I
Baltimore
Integrated Environmental Management
Project
Phase II Report
Indoor Air
EPA
230/
1987.3
c.2
Regulatory Integration Division
Office of Policy Analysis
Office of Policy, Planning, and Evaluation
U.S. Environmental Protection Agency
•t 1987
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.S. Environ-.,' ••
Room 7
401 M Street,
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Baltimore-
Integrated Environmental Management Project
Phase II Report:
Indoor Air
Prepared
by
David Filbert, Ch ief
Bureau of Air Quality Management
Baltimore County Department of Environmental Protection
and Resource Management
Roberta Grossman
(formerly) Regulatory Integration Division
U.S. Environmental Protection Agency
1987
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Preface
This report was prepared under the auspices of the Baltimore
Integrated Environmental Management Project (IEMP). The Baltimore
IEMP is a collaborative effort of the State of Maryland, Anne
Arundel and Baltimore Counties, the City of Baltimore, and the
U.S. Environmental Protection Agency. EPA initiated the project
as part of its pursuit of new approaches to environmental manage-
ment and policy. The purpose of the IEMP is to use an integrated
approach to identify and assess environmental issues that concern
managers, to set priorities for taking action on them, and to
analyze appropriate approaches to managing them.
The Baltimore IEMP represents the second of four geographic
projects that EPA initiated across the country. The Baltimore
area was chosen, not because it has a significant toxics problem,
but because EPA and local officials wanted to explore better ways
to identify, assess, and manage the human health risks of environ-
mental pollutants in the area. Other lEMPs include Philadelphia,
Santa Clara County, and Denver.
The decision-making structure of the Baltimore IEMP consisted
of two committees, which also served as the* means for State and
local participation: the Management Committee and the Technical
Advisory Committee. The Management Committee with members repre-
senting Baltimore City, Baltimore County, Anne Arundel County, and
the State, managed the IEMP and set its overall policy directions.
The Technical Advisory Committee composed of technical managers
from the City of Baltimore, the two counties, and the State, as
well as representatives from the Maryland Regional Planning
Council and the academic community, recommended issues to study,
advised the MC on the technical and scientific aspects of the
project, and oversaw and commented on all EPA and consultant
work. EPA provided administrative, technical, and analytical
support.
The Baltimore IEMP examined five environmental issues: air
toxics, Baltimore Harbor, indoor air pollution, abatement of the
hazards from lead paint, and potential contamination of ground-
water from underground tanks. For further information on these
reports or other IEMP studies, contact the Regulatory Integration
Division, the Office of Policy Analysis (PM-220), in the Office
of Policy, Planning, and Evaluation, U.S. Environmental Protec-
tion Agency, Washington, D.C. 20460.
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ACKNOWLEDGMENTS
Numerous individuals contributed their time and effort to
the preparation of this report.
Indoor Air Pollution Work Group
{Catherine Farrell, M.D. , MPH, Chief, Division of Environmental
Disease Control, Maryland Department of Environment
David Filbert, Chief, Bureau of Air Quality Management, Baltimore
County Department of Environmental Protection and Resource
Managemen t (Cha irman)
Joseph Abey, Chief, Air Quality Control Section, Anne Arundel
County Department of Health
Charles Billings, Ph.D., (formerly) Associate Professor, Environ-
mental Health Engineering, School of Hygiene and Public Health,
Johns Hopkins University
Elkins W. Dahle, Jr., P.E., Director, Bureau of Industrial Hygiene
Baltimore City Department of Health
Roberta Grossman, (formerly) Regulatory Integration Division, U.S.
EPA
Allan B. Heaver, Director, Baltimore Building Owners and Managers
Assoc iation
Thomas A. King, P.E., Manager, Environmental Systems Department,
Mueller Associates, Inc.
