United States
Environmental Protection
Agency
Office of Air and Radiation
(6609J)
EPA402-K-01-003
October 2001

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INTRODUCTION
The U.S. Environmental Protection Agency (EPA) is pleased to issue the Healthy
Buildings, Healthy People (HBHP) report, a vision for indoor environmental
quality in the 21st Century. The importance of the indoor environment to human
health has been highlighted in numerous environmental risk reports, including
the 1997 report of the Presidential and Congressional Commission on Risk
Assessment and Risk Management. On average, we spend about 90 percent of
our time indoors, where pollutant levels are often higher than those outside.
Indoor pollution is estimated to cause thousands of cancer deaths and hundreds
of thousands of respiratory health problems each year. In addition, hundreds of
thousands of children have experienced elevated blood lead levels resulting from
their exposure  to indoor pollutants.

The report challenges all of us to work together to improve the quality of our
environment. It can also serve as the basis for discussion and education among
professionals in public policy, health, building sciences, product manufacturing,
and environmental research. The report is also a blueprint for channeling avail-
able resources. Already, EPA has undertaken program initiatives focusing on
childhood asthma, characterizing the effect of building and consumer
products on the indoor environment, increasing the demand for cleaner indoor
products for use in schools, creating standards of care for existing buildings, and
designing guidance for new schools. EPA is also integrating good indoor envi-
ronmental quality (IEQ) concepts into the Energy Starฎ label program for com-
mercial office buildings. Moreover,  other current federal programs, while not
direct outgrowths of the HBHP effort, are complementary of it. For example, at
the Department of Housing and Urban Development (HUD), the Healthy
Homes project has identified moisture and molds as a priority to be addressed in
its grants process, and  the Healthy  People 2010 effort at the Department of
Health and Human Services (DHHS) contains several goals relating to IEQ
progress in existing buildings. We challenge others, including government, tribes,
the health community, academia, non-profit organizations, and industry, to
embrace the HBHP goals and work together to invest in the actions outlined in
the report. In this way, we can begin to make progress towards realizing the
vision of HBHP.

The HBHP report is the outcome of a cross-Agency effort to define a strategic
vision and potential actions for improving the quality of our indoor environment
and was jointly led by the Office  of Air and Radiation (OAR) and the Office of
Prevention, Pesticides,  and Toxic Substances (OPPTS) with substantial involve-
ment from the Office of Research and Development (ORD). As part of this
effort, we sought the advice of many outside experts and visionaries.

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During this collaborative process, we learned a great deal from our stakeholders.
For example, we need to further understand indoor sources of pollutants and
their health effects, integrate building design and maintenance, encourage
federal buildings to be "model" indoor environments, support the development
of new product technologies, and educate the public. Also, we need to work
closely with other federal agencies; state, local and tribal governments; health
and community organizations; and industry and other private groups to improve
the Nation's health.

Based on stakeholder and cross-Agency input, EPA issued a draft report in
March 2000 containing a vision, goals, guiding principles, and potential actions
to improve human health indoors. The draft report was available on EPA's web
site and was sent to over 300 stakeholders representing the public, environmen-
tal and health interests, academia, federal agencies, state and local governments,
tribes, non-profit organizations, trade associations, and industry. The public was
asked to submit comments by May 31, 2000. This comment period was extended
to June 30, 2000 at the request of several commentors. We received comments
from over 40 individuals and organizations; many of them have been incorporat-
ed into the final report, or have been addressed in Appendix C. Interestingly, this
effort has attracted attention in Canada where a parallel effort, Healthy Indoors:
Achieving Healthy Indoor Environments in Canada (www.HealthyIndoors.com)
is using our draft report as a centerpiece in its stakeholder dialogues.

The draft HBHP report was  positively received, and many indicated that the
document was a significant  step in addressing an important, but often over-
looked, public health issue. Although there were a number of specific sugges-
tions for changes to the draft report, nearly all commentors felt the report was
comprehensive, and that the vision and goals captured the central themes and
needs of the issue. Several indicated that the potential actions contained in the
draft report were strategic, and that, when implemented, would be helpful in
addressing the quality of our indoor environment. A summary of the comments
is contained in Appendix C.

While many of the comments we received were incorporated, the basic structure
of the draft report has been  maintained in the final HBHP report. Chapter 1
focuses on why human health indoors deserves the scrutiny, concern, and action
of policy makers. These reasons are primarily health-related. Health risks associ-
ated with indoor environments include asthma, cancer, and reproductive and
developmental effects. However, significant gaps still exist in the current state of
knowledge about indoor environmental risks and exposures. We also believe that

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a particular emphasis must be placed on children's health. Chapter 2 presents a
vision statement and outlines goals, broad strategies, and guiding principles to
achieve success in every sector of our society over the next 25 to 50 years. In short,
our objective is to realize major human health gains over the next 50 years by
upgrading indoor environments. Five goals or strategies have been set to accom-
plish this objective: (1) achieve major health gains and improve professional
education; (2) foster a revolution in the design of new and renovated buildings;
(3) stimulate nationwide action to enhance health in existing structures; (4) create
and use innovative products, materials, and technologies; and (5) promote health-
conscious individual behavior and consumer awareness. In addition to providing
information on actions and strategies that can be taken to protect people indoors,
EPA's vision acknowledges the important role played by individuals in protecting
their own health and the health of those around them.  Chapter 3 lays out potential
actions that EPA or others may pursue.

Appendix A provides an overview of current indoor environmental program priori-
ties in various offices within EPA. Appendix B examines the  roles of the Agency's
partners in indoor environmental protection, including  federal, state, local, and
tribal organizations, as well as stakeholders in the private sector. Appendix C pro-
vides a summary of the comments on the draft report and how the comments can
be accessed through our docket.

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ACRONYMS
ACGIH         American Conference of Governmental Industrial Hygienists
AIA            American Institute of Architects
AIDS           Acquired Immune Deficiency Syndrome
AMCL          Alternative Maximum Contaminant Level
ANSI           American National Standards Institute
ASHRAE        American Society of Heating, Refrigerating, and Air-Conditioning Engineers
ASTHO         Association of State and Territorial Health Officials
ASTM          American Society for Testing and Materials
ATSDR         Agency for Toxic Substances and Disease Registry
BEIR           National Academy of Sciences' Committee on the Biological Effects of Ionizing
                Radiation
CDC           Centers for Disease Control and Prevention
CDN           Clinical Directors Network
CDPHE         Colorado Department of Public Health and the Environment
CERCLA        Comprehensive Environmental Restoration Compensation and Liability Act
CLI             Consumer Labeling Initiative
CO             Carbon Monoxide
CPSC           U.S. Consumer Product Safety  Commission
DHHS          U.S. Department of Health and Human Services
DINP           Diisononyl Phthalate
DOC           U.S. Department of Commerce
DOE           U.S. Department of Energy
DOL           U.S. Department of Labor
ECOS           Environmental Council of the States
EPA            U.S. Environmental Protection Agency
ETS            Environmental Tobacco Smoke
E TV            Environmental Technology Verification
FCIC           Federal Consumer Information Center
FHA           Federal Housing Administration
FIFRA          Federal Insecticide, Fungicide, and Rodenticide Act
GSA           General Services Administration
HBHP          Healthy Buildings, Healthy People
HMOs          Health Maintenance Organizations
HUD           U.S. Department of Housing and Urban Development
HVAC          Heating, Ventilating, and Air-Conditioning
IAQ            Indoor Air Quality
IEQ            Indoor Environmental Quality
IQ              Intelligence Quotient
IUR            TSCA Inventory Update Rule
MCL           Maximum Contaminant Level

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MHE           Master Home Environmentalist
NAHB          National Association of Home Builders
NAHB-RC      National Association of Home Builders-Research Center
NAS            National Academy of Sciences
NCEA          EPA National Center for Environmental Assessment
NCI            National Cancer Institute
NCSL          National Conference of State Legislatures
NEHA          National Environmental Health Association
NERL          EPA National Exposure Research Laboratory
NGA           National Governors Association
NH COSH      New Hampshire Coalition for Occupational Safety and Health
NHEERL       EPA National Health and Environmental Effects Research Laboratory
NIH            National Institutes of Health
NIOSH         National Institute for Occupational Safety and Health
NIST           National Institute of Standards and Technology
NRMRL        EPA National Risk Management Research Laboratory
OAR            EPA Office of Air and Radiation
OARM          EPA Office of Administration and Resources Management
OCHP          EPA Office of Children's Health Protection
OECA          EPA Office of Enforcement and Compliance Assurance
OEJ             EPA Office of Environmental Justice
OGWDW       EPA Office of Ground Water and Drinking Water
OPEI           EPA Office of Policy, Economics, and Innovation
OPPTS          EPA Office of Prevention, Pesticides, and Toxic Substances
ORD            EPA Office of Research and Development
OSHA          Occupational Safety and Health Administration
OSHAct        Occupational Safety and Health Act
OSW           EPA Office of Solid Waste
OSWER        EPA Office of Solid Waste and Emergency Response
OW            EPA Office of Water
PBT            Persistent, Bioaccumulative, and Toxic
PESP           Pesticide Environmental Stewardship Program
PHSA          Public Health Services Act
PTI             Pub lie Technology, Inc.
SBS             Sick Building Syndrome
SIDS            Sudden Infant Death Syndrome
TSCA          Toxic Substances Control Act
UL             Underwriters Laboratories
USDA          U.S. Department of Agriculture
VA             Veteran's Administration
VOC            Volatile Organic Compound

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CONTENTS
       CHAPTER 1
                      Why Study Human Health Indoors?	 1
                         Background	2
                         Principles for HBHP 	3
                         Indoor Human Health Risks	4
                         Uncertainties	8
                         Who is Most at Risk?  	9

       CHAPTER 2
                      Vision and Goals	 11
                         Vision	 12
                         Goals to Achieve the Vision	 13
                         Principles for the Future  	 17

       CHAPTER 3
                      Potential Actions 	23
                         Overview	24
                         Potential Actions for Goal 1  	27
                         Potential Actions for Goal 2  	31
                         Potential Actions for Goal 3  	36
                         Potential Actions for Goal 4  	40
                         Potential Actions for Goal 5  	46

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REFERENCES
                 References 	51

APPENDIX A
                 Indoor Environments: Current Program Priorities 	53
                    Overview	54
                    Office of Air and Radiation	57
                    Office of Prevention, Pesticides, and Toxic Substances	60
                    Office of Research and Development	63
                    Office of Solid Waste and Emergency Response  	67
                    Office of Enforcement and Compliance Assurance  	69
                    Office of Water	 70
                    Office of Children's Health Protection	 71
                    Office of Administration and Resources Management	 74
                    Regional Offices  	 75

APPENDIX B
                 Partners in Indoor Environmental Protection  	 77
                    Other Federal Agencies	 78
                    State, Local, and Tribal Agencies	 89
                    Other Stakeholders	 91
APPENDIX C
                 Comments on the Draft Report	97

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CHAPTER 1
WHY STUDY HUMAN HEALTH INDOORS?
                                         BACKGROUND	2
                                         PRINCIPLES
                                         FORHBHP 	3
/////ill H
                                         INDOOR HUMAN
                                         HEALTH RISKS	4
                                         UNCERTAINTIES ... 8
                                         WHO IS MOST
                                         AT RISK? 	9

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WHY STUDY HUMAN HEALTH INDOORS?  •  CHAPTER 1
BACKGROUND
                        Americans spend about 90 percent of their time indoors, where concentrations
                        of pollutants are often much higher than those outside. Risk assessments
                        performed for radon, environmental tobacco smoke (ETS), and lead have
                        shown that health risks are substantial. Thousands of chemicals and biological
                        pollutants are found indoors, many of which are known to have significant
                        health impacts both indoors and in other environments. Although much is
                        known or suspected regarding human health risks in the indoor environment,
                        a comprehensive, integrated effort to assess and manage indoor risks has yet
                        to be undertaken.

                        In 1987,  the EPA Comparative Risk Project was conducted to examine the
                         relative  risk of environmental problems. In 1990, the Relative Risk  Reduction
                        Strategies Committee of EPA's Science Advisory Board conducted a similar,
                        extensive analysis of relative environmental risk. Both resulting reports,
                        Unfinished Business: A Comparative Assessment of Environmental Problems (U.S.
                        EPA 1987) and Reducing Risk: Setting Priorities and Strategies for Environmental
                        Protection (U.S. EPA 1990), ranked indoor air pollution among the top five envi-
                        ronmental risks to public health. In 1997, the Presidential and Congressional
                        Commission on Risk Assessment and Risk Management also found that indoor
                        environmental pollution can pose a substantial environmental risk  and advised
                        EPA to address those risks. During the release of its report, the Commission
                        chairman highlighted indoor environmental pollution as one of the greatest
                        risks to human health.

                        Americans are concerned about their own health and the health of their
                        children. However, despite efforts by EPA and other private and public groups
                        to conduct research on indoor environmental issues and to communicate the
                        findings of that research, most Americans do not have a clear sense of the
                        significant health risks  of indoor pollution. They also do not know what they
                        can do to reduce risk for asthma, cancer, and other serious diseases caused by
                        indoor pollutant exposure.

                        Nor do many building professionals yet understand how to integrate indoor air
                        quality objectives into the design and operation of the Nation's buildings. The
                        economic value of improved health and productivity can be substantial, and
                        can be achieved through integrated building design, commissioning, and oper-
                        ations which may reduce costs or result in only modest cost increases. Thus,
                        indoor air quality promises to become an important part of the movement
                        toward green buildings and green products. Further, any productivity gains will
                        serve to  enhance the Nation's competitiveness in the global economy.

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PRINCIPLES  FOR  HBHP
The following two principles will serve to provide a workable context for iden-
tifying and addressing priorities for improving the indoor environment:

First, exposure needs to occur within or be aggravated by the building.

This principle is relatively straightforward. However, there are diverse types
of buildings, including homes, schools, day care facilities, nursing homes,
offices, factories, hospitals, hotels, restaurants, retail shops, theaters, arenas,
and correctional facilities. Impacts on human health and methods for reducing
exposure to indoor air pollution and the associated risk vary by building type,
use, and activity.

Second, risk reduction must be  accomplished through better building
design, construction, and operation; improvements in the development
and use of indoor products; or mitigation of existing exposures within a
building or in its immediate vicinity.

This principle excludes some risks that, although they occur indoors, originate
outside the building and are best mitigated at a distance. For example, risks
would be excluded if the source of the pollutant is industrial discharge (e.g.,
drinking water contaminated by lead tailings from a mine or air pollutants
entering the environment from industrial smokestacks1). Risks would be included
when the pollutant is added indoors (e.g., drinking water contaminants from lead
solder in plumbing in the building or air pollutants emitted from sources within
the building). Pesticide residues on food from the spraying of crops would be
excluded, while pesticides used directly indoors, or that are used near the home
and are tracked indoors, would be considered indoor pollution.
                                        CHAPTER 1 • WHY STUDY HUMAN HEALTH INDOORS?

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 WHY STUDY HUMAN HEALTH INDOORS? • CHAPTER 1
INDOOR  HUMAN HEALTH  RISKS
The risks to human
health indoors
include asthma,
cancer, reproductive
and developmental
problems, and other
health effects.
Exposures to radon, ETS, lead, and other chemical and biological contaminants
in the indoor environment result in a wide array of health impacts. Known
health effects of indoor pollutants include asthma; cancer; developmental
defects and delays, including effects on vision, hearing, growth, intelligence,
and learning; and effects on the cardiovascular system (heart and lungs).
Pollutants found in the indoor environment may also contribute to other
health effects, including those of the reproductive and immune systems.
Some pollutants, such as carbon monoxide (CO), are acutely toxic and can
result in death. The following sections summarize several health endpoints
of greatest concern.

ASTHMA

An estimated 17 million Americans suffer from asthma (U.S. EPA 1999).  In
addition, about 5,000 deaths occur yearly from asthma—an increase of 33
percent in the last decade (Mannino et al. 1998). Consequently, the social and
economic costs are large. Among chronic diseases, asthma is the number one
cause of absenteeism from school (Pope et al. 1993).  Asthma cost an estimated
$6.2 billion in the United States in 1990, including direct medical and indirect
non-medical costs combined (Weiss et al. 1992). An  update of this figure would
fall in the range of $7 to $9 bfflion in 1998 dollars.

Some groups in this country (e.g., children, certain  minorities, seniors, and
low-income, urban populations) are disproportionately affected by asthma.
An estimated 1.8 million people required emergency room services for asthma
in 1995. Mortality rates associated with  asthma among African-Americans,
as a whole, are two- to three-fold higher than those among whites. Mortality
rates for African-American children are five-fold higher than those for their
white peers (Mannino et al. 1998). While research has not yet explained the
rise in the incidence of asthma, nor all the reasons why individuals first con-
tract it, there is general agreement that controlling indoor exposures is an
important protective measure (NAS 2000).

Recently, the National Academy of Sciences (NAS)/Institute of Medicine issued
a report on asthma and indoor air quality, confirming that dust mites and other
allergens, microorganisms, and some chemicals found indoors are triggers for

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asthma. In addition, the report stated there was sufficient evidence to link the
exposure of preschool-aged children to ETS and exposure to house dust mites
with the development of asthma (NAS 2000). ETS may significantly aggravate
symptoms of asthma for 200,000 children and may affect as many as 1,000,000
children to some extent (U.S. EPA 1992).

CANCER

A number of indoor contaminants, such as asbestos, radon, tobacco smoke,
and benzene, are known human carcinogens. Other indoor contaminants,
such as certain chlorinated solvents, polycyclic aromatic hydrocarbons,
aldehydes, and pesticides, are considered likely to cause cancer in humans.

The National Academy of Sciences, in its latest report on radon health science
(NAS 1998), concluded that radon is the second leading cause of lung cancer
in the country. NAS has estimated that about 12 percent of the lung cancer
deaths in the United States are linked to radon. They calculate the number of
lung cancer cases attributable to radon exposure to range from 15,000 to
22,000 annually.

Environmental tobacco smoke is estimated to cause an additional 3,000 lung
cancer deaths in non-smokers each year (U.S. EPA 1992).2 Other forms of
cancer have also been found to be associated with indoor pollutants
(e.g., leukemia with benzene; bladder cancer with ETS).

