edd shaya 19 FO ndali nSu iia A A A A q auqa 20 Eighting i aara ua un a qa E AA aAA EA a Eaa aa a a aa aaa Eia anaa 20 ROOTS simi da 21 Wall a E ide ocios 22 WINdOWS 100 iaa 24 Comments Exterior Sectio niensis n a i E EE AENA G 25 B ilding Systems MASIA a rin ELi EAEL EEA ia 26 Electrical SysteMS conina anA A AA 26 Fire Protection uu ua ulus kesan A a 27 HVAC usina A a T E 28 Comments Building Systems SectiON oooocoinniiionia NOE EEEE ETENE NEE E cocine 30 Healthy Housing Inspection Manual Page MI See www healthyhomestraining org References Page 80 of 137 Common Areas Items B2 102 a 31 Elevators E ng A 31 MIMI A A passa qa 31 SMOKING ALCS criteria E a da di anida 31 Interior Trash cucuta EE a ai a a laa 31 Outlets Switches Cover Plate 00 0 iaa 31 Smoke and Carbon Monoxide DetectorS oocoococonononcccncnononononnnonnnnnnononononnnno
72. EE E a a a 84 Comments and Notes sicsstautedcccessvienivettuaaadadtgunsscnegessstadasaaleieedceavas laqanku Sa haaabutla adik A AA E A ads 84 APPENDIX 2 2003 International Property Maintenance Code 2003 IPMC Cross Referenceg 85 APPENDIX 3 Additional Resources I n nn nrnna 87 Optional Environmental Sampling Methods Links to Information on the Internet 87 Selected Web References for Healthy Homes Issues U U U U uu u 88 Page VI Healthy Housing Inspection Manual See www healthyhomestraining org References Page 83 of 137 Preface THE HEALTHY HOUSING INSPECTION MANUAL completes the foundation of the Centers for Disease Control and Prevention s CDC s Healthy Homes Initiative The manual reflects the ongoing commitment of both CDC and the U S Department of Housing and Urban Development HUD to work together to provide local jurisdictions with tools to address housing related health hazards Development of this manual was supported by the HUD and CDC Healthy Homes Initiatives The agencies initiatives related to healthy homes were created to develop a holistic approach to healthy housing based on the following broad objectives e Broaden the scope of single issue public health and safety programs such as childhood lead poisoning prevention residential asthma intervention injury prevention to adopt a holistic approach addr
73. Fires Installed working smoke alarms But the following were found to be less effective Community programs that give away smoke alarms without taking steps to make sure they are actually installed are less effective than programs that actually install alarms and have not been proven to reduce injuries Preventing Drowning Isolation 4 sided pool fencing But the following were found to be ineffective Use of three sided pool fences instead of complete four sided pool fencing is not effective and may actually increase risk because care givers may believe the incomplete fencing is adequate Reducing Scald Burns Pre set safe temperature hot water heaters The following were also found to be ineffective Portable air cleaning filtration systems are ineffective in controlling exposures to environmental tobacco smoke and also formaldehyde although it is possible that there may be some modest decline in exposure Air cleaners that produce large amounts of ozone should not be used because they result in increased exposure to ozone which mimics the health effects of radiation exposure and is a known respiratory toxicant See www healthyhomestraining org References Page 25 of 137 The State of Childhood Asthma United States 1980 2005 U S Centers for Disease Control and Prevention Millions of children in the United States are affected by asthma a chronic respiratory disease characterized by attacks of difficulty breathing An
74. Health Care Use and Mortality 2000 2001 National Center for Health Statistics Centers for Disease Control and Prevention Ibid Centers for Disease Control Surveillance for Asthma United States 1960 1995 MMWR 1998 47 SS 1 Environmental Health Watch website www ehw org Asthma ASTH_ homel htm August 25 2004 Centers for Disease Control Surveillance for Asthma United States 1980 1999 MMWR 2002 51 55 01 www hud gov offices lead MENT 0 Ml CARBON MONOXIDE ON DEV ax U S Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control You can t se or smell carbon monoxide but at high levels it can kill a person in minutes U S Environmental Protection Agency Did you know m Over 500 people in the United States die from accidental carbon monoxide CO poisoning each year m Over 10 000 people seek medical attention for CO poisoning each year m Infants people with lung or heart disease or people with anemia are more seriously affected What is it Carbon monoxide is a gas that cannot be seen smelled or tasted and can be fatal when breathed The symptoms that occur with carbon monoxide poisoning are similar to those of the flu and allergies These similarities often lead to an incorrect diagnosis such as a migraine headache stroke food poisoning or heart disease Carbon monoxide poisoning is caused by m Operatin
75. Healthy Homes Perspective Potential Errors in American Housing Survey All numbers from the American Housing Survey AHS except for sample size are estimates As in other surveys errors come primarily from the following Incomplete data Incomplete data are adjusted by assuming that the respondents are similar to those not answering and the size of these errors is estimated Wrong answers The U S Census Bureau does not adjust for wrong answers and does not estimate the size of the errors Sampling Sampling errors are not adjusted and the size of the error is estimated WRONG ANSWERS Wrong answers happen because people misunderstand questions cannot recall the correct answer or do not want to give the right answer The table below shows which items have been measured for inconsistency when people are reinterviewed after a few weeks The actual survey did not catch and reconcile these inconsistencies and continuously occurring errors are not measured at all Thus a high rate of wrong answers remains for some items The Census Bureau categorizes these levels of inconsistency into three ranges 1 Less than 20 is considered a low level of inconsistency 2 Between 20 and 50 is considered a moderate level of inconsistency 3 Greater than 50 is considered a high level of inconsistency indicating that responses are not reliable Table Y Different Answers a Month Apart HIGH LEVEL OF INCONSISTENCY Other kinds of hea
76. International SBCCD developed the IPMC as a comprehensive set of regulations for existing buildings that was consistent with the existing model property maintenance codes at the time A new edition is promulgated every three years The International Property Maintenance Code is founded on principles that the IPMC must 1 Adequately protect public health safety and welfare 2 Not unnecessarily increase construction costs 3 Not restrict the use of new materials productions or methods of construction and 4 Not give preferential treatment to particular types or classes of materials products or methods of construction Adoption The International Property Maintenance Code is available for adoption and use by jurisdictions internationally Its use within a governmental jurisdiction is intended to be accomplished through adoption by reference At the time of adoption jurisdictions should insert the appropriate information in provisions requiring specific local information such as the name of the adopting jurisdiction These locations are shown in bracketed words in small capital letters in the code and in the sample ordinance To find out whether the International Property Maintenance Code or any of the other ICC Codes have been adopted in your community go to www iccsafe org government adoption html Maintenance The International Property Maintenance Code is kept up to date through the reviewof proposed changes submitted by code
77. MA ULUNJOD oq OL Awe u SUIS A IA 3 Ae UA uwnjoo OQ OL Ajlwe4 u SUIS Mana y lltueJ YM UNIO oq OL Ajlwe4 u SUIS MAIN y SAXO Id pue spaq uo siaddiz ym sJ3A09 SSa yeu jqe ws dw usba e es O SAXO OJ se ajeonpa s y 1snp 0 9161a e S juaned J O Od OL ASYNN 01 U09 uosiod BunuBil sayoiod sBulpies Sjem suleyS I Page 103 of 137 References Buil poui jyuoneAou zi NYS9ONO9 yoyjes e1 u o yajes uloH ining org SMOPUIM s1949 89 jsng yodueg ee www healthyhomestra SI19A09 SS9IYRIN NYaoNODY eaiy Buid ls sKeMIIE S JO WO JOq pue do y ye sajeB Ja ppoj UOIPsJODDe UOU e SU S qe 1ene seoinose ajeb Jo ppo aje aJey JOUJOYM auluejep o welBold uonu A id Anfu peo jpejuoo 3 OZL gt 0 aunyesedwia Jejem joy jas qn ayy u p pu yeun u pj y anes zou oq Aoqe 2WOH JO aby SIS sas nosa Buns pes jnoge yyesy jo sjuauyiedap jesoj pue ajejs Jno Je dd 10 welbBold uonu A id Buluosiod pea pooyp iyo ay joejuoo y9ea S p IU9 e UIUJIM saulsipau JO s ddns Burueajo spinbil joy aey you oq O O oa OL MINV Aoqe WOH Jo aby SIS Aoqe SsUONe saju Ses wsy YORSI ueo USJPIIYO 1 uA s1e yBi pue seyojeuw aJo s JOU OG JaJem Jesu seouel dde eoioaje asn jou og y a9noeld pue a e ul auoy JNOA Buldeose 104 uejd azes Awe ay u ip iu5 yoes asnoy ay apisino ae no Jaye o aoejd e ane
78. Renovation Repair and Painting Rule Page 27 See www healthyhomestraining org References Page 33 of 137 A HUD Housing Quality Standards I Overview The U S Department of Housing and Urban Development HUD sets standards for housing receiving federal assistance The primary standards are the Housing Quality Standards HQS at 24 CFR 982 401 The HQS were adopted in 1995 and last revised in 1999 All housing funded through HUD s Housing Choice Vouchers formerly known as Tenant Based Section 8 Voucher must comply HQS as a condition of receiving funding Local public housing authorities conduct initial and annual inspections to ensure compliance with the HQS The HQS form the basis for HUD s Uniform Physical Condition Standards and it Public Housing Assessment System that applies to public housing and to Project Based Section 8 Housing also known as Housing Assistance Payment Program II HOS s Provisions a Performance and acceptability requirements 1 This section states the housing quality standards HQS for housing assisted in the programs 2 i The HQS consist of A Performance requirements and B Acceptability criteria or HUD approved variations in the acceptability criteria ii This section states performance and acceptability criteria for these key aspects of housing quality A Sanitary facilities B Food preparation and refuse disposal C Space and security D Thermal enviro
79. Report 85 10 Web site http www nyserda org Page 7 of 9 See www healthyhomestraining org References Page 119 of 137 6 American Lung Association 2004 November Secondhand smoke fact sheet Retrieved May 5 2005 from Web site http www lungusa org site pp asp c dvLUK900Eg8 b 35422 7 Centers for Disease Control and Prevention November 7 1997 State Specific Prevalence of Cigarette Smoking Among Adults and Children s and Adolescents Exposure to Environmental Tobacco Smoke United States 1996 MMWR 46 44 1038 43 8 National Institutes of Health Last Updated May 2004 Health and safety information on household products Retrieved July 11 2005 from website of the National Library of Medicine http householdproducts nlm nih gov index htm 9 Malin N 1999 February Paint the room green Environmental Building News 8 2 Available from http www buildinggreen com articles IssueTOC cfm Volume 8 amp Issue 2 10 U S EPA s Office of Indoor Air Quality Last updated November 18 2004 Sources of Indoor Air Pollution Organic Gases Volatile Organic Compounds Retrieved July 11 2005 from Web site http www epa gov iaq voc html 11 Carpet and Rug Institute Green Label Plus the higher standard for indoor air quality Retrieved May 2 2005 from Web site http www carpet rug com drill down _2 cfm page 8 amp sub 3 12 O Wilke O Jann Brodner VOC and SVOC Emission
80. Summary of Two Key Institute of Medicine Reports Regarding Asthma Indoor Air Quality Damp Indoor Spaces and Mold Association Between Biologi i posures in the Home and Development of Asthma in Sensitive Exacerbation of Asthma in Sensitive Individuals individuals Biological Agents Chemical Agents Biological Agents Chemical Agents Sufficient Evidence of a Causal Relationship House dust mite No agents met this e Cat e ETS in preschool definition e Cockroach aged children e House dust mite Sufficient Evidence of an Association No agents met e ETS in preschool e Dog Nitrogen oxides this definition aged children e Fungi or molds high level e Rhinovirus exposures Limited or Suggestive Evidence of an Association Cockroach in preschool No agents met e Domestic birds ETS in school aged children this definition e Chlamydia pneumoniae aged and older Respiratory Syncytial Virus e Mycoplasma pneumoniae children amp adults e Respiratory Syncytial Virus Formaldehyde Fragrances 1 Inadequate or Insufficient Evidence to Determine Whether or Not an Association Exists Nitrogen oxides e Rodents as pets or feral Pesticides Pesticides animals Plasticizers Cockroaches except for Plasticizers Chlamydia trachomatis Volatile organic preschool aged children Volatile organic Endotoxins compounds Endotoxins compounds VOCs Houseplants VOCs Fungi or molds Formaldehyde Pollen exposure in indoor Chlamydia pneumoniae e Fragrances
81. The leading causes of home injury deaths in 1998 were falls and poisonings which accounted for 6 756 and 5 758 deaths respectively Overall falls were the leading cause of nonfatal unintentional injuries occurring at home and accounted for 5 6 million injuries 48 of households have windows on the second floor or above but only 25 have window locks or bars to prevent children from falling out Protection of the neighborhood against automobile traffic hazards P30 See www healthyhomestraining org References Page 48 of 137 D Uniform Residential Landlord and Tenant Act I Overview The Uniform Residential Landlord and Tenant Act URLTA was completed by the Uniform Law Commission ULC in 1972 The ULC Drafting Process A uniform state law is one in which uniformity of the provisions of the act among the various jurisdictions is a principal and compelling objective To draft an act ULC appoints a drafting committee from among the ULC membership attorneys from diverse practice areas Each draft receives at least two years consideration The drafting process draws on the expertise of state appointed commissioners legal experts and advisors and observers representing the views of other legal organizations or interests that will be subject to the proposed laws Draft acts are submitted for initial debate of the entire ULC at an annual meeting Each act must be considered section by section at no less than two
82. Walls The resident reported open cracks or holes in the interior wall or ceilings of the housing unit Included are cracks or holes that do not go all the way through to the next room or to the exterior of the housing unit Hairline cracks or cracks that appear in the walls or ceilings but are not large enough to insert the edge of a dime are not counted Very small holes caused by nails or other similar objects are also not counted e Structural Holes in Floors The resident reported holes in the interior floors of the unit The holes may or may not go all the way through to a lower floor or to the exterior of the unit The holes are only counted if large enough for someone to trip in e Structural Paint Plaster The resident reported peeling paint or broken plaster The area of peeling paint or broken plaster must be on the inside walls or ceilings and at least one area of broken plaster or peeling paint must be larger than 8 inches by 11 inches Resident Dissatisfied The resident rated structure based on a scale from 1 to 10 where 10 is the best and 1 is the worst Resident is dissatisfied if the structure is rated 1 2 or 3 National Center for Healthy Housing See www healthyhomestraining org ahs References Page 12 of 137 ining org See www healthyhomestra Total Occupied Units 000 GENERAL Owner occupied 000 Renter occupied 000 Owner Occupied Renter occupied Units in Structure 1 detached 1 attached
83. YeJo JO JOJO9 JOpO a Se Jajem ul saBueyo ajqeso1jou ajay ay o Jea se ay UIYJIM pajsa u q Jajem ayi SeH O pesn zou asnos ajeulaye mq pajoajep sjueuwejuos A penuue pajzsa Jajem S o lajem papyoq JO Jay ajenidoldde pasn asnos a eusaye pue pajoajep sjueuwejuos jenuue pasa Jajem S o exo pue s l eniu poyasnoy ul sjuejul JO uewom yueuBald Ji pue elajoeq Joy Ajjenuue pas azem S o Euoneoyioads s uswasinbel Jeyjo JO a e s 0 Buipioooe payonsjsuoo uoneuuojui Busa m pue pajoajod pe ujl A ay S o J9Jem 104 ulle u jo juauedep B s JO e5o JORJUOD peaj Jo Jajem3sa O suons nb euonippe s u ysy O Od OL ATIINV4 Od OL ISYNN 92 INOS 1938 M Gulu e obeweg PIOIN References Page 102 of 137 ining org Ithyhomestra J9Jem om pjoyasnoy e z N2139NOO suoydaja Jesu 222 L 222 008 1 Jequunu jo 1juos uosiod jeuo eu y Sod O suong o A po2 qissod 104 yeay jo pseog eso ay Buljeo Japisuoy suledes p p u jnoge p Jo pue JNOA yym J12 USU 191u 1 J sedas lesseoau axeu u u Jeumoauloy J OO ease yom ayy Bururejuos pue senbiuyoe 5uyelaua6 snp BulAjipow se yons syoiaeyeq abuey o UOIJEAOUSI ajes pea noqge yeay Jo sjuawyedap eo pue aye s UNOA Je ddd1D eu ym ynsuoo o pjo suea xis uey ssa p iyo OU si J u pue g 61 eJd YING sem auoy ay O ddd19 91815 YUM ynsuog sjuauaimbas pue suoejnp eoo pue a e s uo pase
84. able e When to post signs Before beginning renovation until after post renovation cleaning verification is completed Containing the Work Area e Isolate work area Take steps necessary to ensure no dust or debris leaves work area while renovation is being performed e Maintain integrity of containment Ensure plastic and other impermeable materials are not torn or displaced e Emergency exit Ensure containment installed so that it does not interfere with occupant and worker egress in an emergency Preparing the Work Area e Objects in Work Area Remove or cover with impermeable Not Reouired material with all seams and edges sealed eee eh e Ducts Opening in Close and cover all ducts with impermeable spna Work Area material e Windows and Doors in Work Area Close doors and windows within 20 and on multi story buildings all below renovation Close windows and doors Cover doors with impermeable material e Access Doors If door is used while Job is being performed allow workers to pass through while confining dust and debris to work area e Floors Ground Cover with taped down impermeable material 6 beyond the perimeter of surfaces undergoing renovation or a sufficient distance to contain the dust whichever is greater Cover with disposable impermeable material extending 10 beyond perimeter of surfaces undergoing renovation or a sufficient distance t
85. acmat cfm August 25 2004 See www healthyhomestraining org References Page 127 of 137 yy www hud gov offices lead aly es R X 7 3 H gt HOME SAFETY ul DEN oo U S Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control 2 e x en Nh 4i A AVERTENCIA A There are simple steps you can take to help keep your loved ones safe in and around the home Home Safety Council Did you know m Home accidents kill one person every 16 minutes and injure one person every four seconds in the U S m More than 1 2 million poisonings among children under age 5 were reported to U S poison control centers in 20022 m Nearly 40 000 children under age 14 are injured by fires each year Home Safety includes preventing unintentional injuries Unintentional injuries in the home include poisoning fires and burns choking drowning suffocation strangulation firearms and falls and they are all preventable What you can do There are many small and easy things you can do to protect your family from injuries in the home some of which are listed below Post emergency telephone numbers next to all phones to make it as easy as possible to get help if someone gets hurt Poison m Read warning labels and follow storage directions on household products Poisonous products can include medicines cleaning supplies hair spray and home repa
86. al electrical appliances The electrical fixtures and wiring must ensure safety from fire 2 Acceptability criteria i There must be at least one window in the living room and in each sleeping room ii The kitchen area and the bathroom must have a permanent ceiling or wall light fixture in proper operating condition The kitchen area must also have at least one electrical outlet in proper operating condition ui The living room and each bedroom must have at least two electrical outlets in proper operating condition Permanent overhead or wall mounted light fixtures may count as one of the required electrical outlets See www healthyhomestraining org References Page 36 of 137 g Structure and materials 1 Performance requirement The dwelling unit must be structurally sound The structure must not present any threat to the health and safety of the occupants and must protect the occupants from the environment 2 Acceptability criteria i Ceilings walls and floors must not have any serious defects such as severe bulging or leaning large holes loose surface materials severe buckling missing parts or other serious damage ii The roof must be structurally sound and weathertight ui The exterior wall structure and surface must not have any serious defects such as serious leaning buckling sagging large holes or defects that may result in air infiltration or vermin infestation iv The condition and equipment of interior
87. and maintained to prevent the erosion of soil and to prevent the accumulation of stagnant water thereon or within any structure located thereon 302 5 Rodent harborage All structures and exterior property shall be kept free from rodent harborage and infestation Where rodents are found they shall be promptly exterminated by approved processes which will not be injurious to human health After extermination proper precautions shall be taken to eliminate rodent harborage and prevent reinfestation See www healthyhomestraining org References Page 40 of 137 304 2 Protective treatment All exterior surfaces including but not limited to doors door and window frames cornices porches trim balconies decks and fences shall be maintained in good condition Exterior wood surfaces other than decay resistant woods shall be protected from the elements and decay by painting or other protective covering or treatment Peeling flaking and chipped paint shall be eliminated and surfaces repainted All siding and masonry joints as well as those between the building envelope and the perimeter of windows doors and skylights shall be maintained weather resistant and water tight All metal surfaces subject to rust or corrosion shall be coated to inhibit such rust and corrosion and all surfaces with rust or corrosion shall be stabilized and coated to inhibit future rust and corrosion Oxidation stains shall be removed from exterior surfaces Surfaces designed for