Members of the Baltimore IEMP Management Committee
J. James Dieter, Special Assistant to the Director, Department of
Environmental Protection and Resource Management, Baltimore
County
Max Eisenberg, Assistant Secretary for Toxics, Environmental
Science, and Health, Department of the Environment, State of
Maryland
Robert Perciasepe, (formerly) Assistant Director, Department of
Planning, City of Baltimore
Claude Vannoy, Assistant to the County Executive for Land Use,
Anne Arundel County
11
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Members of the Baltimore IEMP Technical Advisory Committee
Jared L. Cohon, Vice Provost for Research, and Professor of Geographic
and Environmental Engineering, Johns Hopkins University (Chairman
Technical Advisory Committee)
Don Andrew, Administrator, Engineering & Enforcement Programs, Depart-
ment of the Environment, State of Maryland
i>
Philip Clayton, Manager, Cooperative Clean Water Program, Regional
Planning Council
Emery Cleaves, Deputy Director, Maryland Geological Survey
Ralph Cullison, Baltimore City Department of Public Works, City of
Baltimore
N. Singh Dhillon, Director, Environmental Health, Anne Arundel County
Health Department
Tom Ervin, Environmental Planner, Anne Arundel County Office of
Planning and Zoning
Katherine Parrell , M.D. MPH, Chief, Division of Environmental Disease
Control, Office of Environmental Programs, State of Maryland
David Filbert, Director of Air Pollution Control, Baltimore County
Department of Environmental Protection and Resource Management
Frank Hoot, Assistant Commissioner, Environmental Health, Baltimore
City Health Department (Chairman, Human Health Subcommittee)
Sam Martin, Consultant, vice Chairman of TAC
Janice Outen, Supervisor of Water Quality, Baltimore County Depart-
ment of Environmental Protection and Resource Management
Colin Thacker, Special Assistant to the Director, Baltimore County
Department of Environmental Protection and Resource Management
Bill Wolinski, Water Quality Coordinator, Baltimore City Water Qual-
ity Management Office
111
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Support Staff and Resource Persons
Roberta Grossman, (formerly) U.S. EPA Regulatory Integration Division
Bruce W. Jacobs, C.I.H., (formerly) Environmental Toxicologist, Office
Office of Environmental Programs, Maryland Department of Environment
John Shumaker, Program Supervisor, Bureau of Air Quality Management
Baltimore County Department of Environmental Protection and Resource
Management
Melissa Wieland, Environmental Technician, Environmental Programs
Unit, Baltimore Gas and Electric Company
Charles Courtney, Chief Air Pollution Control, Baltimore City Depart-
ment of Ffealth
Jeffrey M. Paull, M.S., MPA, Environmental Toxicologist, Science and
Health Advisory Group, Maryland Department of the Environment
Staff of U.S. Environmental Protection Agency
Daniel Beardsley, Director, Regulatory Integration Division
Arthur Koines, Chief, Geographic Studies Branch
John Chamberlin, Site Director, Baltimore IEMP
Andrew Manale, Senior Analyst, IEMP
Catherine Tunis, Policy Analyst, IEMP
Ellen Tohn, Policy Analyst, IEMP
iv
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Table of Contents
Preface • i
Acknowledgments it
Table of Contents v
List of Tables and Appendices vi
Executive Summary vii
Introduction 1
Background on Indoor Air Pollution 3
Health Hazards 3
Current Regulatory and Government Activities.... 4
The Evaluation Process 5
Step !:__ Select the Pollutants for Further Study 5
Step 2: Develop and Review Background Information 6
Documents on Each Pollutant
Step 3: Summarize the Background.Information Documents..?
Step 4: Develop Criteria for Evaluating the Pollutants..?
Step 5: Apply the Rating Criteria to the Pollutants 9
Step 6: Identify Potential Programs 13
Step 7: Develop Criteria for Evaluating the Potential
Programs 16
Step 8: Apply the Criteria to the Potential Programs....19
Step 9: Set Priorities for Implementing the Programs.... 22
Conclusions and Recommendations 23
Program Recommendations for Passive Smoking 24
Program Recommendations for Radon 24
Some Observations on the Evaluation Methodology 24
References 26
Appendix 1
Appendix 2
Appendix 3
Appendix 4a
Appendix 4b
Appendix 5a
Appendix 5b
Appendix 6
Indoor Air Pollution Questionnaire
Compilation of Questionnaire Data
Background Information Document Summaries
"Toxicology," an article by Thomas J. Haley, P.D.