REPRODUCTIVE  AND DEVELOPMENTAL EFFECTS

During the period 1991-1994, almost 900,000 children aged 1-5 years had
elevated blood lead levels, which are associated with a variety of developmental
delays, including decreased intelligence quotient (IQ); stature, growth, and
hearing deficits; and learning disabilities (U.S. DHHS 1997a).The geometric
mean blood lead level for children aged 1-5 years was 2.7 ug/dl in 1991-1994. In
1999, the geometric mean was estimated to be 2.0 ug/dl for this age group. The
1999 sample was not large enough to produce reliable estimates of the number
of children with elevated blood lead levels. State surveillance data are consistent
with the decline in the national geometric mean, but the state data also confirm
                                         CHAPTER  1 •  WHY STUDY HUMAN  HEALTH INDOORS?

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WHY STUDY HUMAN HEALTH INDOORS?  • CHAPTER 1
                         that the risk for an elevated blood lead level in children remains high in some
                         counties and varies greatly among and within states (U.S. DHHS 2000). Several
                         studies indicate that common indoor pollutants such as lead and ETS can also
                         impair fetal development. A California report estimates that 9,700 to 18,600 cases
                         of low birth weight in infants are caused each year by ETS (NCI 1999).

                         Many other environmental agents,  including a number of chemicals
                         commonly found indoors (e.g., tobacco smoke, some pesticides, lead and
                         other heavy metals, alcohols, plastic additives), are suspected of causing devel-
                         opmental toxicity in humans (U.S. EPA 1991a, NCI 1999). Endocrine disrupters
                         (e.g., certain pesticides and plasticizers), which affect the normal function of
                         sex and thyroid hormones, present a new area of concern for reproductive
                         toxicity. Adverse effects on  a developing child may result from exposure prior
                         to conception in either parent, exposure during pregnancy, or post-natal
                         exposure. These effects range from  low birth weight to genetic diseases to
                         lower IQs and infertility.

                         OTHER HEALTH  EFFECTS

                         Indoor environments can cause or amplify many other health effects as well. The
                         California ETS report estimates that 35,000 to 62,000 cardiovascular deaths per
                         year among non-smokers can be attributed to ETS exposure (NCI 1999). Recent
                         studies have shown that, compared to those who had not been exposed, ETS was
                         associated with a 20 percent increase in the progression of atherosclerosis (hard-
                         ening of the arteries) (Howard et al.  1998). Carbon monoxide poisoning associat-
                         ed with the improper use and maintenance of fuel-burning appliances kills more
                         than 200 people per year in this country and results in about 10,000 admissions
                         to hospital emergency rooms for treatment (U.S. CPSC 1997). An additional 600
                         to 700 accidental deaths from CO poisoning occur indoors from other sources,
                         including automobiles (Cobb and Etzel 1991). The agent for Legionnaires'disease,
                         a potentially deadly pneumonia which affects 10,000 to 15,000 people each year,

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is associated with cooling systems, whirlpool baths, humidifiers, food market
vegetable misters, and other indoor sources, including residential tap water (EPA
et al. 1994; U.S. DHHS 1997b). Effects associated with toxins from indoor fungi
and bacteria range from short-term irritation to immunosuppression and cancer
(EPA et al. 1994).

Studies show that symptoms of sick building syndrome (SBS) may be caused
or intensified by indoor environmental problems (U.S. EPA 1991b, U.S. EPA
et al. 1994). The term"sick building  syndrome/'first employed in the 1970s,
describes a spectrum of specific and non-specific complaints reported by a
population of building occupants. These symptoms can be associated with
their presence in the building. These complaints may also result from causes
other than SBS, including illness contracted outside the building, acute
sensitivity (e.g., allergies), job-related stress or dissatisfaction, and other
factors. Data are insufficient to  thoroughly evaluate many SBS problems.
                                         CHAPTER 1 • WHY STUDY HUMAN HEALTH  INDOORS?

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 WHY STUDY  HUMAN HEALTH INDOORS? • CHAPTER 1
UNCERTAINTIES
                        Although EPA has estimated the carcinogenic potency of a number of
                        indoor pollutants, the Agency has conducted comprehensive population risk
                        assessments for only a few substances (e.g., radon, ETS, lead). A comprehen-
                        sive indoor environments risk assessment should cover all of the chemical and
                        biological indoor pollutants for which sufficient toxicological and exposure
                        data exist.

                        Most chemicals in commercial use have not been tested for possible health
                        effects. Fewer than one-third of regulated, high-production chemicals, includ-
                        ing many found indoors, have undergone even a screening level of testing
                        for adverse effects. Health effects data are particularly critical for indoor expo-
                        sure because median indoor concentrations are one to five times the median
                        outdoor concentrations of many hazardous air pollutants. Considering that
                        people spend approximately 90 percent of their time indoors, median indoor
                        exposures (concentration  multiplied by time) may be 10 to 50 times higher
                        than outdoor exposures (U.S. EPA 1998).

                        Significant uncertainties exist in the areas of exposure assessment and control.
                        For example, data are lacking on the rate and frequency of emissions from many
                        sources, such as building materials and consumer products. There is also a lack of
                        data on the identity of the  chemicals emitted, as well as on the cost and perform-
                        ance of solutions to reduce exposures. While there are standard methods to
                        quantify emissions from certain types of products and materials (e.g., carpets,
                        office furniture, paints), many more  are needed to facilitate widespread commer-
                        cial development of new products and materials that emit significantly lower lev-
                        els of indoor pollutants.  Significant uncertainties still exist regarding how a
                        change in building design, operation, and maintenance will influence the mix of
                        indoor pollutants, as well as how to measure the concentrations of biological
                        contaminants present indoors. Exposures in schools, residences, and most other
                        non-occupational indoor environments still remain largely unstudied.

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WHO IS  MOST AT  RISK?
Children often experience higher exposures to environmental pollutants than
adults because, per pound of body weight, they breathe more air and ingest
more material than adults. Children also more readily absorb contaminants.
Additional exposure pathways resulting from activities such as crawling and
sucking and gnawing on toys can also elevate risk for children. For example,
between 1991 and 1994, almost 900,000 children in this country had unaccept-
able blood lead levels from exposure in their own homes (U.S. DHHS 1997a).
Minority status, income status, and age of housing have all been shown to
correlate with elevated blood lead in children. Children are more susceptible to
the effects of lead exposure because their brains are still developing, they ingest
more lead than adults through hand-to-mouth activity, and their developing
systems more readily absorb lead than those of adults (U.S. EPA 1996).

EPA estimates that ETS is responsible for between 150,000 and 300,000 lower
respiratory tract infections in infants and children under 18 months of age, as
well as an increased prevalence of fluid build-up in the middle ear. This is
estimated to result in between 7,500 and 15,000 hospitalizations each year.
Post-natal ETS exposure has also been implicated in 1,900 to 2,700 cases of
sudden infant death syndrome (SIDS) annually (NCI 1999).

Individuals may be more vulnerable to indoor contaminants because of age,
genetics, nutrition, metabolism, exposure levels, existing diseases, and other
factors. For example, older people are at particular risk for adverse effects on
the nervous and cardiovascular systems; asthmatics are more vulnerable to
allergens and respiratory irritants; and people with acquired immune  deficiency
syndrome (AIDS)  and other  immunodeficiencies  are more vulnerable to
pneumonia, pathogenic yeasts, and other illnesses.
                                         CHAPTER  1  •  WHY STUDY HUMAN  HEALTH INDOORS?

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      WHY STUDY HUMAN HEALTH INDOORS? •  CHAPTER  1
      END NOTES
                              1When attempting to reduce the "total" impact on human health, knowledge
                               of the relative risk from ambient air pollutants that make their way indoors
                               and from pollutants emitted by indoor sources will determine the focus of
                               where the most effective risk reduction can occur.

                              2 A U.S. District Court decision vacated several chapters of EPA's 1993 scientific
                               risk assessment document that served as the basis for EPA's classification of
                               secondhand smoke  as a Group A carcinogen and  estimates that ETS causes
                               3,000 lung cancer deaths in  non-smokers each year. The ruling was largely
                               based on procedural grounds. EPA is appealing this decision. None of the
                               findings concerning the serious respiratory health effects of secondhand smoke
                               in children was challenged.

                               EPA firmly maintains that the bulk of the scientific evidence demonstrates
                               that ETS causes lung cancer and other significant  health threats to children and
                               adults. EPA's 1993 report estimating the risks posed by ETS was peer-reviewed
                               by 18 eminent, independent scientists who unanimously endorsed the study's
                               methodology and conclusions. Since then, numerous independent health studies
                               have presented an impressive accumulating body  of evidence that confirms and
                               strengthens the EPA findings. It is widely accepted in the scientific and public
                               health communities that secondhand smoke poses significant health risks to
                               children and adults.
10

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CHAPTER 2
VISION AND GOALS
                                             VISION
.12
                                             GOALS TO ACHIEVE
                                             THE VISION 	13
                                             PRINCIPLES FOR
                                             THE FUTURE 	17

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VISION
  STRATEGIES
  •  Leveraging
     Action Through
     Partnerships

  •  Encouraging
     New
     Technologies

  •  Market
     Incentives

  •  Research and
     Development

  •  Legislation,
     Policy, and
     Standards

  •  Education and
     Information
All across our nation, people live, work, and learn in healthy indoor
environments. The environments inside our buildings help us reach our
full potential for good health and productivity. No one is excluded: we
create healthy buildings at every income level and help all our children
grow up to be healthy adults. We understand the importance of healthy
indoor environments, create a demand for them, and expect them as
something that everyone deserves. By choosing designs, ventilation systems,
materials, and products wisely, we are able to create healthy buildings
while substantially reducing energy use, cutting materials costs, and raising
productivity. The Nation's success in improving human health indoors
serves as a model for better building design and construction, rehabilitation
and maintenance, and product development around the world.


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GOALS TO ACHIEVE  THE VISION
Our Objective:  To Achieve Major Human Health Gains Over the Next
               50 Years By Upgrading Indoor Environments.

GOAL 1:

  Achieve Major Health Gains and Improve Professional Education

  •  Known risks from indoor environments are effectively addressed, lead-
     ing to significant health gains in many areas, including:

        Avoidance of excess lung cancer deaths caused by exposure
        to radon, ETS, and asbestos.

        Avoidance of excess cancer deaths caused by indoor exposure to
        volatile organic compounds and other chemicals.

        Avoidance of delays in physical and mental development in
        children, lowered IQ levels, shortened attention  spans, and
        behavioral problems associated with elevated blood lead levels.

        Avoidance of excess deaths, illness, and lost school/work time from
        asthma and other respiratory diseases; improved comfort for the
        estimated 17 million Americans who have asthma, and many of the
        more than 50 million who suffer from allergies.

        Significant reductions in the spread of infectious diseases, such
        as tuberculosis, Legionnaires' disease, and influenza.

        Significant reductions in other health effects, including eye, nose
        and throat irritation, headaches, fatigue, loss of coordination, nausea,
        developmental and reproductive damage, and damage to the liver, kid-
        neys, and central nervous system.

        Major productivity gains from improvements in worker and
        student performance.

  •  The most important risks posed by indoor environments are identified
     and quantified,  and communicated in an appropriate manner for the
     general public; risks from interactions of toxins and  cumulative low-level
     exposures are clarified.
GOAL 1:
Achieve Major
Health Gains and
Improve
Professional
Education

GOAL 2:
Foster a Revolution
in the Design of
New and Renovated
Buildings

GOAL 3:
Stimulate
Nationwide Action
to Enhance Health
in Existing
Structures

GOAL 4:
Create and Use
Innovative Products,
Materials, and
Technologies

GOAL 5:
Promote Health-
Conscious
Individual Behavior
and Consumer
Awareness
                                                           CHAPTER 2 • VISION AND  GOALS   13

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      VISION AND GOALS  •  CHAPTER  2
                                •   Information about indoor health risks and healthy indoor environments is
                                    fully integrated into professional curricula and the training and practice of
                                    health, science, manufacturing, and building professionals.

                               GOAL 2:

                                Foster a Revolution in the Design of New and Renovated Buildings

                                •   The planning and construction of nearly all new buildings is based
                                    on an integrated design1 process that looks at whole-building systems
                                    and seeks out least-cost strategies for simultaneously achieving health-
                                    enhancing indoor environments, efficiency in the use of energy and
                                    materials, high functionality, comfort, and productivity.

                                •   New buildings  with health-enhancing indoor environments and high
                                    energy efficiency  cost no more to own and operate than conventional
                                    buildings, and often cost less.

                                •   Cost-effective building rehabilitation, renovation, and remodeling
                                    strategies have been developed that address all major identified risks
                                    in the indoor environment.

                                •   Residential and non-residential rehabilitation, renovation, and
                                    remodeling projects are undertaken using integrated design processes
                                    and achieve large improvements in indoor environmental quality,
                                    energy efficiency, and productivity.

                                •   The great majority of new and renovated buildings are designed for
                                    easy maintenance with low-impact products and procedures.
14

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GOAL 3:

  Stimulate Nationwide Action to Enhance Health in Existing Structures

  •  Guidelines for healthy building operation, maintenance, renovation, and
     remodeling are developed and routinely followed in commercial and
     office buildings.

  •  Standards of care and livability are developed and routinely followed in
     residential rental buildings.

  •  Building managers and engineers, maintenance and custodial workers,
     trash handlers, recyclers, renovators, and others who contribute directly to
     maintaining clean, healthy indoor environments have proper training and
     the capability to carry out their work.

GOAL 4:

  Create and Use Innovative  Products, Materials, and Technologies

  •  Building materials and consumer products that pose potential health and
     environmental risks are subject to standardized, life-simulation tests.

  •  An easily understood "green labeling" system has been developed that
     allows consumers to assess health risks and make informed choices
     among building materials and consumer products used indoors.

  •  Low-toxicity, resource-efficient products are widely available in all indoor
     product areas and usually cost no more than conventional products.

  •  Low-cost testing kits and sensors for detecting exposure to a wide range of
     indoor pollutants and assessing personal risks are available to all.
                                                               CHAPTER 2 •  VISION AND GOALS    15

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      VISION AND GOALS • CHAPTER 2
                              GOAL 5:

                                Promote Health-Conscious Individual Behavior and Consumer Awareness

                                •  Everyone is aware of the importance of indoor environments for
                                   maintaining and enhancing health. Indoor environmental quality is
                                   seen as just as important to health as environmental quality outdoors.

                                •  Nearly everyone is familiar with how to access information about indoor
                                   environments, including information on health effects, environmental
                                   impacts, pollution prevention strategies, integrated building design, and
                                   indoor enviro-friendly products.

                                •  Information is easily available and useful to the general public (including
                                   access in multiple languages) and to all relevant constituencies, including
                                   building professionals, product manufacturers, and health professionals.

                                •  Nearly all involuntary exposure to ETS has ceased, so that it is no longer
                                   a significant health threat.

                                •  The great majority of homeowners, tenants, and landlords significantly
                                   reduce exposure to indoor pollutants and irritants by practicing good
                                   building maintenance, e.g., controlling moisture problems, exterminating
                                   cockroaches and other vermin, changing air filters, and testing for radon,
                                   lead, asbestos, carbon monoxide, and other toxics.

                                •  More informed consumer product purchasing and use has led to a
                                   substantial reduction in health risks associated with cleaning, painting,
                                   lawn and garden care, and other aspects of personal behavior in home
                                   environments.
16

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PRINCIPLES  FOR THE FUTURE
WHOLE-SYSTEMS THINKING

From the smallest home to the largest office building, we will improve indoor
environments through an integrated design process that looks at the building
life cycle, whole-building systems, and the leverage points where individual
expenditures can generate multiple benefits. A whole-systems perspective
that evaluates the building, including its site, heating, ventilating, and air-condi-
tioning (HVAC) systems, materials, finishes, carpets, paints, appliances, and
equipment, is the key to implementing the least-cost design and remodeling.

PROTECTING OUR CHILDREN

We will create indoor environments that are healthier for everyone by
making indoor environments safer for the most vulnerable among us,
especially children. Improving indoor environments is critical to children's
health and lays the groundwork for healthier generations to come.

ENVIRONMENTAL  JUSTICE

Some population groups—usually low-income people, and often minorities
—are exposed to a  disproportional amount of environmental hazards both
indoors and outdoors, at home and at work. Economically disadvantaged
people  often have fewer chances to improve their housing or workplace
conditions. Environmental justice requires that we make extra efforts to
ensure  that these groups are equally protected.

RlGHT-TO-KNOW

Citizens have a right to know what is in their environment and how it affects
them. This allows them to make informed choices to protect themselves from
environmental health threats. This principle applies to indoor environments
just as much as to outdoor ones. It will become increasingly relevant as
low-emission products and low-cost indoor testing and sensor technologies
are marketed.
                                                          CHAPTER 2 •  VISION AND GOALS   17

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      VISION AND  GOALS • CHAPTER 2
                              ENHANCING HEALTH

                              Indoor environmental conditions can lead people to under-perform and to
                              feel less than their best without producing overt symptoms of illness. Efforts
                              to improve indoor environments should not only prevent illness, but also aim
                              to enhance health, vitality, and productive activity.

                              GOOD SCIENCE

                              Strategies for improving indoor environments need to be based on scientific
                              facts. We need a better understanding of indoor sources, people's exposure
                              in various indoor environments, how those exposures affect health and
                              productivity, and how they can be minimized by prevention-oriented,
                              least-cost strategies. We also need to know more about the relationships
                              between pollutant levels and building characteristics, operation and
                              maintenance, and furnishings.

                              POLLUTION  PREVENTION/HEALTH PROMOTION

                              Preventing indoor environmental problems from occurring in the first place is
                              far more cost-effective than remediating problems and treating illnesses after
                              they occur. The key to stopping the escalation of health care costs is to
                              "design out" the conditions which cause illness, including unhealthy
                              environments in homes, schools, and workplaces.

                              IMPORTANCE OF  WIDESPREAD UNDERSTANDING

                              Indoor environmental quality is the sum total of decisions made by an enor-
                              mous variety of individuals and institutions, including architects and builders;
                              bankers and real estate agents; academic scientists and medical professionals;
                              national, state, and local governments; building owners and managers; prod-
                              uct manufacturers and retailers; janitors and sanitation workers; employers
                              and unions; parents; consumers; and others. We can improve indoor environ-
                              ments faster if all these parties become more knowledgeable, so that the
                              impetus for change emerges from all sectors.
18

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CREATIVE PARTNERSHIPS

Improving human health indoors requires a new level of systematic coopera-
tion among disciplines, as well as the many public, private, and voluntary
organizations whose activity affects indoor environments. Partnerships among
disciplines are critical for whole-systems thinking and integrated design.
Partnerships between government and business can bolster research efforts
and speed the emergence  of profitable solutions. Partnerships among federal,
state, and local governments can accomplish far more than federal action
alone. Such creative linkages are key to improving indoor environmental
quality and lowering health risks.