88. ange achieved See notes at end of chart continued References Page 7 of 137 Healthy People 2010 Objectives Related to Healthy Homes Mid Course Review 2005 NO CHANGE IN OBJECTIVE 8 11 Eliminate elevated blood lead levels in children Target Zero percent Baseline 4 4 percent of children aged 1 to 5 years had blood lead levels exceeding 10 g dL during 1991 94 Target setting method Total elimination Data source National Health and Nutrition Examination Survey NHANES CDC NCHS NO CHANGE IN OBJECTIVE Data updated and footnoted Reduce pesticide exposures that result in visits to a health care facility Target 11 398 visits per year Baseline 22 9337 visits to health care facilities were due to pesticides in 1997 A total of 172 088 pesticide exposures were documented in 1997 REVISED OBJECTIVE Reduce indoor allergen levels Target and baseline With Measured Allergens Baseline Target x Pm j 8 16a Group dust mite allergens that exceed 2 micrograms per gram of dust in the bed Sie 8 16b Group dust mite allergens that 19 4 exceed 10 micrograms per gram of dust in the bed German cockroach allergens that 6 1 exceed 0 1 unit per gram of dust in the bed Target setting method 20 percent improvement Data source National Survey of Lead and Allergens in Housing NIEHS and U S Department of Housing and Urban Development See www healthyhomestraining org References Page 8
89. annual meetings by all commissioners Once approved the final step is a vote by states A majority of the states present and no less than 20 states must approve an act before it can be officially adopted URLTA URLTA establishes the landlord and tenant relationship on the basis of contract rather than property law and thus gives the parties contractual rights and remedies As of 2008 URLTA has been adopted by 21 states Alabama Kansas Oklahoma Alaska Kentucky Oregon Arizona Michigan Rhode Island Connecticut Mississippi South Carolina Florida Montana Tennessee Hawaii Nebraska Virginia Iowa New Mexico Washington See National Conference of Commissioners on Uniform State Laws NCCUSL at www nccusl org Update NCCUSL s electronic archives is maintained by the University of Pennsylvania Law School at www law upenn edu bll archives ulc ulc_final htm final 10 See www nccusl org Update DesktopDefault aspx tabindex 5 amp tabid 61 11 See www nccusl org Update uniformact_factsheets uniformacts fs urlta asp See www healthyhomestraining org References Page 49 of 137 IL URLTA s Property Maintenance Obligations URLTA is intended to encourage landlords and tenants to maintain and improve the quality of housing and clarify the rights and obligations of landlords and tenants URLTA 1 102 Landlord Obligations Generally URLTA requires that a landlord e comply with applicable building and housing
90. apter 9 Plumbing Introduction Elements of a Plumbing System Water Service Hot and Cold Water Main Lines Water Heaters Drainage System Corrosion Control Water Conservation Putting It All Together References Additional Sources of Information Chapter 10 Onsite Wastewater Treatment Introduction Treatment of Human Waste Onsite Wastewater Treatment Systems Septic Tank Systems Alternative Septic Tank Systems Maintaining the Onsite Wastewater Treatment Systems Symptoms of Septic System Problems Septic Tank Inspection References Additional Sources of Information References Page 112 of 137 National Center for Healthy Housing References from HHTC Curriculum Overview 1 Lowry S 1991 October Housing British Medical Journal 303 6806 838 40 2 Samet JM Spengler JD et al 2003 Indoor environments and health Moving into the 21st century American Journal of Public Health 93 9 1489 93 3 Krieger J and Higgins D L 2002 Housing and health Time again for public health action American Journal of Public Health 92 5 758 768 4 van Winkle M R and Scheff P A 2001 Volatile organic compounds polycyclic aromatic hydrocarbons and elements in the air of ten urban homes Indoor Air 11 1 49 64 5 US Census Bureau 1997 American Housing Survey Web site http www census gov hhes www housing ahs ahs html 6 National Institute of Allergy and Infectious Diseases Ast
91. are ventilated through an adjoining room the unobstructed opening to the adjoining room shall be at least 8 percent of the floor area of the interior room or space but not less than 25 square feet 2 33m2 The ventilation openings to the outdoors shall be based on a total floor area being ventilated 403 2 Bathrooms and toilet rooms Every bathroom and toilet room shall comply with the ventilation requirements for habitable spaces as required by Section 403 1 except that a window shall not be required in such spaces equipped with a mechanical ventilation system Air exhausted by a mechanical ventilation system from a bathroom or toilet room shall discharge to the outdoors and shall not be recirculated 403 4 Process ventilation Where injurious toxic irritating or noxious fumes gases dusts or mists are generated a local exhaust ventilation system shall be provided to remove the contaminating agent at the source Air shall be exhausted to the exterior and not be recirculated to any space 403 5 Clothes dryer exhaust Clothes dryer exhaust systems shall be independent of all other systems and shall be exhausted in accordance with the manufacturer s instructions See www healthyhomestraining org References Page 42 of 137 503 4 Floor surface In other than dwelling units every toilet room floor shall be maintained to be a smooth hard nonabsorbent surface to permit such floor to be easily kept in a clean and sanitary condition 505 4
92. ases can be controlled symptoms can be prevented or minimized American Academy of Allergy Asthma and Immunology The Allergy Report Did you know m As many as 40 or 50 million people in the United States suffer from allergies m Allergies cause swollen eyes itching skin dripping noses light headedness and even death What is it An allergy is a strong reaction by your body s immune system to some thing that would normally be harmless a food plant or medicine s Common reactions include a stuffy nose itchy eyes or a skin rash Severe allergic reactions see below require immediate medical attention Many people who have allergies also have asthma Allergic reactions may trigger asthma attacks where a swelling and tightening of your airways that makes it difficult to breathe see Asthma fact sheet Signs of Allergies and Allergic Reactions include m Asthma shortness of breath cough chest tightness or wheezing See Asthma fact sheet Itchy watery eyes Itchy inflamed or runny nose Hives or itchy rash on skin Dark circles under and around eyes Recurring headache Diarrhea or stomach cramps Anaphylaxis a severe reaction may be life threatening Symptoms include swelling tingling in the mouth and a red itchy rash as well as light headedness shortness of breath severe sneezing stomach cramps and loss of blood pressure If these symptoms are present go immed
93. asthma attack is a distressing and potentially life threatening experience Scientific advances have greatly improved the understanding of the mechanisms that cause asthma attacks and have led to effective medical interventions to prevent morbidity and improve quality of life Yet the burden in prevalence health care use and mortality remains high Asthma remains a significant public health problem in the United States See December 29 2006 Revision at www cdc gov nchs data ad ad381 pdf O 4 4 7 8 percent E 7 9 8 5 percent I 8 6 9 7 percent E Over 9 8 percent O Data not reliable NOTES Ranges are based on approximate quartiles among states with available estimates Differences portrayed in this map should be interpreted with caution The 95 percent confidence intervals for many states overlap Current asthma prevalence estimates are based on the questions Has a doctor or other health professional ever told you that child s name had asthma and Does child s name still have asthma Estimates for Delaware the District of Columbia Mississippi Nebraska Nevada and New Hampshire have a relative standard error greater than 30 percent and less than or equal to 50 percent and should be interpreted with caution as they do not meet the standard of reliability or precision The estimates for Alaska Idaho Maine Montana North Dakota South Dakota Vermont West Virginia and Wyoming have a relative standard error greater than 50 per
94. atteries replaced in last 6 months Fire extinguisher purchased or recharged in last 2 years Sprinkler system inside home Working carbon monoxide Occupied Units Owner Renter 110 692 75 647 35 045 1 6 0 4 4 1 1 1 0 7 2 0 8 0 6 4 11 4 3 4 2 8 4 6 1 9 1 1 3 8 1 0 0 8 1 5 19 8 25 6 7 3 0 3 0 3 0 2 92 4 93 1 90 8 61 7 63 8 57 1 43 6 49 2 31 5 3 9 23 7 2 32 6 37 4 22 1 American Housing Survey National 2007 Selected Elements Related to Healthy Homes Const lt 4 years 5 747 0 6 0 3 7 7 2 3 0 9 0 8 22 5 0 4 98 0 58 2 49 2 11 8 35 8 See www healthyhomestraining org 20 392 1 8 1 7 6 6 3 6 1 9 0 9 20 5 0 2 95 0 67 6 43 3 3 3 25 292 1 5 1 0 5 1 3 1 1 8 1 1 18 9 0 2 94 3 66 8 43 2 2 7 Manuf Severe Moderate Movedin Below Housing Problems Problems Elderly past year poverty Northeast Midwest 6 919 1 806 3 965 22 864 17 904 14 157 0 3 8 9 39 4 1 1 3 5 3 6 1 1 69 7 0 0 1 2 1 4 2 3 10 1 14 3 13 7 5 2 10 2 11 3 6 8 8 9 6 3 2 9 3 7 3 8 1 8 7 4 9 9 1 2 3 9 4 1 0 9 2 7 3 6 0 7 1 4 1 4 50 9 15 0 17 2 22 8 10 2 14 4 0 8 1 2 0 2 0 2 0 3 0 3 88 0 84 3 82 5 91 1 91 5 86 6 57 1 57 0 52 5 60 6 55 1 57 1 43 3 31 7 31 5 40 4 37 4 32 6 0 9 4 9 5 3 5 2 7 1 4 6 18 7 29 7 21 2 32 0 247 22 7 54 7 45 7 South 40 609
95. ature of not less than 68 F 20 C in all habitable rooms bathrooms and toilet rooms Exceptions 1 When the outdoor temperature is below the winter outdoor design temperature for the locality maintenance of the minimum room temperature shall not be required provided that the heating system is operating at its full design capacity The winter outdoor design temperature for the locality shall be as indicated in Appendix D of the International Plumbing Code 2 In areas where the average monthly temperature is above 30 F 1 C a minimum temperature of 65 F 18 C shall be maintained 603 2 Removal of combustion products All fuel burning equipment and appliances shall be connected to an approved chimney or vent Exception Fuel burning equipment and appliances which are labeled for unvented operation 603 5 Combustion air A supply of air for complete combustion of the fuel and for ventilation of the space containing the fuel burning equipment shall be provided for the fuel burning equipment 603 6 Energy conservation devices Devices intended to reduce fuel consumption by attachment to a fuel burning appliance to the fuel supply line thereto or to the vent outlet or vent piping therefrom shall not be installed unless labeled for such purpose and the installation is specifically approved 607 1 General Duct systems shall be maintained free of obstructions and shall be capable of performing the required function See www healthyhomest
96. avoid confusion about the doors O Label each room using the same names and abbreviations as listed on the Visual Survey Report O Draw an asterisk in rooms where children sleep or play O Be sure to note entryway of the home 5 Perform the Visual Survey note hazards on both the Floor Plan and Visual Survey Report O Fill in the top of the Visual Survey Report and cross out columns for rooms that are not present Add names or areas if necessary If you Seewww healthyhomestraining org References Page 91 vofv131f org Revised 7 04 416 Visual Survey Instructions do not have enough columns use a second copy of the report and write of 2 on the first sheet and 2 of 2 on the second O Draw a star asterisk next to the names of rooms where children sleep or play O In each room look for the problems listed below For each 1 note the location of each problem on the floor plan using the abbreviation from the key below AND 2 make a check mark YJ next to the name of the problem in the column for that room on the Visual Survey Report a Deteriorated paint peeling flaking chipping cracking paint Deteriorated in any way Paint coming loose from the painted surface wood plaster metal drywall Teeth marks on the painted surface b Cockroaches or their remains Note the location if you see any cockroaches their shells or debris or if the resident reports seein
97. away from fireplaces heaters and radiators Replace frayed electrical wires m Take care to avoid kitchen fires and burns Stay in the kitchen while cooking Turn pot handles toward the inside of the stove so children cannot grab them Install ground fault circuit interrupters GFCIs in kitchens and bathrooms m Set water heater thermostats below 120 F 50 C Always test the water before bathing yourself or your child Drowning Choking Suffocation and Strangulation m Never leave children alone near water including bathtubs buckets swimming pools rivers and the ocean Learn and practice First Aid and CPR m Use child proof fencing around all swimming pools and hot tubs m Avoid toys for children under 3 years of age that are smaller than 2 inches long and 1 inche wide Toys for young children should never have small or removable parts that could be choked on m Avoid window blinds with looped cords which may cause strangula tion if not stored out of children s reach m Keep plastic bags and drawstring cords away from children Falls and Other Injuries m Keep your floors free of anything that may cause tripping such as toys shoes or magazines m Use stools ladders and stepladders carefully m Make sure that your home is well lit WWW ag y e a a HOME SAFETY m Use guards on windows and safety gates near stairs to keep children from falling m Follow manufacturers instructions for storing and us
98. building noise Related health effects Environmental tobacco smoke in dwellings Respiratory and allergic effects Lead in paint dust soil and drinking water Lead related health effects Humidity and mould in dwellings Related health effects Hygrothermal conditions House dust mite exposure amp respiratory disease Building and equipment factors Injuries domestic accidents Injury Database on domestic accidents Injuries Multifamily housing high rise housing and housing quality Mental health Linkages with some evidence for estimating burden of disease Ventilation in the dwelling Respiratory and allergic effects Volatile organic compounds Respiratory cardiovascular and allergic effects Cockroaches and rodents in dwellings Respiratory and allergic effects Cats dogs and mites in dwellings Respiratory and allergic effects Pets and mites Respiratory allergic or asthmatic effects Sanitation and hygiene conditions Related physical health effects Social conditions of housing Fear fear of crime Poverty and social exclusion Related health effects Crowding Related health effects Social factors social climate Mental health Linkages with insufficient evidence for estimating burden of disease Lighting conditions in the dwelling Mental and other health effects Particulate matter in indoor air
99. buildingmanagers pdf g Alliance for Healthy Homes http www afhh org dah dah_pesticides htm h Canada 1 University of Toronto Integrated Pest Management in Housing http www utoronto ca forest termite IP MH html IPM Institute of North America IPM Standards for Schools i http www ipminstitute org school htm ii http www ipminstitute org IPM_Star ipmstar_profiles_monroe_county_in htm j PHA RESOURCE H HUD funded Healthy Public Housing Project conducted by Harvard School of Public Health in Boston public housing http www hsph harvard edu hphi 3 See www healthyhomestraining org References Page 66 of 137 k PHA Case Studies Hi CUYAHOGA HOUSING AUTHORITY http www ehw org Asthma ASTH_ EPA _IPM_CaseStudy pdf iv Boston Housing Authority http www asthmaregionalcouncil org about documents IPMinMultifamilyHousing7 25 06 doc The above list of IPM practices does not constitute a HUD endorsement of any specific practice but provides IPM ideas and practices that have reportedly been used to improve pest management while reducing unnecessary dependence on pesticides HUD encourages PHAs TDHEs to share their policies procedures resident leases and written case studies so that these may be published on the HUD web for others to read For further information about this Notice contact the nearest HUD Office of Public Housing within your state Tribes and TDHE s should contact the near
100. ceilings walls floors window sills and pipes m Search behind and underneath materials such as carpeting furniture or stored items m Inspect kitchens bathrooms and basements for standing water water stains and patches of out of place color Respond fix any water problems immediately and clean or remove wet materials furnishings or mold m Clean up spills or floods within one day Dry all surfaces and fix the problem or leak to prevent further damage Install a dehumidifier where there is high humidity Replace contaminated components such as drywall and insulation Clean mold off non porous surfaces with a weak solution of bleach and water Throw away moldy materials that cannot be cleaned such as carpet upholstered furniture drywall and floorboards m When cleaning mold protect yourself by wearing long sleeves pants shoes and rubber gloves as well as goggles and a face mask m f you find a large area of mold larger than the top of a twin sized bed or are allergic to mold consider hiring a professional to clean it and fix the cause of the problem For a list of mold removal professionals look under Fire and Water Damage Restoration in your telephone book See www healthyhomestraining org Moldy materials that cannot be cleaned should be thrown away For More Information Visit HUD s website at www hud gov offices lead for more information about addressing health hazards in homes o
101. cent and therefore are not represented in this figure SOURCE CDC NCHS National Health Interview Survey Figure 1 Current asthma prevalence among children 0 17 years of age by State annual average for the period 2001 2005 See www healthyhomestraining org References Page 26 of 137 National Center for Chronic Disease Prevention and Health Promotion Behavioral Risk Factor Surveillance System BRFSS Maps Year 2006 Adults who have been told they currently have asthma Percentage of respondents reporting Yes Legend Percent 0 lt 7 2 D 73to 8 P 8 1 to 87 M 8 5to 9 3 M gt 9 4 No Data Classification Method Natural Breaks Image saved 7 7 2008 Honolulu AD pr Miami Fort Lauderdale Miami Bez Centers for Disease Control and Prevention CDC Behavioral Risk Factor Surveillance System Survey Data Atlanta Georgia U S Department of Health and Human Services Centers for Disease Control and Prevention 2007 See http apps nccd cdc gov gisbrfss map aspx See www healthyhomestraining org References Page 27 of 137 National Center for Chronic Disease Prevention and Health Promotion Behavioral Risk Factor Surveillance System BRFSS Maps Year 2006 Adults who have ever been told they have asthma Percentage of respondents reporting Yes Legend Percent O 11 4 O 115to125 MH 12 6to 13 4 MM 135to14 7 gt 145 E No Data Classification Method Natural Breaks Image saved 7 7
102. ches that have been used to make existing homes healthier and safer This analysis focuses on regulatory approaches that address current conditions in existing homes It does not address new construction or how rehabilitation must be conducted in existing homes 1 Housing Property Maintenance Code The U S Department of Housing and Urban Development HUD sets standards for housing receiving federal assistance For example housing funded through Housing Choice Vouchers formerly known as Tenant Based Section 8 Voucher must comply with Housing Quality Standards HQS See Part A on page 4 for more information on HQS HUD also sets general standards for housing covered by mortgage insurance For all other housing there are no national codes for existing housing or property maintenance HUD sets standards for the design and construction of manufactured housing and housing receiving federal assistance but does not regulate the maintenance of that housing While all states have a code for new construction or major rehabilitation projects few states have adopted standards mandating minimum conditions in or requiring maintenance of existing housing In the absence of state standards most urban and many suburban local jurisdictions adopted a housing or property maintenance code The nation s model housing or property maintenance code is the International Property Maintenance Code PMC The IPMC is managed by the International Code Council ICC
103. e and use patterns in Minnesota households with children J Expo Anal Environ Epidemiol 10 2 159 67 Keep It Dry 1 Fisk W J Health and productivity gains from better indoor environments and their implications for the US Department of Energy Lawerence Berkeley Laboratory Berkeley CA Retrieved October 2 2004 from Web site http www rand org scitech stpi Evision Supplement fisk pdf 2 Dales R et al 1998 Influence of residential fungal contamination on peripheral blood lymphocytes populations in children Arch Environ Health 53 3 190 5 3 Texas Mold Commission Survey of 500 single family houses Texas Colorado Tennessee Florida North Carolina South Carolina 4 Rose W B 1998 August September Details for a dry basement Fine Homebuilding 115 99 103 5 Asthma Regional Coordinating Conference of New England 2001 Healthy and Affordable Housing Practical Recommendations for Building Renovating and Maintaining Housing Read This Before you Design Build or Renovate Web site http www eere energy gov buildings building america pdfs db 32114 pdf Page 4 of 9 See www healthyhomestraining org References Page 116 of 137 6 Community Environmental Health Resource Center CEHRC Mold and moisture assessment instructions Retreived July 11 2005 from Web site http www cehrc org tools moldmoisture mmasstinstr cfm 7 Brennan T 1989 Fan Door Testing of Crawl Space Buildings In Max