(in part)
Justification for the Pollutant Rating Scores
Passive Smoking: Justification for Ratings of
Potential Programs
Radon: Justification for Ratings of Potential
Programs
Pollutant/Programs Overview Chart
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LIST OF TABLES AND EXHIBIT
Exhibit 1 Indoor Air Pollution Work Group 3
Table 1 Pollutant Rating Scores 10
Table 2 Results of Pollutant Ranking 11
Table 3 Program Criteria Ratings - Passive Smoking 20
Table 4 Program Criteria Ratings - Radon 21
VI
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EXECUTIVE SUMMARY
In recent years numerous studies have shown that indoor
concentrations of many pollutants can reach levels that exceed
outdoor air quality standards. Since many people spend up to 90
percent of their time indoors, these concentrations may present
a significant public health hazard.
The Baltimore Integrated Environmental Management Project
(IEMP) conducted a Phase I study to identify major environmental
issues for further study. Indoor Air Pollution was one of five
issues selected for analysis in Phase II. The Indoor Air Pollu-
tion Work Group was established to determine:
0 which indoor air pollutants in the Baltimore area should
be assigned the highest priority for further evaluation;
and
0 which programs, if necessary, could most effectively and
efficiently reduce exposure to those pollutants.
Using professional judgment and very limited national and
local data, we began by selecting several indoor pollutants con-
sidered to be prime candidates for evaluation: asbestos, chlordane,
chloroform, formaldehyde, lead, (later assigned to another work
group for consideration), products of combustion, radon, tobacco
smoke (passive smoking), and volatile organic compounds (VOC).
We then prepared a comprehensive background information document
for each pollutant. Each document included a general discussion
of the pollutant, its sources, factors leading to exposures, health
effects, control strategies, and ongoing control/assessment activ-
ities along with a more specific discussion of information relevant
to the Baltimore area. These documents are available separately
from this report, as Baltimore IEMP Indoor Air Pollution Phase II
Study; Support Documents 1987.
We rated and ranked each pollutant using four criteria: the
population potentially exposed to the pollutant, the pollutant's
potential health effects, how government agencies and interested
organizations perceive the pollutant's risks, and the public's
concern over the pollutant. We concluded that:
0 of the nine pollutants we considered, passive smoking,
radon, and asbestos are of greatest concern;
o chlordane and formaldehyde are of least concern; and
o combustion products, chloroform, and other VOCs fall some-
where in between.
vn
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We Identified and evaluated potential programs for assessing
or controlling the highest-priority pollutants. As an initial
step, we used a fifth criterion—current activity to control the
problem—to evaluate the priority pollutants. We found significant
efforts already under way to control asbestos. Therefore, we fo-
cused our efforts on passive smoking and radon. We rated various
control and assessment programs, using the five criteria of cost,
time frame, acceptability to the public, legal considerations,
and political sensitivity. As a result, we recommended the follow-
ing programs for dealing with these problems:
0 passive smoking
— stop-smoking clinics, self-help programs
— public education
-- smoking policies in government and nongovernment build-
ings
0 radon
— education of the public and government officials
— conduct of a State or local survey to establish a
profile of the radon problem in the area.
As a conseguence of this oroject, we engaged in extensive
communication with individuals representing a large number of
agencies and organizations concerned with indoor air pollution.
This laid a foundation for continued cooperation. The agencies
and organizations that participated in the study should explore
ways to capitalize on and make formal this informal communication
network.
The results of the Indoor Air Pollution study should offer
useful guidance and background for the formulation of further
studies and control programs. However, these results cannot be
considered definitive.
The lack, of data on measured indoor concentrations and expo-
sures in the Baltimore area, and the lack of resources to generate
such data, rendered a more comprehensive evaluation impossible.
As a result, the Phase II work was based on readily available
national information and on the collective experiences, expertise,
and professional judgement of the work group members.