FEDERAL INTEGRATION  AND  LEADERSHIP

Improving indoor environments requires better coordination within and
among federal government agencies to align efforts and set clear roles for
each organization. New efforts will be required within EPA to span internal
boundaries and collaborate more effectively with other agencies.

The federal government can lead by example and through implementing
strategies that empower others. Key areas for federal action include
constructing facilities that  are models of IEQ and developing criteria and
management systems for IEQ that provide examples for other agencies.
(EPA specifically considered IEQ as it designed and constructed its new research
facility in Research Triangle Park, NC and continues to consider the impacts  on
IEQ as it makes decisions about products and materials to be used or installed
in the building.) The federal government can also enable other stakeholders,
using strategies such as supporting research and development, providing
information, stimulating the marketplace through purchasing, and setting
standards or encouraging efforts to develop standards within the private sector.
                                                             CHAPTER 2 • VISION AND GOALS    19

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      VISION AND  GOALS • CHAPTER 2
                              RESOURCE AND  ECONOMIC EFFICIENCY

                              Strategies for improving indoor environments can be designed to promote
                              economic efficiency, spur technological innovation, and benefit business, while
                              promoting public health at the same time. Choosing designs, materials, and
                              products wisely will create healthy indoor environments while simultaneously
                              improving efficient use of energy and materials. Energy use can be reduced
                              through more efficient building envelopes, glazings, and lighting systems. The
                              need for materials can be reduced by minimum-materials design, minimum-
                              toxicity components, improved durability, more flexible building design (so
                              buildings do not have to be replaced when their use changes), and more
                              extensive recycling and reuse of building materials. Technologies to use water
                              more efficiently can also play an important role in areas where water supplies
                              are limited. Money can be saved by downsizing HVAC equipment, reducing
                              material costs, and cutting operating expenses for heating, cooling, and
                              lighting. Small businesses may require special strategies to enable them to
                              stay competitive and improve  indoor environments.

                              INTERRELATIONSHIP OF  INDOOR AND OUTDOOR  ENVIRONMENTS

                              We need to take into account the  relationship between indoor and outdoor
                              environments. Some health endpoints, like asthma, are impacted by both,
                              and the contribution of each  is not separable. Designs for healthy buildings
                              should include  energy-saving landscaping and should be tailored to deal with
                              the special problems posed by regional climates and local conditions. Healthy
                              indoor environments are easier to achieve when outdoor environmental
                              quality is high,  because what comes in from the outside affects the indoors.

                              GOALS AND MEASUREMENTS

                              Clear goals and measurements of movement toward  them must be set.
                              Appropriate measurements of success are essential for tracking and
                              demonstrating  progress, evaluating programs, and directing strategies.
20

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END NOTE
integrated design looks at all the parameters of a building, including its site,
 over its lifetime, and finds the maximum balance between good IEQ, energy
 efficiency, comfort, and materials use.
                                                          CHAPTER 2 • VISIONS AND  GOALS   21

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22

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CHAPTER 3
POTENTIAL ACTIONS
                                                   OVERVIEW  	24
                                                   POTENTIAL ACTIONS
                                                   FOR GOAL 1 	27
                                                   POTENTIAL ACTIONS
                                                   FOR GOAL 2 	31
                                                   POTENTIAL ACTIONS
                                                   FOR GOAL 3 	36
                                                   POTENTIAL ACTIONS
                                                   FOR GOAL 4 	40
                                                   POTENTIAL ACTIONS
                                                   FOR GOAL 5 	46
                                                   REFERENCES 	51

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      POTENTIAL ACTIONS • CHAPTER 3
     OVERVIEW
       The following is an
       outline of potential
       actions for the five
       goals identified in
       Chapter 2.
GOAL 1:

 Achieve Major Health Gains and Improve Professional Education

     A.  Develop a risk assessment methodology, perform research, and
        conduct assessments.

     B.  Along with other public health agencies, develop a public health
        metric (or series of metrics) as a baseline against which to demon-
        strate health gains.

     C.  Demonstrate specific health gains from good IEQ practices and
        marshal evidence to indicate that the gains are due to actions taken.

     D.  Provide information/education to foster understanding and action.

GOAL 2:

 Foster a Revolution in the Design of New and Renovated Buildings

     A.  Quantify the benefits and costs of integrated design and use this
        information to provide incentives to build/renovate buildings with
        integrated building designs.

     B.  Facilitate competitions or industry consortia to develop integrated
        building designs.

     C.  Develop and promote building system performance targets.

     D.  Develop university and continuing education curricula.
24

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GOAL 3:
  Stimulate Nationwide Action to Enhance Health in Existing Structures
     A. Identify and fill knowledge gaps for the full range of existing
        buildings.
     B.  Develop and promote excellent IEQ standards of care.
     C. Develop specific guidance documents for critical junctures in the
        life cycle of existing buildings.
     D. Develop metrics for a performance-based building rating/
        certification program.
     E.  Provide information targeted to do-it-yourselfers.
     F.  Develop homeowner/tenant checklists.
GOAL 4:
  Create and Use Innovative Products, Materials, and Technologies
     A. Further develop tools to prioritize our efforts to reduce risks from
        sources and pollutants indoors.
     B.  Document and evaluate state-of-the-art sensors, test kits, and
        indoor-related prevention and control technologies.
     C. Perform comparative exposure  and  risk  assessments on products and
        materials.
     D. Develop product testing protocols.
     E.  Work with stakeholders and outside standard-setting organizations to
        develop voluntary, consensus-based standards and guidelines.
     F.  Provide market incentives to drive manufacturers to develop both
        new products and new technologies.
     G. Work with interested stakeholders to develop and disseminate prod-
        uct labels, instructional materials, enhanced material safety data
        sheets, and product specifications.
                                                             CHAPTER 3 • POTENTIAL ACTIONS    25

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      POTENTIAL ACTIONS • CHAPTER 3
                             GOAL 5:
                              Promote Health-Conscious Individual Behavior and Consumer Awareness
                                  A. Initiate a campaign to educate society's leaders on IEQ.
                                  B. Create a healthy children program.
                                  C. Ensure consumers are well-informed.
                                  D. Provide for healthy home care.
26

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POTENTIAL  ACTIONS  FOR GOAL  1
A fundamental requirement for improving human health indoors is a
better understanding of the health risks posed by different types of indoor
environments. A comprehensive assessment of health risks across the
wide variety of indoor environments, and their relationship to ambient
pollutants, will require extensive research efforts. Issues needing further
research include test methods, basic toxicology for agents and mixtures,
and the development of biomarkers and appropriate environmental
measurements. A sustained, long-term effort is needed to identify and
quantify the most important indoor health risks.

To demonstrate how healthier buildings lead to healthier people, research
is also needed to establish public health baselines against which health gains
can be measured. Critical to achieving this goal is the quick communication
of research findings about indoor health risks, and how they can be avoided,
to building and public health  professionals, product manufacturers, and the
public. Metrics are needed to  measure the status and trends of a number of
health effects caused by poor  indoor environmental quality. This effort will
require coordination with other public health agencies interested in indoor
environmental issues. Once metrics are established, they can be used to
demonstrate health gains from appropriate risk management options.

We can improve the indoor environment most rapidly if all parties involved
become more knowledgeable, so that the impetus for change comes from all
directions.

  A.  Develop a risk assessment methodology, perform research, and
     conduct  assessments.

     These assessments will determine how potential risks posed by indoor
     exposures can be predicted accurately, quickly, and cost-effectively.
GOAL1
Achieve Major
Health Gains
and Improve
Professional
Education
                                                         CHAPTER  3 • POTENTIAL ACTIONS   27

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      POTENTIAL ACTIONS  • CHAPTER 3
                                    1.  Address multiple pathways, multiple agents, and non-traditional
                                       stressors (e.g., thermal, light, sound).

                                    2.  Develop a peer-reviewed, high-level cross-Agency research strategy,
                                       with buy-in from other agencies as well as non-federal stakeholders,
                                       designed to improve public health. This strategy may be developed at
                                       the level of the White House Committee on Environment and Natural
                                       Resources and should address:

                                       •  Appropriate test methods to assess the often symptom/complaint-
                                          related issues associated with indoor environments.

                                       •  lexicological testing for agents and mixtures, especially for agents
                                          affecting immunotoxicity, neurotoxicity and human performance.

                                       •  Vulnerable populations, particularly children.

                                       •  Development of biomarkers and  appropriate environmental
                                          measurements.

                                       •  A testing strategy to help address associated health risks.

                                       •  Measurements and models to determine exposures in various
                                          indoor microenvironments.

                                       •  Methods and models to quantify emissions from indoor sources
                                          and determine penetration of ambient pollutants indoors.

                                       •  Innovative risk management options to reduce exposures.

                                    3.  Manage a coordinated effort (government and non-government)
                                       to perform the necessary exposure, effects assessment,  and risk man-
                                       agement research.

                                    4.  Complete the EPA portion of the inter-agency research effort.

                                    5.  Establish an indoor environmental risk assessment methodology and
                                       databases for ready access.
28

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B. Along with other public health agencies, develop a public health
   metric (or series of metrics) as a baseline against which to demonstrate
   health gains.

   Metrics are needed to measure status and trends for asthma and
   allergens, productivity/human performance, irritancy, neurotoxicity,
   reproductive toxicity, infectious disease, cancer, and other health impacts.

   1.  Identify health conditions that should be included in  the public health
       baseline.

   2.  Ensure:

       • Collection of the necessary public health data to assess the  public
         health baseline.

       • Development and acceptance of public health indicators and metrics.

       • A commitment to using the indicators and metrics on a national scale.

C. Demonstrate specific health gains from good IEQ practices and marshal
   evidence to indicate that the gains are due to actions taken.

   1.  Identify specific actions, and ensure that the actions are implemented,
       documented, and tracked.

   2.  Push aggressively to implement those actions likely to produce the
       largest  reduction for each known risk.

   3.  Monitor national status and trends of public health by working with
       other public health agencies.

   4.  Demonstrate the link between improved public health and actions
       taken by assessing changes to the public health baseline.
                                                            CHAPTER 3 • POTENTIAL ACTIONS    29

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      POTENTIAL ACTIONS  • CHAPTER 3
                                D. Provide information/education to foster understanding and action.
                                    1.  Integrate information about indoor health risks and healthy indoor
                                       environments into professional curricula and health professional
                                       training, as well as training of building professionals.
                                       a. Include case studies in the educational curricula of medical
                                         professionals, architects, and engineers.
                                       b. Educate insurance and real estate agents, building sanitation
                                         engineers, code enforcement and code writing bodies, mortgage
                                         lenders, etc.
                                    2.  Develop health issue papers for the public on such known risks as:
                                       • Radon
                                       • Environmental tobacco smoke
                                       • Lead poisoning
                                       • Asthma/allergies
                                       • Infectious diseases
                                       • Reduced productivity from symptom-based conditions
                                    3.  Develop additional health issue papers as research identifies
                                       further hazards.
30

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POTENTIAL ACTIONS  FOR  GOAL 2
Dramatic improvements in the indoor environments of the next century
will be achieved with integrated design and good indoor environmental quality
planning and construction. The design and construction of new residential and
commercial buildings accounts for some $381 billion per year in the U.S. econo-
my, with new homes alone accounting for $182 billion (U.S. DOC 1996, 1997).
Extensive building renovations offer similar opportunities for improving indoor
environments. Once the poor stepsister of the building industry, non-residential
rehabilitation is now a major market. Most of this work requires total building
overhaul or major renovations, not just remodeling or repair.

A number of buildings have been constructed around the world over the
past few years using an integrated design process. They demonstrate that
improvements in energy efficiency can complement indoor environmental
upgrades. Often, integrated design actually saves money by downsizing HVAC
equipment, reducing material costs, and cutting operating expenses for heating,
cooling, and lighting. New and renovated buildings can also be designed for
easy maintenance with low-impact, high-efficiency products and procedures.

Several kinds of initiatives are needed to help integrated design move from its
present status of "innovative best practice" to standard practice. Research is
needed to establish the economic costs and benefits of integrated design and
good IEQ construction, as well as the costs of health care, productivity loss,
and poor building performance related to inferior ventilation, IEQ design, and
construction. Reliable information of this kind will eventually influence costs
for insurance, mortgages, and health care coverage, creating strong economic
incentives for integrated design.

Needed as well are new tools to provide industry and consumers with the
information they require to make sound building and renovation decisions.
Professionals in the design and building industries need to agree on the
elements of good IEQ design and on appropriate ways to measure and com-
pare the features offered by given designs. Collaboration with professionals
and organizations in the design, engineering, construction, building
GOAL 2
Foster a Revolution
in the Design of
New and Renovated
Buildings
                                                           CHAPTER 3 • POTENTIAL ACTIONS   31

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      POTENTIAL  ACTIONS • CHAPTER 3
                                products, real estate, government, and public health communities is essential
                                to speed change in professional practice, professional curricula, and standards
                                and code setting.

                                  A.  Quantify the benefits and costs of integrated design and use this
                                     information to provide incentives to build/renovate buildings with inte-
                                     grated building designs.

                                     Integrated design simultaneously achieves good indoor environmental
                                     quality, energy efficiency, high functionality, comfort, and productivity.
                                     Building design, construction, and procurement professionals need sound
                                     financial arguments to make healthy indoor environment features a priority
                                     in new buildings.

                                     1.  Convene a stakeholder process to define good/superior IEQ for
                                         various building types.

                                     2.  Collect existing information and perform needed research to quantify
                                         initial building and lifetime costs of superior IEQ and the savings from
                                         improved health, productivity,  and building systems performance. Focus
                                         on energy, productivity, absenteeism, cost of law suits and worker's
                                         compensation, tenant turnover/retention, sale of homes, rental rates,
                                         costs of implementing guidance, and assessment of the market value
                                         for a "healthy building."

                                     3.  Use existing data and research results to develop building design
                                         simulation packages that demonstrate the consequences of building
                                         design and product choice on the health, economics, and productivity of
                                         the occupants. Address air quality,  air flow, energy consumption, life cycle
                                         effects, moisture intrusion, humidity, and health/productivity impacts.

                                     4.  Promote integrated design cost/benefit information for good decision
                                         making by:

                                         a.  Widely disseminating cost/benefit information to builders,
                                            product manufacturers, commercial realtors, insurance and
32

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      mortgage companies, public health professionals, and consumers to
      improve understanding and encourage integrated designs.

   b.  Championing insurance industry rate incentives for superior
      IEQ buildings using cost-benefit arguments. Work with consumer
      advocacy organizations and insurance companies or their profes-
      sional organizations to pioneer reduced premium costs for holders of
      health, home, or commercial property insurance policies who have
      created high-quality indoor environments.

    c. Creating primary and secondary mortgage banking instruments that
      result in savings for residential remodeling and new construction
      projects  that use integrated design. Use cost-benefit arguments that
      demonstrate savings from improved systems performance, lowered
      taxes, and improved insurance rates, and work with consumer
      groups and mortgage bankers to craft lower debt-to-equity rates for
      residential lending. This program may be modeled on or integrated
      with the Energy Efficient Mortgage program.

   d.  Working with school districts to revise how schools allocate
      resources, taking into account the cost of new construction,
      maintenance, and future costs, and revising federal and state
      formulas to reflect these factors.

   e.  Educating consumers on the benefits of an integrated design
      approach.

Facilitate competitions or industry consortia to develop integrated
building designs.

Options to be  considered:

1.  Establish a consortia of designers, manufacturers, and other
   stakeholders to develop the designs and the building materials
   for high-performance buildings.
                                                        CHAPTER 3 •  POTENTIAL  ACTIONS    33

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      POTENTIAL ACTIONS  • CHAPTER 3
                                     2.  Promote juried design competitions, undertaken with other
                                        stakeholders, that focus the creativity of architects and designers on
                                        improved indoor environments.

                                     3.  Provide grants to show that integrated designs are feasible.

                                 C.  Develop and promote building system performance targets.

                                     1.  Through a stakeholder process, develop IEQ performance targets for
                                        new or renovated buildings. Work with established voluntary standards-
                                        setting organizations to create a unified set of voluntary standards,
                                        incorporating key lEQ-related variables (maintainability, air quality,
                                        energy efficiency, air flow, ventilation, materials selection, limiting
                                        moisture intrusion, controlling humidity, and feedback loops for
                                        measurement and evaluation). Develop a voluntary ratings system
                                        that predicts performance.

                                     2.  Procure a Presidential Executive  Order requiring new or renovated
                                        federal buildings to comply with the voluntary standards.

                                     3.  Establish a green codes program where localities lower permitting
                                        fees, cut taxes, or simplify procedures for buildings that adhere to a
                                        voluntary IEQ buildings rating system. Work with international code
                                        officials and local government organizations responsible for building
                                        codes to develop model programs. Where possible, integrate green
                                        code efforts with American Institute of Architects  (ALA.) and other
                                        existing green buildings efforts (U.S. Green Buildings Council, Energy
                                        Starฎ, the Office of Policy, Economics, and Innovation (OPEI) Smart
                                        Growth Network, and the OPEI/Office of Solid Waste (OSW)/National
                                        Association of Home Builders (NAHB) Research Center program) to
                                        develop a local green builder program model.

                                     4.  Create a recognition program for  integrated-design buildings.
                                        Highlight buildings built with whole-systems design, including
34

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       schools, office buildings, and low- and moderate-income housing.
       Assist in developing an industry organization or an independent
       authority to establish and oversee a recognition program that directs
       potential consumers to the benefits offered by the building's good
       IEQ. Integrate these efforts with existing green buildings efforts.

D.  Develop university and continuing education curricula.

    Develop curricula and work with state licensing agencies to incorporate
    integrated design standards and continuing education requirements for
    designers, architects, engineers, and health professionals. Begin a certifi-
    cation process for companies and individuals for added marketability
    and develop a mechanism for recognition and price differentiation in
    the marketplace. Develop integrated design components for existing
    professional training programs. Partner with state contractor licensing
    organizations, builders, remodelers, and other industry groups to promote
    integrated design standards.
                                                             CHAPTER 3 •  POTENTIAL  ACTIONS    35

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      POTENTIAL ACTIONS • CHAPTER 3
      POTENTIAL ACTIONS  FOR GOAL  3
       GOALS
       Stimulate
       Nationwide Action
       to Enhance Health
       in Existing
       Structures
The indoor environments of existing structures must also be considered. Each
year, the inventory of existing buildings grows both older and larger. From the
point of view of human health, therefore, it is important to improve the indoor
environmental quality of existing buildings so that virtually everyone lives and
works in healthy surroundings.