104. e diseases Nationally 74 8 of homes are served by a public sewer with 24 1 served by a septic tank or cesspool and the remaining 1 1 using other means Exclusion of vermin which may play a part in the transmission of disease P21 Vermin such as rodents have long been linked to property destruction and disease Integrated pest management along with proper housing construction has played a significant role in reducing vermin around the modern home Proper food storage rat proofing construction and ensuring good sanitation outside the home have served to eliminate or reduce rodent problems in the 21st century home Provision of facilities for keeping milk and food fresh undecomposed P22 See www healthyhomestraining org References Page 46 of 137 Facilities to properly store milk and food has been instrumental in reducing foodborne diseases 12 Provision of sufficient space in sleeping rooms to minimize the danger of infection P23 Much improvement has been made in the adequacy of living space for the U S family over the last 30 years Excessive crowding in homes has the potential to increase communicable disease transmission and the stress level of occupants Protection Against Accidents 7 Principles 13 Erection of the dwelling with materials and methods to minimize danger of accidents due to collapse of any part of the structure P24 14 Control of conditions likely
105. e found shall be promptly exterminated by approved processes that will not be injurious to human health After extermination proper precautions shall be taken to prevent reinfestation 308 2 Owner The owner of any structure shall be responsible for extermination within the structure prior to renting or leasing the structure 308 3 Single occupant The occupant of a one family dwelling or of a single tenant nonresidential structure shall be responsible for extermination on the premises 308 4 Multiple occupancy The owner of a structure containing two or more dwelling units a multiple occupancy a rooming house or a nonresidential structure shall be responsible for extermination in the public or shared areas of the structure and exterior property If infestation is caused by failure of an occupant to prevent such infestation in the area occupied the occupant shall be responsible for extermination 308 5 Occupant The occupant of any structure shall be responsible for the continued rodent and pest free condition of the structure Exception Where the infestations are caused by defects in the structure the owner shall be responsible for extermination 403 1 Habitable spaces Every habitable space shall have at least one openable window The total openable area of the window in every room shall be equal to at least 45 percent of the minimum glazed area required in Section 402 1 Exception Where rooms and spaces without openings to the outdoors
106. e is substantial variation in their performance under the Dry and Contam inant Free categories with scores ranging from A to D Energy Star IAP and Green Communities received an A under the Dry category ENERGY STAR IAP Green Communities and LEED H because they require extensive moisture control practices The LEED H program addresses several aspects of moisture control through its Durability Plan requirement One concern is that it is not possible to assess whether the plan will always include the most important moisture control elements Nonetheless because the durability plans are mandatory and will be evaluated as part of program participation NCHH rated LEED H s Dry criteria as similar to the NCHH specific requirements Ensuring structures are properly ventilated is particularly important because of the green building mandate to improve energy efficiency by tightening the building envelope Energy upgrades can benefit occupant health by increasing comfort and reducing unplanned airflows which can result in moisture problems Mechanical ventilation helps ensure contaminants and humidity are exhausted to the outside and that the home receives clean fresh air NCHH has identified the American Society of Heating Refrigerating and Air Conditioning See www healthyhomestraining org References Page 74 of 137 Engineers standard 62 2 ASHRAE 62 2 2007 as the industry standard for ventilation for buildings of four stories or less which should be
107. e left column presents NCHH s recommended criteria for achieving the aforementioned principles We compared each program to these criteria and assigned a score based on the following scoring system Score Green Program Description 3 Includes mandatory criterion equivalent to NCHH criterion 2 Includes mandatory criterion similar to NCHH criterion 1 Includes optional criterion that is similar to NCHH criterion 0 Does not include similar criterion Table 2 provides summary grades for each program both by each healthy homes principle and overall We established a target score for each category by multiplying the number of criteria under each healthy homes principle by 2 5 average 2 and 3 of the scores listed above For example if half of the criteria in a category scored a 3 i e half criterion were mandatory and equivalent to the NCHH standard and half scored a 2 i e were mandatory and similar but not equivalent to the NCHH standard then the program would achieve 100 of the target score The score of 2 5 acknowledges that some differences in the language for a specific criterion are likely and acceptable The overall grade A B C D for the program was calculated by totaling the scores for all the criteria across categories This provides all criterion equal weight in arriving at a total grade Grading Key A gt 100 of target score all NCHH criteria included A 90 100 of target score Se
108. e space cleanliness peace of mind normal family and household activity c Protection Against Contagion e g from disease vermin sewage contaminated water over crowding food decay and d Protection Against Accidents e g from falls fire burns gas mechanical injuries electrical shock building collapse traffic The Principles are summarized below along with analysis excerpted from the HH Manual The number of each Principle as identified in APHA s 1938 report is indicated by PH 4 www apha org APHA Committee on the Hygiene of Housing Basic Principles of Healthful Housing Preliminary Report March 1938 www pubmedcentral nih gov articlerender fcgi artid 1529239 or www ajph org cgi reprint 28 3 351 The manual is published by the U S Department of Health and Human Services and U S Department of Housing and Urban Development www cdc gov nceh publications books housing cha02 htm See www healthyhomestraining org References Page 44 of 137 Fundamental Physiological Needs 8 Principles 1 A thermal environment to avoid undue heat loss P1 and permit adequate heat loss P2 The lack of adequate heating and cooling systems in homes can contribute to respiratory illnesses or even lead to death from extreme temperatures A majority of today s homes can maintain healthy temperatures although many houses still lack adequate insulation An atmosphere of reasonable chemica
109. e www healthyhomestraining org References Page 72 of 137 B 80 89 of target score C 70 79 of target score D lt 69 of target score This analysis did not assign a weighting factor to each individual criterion because there are generally insuf ficient scientific data to support such a judgment The concept of healthy homes involves taking a holistic approach to the home environment by implementing packages of upgrades which together can ensure the health safety and durability of a home For this reason the analysis does not credit programs for establish ing a threshold number of points for optional items By definition this inclusion of optional items even to achieve an overall point value will entail trading off some indoor environmental quality item for another See www healthyhomestraining org References Page 73 of 137 Results Tables 1 and 2 show the results of the analysis The Enterprise Community Partners Green Communi ties Program and the EPA Indoor Air Package Programs ranked the highest among the programs included in the analysis This is largely due to the fact that they include many mandatory criteria for the indoor environment The LEED H and ICC 700 2008 rating systems in clude a mixture of mandatory and optional criteria to achieve even the lowest LEED rating of certifiable It is not possible to assess the mix of criteria that a builder will select to comply with the standard N
110. eb aa 54 Moisture Hazard iii aqakusun ara aaa ha aa a ra aaa aa aara aa Taaa 55 Swimming Pool Spa OF WHINPOON uuu u u u u 22 2 ahua aaa a a a EE T 55 Other Hazald eee ee eee en ee eee eee eee 56 Comments Other ltems Secti0N ccccccccccccccccccceecccc ee eceeeeeceeeeecesuaueseeeesceueeeseesauueeeaeseeueeesesaaaeeeeaaseeunaesees 57 Overall Comments on ThiS INSp GtioB u u L L uuu ns a Gl n ha Q m aha Maza 58 Page IV Healthy Housing Inspection Manual See www healthyhomestraining org References Page 81 of 137 APPENDIX 1 Description of Health and Safety Conditions Identified on the Visual Assessment Form 59 Site CU Mit Sd uu ae eee at saa A ees 59 FENCING ANG Gale cortito rte ee 59 Grounds A cach eases sfaniaesanaddanacan suman gen E ae 59 Children s Play Ar8a8 u p u a A sda taceies dda AAA 60 Olesa o aid iaa 61 Building Exterior Items O62 pana 62 DO Suisse aid a db 62 Fire Es amp 8peS mii a ii 63 FOUNGAUIOMNS iii A A A A AAA AA AAA ees 64 NO 64 ROO Si A IA 64 Walls sea ta A E RO OA ADE EA am astuta 65 WINDOWS stats ra A ad O E A A aaa 66 Building Systems Items 63 81 uuu a a 67 Electrical Systems BUIGING oia a ts aasawa asa de noc 67 Fire Protection Building n rn 68 HVAC BULGING u aaa taa acted upa ayau umapa waqa qayaqa A ade 69 Common Areas Items 82 102 a L au ua aaa A Ai ss agua A a i aan 70 El SvalorSXux Tusma Sus a E a 1 EEEE EEE apu h
111. ed None present 1 Tested and passed 4 Smoke alarm working and well placed LI No smoking allowed LI None 4 Vacuum non HEPA D Tested failed and mitigated mitigated 1 Tested failed and mitigated outdoors LJ Air fresheners LJ HEPA vacuum See www healthyhomestraining org 1 Tested failed and CO alarm working and one on each floor 1 Smoking only allowed 1 Musty odor evident 2 Dog A Full access in home Oi Family shows evidence U Family shows evidence U Family shows evidence U Family shows evidence T Not tested Don t know Li Not tested Don t know T Not tested Don t know 1 CO alarm does not log peak level 1 Smoking allowed indoors 1 bedroom 1 playroom 1 Potpourri incense candles 1 Damp mop and damp dusting A Visible water mold damage i Other L Sleeping location Present in O kitchen LI bedroom H other Present in O kitchen L bedroom U other Present in UU kitchen LI bedroom H other Present in L bedroom LI other m Loose peeling or chipping paint L Damaged material 1 Failed test but not mitigated 1 No smoke alarm T No CO alarm T Total smokers in household J Mother smokes 1 Other strong odors 1 Sweep or dry mop References Page 95 of 137 NURSE OBSERVED INFORMATION Bolded responses indicate areas of greater concern Drinking Water Source Cleanliness lt 5 2 Ventilation s
112. ed in a high safety locked cabinet The family does not have a formal fire escape plan The mom reports that the hallway lighting is good She has no safety concerns about lighting In the kitchen you note the coffee maker and tea kettle You ask about the child s access to hot liquids The mom notes that her son is older and is aware that he should not touch hot things You ask the mom if she knows what the hot water temperature is set at She does not know Bedroom and Bathroom e View Bedroom and Bathroom Walkthrough video clip 6 6 MB e View photos of bedroom conditions e View photos of bathroom conditions You ask the mom about the use of humidifiers in the bedroom She notes that she sometimes uses them in the winter because the air gets too dry from the hard to control heat As you talk further the mom confirms that the bathroom fan does function although it is a bit noisy You observe a hair dryer on the edge of the sink You ask the mom about adult supervision when her child is bathing She notes that she is right there most of the time but may sometimes leave the room to grab a towel or item of clothing for the child Medication Review and Wrap up e View Medication Review and Wrap up video clip 7 0 MB See www healthyhomestraining org References Page 108 of 137 ational Cente onHealthy Housing National Healthy Homes Training Center and Network Healthy Homes Maintenance Checklist The followi
113. eeting Leave sheeting to isolate contaminated rooms in place under after cleaning and removal of other sheeting Mist protective sheeting before folding it Fold the dirty side inward Tape shut to seal or seal in heavy duty bags e General Clean all objects and surfaces in work area and 2 outside work area cleaning from higher to lower e Walls Use HEPA vacuum or wiping with a damp cloth e Carpets and Rugs Thoroughly vacuum with a HEPA vacuum equipped with a beater bar e Remaining Surfaces Thoroughly vacuum remaining surfaces and objects with a HEPA vacuum e Final Cleaning Other Than Floors Wipe remaining surfaces and objects except for carpeted or upholstered surfaces with a damp cloth e Final Cleaning Uncarpeted Floors Mop floors thoroughly using a mopping method that keeps wash water separate from the rinse water or using a wet mopping system Post Cleaning Verification See Next Table HEPA vacuum means a vacuum cleaner which has been designed with a high efficiency particulate HEPA filter as the last filtration stage A HEPA filter is a filter that is capable of capturing particles of 0 3 microns with 99 97 efficiency The vacuum cleaner must be designed so that all the air drawn into the machine is expelled through the HEPA filter with none of the air leaking past it 2 Wet mopping system means a device with the following A long handle a mop
114. el and contractors b Identifying 1 pests and 2 environmental conditions that limit the spread of pests including the presence of pests natural enemies c Establishing an ongoing monitoring and record keeping system for regular sampling and assessment of pests surveillance techniques and remedial actions taken including establishing the assessment criteria for program effectiveness d Determining with involvement of residents the pest population levels by species that will be tolerated and setting action thresholds at which pest populations warrant action e Improving sanitation waste management mechanical pest management methods and or natural control agents that have been carefully selected as appropriate in light of allergies or cultural preferences of staff or residents f Monitoring and maintaining structures and grounds e g sealing cracks eliminating moisture intrusion accumulation and adding physical barriers to pest entry and movement g Developing an outreach educational program and ensuring that leases reflect residents responsibilities for 1 proper housekeeping 2 reporting presence of pests leaks and mold and 3 cooperating with specific IPM requirements such as obtaining permission of HA management before purchasing or applying any pesticides h Enforcing lease provisions regarding resident responsibilities such as housekeeping sanitation and trash removal and storage i Using pest
115. ence to Determine Whether or Not an Association Exists e Airflow obstruction in otherwise healthy persons e Dyspnea shortness of breath e Skin symptoms e Skin symptoms e Mucous membrane irritation syndrome e Asthma development e Gastrointestinal tract problems e Gastrointestinal tract problems e Chronic obstructive pulmonary disease e Airflow obstruction in otherwise healthy persons e Fatigue e Fatigue e Inhalation fevers nonoccupational exposures e Mucous membrane irritation syndrome e Neuropsychiatric symptoms e Neuropsychiatric symptoms e Lower respiratory illness in otherwise healthy e Chronic obstructive pulmonary disease adults e Cancer e Cancer e Inhalation fevers nonoccupational exposures e Acute idiopathic pulmonary hemorrhage in infants e Reproductive effects e Reproductive effects e Lower respiratory illness in otherwise healthy adults e Rheumatologic and other immune diseases e Rheumatologic and other immune diseases e Acute idiopathic pulmonary hemorrhage in infants Source National Academies Press 2004 Damp Indoor Spaces and Health Tables ES 1 and ES 2 Institute of Medicine of the National Academies ISBN 0 309 09246 9 See www nap edu books 0309091934 htm e Sufficient Evidence of a Causal Relationship Evidence is sufficient to conclude that a causal relationship exists between the agent and the outcome That is the evidence fulfills the criteria for sufficient evidence of an association and
116. enerally using a four tiered approach in the following sequence e Set Action Thresholds i e decide the point at which pest populations or environmental conditions indicate that pest control action is required e Monitor and Identify Pests i e ensure that pesticides are really needed and that the correct pesticide will be used e Prevention i e manage the indoor space to prevent pests from becoming a threat and e Control i e use less risky pest controls first e g highly targeted chemicals such as pheromones or mechanical control e g trapping use additional methods if necessary e g targeted spraying use broadcast spraying of non specific pesticides as a last resort Pesticide Labeling Pesticide labels constitute the law concerning the proper use of a pesticide Failure to use a pesticide by a professional or by a consumer in accordance with the label requirements and prohibitions is a violation of the law and may be grounds for an enforcement action To promote proper pesticide use by consumers EPA employs outreach and education and voluntary programs The Directions for Use section of a label reflects EPA s determination that the use of the product in such a manner does not cause unreasonable adverse effects on the environment Other sections explain the ingredients effects and other facts Generally the Directions for Use section states the o Pest s the product may be used to control o S
117. energy saving features that typically make them 20 30 more efficient than standard homes IAP requires a suite of additional prescriptive measures including Moisture Control Radon Control Pest Control e HVAC Systems Combustion Safety Building Materials Home Commissioning Like Energy Star IAP requires third party verification through the Home Energy Rating System HERS Mandatory Criteria Yes comprehensive Third Party Certification Yes Building Performance Testing Yes Units Certified Not Applicable Pilot Program www energystar gov index cfm c bldrs_lenders_raters nh_iap See www healthyhomestraining org References Page 71 of 137 Method of Analysis We compared the criteria of the four national programs to a detailed list of healthy homes measures that are aligned with NCHH s seven healthy homes principles Those principles involve keeping homes Dry Clean Ventilated Safe Contaminant Free Pest Free Malntained These principles were developed by a broad based expert workgroup of housing and health professionals as part of the federally funded National Healthy Homes Training Center and Network The principles reflect the latest in scientific research and best practices related to reducing housing related health hazards For more in formation see www healthyhousing org training Table 1 presents a detailed analysis comparing each program to the NCHH criteria Th
118. enforcing officials industry representatives design professionals and other interested parties Proposed changes are carefully considered through an open code development process in which all interested and affected parties may participate The contents of the code are subject to change both through the Code Development Cycles and the governmental body that enacts the code into law For more information regarding the code development process contact the Code and Standard Development Department of the International Code Council While the development procedure of the International Property Maintenance Code assures the highest degree of care ICC and the founding members of ICC BOCA ICBO SBCC their members and those participating in the development of the code do not accept any liability resulting from compliance or noncompliance with the provisions because ICC and its founding members do not have the power or authority to police or enforce compliance with the contents of the code Only the governmental body that enacts the code into law has such authority 3 x www iccsafe org See www healthyhomestraining org References Page 39 of 137 Relationship to Other ICC Codes The International Property Maintenance Code is complements and is fully compatible with all the International Codes I Codes published by the International Code Council ICC including the International Building Code ICC Electrical Code International Energy