The Baltimore data base on indoor concentrations and exposures
should improve in the near future. EPA's Office of Research and
Development is conducting a project in the Baltimore Area called
the Total Exposure Assessment Methodology (TEAM). This project
is collecting data on personal exposures to indoor and outdoor
toxic air pollution. It should prove to be a valuable source of
specific, local data for further consideration of which pollutants
in the area are of most concern. The data from this project should
be available in 1988.
Vlll
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INTRODUCTION
In the summer of 1983, the Environmental Protection Agency
(EPA) initiated the Baltimore Integrated Environmental Manage-
ment Project (IEMP). The project's objectives were to identify
and assess the significance of environmental problems in the
Baltimore area, to set priorities for taking action on those
problems, and to select appropriate approaches to manage them.
The project involved representatives of the State of Maryland,
the City of Baltimore, and Baltimore and Anne Arundel Counties.
The lEMP's Management Committee (MC) and Technical Advisory
Committee (TAG) served as the vehicles for State and local parti-
cipation. Charged with managing the IEMP, the four members of the
MC derived their authority from the highest-level policy-making
bodies within the three local jurisdictions and the State. The
fifteen-member TAC was composed of technical managers from the
three local jurisdictions and the State, as well as representatives
from the Baltimore Area Regional Planning Council and the academic
community. Besides providing technical and scientific advice to
the MC, the TAC members served as liaisons to other policy makers
in the local agencies. EPA served as staff to both committees
and provided technical, analytic, and administrative support to
the project.
The Baltimore IEMP consisted of two phases. In Phase I, we
identified 32 environmental issues for further study and developed
a process for setting priorities among them.* We selected five
issues for study in Phase II: indoor air pollution, toxic air
pollution, the Baltimore Harbor, underground storage tanks, and
multimedia metals.
For this Phase II study, the TAC established a work group on
indoor air pollution (see Exhibit 1). The work group's objectives
were to develop a method for identifying and evaluating both (1)
indoor pollutants of concern in the Baltimore area, so we could
set priorities for dealing with them, and (2) programs for reducing
exposures to them. Because of a lack of available data on human
exposure to indoor pollutants in the Baltimore area and a lack of
resources to generate new data, we relied heavily on our own pro-
fessional judgment. Thus, the expertise and experience of the
members of the work group were critical to the success of the study.
* For a complete discussion of the Baltimore IEMP and Phase I
activities, see the Baltimore Integrated Environmental Manage-
ment Project: Phase I Report, May 1987, U.S. EPA Office of
Policy Analysis PM-220.
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Exhibit I
Indoor Air Pollution Work Group
David Filbert (Chairman), Chief, Bureau of Air Quality Management,
Baltimore County Department of Environmental Protection
and Resource Management
Charles Billings, Ph.D., (formerly) Associate Professor, Environ-
mental Health Engineering, School of Hygiene and Public Health,
Johns Hopkins University
Katherine P. Farrell, M.D., MPH, Chief, Division of Environmental
Disease Control, Maryland Department of Environment
Elkins W. Dahle, Jr., P.E., Director, Bureau of Industrial Hygiene,
Baltimore City Department of Health
Joseph Abey, Chief, Air Quality Control Section, Anne Arundel
County Department of Health
Allan B. Heaver, Director, Baltimore Building Owners and Managers
Association
Jack R. Lodge, Senior Engineer, Environmental Programs Unit,
Baltimore Gas and Electric Company
Arthur I. Nieberding, P.E., Project Manager, Mueller Associates,
Inc.
Velma B. Rector, Associate Director, Program Development, American
Lung Association of Maryland
Thomas A. King, P.E., Manager, Environmental Systems Department,
Mueller Associates, Inc.