Because industrial environments are unique and, for the most part, well-regu-
lated, our efforts focus on non-industrial buildings of all types. These non-
industrial buildings range from single-family, owner-occupied structures to
large multi-tenanted residential buildings; from small retail establishments to
large office buildings; from hospitals to prisons to schools.

Several types of initiatives can combine to improve IEQ in existing buildings.
Guidelines can  be developed and promoted for improving IEQ in routine
remodeling and repairs. Standards of care and livability for healthy building
operation and maintenance can be institutionalized. Research can support the
development of guidance and make outreach programs more effective.
Education and training programs can ensure that those responsible for manag-
ing and maintaining buildings have the ability to perform their work. Better
measures of building performance and recognition programs can heighten
awareness of the issue in general and the status of particular buildings.
Enhancements to energy efficiency can be made in tandem and can often pay
the bill for IEQ  improvements.

  A.  Identify and fill knowledge gaps for the full range of existing buildings.

     Buildings of interest cover a wide spectrum and can include residences,
     hospitals, and hotels.

     1. Develop and carry out a data inventory analysis and a research
        agenda in the following areas:

        •  Current IEQ in non-office buildings. (EPA has recently completed
           the data  collection phase of a baseline study of office buildings.)

        •  Short-and long-term costs and benefits of good IEQ, including such
           factors as improved health (and health costs), energy, productivity,
           absenteeism, cost of law suits and worker's compensation, tenant
36

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         turnover/retention, fire susceptibility, equipment life expectancy, sale
         of homes, rental rates, costs of implementing guidance, and assess-
         ment of the market value for a "healthy building."

       • IEQ diagnostic protocols and detection technologies.

       • Building ventilation control technologies that are most effective
         from IEQ and energy standpoints.

       • Building maintenance protocols and their impact on IEQ, includ-
         ing cleaning and maintenance products.

       • Building IEQ remediation protocols.

    2.  Target a building with stable historical data and identify stakeholders
       who can study the effectiveness of EPA's  guidance in improving IEQ
       and its effect on health, including quantifying effects through health
       insurance claims, sick leave, and productivity  gains and losses.

B.  Develop and promote excellent IEQ standards of care.

    1.  Work with stakeholders to facilitate the creation of integrated IEQ
       standards of care for different building types, taking into account the
       interrelated roles and responsibilities of building owners, managers,
       occupants, and tenants.

    2.  Procure a Presidential Executive Order requiring existing federal
       buildings (both owned and leased) to comply with integrated IEQ
       standards of care.

    3.  Encourage the adoption of IEQ  standards of care in mortgage and
       insurance policies and rates, hospital certification, voluntary practice
       guidelines, and building codes.

    4.  Develop a voluntary Building Coalition dedicated to promoting
       the  adoption of IEQ standards of care. The Coalition could: develop
       an outreach mechanism/tool to encourage adoption, including the
       development of training outlined below; create a building recognition
                                                             CHAPTER 3 • POTENTIAL ACTIONS    37

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      POTENTIAL ACTIONS • CHAPTER 3
                                       program; manage the development of the IEQ performance index;
                                       and serve as the focal point for future progress on IEQ in existing
                                       buildings.

                                    5.  With stakeholders, develop training and other tools to educate
                                       various audiences on IEQ standards of care. Promote adoption by
                                       institutions that educate architects, engineers, home inspectors, and
                                       other building professionals, and as continuing education or
                                       a prerequisite for certification by professional organizations. Promote
                                       education and training programs to ensure that building managers
                                       and engineers, maintenance and custodial workers, trash handlers,
                                       pest management contractors, recyclers, and others who contribute
                                       directly to maintaining indoor environments have the information
                                       and capabilities they need for carrying out their work. Ensure that
                                       training and other tools reach other IEQ service providers, local
                                       health officials, and residential audiences.

                                C.  Develop specific guidance documents for critical junctures in the life
                                    cycle of existing buildings.

                                    1.  Improve the indoor environment and educate people about the
                                       IEQ effects  of decisions and activities that may result in increased
                                       hazards, including disturbance of asbestos and lead paint.
                                       Key events  may occur:

                                       •  During remodeling

                                       •  At sale of building/home

                                       •  At building commissioning and decommissioning

                                       •  During annual safety inspection

                                       •  During tenant improvement projects

                                       •  During building recertification

                                       •  After flooding/fire/storms
38

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   2.  Develop outreach programs to encourage people to take action.

D. Develop metrics for a performance-based building rating/certification
   program.

   1.  Facilitate stakeholder development of an IEQ performance metric
       for different building types that utilizes research done under other
       action items elsewhere in this plan (e.g., baseline data on IEQ,
       health effects data, cost/benefit information).

   2.  Facilitate the establishment of a performance-based rating/
       certification program that utilizes an IEQ performance metric
       and baseline data to develop a voluntary performance standard
       or threshold and a verification protocol. Promote this program to
       building owners, insurers, occupants, government officials, and con-
       sumers using a variety of success stories.

E. Provide information targeted to do-it-yourselfers.

   Work in partnership with major hardware retailers, and other organizations
   that target do-it-yourselfers, to include point-of-purchase displays, print
   advertising, promotion of products meeting good IEQ standards, and home-
   owner on-line workshops with IEQ experts. Focus materials and activities
   on raising homeowner awareness of good renovation design for IEQ.

F. Develop homeowner/tenant checklists.

   Develop instruments that allow homeowners/tenants to do their own
   IEQ self audits which identify issues in the home and stress the impor-
   tance of proper cleaning and maintenance of home appliances. Develop
   and implement a strategy to disseminate these checklists widely.
                                                            CHAPTER  3 • POTENTIAL  ACTIONS    39

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      POTENTIAL ACTIONS • CHAPTER 3
      POTENTIAL ACTIONS  FOR GOAL 4
       GOAL 4
       Create and Use
       Innovative
       Products, Materials,
       and Technologies
The products, materials, and technologies that we use inside our buildings are
another potential source of indoor environmental problems. A key component
for achieving building improvements is the use of building materials, during
construction and renovation, which produce low levels of any potentially harm-
ful emissions.

Many strategies are available to accelerate the innovation of products,
materials, and technologies. The most fundamental approach is to develop
a reliable emissions testing system, to perform comparative risk assessments,
and to develop voluntary, consensus-based guidelines and standards to assist
in the evaluation of products, materials, and technologies. The results of
standardized testing can be used to develop low-toxicity products that are
competitively priced with conventional products and can serve as a basis
for developing information to assist consumers in making informed choices
among products, materials, and technologies used indoors.

Voluntary guidelines and standards for products, materials, and technologies can
take many forms. For example, guidelines or standards might ask a manufacturer
to provide emission levels from a product for comparative purposes with other
similar products, or they may set a level above which a product is regarded as
"unsafe/'They may also ensure the appropriate use of products (e.g., labeling on
the use of adequate ventilation or limiting the use to certified applicators). In
addition, certain industry members who perform well in reducing emission
levels may be recognized under a program similar to the EPA Green Lightsฎ or
Energy Starฎ programs.

While the first line of defense is to prevent pollution by controlling sources
of indoor pollutants, rapid progress is also needed in monitoring and control
technologies. Low-cost sensors and test kits, for example, will eventually make
it possible for nearly everyone to assess their risks indoors. Improvements
are needed in technologies to "clean" air and to increase ventilation efficiency
in buildings.
40

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A.  Further develop tools to prioritize our efforts to reduce risks from
    sources and pollutants indoors.

    In consultation with all interested stakeholders, continue developing
    and using tools to prioritize those products and materials that may
    present the greatest exposures and risks to human health indoors. This
    prioritization should address both the health risks and potential benefits
    of the products and materials. Continually review and update the tools
    as new information becomes available on product formulations and
    emissions, exposure data, and toxicity information.

    1.  Work with all interested stakeholders to collect and compile
       additional existing data to assist in this prioritization.

    2.  Seek input, through stakeholder workshops, on those priority
       consumer products and building materials that, based upon the
       best available data, have the largest relative impact on health in
       indoor environments based on both chemical and biological
       contaminant emissions.

    3.  In the interest of the  public's right to know, make summaries of
       the publicly available chemical formulations in product categories
       available through a web page and prepare chemical exposure and toxic-
       ity fact sheets for the chemicals and product categories that are acces-
       sible through this web page.

B.  Document and evaluate state-of-the-art sensors, test kits, and indoor-
    related prevention and control technologies.

    1.  Survey, monitor, document, and assess the status and progress
       of technologies based on efficacy, health impacts  (e.g., enhanced
       growth of microorganisms, chemical emissions), and cost; identify
       the trends, technical issues, and needs of future development.

    2.  Publish and periodically update this analysis in a database, by tech-
       nology type; use the database as a source of information on current
       technologies and as a measurement tool to assess progress in stimu-
       lating research and development to improve these devices.
                                                            CHAPTER  3 • POTENTIAL  ACTIONS    41

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      POTENTIAL ACTIONS • CHAPTER 3
                                C.  Perform comparative exposure and risk assessments on products
                                    and materials.

                                    1.  Provide leadership in working with outside stakeholders to establish
                                       an exposure and health risk assessment methodology for consumer
                                       products and building materials used indoors that would address
                                       the total health impacts of products, including beneficial impacts
                                       (e.g., disinfection).

                                    2.  Develop consensus on the general methods to be used to consider
                                       relevant information, including:

                                       •  Data on all routes of exposure  (nasal, inhalation, dermal, and oral)
                                          and their comparative importance.

                                       •  The effects of indoor sinks and interactions of multiple pollutants
                                          from multiple sources on indoor exposure levels.

                                       •  Both toxicological and sensory health impacts.

                                       •  Evaluation of dose-response relationships.

                                D.  Develop product testing protocols.

                                    1.  Establish a standardized, consensus-based generalized emissions
                                       testing system with stakeholders, so that the potential exposure and
                                       health risk of most consumer products and building materials can be
                                       assessed. Develop and validate low-toxicity products using the test-
                                       ing and assessment system.

                                    2.  Assist stakeholders in developing standardized, consensus-based
                                       emissions testing and risk assessment systems specific to their
                                       products or materials and in promoting the concept of low-toxicity
                                       products and materials.
42

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E.  Work with stakeholders and outside standard-setting organizations to
   develop voluntary, consensus-based standards and guidelines.

   1.  Develop standards or guidelines for emissions levels of chemicals
       from products and materials used indoors by convening a
       dialogue to set consensus-based ground rules that can be used
       by organizations outside the federal government to develop
       standards and guidelines.

   2.  Develop guidance on safe levels of pollutants in indoor environments to
       assist in the development of sensor and control technologies.

   3.  Develop standards or guidelines to evaluate the efficacy, reliability,
       and cost-effectiveness of new technologies used to monitor or
       control pollutants (e.g., sensors, air cleaners).

F.  Provide market incentives to drive manufacturers to develop both new
   products and new technologies.

   The incentives will provide for healthier indoor environments and will
   not compromise  other aspects of environmental performance. EPA will
   lead other stakeholders in working with a wide range of consumers to
   direct demand toward healthier indoor products and technologies.

   1.  Focus on creative market incentives such as those derived from
       financing and insurance mechanisms (e.g., discounts in health
       insurance rates for people who live in homes with healthier
       indoor environments).

   2.  Work with institutional buyers within the federal government and
       elsewhere (e.g., hospitals, schools and universities, retail sector) to
       increase demand for cleaner indoor products through individual
       pilot projects focusing on specific products or materials. Establish
       bidding procedures for manufacturers to compete on the basis of
       both price and emissions to ensure lower emissions at reasonable
       prices. Develop a database and communications program to collect
                                                           CHAPTER 3 • POTENTIAL ACTIONS    43

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      POTENTIAL ACTIONS  • CHAPTER  3
                                       the experience and bid results from participants and to communicate
                                       information on technical feasibility and cost to spur new buyer
                                       membership and competition by manufacturers.

                                    3.  Periodically survey the market to gauge the extent to which demand
                                       rises for cleaner products and the extent to which that demand is
                                       leading towards improvements in products and technologies.

                                    4.  Develop and implement a healthy products award program to
                                       recognize companies that develop, market, or purchase cleaner
                                       indoor products.

                                    5.  Provide programmatic grants to product manufacturers and other
                                       parties to develop low-emitting or low-toxicity products that are less
                                       problematic from a public health perspective.

                                    6.  Promote lEQ-friendly products through the development of
                                       planning and sales software for building contractors. Integrate
                                       this effort with the Office of Prevention, Pesticides, and Toxic
                                       Substances' Environmentally Preferable Products program.

                                    7.  Make  cost-effective IEQ monitors and control technologies a
                                       standard feature.

                                       a. Identify stakeholders to popularize the standard use of basic detec-
                                         tion systems for home and work and help develop a clearinghouse
                                         for  appropriate sensor and mitigation technologies.

                                       b. Fund an effort, possibly through programmatic demonstration
                                         grants, to integrate reliable indoor sensor technologies with envi-
                                         ronmental controls (i.e./7smart"building systems) in institutional
                                         settings, such as offices, hospitals, schools, and prisons, as a
                                         means to create an awareness of indoor pollutants and demand
                                         for  a healthier indoor environment.
44

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       c. Integrate available and reliable indoor sensor technologies with
         environmental control systems in residential settings to create
         consumer demand for healthier indoor environments.

       d. Initiate a field study to evaluate commercially available indoor
         pollutant monitors and control devices for both performance
         and practicality.

       e. Assure federal adoption of new systems.

G. Work with interested stakeholders to develop and disseminate product
   labels, instructional materials, enhanced material safety data sheets, and
   product specifications that will allow for the incorporation of a broad
   spectrum of environmental and performance information. These materi-
   als can be used by consumers to select the best products, materials,  and
   new technologies for use indoors.

   1.  Encourage consumers to make informed choices when deciding
       what products, materials, and technologies to purchase for use
       indoors, as well as how they should be used.

   2.  Collect background research and conduct individual interviews and
       focus group discussions to develop specific recommendations for the
       type and design of user information to enable consumers to weigh
       environmental impacts indoors, as well as product performance and
       beneficial aspects, in purchasing decisions for both products and new
       technologies.

   3.  Develop appropriate user information, which focuses on reducing
       human health risks in the indoor environment and includes informa-
       tion on the beneficial aspects and performance characteristics of the
       products and materials. Convene all interested stakeholder groups,
       including industry, institutional purchasers, and  organizations
       experienced in providing user information for priority indoor
       products, technologies, and services.
                                                            CHAPTER 3 • POTENTIAL ACTIONS    45

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      POTENTIAL ACTIONS  •  CHAPTER 3
     POTENTIAL ACTIONS FOR  GOAL 5
       GOALS
       Promote Health-
       Conscious
       Individual Behavior
       and Consumer
       Awareness
More health-conscious individual behavior can create healthier indoor
environments. In an ideal situation, nearly everyone sees indoor environmen-
tal quality as important for health and most people know how to get
information they need. For individuals to engage in health-conscious
behavior regarding their indoor environment, they must be informed, have
the tools necessary to act, and believe their actions will result in a benefit to
their health, lifestyle, or productivity.

Improving indoor environmental quality and reducing the health risks of
serious indoor environmental problems will require millions of self-initiated
actions by individual home dwellers, building owners and managers, parents,
school officials, real estate professionals, and other key target audiences.
Effective programs to achieve this mission must emphasize communication and
outreach to catalyze and influence actions by the millions  of individuals who
make decisions affecting indoor environments.

The following list of specific recommended initiatives uses a variety of targeted
approaches for encouraging health-conscious individual behaviors to improve the
indoor environment. As further research into indoor environmental health risks
and mitigation strategies is conducted, new initiatives to encourage health-
conscious individual behaviors will be developed.

  A.  Initiate a campaign to educate society's leaders on IEQ.

     1.  Work with private sector leaders and  public policy makers at the
        federal, state, and local levels to demonstrate the significance of the
        indoor environment and the cost-effective benefits of improved
        conditions in homes, schools, workplaces, and public buildings.

     2.  Develop a highly-targeted campaign aimed at encouraging society's
        leaders to understand the following key facts about indoor environ-
        mental  quality:

        • People spend 90 percent of their time indoors.

        • Indoor environmental problems are high risk.

        • There are cost-effective solutions to many IEQ problems.
46

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       • Research is needed to improve our understanding of how to
         prevent IEQ problems.

   3.  Reach out to scientists, influential medical centers, high-level health
       officials, state legislators, tribal leaders, private sector executives,
       influential state and local officials, and other key opinion leaders.
       Use a variety of targeted channels ranging from scientific journals to
       the mass media, including articles in popular publications and airline
       flight magazines, speakers at key conventions, and feature segments
       in TV programs and Sunday morning talk shows. Conduct these
       activities in partnership with key stakeholders.

B. Create a healthy children program.

   1.  Protect children from asthma by reducing the degree to which
       indoor environmental conditions contribute to the rate and severity
       of asthma in children. Work in close partnership with other federal
       agencies to: integrate prevention messages into existing treatment
       messages; emphasize innovative outreach in homes; use schools to
       deliver proven asthma prevention and management messages to
       children of preschool and primary school age; track the effectiveness
       of these school interventions; leverage the existing health care system
       to reduce costs by promoting asthma prevention and management
       education; and employ cutting-edge mass media approaches to
       raise parent and child awareness and induce health-promoting
       behavioral changes.

   2.  Develop an action campaign to improve the indoor environments of
       children. Form a cross-government team, including EPA representa-
       tives from OPPTS, OAR, and the Office of Children's Health
       Protection (OCHP), to improve the indoor environments of children
       in homes, day care facilities, and schools. Work with stakeholders to
       educate  parents, day care providers, child health care providers, and
       school officials on the benefits  of reducing children's exposure to lead,
       secondhand smoke, radon, allergens, pesticides, and other harmful
       indoor pollutants. Explore partnerships with health maintenance
                                                            CHAPTER 3 •  POTENTIAL ACTIONS    47

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      POTENTIAL ACTIONS  •  CHAPTER 3
                                        organizations (HMOs) to encourage participating physicians to include
                                        environmental factors in checkups. Explore mechanisms for incorporat-
                                        ing environmental factor training into medical school programs for
                                        patient background, screening, and diagnosis.

                                     3.  Initiate a three- to five-year campaign to reduce minority children's
                                        exposure to indoor environmental tobacco smoke using transit and
                                        other media appropriate to minority audiences. Expand existing
                                        media campaigns to include TV, radio, print, transit, billboard, and
                                        other materials targeted specifically to minority populations.

