1. 1 HEALTH AND HOUSING: AIR QUALITY AND EMERGING ISSUES PRESENTED BY KRISTINA WIENEKE DIRECTOR OF PUBLIC POLICY, NEW YORK AMERICAN LUNG ASSOCIATION OF THE NORTHEAST

2. 2 WHAT CONTRIBUTES TO POOR INDOOR AIR QUALITY? Mold & dampness Bugs and Pollen Radon Tobacco Smoke Particles Chemicals and gases Asbestos and lead

3. 3 WHY LEARN ABOUT IAQ? Air pollution affects everyone People worry about it—and not always about the most dangerous aspects You can help people do something about it You can improve everybody’s air MOST importantly Indoor and outdoor air pollution can cause many serious health problems, including death

5. 5 WHAT CAN WE DO ABOUT IT? CONTROL THE SOURCE VENTILATION FILTRATION LEGISLATION

6. 6 CONTROL SOURCES? Don’t bring it indoors if possible Tobacco smoke Chemicals & gases Rain & humidity Pollen Ozone Animal dander Keep what’s indoors under control Moisture Bugs & bacteria Asbestos & lead

7. 7 IN THE INTEREST OF TIME, LET’S TALK ABOUT… MOLD RADON TOBACCO SMOKE What are we doing as an organization to tackle these issues…?

8. 8 MOLD Molds Produce Allergens Irritants Toxic Substances Other volatile organic compounds Typical Symptoms Reported Odors, mustiness Burning sensation Headaches Nosebleeds Irritation of eyes, skin, nose, throat, lungs in allergic, non-allergic individuals Difficulty breathing Specific allergic reactions Aggravation of asthma

9. 9 CONTROLLING MOLD MOISTURE CONTROL ISTHE KEY TO MOLD CONTROL Control Humidity (25% - 50%) Prevent Condensation (avoid cold interior surfaces) Find and fix water intrusion and leaks(through building envelope, from pipes)

10. 10 RADON National Radon Health Advisory Indoor radon gas is a national health problem. Radon causes thousands of deaths each year. Millions of homes have elevated radon levels. Most homes should be tested for radon. When elevated levels are confirmed, the problem should be corrected. -- U. S. Public Health Service

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12. 12 RADON MITIGATION STRATEGIES Reduce Radon Levels After Entry (difficult) - dilute with increased ventilation - filter radon and its decay products from the air Reduce Radon Entry ( easier) - collect before it gets into the building air, and discharge to a safe location - seal entry routes -change air pressure differences so radon doesn’t come inside

13. 13 EXAMPLE OF LEGISLATIVE EFFORTS IN NY MOLD: A 969/ S 3756 ROSENTHAL/ESPALLIAT Relates to the remediation and prevention of indoor mold and requiring the disclosure of indoor mold history upon the sale of certain real property. RADON: S 1333 BRESLIN Requires the state fire prevention and building code council to implement rules and regulations requiring the use of radon-resistant features in new home construction. Additional Resources… www.epa.gov/iaq/molds/ www.epa.gov/iaq/radon/ www.lungusa.org

14. 14 Housing and Secondhand Smoke: Clean Air as an Equity Issue

15. 15 No Safe Level of Exposure to SHS "The scientific evidence is now indisputable. Secondhand smoke is not a mere annoyance. It is a serious health hazard that can lead to disease and premature death in children and nonsmoking adults.“ US Surgeon General Richard Carmona, 6/27/2006 No Safe Level of Exposure to SHS "The scientific evidence is now indisputable. Secondhand smoke is not a mere annoyance. It is a serious health hazard that can lead to disease and premature death in children and nonsmoking adults.“ US Surgeon General Richard Carmona, 6/27/2006 SECONDHAND SMOKE IS DEADLY Environmental Tobacco Smoke is classified as a Group A carcinogen -- a substance known to cause cancer in humans for which there is no safe level of exposure. -Environmental Protection Agency SECONDHAND SMOKE IS DEADLY Environmental Tobacco Smoke is classified as a Group A carcinogen -- a substance known to cause cancer in humans for which there is no safe level of exposure. -Environmental Protection Agency