Support Staff and Resource Persons
Roberta Grossman, U.S. EPA Regulatory Integration Division
Bruce W. Jacobs, C.I.H., Environmental Toxicologist, Office of
Environmental Programs, Maryland Department of Environment
John Shumaker, Program Supervisor, Bureau of Air Quality Manage-
ment, Baltimore County Department of Environmental Protection
and Resource Management
Melissa Wieland, Environmental Technician, Environmental Programs
Unit, Baltimore Gas and Electric Company
Charles Courtney, Chief, Air Pollution Control, Baltimore City De-
partment of Health
Jeffrey M. Paull, M.S., MPA, Environmental Toxicologist, Science and
Health Advisory Group, Maryland Department of Environment
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Comprised initially of three members of the TAG, the work group
added a representative from Anne Arundel County to provide represen-
tation of all three jurisdictions in the study area. We invited
additional members on the basis of their experience and expertise
in such areas as building codes and construction methods, air quality
management within buildings, particular pollutant]characteristics,
health concerns, control options and strategies,' and public edu-
cation. Several outside individuals provided special expertise
and technical assistance. The final membership is listed in Table
1.
Our primary focus was on developing a method for identifying
and ranking pollutants of concern and for evaluating and setting
priorities for programs to reduce exposures to them. For that
reason, this report is not a comprehensive analysis of indoor air
pollution in the Baltimore area. It does present some conclusions
on certain pollutants and programs for addressing them.
Before describing the Phase II method for evaluating indoor
air pollutants, we will briefly discuss the hazards from these
pollutants and the current regulatory and government activities for
controlling them.
BACKGROUND ON INDOOR AIR POLLUTION
During the past two decades, considerable amounts of time
and money have been spent on controlling emissions of pollutants
into the outdoor (ambient) air. However, many people spend as
much as 90 percent of their time indoors. [1] The people most
susceptible to the risks from air pollutants—the elderly, the
sick, and the very young—spend almost 100 percent of their time
indoors. [2] Thus, even with significant success in reducing
ambient concentrations of air pollutants, human exposure to some
pollutants may remain high.
Health Hazards
The public and the scientific community have become increasingly
aware of and concerned about the potential hazards from indoor air
pollutants. Numerous studies nationwide have established that
indoor concentrations of some pollutants can reach levels that
exceed outdoor standards for these pollutants. Efforts to conserve
energy through improved insulation of homes and the use of certain
building materials and consumer products may have exacerbated the
magnitude and severity of this public health problem.
The spectrum of indoor air pollutants includes chemical, bio-
logical, and physical agents, some of which are known and potential
human carcinogens. Some contaminants enter indoor environments
through ventilation systems or by infiltration, while others emanate
from indoor sources.
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Adverse reactions to poor indoor air quality generally fall
into three categories: (a) feelings of discomfort {e.g., thermal
discomfort, unpleasant odors, lack of air movement)? (b) acute
(short-term) health effects (e.g., mucous membrane irritation,
allergic reactions, skin rash, headaches, nausea, fatigue); and
(c) chronic (long-term) health effects (e.g., respiratory disease,
chemical sensitivity, repressed immune system response, malignan-
cy) . [3] The acute effects usually manifest themselves immediate-
ly. In contrast, some chronic environmental diseases may not be-
come evident for ten years or more. Thus, the occupants of a "sick"
building may unknowingly be subjecting themselves to some irrevers-
ible health hazards. Therefore, much of the concern about indoor
air quality focuses on the long-term health effects from indoor
exposures.
Current Regulatory and Government Activities
The Clean Air Act authorizes EPA as the lead agency in the
federal government for controlling ambient air pollution. "Ambient
air" has generally been defined as the air outside residences or
buildings to which the general public has access. [4] While the
Occupational Safety and Health Administration is responsible for
safeguarding industrial indoor environments, no one federal agency
has jurisdiction over nonindustrial indoor environments. Thus,
nonindustrial indoor air pollution has received very little federal
attention to date. To fill this void, the Government Accounting
Office has recommended that Congress amend the Clean Air Act to
give EPA the lead responsibility in this area. [6]
In 1986 Congress passed the "Radon Gas and Indoor Air Quality
Research Act" as Title IV of the Superfund Amendments. [5] Title
IV directs EPA to establish a radon and indoor air quality program
to assess the extent of the problem, to coordinate research and
development, and to recommend appropriate action to Congress with-
in two years of the act's passage.