119. environments Mycoplasma pneumoniae ETS in older Insects other than Chlamydia trachomatis children and adults Cockroaches Houseplants Pollen Cat Dog Domestic Birds Rodents Limited or Suggestive Evidence of No Association Rhinovirus adults No agents met No agents met No agents met this definition this definition this definition Source National Academies Press 2000 Clearing the Air Asthma and Indoor Air Exposures Executive Summary Institute of Medicine ISBN 0 309 06496 1 See www nap edu books 030906496 1 html At concentrations that may occur only when gas appliances are used in poorly ventilated kitchens e Sufficient Evidence of a Causal Relationship Evidence fulfills association criteria and in addition satisfies criteria regarding the strength of association biologic gradient dose response effect consistency of association biologic plausibility and coherence and temporality used to assess causality Sufficient Evidence of an Association Association has been observed in studies in which chance bias and confounding factors can be ruled out with reasonable confidence e g several small bias free studies showing an association that is consistent in magnitude and direction Limited or Suggestive Evidence of an Association Evidence is suggestive of an association but is limited because chance bias and confounding cannot be ruled out with confidence e g one high quality study shows association but
120. es healthier by giving them a better understanding of the direct relationship between exterior problems such as a sloping outside wall and interior problems such as rats large holes in the floor and water damage that can impact resident health and safety With this understanding communities can more effectively and efficiently identify homes with serious health and safety threats and set priorities for assessments of the interior The table is based on the American Housing Survey AHS The AHS tracks some but not all items related to health For example it does not track cockroaches radon lead based paint and carbon monoxide levels Background on American Housing Survey The AHS is conducted by the Bureau of the Census for the Department of Housing and Urban Development HUD to describe the condition of the Nation s housing The AHS includes apartments single family homes mobile homes and vacant housing units It describes household characteristics income housing and neighborhood quality housing costs equipment and fuels size of housing unit and recent movers National data are collected in odd numbered years and data for each of 47 selected Metropolitan Statistical Areas MSA are collected currently about every six years The national sample covers an average 55 000 housing units Each metropolitan area sample covers 4 100 or more housing units The AHS returns to the same housing units year after year to gather data therefore this su
121. essing multiple housing deficiencies that affect health and safety e Build competency among environmental public health practitioners public health nurses housing specialists housing owners housing managers and others who work in the community so they can incorporate healthy housing activities into their professional activities e Develop national healthy homes capacity through crossdisciplinary grants contracts and other activities at the federal state tribal and community levels that research and demonstrate low cost effective home hazard assessment and intervention methods e Develop effective education and outreach materials with a particular focus on high risk populations to increase public awareness of residential hazards and highlight effective actions households can take to reduce the risk for illness and injury Healthy Housing Inspection Manual J Page 1 See www healthyhomestraining org References Page 84 of 137 The Healthy Housing Inspection Manual is a model reference tool that local jurisdictions or others may use as is or modify based on local needs Use of the manual is expected to improve the effectiveness and efficiency of the public health housing management and workforces that identify prevent and control health problems associated with housing The manual does not introduce any inspection requirements nor does it modify any existing inspection requirements for housing agencies residents HUD or CDC T
122. est 25 292 2 1 4 6 1 4 3 1 1 6 1 0 3 5 1 8 3 7 82 8 13 3 4 7 6 4 2 0 1 1 South 40 609 2 4 4 7 1 7 2 4 1 5 1 2 3 8 3 9 2 1 82 6 7 6 4 6 1 1 1 3 1 0 West 24 400 1 8 4 1 1 3 2 1 1 1 0 7 3 2 5 5 1 8 82 3 6 4 3 8 0 7 1 5 0 7 References Page 14 of 137 Total Occupied Units 000 INTERIOR Holes in floors Open cracks or holes Broken plaster or peeling paint Water Leakage in Last 12 With leakage from inside Fixtures backed up or Pipes leaked Broken water heater Other or unknown Rodents in Last 3 Months Signs of rats Signs of mice Signs of rodents not sure Electrical No electrical wiring Exposed wiring Rooms without electric outlets With fuses or breakers blown in last 3 months Occupied Units 110 692 1 0 4 8 2 0 7 9 2 1 3 4 0 8 2 0 0 7 5 5 0 4 0 0 1 0 1 3 9 1 Owner 75 647 0 6 3 7 1 4 6 6 1 7 2 8 0 8 1 6 0 5 5 2 0 3 0 1 0 8 1 1 9 1 Renter 35 045 1 7 7 2 3 2 10 7 2 8 4 8 0 8 2 8 1 0 6 0 0 6 0 0 1 4 1 8 9 1 American Housing Survey National 2007 Selected Elements Related to Healthy Homes Const lt 4 years 5 747 0 1 1 6 0 4 3 8 1 0 1 9 0 2 0 8 0 1 2 6 0 1 0 3 0 6 1 2 8 5 See www healthyhomestraining org 20 392 1 1 5 2 2 5 8 4 2 1 3
123. est HUD Office of Native American Programs Locations of these offices are available on HUD s website at http www hud gov s Orlando J Cabrera Assistant Secretary for Public and Indian Housing See www healthyhomestraining org References Page 67 of 137 Summary of National Green Building Programs Enterprise Community Partners Green Communities Criteria Green Communities is a major initiative led by Enterprise Community Partners Enterprise Established in September 2004 it is a five year 555 million commitment to create more than 8 500 homes that deliver significant health economic and environmental benefits for low income families and communities The pro gram establishes green building criteria and provides funding to assist developers in planning and construc tion As of January 2008 Enterprise has invested over 570 million in over 250 developments that will result in more than 11 000 homes that meet the Green Com munities Criteria Projects developed under the criteria must satisfy all 40 mandatory elements and gain additional points 35 points for new construction or 30 for rehabilitation proj ects from optional criteria The criteria allow flexibility if a particular hardship is demonstrated and an alterna tive is proposed that meets the intent and accomplishes the same outcome as the criteria Building projects that conform to the criteria are eligible for grants loans and tax credit equity as i
124. ested in building local capacity to address housing related health hazards Healthy Homes Training Center and Network http www healthyhomestraining org Page 2 Healthy Housing Inspection Manual See www healthyhomestraining org References Page 85 of 137 e the Healthy Housing Reference Manual which gives public health and housing professionals the tools necessary to ensure that housing stock is safe decent and healthy for our citizens particularly children and the elderly who are often most vulnerable and spend more time in the home http www cdc gov nceh publications books housing housing htm FORMAT OF THIS MANUAL HUD and CDC recommend that section 1 the Healthy Housing Model Resident Questionnaire a voluntary health assessment be completed first The questionnaire should be used to collect information that cannot be determined visually Information from the questionnaire can provide important clues that point to housing deficiencies SECTION 2 the Visual Assessment Data Collection Form should be used to collect information that can be determined without asking questions of a resident This form includes detailed assessment of exterior housing kitchen bathroom and living area as well as a general building information This manual also contains three supporting appendices e a data dictionary that defines housing deficiencies listed in the Visual Assessment Data Collection Form a cross reference to code
125. eves that such variation is likely to adversely affect the health or safety of participant families or severely restrict housing choice b Sanitary facilities 1 Performance requirements The dwelling unit must include sanitary facilities located in the unit The sanitary facilities must be in proper operating condition and adequate for personal cleanliness and the disposal of human waste The sanitary facilities must be usable in privacy 2 Acceptability criteria i The bathroom must be located in a separate private room and have a flush toilet in proper operating condition ii The dwelling unit must have a fixed basin in proper operating condition with a sink trap and hot and cold running water 111 The dwelling unit must have a shower or a tub in proper operating condition with hot and cold running water iv The facilities must utilize an approvable public or private disposal system including a locally approvable septic system c Food preparation and refuse disposal 1 Performance requirement i The dwelling unit must have suitable space and equipment to store prepare and serve foods in a sanitary manner 11 There must be adequate facilities and services for the sanitary disposal of food wastes and refuse including facilities for temporary storage where necessary e g garbage cans 2 Acceptability criteria i The dwelling unit must have an oven and a stove or range and a refrigerator of appropriate size for
126. forhealthyhousing org Chapter 1 Housing History and Purpose Introduction Preurban Housing Ephemeral Dwellings Episodic Dwellings Periodic Dwellings Seasonal Dwellings Semipermanent Dwellings Permanent Dwellings Urbanization Trends in Housing References Additional Sources of Information Chapter 2 Basic Principles of Healthy Housing See www healthyhomestraining org x 39 IN i U S Department of Health and Human Services U S Department of Housing and Urban Development Healthy Housing Reference Manual Introduction Fundamental Physiologic Needs Fundamental Psychologic Needs Protection Against Disease Protection Against Injury Protection Against Fire Fire Extinguishers Protection Against Toxic Gases References Additional Sources of Information Chapter 3 Housing Regulations Introduction History Zoning Housing Codes and Building Codes x Zoning and Zoning Ordinances Exceptions to the Zoning Code Housing Codes Building Codes References Additional Sources of Information Chapter 4 Disease Vectors and Pests Introduction Disease Vectors and Pests Rodents Cockroaches Fleas Flies Termites Fire Ants References Page 111 of 137 Mosquitoes References Chapter 5 Indoor Air Pollutants and Toxic Materials Introduction Indoor Air Pollution Biologic Pollutants Chemical Pollutants Toxic Materials Asbestos Lead
127. formaldehyde in wood in manufactured housing The HUD label has been widely used as a voluntary standard beyond manufactured housing In addition several national associations including the Underwriters Laboratories UL International Standards Organization ISO National Fire Protection Association NFPA and the American National Standards Institute ANSI adopt voluntary industry consensus standards States and local jurisdictions can set standards only when there are no federal standards or when their actions are consistent with or the same as federal standards See Part E on page 23 for more information on these federal product standards Hazard Management Laws The federal state and local government set a wide mix of requirements for the management of specific hazards in existing housing EPA sets standards for asbestos lead based paint and pesticides and has the authority to set standards for radon HUD sets standards for lead based paint in federally assisted housing States and local jurisdictions set standards similar to or more stringent than the federal government They also act in the absence of federal action such as requiring carbon monoxide alarms requiring treatment of arsenic treated lumber or licensing mold or radon assessors or remediators See Part F on page 25 for more information on federal hazard management laws See Part G on page 28 for more information on EPA s Renovation Repair and Painting Rule Page 2 of 33
128. g them c Holes in walls between the inside and outside of the building and between rooms Look for openings around windows and exterior doors d Unvented gas oven clothes dryer or heater An appliance that burns natural gas kerosene wood or other fuel is unvented if tt does not have a pipe or ductwork that sends the exhaust outside e Mold or fungus or similar stains on the wall on the carpet under sinks outside of showers or around windows On the Visual Survey Report check obvious source of moisture if the mold is near a source such as a dripping drain or moisture around a window If there is no obvious moisture source for the mold check the other box O Indicate the extent of the problem for deteriorated paint and water damage by noting on the following on the Visual Survey Report e N None e L Low less than 2ft e M Moderate 2 10ft e H High 10ft or more e E Extreme structural damage caused by this problem Seewww healthyhomestraining org References Page 92v04v1431f org Revised 7 04 O 5 6 Visual Survey Instructions On the Visual Survey Report only note the following potential problems a Walls appear wet or newly stained or the plaster or drywall is bulging b Rodents or evidence Note if you see or the resident reports seeing rats or mice or very small pellets that may be rodent droppings c Strong musty smell like mold or fungus d Nat
129. g fuel buming products such as electrical generators without prop er ventilation Some of these products may be used indoors near an open window and others may not be used indoors at all Look at the manufac turers instructions before operating any fuel buming device in your home m Car exhaust entering the home from the garage m Combustion equipment such as furnaces or hot water heaters that are not working properly or have blocked exhaust systems continued on back e WwWw hea vno E a y ord www hud gov offices lead Us Deportment ot Housing and CARBON MONOXIDE Urban Development Office of Healthy Homes and Lead Hazard Control For more information Visit HUD s website at www hud gov offices lead for more information about addressing health hazards in homes or to leam if HUD has a Healthy Homes program in your community From this website you can download a copy of Help Yourself to A Healthy Home for more practical steps you can take to make your home a healthy home Other Federal Resources US Centers for Disease Control and Prevention www cdc gov nceh airpollution carbonmonoxide cofaq htm US Environmental Protedion Agency www epa gov children Other Resources What can you do Healthy Indoor Air America s Homes www healthyindoorair org facts_ co html m Make sure fuel burning appliances are installed by a professional and f are working properly Community Environmental Health Resource Ce
130. ge as contract for renovation for owner and for lease for occupant of non owner occupied target housing Certification requires address of unit date and method of delivery names of person making delivery reason for acknowledgement signature of certified renovator and date of signature Notice must describe general nature and locations of the planned renovation activities the expected starting and ending dates statement of how occupant can get pamphlet at no charge from renovation firm Tf pamphlet is not posted then provide information on how interested occupants can review a copy of the pamphlet or obtain a copy from renovation firm at no cost 6 Signs must describe general nature and locations of the renovation and the anticipated completion date See www healthyhomestraining org References Page 60 of 137 Required Work Practices for Renovations 40 CFR 745 85 Interior Renovations Exterior Renovations Information Distribution 40 CFR 745 84 See Previous Table Work Area Identification Physical area that the Certified Renovator establishes to contain the dust and debris generated by renovation Occupant Protection e Where to post signs At perimeter of work area e What to say on signs Warn occupants and others not involved in renovation to remain outside the work area OSHA Lead Warning Sign is acceptable e What language Primary language of occupants to extent practic
131. ge should have their blood tested if they have not been tested before and i They live in or regularly visit a house built before 1950 ii They live in or regularly visit a home built before 1978 with on going or recent renovations or remodeling or iii They have a sibling or playmate who has or did have lead poisoning For more information Visit HUD s website at www hud gov offices lead for more information about addressing health hazards in homes or to leam if HUD has a Healthy Homes program in your community From this website you can download a copy of Help Yourself to A Healthy Home for more practical steps you can take to make your home a healthy home Other Federal Resources e WwWw hnea vno a y ord LEAD U S Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control OHHLHC www hud gov offices lead or call 202 755 1785 x 104 The National Lead Information Center 1 800 424 LEAD 5323 www epa gov lead leadpbed htm Centers for Disease Control and Prevention CDC www cdc gov nceh lead lead htm Environmental Protection Agency EPA www epa gov lead U S Occupational Safety and Health Administration OSHA www osha slc gow SLTC lead index htm U S Consumer Product Safety Commission CSP C Www cpsc gov or call 1 800 638 8270 Other Resources Dust created by opening and closing windows is a common lead hazard Photo by January E Jones Improving Kids
132. he manual is not a substitute for the Federal Housing Administration FHA Minimum Property Standards Finally the manual does not propose to establish any regulatory authority for HUD or CDC with regard to residential inspection requirements The Healthy Housing Inspection Manual takes environmental health professionals and housing managers specialists and inspectors through the elements of a holistic home inspection It is also a useful reference tool for nurses outreach workers and others who are interested in preventing illness and injury due to residential health and safety hazards The Healthy Housing Inspection Manual addresses the broad range of housing deficiencies and hazards that can affect residents health and safety The purpose of the manual is to e improve communication and collaboration among public health professionals housing professionals property owners and property managers e increase the understanding of the relations among exposure to hazardous agents conditions in the home and adverse health outcomes and improve the ability of programs to address an array of housing deficiencies in an efficient effective and timely manner HUD and CDC have also jointly developed and funded other important activities related to healthy homes including e a healthy housing curriculum that addresses the training needs of environmental public health practitioners public health nurses housing specialists and others inter
133. hma A Concern for Minority Populations January 1997 7 NHANES survey 1998 1994 http www cdc gov nchs nhanes htm 8 Landrigan PJ Schechter CB Lipton JM Fahs MC amp Schwartz J 2002 Environmental pollutants and disease in American children estimates of morbidity mortality and costs for lead poisoning asthma cancer and developmental disabilities Environmental Health Perspectives 110 7 721 728 9 US Dept of Health and Human Services 1998 May 21 HHS Targets Efforts on Asthma Retrieved March 12 2005 from Web site http www hhs gov news press 2001pres 01 fsasthma html 10 Gragg R 1996 Proximity and Demographic Analyses of Targeted Environmental Hazardous Sites in Florida Florida Environmental Equity and Justice Commission Final Report 9 36 11 Jacobs D E Clickner R P Zhou J Y Viet S M Marker D A Rogers J W Zeldin D C Broene P Friedman W 2002 The prevalence of lead based paint hazards in U S housing Environmental Health Perspectives 110 10 A599 606 12 Costa L G 1997 Basic toxicology of pesticides Occupational Medicine 12 2 251 68 Page 1 of 9 See www healthyhomestraining org References Page 113 of 137 13 Preston A M Rodriguez C Rivera C E Sahai H 2001 Determinants of environmental tobacco smoke in a population of Puerto Rican children Nicotine Tobacco Research 3 3 185 14 Sexton K Gong H Jr Bailar J C 3rd F
134. iately to a doctor or emergency room for treatment continued on back Aa WWW z 2 m a V a D www hud gov oftices lead U S Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control ALLERGY Types of allergies There are many types of allergies The following are some of the most common Indoor Outdoor Foods dust m pollen m milk dust mites from flowering citrus fruits a mold trees and grass eggs mold m pets most often peanuts animal skin flakes wheat sca fish amp shellfish What you can do Know your allergies and know what to avoid Not everyone is allergic to the same things m Contact your doctor about any unusual reactions to food plants medicines or other items m Avoid contact with things you know trigger allergies Avoid being outside or having the windows open when pollen counts are high Read food labels carefully to avoid ingredients that cause reactions Choose medicines and home care products carefully Remove carpet or vacuum often to avoid animal dander m Keep a clean home for more tips see Asthma fact sheet Control pests such as mice and cockroaches Vacuum floors and upholstery often and consider removing carpet Avoid having mold cigarette smoke pesticides and chemicals inside the house Keep pets out of the bedrooms of family members who are allergic to them m In the event of a severe allergic reaction