                                     4.  Educate children on  indoor environmental risks by teaming with
                                        stakeholders to develop curricula, science lessons, teaching modules,
                                        and other mechanisms for mainstreaming indoor environmental subject
                                        matter into the Nation's formal education system. Teaching children
                                        about the importance of the indoor environment to human health will
                                        help to ensure health-conscious behaviors in two long-term ways: (1)
                                        by developing an awareness of how the indoor environment impacts
                                        health and productivity so that children will ultimately be better man-
                                        agers of their own indoor environments as adults and (2) when children
                                        adopt environmentally conscious behaviors, the adults in their lives
                                        often emulate those  behaviors  (e.g., recycling).

                                 C.  Ensure consumers are well-informed.

                                     1.  Take a comprehensive approach to the real estate sector, which provides
                                        a critical link to achieving measurable risk reduction on radon, carbon
                                        monoxide, lead in paint, asbestos, underground storage tanks, and
                                        drinking water. Agents, brokers, home inspectors, attorneys, mortgage
                                        bankers, and other real estate professionals are uniquely positioned to
                                        assist consumers in making informed decisions about correcting envi-
                                        ronmental problems before they purchase commercial and residential
                                        properties. Collaborate within EPA to develop and implement a cross-
                                        Agency strategy and workgroup, integrated public information materi-
                                        als, information clearinghouse, web site, one-stop environmental real
                                        estate hotline, and outreach partnerships with each of the major seg-
48

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       ments of the real estate professions. Engage other federal institutions
       (e.g., the Department of Housing and Urban Development,
       the Veteran's Administration (VA), Fannie Mae, Freddie Mac) to
       coordinate environmental requirements.

   2.  Publish "50 Things You Can Do to Improve Your Indoor Environment."
       Develop and promote clear and consistent messages on indoor
       environmental concerns and questions frequently asked by the public.
       Prepare and distribute these as concise, easy-to-use materials in
       multiple formats (web page, consumer advice booklet, magazine
       article) which clearly explain what people can do now to improve
       their indoor environments.

   3.  Encourage more informed consumer product purchasing. Engage the
       private sector and other concerned federal agencies in designing ways
       to educate consumers about how to purchase products wisely and
       use them with appropriate care. Consumers infrequently read product
       labels before using the contents and often disregard important
       manufacturer's instructions concerning safe use of the product.
       Likewise, product labels lack uniformity in the way safety and use
       instructions are presented. Directions such as "use with adequate
       ventilation" are subject to broad interpretation.

   4.  Initiate a consumer campaign to improve indoor workplace environ-
       ments. With groups like the  Occupational Safety and Health
       Administration  (OSHA) and organized labor, develop a comprehen-
       sive information campaign to educate the public about the
       straightforward, cost-effective actions that can be taken to improve
       indoor air quality in workplaces. Adjuncts to the  campaign could
       include a toll-free hotline number, web site, or other places where
       building occupants, as well as owners and operators, can receive
       information and resource materials.

D. Provide for healthy home care.

   1.  Encourage broad-based public information programs and
       campaigns on household cleaning and maintenance that combat
       indoor environmental hazards. For example, expand the Master
                                                           CHAPTER 3 •  POTENTIAL ACTIONS    49

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      POTENTIAL ACTIONS  • CHAPTER 3
                                       Home Environmentalist (MHE) Program nationwide. A small pilot
                                       program that has successfully demonstrated a change in behavior,
                                       the Master Home Environmentalist Program is a hands-on, tuition-
                                       free program that teaches people about the indoor environment in
                                       return for their commitment to teach others. Topics include ways to
                                       reduce tracking soil containing lead and pesticides into the home;
                                       proper vacuuming techniques and how to evaluate the effectiveness
                                       of vacuum cleaners; safe methods to dispose of household waste;
                                       ways to identify and fix problems related to moisture indoors; and
                                       ways to reduce bioaerosols, dust mites, bacteria, and fungi indoors.

                                    2.  Make accurate information available to the public on air cleaning
                                       and filtration equipment. Working with public and private sector
                                       stakeholders, ensure that accurate information is available to the
                                       public so consumers can make wise choices when considering air
                                       cleaning and filtration equipment. Establish a system to prevent
                                       false advertising of indoor air cleaning devices, and design a means
                                       of assessing the safety and effectiveness of new devices.

                                    3.  Establish an educational mini-grant program on moisture control
                                       and the use of microbe-resistant building materials, especially for
                                       low-income populations in high-humidity regions. Coordinate with
                                       existing educational programs on moisture-related illnesses such as
                                       asthma and Legionnaires' disease.
50

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APPENDIX A
 INDOOR ENVIRONMENTS:
 CURRENT PROGRAM PRIORITIES
             OVERVIEW 	54
             OFFICE OF AIR AND RADIATION 	57
             OFFICE OF PREVENTION, PESTICIDES, AND TOXIC SUBSTANCES
60
             OFFICE OF RESEARCH AND DEVELOPMENT 	63
             OFFICE OF SOLID WASTE AND EMERGENCY RESPONSE 	67
             OFFICE OF ENFORCEMENT AND COMPLIANCE ASSURANCE 	69
             OFFICE OF WATER 	70
             OFFICE OF CHILDREN'S HEALTH PROTECTION 	71
             OFFICE OF ADMINISTRATION AND RESOURCES MANAGEMENT	74
             REGIONAL OFFICES 	75
                                                                 53

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      INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES • APPENDIX A
     OVERVIEW
       EPA OFFICES WORK TOGETHER
         THE CARPET POLICY DIALOGUE

            This voluntary dialogue was jointly led by OPPTS and
            OAR and included representatives of a number of other
            offices within the Agency, as well as all interested
            stakeholders (i.e., industry, unions, public interest
            groups, other federal agencies). The  dialogue resulted
            in industry agreement to test new carpet floor-covering
            materials for total volatile organic compound (VOC)
            emissions and to explore ways to lower VOC emissions
            from carpet products. Most importantly, the industry
            undertook an extensive consumer education program,
            in cooperation with other dialogue participants,
            designed to provide the public with information on the
            role that carpet products play in  indoor air quality and
            ways in which consumers can make informed purchase
            decisions.

         RADON IN DRINKING  WATER

            OAR is collaborating with the Office of Ground
            Water and Drinking Water (OGWDW) to develop a
            unique and innovative drinking water rule for radon.
            The cost-effectiveness of reducing  radon risk is
            substantially greater for indoor air (from soil gas)
            than from drinking water. Because of this, EPA, in
            proposing a maximum contaminant level (MCL) for
            drinking water (64 FR 59245, November 2,1999), also
            made available a higher alternative maximum
            contaminant level (AMCL) accompanied by a multi-
            media mitigation program to address risks in indoor
            air. The proposed regulations will provide states flexi-
            bility in how to limit the public's exposure to radon.
EPA's Strategic Plan includes
program priorities aimed directly at
protecting human health indoors,
as well as protecting it as part of
broader environmental protection
programs. EPA's indoor environ-
ments programs address well-known
risks, such as radon, lead, asbestos,
and environmental tobacco smoke.
These programs also provide tools
and guidance on good indoor envi-
ronmental practices in residences,
schools, and office buildings. Other
EPA programs are broader in scope
(e.g., providing safer chemicals and
products, reducing exposures to
hazardous waste streams, reducing
risks to disadvantaged and dispro-
portionately exposed populations),
but have the protection of human
health indoors as a program compo-
nent. Although EPA has made signif-
icant progress in reducing risks from
some well-known hazards indoors,
much remains to be done.

EPA's strategic focus revolves
around four main areas: science
and engineering, guidance and
policy development, generating
public action, and measuring results.

The Agency believes that both
regulatory and non-regulatory
approaches have value. Regulations
mandate behavioral changes by
industry and others  to prevent
exposure to toxic substances.
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                                                                   STRATEGIC FOCUS
Non-regulatory processes are often used to
mitigate unexpected risks or to mitigate risks
through voluntary actions.

PREVENTIVE APPROACHES:

EPA uses the Federal Insecticide, Fungicide,
and Rodenticide Act (FIFRA) and the Toxic
Substances Control Act (TSCA) to prevent
hazardous pollutants from unnecessarily
entering the indoor environment. These
statutes require manufacturers or users to
submit information to characterize the health
risks a substance might pose before it can be
manufactured or distributed. EPA can then
direct the manufacturer to take measures
to reduce exposure to the substance, such
as limiting where and how much of the
substance can be used, mandating labeling
and use of protective equipment  to ensure
proper use, and requiring training of the
people who use the substance. Regulation
can also further restrict or even ban a sub-
stance when there is no other way to
provide adequate protection. EPA works
closely with industry and other stakeholders
to assist them in reducing risks to workers,
communities, and the environment by
developing pollution prevention and waste
minimization tools. EPA observations of
chemical plant incidents and subsequent
investigations are being brought to the
attention of industry to learn from mistakes
made and to further upgrade indoor/outdoor
plant safety.
Measuring Results

• Selecting appropriate
environmental indicators
to measure progress

• Continuous
improvement and
adjustment of strategies
and activities for
achieving risk reduction
goals
Generating Public
Action

• Establishing
partnerships to
communicate guidance
and promote effective,
timely action

• Forging constructive
alliances to leverage
resources and to ensure
statutory authorities are
used effectively

• Designing market-
based incentives to
lower source emissions
and providing the
information necessary to
make informed decisions
Science and
Engineering

• Targeting the greatest
risk first

• Identifying and filling
research gaps

• Enhancing
understanding of the
multi-factorial nature of
indoor environmental
quality
Guidance and Policy
Development

• Developing and
refining guidance
using a broad-based
consensus approach

• Preventing indoor
pollution through source
control and building
management and
construction

• Using a continuum
of risk management
approaches to control
risks (information-
motivation-incentives-
mandates)
                        APPENDIX A  •  INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES    55

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      INDOOR ENVIRONMENTS:  CURRENT PROGRAM PRIORITIES • APPENDIX A
                              APPROACHES FOR EXISTING  RISKS:

                              In some cases, products or materials in the indoor environment may
                              present a risk to human health indoors. Besides emissions from products and
                              materials, chemical pollutants can be introduced to the indoor environment
                              from contaminated potable water, outdoor air, soil, and other external sources.
                              In some cases (e.g., asbestos, lead, radon), EPA's approaches to addressing
                              these risks are, in part, specified by statutes.

                              In many cases, however, EPA's approach has been to obtain non-regulatory,
                              voluntary actions by industry to address risks. The mechanism used for
                              eliciting this voluntary approach has often been stakeholder dialogues. These
                              dialogues may result in the development of voluntary guidelines and stan-
                              dards based on levels of a pollutant, source emissions, ventilation parameters,
                              and building or maintenance practices either in lieu of, or in addition to, regu-
                              latory action. Other non-regulatory approaches that may be taken include risk
                              communication, training, technical assistance, cooperative partnerships, com-
                              munity activities, and other pollution prevention activities.

                              Discussions of each office's priorities and activities for protecting human
                              health indoors are provided below.
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OFFICE OF AIR AND  RADIATION  (OAR)
OAR's goal is to ensure that, by 2005,16
million more Americans are living or working
in homes, schools, or office buildings with
healthier indoor air than in 1994. To accomplish
this, several measurable milestones have been
established for 2005:

  •  To reduce lung cancer, respiratory diseases,
     and other health problems,  11.5 million
     more Americans will benefit from healthier
     indoor air in their homes by the:

       Mitigation of 700,000 homes with high
        radon levels and the construction of
        one million homes with radon-resist-
        ant construction techniques.

       Reduction of the proportion of house-
        holds in which children ages six and
        under are regularly exposed to smoking
        from 27 percent in 1994 to 15 percent.

  •  To reduce lAQ-related illness, five percent
     of office buildings will be managed with
     IAQ practices consistent with EPA's Building
     Air Quality guidance.

  •  To reduce health problems in the nearly 10
     million children made ill annually from
     indoor air problems in schools, 15 percent
     of the  Nation's schools will  adopt good
     IAQ practices consistent with EPA's IAQ
     Tools for Schools guidance.

  •  To reduce the indoor air impacts on asth-
     ma, one million children with asthma will
     have reduced exposure to indoor asthma
     triggers. In addition, 200,000 low-income
     adults with asthma, and 2.5 million people
     with asthma overall, will have reduced
     exposures to indoor asthma triggers.
NATIONAL  ENVIRONMENTAL HEALTH
ASSOCIATION (NEHA)—RADON
Working through a cooperative partnership,
about 100 NEHA employees are trained annually
on indoor air quality (IAQ) and risk reduction
strategies. In return, each individual develops a
one-year plan of action for achieving IAQ risk
reduction as part of their work. The results are
impressive.

Tom Dickey, an East Moline, IE local city health
department inspector, completed a three-day
radon training program in Washington, DC and
decided to pursue an incentive-based program
for encouraging radon-resistant new construc-
tion. He successfully encouraged the City
Council to pass a resolution granting a "radon
rebate" on the fee that the city assesses on new
homes if the homes are built to be radon-resist-
ant. The rebate is roughly proportional to the
incremental cost incurred by builders in East
Moline to make  their homes radon-resistant.
Since the rebate program was begun in June
1994, many new homes in East Moline have been
built to be radon-resistant. Mr. Dickey has men-
tored other NEHA/EPA radon community-based
risk reduction programs to encourage the use of
these kinds of highly-effective incentive strate-
gies.
                     APPENDIX A • INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES    57

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      INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES • APPENDIX A
                              OAR has recently begun a new initiative on asthma. Its mission is to ensure
                              that indoor environmental management is an integral part of asthma
                              management in the United States. Although both medical treatment and
                              indoor environmental management are needed to effectively control asthma,
                              the latter is not often practiced nor part of the prescription for managing
                              asthma. The Indoor Environments Program will focus on two primary audi-
                              ences: the public health/medical community and children with asthma and
                              the people who manage their environments. The Program plans to reach
                              these audiences through several activities:

                                •  Health care/managed care summits

                                •  A media campaign

                                •  An in-home education program

                                •  School/day care-based education of children

                                •  Integration of ETS into tobacco control programs

                                •  Improving indoor environments in schools

                              A number of different specific strategies exist to achieve OAR's priorities. OAR
                              works with its regional offices, state and local agencies, and private partners
                              to get local action on indoor environmental issues. OAR stimulates local
                              action on radon through the State Indoor Radon Grants program, which has
                              resulted in significant risk reduction in homes. A unique feature of the OAR
                              program's voluntary efforts is a network of cooperative partnerships with
                              organizations that speak to and for the public, as well as key constituencies,
                              including county and local environmental health officials, susceptible minority
                              and disadvantaged populations, schools, real estate and building profession-
                              als, etc. This network allows OAR to leverage the personnel, expertise, and
                              credibility of these organizations, as well as mobilize hundreds of community-
                              based affiliates at the state and local level.
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OAR also takes a proactive approach in providing a broad range of informa-
tion about indoor air-related risks, as well as the steps to reduce them,
through the use of public awareness campaigns, guidance document
dissemination, training course delivery, the operation of several linked
hotlines and clearinghouses, a web site, and related outreach efforts. These
efforts reach a broad audience, including homebuilders and buyers, real estate
professionals, health professionals, environmental and public health officials,
facility owners and managers, school administrators and teachers, and service
providers (such as day care providers, maintenance personnel, and pest
control companies).
                     APPENDIX A • INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES    59

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     INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES • APPENDIX A
     OFFICE OF PREVENTION, PESTICIDES,
     AND TOXIC SUBSTANCES (OPPTS)
                            Many of OPPTS's priorities for 2005 relate to human health indoors.
                            By 2005, OPPTS expects that:

                             •  Lead poisoning will be significantly reduced from levels in the early
                                1990s, with particular emphasis on children in high-risk groups.

                             •  Of the approximately 3,000 high-volume chemicals in commerce and
                                the 1,000 chemicals expected to enter commerce each year, EPA will sig-
                                nificantly increase the introduction and use by industry of safer
                                or "greener" chemicals. Fewer than 100 cases per year will need
                                regulatory management by EPA.

                             •  There will be a significant increase in industry's use of pollution
                                prevention and "green approaches" in the design, development,
                                manufacture, and use of chemicals so that there is increased
                                availability of safer substitutes.

                             •  EPA will annually review about 2,500 Premanufacture Notifications
                                submitted by chemical manufacturers and take appropriate risk
                                management actions to protect human health and the environment.
                                EPA will concentrate on protecting children and workers from
                                potential inhalation and dermal exposures.

                             •  EPA has proposed to amend the TSCA Inventory Update Rule (IUR)
                                to collect information needed for risk screening and develop and
                                implement a chemical hazard classification scheme.

                             •  EPA will achieve  significant progress in acquiring test data on
                                chemicals entering commerce and high-volume chemicals, including
                                testing for endocrine disruption.

                             •  There will be significant reductions in exposures to toxic fibers,
                                e.g., asbestos.

                             •  Toxicity test data  gaps will be identified for household chemicals which
                                result in substantial exposures to consumers and children. Toxicity
                                testing actions will be initiated or completed for 50 percent of these
                                chemicals. Risk management actions will result in significant risk
                                reduction to consumers, and information/education programs will
                                empower them.
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  •  EPA will improve the ability of the public to reduce exposure to specific
     environmental and public health risks by making current, accurate,
     substance-specific information widely and easily accessible.

  •  EPA will provide chemical data and tools to the public for them to
     understand and analyze environmental data. The data and tools will be
     tailored to suit various needs, such as ranking potential concerns for
     indoor environmental quality and"green design,"as well as product
     labels to be easily understood by consumers.

  •  All pesticides licensed before 1988 will have complete and reviewed
     databases, in accordance with the most current requirements, to
     support their uses (more recently licensed pesticides will already be
     in full compliance).

  •  Where necessary, consumer information on labels will be updated and
     clarified to prevent unnecessary indoor use and exposures.

  •  For nearly all pesticides, risk assessments accounting for  all sources of
     exposure, including indoor exposures, will be conducted.

OPPTS programs are primarily oriented towards prevention rather than
remediation. Both the toxics and pesticide programs operate in an environ-
ment of mandated deadlines and regulatory requirements. Science and risk
assessment are integral; harmonization of test methods between toxics and
pesticides, as well as with others both inside and outside EPA,  is an important
operating principle. In addition, tool and data development in  the areas of
exposure, hazard, risk, and economics are ongoing activities in both the toxics
and pesticides offices.