In an interim report released in April 1987, EPA announced
that it is adopting a dual approach to indoor air pollution
control because of the complexity of the problem. Agency efforts
will concentrate on eliminating the pollutants and their sources,
as well as on developing regulations or guidance to change how
buildings function.[7]
Other federal agencies that have statutory responsibilities
related to indoor air quality are the Department of Energy, which
is responsible for energy conservation programs affecting resi-
dences and new buildings; the Consumer Product Safety Commission,
which is responsible for ensuring the safety of consumer products;
the Department of Housing and Urban Development, which sets federal
standards and regulations for buildings and building materials; and
the Federal Trade Commission, which is responsible for ensuring
truth in advertising.
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local agencies have been more active than federal
ling with indoor air guality problems, especially
f\ /•»'i^4i»»rfane«' *—r^r\/^ov*no an/1 /•*• f\-rn r\ 1 a "i r* 4" e a !•% m i 4* i M ol /"\ /*\ •"*
State and local agencies have been more active than federal
agencies in dealing with indoor air quality problems, especially
tg to citizens' concerns and complaints about indoor
>n r11 a naf-ir\r»ai cm-trow chowoH hh^f 32 states have
agencies in dealing with indoor air quality problems, especially
in responding to citizens' concerns and complaints about indoor
air pollution. [3] A national survey showed that 32 states have
a program—or at least a staff person—responsible for investigat-
ing exposures to indoor air pollutants. [8] Some of the states
active in indoor air quality are California, Massachusetts,
Minnesota, New York, New Jersey, Texas, Washington, and Wisconsin.
However, for the most part, many agencies lack the funding and
expertise to deal effectively with indoor air quality issues. They
also are severely limited by a lack of clearly defined standards,
regulations, and responsibility.
THE EVALUATION PROCESS
The work group developed a process to examine indoor air
pollutants, to rate their relative importance, and to identify
programs to reduce exposures and/or provide for further assessment
where deemed necessary. The process consist of nine steps:
Step 1: Select pollutants for further study.
Step 2: Develop and review background informantion documents
on each pollutant.
Step 3: Summarize the background information documents.
Step 4: Identify criteria for evaluating the pollutants.
Step 5: Apply the rating criteria to the pollutants.
Step 6: Identify potential programs.
Step 7: Develop criteria for evaluating the potential
programs.
Step 8: Apply the criteria to the potential programs.
Step 9: Set priorities for implementation of the programs.
Step 1; Select Pollutants for Further Study
Using information from nationwide studies and our own collec-
tive experience, we selected the following potential pollutants
and indoor air pollution problems for possible further study;
aeroallergens
aeropathogens
asbestos
odors
radon
products of combustion
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benzene
chlordane
chloroform
electromagnetic/microwaves
formaldehyde
lead
other pesticides
specific symptoms of unknown orgin
tobacco smoke
ventilation
volatile organic compounds
(VOCs)
We then designed and completed a questionnaire to help charac-
terize the nature and extent of the indoor air pollution issue in
the study area (see Appendix 1).* Based on work group responses
to the questionnaire and our professional judgment, we decided to
focus thie study on a select group of pollutants, rather than on
"nonpollutant" issues, such as ventilation and specific symptoms
of unknown origin. Thus, we selected the following 9 pollutants
for further study:
asbestos
chlordane
chloroform
formaldehyde
lead
products of combustion
radon
tobacco smoke
VOCs
We decided to examine these pollutants only in residential
buildings and in public, commercial/institutional buildings, in-
cluding the nonindustrial work place. We ruled out a study of
the health effects of air pollutants in the industrial work place,
since these effects have been the subject of considerable observa-
tion, evaluation, and control since the early 1900s.
Step2; Develop and Review Background
Information Documents on Each Pollutant
,._ ..~~,, developed a background information document on each of
the pollutants selected for further study. These documents helped
y*S *" s~i "1 *n 4- -1 r -r f\. 1 nt«t ^-i «<* 4- *s *•»*•• s*v *"k £• *% —> *~* W» V* ,f. "1T^*t-*»-i.4- —i -MI tA -! s*3 *-vvt t 4 £ T »
We next
us assess the relative
posure, health
assessment activities, and data
area.
importance of each pollutant and identify
document contains a general
to ex-
us assess cne relative importance or eacn pollutant ana 3
potential control strategies. Each document contains a
discussion of the pollutant, its sources, factors leading
posure, health effects, control strategies, known control
strategies, known control and/or
specific to the Baltimore study
This was the most time-intensive step of the evaluation process.
