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 asthmaan 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.
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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.
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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 groupsusually 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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REFERENCES
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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.
54
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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
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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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APPENDIX C
COMMENTS ON THE DRAFT REPORT
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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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