1. INDOOR AIR POLLUTANTS CASEY GUILLAUME MPH 500 Foundations of Public Health Professor Madeline Angela Meyer

2. Overview  What are indoor air pollutants?  Air quality importance  Health risks  Behavioral factors  Social factors  Questions  References

3. What are indoor air pollutants?  The California Air Resources Board (2006) classifies indoor air pollution as "toxic gases or particles that can harm your health"  The most common indoor air pollutants are:  Radon  Combustion products  Biological (molds, pet dander, pollen)  Volatile organic compounds  Environmental tobacco smoke  Lead dust  Asbestos

4. What are indoor air pollutants?  Radon  a naturally occurring radioactive gas  gas is released from the soil and seeps into homes through cracks in the foundation  Combustion products  "gases or particles that come from smoking and burning of fuels“  carbon monoxide, nitrogen dioxide, and particulate matter  Sources include gas, wood and coal stoves, gas and propane engines, fireplaces, and candles

5. What are indoor air pollutants?  Biological (molds, pet dander, pollen)  “small proteins from a variety of sources that can trigger an immune response" (Emory University, 2013)  biological contaminants are, or are produced by, living things  can be found in areas that contain moisture  Volatile organic compounds  gases vaporizing from solids or liquids while at room temperature  widely used ingredients in many household products.  examples include paints, aerosol sprays, disinfectants, cleansers, wax, paint removers, varnishes, glues, and fuels

6. What are indoor air pollutants?  Environmental tobacco smoke (ETS)  known as secondhand smoke, involuntary or passive smoke  "considered a leading component of indoor air pollution" (Emory University, 2013) 1  combination of cigarette, pipe or cigar smoke and exhaled smoke  Lead dust  naturally occurring element found in small amounts in the earth’s crust  can be found in and around our homes, including paint, ceramics, pipes and plumbing materials, gasoline, batteries, and cosmetics.  Asbestos  mineral fiber that occurs in rock and soil (EPA, 2013) 2  used in building materials (roofing shingles, tiles, paper products, and cement products), friction products (automobile clutch, brake, and transmission parts), heat-resistant fabrics, packaging and coatings

7. Air quality importance  According to the Journal of Allergy and Clinical Immunology (2008), persons in industrialized countries spend nearly 22 hours indoors every day 1  Indoor air quality refers to the quality of the air in a home, school, office, or other building environment  The American Lung Association noted that "poor indoor air quality is the fourth largest environmental threat to our country" (2013) 2

8. Health risks  The pollutant levels and length of exposure effects the severity of the health risk  There are populations that are effected more than others:  young children  elderly  Individuals with compromised respiratory or cardiovascular systems  These populations tend to spend more time inside  Stress can also lead to low functioning immune systems, making people with high stress susceptible to the effects of poor air quality  Other populations that can be affected are those with allergies or are sensitive to chemicals

9. Health risks  Air pollution indoors may cause approximately 2.7% loss of disability adjusted life years around the world (Duflo, Greenstone, Hanna, 2008)  Refers to lower quality of life due to illness, disease, or early death

10. Health risks  Children spend much of their time inside during daycare, school, and home  "Up to 20% of fatalities among children under five" are caused by acute respiratory infections from pollutants inside the home, especially among developing countries (Duflo et al., 2008)

11. Health risks  Worldwide, allergen rates among children are approaching 40-50 percent (American Academy of Allergy, Asthma, & Immunology, 2013)  Prevalence of allergies has continued to increase.

12. Health risks  Immediate effects:  Irritation of eyes, nose, and throat  Nausea  Light-headedness, dizziness  Headache  Fatigue  Allergic reaction  Dependent upon individual sensitivity  Often short-term and cease after reduced exposure

13. Health risks  Long-term effects:  Cancer  Heart disease  Respiratory illness (asthma, bronchitis, emphysema)  Fatalities can occur due to exposure to higher than normal levels or from disease

14. Health risks  Other health outcomes associated with poor indoor air quality include:  Low birth weight  Increased chance of prenatal death in the early stages of pregnancy,  Ear infections  Blindness  There is a need more scientific evidence to back up these claims