135. icides only when necessary with preference for products that while producing the desired level of effectiveness pose the least harm to human health and the environment and as appropriate notifying PHA management before application j Providing and posting Pesticide Use Notification signs or other warnings 5 HEALTH AND COST CONCERNS Pests may adversely impact health and contribute to worsening some diseases such as allergies and asthma Therefore pest control methods are targeted to protecting the health of residents and staff Even though applying pesticides may be effective in eliminating pest populations many of these chemicals may be associated with health and or environmental risks and their use should be minimized if alternative methods exist IPM frequently has proven to be more effective in reducing pest populations than depending solely on broadcasting pesticides Therefore IPM offers the potential of ensuring efficacy of pest elimination while protecting the health of residents and staff Most of the effective methods of pest elimination including ongoing repairs erection of barriers and monitoring will extend the useful life of the property and thereby generate significant savings that offset costs of the pest control operations Many of these non application methods including structural maintenance especially inspecting for and repairing leaking pipes and cracks in roofs walls and windows are effective in pre
136. ifos and diazinon from consumer use and restricted access to the products In May 2008 EPA took the unusual step of limiting the use and sale of rodenticides because of pervasive misuse More than 3000 children required treatment for accidental exposure to a type of rodenticide that acts as an anticoagulant in mammals These second generation anticoagulants kill rodents with just one feeding and persist in body tissues EPA required that all rodenticide bait products be sold to consumers only in tamper resistant bait stations Loose bait such as pellets would be prohibited 13 See www epa gov pesticides 14 See www epa gov pesticides reregistration REDs factsheets chlorpyrifos_fs htm S See www epa gov pesticides reregistration diazinon 16 See www epa gov opp00001 reregistration rodenticides See www healthyhomestraining org References Page 53 of 137 See www epa gov pesticides for more information TIT CPSC Hazardous Substances Laws The Consumer Product Safety Commission sets product standards pursuant to the Consumer Product Safety Act and the Federal Hazardous Substance Act The CPSC has adopted mandatory products standards for the following items related to housing furniture and appliances e Safety standard for walk behind power lawn mowers 16 CFR Part 1205 e Safety standard for swimming pool slides 16 CFR Part 1207 e Safety standard for automatic residential garage door operators 16 CFR Part 1211
137. ilers hot water heaters Check for signs of water damage Clean kitchen range hood screens Check operation of windows Clean dryer vents and screens and doors Clean exhaust fan outlets and screens O Lubricate and repair windows oy ard door O Clean outdoor air intakes and screens Clean air conditioning coils drain pans O a Clean dehumidifier coils check operation f s S Clean and tune furnaces 2 Cf F q amp a Clean and tune ovens and ranges Electrical Equipment Check for damaged cords Test ground fault interrupters Test outlets for proper hot E neutral and ground Check smoke and CO alarms Ensure storage of fuel cans Proper operation of garage door safety shut off Check for signs of water damage Check for signs of rodents bats roaches termites recovery ventilation Warm air furnace merv 8 Check for signs of rodents E mx bats roaches termites Air conditioner central air merv 8 Check for water damage Dehumidifier O Ensure insulation in place Outdoor air to return to heat o Check that fans still exhaust to outdoors check ductwork connections References Page 110 of Building a lead safe and healthy home environment for all children 10227 Wincopin Circle Suite 100 Columbia MD 21044 e www center
138. ill M S Jerrett M Kawachi I Levy J I Cohen A J Gouveia N Wilkinson P Fletcher T Cifuentes L Schwartz J 2003 Health wealth and air pollution Advancing theory and methods Environmental Health Perspectives 111 16 1861 70 21 Committee on Damp Indoor Spaces and Health Board on Health Promotion and Disease Prevention Institute of Medicine 2004 Damp Indoor Spaces and Health Washington D C National Academies Press 22 Platt S D Martin C J Hunt S M Lewis C W 1989 Damp housing mould growth and symptomatic health state British Medical Journal 298 6689 1673 8 23 Duff A L Pomeranz E S Gelber L E Price G W Farris H Hayden F G Platts Mills T A Heymann P W 1993 Risk factors for acute wheezing in infants and children viruses passive smoke and IgE antibodies to inhalant allergens Pediatrics 92 4 535 40 Page 2 of 9 See www healthyhomestraining org References Page 114 of 137 24 Lanphear B P Kahn R S Berger O Auinger P Bortnick S M Nahhas R W 2001 Contribution of residential exposures to asthma in us children and adolescents Pediatrics 107 6 E98 25 Platts Mills T A Blumenthal K Perzanowski M Woodfolk J A 2000 Determinants of clinical allergic disease The relevance of indoor allergens to the increase in asthma American Journal of Respiratory Critical Care Medicine 162 3 Pt 2 S128 33 26 Platts Mills T A
139. in addition satisfies the following criteria strength of association biologic gradient consistency of association biologic plausibility and coherence and temporally correct association Sufficient Evidence of an Association Evidence is sufficient to conclude that there is an association That is an association between the agent and the outcome has been observed in studies in which chance bias and confounding can be ruled out with reasonable confidence Limited or Suggestive Evidence of an Association Evidence is suggestive of an association between the agent and the outcome but is limited because chance bias and confounding cannot be ruled out with confidence Inadequate or Insufficient Evidence to Determine Whether an Association Exists The available studies are of insufficient quality consistency or statistical power to permit a conclusion regarding the presence of an association Alternatively no studies exist that examine the relationship See www healthyhomestraining org References Page 2 of 137 World Health Organization Regional Office for Europe Quantifying Disease from Inadequate Housing Housing Inadequacy Disease Linkages with sufficient evidence for estimating burden of disease Heat Related cardiovascular effects and or excess mortality Cold indoor temperatures Winter excess mortality Energy efficiency of housing Health Radon exposure in dwellings Cancer Neighbourhood and
140. ing lawn equipment or chemicals m Wear protective gear on eyes and ears when using power tools m Keep sharp or electronic kitchen and bathroom items out of children s reach Keep electric appliances away from water m Always keep firearms well secured Firearms should always be locked unloaded and stored out of reach Store ammunition in a separate locked location For more information Visit HUD s website at www hud gov oftices lead for more information about addressing health and safety hazards in homes or to learn if HUD has a Healthy Homes program in your community From this website you can download a copy of Help Yourself to A Healthy Home for more practical steps you can take to make your home a healthy home Other Federal Resources US Centers for Disease Control and Prevention www cdc gov od oc childhealth US Environmental Protection Agency www epa gov children Other Resources National Safe Kids Campaign www safekids org National Safety Council www nationalsafetycouncil org Home Safety Council www homesafetycouncil org Emergency Resources National Poison Control Center hotline 1 800 222 1222 For other emergencies fire drowning choking falls etc call 911 In areas without 911 service memorize your fire department s emergency phone number In case of fire dial 911 from outside your home National Safety Council Report on Injuries in America 2002 www nationalsafetycouncil o
141. interior The area of peeling paint or broken plaster must be on the inside walls or ceilings and at least one area of broken plaster or peeling paint must be larger than 8 inches by 11 inches 2 Electric fuses and circuit breakers These statistics are presented for occupied housing units The data show whether an electric fuse has blown or circuit breaker has tripped in the home in the 3 months prior to the interview or while the household was living in the unit if less than 3 months A blown fuse or tripped breaker switch results in the temporary loss of electricity until the fuse is replaced or the breaker switch reset Blown fuses inside major pieces of installed equipment such as some air conditioners are counted as blown fuses or tripped breaker switches The item may identify inadequate wiring but it also happens commonly when people move into houses and are unfamiliar with which items can be turned on at the same time 3 Electric wiring A housing unit is classified as having exposed electric wiring if the unit has any wiring that is not enclosed either in the walls or in metal or plastic coverings Excluded are appliance cords extension cords chandelier cords and telephone antenna or cable television wires 4 Electric wall outlets A housing unit is classified as having rooms without electric wall outlets if there is not at least one working electric wall outlet in each room of the unit A working electric wall outlet is one that
142. ir materials m Keep poisonous products out of children s sight and reach on high shelves Install child proof latches on cabinets that do not have locks continued on back www hud gov oftices lead U S Department of Housing and Y z Urban Development k Office of Healthy Homes and Lead Hazard Control m Store food and non food products separately to prevent confusion and protect your family from container contamination and toxic spills m Always choose non toxic alternatives when possible and use products with child resistant caps m Never mix cleaning products together they may produce dangerous fumes ammonia and bleach should never be mixed m Install Carbon Monoxide CO detectors in your home m Flush expired medicines down the toilet rather than throwing them in the garbage m If it is necessary to use harsh chemicals use them when children are not at home or at least are in a different room Always wear gloves when handling products that could be toxic and follow all manufacturers instructions Fires and Burns m Install smoke detectors on every floor of your home near every bedroom Test detectors every month and change their batteries every year Never disable smoke detectors m Develop a family escape plan m Keep matches lighters and candles out of children s reach Never smoke in bed It is the leading cause of fire related deaths m Keep anything that can catch fire
143. ired if failed 1 wipe Step 8 If failed wait one hour or until dried completely whichever is longer Required if failed 2 wipe Step 9 Wipe with dry disposable cleaning cloth The work passes Required if failed 2 wipe Passes even if darker than card Notice to owner or occupant None required 1 Recleaning means 1 Thoroughly vacuum surfaces and objects in the work area with a HEPA vacuum HEPA vacuum must have a beater bar when vacuuming carpets and rugs 2 Wipe all remaining surfaces and objects in the work area except for carpeted or upholstered surfaces with a damp cloth 3 Mop uncarpeted floors thoroughly using a mopping method that keeps wash water separate from the rinse water or using a wet mopping system using disposable 2 Wet disposable cleaning cloth means a commercially ava designed to be used for cleaning hard surfaces absorbent cleaning pads ilable premoistened white disposable cloth 2 Cleaning verification card means a card developed and distributed or otherwise approved by EPA for the purposes of determining whether post renovation cleaning has been properly completed Dry disposable cleaning cloth means a commercially avail able dry electrostatically charged white disposable cloth designed to be used for cleaning hard surfaces See www healthyhomestraining org References Page 63 of 137 AMENTO E h O
144. irs U No Crib mattress O Fits well O Loose 1 NA Window guards T Yes UU No Window blind cords Split cord T Looped cord NOTES Funded by The U S Environmental Protection Agency and developed by Bs National Center for Healthy Housing 10227 Wincopin Circle Suite 200 Columbia MD 21044 Tel 410 992 0712 www centerforhealthyhousing org With thanks to N E E T F The National Environmental Education amp Training Foundation We credit its Environmental Management of Pediatric Asthma Guidelines for Health Care Providers and model Pediatric Environmental History Form and eae The Center for Healthy Homes and Neighborhoods at Boston University We credit its model Pediatric Asthma Allergy Home Assessment form See www healthyhomestraining org References Page 97 of 137 See www healthyhomestraining org References Page 98 of 137 SUONE OIA po2 ajqissod 104 yeay jo pseog eso ay Sul eo sapisuoy suredal p p u moqe pio pue Ino YM ye Ud Jajuar JI HCH siiedas lessagau axeu Udy Jeumoauloy y DJ sxea qissod Jayjo Jo Buijooi Buiquunid aulWex3 Jajem jo asnos e JO pajeBisaaul aq SNW Jopo jsnu Jo pjow Auy o ymo pjow plone o ep e sunoy may e Jayipiluuiny uns AJUQ O Buoys aJojeq Jalpluny uea pue ueq O Alp ease Bulpunowns desy O AIP J U YO alow aBueyy suononnsul Jounjoejnuew Mojo Aena sayy ea6ueyD H suononu su SJounjoeynueW mojo s ep lano Jal pluny uea
145. is in operating condition that is it can be used when needed If a room does not have an electric wall outlet an extension cord used in place of a wall outlet is not considered to be an electric wall outlet 5 Flush toilet and flush toilet breakdowns A privy or chemical toilet is not considered a flush toilet Flush toilets outside the unit were not counted The statistics on breakdowns of flush toilet are shown for housing units with at least one flush toilet for the household s use only The flush toilet may be completely unusable because of a faulty flushing mechanism broken pipes stopped up sewer pipe lack of water supplied to the flush toilet or some other reason For households with more than one toilet the question asked about times when all toilets were unusable 6 Foundation This item is restricted to one unit buildings and excludes mobile homes A structure has a basement if there is an enclosed space at least partially underground in which a person can walk upright under all or part of the building The basement is under all the building if it is under the entire main See www healthyhomestraining org References Page 19 of 137 10 11 12 13 American Housing Survey A Healthy Homes Perspective structure excluding garages car ports and porches Crawl space is space between the ground and the first floor of the house but it is not high enough for a person to walk upright A house is built on a concrete slab if
146. ites where the product may be used 2 Integrated Pest Management IPM Principles www epa gov pesticides factsheets ipm htm 26 See www epa gov pesp 2 See Label Review Manual Directions for Use www epa gov oppfead 1 labeling Irm chap 11 htm 2 See e g Read the Label First and Consumer Labeling Initiative www epa gov pesticides label index html See www healthyhomestraining org References Page 56 of 137 Required or preferred application methods and prohibited methods Proper application of the pesticide and the rate of application Restrictions on use for factors such as weather season contamination of sensitive areas Limits on how often the pesticide should or may be applied Maximum applicable rates and Any other requirements as necessary G Oo OQ oO O O IV Radon The 1988 Indoor Radon Abatement Act IRA A established the national goal that air within buildings in the U S should be as free of radon as the ambient air outside IRAA does not explicitly require EPA to promulgate regulations but Section 310 authorizes EPA to issue regulations as may be necessary to carry out the statute IRAA also authorizes EPA to provide grants to states to support testing and reducing radon in homes EPA relies on voluntary programs to promote radon awareness testing and reduction The program sets an Action Level of 4 picocuries per liter pCi l of air for indoor radon This level is not the
147. l purity P3 Provision of a adequate daylight illumination and avoidance of undue daylight glare P4 b direct sunlight P5 and c adequate artificial illumination and avoidance of glare P6 Research has revealed a strong relationship between light and human physiology one of the physiologic responses is the production of vitamin D It affects body rhythms and psychologic health Adequate lighting is important to see unsanitary conditions and to prevent injury Improper indoor lighting can also contribute to eyestrain Protection against excessive noise P7 Noise has physiologic impacts aside from the potential to reduce hearing ability elevated blood pressure negative cardiovascular effects increased breathing rates digestion and stomach disturbances ulcers negative effects on developing fetuses difficulty sleeping after the noise stops plus the intensification of the effects of drugs alcohol aging and carbon monoxide and cause other adverse effects Provision of adequate space for exercise and for the play of children P Healthful housing should include the provision of safe play and exercise areas Many American neighborhoods are severely deficient with no area for children to safely play no sidewalks or street lighting nor are essential services available by foot Fundamental Psychological Needs 7 Principles 6 Provision of a adequa
148. lead NENT 0 H ASTHMA Q lt ep Pean DEV as U S Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control The important thing to remember is that you can control your asthma Centers for Disease Control Basic Facts About Asthma Did you know m Over 20 million people in the United States suffer from asthma m Over 6 3 million children under 18 report having asthma m There were 75 more cases of asthma in 1994 than in 1980 m Asthma is the third leading cause of hospitalization in the United States What is it Asthma is a lung disease It causes people to wheeze cough be short of breath and sometimes even die People with asthma can suffer from frequent periods of difficulty breathing called asthma attacks During an El attack the airways swell the muscles around them tighten and the airways produce thick yellow mucous Asthma is not contagious but it does run in families so if E parents have asthma their children are more likely to have it too I Children particularly those living in urban areas and crowded or unclean ents conditions are especially at risk for developing asthma African American e children living in low income families tend to have more severe asthma and are at greater risk of death a Y Each person is different but many things called asthma triggers can cause P W asthma attacks These can be found
149. lied Occupational and Environmental Hygiene 15 1 39 47 2 Tsongas George Portland State Portland Oregon Jan Feb 1993 3 Community Environmental Health Resource Center Carbon Monoxide www cehrc org tools carbon cobacmat cfm 4 Source Home Safety Council Winter Home Safety Fact Sheet 2003 5 Fisk W J Health and productivity gains from better indoor environments and their implications for the US Department of Energy Lawerence Berkeley Laboratory Berkeley CA Retrieved October 2 2004 from Web site http www rand org scitech stpi Evision Supplement fisk pdf 6 International Building Code and the International Mechanical Code 7 The American Society of Heating Refrigeration and Air conditioning Engineers published ventilation Standard 62 2 for low rise residential buildings 8 Garrett MH Hooper MA Hooper BM Abramson MJ Respiratory symptoms in children and indoor exposure to nitrogen dioxide and gas stoves American Journal Respiratory and Critical Care Medicine 1998 158 891 895 Page 6 of 9 See www healthyhomestraining org References Page 118 of 137 Keep It Safe 1 Website of the Consumer Product Safety Commission http www cpsc gov cpscpub pubs grand 12steps 12steps html 2 Source CDC 2001 3 Carol W Runyan PhD et al January 2005 Unintentional injuries in the home in the United States Part I Mortality American Journal of Preventive Medicine Volume 28 Issue 1 Pages 73 79
150. mamanta E E A 70 Signage enis ansan a ERA il ii 70 SMOKINQ AOIS rrara E E A ADA A 70 Interior WASH iii ia 70 Outlets Switches Cover Plates coria ir it acid 70 Smoke and Carbon Monoxide Detectors r 70 WalkWaySi Ste pS iii a A A A ciao 70 Cali id rola EAE A EA AA a a A A et 71 EOS iaa A AA AAA 71 Healthy Housing Inspection Manual Page V See www healthyhomestraining org References Page 82 of 137 Housing Unit Items TIT iii saves T A 72 Baldissera adaaavenaaen 72 Ceiling Floors and Walls s 74 A O 74 ElectIcal ua nm ai OR ndo D A Pashik papaq qat Eta a 75 Water Hetero AA AAA RARA 76 FPIVAQ y di kat tz EEE AA E E AAA a ARE EE AA 76 Kira Ar 77 Laundry Area uu uuu uqapas ds 79 Ligi uay kas a cen wn eens va E A ia 79 Patio Porch BalOOny uu uu pa AAA E E EE te 79 Smoke and Carbon Monoxide Detectors senteinu eaa aaa E a a Aa 80 A NA 80 WINDOWS seene ae a Le A uk anka Sam osa Sam a aa 81 Other tems Items 197 220 ini u uum nu unquni utasa ad 81 Garbage and Debris LLULLU awama qua aB eect eet aada aha iaaa Enpa aida apaa da akadai EER 81 INJURY WAZA wet u y uuu uu kuu A asua asas ass 82 Childproofing Measures siii naqam s a tado laa da 82 POISOMINGHAAZANS aora uu uu ED dias 82 PestiHazardS ua ua a ai iia 82 Moist re FlazardSu u u uu aE asahan qunqa AA AAN aaa Pelai 83 Swimming Pool Spa or Whirlpoo uuu uuu u a ia 83 Other Hazard Siste eana a R E E A
151. maximum safe level for radon in the home but rather is the point at which EPA has deemed the cost to the homeowner to fix the problem is warranted by the risk EPA works with homeowners home builders building code organizations and others to promote awareness make new homes more radon resistant and encourage radon testing when existing homes are sold In June 2008 EPA s Inspector General IG announced that radon exposure has increased since 1988 and that EPA s voluntary program has not achieved the IRAA s national goal The IG recommended that EPA e Develop a strategy for achieving IRAA s goal using the rulemaking authority of section 310 or explain its alternative strategy e Identify limitations in its statutory authority and report these to Congress e Provide metrics that will better measure the magnitude of the potential radon problem in relation to the number of homes at risk and e Revise how EPA reports Indoor Radon Program results in its accountability reports 2 Source www epa gov radiation radionuclides radon html epadoing 30 Title III of the Toxic Substances Control Act 15 U S C 2661 2671 3 EPA Office of the Inspector General More Action Needed to Protect Public from Indoor Radon Risks www epa gov oig See www healthyhomestraining org References Page 57 of 137 G EPA s Renovation Repair and Painting Rule Scope of Rule Renovation repair and painting acti
