GOOD Afternoon & Welcome!Wednesday, December 12, 2012 (1:00 p.m. to 4:45 p.m.) Healthy Housing Inspection and Remediation Techniques

This session will include a step by step process in how to conduct a Healthy Homes inspection and recommend corrective actions.

It will instruct participants in how to recognize “red flags” that cause unhealthy housing conditions including lead dust and paint, asthma triggers, moisture intrusion, radon, asbestos, insect and rodent infestation, and poor indoor air quality.

Healthy Homes1. History/Evolution2. Concept/Theory/Definition3. Primary components (Step by Step)

A. QuestionnaireB. Visual Assessment

1) (Red flags)a) Lead dust and paintb) Asthma triggersc) Moisture intrusiond) Radone) Asbestos,f) Insect and rodent infestation

g) Poor indoor air quality.

4. Remediation options/tech.5. Summarize HH Process

History/Evolution• 1938, American Public Health Association (APHA)

formulated Basic Principles of Healthful Housing to promote the “physical, mental and social health” in & of housing.

• Established 30 Principles– Physiological Needs (8)– Psychological Needs (7)– Protection against Contagion(8)– Protection against Accidents (7)

• identified Specific Requirements • Methods of Attainment

History/Evolution

1. U.K. used the Principals as a foundational document in the development of a HH rating system. (Newark RFP)

2. CDC modeled its original basic housing inspection manual after the principals

3. U.S. has endorsed these principals in the “Healthy Housing Reference Manual” (HH Manual).

ACTUAL BIDS SUBMITTED Year 1 Year 2

Company A $845.00 $875.00

LEW Corp $2,975.00 $2,874.00

Company B $650.00 $650.00

Company C $7,550.00 $7,550.00

Company D $395.00 $385.00

History/Evolution

7 Principals of Modern Healthy Homes

1. Dry: Damp houses provide a nurturing environment for mites, roaches, rodents, and molds, all of which are associated with asthma.

2. Clean: Clean homes help reduce pest infestations and exposure to contaminants.3. Pest-Free: Recent studies show a causal relationship between exposure to mice and

cockroaches and asthma episodes in children; yet inappropriate treatment for pest infestations can exacerbate health problems, since pesticide residues in homes pose risks for neurological damage and cancer.

4. Safe: The majority of injuries among children occur in the home. Falls are the most frequent cause of residential injuries to children, followed by injuries from objects in the home, burns, and poisonings.

5. Contaminant-Free: Chemical exposures include lead, radon, pesticides, volatile organic compounds, and environmental tobacco smoke. Exposures to asbestos particles, radon gas, carbon monoxide, and second-hand tobacco smoke are far higher indoors than outside.

6. Ventilated: Studies show that increasing the fresh air supply in a home improves respiratory health.

7. Maintained: Poorly-maintained homes are at risk for moisture and pest problems. Deteriorated lead-based paint in older housing is the primary cause of lead poisoning, which affects some 240,000 U.S. children.

History/Evolution

• These documents & the basic “Key Principals’ of modern Healthy Housing associate with;

1. Dryness 2. Cleanliness

3. Proper Ventilation 4. Pest Free

5. Contaminants avoidance 6. Well Maintained

7. Safe !!!

Current Initiative for HH

• U.S. initiatives related to healthy homes were created to develop a holistic approach to healthy housing based on the following broad objectives:

ho·lis·tic/hoʊˈlɪs tɪk/ Show Spelled [hoh-lis-tik] Show IPA adjective 1. incorporating the concept of holism in theory or practice: holistic psychology.

ho·lism/ˈhoʊ lɪz əm/ Show Spelled [hoh-liz-uh m] Show IPA noun, Philosophy . 1. the theory that whole entities, as fundamental components of reality, have an existence other than as the

mere sum of their parts. Compare organicism ( def 1 ) . 2. Also, holiatry. Medicine/Medical . care of the entire patient in all aspects.

Develop national healthy homes capacity through cross disciplinary 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. 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. 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 addressing multiple housing deficiencies that affect health and safety. 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.

Holistic Approaches - Broad Objective

Primary Components of a HH Evaluation1. Resident Questionnaire

2. Visual Assessment Sub Components of both

LEAD PAINT & DUST ASTHMA TRIGGERS

MOISTURE INTRUSION RADON

ASBESTOS INSECT & RODENTS

IN-DOOR AIR QUALITY + PLUS + PLUS + PLUS

Resident questionnaire

Questions about? Housing

Characteristics? In-door

pollutants? Home safety? Health

Assessment data (voluntary)

Healthy Homes Model Résident Questionnaire

Information from questionnaire responses can provide important clues that point to housing deficiencies.