OPPTS has regulatory programs in place for two critical indoor pollutants,
lead and asbestos. Activities to address these pollutants include:

  •  Training and certification programs for workers

  •  State programs and grants

  •  Information disclosure upon real estate transfer and renovation

  •  Federally identified hazard levels
                      APPENDIX A  •  INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES    61

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CONSUMER LABELING INITIATIVE
The Consumer Labeling Initiative (CLI) is a
voluntary, cooperative partnership to foster pollution
prevention, empower consumer choice, and improve
understanding by presenting clear, consistent, and
useful information on household consumer product
labels. Government, industry, and other groups are
working together in the CLI to make it easier for
consumers to find, read, and understand  label
information about a product's safe use and its
environmental and health impacts. This information
will enable customers to compare products and safely
use the  ones they select.
Between 1996 and 1998, CLI conducted significant
research with consumers around the country which
included one-on-one interviews, focus groups, and
phone and written surveys. The purpose of the
research was to determine how consumers use pesti-
cide and cleaner labels, if and when they read the
labels, and what information  they thought could be
improved or deleted.
The outcome of the research was a series of recom-
mendations for label improvements in both language
and format, as well as the implementation of a
consumer education campaign called "Read the Label
Firstl" The education campaign is now in full swing
and includes the distribution of posters; brochures on
the importance of reading labels; promotional items
with relevant hotline phone numbers, as well as the
campaign logo; fact sheets; TV and radio segments;
a truck advertising campaign; and various train-the-
trainer sessions given by our  state and industry
partners, as well as many other CLI participants.
In addition to its regulatory programs,
OPPTS also has voluntary pollution
prevention activities designed to produce
safer indoor environments. OPPTS works
with industry stakeholders to develop
tools and information that can lead to
formulation of safer consumer products
for use in the indoor environment.
Following Executive Order 13101, OPPTS
works with federal consumers, such as
the  General Services Administration
(GSA), to provide them with the informa-
tion they need to make purchasing deci-
sions that are better for the environment,
both indoors and out.

OPPTS also has the Pesticide
Environmental Stewardship Program
(PESP). PESP is EPA's program designed
to address the risks of pesticides and
encourage the use  of safer pesticides. A
major element of PESP is the encourage-
ment of voluntary partnerships with pri-
vate industry to promote safer pesticides
and environmental stewardship.

Consumer education is important and
OPPTS is working with partners to
clarify product labeling procedures.
OPPTS is also working with partners to
develop tools to improve the assessment
of chemical safety in consumer products
and building materials.

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OFFICE OF RESEARCH  AND DEVELOPMENT  (ORD)
ORD produces technical reports, methods, models, and other scientific
information to improve the Agency's understanding of the effects of indoor
contaminants and their sources, as well as risk management options to reduce
exposure. In addition, this research provides technical information that is used
by OAR and OPPTS to develop guidance documents on indoor environmental
quality and understand the relative risks of various indoor contaminants.
The data produced by ORD are also used by product manufacturers to
evaluate the risks posed by their products and by building owners and
operators responsible for protecting tenants from harmful levels of indoor
contaminants. Specific activities planned by ORD are to:

  •  Develop information on the effects of both biological and chemical
     contaminants found indoors.

  •  Develop methods and models to quantify source emissions.

  •  Collect data on human exposures to indoor contaminants through
     field studies.

  •  Produce multi-pathway exposure models that include modules that
     account for the contribution of contaminants from various indoor
     microenvironments and take into account penetration of ambient
     air indoors.

  •  Develop information to aid school and building managers, the private
     sector, and government officials in determining which control approach-
     es (e.g.,  air cleaners, source management, ventilation system
     design/operation) will have the greatest impact on risk reduction.

  •  Develop information for manufacturers of building materials and prod-
     ucts that pose the greatest risk, assisting them in preventing and reduc-
     ing emissions through product redesign and process changes.
                    APPENDIX A •  INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES    63

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      INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES  • APPENDIX A
                              ORD, OAR, and OPPTS have worked jointly to identity the most critical
                              uncertainties associated with indoor pollutants and have developed the
                              following list of key research needs:

                                •  Source Characterization/Solutions

                                       Develop information on and prioritize indoor environmental sources,
                                       and establish processes to reduce or prevent pollutant exposures
                                       associated with those sources. The most important needs are:
                                       (1) prioritization of indoor environmental pollution sources in terms
                                       of next actions, e.g., additional studies, guidance development,
                                       industry dialogues, and pollution prevention; (2) development of
                                       standardized methods for source emission testing; and (3) under-
                                       standing of typical and high-end indoor exposures, how these expo-
                                       sures relate to indoor pollutant levels, and how their relative risks
                                       compare to outdoor air problems and environmental hazards in
                                       other media.

                                       Assess the impact of building practices on indoor environmental
                                       quality. Develop and compare investigation and mitigation
                                       techniques, including IEQ and energy performance of ventilation
                                       systems  in large buildings, cost/benefit analysis of IEQ controls, and
                                       assessment of IEQ guidance utilization.

                                •  Health Effects Assessment

                                       Improve the Agency's understanding of the health effects of indoor
                                       pollutants, both chemical and biological, by developing data on the
                                       risks of indoor pollutants, including irritancy, central nervous system
                                       and sensory effects, and the effects of mixtures.
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  •  Exposure Assessment

        Improve the Agency's understanding of the exposure-time-activity
        pattern factors that contribute to multi-pathway indoor human
        exposures. Characterize and provide an integrated assessment of
        these exposures (e.g., inhalation, dietary, dermal) to indoor
        contaminants and to the dose within the human body, culminating
        in a first-generation exposure model.

  •  Risk Assessment

        Improve the Agency's current knowledge of indoor environmental
        risks by assessing risks from exposure to chemical pollutants, includ-
        ing organics, nitrogen oxides, carbon monoxide, particulate matter,
        and microbiologicals.

Current ORD  indoor environmental research is conducted as a component of
several broader research programs, including particulate matter, air toxics, and
human health protection, where indoor exposures contribute significantly to
the risks.  Research will be conducted using ORD's grants program under the
National Center for Environmental Research and ORD laboratories and
centers using in-house research facilities and staff, as follows:
MAJOR RESEARCH AREA
Source Characterization/Solutions
Exposure Assessment
Health Effects Assessment
Risk Assessment
RESPONSIBLE NATIONAL
LABORATORY
National Risk Management Research
Laboratory (NRMRL)
National Exposure Research
Laboratory (NERL)
National Health and Environmental
Effects Research Laboratory
(NHEERL)
National Center for Environmental
Assessment (NCEA)
                     APPENDIX A  • INDOOR ENVIRONMENTS:  CURRENT PROGRAM  PRIORITIES    65

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      INDOOR ENVIRONMENTS:  CURRENT PROGRAM PRIORITIES • APPENDIX A
       CONVERSION  VARNISH EMISSIONS
       ORD completed a study which examines the emissions of formalde-
       hyde and other organic chemicals from conversion varnishes into the
       indoor environment. Conversion varnishes provide sturdy, chemical-
       and water-resistant coatings for kitchen and bathroom cabinets and
       some furniture. They are made up of two components, a polymer resin
       and a catalyst, which are mixed prior to application. The mixture then
       reacts to form a continuous film coating on the surface of the wood.
       The study showed that the organic solvent portion of the coating is
       emitted quickly, typical of most coatings. These emissions will occur
       mostly while the cabinet is still in the manufacturing plant. The
       formaldehyde, however, is emitted by a different mechanism. Rather
       than showing the emission behavior typical of most coatings, the
       formaldehyde is emitted over a longer period of time. For the coatings
       tested, the total amount of formaldehyde emitted was between two
       and eight times the amount present in the formulation. This reflects a
       net production of formaldehyde resulting from the chemical reactions
       that occur during curing and ageing of the coating. In addition, the
       formaldehyde emissions do not decay as quickly as other (evapora-
       tive) emissions more typical of coatings. Rather, the emissions level
       out over time. The coatings continue to emit significant amounts of
       formaldehyde even after 42 days, long after they could be placed in a
       consumer's home. Modeling showed the potential for exposures near
       the irritation threshold for formaldehyde from this source alone. The
       next phase of work on this project is to test promising new alterna-
       tives to conversion varnishes to determine whether they can reduce
       total emissions and indoor emissions (and therefore potential for
       human exposure).
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OFFICE  OF SOLID WASTE  AND
EMERGENCY RESPONSE (OSWER)
OSWER's priorities applicable to protecting indoor
environments include:

  •  Improve indoor workplace safety by reducing the risk of
     industrial chemical accidents. OSWER will develop and
     disseminate alerts and advisories to industrial sectors based
     on an enhanced knowledge acquired from increased EPA
     chemical accident investigations. A joint EPA-OSHA
     Chemical Accident Investigation Team is currently in place
     to investigate major chemical accidents and disseminate
     "lessons learned" to involved industry sectors.

  •  Reduce risk of worker exposure by reducing the most
     persistent, bioaccumulative, and toxic (PBT) chemicals in
     industrial waste streams found at work. By 2005, reduce
     these types of chemicals in waste streams to 50 percent of
     1991 levels.

  •  Continue to develop and employ innovative strategies for
     promoting indoor cleanup of contaminants by reducing the
     cost of waste management without sacrificing human
     health  or environmental protectiveness.

  •  Continue to provide technical expertise and conduct
     response actions using Comprehensive Environmental
     Restoration Compensation and Liability Act (CERCLA)
     authority. CERCLA authority may be used to respond to
     threats of environmental releases of hazardous substances,
     pollutants, or contaminants  that are found within homes
     and offices.

  •  Expand OSWER's ongoing partnerships with the
     construction and remodeling industries to promote the
     use of safe and recycled materials indoors.
PROMOTING LOCAL GREEN
BUILDER PROGRAMS
OSWER, in partnership with
OPEI and the National
Association of Home Builders
Research Center (NAHB-RC),
is developing a model "green
builder" program, based on
existing programs in such cities
as Austin, TX and Denver, CO.
This program will educate
builders on environmentally
friendly construction and offer
them marketing incentives for
applying these techniques. The
model, which will be designed
to be easily adopted by local
home builders associations and
governments nationwide, will
be tested by the Greater
Atlanta Home Builders
Association as it develops its
own "green builder" program.
OSWER, OPEI, and NAHB also
jointly sponsored the first
Green Buildings conference
aimed at mainstream home-
builders on April 8-9,1999 in
Denver, CO.
                    APPENDIX A • INDOOR ENVIRONMENTS: CURRENT PROGRAM  PRIORITIES    67

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      INDOOR ENVIRONMENTS:  CURRENT PROGRAM PRIORITIES • APPENDIX A
                              Many of OSWER's principles and strategies are designed to reduce risk to
                              humans in the workplace through concepts such as source reduction. OSWER
                              also seeks to reduce future risk inside plants by making unsafe processes safe
                              in the future. OSWER strives to employ good science and technology to make
                              sound environmental policy decisions which are protective and based on
                              common sense and reality. The Office works closely with industry and other
                              stakeholders to assist them in reducing risks to their workers, to their commu-
                              nities, and to the environment by developing pollution prevention and waste
                              minimization tools and ideas. OSWER works to ensure that a high level of
                              public participation is achieved and that state and local involvement exists so
                              that policies and regulations are protective, equitable, and implementable.

                              OSWER also develops new technologies through research and promotes
                              innovative remediation concepts (such as Brownfields) to achieve the timely,
                              cost-effective cleanup of previously contaminated sites and to develop policy
                              and regulation to prevent future ones from occurring. These cleanup actions
                              seek to minimize threats from exposure to  contamination sources whose
                              routes can affect indoor environments (e.g., tap water or indoor air). These
                              pollution prevention strategies, risk management activities, remediation
                              strategies, and chemical emergency response/process safety work, aimed at
                              cost-effectively eliminating, reducing, or minimizing emissions and contami-
                              nation, will result in cleaner and safer environments in which Americans can
                              reside, work, and enjoy life indoors as well as out.

                              OSWER also seeks to increase resource efficiency and improve waste
                              management in the construction and demolition industries through the pro-
                              motion of environmentally friendly building or "green building" programs.
                              While OSWER's primary interest in this field involves expanding recycling and
                              reuse of building products, as well as reducing the amount of demolition
                              debris, the "green building" movement also includes such elements as energy
                              efficiency, water conservation, and indoor environmental quality. Therefore,
                              opportunities exist for OSWER, OAR, and other offices to join forces to create
                              effective, unified "green building" programs that command the respect and
                              interest  of the building industries and the public. Through such programs, EPA
                              can further the construction of buildings that protect human health and envi-
                              ronmental quality.
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OFFICE OF ENFORCEMENT
AND COMPLIANCE  ASSURANCE  (OECA)
OECA's priorities applicable to indoor environments issues are to:

  •  Work with media program offices to identify areas to be targeted
     (e.g., high-risk, disproportionately exposed populations and other
     priority areas of non-compliance).

  •  Provide the public, especially disproportionately exposed and under-
     represented populations, with a meaningful opportunity to participate in
     the development and implementation of environmental protection strate-
     gies that involve the National Enforcement and Compliance Program.

  •  Ensure that all federal and state enforcement programs include a plan
     for encouraging and responding to citizen reports of violations or other
     environmental incidents.

  •  Develop the tools to identify or target particular areas or populations
     associated with disproportionate exposure and other appropriate factors.

  •  Work with the Interagency Working Group on Environmental Justice to
     address case and policy issues that develop between agencies.

  •  Develop joint agency enforcement initiatives (e.g., EPA/OSHA joint
     chemical pollution/worker safety cases).

OECA's programs are primarily for the enforcement and implementation of
regulatory requirements. In the indoor environments area, OECA is currently
focusing on compliance with asbestos in schools requirements, lead-based
paint disclosure requirements, and illegal use of pesticides in homes.

However, through the Office of Environmental Justice's (OEJ) Environmental
Justice Small Grants and Community/University Grants Programs, OECA has
funded numerous local projects dealing with indoor environmental issues, such
as lead dust, radon, and asthma. In addition, OEJ has worked closely with OAR
to support the Open Airways program and to jointly sponsor a training session
on asthma issues and solutions.
                    APPENDIX A • INDOOR  ENVIRONMENTS: CURRENT PROGRAM PRIORITIES   69

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     INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES • APPENDIX A
     OFFICE OF WATER (OW)
                            Under the Safe Drinking Water Act, EPA sets and enforces standards on
                            public water supplies to prevent human health impact. Human exposures
                            to contaminants brought into the home by drinking water can result from
                            inhalation and dermal exposure, as well as by ingestion via eating and
                            drinking. EPA attempts to take all of these exposure routes into account in
                            the risk assessments that are done for regulatory development.

                            Inhalation exposure is the major exposure pathway for the risk posed by
                            radon in drinking water. It is also a very significant exposure pathway for
                            other volatile contaminants found in drinking water, such as chlorinated
                            solvents. Inhalation exposure results from showering, in which a large
                            amount of water is aerated in a small enclosed space, as well as from other
                            indoor water uses.
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OFFICE OF CHILDREN'S HEALTH
PROTECTION (OCHP)
EPA's Office of Children's Health Protection was established in 1997 to
promote children's environmental health within EPA, across the federal
government, in the non-governmental sector, and in states and communities.

MISSION AND GOAL

OCHP's mission is to make the protection of children's health a fundamental
goal of public health and environmental protection in the United States. The
Office's goal is that every individual, community, organization, corporation,
and government agency will:

  1. understand the link between children's health and the environment, and

  2. take positive action to improve children's environmental health.

OCHP's overall strategy for addressing risks to children is twofold: (1) to
build the infrastructure and capacity to address children's health issues at the
federal, state, and community levels and among private sector organizations
and individuals and (2) to increase awareness and action on children's
environmental health issues throughout all sectors of society.

EPA SCIENCE AND  REGULATIONS

Within EPA, OCHP serves as a focal point for providing technical support on
children's environmental health issues to policy makers and outside organiza-
tions. It promotes consideration of children's health by media program and
research offices, and coordinates Agency-wide initiatives and interagency
initiatives with other federal agencies.
                    APPENDIX A •  INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES    71

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      INDOOR ENVIRONMENTS:  CURRENT PROGRAM PRIORITIES • APPENDIX A
                              In the area of science, OCHP works to improve the science to increase our
                              understanding of children's unique risk and provide sound data on which
                              to base decisions by advocating for increased funding for children's
                              environmental health issues, improved risk assessment procedures, and the
                              conduct of a comprehensive longitudinal cohort study of the relationship
                              between children's health and their environment.

                              OCHP works to improve the standard-setting process so that risks to children
                              are explicitly considered by providing guidance  and analysis on the costs and
                              benefits of protecting children. OCHP works with the National Center for
                              Environmental Economics on indicators of environmental factors affecting
                              children's  health.

                              FEDERAL  LEADERSHIP

                              EPA has exercised a leadership role in the federal community on children's
                              environmental health, in part by recognizing the fundamental importance of a
                              top to bottom partnership with  the Department of Health and Human
                              Services and other agencies through the President's Task Force on
                              Environmental Health Risks and Safety Risks to Children.

                              STATES

                              OCHP provides resources and assistance to the  states to  develop programs to
                              address their children's environmental health issues through state organiza-
                              tions such as: the Association of State and Territorial Health Officials (ASTHO);
                              the Environmental Council of the States (ECOS); the National Conference of
                              State Legislatures  (NCSL); and the National Governors Association (NGA). In
                              addition, OCHP provides resources to EPA's  Regional offices to support their
                              efforts to build capacity in the states and local communities.
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COMMUNITIES

OCHP works with community organizations to help them understand and
address their children's environmental health issues. Examples include:
(1) the Child Health Champion Community Program to empower local
citizens and communities to take steps toward protecting their children from
environmental health threats; (2) the Child Health Champion Environmental
Monitoring and Education Project to provide easily understood up-to-date
environmental information for communities; and (3) working with youth
organizations, such as the Boy Scouts and Girl Scouts, 4-H, the Future
Farmers of America, and the United National Indian Youth, to incorporate
children's environmental health into their existing programs. OCHP maintains
EPA's Children's Health Protection Web Site, which provides information to
parents and others on ways to protect children from environmental risks.