It involved identifying sources of information, interviewing, collec-
ting and presenting the information accurately, and reviewing it.
We also obtained outside review. (Outside reviewers are listed on
each document. The complete documents are in the separate volume,
Baltimore IEMP Indoor Air Pollution Study: Support Documents 1987.)
Taking this time was essential, however, to make sure that the
*The same questionnaire was also completed by several other organ-
izations as part of Step 4 of the process. Appendix 2 contains the
compilation of all questionnaire responses.
-6-
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evaluation process was based on the most complete, accurate and
reliable information then available.
A problem in performing this step was the difficulty we had
keeping the documents up to date. Activity dates and the status
of projects, reports, and regulatory actions were constantly
changing. To deal with this problem, we established a cut-off
date for collecting and reviewing'the information for each pollu-
tant. (However, we did update them to the extent possible, after
completing the Phase II study.)
Step 3; Summarize the Background Information Documents
After completing the background information documents, we
summarized them in a brief, usable format, (see Appendix 3).
Each summary contained the key information on which the rest
of the process would depend: the pollutant's health effects,
the population potentially exposed to the pollutant, ongoing
activities to control or assess the pollutant, and available
techniques for controlling it.
Step 4; Develop Criteria for Evaluating the Pollutants
To determine the relative significance of each pollutant
to indoor air pollution in the study area, we developed the
following five criteria:
° Population in the study area potentiallyexposed to the
pollutant. We based this criterion on our assessment
of the nature and prevalence of the sources of the
pollutant relative to the population distribution in
the study area.
° Known acute or chronic healtheffects. We based our
evaluation of this factor on determinations reported
by EPA, the National Academy of Sciences, the Inter-
national Agency for Research on Cancer, the Consumer
Product Safety Commission, and other established scien-
tific and research organizations. The health effects
are based on data generated from laboratory and epidemi-
ological studies. In addition, our rating of each pol-
lutant for this factor encompasses our judgement of like-
ly indoor concentrations and the risk associated with
them.
0 Agencies* and organizations' perceptions of the impor-
tance of each pollutant. Although this is a subjective
factor, we thought it was important to consider the pro-
fessional opinions of the agencies represented by work
group members and of 'other organizations in the study
area involved with indoor air pollution. To rate this
criterion, we used the findings and experiences from
actual field investigations in the study area, as well
as national information and research results.
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° Public's perception of the health risks of the pollut-
ants .
We rated this criterion according to the numbers and
types of public complaints and requests for assistance
the agencies and organizations received, as well as
public responses to informational and educational
campaigns (e.g., TV or radio program responses).
0 Current activity level. The gauge for this criterion
was the number of ongoing local and national activities
and programs aimed at regulating, controlling, or as-
sessing potential exposures to indoor air pollutants.
Examples of these activities are the State of Maryland's
regulations governing the removal and encapsulation of
asbestos, federal research on exposures to VOCs, legis-
lation to require training for commercial pesticide
applicators, and public information programs on radon.
We obtained this information from local and national
agencies and organizations.
There are no existing data on exposures to indoor air pol-
lutants in the Baltimore study area. Consequently the work group
selected these criteria as surrogate measures for exposure data.
In the professional judgement of the work group, they represent
the factors of concern in evaluating indoor air pollutants.
