1. Alaska Native Tribal Health Consortium Alaska’s Air Inside and Out Presented by: Josh Liles Asst. Environmental Health Consultant Environmental Health Support

2. Road Map Introduction to ANTHC ANTHC’s Tribal Air Program ANTHC’s Healthy Homes Program

3. Introduction to ANTHC Alaska Native Tribal Health Consortium Wellness Alaska Native Medical Center Business Environmental Health, Engineering & Construction

4. Road Map Introduction to ANTHC ANTHC’s Tribal Air Program ANTHC’s Healthy Homes Program

5. We offer assistance to Alaskan Tribes for both indoor and outdoor air quality projects. Assistance we offer: Education and Outreach Answer questions over the phone Handouts, Assessment Kits Capacity Building Training on equipment Phase 1 air assessment Monitoring Indoor Air Quality Burning Road Dust Cooperative agreements Mini-Grants Loaner Equipment Technical support

6. Tribal Air Quality Cooperative Agreements (Mini-Grants) 3,000-10,000 grants designed to help communities deal with air quality issues Funded through ANTHC’s CAA 103 Grant Administered by ANTHC-EHS Assistance with: Program Development Technical support and training Loaner equipment Competitive Funding opportunity 3-5 projects

7. Past Mini-Grant Projects From 2012-2014 the Air Quality Program has funded 12 projects Past projects include: Outdoor air Road dust in several villages (#1 problem we currently face) Indoor air Radon Wood stove change out Healthy homes

8. Road Map Introduction to ANTHC ANTHC’s Tribal Air Program ANTHC’s Healthy Homes Program

9. ANTHC Environmental Health Support received a call from a pulmonologist to see if there could be a link between poor indoor air quality and children's LRTI How we got started?

10. Respiratory Health in Alaska Alaska Native children have some of the highest rates of respiratory illness ever documented Causes Poor indoor air quality Lack of in-home piped water services

11. Steps Identify homes with children that have chronic respiratory illness – Children 1-12 yrs. with 4 or more clinic visits OR 1 respiratory hospitalization in the previous year Assess the home Modify the home to improve air quality In home air monitoring Pre-modification Post-modification 1 yr. post modification Promote behavior changes

12. Challenges we face in the project Coordination On many different levels Weather Transportation Time

13. Air Sampling PM 2.5 (TSI DustTrak II) VOC’s CO 2, Temperature, Relative Humidity (Extech CO210) CO (Lascar)

14. Summary of Air Quality Results CO 2 (-22%) VOCs (-77.5%) PM2.5 (-7.7%) Pm2.5 excluding Home #11 (-31.9%) Naaman Tomaganuk, Housing Crew Member

15. Limitations for Health Data Results (for completed 30 homes) Health data is only from residents reported lung health questionnaires of 2 week intervals Administered at initial contact, immediately before home modifications, 2 weeks, 3 months, & 1 year after home modifications Health data will be collected from chart reviews for clinic visits and hospitalizations Administered 1 year before and 1 year after home modifications School absences data will come from questionnaires and will not be verified through school records

16. Preliminary Results Observed Changes (30 homes): – Cold or Runny Nose (-23.0%) – School absence from breathing problems (-27.3%) – Clinic visits for respiratory (18 before, 9 after) – Hospitalization for respiratory (7 before, 0 after)

17. Wrap up and final thoughts Hopefully you were able to understand and follow the story Hopefully our story will help generate some ideas to help you seek out unique and innovative ways to help solve issues. Build partnerships

18. The End Questions/Comments?

19. What are the 7 Principles? 1.Contaminant-Free 2.Ventilated 3.Dry 4.Safe 5.Maintained 6.Clean 7.Pest-Free

20. What can we change?