15. Behavioral factors  "The health belief model specifies several factors that determine whether a person is likely to change behavior" (Schneider, 2014, pg 227) 1  Following example uses mold  1. Extent to which the individual feel vulnerable to the threat  Public needs education on where mold is found and what it looks and smells like to understand they are vulnerable  The Institute of Medicine reviewed several studies that "indicated that at least 20% of buildings had one or more signs of dampness" (WHO, 2009) 2

16. Behavioral factors  2. Perceived severity of the threat  Low-income areas are more susceptible  3. Perceived barriers to taking action to reduce the risk  Opening windows and using fans to ventilate rooms  Cleaning and fixing leaks or spills quickly reduces and prevent mold growth  4. Perceived effectiveness of taking an action to prevent or minimize the problem  Acting quickly to reduce or prevent moisture build up is effective  Investing in a humidity meter can keep homes in recommended humidity levels (~50% or less)

17. Social factors  The ecological model of health behavior "looks at how the social environment... supports and maintains unhealthy behaviors" (Schneider, 2014, pg 228) 1  Intrapersonal factors  Do not smoke  Install carbon monoxide sensors and "test your home for radon, an invisible gas that causes lung cancer" (American Lung Association, 2013) 2  Put away food and cover trash  Fix leaks and clean up spills quickly

18. Social factors  Interpersonal factors  Ask those visiting your home to refrain from smoking  Institutional factors  Areas that have a high population need to be ventilated properly  Community factors  Community help is especially helpful after floods or natural disasters. As more time passes during clean up, the greater risk of serious mold damage, gas leaks, etc  Public policy  Regulations on building and housing codes should be strictly enforced and updated regularly

19. Questions?  Any questions?  Thanks for viewing!

20. References  Alexis, N., Bacchus, H., Bernstein, J., Bernstein, L., Fritz, P., Horner, E., Li, N., Mason, S., Nel, A., Oullette, J., Reijula, K., Reponen, T., Seltzer, J., Smith, A., Tarlo, M. (March 2008). The health effects of nonindustrial indoor air pollution. The Journal of Allergy and Clinical Immunology, 121(3): 585-591. Retrieved from http://www.jacionline.org/article/S0091-6749%2807%2902209-9/fulltext  American Academy of Allergy, Asthma, & Immunology. (2013). Allergy statistics. Retrieved from http://www.aaaai.org/about-the-aaaai/newsroom/allergy- statistics.aspx  American Lung Association of the Mid-Atlantic. (2013). Indoor air quality. American Lung Association. Retrieved from http://www.lung.org/associations/charters/mid-atlantic/air- quality/indoor-air-quality.html  American Lung Association. (2013) Keep pollution out of your home. Retrieved from http://www.lung.org/healthy-air/home/resources/keep-pollution-out-of-your-home.html  California Air Resources Board. (2006). Reducing indoor air pollution. California Environmental Protection Agency. Retrieved from http://www.arb.ca.gov/research/indoor/rediap.htm

21.  Duflo, E., Greenstone, M., Hanna, R. (15 February 2008). Indoor air pollution, health and economic well-being. Surveys and Perspectives Integrating Environment and Society,1(1). Retrieved from http://sapiens.revues.org/130  Emory University School of Medicine. (2013). Indoor air pollutants. Retrieved from http://www.pediatrics.emory.edu/centers/pehsu/Substance %20of%20Concern/inpollutant.html  Environmental Protection Agency. (2011). Indoor air. Retrieved from http://cfpub.epa.gov/eroe/index.cfm?fuseaction=list.listByS ubTopic&ch=46&s=343

22.  Health Indoor Air for America's Homes. (n.d.) Combustion pollutants. Federal Citizen Information Center. Retrieved from http://publications.usa.gov/USAPubs.php?NavCode=M&PHPSESSID =2unmldre88qehk be4fqk0dkl95  Schneider, M.-J. (2013). Introduction to public health. 4 th edition. Burlington, MA: Jones & Bartlett Learning.  World Health Association. (2013). Health effects. Retrieved from http://www.who.int/indoorair/health_impacts/disease/en/index.ht ml  World Health Organization. (2009). WHO guidelines for indoor air quality: dampness and mould. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0017/43325/E9 2645.pdf