The Healthy Homes Model Resident Questionnaire is a tool that can be adapted by local jurisdictions to meet their specific needs.

Healthy Homes Model Résident Questionnaire

WAS QUESTIONNAIRE ADMINISTERED? ? Q:Yes or No Q:Why not:? Q:Vacant Date: ? Name of Questionnaire Administrator:? Building and/or Unit Address: _____

City, State, Zip: ? No. of persons living in unit:? No. of children:? Age of children living in unit: ? Unit status Q:Occupied or Vacant

Healthy Homes Model Résident Questionnaire

• Voluntary Health Assessment Data– 1st ? – have U or others Incurred these cond. When

in the house w/in <12months– 2nd ? Any symptoms worsen when in unit, better

when leaving? Allergies Eye Irritation Doc. diag. Asthma or Symptoms: cough, wheezing, shortness breath, chest

tightness, Phlegm w/o cold Headaches Hay fever Chronic Bronchitis Respiratory Disease Sinus Problems Ear Infections Skin infection/rash

•Injuries•Poisonings•Others issues

Visual AssessmentIMPORTANT NOTE: The visual assessment should be used to collect information that can be determined without asking questions of a resident. (YOUR OWN SITE RECONASSANCE)

Site: Fencing, Gates, Grounds/pavements, Play areas, Other() Building Exterior: Doors, fire escapes, foundations, lighting, roofs, walls,

windows Building Systems: Electrical Sys. , Fire Protection, HVAC Common Areas: Elevators, signage, smoking area, interior trash, Outlets-

Switches-Cover Plates, Smoke & Carbon Monoxide detectors, Walkways/steps, Ceiling, Floors

Housing Unit: Bathroom, Ceiling-floors-walls, Doors, Electrical, Water Heater, HVAC System, Kitchen, laundry, Lighting, Patio-Porch-Deck-Balcony, Smoke-Carbon Monoxide, Stairs, Windows

Other: Garbage& Debris, Injury Hazards, Childproofing, Poisoning, Pest hazards, Moisture hazards, Swimming pool-spa-whirlpool, Other……

“Red Flag” Sub-Components of Both: Lead dust and paint

Questionnaire:• Age of Property (1978)• Children reside in Property• Overall attitude of Maintenance• Pregnant or to-be• Nearby Industrial applications• Paint condition (impact & Friction)• Cleaning Habits

Visual:• Paint Cond. • Children's/Pregnant belongings• Overall Cleanliness• Cleaning supplies (HEPA vac)

Corrective Action:• Presumption vs. Testing• (Lab, XRF, Chemical)

• Interim Controls (<20yr, Interim)• Abatement (20yr.-permanent )

Lead in Paint, Dust, and Soil

Why Do You Need to Be Concerned About Lead?• Lead is a toxic metal that was used for many years in products

found in and around our homes. Lead also can be emitted into the air from motor vehicles and industrial sources, and lead can enter drinking water from plumbing materials. Lead may cause a range of health effects, from behavioral problems and learning disabilities, to seizures and death. Children six years old and under are most at risk.

• Most Common Sources of Lead Poisoning:• Deteriorating lead-based paint • Lead contaminated dust • Lead contaminated residential soil

“Red Flag” Sub-Components of Both: Asthma triggers

• Questionnaire: are you aware of• Cockroaches-Pest free clean dry maintained (keep its)• Rodents – Pest free maintained dry clean• Mold – dry maintained clean ventilated (keep its)(this

list of ?’s is more extensive). • Nitrogen Oxides – (combustion appliances) Ventilated

maintained

• Visual:• Inside, above, behind … walls, ceilings, floors• Exterior • Moisture damage, water staining • Cockroach/rodent droppings, nesting, fur

Spores(conidia)

HyphaeCommon

household roaches

A) German cockroach

B) American cockroach

C) Australian cockroach

D&E) Oriental cockroach

“Red Flag” Sub-Components of Both: Moisture intrusion

Questionnaire:• Are you aware of Moisture intrusion• Have there been any leaks, floods• Smell Musty/Moldy• Does any feel ?