152. me CEHRC Community Environmental Health Resource Center www cehrc org wwuw healthyhomestraining org References Page 87 of 13 See www healthyhomestraining org References Page 88 of 137 Visual Survey Instructions I Talk with the resident before you begin O Explain that you will draw floor and site plans take notes take photographs collect samples and possibly leave roach traps a carbon monoxide alarm or radon detectors for more than one day O Explain what kinds of samples you plan to take after you finish the visual survey O Ifatenant ask whether the resident received lead hazard disclosure information from the landlord and note the response in the space provided at the bottom of the Visual Survey Report 2 Survey the exterior and grounds and draw the Site Plan The Site Plan is a sketch of the area around the home where you will not any problems you identify and where you collect soil samples See CEHRC s website for the Site Plan form and an example O Walk around outside the building to look at the overall layout of the property O On the Site Plan draw the outline of the building and where it sits on the property O Label important features on the Site Plan e The location of the street and other landmarks e Play areas e Trash areas dumpster trash collection area e Outdoor parking areas e Garages or other buildings Seewww healthyhomestraining org References Page 89 vo4v134
153. ment The use of this material is voluntary for the HAs however HUD promotes the use of IPM for pest control 3 BACKGROUND The goal of IPM per the Environmental Protection Agency is to manage pest damage by the most economical means and with the least possible hazard to people property and the environment To undertake IPM property managers should be committed to ongoing or continuous monitoring and record keeping education of residents and staff and good communication between residents and building managers IPM methods involve restricted access to food water sanitation and waste management mechanical control natural control agents physical barriers structural maintenance and where necessary conservative application of pesticides HUD has supported IPM for more than two decades and published and distributed Maintenance Guidebook Seven Termite Insect and Rodent Control to all PHAs in 1995 Some HAs use the IPM approach to pest management and have seen it dramatically reduce both pest populations and pesticide use IPM programs have also positively engaged residents through the outreach and education needed to prepare them for their role in implementing IPM See www healthyhomestraining org References Page 64 of 137 4 DEFINITION IPM efforts involve HA staff contractors and residents and include a Communicating the HA s IPM policies and procedures to all building occupants administrative staff maintenance personn
154. ncentives This is currently the only national green building program that requires a minimum number of new homes or apartments to be dedicated to lower income residents The criteria are divided into the following categories Integrated Design Process Site Location and Neighborhood Fabric Site Improvements Water Conservation Energy Efficiency Materials Beneficial to the Environment Healthy Living Environment Operations and Maintenance Optional criteria are available in Location and Neighborhood Fabric Site Improvements Energy Efficiency Materials Beneficial to the Environment and Healthy Living Environment A review panel evaluates each project for grant approval As part of the grant requirement the grantee s architect and construction manager must self certify compliance with the program criteria Mandatory Criteria Yes comprehensive Third Party Certification No Building Performance Testing Optional Units Certified Completed as of June 30 2008 11 970 www greencommunitiesonline org See www healthyhomestraining org References Page 68 of 137 US Green Building Council s Leadership in Energy and Environmental Design for Homes LEED for Homes The U S Green Building Council USGBC administers the Leadership in Energy and Environmental Design LEED program LEED for Homes is a voluntary initiative designed to actively promote the transformation of the mainstream home building industry
155. nd removal of moldy items Reducing Exposure to Pests and Pesticides Cockroach control through Integrated Pest Management IPM IPM includes A ES Household cleaning and tool dispensing Professional cleaning Education of residents Baits Structural repairs and When necessary intensive application of low toxicity non spray pesticides Reducing Exposure to Pesticide Residues Integrated pest management IPM which includes 1 2 3 4 See www healthyhomestraining org Professional cleaning Sealing of pest entry points Application of low toxicity pesticides and Education References Page 24 of 137 Reducing Exposure to Radon in Air to Less than 4 pCi L Active sub slab depressurization systems in high risk areas Reducing Exposure to Environmental Tobacco Smoke Elimination of environmental tobacco smoke But the following were found to be ineffective Portable air cleaning filtration systems are ineffective in controlling exposures to environmental tobacco smoke and also formaldehyde although it is possible that there may be some modest decline in exposure Reducing Children s Blood Lead Levels Deteriorated Lead Based Paint and Dust Lead Residential lead hazard control But the following were found to be ineffective Single professional cleaning regimens have been shown to be ineffective in controlling long term exposures to lead contaminated dust Reducing Death and Injuries from Residential
156. nd unfinished attics Smoke detectors must be installed in accordance with and meet the requirements of the National Fire Protection Association Standard NFPA 74 or its successor standards If the dwelling unit is occupied by any hearing impaired person smoke detectors must have an alarm system designed for hearing impaired persons as specified in NFPA 74 or successor standards 2 For units assisted prior to April 24 1993 owners who installed battery operated or hard wired smoke detectors prior to April 24 1993 in compliance with HUD s smoke detector requirements including the regulations published on July 30 1992 57 FR 33846 will not be required subsequently to comply with any additional requirements mandated by NFPA 74 1 e the owner would not be required to install a smoke detector in a basement not used for living purposes nor would the owner be required to change the location of the smoke detectors that have already been installed on the other floors of the unit See www healthyhomestraining org References Page 38 of 137 B International Property Maintenance Code I Overview The International Code Council ICC published the first edition of the International Property Maintenance Code in 1998 ICC s three charter members of the International Code Council Building Officials and Code Administrators International Inc BOCA International Conference of Building Officials ICBO and Southern Building Code Congress
157. ng checklist was developed for the Healthy Homes Training Center and Network as a tool for healthy home maintenance A healthy home is one that is constructed maintained and rehabilitated in a manner that is conducive to good occupant health To maintain a healthy home occupants should keep it dry clean well ventilated free from contaminants pest free safe and well maintained Good home maintenance can act to Yard amp Exterior reduce allergens prevent illness and reduce injury from accidents This checklist provides basic guidelines items may need to be checked more often depending on local conditions and manufacturer suggestions Developed for the National Healthy Homes Training Center by Terry Brennan and Ellen Tohn technical advisors to the National Center for Healthy Housing Water drains away from house O Shingles in good condition No trip fall choking sharp Check chimney valley plumping edge hazards vent skylight flashing Fence around pool intact o Make sure gutters discharge a water away from building Check for signs of rodents bats roaches termites Check attic vents Drain outdoor faucets and Check attic for signs of hoses roof leaks Clean window wells and Check for icicles and ice dams winter check drainage 9 Look for peeling paint Clean gutters and downspouts 9 2 o Look for signs of leaks where
158. ng unit or used by the tenant as clear as their condition permits Use in a reasonable manner all electrical plumbing sanitary heating ventilating air conditioning and other facilities and appliances including elevators in the premises Not deliberately or negligently destroy deface damage impair or remove any part of the premises or knowingly permit any person to do so and Conduct himself and require other persons on the premises with his consent to conduct themselves in a manner that will not disturb his neighbors peaceful enjoyment of the premises See www healthyhomestraining org References Page 52 of 137 E Product Standards L Overview The federal government is primarily responsible for setting standards for products in commerce that may impact health and safety These standards reduce the dangers posed by these products by banning their use in housing requiring safer designs or specifying label requirements EPA regulates pesticides and does not allow them to be sold or used with prior approval The Consumer Product Safety Commission CPSC regulates most other consumer products related to housing but requires only compliance with general requirements In response to specific problems CPSC adopts specific standards to address the problem such as banning lead containing paint HUD sets standards for formaldehyde in wood in manufactured housing The HUD label has been widely used as a voluntary standard beyond manufactured
159. nguuojul aow 429 aBueyo Jolneyaq pue juaulsBeueu 1s d jnoge Awe ajeonpy Ajlwey YM uwnjoo OQ OL Ajlwe4 u SUIS MaIAaY susBJa e eonpaJ 0 M SA jad ysem Aeme U AIB aq jouue9 syad y o Keme udaib aq pinoys sad ajqissod y o suooJpaq u pamoJ e aq JOU pinoys sjeg O SMO OJ Se ajesnpa sjed o 91613 s juaned Ji Oo OO 0 OOOOO OOO OO 0 O Od O Od OL ASYNN p nunuo gt o s ue niloq 100pu insodxg youus o55eqo L Page 100 of 137 References wueje OS uue e ayows so s qsy ining org uopey spiezey juled pea hyhomestra say2e014909 sye1 a91uu suone3saju E Ssi9d NYJINOI See www hea References Page 101 of 137 Jea sej ay Ul spiepue s paseq y e y JO suonejoia Aue jo siaeunsuos panou sey Jaiddns Jajem S qnd y y no puly O uue ym uwnjoo oq OL Alwe u sway maoy O uoneuoju Buse sqe Joyemajes Aob eda MMM Ajddns sa em 911qNd JayeM 104 y je y jo juauedep 9 e s JO e90 JORJUOD peaj Jo Jaejem3sa O ye Buns uayem jnoge uoneuuoju BOW aH O 51nos 19JemM Buyung 2 D g pea sul Buiddou jam asp uonequesexa ewyzse ue Awe UM uwnjoo oq OL Ajilwe Ul sway manoy O D 196611 Aew pue susoquie snp s yew yoiym Buldsems Jo Bulddow Ap ploay O Buiddouu jam jo syjeusq jnoge ajeonp3 O Bujuea y Ae UMA UNOS oq OL Ajlwe4 u sway maoy O Alttue lt o apinold pue JUNU DOA DeI AOD ede MMMd je
160. nment E Illumination and electricity F Structure and materials G Interior air quality H Water supply D Lead based paint J Access K Site and neighborhood L Sanitary condition and M Smoke detectors 3 All program housing must meet the HQS performance requirements both at commencement of assisted occupancy and throughout the assisted tenancy See www hud gov offices pih programs hcv about fact_sheet cfm for more information on the Housing Choice Voucher program See www hud gov offices pih programs hcv semap semap cfm for HUD s Section 8 Management Assessment Program See www healthyhomestraining org References Page 34 of 137 4 i In addition to meeting HQS performance requirements the housing must meet the acceptability criteria stated in this section unless variations are approved by HUD ii HUD may approve acceptability criteria variations for the following purposes A Variations which apply standards in local housing codes or other codes adopted by the PHA or B Variations because of local climatic or geographic conditions 111 Acceptability criteria variations may only be approved by HUD pursuant to paragraph a 4 i1 of this section if such variations either A Meet or exceed the performance requirements or B Significantly expand affordable housing opportunities for families assisted under the program iv HUD will not approve any acceptability criteria variation if HUD beli
161. nononononnnnnnnnnnnonenennninnnnninnns 32 WalkwWays StepS cuicos an dis 32 COMM a ii A A A ad 32 A anasu a a a a a kode dadees a dees agdeam ssieie recess ies 33 Comments COMMOMATEAS SOCHON ini il as 35 Housing Unit Items TOTO u u u uu uu uuu u E aa a aana 36 Batho urusa aasan nalan A gana askpspaaqaaka usustls lana kad 36 Ceiling Floors and WAS uuu upa A lu hawa kO aa al 38 DOGS i u PO PEO EE E A EAA Setaceutssaeacemets A A A A NENEA A hasa se 40 Electrical raea dinos 41 Water HC ade A da iii 42 FPIVAG SSW u u T A AT 43 TM 2 uyan aaa apasaahuqp yaaa A Ai 45 Laundry zAr68 n un upas akhu kaqa haqa apaun asan agua issuu hawapas aaa pasa a 47 LINO voii it td E A E ELO AR 48 Patio Porch Deck BalCOny ooonoocccccnnconcccconononcccnonnnnnoncnonn nn nr rca ieee ernie rr E EEEE anian iieii R Ei kiini 48 Smoke and Carbon Monoxide DetectorS oooooccononcncccncccncncnnnnnnnnnnnnononononnnnononononnnnnnnnnnnonenenennnnnnnnninnns 49 JA E 50 WI dOW8 1 u uuu incl lodos 50 Comments Housing Unt Sectas qaa akanayaq buqha uqapaqaykusqaqaqqhusqqiuwduska aa Qaqaqa RARA Aaa 51 Other Items ferms 1972Z229 uuu uuu umu is diia 52 Garbage and DebriS vaciando 52 nj ry F lazardSu xu uk aya an supaq cuussqis dete ented Hav di dia 52 Childproofing Measures r 53 Poisoning HazardS u u uu asasssssaqasspeshemuapasasqcakasuqastasstastastustassquqasssqaskasstaskassastascassiuasaas 53 P sttHaZards uuu uuu umu A a kuq tase de
162. nter CEHRC www cehrc org tools carbon cobacmat cfm m Never run your car in a closed garage and move cars out of attached garages immediately after starting them Ask your doctor or contact your local or state department of health m Never use a gas range or oven to heat a home m Choose vented appliances like gas fireplaces whenever possible m Have your heating systems and chimneys inspected and cleaned by a Install carbon monoxide detectors in your home qualified technician every year m Replace dirty air filters on heating and cooling systems a m Never run a generator pressure washer or any gasoline powered engine inside a basement garage or other enclosed structure even if the doors or windows are open unless the equipment is professionally installed and vented m Never use a charcoal grill hibachi lantem or portable camping stove inside a home tent or camper m Make sure there is good ventilation at all times install proper ventila tion for interior combustion appliances and consider installing air exchangers or air conditioning for tightly sealed homes m Install carbon monoxide detectors near sleeping areas Centers for Disease Control and Prevention Carbon Monoxide Poisoning Fact Sheet www cdc gov nceh airpollution carbonmonoxide cofaq htm August 25 2004 Community Environmental Health Resource Center CEHRC Carbon Monoxide Background Materials www cehrc org tools carbon cob
163. o collect falling paint debris whichever is greater unless the property line prevents 10 of such ground covering e Tools Ensure all personnel tools waste containers and other items are free of dust and debris before leaving the work area Not Required Prohibited and Restricted Work Practices The following must not be used in the work area e Open flame burning or torching e Machines to remove paint through high speed operation without HEPA exhaust control or e Operating a heat gun at temperatures at or above 1100 degrees Fahrenheit Waste from Renovations See www healthyhomestraining org References Page 61 of 137 Required Work Practices for Renovations 40 CFR 745 85 Interior Renovations Exterior Renovations e During Work Contain waste to prevent release of dust and debris before the waste is removed from the work area for storage or disposal If a chute is used to remove waste from work area it must be covered e End of Day and End of Work Collected waste must be stored under containment in an enclosure or behind a barrier that prevents release of dust and debris out of work area and prevents access to dust and debris e Transporting Waste Contain waste to prevent release of dust and debris Cleaning the Work Area e Paint Chips amp Debris Collect and without dispersing any of it seal this material in a heavy duty bag e Plastic Sh
164. od faith The landlord and tenant of any dwelling unit other than a single family residence may agree that the tenant is to perform specified repairs maintenance tasks alterations or remodeling only if 12 See www law upenn edu bll archives ulc fnact99 1970s urlta72 htm or www law upenn edu bll archives ulc ulc_final htm final See www healthyhomestraining org References Page 51 of 137 e 1 The agreement of the parties is entered into in good faith and is set forth in a separate writing signed by the parties and supported by adequate consideration 2 The work is not necessary to cure noncompliance with subsection a 1 of this section and 3 The agreement does not diminish or affect the obligation of the landlord to other tenants in the premises The landlord may not treat performance of the separate agreement described in subsection d as a condition to any obligation or performance of any rental agreement 3 101 Tenant to Maintain Dwelling Unit A tenant shall 1 2 3 4 5 6 7 Comply with all obligations primarily imposed upon tenants by applicable provisions of building and housing codes materially affecting health and safety Keep that part of the premises that he occupies and uses as clean and safe as the condition of the premises permit Dispose from his dwelling unit all ashes garbage rubbish and other waste in a clean and safe manner Keep all plumbing fixtures in the dwelli
165. ods to identify monitor and solve the pest problem without using lots of pesticides For more information Visit HUD s website at www hud gov offices lead for more information about addressing health hazards in homes or to learn if HUD has a Healthy Homes program in your community From this website you can download a copy of Help Yourself to A Healthy Home for more practical steps you can take to make your home a healthy home Other Federal Resources US Centers for Disease Control and Prevention www cdc gov od oc childhealth US Environmental Protection Agency www epa gov children Other Resources Environmental Health Watch has several resources on IPM and cockroach control www ehw org Children s Environmental Health Coalition s HeatlheHouse also has several resources on using IPM in the home www checnet org healthehouse Place baits near baseboards out of reach from children Photo by January E Jones Improving Kids Environment www hud gov offices lead
166. of 137 Healthy People 2010 Objectives Related to Healthy Homes Mid Course Review 2005 NO CHANGE IN OBJECTIVE 8 18 Increase the proportion of persons who live in homes tested for radon concentrations Target 20 percent Baseline 17 percent of the population lived in homes in 1998 that had been tested for radon age adjusted to the year 2000 standard population Target setting method Better than the best Data source National Health Interview Survey NHIS CDC NCHS NO CHANGE IN OBJECTIVE Increase the number of new homes constructed to be radon resistant Target 2 1 million additional new homes Baseline 1 4 million new homes as of 1997 Target setting method 50 percent improvement Data source National Association of Home Builders Research Center Survey National Association of Home Builders NO CHANGE IN OBJECTIVE Increase the proportion of persons living in pre 1950s housing that has been tested for the presence of lead based paint Target 50 percent Baseline 16 percent of persons aged 18 years and older living in homes built before 1950 in 1998 reported that their homes had been tested for the presence of lead based paint age adjusted to the year 2000 standard population Target setting method Better than the best Data source National Health Interview Survey NHIS CDC NCHS See www healthyhomestraining org References Page 9 of 137 Healthy People 2010 Objectives Related to Health
167. of Housing and Urban Development HUD administers and enforces the LSH Rule 2 15 U S C 2601 2692 40 C F R Part 745 Subparts E and L 42 U S C 6973 See www healthyhomestraining org References Page 55 of 137 Generally these laws establish disclosure obligations and performance standards for activities that disturb LBP but do not impose an affirmative obligation to perform LBP risk reduction work and do not empower federal authorities to demand such work There are two exceptions e The LSH Rule applies to federally owned or assisted pre 1978 housing approximately 3 percent of pre 1978 housing The rule requires disclosure and various evaluation and risk reduction measures based upon the classification of the housing as determined by the level of federal assistance age of housing ownership and other factors e RCRA Section 7003 empowers EPA to order a responsible person to take action as may be necessary to protect human health and the environment when a solid waste including a LBP hazard presents an imminent and substantial endangerment See Part G for more information on EPA s Renovation Repair and Painting Rule TIT Pesticide Use Integrated Pest Management IPM EPA promotes the use of IPM in residential settings through outreach and education and its Pesticide Environmental Stewardship Program PESP 26 IPM is a series of pest management evaluations decisions and controls g