PRIVATE ORGANIZATIONS

OCHP works with private  sector organizations on children's environmental
health issues. For example, OCHP is working with health care provider organ-
izations, such as the American Academy of Pediatrics and the American
Nurses Association, to promote the incorporation of environmental health into
pediatric and nursing practices to increase the ability of primary health care
providers to identify, prevent, and  reduce environmental health threats to chil-
dren.
                     APPENDIX A • INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES    73

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     INDOOR ENVIRONMENTS: CURRENT PROGRAM PRIORITIES • APPENDIX A
     OFFICE OF ADMINISTRATION
     AND RESOURCES MANAGEMENT (OARM)
                           The Office of Administration and Resources Management's main goal regarding
                           human health indoors is to provide a safe and healthful environment for EPA's
                           own employees. Because of their expertise within EPA, OARM often works
                           in conjunction with other EPA offices, other federal agencies, and outside
                           organizations on indoor environmental issues.

                            • As part of the EPA New Headquarters project, OARM performs chamber
                               testing, modeling, and specification writing to strive for improved indoor
                               environmental quality. The protocols that have been developed by
                               OARM for office furniture during this process are now being used in an
                               Environmental Technology Verification (ETV) project with the furniture
                               industry that will result in a national furniture testing program.

                            • OARM is also actively working with OPPTS to institutionalize the
                               "Green Cleanser" project and develop language  to promote the use
                               of these cleaners in EPA buildings.

                            • With Public Technology, Inc. (PTI), OARM participated in publishing two
                               guides for sustainability in buildings. OARM is continuing to work with
                               the President's Council on Sustainable Development  on these and
                               related projects.

                            • With the General Services Administration, OARM has developed guides
                               for the management of asbestos and lead at federal facilities.

                            • OARM's multimedia laboratory uses computer technology to build
                               learning and program support tools that have wide application in the
                               federal, private, and academic communities.
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REGIONAL OFFICES
The EPA Regions support and implement the national programs
discussed earlier in this Appendix. In doing so, these offices have
demonstrated initiative and creativity in working with very
limited resources to address indoor risks in innovative ways.
When available, the Regions use statutory authorities. For
example, EPA Regional Offices are:
  •  Working with state and tribal partners to develop lead
     programs, per Title IV of the Toxic Substances Control Act,
     for certification and training of lead workers.
  •  Working with state and tribal partners to implement radon
     programs using the grant authorities of the Indoor Radon
     Abatement Act to promote voluntary programs for radon
     awareness, testing, and mitigation.
  •  Working with state and tribal partners to develop and
     implement asbestos-in-schools management programs,
     per the Asbestos Hazard Emergency Response Act.
  •  Working with public water supplies to address the require-
     ments of the Safe Drinking Water Act and the Lead and
     Copper Rule.
Of equal, and in some cases more, importance are unique efforts
for outreach, education, and technical assistance for non-regula-
tory programs, using a multitude of government, non-profit, and
other stakeholder partners. Examples include:
  •  Through Regional Indoor Air Quality Programs, efforts have
     been tailored to educate the public on a variety  of issues
     using an increasing array of effective tools. Depending on
     geography and climate, such issues as toxic mold, asthma
     and its triggers, CO poisoning, indoor use of pesticides, and
     environmental tobacco smoke are being addressed.
REGION 1
NH  TOOLS FOR  SCHOOLS
Two schools in New Hampshire
were the first successful pilot
schools in the country to fully
and successfully implement
EPA's Tools for Schools Indoor
Air Action Kit. The Pennichuck
Junior High School in Nashua
and the Little Harbor
Elementary School in
Portsmouth began the process
of implementing the Kit in the
Fall of 1996 by appointing an
IAQ Coordinator and forming
an IAQ Team. To better inform
team members about indoor air
quality and how to more fully
use the guidance, each team
was given indoor air training
by the NH Division of Human
Health Services and an EPA
grantee, the NH Coalition for
Occupational Safety and
Health (NH COSH).
                     APPENDIX A • INDOOR ENVIRONMENTS: CURRENT  PROGRAM  PRIORITIES    75

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      INDOOR  ENVIRONMENTS: CURRENT PROGRAM PRIORITIES • APPENDIX A
       REGION 2
       CLINICAL DIRECTORS  NETWORK PROJECT
       It is important to research effective ways to
       reduce asthma morbidity and translate that
       research into practice. Translation is the
       focus of a Region 2-funded grant to a non-
       profit entity called Clinical Directors
       Network (CDN). CDN's asthma project is
       operating in 11 sites in four EPA Regions
       nationwide. It is a clinically controlled study
       designed to measure the improvement in
       asthma morbidity that can be gained from
       implementing both in-home environmental
       interventions and improved clinical man-
       agement of asthma. It makes use of the
       "Best Practices" known so far, and will offer
       insight as to the best ways to implement
       this information.
•  IAQ in Schools is being addressed through
   large outreach campaigns using EPA's IAQ
   Tools for Schools Kit. Leveraging of stake-
   holder resources is crucial to these efforts.
•  Exposure to lead from paint, dust, soil, and
   drinking water are addressed with large
   outreach and education campaigns, incor-
   porating many partners.
            REGION  10
            SEATTLE/ALASKA  HEALTHY HOMES
            Through a grant with the American Lung Association of Washington, the Master Home
            Environmentalist Program promotes human health by increasing awareness of home
            environmental pollutants and encourages actions to reduce exposures.  The MHE
            program uses innovative and holistic approaches to identify hazards and ways to make
            homes healthier. The program relies on volunteers to reach out to local communities to
            deliver the latest information about environmental health issues. Volunteers complete
            extensive training in lead, dust, indoor air, household hazardous chemicals, and moisture
            problems in the home. Outreach has been conducted in Galena, AK and Seattle, WA.
            There is a new program beginning in Yakima, WA.
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APPENDIX B
PARTNERS IN INDOOR
ENVIRONMENTAL PROTECTION
                                         OTHER FEDERAL
                                         AGENCIES 	78
                                         STATE, LOCAL,
                                         AND TRIBAL
                                         AGENCIES 	89
                                         OTHER
                                         STAKEHOLDERS.... 91
                                                        77

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     PARTNERS IN INDOOR ENVIRONMENTAL PROTECTION • APPENDIX B
     OTHER  FEDERAL AGENCIES
       WORKING TOGETHER
       EPA has worked in conjunction with a number of federal agencies on joint efforts to protect
       human health indoors. A few examples of these activities are:
       JOINT PUBLICATIONS:

        With CPSC:

           •  The Inside Story

           •  Asbestos in the Home

           •  Combustion Appliances and Indoor Air
              Pollution

           •  What You Should Know About Using
              Paint Strippers

           •  Indoor Air Pollution: An Introduction for
              Health Professionals

        With DHHS:

           •  Building Air Quality: A Guide for
              Building Owners and Managers

           •  A Citizen's Guide to Radon

           •  Introduction to Indoor Air Quality

        With CPSC and HUD:

           •  Protect Your  Family From Lead in Your
              Home
  With CPSQ OSHA, the National Institute for
  Occupational Safety and Health (NIOSH), and
  the Colorado Department of Public Health and
  the Environment (CDPHE):

    •  Preventing Carbon Monoxide Poisoning
        from Small Gasoline-Powered Engines
        and Tools

JOINT PROJECTS:

  EPA is working with:

    •  HUD, CPSQ and DHHS on a number
        of projects related to lead-based paint
        hazards.

    •  GSA, under Executive Order 13101, to
        develop guidance on environmentally
        preferable products for use in federal
        buildings.

    •  The Department of Energy (DOE) to
        implement energy-efficiency and
        other improvements at EPA facilities
        to improve laboratory operations and to
        take relevant lessons to a broader audi-
        ence (e.g., hospitals, computers, etc.).

    •  The Department of Agriculture  (USDA)
        to develop a list of bio-based products
        that may be preferable for use in the
        indoor environment.
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A number of federal agencies and departments outside EPA have responsibili-
ties for protecting human health indoors. The efforts of the Occupational
Safety and Health Administration in the Department of Labor (DOL), the
National Institute for Occupational Safety and Health in the Department of
Health and Human Services, and the General Services Administration focus
on protecting the health of the workforce.

Other agencies and departments focus on reducing exposures and risks to the
general population. The Consumer Product Safety Commission is responsible
for protecting American families, especially children, from the unreasonable
risk of injury (including illness) and death from about 15,000 types of con-
sumer products under the Commission's jurisdiction. The Department of
Housing and Urban Development provides for safe and healthful housing
through programs to reduce exposures to formaldehyde, lead, and other toxic
materials in homes.

Several agencies and departments are involved in important research
activities to ensure the  protection of human health indoors. For example,
the Centers for Disease Control and Prevention  (CDC),  the Agency for Toxic
Substances and Disease Registry (ATSDR), and the National Institutes of
Health (NIH) perform wide-ranging public health research on pollutants
indoors (e.g., lead, radon, environmental tobacco smoke, combustion
products, allergens, Legionnella).The Department of Energy evaluates
the health effects of radon exposure. DOE and the National Institute of
Standards  and Technology (NIST) perform research on the relationship
between air movement and contaminant levels in buildings and other
related issues.

A number of other federal agencies and departments also have key roles
in protecting human health indoors. Many of these agencies are members
of the Interagency Committee on Indoor Air Quality. A list of Current
Federal Indoor Air Quality Activities can be found in EPA publication
EPA-402-K-99-001.
                           APPENDIX  B • PARTNERS IN INDOOR ENVIRONMENTAL PROTECTION    79

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      PARTNERS IN INDOOR ENVIRONMENTAL PROTECTION • APPENDIX B
                              OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION  (OSHA)

                              Under the Occupational Safety and Health Act (OSHAct), OSHA develops
                              and enforces occupational safety and health standards, including those related
                              to exposures to toxic substances, and has proposed a comprehensive indoor
                              air quality standard for workplaces.

                              Key activities at OSHA include:

                               •  Protecting the health and safety of American workers by promulgating
                                   mandatory standards and by inspecting workplaces to ensure compliance
                                   with those standards.

                               •  Regulating worker exposure to toxic substances and harmful physical
                                   agents, including asbestos, lead, and noise.

                               •  Publishing a proposed rule on April 5,1994 (59 FR 15968) to require
                                   employers to write and implement indoor air quality compliance plans
                                   that would include inspection and maintenance of current building
                                   ventilation systems to ensure that they are  functioning as designed.
                                   Other proposed provisions would require employers to maintain healthy
                                   air quality during renovation, remodeling, and similar activities. The
                                   provisions for indoor air quality would apply to 70 million workers and
                                   more than 4.5 million non-industrial work  environments, including
                                   schools and training centers,  offices, commercial establishments, health
                                   care facilities, cafeterias, and factory break rooms. The OSHA Standards
                                   Team is analyzing the docket, defining issues, and gathering new data.

                               •  Assisting and providing guidance to federal and state compliance
                                   officials, and to building managers, employers, engineers, and owners
                                   through OSHA's outreach program, in evaluating indoor environmental
                                   quality in non-industrial workplaces (including the occurrence of
                                   Legionnaires'disease and occupational asthma).
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CONSUMER PRODUCT SAFETY COMMISSION (CPSC)

The Commission enforces five federal statutes: the Consumer Product Safety
Act, the Flammable Fabrics Act, the Poison Prevention Packaging Act, the
Federal Hazardous Substances Act, and the Refrigerator Safety Act. CPSC's
mission is to:

  •  Protect the public against unreasonable risks.

  •  Assist consumers in evaluating comparative safety.

  •  Develop uniform safety standards so as to minimize conflicting state and
     local regulations.

  •  Promote research and investigation into causes and prevention of
     product-related deaths, illnesses, and injuries.

CPSC uses a variety of approaches to identify product hazards, including
an internationally recognized hospital emergency room reporting system
and a toll-free hotline. The Agency assesses these hazards using a risk-based
approach grounded in the best scientific data. Once the hazards are assessed,
CPSC uses a wide range  of tools to correct them, including:

  •  Voluntary standards and guidelines

  •  Product recalls and corrective actions

  •  Mandatory rulemaking (e.g., performance standards, bans, labeling)

  •  Consumer education

Because CPSC is a federal agency, its product safety work and uniform
safety guidance and  standards ensure businesses a level playing field for
domestic and imported consumer products. CPSC evaluates and acts on
health hazards associated with the use of products in the following areas:
fire (e.g., cigarette lighters and upholstered furniture); mechanical (e.g.,
children's products, household/structural products, power tools and
equipment, sports and recreational products); electrical (e.g., lights); and
                           APPENDIX B • PARTNERS IN  INDOOR ENVIRONMENTAL PROTECTION    81

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      PARTNERS IN INDOOR  ENVIRONMENTAL PROTECTION • APPENDIX B
                              chemical (e.g., fuel-burning appliances). Some specific CPSC activities
                              relating to human health indoors include:

                                •  Evaluating carbon monoxide alarms to protect against CO poisoning
                                   and working with Underwriters Laboratories (UL) to develop a new
                                   standard for CO alarms.

                                •  Conducting recalls and developing corrective actions for products
                                   that present a substantial risk of CO poisoning.

                                •  Developing voluntary standards to limit combustion pollutant
                                   emissions from kerosene heaters, unvented gas space heaters, and
                                   camping heaters.

                                •  Working with the gas water heater industry to develop an effective
                                   voluntary standard to address the ignition of flammable vapors.

                                •  Evaluating consumer products for the presence of asbestos fibers and
                                   assessing any potential risk.

                                •  Reducing consumer exposures to lead and protecting against childhood
                                   lead poisoning by investigating the release of lead from imported vinyl
                                   miniblinds and  requesting the industry cease using lead as a stabilizer in
                                   these products.

                                •  Conducting recalls of children's jewelry and toys  containing lead.

                                •  Initiating rulemaking to ban candle wicks containing greater than 0.06
                                   percent lead.

                                •  Conducting a study  of leaded paint and developing a strategy for
                                   use by state agencies for identifying and controlling leaded paint.

                                •  Assessing the potential toxicity of fire-retardant chemicals.

                                •  Initiating rulemaking to address the hazards of small flame ignitions of
                                   upholstered furniture.
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•  Assessing the performance of residential smoke alarms.

•  Identifying the potential for emissions of bioaerosols from portable
   humidifiers and developing guidelines for cleaning and maintaining
   these humidifiers to reduce  bioaerosol emissions.

•  Investigating and analyzing monitoring data on biological pollutants in
   homes, as part of the Harvard Six-City  Study.

•  Assessing the impact of selected residential heating, ventilating, and
   air-conditioning systems and control technologies on indoor air quality.

•  Evaluating carpet systems to determine if the chemicals they emit
   into the air might be responsible for the health complaints reported by
   consumers.

•  Measuring and assessing the risk of indoor air pollutant emissions
   from wood-burning stoves.

•  Convening a Chronic Hazard Advisory Panel of scientists to study issues
   related to the chronic toxicity and risk associated with exposure to
   diisononyl phthalate (DINP) in children's PVC products.

•  Promulgating several regulations requiring child-resistant packaging for
   medicines and household chemicals to  reduce the number of deaths to
   children under the  age of five from accidental ingestion.

•  Assessing the potential for noise-induced hearing loss from consumer
   products.

•  Developing and disseminating consumer information booklets/
   brochures on asbestos, formaldehyde, biological pollutants, lead,
   combustion pollutants, and  carbon monoxide alarms.
                         APPENDIX B  •  PARTNERS  IN INDOOR ENVIRONMENTAL  PROTECTION    83

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      PARTNERS IN INDOOR  ENVIRONMENTAL PROTECTION • APPENDIX B
                              DEPARTMENT OF ENERGY (DOE)

                              Under the Energy Organization Act, the Atomic Energy Act, and the Energy
                              Conservation and Production Act, DOE is charged with:

                                •  Conducting research on the health effects of ionizing radiation,
                                   including radon.

                                •  Establishing guidance for energy-efficient buildings and promoting
                                   their use.

                                •  Evaluating the impact of energy conservation standards on habitability.

                              Key research at DOE includes:

                                •  Developing, testing, and evaluating energy-efficient and cost-effective
                                   techniques to maintain indoor environmental quality.

                                •  Developing methods and protocols for measuring emissions from key
                                   building materials and products.

                                •  Determining the relationship between organic pollutants in large
                                   buildings and residences and energy-conservation methods.

                                •  Developing methods to model and measure infiltration and interzonal
                                   airflows and assess ventilation of U.S. housing and associated energy use.

                                •  Assessing the potential to improve productivity of office workers by
                                   providing better indoor environments (in conjunction with the National
                                   Institute for Occupational Safety and Health).

                                •  Supporting the American Society of Heating, Refrigerating, and Air-
                                   Conditioning Engineers (ASHRAE) in developing effective ventilation
                                   and indoor air quality standards.

                                •  Developing practical measurement techniques for ventilation rates and
                                   efficiencies.
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DEPARTMENT OF HEALTH AND HUMAN SERVICES  (DHHS)

Under the Public Health Services Act (PHSA), DHHS performs research and
other activities on the cause, diagnosis, treatment, control, and prevention of
disease related to indoor pollution. These activities include:

  •   Identifying pollutants and other environmental conditions responsible
      for human disease and adverse effects on humans.

  •   Evaluating the health costs of pollutants (with EPA and others).

There are a number of institutes and agencies within DHHS that are
doing work to protect human health indoors. The National Institute for
Occupational Safety and Health within the Centers for Disease Control
and Prevention answers inquiries on indoor environmental quality in non-
industrial workplaces (e.g., offices) and performs site investigations to solve
environmental problems in these workplaces. NIOSH also conducts
epidemiologic research on the causes and prevention of health effects in
non-industrial indoor workplaces and, through the Indoor Environment
Team of the National Occupational Research Agenda process, is working
to define and facilitate a priority research agenda to improve the health of
workers in these  indoor environments.

Other activities at CDC include:

  •   Providing information to state health departments and members of the
      public concerning the health effects of indoor environmental pollutants.

  •   Developing reliable tests for tobacco smoke exposure.

  •   Providing assistance to state and local health departments in conducting
      screening and surveillance activities in order to minimize the adverse
      effects of environmental lead contamination.

  •   Providing assistance to states to address asthma including a variety of
      training and program development efforts, transfer of best practices, and
      modes for surveillance.
                           APPENDIX B  • PARTNERS  IN  INDOOR ENVIRONMENTAL  PROTECTION   85

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      PARTNERS IN INDOOR ENVIRONMENTAL PROTECTION  • APPENDIX B
                              The Agency for Toxic Substances and Disease Registry within DHHS
                              provides assistance and advice on indoor environmental contaminant
                              exposures related to hazardous waste sites.

                              Several institutes within the National Institutes of Health are also doing work
                              to protect human health indoors, especially in the area of asthma.