Visual:• Do you see any water staining• Do you see any mold• Are there missing/broken/short/clogged draining

pipes

Corrective Action:• Find Moisture source• Correct Moisture source• Appropriately clean/wipe affected area• Dry/Encapsulate/entomb• Tape lift/swab/air sampling

“Red Flag” Sub-Components of Both: Moisture intrusion

How to Test Air

Viable samples

“living”

Biotest RCS Sampler

Anderson Impactor

Viable samples

“living”

How to Test Air

EMLAB - BioCassette

How to Test Air

Non-Viable samples

“dead”

Surface SamplingTape Sample

Non-Viable samples

“dead”

Surface SamplingSwab Sample

Non-Viable or Viable

samples

How to Remediate Mold Contamination

• Guidance documents:– IICRC: S520, Standard Reference Guide for Professional

Mold Remediation– AIHA: Recognition, Evaluation, and Control of Indoor

Mold– USNAVY: Remediation Wheel– NYCDHMH: Guidelines on Assessment and

Remediation of Fungi in Indoor Environments

US Navy Remediation Wheel

http://www-nehc.med.navy.mil/IH/images/MR_wheel.gif

REMEDIATION• Find Source of Moisture

• Cure Source

• Wash area

• HEPA Vacuum

• Remove & Replace

“Red Flag” Sub-Components of Both: Radon

Questionnaire:• Type of House Construction (slab, basement, crawl-

space)• Is there a radon system in place• Lowest Livable area used by family• Radon History (area or actual prev. results)• French drain, sump pump, cracks ?

Visual:• Lowest room frequented by family members• is there a French drain, sump pump, cracks in

foundation/walls. • Ventilation

Corrective Action:• Test-Charcoal Canister, Gas Continuous Monitor (4pcu-

action level)• Improve Ventilation (fans on timers, open windows)• Install a Radon remediation system (active of passive)

Radon - Chemical SymbolElement Number: Rn222

Radon is a cancer-causing radioactive gas.

You cannot see, smell or taste radon but it may be a problem

The Surgeon General has warned that radon is the second leading cause of lung cancer in the United States today.

Radon's primary hazard is caused from inhalation of the gas and its highly radioactive heavy metallic decay products (Polonium, Lead, and Bismuth)

How it gets into schools and homes

NJ/PA = RED has showed 20% & greater have elevated radon levels

Corrective Action – Remediation

Radon little issues

• Gas looks for path of least resistance– Rainy day – inside levels go up– Snow and ice – inside levels go up– Hot dry season – inside levels go down

• Seal off slab or floor openings• Seal off pump openings• Ventilation is key – fans/pump on timers• Air circulation

Sub-Components of Both: Asbestos

Questionnaire:• Age of Property (1978)

Visual:

Corrective Action:

Friable vs. non-friableAsbestos: What's the Dangerous Difference?

The legal definitions of "friable" and "non-friable" asbestos clearly depicts the differences between dangerous and safe asbestos-containing materials (ACMs).

Friable ACM is any material that contains more than one percent asbestos by weight or area, depending on whether it is a bulk or sheet material and can be crumbled, pulverized, or reduced to powder by the pressure of an ordinary human hand.

• Non-friable ACM is any material that contains more than one percent asbestos, but

cannot be pulverized under hand pressure.

• Materials are slightly more confusing within the classification of non-friable ACM:

• Category I non-friable includes asbestos packings, gaskets, resilient floor covering, and asphalt roofing products.

• Category II is any non-friable ACM not included in Category I.

• The difference is which non-friable asbestos materials are "Regulated Asbestos Containing Materials" (RACMs). The legal definition covers:– All friable ACMs, – Including category I non-friable asbestos materials that have become friable as

the other materials in them have broken down with age and weather. – Category I non-friable asbestos materials that will be, or have been, subjected

to sanding, grinding, cutting, or abrading. – Category II non-friable asbestos materials that have a high probability of

becoming or have become crumbled, pulverized, or powdered by the forces expected to act on the material in the course of demolition or renovation operations.

• Any asbestos-containing material can become friable and fall under federal regulation.

How to identify & where can

it be Found • Fireproofing material• Sprayed on steel beams• Concrete and concrete like products• Cement products• Siding• Roofing shingles• Wallboard• Cladding• Partitions• Piping• Asphalt products• Vinyl products• Floor tile• Joint Compounds• Adhesives• Acoustical plaster• Pipe insulation & packing

Asbestos has been used in literally hundreds of products. Collectively, these are frequently referred to as asbestos-containing material (ACM).