168. oms Both inside and outside the home old deteriorated paint releases lead which mixes with dust and soil Children who ingest lead or lead dust by putting their hands or other objects in their mouths by eating paint chips or by playing in lead contaminated soil may become poisoned continued on back e WWW nea Y e www hud gov offices lead U S Department of Housing and a Urban Development k Office of Healthy Homes and Lead Hazard Control In homes built before 1978 treat peeling paint as a lead hazard What can you do 1 In your home if it was built before 1978 a Have it checked for lead hazards by a professional including the soil b Mop smooth floors using a damp mop frequently to control dust c Vacuum carpets and upholstery to remove dust preferably using a vacuum with a HEPA filter or a higher efficiency collection bag d Take off shoes when entering the house e Pick up loose paint chips carefully then HEPA vacuum f Take precautions to avoid creating lead dust when remodeling renovating or maintaining your home 2 For your child a Frequently wash your child s hands and toys to reduce exposure b Use cold tap water for drinking and cooking c Avoid using home remedies such as arzacon greta or pay loo ah and cosmetics such as kohl or alkohl that contain lead d Have your child s blood lead level tested at age 1 and 2 Children from 3 to 6 years of a
169. ord J G Gold D R Lambert W E Utell M J 1993 Air pollution health risks Do class and race matter Toxico Ind Health 9 5 843 78 15 Chew G L Perzanowski M S Miller R L Correa J C Hoepner L A Jusino C M Becker M G Kinney P L 2003 Distribution and determinants of mouse allergen exposure in low income New York City apartments Environmental Health Perspectives 111 10 1348 51 16 Perera F P Illman S M Kinney P L Whyatt R M Kelvin E A Shepard P Evans D Fullilove M Ford J Miller R L Meyer I H Rauh V A 2002 The challenge of preventing environmentally related disease in young children Community based research in New York City Environmental Health Perspectives 110 2 197 204 17 Perera F P Rauh V Tsai W Y Kinney P Camann D Barr D Bernert T Garfinkel R Tu Y H Diaz D Dietrich J Whyatt R M 2003 Effects of transplacental exposure to environmental pollutants on birth outcomes in a multiethnic population Environmental Health Perspectives 111 2 201 5 18 Brown P 1995 Race class and environmental health A review and systematization of the literature Environmental Research 69 1 15 30 19 Perlin S A Wong D Sexton K 2001 Residential proximity to industrial sources of air pollution Interrelationships among race poverty and age Journal of the Air and Waste Management Association 51 3 406 21 20 O Ne
170. org Revised 7 04 216 Visual Survey Instructions 3 Note hazards on Site Plan and Visual Survey Report O Note the following hazards 1 on the Site Plan AND 2 by making a check mark next to the name of the problem in the exterior column on the Visual Survey Report e Bare soil no grass mulch or wood shavings in the yard around the home or in a common outdoor area in play areas in sand boxes under swing sets in areas where kids play along the dripline within three feet of the building and in other areas of the yard e Deteriorated Paint peeling flaking chipping cracking Deteriorated in any way Paint coming loose from the surface or substrate wood plaster metal drywall On the home fences etc Holes in the walls of the building Look for openings around windows and doors O Indicate the extent of the problem for deteriorated paint and water damage by noting on the following on the Visual Survey Report e N None e Low less than 2ft e M Moderate 2 10ft e H High 1 Oft or more e E Extreme structural damage caused by this problem O Note the following hazards on the Visual Survey Report only e Rodents or evidence Note if you see or the resident reports seeing rats or mice or very small pellets that may be rodent droppings e Other physical conditions that seem hazardous such as standing water woodpiles near exterior wall
171. q spuezey peaj Aue gedas o juaussesse ys Jo uonoadsul jued pea e job o pjo siea xis uey SSB p iyo e SI 3194 pue 8 6 aud y ing sem auoy ey y O sA0qe uuoH jo aby ses O Od OL ATINVS ainsodxa 1snp AIsSs 52x onp 1 o SAdeJp pue sulejino piony a qeedim ase zey sjuau eal MOPUIM asf snp o 916 191 ase NOA Ji uluu p o Buysa usb a e 396 oneuuolduu s y 0o00 s xoq Jo seq ul Jaynjo ess 1 n 9 ss YM snp sonpey OO 00 s1ayjo Aq pasn Jaquunu si yey J auluajep o p N jepues ueB N wo Swed Jaquinu Jes g ainsodxe jsnp sonpe o Buroo jqe d m yjoouus yym y Buloe das Japisuod pjo sies g uey aJou SI jadieo J PM A apisino sBni ease axeys JM A UNNA YUM jad e9 em 0 gm ue O 0o00 say snp o 91619118 ae NOA y ul uuj 9 p o Buysa usBa e 396 onewojdu s y O Od OL ATIIAV4 JILUEJ UYA UNOS odq O lluued u SWS Maney Ayes 0 ZZZL 222 008 1 Jaquunu oljuo5 UOSIOd euonyeu pIAO1d Alle YM UNOS OQ O Awe u SUSY Manoy plo pue 11au UM 118 O wey jesunos u u uuou sjual Aj J suie esoo x 0 siredas Jour Bueu se yons siolneyaq eBueyo o jesunos u y uuou sumo JILUe J Aue UMA ULUNJOD oq OL Ajlwe4 u SUIS A IA 3 SAOQe SWOH jo aby ses Oo OO 0 O O Od OL 3ASYNN Ayes YM uwnjoo OQ OL lltue3 ul SUIS M N s p snp o d1Hayje s Ju ned Ji Ape U
172. r paper so pests have fewer places to hide m Put food in tightly sealed containers such as plastic with tight lids Do not leave open containers of food on counters or in cabinets Put pet food dishes away overnight m Keep trash in a closed container and take it out frequently every day if possible Don t let trash pile up outside m Fix plumbing or other water leaks Pests need water sources to survive m Seal cracks and holes Use a caulk gun to seal cracks around baseboards shelves pipes sinks and bathroom fixtures Use roach baits properly and only if necessary Place baits out of the reach of children and pets m Put the bait close to the pests hiding places It must be closer than other sources of food m Good spots for baits are next to walls baseboards under sinks in cabinets and near plumbing fixtures Place baits in areas of roach activity m Do not spray any pesticides This will keep the pests away from the baits pe Www hea Y 2 5 SAFE PEST CONTROL If needed call a pest control professional who uses IPM practices If you have taken all the steps described above and still have a pest problem you may need a professional to help m f you live in an apartment or rent a home speak to your landlord or property manager about using an IPM professional Talk to other tenants about the importance of IPM for long term solutions to your building s pest problems m IPM professionals utilize various meth
173. r to learn if HUD has a Healthy Homes program in your community From this website you can download a copy of Help Yourself to A Healthy Home for more practical steps you can take to make your home a healthy home Additional information on mold can be found on a web site developed by HUD at www healthy homes info Other Federal Resources EPA Indoor Air Quality Mold Mold Resources www epa gov mold CDC National Center for Environmental Health Mold www cdc gov nceh airpollution mold FEMA Actions to Take Following a Flood www fema gow hazards floods Other Resources American Academy of Allergy Asthma and Immunology AAAAI www aaaai org American Industrial Hygiene Association www aiha org Minnesota Department of Health Mold www health state mn us divs eh indoorair mold California Department of Health Mold www cal iag org References Page 133 of 137 www hud gov offices lead KMENT On H RADON oR DEN os U S Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control es You can t see radon And you can t smell it or taste it But it may be a problem in your home U S Environmental Protection Agency Did you know m Radon is the second leading cause of lung cancer after smoking m Approximately 20 000 cancer deaths each year are caused by radon What is it Radon is a radioactive gas that cannot be seen smelled or ta
174. raining org References Page 43 of 137 C APHA s Basic Principles of Healthful Housing I Overview In 1938 the American Public Health Association APHA formulated Basic Principles of Healthful Housing Principles to promote the physical mental and social health essential in housing For each of the 30 Principles APHA also identified Specific Requirements and the Methods of Attainment considered at that time to be the more important means by which to achieve the Principle s objectives II How The Principles Have Been Applied The Principles continue to inform the dialogue about and development of policies to promote healthy housing For example U S federal agencies endorse the Principles in the Healthy Housing Reference Manual HH Manual The CDC also modeled its original basic housing inspection manual after the Principles In the U K the University of Warwick used the Principles as a foundational document in the development of the Health and Housing Rating System the nation s housing inspection system The Principles comport with modern tenets of healthy housing i e keep housing dry clean ventilated and pest free avoid contaminants and properly maintain housing HL APHA s Principles The 30 Principles fall into four categories a Fundamental Physiological Needs e g for illumination heat cooling space chemical purity quiet b Fundamental Psychological Needs e g for privacy adequat
175. rb less than the following square feet of paint surfaces in 30 calendar days counting all paint on a removed component o 6 square feet per room for interior activities or o 20 square feet for exterior activities But this exemption does NOT apply to the following o Window replacement o Demolition of painted surface areas o Using any of the following Open flame burning or torching Machines to remove paint through high speed operation without HEPA exhaust control or Operating a heat gun at temperatures at or above 1100 degrees Fahrenheit e No Lead Based Paint Will be Disturbed If one of the following methods is used to determine that the paint on the component to be disturbed was not lead based paint o Written determination by certified lead inspector or risk assessor or o Proper use of EPA recognized test kit by certified renovator Note that person contracting for the renovation must be informed of results by certified renovator within 30 days after renovation complete e Do It Yourself Work performed by owners themselves in their residence EPA S RRP RULE DOES NOT PREEMPT MORE STRINGENT REQUIREMENTS SUCH AS THOSE BY HUD STATES OR COMMUNITIES See www healthyhomestraining org References Page 58 of 137 Limits on Scope of Rule e Owner Occupied Target Housing Exempt from training and work practice requirements if owner signs written statement that all apply o No child under age 6 resides there Resides means Prima
176. results of other studies are inconsistent Inadequate or Insufficient Evidence to Determine Whether or Not an Association Exists Available studies are of insufficient quality consistency or statistical power to permit a conclusion or no studies exist Limited or Suggestive Evidence of No Association Several adequate studies are mutually consistent in not showing an association but limited to the conditions level of exposure and length of observation covered in the study See www healthyhomestraining org References Page 1 of 137 Summary of Two Key Institute of Medicine Reports Regarding Asthma Indoor Air Quality Damp Indoor Spaces and Mold Summary of Findings Regarding Association Between Health Outcomes and Exposure to Presence of Mold or Other Agents Damp Indoor Environments in Damp Indoor Environments Sufficient Evidence of a Causal Relationship Sufficient Evidence of an Association e Upper respiratory nasal and throat tract e Upper respiratory nasal and throat tract symptoms ee e Cough 2 Houga e Hypersensitivity pneumonitis in susceptible persons e Wheeze e Wheeze e Asthma symptoms in sensitized persons e Asthma symptoms in sensitized persons Limited or Suggestive Evidence of an Association e Dyspnea shortness of breath e Lower respiratory illness in otherwise healthy children e Lower respiratory illness in otherwise healthy children e Asthma development Inadequate or Insufficient Evid
177. rg library report_injury_usa htm August 25 2004 National Safe Kids Poison www safekids org tier2_rl ctm folder_id 176 August 25 2004 National Safe Kids Fire www safekids org tier2_rl cfm folder_id 171 August 25 2004 www hud gov offices lead hl 0 gt lal a all O IN e N K o 2 ll DEV AS U S Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control Despite progress lead poisoning remains one of the top childhood environmental health problems today President s Task Force on Environmental Health Risks and Safety Risks to Children Did you know m Many homes built before 1978 have lead based paint m 3 8 million homes in the United States have peeling or chipping lead based paint or high levels of lead in dust m Infants children under six and pregnant women should have their blood tested for lead m Inthe United States children from poor families are eight times more likely to get lead poisoned What is it Lead is a toxic metal used in a variety of products and materials When lead is absorbed into the body it can cause damage to the central nervous system and vital organs like the brain kidneys nerves and blood cells Symptoms of lead poisoning include headaches stomachaches nausea tiredness and irritability which may also occur with the flu and some viruses Lead can also harm children without causing obvious sympt
178. rvey is ideal for analyzing the flow of households through housing For more information go to www census gov hhes www housing ahs ahs html Key Definitions Related to Healthy Homes e Leaks Interior or Exterior Resident reported leakage that occurred in the 12 months prior to the interview or while the household was living in the unit if less than 12 months Housing units with water leakage are classified by whether the water leaked in from outside the building roof basement walls closed windows or doors or inside of the building fixtures backed up or over flowed or pipes leaked e Rodents Rats or Mice Resident reported mice or rats if they saw mice or rats or signs of mice or rats inside the house or building during the 3 months prior to interview or while the household was living in the unit if less than 3 months Signs of mice or rats include droppings holes in the wall or ripped or torn food containers e Heating Heating Problems Resident reported that the home was uncomfortably cold for 24 hours or more during the winter prior to the interview for any reason e Heating Fire CO Danger Resident reported using as primary heating source either room heater without flue i e any room heater that burns kerosene gas or oil and that does not connect to flue vent or chimney or a stove or oven for heat portable electric heater stove cooking stove fireplace without insert or no heat e Structural Cracks in
179. ry residence of custodial parents legal guardians and foster parents or Informal caretaker s residence where child lives and sleeps most of the time o No pregnant woman resides there and o Not child occupied facility e Emergency Renovations Not Due to Elevated Blood Level Exempt from information distribution warning signs containment waste handling training and certification requirements to extent necessary to respond to emergency However cleaning requirements cleaning verification and recordkeeping still required An emergency renovation is one that o Isa sudden unexpected event o If not immediately attended to Presents a safety or public health hazard or Threatens equipment and or property with significant damage e Emergency Renovations in Response to Elevated Blood Lead in Resident Child Interim controls are exempt from advance information distribution requirements Deadlines in EPA s Renovation Repair and Painting Rule Deadlines 6 21 08 12 22 08 4 22 09 10 22 09 4 22 10 Training May apply for Firms EPA accreditation Renovation May apply for Firms EPA certification Certified Stop claims of training Renovators for EPA certification as Individuals renovator or dust sampling technician without accreditation Full Compliance Required New Renovate New Right pamphlet pamphlet must be used EPA EPA recognizes Recognized negative tests Test Kits
180. s accumulated trash obvious water damage or wood rot and damaged gutters downspouts and other Seewww healthyhomestraining org References Page 90vofv131f org Revised 7 04 3 6 Visual Survey Instructions building components 4 Draw one Floor Plan for each floor of the home The Floor Plan shows the layout of the rooms as seen from above The Floor Plan makes it easy for you to note where you identify problems You will also use the Floor Plan to show where you collect samples leave testing materials for collection and take photographs The Floor Plan does not have to be drawn using exact measurements It should show the general relationships between rooms in the home and exterior walls See CEHRC s website for the Floor Plan for and an example O Walk through the home to get a good understanding of the overall ayout of the rooms Draw the overall outline of the entire home If the home has more than one floor note which floor each Floor Plan represents before you draw it If the home has two floors one copy of the floor plan will be marked 1 of 2 and the other will be 2 of 2 If you draw a plan for an unoccupied basement mark it 0 O Draw the walls between rooms then the doors and windows a Draw a rectangle for each door b Draw a circle through the line of the wall for each window A c Mark the walls of closets to help you keep the walls in perspective and
181. s from adhesives floor coverings and complete floor structures Proceedings Indoor Air 2002 pg 962 13 U S EPA Assessment of Risks from Radon in Homes EPA 402 R 03 003 June 2003 14 U S EPA Respiratory Health Effects of Passive Smoking Lung Cancer and Other Disorders EPA 600 f 90 006F December 1992 15 U S EPA Home Buyer s and Seller s Guide to Radon EPA 402 K 05 005 May 2005 16 U S EPA EPA Map of Radon Zones www epa gov radon zonemap html 17 U S EPA A Citizen s Guide to Radon EPA 402 K 02 006 May 2004 18 U S EPA www epa gov radon construc html 19 U S EPA Building Radon Out EPA 402 K 01 002 April 2001 20 U S EPA Consumer s Guide to Radon Reduction EPA 402 K 03 002 Feb 2003 Page 8 of 9 See www healthyhomestraining org References Page 120 of 137 21 American Society for Testing and Materials ASTM Standard Practice for Installing Radon Mitigation Standards in Existing Low Rise Residential Buildings 22 U S EPA Radon Mitigation Standards EPA 402 R 93 078 April 1994 Making It Work 1 Fairhill Case study Data provided by City of Philadelphia Page 9 of 9 See www healthyhomestraining org References Page 121 of 137 ban Ree H ALLERGY on DEN or U S Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control es R lt 21 Allergic dise
182. se as many harmful pesticides as traditional pest control Avoiding pesticides is especially important in homes Pesticides can contain long lasting toxic chemicals or lung irritants that cause asthma attacks Children are among those most vulnerable to exposure IPM strategies apply pesticides only as needed and use the least hazardous pesticides to control pests continued on back www hud gov oftices lead U S Department of Housing and Y z Urban Development k 0 Office of Healthy Homes and Lead Hazard Control Photo by January E Jones Improving Kids Environment m IPM works better IPM is better at keeping the roaches and other pests away for long periods of time compared to spraying of pesticides or other poisons IPM works by addressing the cause of the problem and taking a long term approach to reducing pests Using pesticides can cause pests to build up a resistance to the poison so that the chemicals do not work as well over time and do not stop the pests from coming back to your home What you can do Look Pay attention to where there are pests in your home how they enter and how many there are By watching and tracking pests in your home you can better decide what actions to take Keep a clean home Keeping a clean house is the best way to keep pests out Some important things to pay attention to are m Clean up food and drink spills right away m Remove clutter such as cardboard boxes o
183. sted and is found naturally around the country When you breathe air containing radon the sensitive cells in your airway are irritated increasing your risk of getting lung cancer Radon is found in the dirt and rocks beneath houses in well water and in some building materials It can enter your house through soil dirt floors in crawlspaces and cracks in foundations floors and walls Once inside radon gas can sometimes get trapped inside the house All houses have some radon but houses next to each other can have very different radon levels so the only way to measure your particular risk is to test your own house Radon is measured in picoCuries per liter of air abbreviat ed pCi L This measurement describes the number of radon gas particles in one liter of air The amount of radon outdoors is usually around 0 4 pCi L and indoors is around 1 3 pCi L Even though all radon exposure is unhealthy radon at levels below 4 pCi L are considered acceptable If your home has more than 4 pCi L you should take action to lower this level continued on back e WwWwW nea V 5 www hud gov offices lead U S Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control What can you do Test your Home About 1 out of every 15 homes has a radon problem and yours could be one of them The only way to know for sure is to test your home You can buy a radon test at a hardware store or