16. 16 WHY IS SECONDHAND SMOKE AN ISSUE OF EQUITY? StreetEasy Survey (Public Health Solutions New York) Rental apartments in smokefree buildings cost between $1,000 and $1,300 more per month, from 2010 to 2014 In 2014, out of 63,105 StreetEasy NYC apartment rental listings, only 2,205 – or3.49% - are in smokefree buildings Median asking rent for rentals in apartments that lack smoke-free protections is $3,137, while the median in smoke-free buildings is $4,295; a rent difference of $1,158 Using the standard 40x -rent/income ratio, New Yorkers need to earn up to $52,000 *more* income in order to afford an apartment in a smokefree building

17. 17 WHY SHOULD APARTMENTS GO SMOKEFREE? SHS in apartments affects millions of people Secondhand smoke cannot be controlled Health risks are same in apts as elsewhere Tenants favor smokefree apartments – 73% support Increasing numbers of complaints about secondhand smoke infiltration in apts It’s legal (Smokers are not a protected class) Economical for landlords / property owners It is an issue of health equity

18. 18 Historic Opportunity to Help our Nation’s Most Vulnerable

19. 19 Prevalence of Public Housing Households with a Smoker Source: American Public Housing Survey 2011

20. 20 HOW ARE SMOKEFREE HOUSING POLICIES BEING PASSED? Three major approaches: Voluntary adoption by private landlords and/or public housing authorities Legislative enactments on local or state levels A35 Paulin: Requires owners of multiple dwelling properties to develop, implement and distribute smoking policies A 7137 Sepulveda: Authorizes a study on the high incidence of asthma in the borough of the Bronx and to prepare a remedial plan ( Bronx statistics show serious inequity: 19% of men smoke, 38.5% of people smell smoke in their homes, nearly 50% of Bronx residents have asthma, 34.4% of those with asthma report smelling smoke in their homes). Federal Housing and Urban Development (HUD)

21. 21 An Overview of HUD’s Proposed Rule

22. 22 Please Keep in Mind Smokefree is our main goal Cessation an important but secondary objective

23. 23 HUD Smokefree Multi-Unit Housing Proposal Key Provisions Issued in Fall 2015 Smokefree proposal would apply to all public housing, other than dwelling units in mixed- finance buildings All public housing authorities (PHAs) would go smokefree in 18 months from date of final rule Interior of buildings plus 25 foot zone within buildings included PHAs would also be required to: Document their smoke-free policies in their PHA plans, a process that requires resident engagement and public meetings. Smokefree policy would be included in a tenant's lease Other Provisions All lit tobacco products included

24. 24 HUD Smokefree Multi-Unit Housing Proposal Proposal Does Not Include: Public health & medical groups urged HUD to add hookah & e-cigarettes* All housing subsidized by the federal government

25. 25 HUD Smokefree Multi-Unit Housing Proposal An Ever Expanding Coalition

26. 26 Moving Forward: Implementation

27. 27 Major Points to Remember Smokefree air policies are about smoking, not smokers. Residents may be afraid they’ll be forced to quit or move out. Property managers may be afraid they’ll have to evict residents who smoke. Many tobacco users may decide to make a quit attempt when a property goes smokefree. Cessation services should be available to residents. Cessation resources (including medication) should be easily accessible with as few barriers as possible. Not every tobacco user will decide to make a quit attempt when a property goes smokefree. Some may be angry about the new policy and some just aren’t ready to make a quit attempt. Everyone needs to comply with the smokefree air policy, even if they don’t stop using tobacco.

28. 28 HOW CAN YOU SUPPORT OUR EFFORTS? Join our coalition Write memos in support of the legislation we care about! Educate landlords and homeowners in your community Please feel free to reach out to me for more information Kristina Wieneke Kristina.wieneke@lung.org 917 636 2952

29. 29 Smokefree Multi-Unit Housing Resources All resources and tools are available at Lung.org/smokefreehousing