Cement PipesElevator Brake ShoesCement WallboardHVAC Duct InsulationCement SidingBoiler InsulationAsphalt Floor TileBreeching InsulationVinyl Floor TileDuctwork Flexible Fabric ConnectionsVinyl Sheet Flooring Cooling TowersFlooring BackingPipe Insulation (corrugated air-cell, block, etc.)Construction Mastics (floor tile, carpet, ceiling tile, etc.)Heating and Electrical DuctsAcoustical PlasterElectrical Panel PartitionsDecorative PlasterElectrical ClothTextured Piants/CoatingsElectric Wiring Insulation

Ceiling Tiles and Lay-in PanelsChalkboardsSpray-Applied InsulationRoofing ShinglesBlown-in InsulationRoofing FeltFireproofing MaterialsBase FlashingTaping Compounds (thermal)Thermal Paper ProductsPacking Materials (for wall/floor penetrations)Fire DoorsHigh Temperature GasketsCaulking/PuttiesLaboratory Hoods/Table TopsAdhesivesLaboratory GlovesWallboardFire BlanketsJoint CompoundsFire CurtainsVinyl Wall CoveringsElevator Equipment PanelsSpackling Compounds

Where can it be found? (Cont.)

Sub-Components of Both: Insect and rodent infestation,

Dion Lerman will cover

Sub-Components of Both: Poor indoor air quality.

• Questionnaire:

• Visual:

• Corrective Action:

• Oil – UST, AST, VOC• Not a healthy

neighborhood!

Healthy Homes Specialist Credential

NCHH and the National Environmental Health Association (NEHA) offer a “Healthy Homes Specialist” credential, designed for health and housing professionals in the public, private, and nonprofit sectors.

To achieve the credential, must complete a comprehensive exam on the seven principles of healthy housing, which include keeping homes: Dry, Clean, Pest-Free, Contaminant-Free, Ventilated, Safe, and Maintained. Individuals seeking the Healthy Homes Specialist credential must:– Be at least 21 years of age;– Have five years of experience in housing, environmental health, or

public health;– Achieve a minimum score of 70% on the qualifying examination; and– Successfully complete an online home assessment exercise.

• You may apply for the HHS credential by completing an application.

• For more information go to www.neha.org/credential/HHS.

• Cost of applying for and taking the HHS exam is $150 NEHA members or $205 non-members.

• Credentialing Staff at 303.756.9090 x339.

Healthy Homes Specialist Credentialing

Healthy Homes Specialist Credential References• Study Guide [PDF]

Contaminant Guide [PDF]

Healthy Homes Reference Manual by U.S. Centers for Disease Control and Prevention and U.S. Department of Health and Urban Development (2006) (236 pages - 14 MB) [PDF]Chapter 1 Housing History and Purpose (8 pages - 0.5 MB) [PDF]Chapter 2 Basic Principles of Healthy Housing (11 pages - 0.5 MB) [PDF]Chapter 3 Housing Regulations (13 pages - 0.5 MB) [PDF]Chapter 4 Disease Vectors and Pests (18 pages - 1.8 MB) [PDF]Chapter 5 Indoor Air Pollutants and Toxic Materials (23 pages - 1.1 MB) [PDF]Chapter 6 Housing Structure (22 pages - 1.9 MB) [PDF]Chapter 7 Environmental Barriers (7 pages - 1.2 MB) [PDF]Chapter 8 Rural Water Supplies and Water Quality Issues (12 pages - 1.2 MB) [PDF]Chapter 9 Plumbing (16 pages - 1.0 MB) [PDF]Chapter 10 On-Site Wastewater Treatment (12 pages - 1.0 MB) [PDF]Chapter 11 Electricity (17 pages - 1.3 MB) [PDF]Chapter 12 Heating, Air Conditioning, and Ventilating (20 pages - 1.2 MB) [PDF]Chapter 13 Energy Efficiency (12 pages - 0.7 MB) [PDF]Chapter 14 Residential Swimming Pools and Spas (12 pages - 0.8 MB) [PDF]Connections Between Health and Housing [PDF]

Laws, Rules and Codes for Healthier Housing [PDF]

Healthy Homes Assessment Tools [PDF]

General Resources and References [PDF]

Guidance on Integrated Pest Management - U.S. Department of Housing and Urban Development (2007) [PDF]Selected Photos

Summarize Healthy Homes Process• Interview Questionnaire• Visual site inspection– Focus on contaminants• Especially “Red Flags”

• Combine Questionnaire data with Visual observations

• Assessment areas of potential concern• Recommend corrective action or additional

follow up• Provide report of findings

Interactive Exercise

1. Distribute Exercise Questionnaire 2. Have complete with neighbor acting as

owner3. Review pictures on overhead 4. Complete Visual field forms5. Summarize Assessment

04/15/2023