                              DEPARTMENT OF HOUSING AND  URBAN DEVELOPMENT (HUD)

                              HUD has been actively involved in a number of key indoor environmental
                              issues. Through the National Manufactured Housing Construction and Safety
                              Standards Act, HUD has provided for safe and healthful conditions in manu-
                              factured housing. Standards for formaldehyde emissions from pressed wood
                              products have been promulgated under this Act. In addition, HUD is working
                              to improve the air distribution systems in these types of homes. HUD also
                              determines HUD/FHA and Public and Indian housing policies on radon issues.

                              Through the Residential Lead-Based Paint Hazard Reduction Act, HUD works
                              to reduce lead exposures in U.S. housing. Key activities in this area have
                              included:
                               •  Implementing the HUD Lead Hazard Control Grant Program, which has
                                   eliminated lead-based paint hazards in 50,000 privately owned low-
                                   income housing units.
                               •  Scientifically evaluating the effectiveness of a range of lead hazard con-
                                   trol strategies, through the National Evaluation of the HUD Lead Hazard
                                   Control Grant Program.
                               •  Conducting research on lead-based paint identification, evaluation, and
                                   control methods, and conducting the National Survey of Lead and
                                   Allergens in Housing, the first such survey.
                               •  Developing, implementing, and enforcing (with EPA and DOJ) the Lead
                                   Disclosure Rule for renting or selling pre-1978 housing.
                               •  Developing, implementing, and enforcing the Lead Safe Housing Rule
                                   for federally owned and assisted properties.
                               •  Surveying public awareness of lead-based paint hazards and their causes,
                                   and determining the effects of hazard disclosure on real estate transac-
                                   tions.
                               •  Developing model provisions for state and local housing codes, model
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     abatement specifications, and work practice guidance and training
     curricula for reducing lead-based paint hazards during maintenance,
     renovation, remodeling, and rehabilitation work.

Finally, conducting general or targeted community programs on environmental
health and safety hazards under their"Healthy Homes Initiative,"HUD considers
allergens and asthma, asbestos, combustion products, insect and rodent pests,
mold and moisture, pesticide residues, and radon key targets for intervention.

A key Initiative objective is reducing multiple hazards in housing that pose
risks for residents, particularly children, using a single intervention. Healthy
Homes projects also focus on developing and implementing cost-effective
strategies for hazard assessment and intervention methods, and for developing
and disseminating technical assistance, guidelines, and model provisions for
housing codes and standards. Much of this work is accomplished through
competitive grants to communities to support local Healthy Homes programs.
HUD also works with other federal agencies to fund joint Healthy Homes
research and education projects, such as "Help Yourself  to a Healthy Home," a
booklet that contains tips on improving indoor air quality.

GENERAL SERVICES ADMINISTRATION (GSA)

GSA provides indoor environmental quality guidelines for federal (GSA-
owned) buildings and leased  space. Key activities include:
  •  Providing information to consumers who purchase office furniture from
     the Federal Supply Service schedule.
  •  Coordinating radon testing and mitigation in GSA-controlled buildings.
  •  Funding indoor air quality research by the National Institute for
     Occupational Safety and Health in  GSA buildings.
  •  Providing an indoor environmental quality program that has:
        An ongoing component that includes responding promptly to
        concerns and, when possible, correcting problems discovered.
        A pro-active component that includes conducting indoor
        environmental assessments  as part of a survey program.

The Federal Consumer Information Center (FCIC), an  office of GSA, offers
several publications from federal agencies on indoor environmental  quality in
their Consumer Information Catalog and on their web site at
http:Avww.pueblo.gsa.gov.
                           APPENDIX B • PARTNERS IN INDOOR ENVIRONMENTAL PROTECTION    87

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PARTNERS IN INDOOR ENVIRONMENTAL PROTECTION • APPENDIX B
                        NATIONAL  INSTITUTE OF STANDARDS AND TECHNOLOGY (NIST)

                        The focus of studies at NIST has been on the relationship between ventilation
                        and contaminant levels in buildings. Activities at NIST include:

                          •  Developing models to account for air movement and contaminant
                             dispersal in buildings.

                          •  Developing an understanding of factors affecting the mixing of carbon
                             monoxide in buildings as it relates to the location of alarms.

                          •  Performing simulation studies of approaches to the ventilation of
                             residential buildings.

                          •  Developing test methods and procedures for studying air change charac-
                             teristics, pollutant levels, and their relationship in large buildings.

                          •  Developing a practical guide to procedures for assessing ventilation rates
                             in commercial buildings.

                          •  Developing test methods for lead in paint (in cooperation with HUD
                             and EPA).

                          •  Maintaining national radium and radon measurement standards.

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STATE,  LOCAL, AND  TRIBAL AGENCIES
The quality and structure of state, local, and tribal indoor environmental
programs vary significantly from state to state. Some states have strong or
moderately strong indoor environmental programs, while others have
essentially no programs at all.

State, local, and tribal programs provide public information, problem assess-
ment, and response, but often these activities are divided among several
agencies, particularly at the state level, as a reflection of the multifaceted
nature of indoor environmental issues. Some states, like California, Florida,
and Vermont, have interagency indoor environmental groups to coordinate
activities across state agencies. The strongest state programs are those which
have been mandated by state legislation. In these states, much of what has
been achieved has been through voluntary compliance. Many state and local
governments do have some regulatory authority in specific areas (e.g.,
asbestos, lead, radon, environmental tobacco smoke). A substantial compo-
nent of many state programs is to assist local governments and tribes to
address indoor environmental issues at the local and tribal level.

State-level indoor environmental programs  are often hampered by the
lack of a routine funding mechanism, with the exception of state radon
programs which can receive federal funding. Agencies  sometimes respond
to problems identified through publicity or public outcry. Such response is
frequently reactive and crisis-driven. In some states, there is no organized
structure in place to educate or empower the public about their indoor
environment, and funding may decrease when the issue drops out of the
media spotlight.

Like state governments, local health and/or environmental offices often have no
established indoor environmental programs. They may create a mechanism to
respond to a current crisis, routine public inquiries, or public outcry.
                          APPENDIX B  • PARTNERS IN INDOOR ENVIRONMENTAL  PROTECTION    89

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      PARTNERS IN INDOOR ENVIRONMENTAL PROTECTION • APPENDIX B
                              The scarcity of local government programs is being offset by grassroots
                              coalitions and non-profit organizations, extension educators, and local
                              professional organizations working independently and in cooperation
                              with each other and federal, state, and local officials on public outreach
                              and program implementation. Some funding and training for indoor
                              environmental activities is available for and utilized by local governments,
                              local health and environment officials, and non-profit organizations. More
                              limited funding may be available for local indoor environmental needs on
                              a competitive or ad hoc basis from federal and/or state agencies.

                              Some tribal governments have established radon and indoor environmental
                              programs and receive federal funding. The close-knit nature of tribal
                              councils and the high regard of elders have proven effective in implementing
                              grassroots environmental programs and allowed for good coordination of
                              environmental program activities. Economic and cultural issues make
                              some environmental issues a particular challenge. Involvement of the
                              tribal council and elders assures awareness of cultural sensitivities and
                              increases the opportunity for success.

                              The strongest indoor environmental programs were found in states where
                              there was a funding mechanism, upper management support of the program,
                              and/or full time staff dedicated to indoor environmental efforts. However,
                              even states with strong programs generally face constraints which keep them
                              from doing the kind of proactive outreach which would prevent indoor
                              environmental problems and crises or have serious gaps in their programs.
                              For example, some statewide/regional programs cover such a large geographic
                              area that individual city or county assistance could be more  effective. Some
                              states have a strong indoor environmental quality program in schools, but do
                              not address homes at all. In other states, efforts for lead or pesticides may be
                              targeted to specific audiences due to staff limitations (e.g., integrated pest
                              management in schools, lead awareness to real estate professionals).
                              Pesticides programs are frequently housed in state agriculture departments,
                              which will follow up on indoor environmental concerns regarding pesticides
                              misuse if contacted.
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OTHER  STAKEHOLDERS
Many different entities in the private sector impact the state of human health
indoors. A few of the key stakeholder groups that have a role in protecting
human health indoors, and their potential roles in solving indoor
environmental problems, are discussed below.

CONSUMER,  ENVIRONMENTAL, AND  HEALTH PROFESSIONALS

Consumer, environmental, health, and other professionals are knowledgeable
about the symptoms and effects produced by environmental pollutants and can
advise the public on possible mitigation of environmental exposures. They use
diverse approaches to protecting human health indoors, including developing
information and education programs to educate the public about indoor envi-
ronmental quality, conducting research to identify problems and recommend
solutions, and participating in the policy-making process.

MANUFACTURING AND NATURAL RESOURCE INDUSTRIES

Manufacturers can ensure good indoor environments by designing products and
materials that eliminate or reduce exposures to toxic chemicals, pesticides, and
other pollutants to safe levels. These include consumer and commercial products,
building materials, office equipment, and furniture. Manufacturers can also label
their products so that they will be properly used and maintained. If a supplier
provides raw materials (e.g., chemicals) to be formulated further into a product,
the supplier can provide the formulator with sufficient health and safety informa-
tion to allow the formulator to determine if the raw material can be safely used in
the intended application. Manufacturers and suppliers can conduct research and
adopt test procedures (e.g., emission test procedures) and standards to ensure that
the products and materials that they sell are safe  for use in indoor environments.
                          APPENDIX B • PARTNERS IN INDOOR ENVIRONMENTAL  PROTECTION    91

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      PARTNERS IN INDOOR ENVIRONMENTAL PROTECTION • APPENDIX B
                              BUILDERS AND ARCHITECTS

                              Builders and architects can work to design and build structures that
                              eliminate indoor environmental problems or enhance indoor environments.
                              By thinking about the quality of the indoor environment in the design stage,
                              in construction practices, and in remodeling, builders and architects can have
                              a substantial impact on the health and safety of the building occupants.
                              Builders and architects can help achieve safe indoor environments by selecting
                              building materials that will not release harmful levels of toxic chemicals into
                              occupied indoor environments (either when the materials are new or as they
                              age) and by designing buildings to be in compliance with indoor air quality
                              ventilation standards. During the remodeling of occupied buildings, builders
                              and architects can help protect the safety of tenants by isolating them from
                              pollutants generated during construction work.

                              BUILDING OWNERS, MANAGERS, AND ENGINEERS

                              Building owners, managers, and engineers ensure good indoor environmental
                              quality by properly operating and maintaining buildings. Building owners,
                              managers, and engineers can foster a good indoor environment by adopting
                              maintenance procedures to eliminate and prevent contamination and ensure
                              an adequate supply of clean air to occupants; using zone ventilation or local
                              exhaust for indoor sources; developing specific procedures for use of cleaning
                              solvents, paints, pesticides, and other products and materials within the build-
                              ing; and abiding by recognized standards of care for building maintenance.
                              Their role includes establishing a process to educate building occupants about
                              their roles in maintaining good indoor environmental quality and encouraging
                              an active exchange of information about indoor environmental problems. They
                              can develop and adopt formal protocols to investigate indoor environmental
                              complaints from occupants, thereby encouraging an atmosphere of trust.
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DIAGNOSTIC AND MITIGATION SERVICES

Diagnostic and mitigation firms respond to hazards and complaints in
problem buildings. They may work closely with building owners, managers,
and engineers or individual homeowners to investigate indoor environmental
quality issues. Professionals in these firms span a broad range of occupations,
including industrial hygienists, mechanical (ventilation) engineers and techni-
cians, microbiologists, architects, chemists, air pollution scientists, industrial
engineers, risk assessment personnel, abatement personnel, and others. The
services of most of these firms include evaluations of ventilation systems,
measurement of indoor pollutants, and characterization of the sources of
pollutants in buildings. Through these efforts, they can be instrumental in
turning a problem building into a healthy building.

REAL ESTATE INDUSTRY

The real estate industry has begun addressing a variety of indoor environmen-
tal issues in the past few years as a result of both client demand and legal
requirements. The real estate industry, discovering a need to know more about
radon, lead, asbestos, the safe application of pesticides, and underground
storage tanks, is partnering with government and industry organizations to
provide the necessary training to its members to facilitate transactions and
improve customer service.

UNIONS

Unions can protect human health indoors by ensuring a clean and healthy
indoor environment for their members. They can work with building
owners, managers, and engineers to ensure that employees are afforded an
optimum work environment. If problems occur, they can come to the aid of
employees who feel that they have been improperly exposed to  pollutants in
their workplaces and can work with building designers, owners, managers,
and engineers in the design and operation of healthy workplaces.
                          APPENDIX B • PARTNERS  IN INDOOR ENVIRONMENTAL PROTECTION    93

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      PARTNERS IN INDOOR ENVIRONMENTAL  PROTECTION • APPENDIX B
                               STANDARD-SETTING ORGANIZATIONS

                               Standard-setting organizations (e.g., building code organizations, the American
                               Society for Testing and Materials (ASTM), the American National Standards
                               Institute (ANSI), the American Society of Heating, Refrigerating, and Air-
                               Conditioning Engineers, Underwriters Laboratories, NSF International, the
                               American Conference of Governmental Industrial Hygienists (ACGIH)) can
                               play an important role in protecting human health in indoor environments.
                               Depending on the organization, they can provide a range of services. One
                               important service of some standard-setting organizations is to foster healthy
                               indoor environments by developing or enhancing, providing for efficient use
                               of, and, and in some cases, enforcing model building codes. Other services
                               standard-setting organizations may provide are setting uniform methods of
                               testing, establishing levels of accepted practice, or developing and maintaining
                               consensus standards. Some may provide certification opportunities, laboratory
                               testing and toxicological assessments related to certification, and conformity
                               assessments and compliance monitoring. Education and training services may
                               also be provided. Standard-setting organizations can help product manufactur-
                               ers, code writers, designers, builders, enforcement officials, and others perform
                               their functions in a more effective and efficient manner. Standard-setting
                               organizations can also play an important role in providing the public with some
                               assurance that their homes, schools, and workplaces, and the products that go
                               into them, are safe.

                               RESEARCH ORGANIZATIONS

                               Many research organizations work to protect human health indoors. Some of
                               these organizations address policy issues, such as providing critical analyses of
                               the potential risks for pollutants indoors, addressing land use and building
                               design issues, or setting future strategies for protecting indoor environments.
                               Scientific research organizations address a wide range of issues related to
                               indoor environments, including proper building design and operation, health
                               and comfort impacts of poor indoor environments, measurements of indoor
                               pollutants and the characterization of emissions  from products and materials
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used indoors, and exposure mitigation (e.g., ventilation, air cleaning, source
control, individual behaviors). Because research in indoor environments is
relatively new, these organizations play a key role in determining future areas
of concern for indoor environments.

INDIVIDUALS

Individuals are the strongest force in protecting human health indoors.
Consumers protect their own health and the health of those around them
by properly maintaining their homes and making informed choices about
consumer goods and services. Building occupants (e.g., office workers) do
the same by properly using products and equipment within the building.
With knowledge, individuals can take many actions to avoid personal
exposures. The value of individual behavior cannot be minimized in our
efforts to develop and implement a nationwide strategy to improve indoor
environments.
                          APPENDIX B • PARTNERS IN INDOOR ENVIRONMENTAL PROTECTION    95

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96

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APPENDIX C
COMMENTS ON THE DRAFT REPORT
                                            97

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      COMMENTS ON  THE DRAFT REPORT • APPENDIX C
         CCESS TO COMMENTS
       IN THE OAR DOCKET
       Full comments on the draft
       report can be accessed in dock-
       et number A-98-05 at:

       Air and Radiation Docket and
       Information Center
       Mail Code 6102
       Room Number M1500
       401 M Street, SW
       Washington, DC 20460

       Phone: 202.260.7549
       Fax:   202.260.4400
       E-mail: a-and-r-docket@epa.gov
Full comments on the draft HBHP report can be accessed
through the OAR docket (see the box on the right). A summary of
the comments is provided below. Comments were received from
over 40 individuals and organizations and represented a wide
array of perspectives.

A number of state officials acknowledged how important the
indoor environment is to public health, and that increased atten-
tion and resources are needed at the state and local level in order
to  effect positive change. We agree with this, and hope that state
and local governments, as resources permit, seriously consider
implementing some of the potential actions contained in this
report. In addition, EPA and others need to partner with state,
local, and tribal governments as we begin to take action to
improve the indoor environment. Moreover, federal and state  leg-
islators need to consider funding sources for state, local, and tribal
involvement.

Several commentors wanted a more explicit recognition of the
interrelationship between indoor and outdoor air pollution, and
the important contribution that ambient pollution makes to the
indoor environment through natural and mechanical ventilation.
We recognize this important relationship, and have modified  the
principles outlined in the final report to more fully make this con-
nection. Moreover, the Office of Air and Radiation at EPA has
recently begun an air toxics pilot project in the City of Cleveland
to  take an integrated look at both the outdoor and indoor sources
of  air toxics, given the strong interrelationship between outdoor
and indoor air. When this pilot is successfully completed, EPA
hopes to replicate it in other urban areas across the country.

A number of commentors wanted us to more explicitly recognize
that combinations of pollutants (i.e., mixtures) may also be
responsible for poor indoor environmental quality. We agree with
this; the draft report specifically recognizes the dearth of research
on mixtures and calls for such research as part of any cross-Agency
research strategy in the "Potential Actions" section associated with
Goal 1.
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Some commentors wanted us to add much more specificity to the "Potential
Actions" section. For example, some commentors wanted us to specify particu-
lar building types, and, for each type, detail associated actions. We intentionally
avoided this type of approach because certain universal needs exist across all
building types. For example, under Goal 2, generating good cost/benefit data,
creating integrated designs, marketing attractive incentives, and promoting
good IEQ standards are common to all building types.

A number of commentors expressed concern that there were not more distinct
references in the draft report to the importance of ventilation to good IEQ. We
agree with the commentors  on the importance of adequate ventilation and
good IEQ. While not explicitly addressed in many places in the draft, we
believe that ventilation issues will be addressed by several of the potential
action areas. For example, ventilation issues will be captured in "risk manage-
ment research" under Goal 1, and are an integral part of "excellent IEQ
standards of care"under Goal 3. However, we have made several changes
in the final report  to more specifically recognize the important link between
ventilation and IEQ.

Finally, some commentors pointed out that a section was needed to address
the legislative and regulatory (including building code) changes  that will be
necessary to realize the  goals outlined in the draft report. We acknowledge
that many approaches, voluntary, as well as regulatory, will be needed in order
to achieve healthier indoor environments. Those who embrace the vision and
goals of the HBHP report will need to decide the most effective  approach to
implement the potential actions identified.
                                            APPENDIX  C • COMMENTS ON  THE DRAFT REPORT    99

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