184. t be able to be used and maintained without unauthorized use of other private properties The building must provide an alternate means of exit in case of fire such as fire stairs or egress through windows See www healthyhomestraining org References Page 37 of 137 D Site and Neighborhood 1 Performance requirement The site and neighborhood must be reasonably free from disturbing noises and reverberations and other dangers to the health safety and general welfare of the occupants 2 Acceptability criteria The site and neighborhood may not be subject to serious adverse environmental conditions natural or manmade such as dangerous walks or steps instability flooding poor drainage septic tank back ups or sewage hazards mudslides abnormal air pollution smoke or dust excessive noise vibration or vehicular traffic excessive accumulations of trash vermin or rodent infestation or fire hazards m Sanitary condition 1 Performance requirement The dwelling unit and its equipment must be in sanitary condition 2 Acceptability criteria The dwelling unit and its equipment must be free of vermin and rodent infestation n Smoke detectors performance requirement 1 Except as provided in paragraph n 2 of this section each dwelling unit must have at least one battery operated or hard wired smoke detector in proper operating condition on each level of the dwelling unit including basements but excepting crawl spaces a
185. t three times last winter for at least 6 hours each time kerosene heaters as the primary heating equipment Electric for 1 Having no electricity or Lacking a Severe 2 All of the following three electric problems 1 kitchen sink Kitchen for a Exposed wiring 2 Refrigerator or Moderate b A room with no working wall outlet 3 Cooking equipment stove and burners or microwave oven c Three blown fuses or tripped circuit inside the structure for the exclusive breakers in the last 90 days use of the unit Hallways Having all of the following four problems in Having any three of the four public areas problems listed under Physical 1 No working light fixtures problems severe under Hallways 2 Loose or missing steps 3 Loose or missing railings and 4 No working elevator Upkeep Having any five of the following six Having any three or four of the six maintenance problems 1 Water leaks from the outside such as from the roof basement windows or doors 2 Leaks from inside structure such as pipes or plumbing fixtures 3 Holes in the floors 4 Holes or open cracks in the walls or ceilings 5 More than 8 inches by 11 inches of peeling paint or broken plaster or 6 Signs of rats in the last 90 days problems listed under Physical problems severe under Upkeep See www healthyhomestraining org References Page 21 of 137 American Housing Survey A
186. te privacy for the individual P9 b opportunities for normal family life P10 and normal community life P11 c facilities to make performing household tasks possible without undue physical and mental fatigue P12 d facilities for the maintenance of cleanliness of the dwelling and the person P13 and e possibilities for reasonable esthetic satisfaction in the home and its surroundings P14 Concordance with prevailing social standards of the local community P15 7 The HH Manual adds a new Principle 1 protection from the elements and does not discuss APHA Principle 3 reasonable chemical purity See www healthyhomestraining org References Page 45 of 137 Privacy is a necessity to most people Ideally everyone would have their own rooms excepting married couples and small children Bedrooms and bathrooms should be accessible directly from halls or living rooms crowding can lead to poor school performance in children A wholesome atmosphere requires adequate living room space and adequate space for withdrawal This includes easy communication with centers of culture and business Protection Against Contagion 8 Principles 8 10 11 Provision of a A safe and sanitary water supply P16 b protection of the water supply system against pollution P17 and c toilet facilities that minimize the danger of transmitting disease
187. ting equipment central warm air 91 Water came in from other places 81 Difficulty hearing with or without a hearing aid 72 Water safe for drinking 66 Other kinds of heating equipment none 63 Peeling paint on the ceiling 63 Other kinds of heating equipment unvented room 62 Electric fuses or breaker switches blown 58 Open cracks or holes in building 58 Other major repairs over 500 each repair done 57 Central air conditioning dehumidifier 56 Broken plaster or peeling paint 55 Water came in from walls doors windows 55 A working electric wall outlet 55 Other kinds of heating equipment fireplace with no insert 54 Broken plaster on the ceiling 53 Water came in from roof 53 Other major repairs over 500 each someone in household did the work 51 Rate the place 10 categories 51 See www healthyhomestraining org References Page 22 of 137 American Housing Survey A Healthy Homes Perspective MODERATE LEVEL OF INCONSISTENCY Holes in the floors 50 Other kinds of heating equipment other built in electric 50 Central air fuel 50 Other kinds of heating equipment portable electric 47 Water came in from basement 45 Water leaked into home from outdoors 43 Other kinds of heating equipment fireplace with insert 43 Heat breakdown 41 Heating equipment broke down for 6 hours or more 41 Other kinds of heating equipment stove 36 LOW LEVEL OF INCONSISTENCY Heating equipment broke 18 Clothes dryer fuel 12 Source of water 8 See w
188. to cause fires or promote their spread P25 15 Between 1992 and 2001 an average of 4 266 Americans died annually in fires and nearly 25 000 were injured The US has one of the highest fire death rates in the industrialized world with 13 4 deaths per million people At least 80 of all fire deaths occur in residences Apartment fires most often start in the kitchen Cooking is the leading cause of home fires usually a result of unattended cooking and human error rather than mechanical failure of the cooking units The leading cause of fire deaths in homes is careless smoking which can be significantly deterred by smoke alarms and smolder resistant bedding and upholstered furniture Manufactured homes can be susceptible to fires More than one fifth of residential fires in these facilities are related to the use of supplemental room heaters such as wood and coal burning stoves kerosene heaters gas space heaters and electrical heaters Most fires related to supplemental heating equipment result from improper installation maintenance or use of the appliance Provision of adequate facilities for escape in the case of fire P26 Three key elements can contribute to a safe exit from a home during the threat of fire The first is a working smoke alarm system By 1995 93 of all single family and multifamily homes apartments nursing homes and dormitories were equipped with alarms A second element
189. to permit the opening of household refrigerator doors from the inside16 CFR Part 1750 For a complete list sorted by product go to www cpsc gov businfo reg1 html It also requires labeling of products and bans products containing hazardous substances if they could injure a child See www cpsc gov for more information 17 See www cpsc gov See www healthyhomestraining org References Page 54 of 137 F Hazard Management Laws The U S Environmental Protection Agency EPA has promulgated regulations to govern asbestos lead based paint LBP and pesticide use as well as manufacture and sale EPA also possesses but has not exercised rulemaking authority for radon I Asbestos National Emission Standards for Hazardous Air Pollutants NESHAP The asbestos NESHAP applies to residential buildings with more than four dwelling units and to other buildings and imposes requirements for handling Regulated Asbestos Containing Material RACM during demolition and renovation projects RACM includes friable asbestos material and non friable material that has or likely will become friable e g will be subject to sanding or grinding or likely will be crumbled or pulverized The NESHAP requires that e Prior to demolition or renovation a certified inspector must inspect all affected areas and EPA must be notified ten 10 days prior to the start of work for o any demolition
190. toward more sustainable practices The long term goal is to recog nize and reward the top 25 of new homes in terms of environmental stewardship LEED for Homes applies to market rate and affordable homes as well single family and multifamily homes The program has completed its pilot phase and began its full program in 2008 The program includes mandatory and optional green construction practices in the follow ing categories for a total of 136 available points Awareness and Education Location and Linkages Energy and Atmosphere Sustainable Sites Water Efficiency Indoor Environmental Quality Materials and Resources Innovation and Design Processes Builders receive credits for achieving criterion in each of the eight criteria categories LEED for Homes has several performance tiers termed Certified 45 59 points Silver 60 74 points Gold 75 89 points and Platinum 90 136 points The award level point thresholds are adjusted based on home size A third party Provider is responsible for determining the LEED for Homes score and the rating The costs of participation in the LEED for Homes Program are established by local or regional Providers plus a registration and certification fee to USGBC based on the number of homes or square footage of multifamily buildings www usgbc org DisplayPage aspx CMS Pagel D 147 The Provider is responsible for the third par ty inspection and performance testing services
191. ts or bedbugs You ask about asbestos and radon The mom reports that she has no knowledge about whether the building has been tested or treated You do not observe any air fresheners or scented candles present but you ask about their use The mom confirms that she does not use those items because they aggravate her child s asthma Next you do a kitchen walkthrough with the mom See www healthyhomestraining org References Page 107 of 137 Kitchen e View Kitchen Walkthrough video clip 5 8 MB e View photos of other kitchen conditions You review the PEHA Survey Form and ask to move on to the bedroom and bathroom Living Room Walkthrough and Neighborhood Review e View Living Room Walkthrough and Neighborhood Review video clip 3 2 MB e View photos of living room conditions You note the active construction outside and the dust that is accumulating in the window sill even though the window is closed You also note that there are no window guards on the windows and that the blinds have looped cords You ask the mom when was the last time the young children were tested for lead Mom notes that it was within the last year and the results were less than 10 You sit down again with the mom to review home safety questions You provide her with a poison control hotline sticker to place on the phone You ask about fire safety issues She notes that there is no smoking allowed in the house and matches are stor
192. type of house is only a temporary radon reduction approach because of the following dis advantages loss of heat or air conditioned air related discomfort and increased costs and security concerns 3 Seal cracks in floors and walls with plaster caulk or other mate tials designed to seal cracks and gaps Contact your state radon office for a list of qualified contractors in your area and for information on how to fix radon problems yourself Always test again after finishing to make sure you ve fixed your radon problem If you are buying a new home ask whether radon resistant construction techniques were used It is almost always cheaper and easier to build these features into new homes than to add them later See www healthyhomestraining org For more information Visit HUD s website at www hud gov offices lead for more information about addressing health hazards in homes or to learn if HUD has a Healthy Homes program in your community Download a copy of Help Yourself to A Healthy Home for more practical steps you can take to make your home a healthy home More Federal Resources US Environmental Protection Agency EPA www epa gov radon Other Resources State Radon Contacts 1 800 438 4318 Indoor Air Quality Information Clearinghouse National Radon Hotline to order radon test kits 1 800 SOS RADON 1 800 767 7236 National Safety Council and EPA Radon Hotline with an operator to answer questions about radon
193. ulations and assist in identifying how to eliminate access to food and water for pests HUD encourages HAs to partner with local pest management organizations 7 REFERENCE MATERIALS FOR IMPLEMENTING IPM a PIH Maintenance Guidebook Seven Termite Insect amp Rodent Control September 1995 http hudclips org sub_nonhud cgi pdfforms HUDGB7 pdf b PIH Notice 95 66 http www hudclips org sub_nonhud cgi pdfforms HUDGB I1N pdf c General Services Administration i GSA Guidelines For Structural Pest Control Operations http schoolipm ifas ufl edu doc bus_prac html H Integrated Pest Management Program Contract Guide Specification 1999 http schoolipm ifas ufl edu doc contract pdf d U S Environmental Protection Agency i General IPM information for schools but generally applicable to such other large buildings as multifamily housing http www epa gov pesticides ipm H EPA staff contacts http www epa gov pesticides about contacts htm ipm iii List of EPA IPM publications and instructions for ordering documents http www epa gov oppfead1 Publications catalog subpage3 htm e U S Department of Defense Armed Forces Pest Management Board Technical Guide No 29 Integrated Pest Management IPM In And Around Buildings http www afpmb org pubs tims tg29 tg29 htm f Massachusetts Department Of Food And Agriculture Pesticide Bureau Integrated Pest Management Kit For Building Managers http www pestinfo ca documents IPMkitfor
194. ural gas or sewer gas smell If you think you smell natural gas advise the resident to call the gas company immediately e Old or worn out carpeting if in poor condition or extremely dirty f Other write in additional physical conditions that seem problematic such as other odors water leaks etc 6 Double check the Visual Survey Report Floor Plan and Site Plan g The resident s name address and unit number and your name should be filled in Make sure the names of the rooms on the Floor Plan s match those on the Visual Survey Report 7 Determine further testing needs and locations Plan to take samples if you have identified any of the following O O O H Deteriorated paint lead Bare soil lead Water damage lead mold and moisture Unvented appliances carbon monoxide Cockroaches or evidence Seewww healthyhomestraining org References Page 93vofvidBif org Revised 7 04 6 6 Visual Survey Instructions 8 Provide follow up instructions schedule the next visit and thank the resident O Explain approximately when and how the Summary Results Report will be presented Schedule a time when someone will be home if you need to return to collect tests for carbon monoxide cockroaches or radon and note this on the Visual Survey Report Seewww healthyhomestraining org References Page 94vof 131f org Revised 7 04 Pediatric Environmental Home Assessment Last updated 6 7 06
195. venting moisture intrusion and accumulation Additionally IPM conscious HAs assess the need to install physical barriers to both pest entry and pest movement within every structure See www healthyhomestraining org References Page 65 of 137 6 IMPLEMENTATION The choice of pest control strategies is the decision of HAs property owners and managers HAs may choose to implement IPM This may be done to the extent and in the manner they determine best at their discretion If a HA uses an outside contractor for pest control the HA s pest control IPM policies and procedures should be incorporated into the specifications or statement of work for the pest management contract The HA may also consider training for maintenance staff and education for residents as well as for HA administrative staff who oversee housing developments or administer occupancy and rental duties such as unit housekeeping inspections If the HA uses its own maintenance staff for pest management proper training in the HA s IPM procedures is essential The contract administrator for any pest management contract should also be trained Successful results rely upon proper implementation training is therefore of the utmost importance Not only must maintenance staff be trained but also residents and their elected leaders Successful IPM requires resident participation through proper housekeeping reporting of pest infestations and trash removal Residents can monitor pest pop
196. vities on target housing or child occupied facility built before 1978 performed for compensation after April 22 2010 Renovation is any modification of any existing structure or portion of an existing structure that results in disturbance of painted surfaces e Target Housing Housing constructed prior to 1978 except o Housing for the elderly or persons with disabilities unless any one or more children age 6 years or under resides or is expected to reside in such housing for the elderly or persons with disabilities or o Any 0 bedroom dwelling e Child Occupied Facility Building or portion of a building constructed prior to 1978 visited regularly by the same child under 6 years of age on at least two different days within any week Sunday through Saturday period provided that each day s visit lasts at least 3 hours and the combined weekly visits last at least 6 hours and the combined annual visits last at least 60 hours It also encompasses o Only those common areas that are routinely used by children under age 6 such as restrooms and cafeterias not simply passed through o Exteriors sides of the building immediately adjacent to the child occupied facility or the common areas routinely used by children under age 6 Activities Exempt from Compliance with the Requirements e Abatement Activities conducted under abatement rules by certified abatement contractor e Minor Repair or Maintenance Activities Activities that will distu
197. welling unit windows that are accessible from the outside such as basement first floor and fire escape windows must be lockable such as window units with sash pins or sash locks and combination windows with latches Windows that are nailed shut are acceptable only if these windows are not needed for ventilation or as an alternate exit in case of fire iv The exterior doors of the dwelling unit must be lockable Exterior doors are doors by which someone can enter or exit the dwelling unit e Thermal environment 1 Performance requirement The dwelling unit must have and be capable of maintaining a thermal environment healthy for the human body 2 Acceptability criteria i There must be a safe system for heating the dwelling unit and a safe cooling system where present The system must be in proper operating condition The system must be able to provide adequate heat and cooling if applicable either directly or indirectly to each room in order to assure a healthy living environment appropriate to the climate 11 The dwelling unit must not contain unvented room heaters that burn gas oil or kerosene Electric heaters are acceptable f Illumination and electricity 1 Performance requirement Each room must have adequate natural or artificial illumination to permit normal indoor activities and to support the health and safety of occupants The dwelling unit must have sufficient electrical sources so occupants can use essenti
198. ww healthyhomestraining org References Page 23 of 137 National Center for Healthy Housing Housing Interventions and Health A Systematic Review of the Evidence In December 2007 a panel of experts met in Atlanta Georgia through a cooperative agreement between the Centers for Disease Control and Prevention CDC National Center for Environmental Health Agency for Toxic Substances and Disease Registry and the National Center for Healthy Housing NCHH The panel conducted an exhaustive review of healthy housing intervention research The panel of experts found sufficient evidence to determine that following interventions were effective See www nchh org Housing_Interventions_and_Health pdf for more details A Controlling Asthma Symptoms and Reducing Asthma Morbidity Multi faceted in home interventions for asthma tailored to the individual that include SADA AUS Home environmental assessment Education Use of mattress and pillow covers Use of HEPA vacuums and HEPA air filters Smoking cessation and reduction in environmental tobacco smoke exposure Cockroach and rodent management Minor repairs and Intensive household cleaning But the following were found to be ineffective Bedding encasement sheet washing and upholstery cleaning each by themselves in isolation from other interventions Reducing Asthma Triggers and Exposure to Asthma Triggers When implemented together eliminating moisture intrusion and leaks a
199. y Homes Mid Course Review 2005 REVISED OBJECTIVE 8 23 Reduce the proportion of occupied housing units that have moderate or severe physical problems Target 3 1 percent Baseline 6 5 percent of occupied U S housing units had moderate or severe physical problems in 1995 Target setting method 52 percent improvement Data source American Housing Survey U S Department of Commerce Bureau of the Census 1 Target revised from 3 0 because of baseline revision after November 2000 publication Baseline revised from 6 2 after November 2000 publication See www healthyhomestraining org References Page 10 of 137 Relationship Between Interior Problems and Exterior Problems Based on the American Housing Survey 2007 National Data for Occupied Housing Likelihood of Finding an Interior Problem if an Exterior Problem is Reported Compared to the Likelihood of Finding an Interior Problem if an Exterior Problem is Not Reported Exterior Problem an Leaks Rodents zeus s From From Rats Mice Heating Fire CO Cracks in Holes in Paint Resident Interior Exterior Problem Danger Walls Floors plaster Dissatisfied Sagging roof 1 860 8 2 7 3 6 5 0 3 0 3 5 3 2 6 8 12 1 9 1 10 7 Missing roofing material 3 846 2 1 8 2 3 3 7 2 2 2 0 2 3 3 8 6 0 5 1 5 8 Hole in roof 12883 2 8 55 5 4 3 2 3 3 4 3 7 6 18 6 11 0 11 9 Sloping outside walls 1 172 6 2 3 3 0
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