While the criteria for population potentially exposed and health
effects bring some quantitative and scientific input to the pro-
cess, the remaining three criteria are largely subjective. To
expand our information base for the agency, organization, and
public perceptions criterion, we sent the indoor air pollution
questionnaire, which we in the work group initially completed
under Step 1, to numerous other agencies and organizations within
the study area. (The questionnaire responses are compiled in
Appendix 2.)
ria:
We established the following scales for each of the crite-
Population Potentially Exposed
1 Less than or equal to 10,000
2 10,001 - 50,000
3 50,001 - 250,000
4 250,001 - 1,000,000
5 Greater than 1,000,000
Health Effects
0 No toxicity (no toxic effects)
1 Slight toxicity
2 Moderate toxicity
2.5 Probable carcinogen (or carcinogenicity in question/
controversy)
3 .. - Severe toxicity or known carcinogen
-8-
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Agency/Organization Perception of Health Threat
1
2
3
Low
Medium
High
Public Concern
1
2
3
Low
Medium
High
Current Activity Level
0
1
2
3
None
Low
Medium
High
We based the health effects scale on a ranking system
devised by Thomas J. Haley. [9] Although Dr. Haley's system
doesn't distinguish between probable and known carcinogens,
we thought that probable carcinogens present a greater haz-
ard than the number 2 ranking suggests. Therefore, we estab-
lished the 2.5 ranking. (Dr. Haley's ranking system is des-
cribed in Appendix 4a.)
Note that the scales assigned to the criteria are both
arbitrary and "ordinal"—i.e., the scores only indicate an
ordering and not differences in the evaluation. Thus, for
example, a pollutant that was assigned a 3 for health effects
is not necessarily three times more important than a pollu-
tant that scored a 1 on that criterion.
Step 5; Apply the Rating Criteria to the Pollutants
Having selected and defined the criteria, we next applied
them and rated the pollutants under consideration. At this
point, we eliminated lead from the process because the Multi-
media Metals Work Group would be evaluating all routes of ex-
posure to lead in its Phase II work, with a particular empha-
sis on home abatement procedures.
We first assigned each pollutant a numerical rating for
each of the five criteria. Table 1 shows the assigned scores.
Appendix 4b explains our reasoning for the pollutant scores.
Next, to rank the pollutants in order of relative priority, we
assigned each pollutant two numerical scores by combining the
rating criteria as follows:
1. (Population Potentially Exposed) x (Health Effects)
2. (Public Concern) + (Agency and Organization Perceptions)
We reserved the current activity level criterion for a later
secondary ranking. Table 2 shows the results of^this^ pollutant
scoring and ranking. '""""•*--
-9-
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Table 1
Pollutant Rating Scores
Pollutant
Chlordane
Formaldehyde
TOCs
Radon
Combustion
Products
Passive
Smoking
Asbestos
Chloroform
Population
Potentially
Exposed
3
3
5
4
5
5
4
5
Health
Effects
2.5
2.5
1
3
2
2.5
3
2.5
Public
Concern
1
1
1
3
1
2
3
1
Agency /Organizat ion
Perception of Health
Threat
1
1
2
3
2
2
3
1
Current
Activity
Level
1
2
1
2
2
2
3
1
Population Potentially Exposed
1 Less than 10,000
2 10,001 - 50,000
3 50,001 - 250,000
4 250,001 - 1,000,000
5 Greater than 1,000,000
Health Effects
0 No Toxicity
1 Slight Toxicity
2 Moderate Toxicity
2.5 Probable Carcinogen
3 Severe Toxicity or Known Carcinogen
Public Concern
1 Low
2 Medium
3 High
Agency/Organization
Perception
1 Low
2 Medium
3 High
Current
Activity Level
0 None
1 Low
2 Medium
3 High
-10-
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Table 2
Results of Pollutant Ranking
Pollutant
Chlordane
Formaldehyde
VDCs
Radon
Combustion
Products
Passive
Smoking
Asbestos
Chloroform
(Population x Health Effects)
3 x 2.5 = 7.5
3 x 2.5 = 7.5
5x1 = 5
4 x 3 = 12
5 x 2 = 10
5 x 2.5 = 12.5
4 x 3 = 12
5 x 2.5 = 12.5
(Public Concern +
Agency and Org Perception)
1 + 1 = 2
1 + 1 = 2
1 + 2 = 3
3 + 3 = 6
1 + 2 = 3
2 + 2 = 4
3 + 3 = 6
1 + 1 = 2
Based on the above ratings, the pollutants are ordered as follows:
(Population x Health Effects)
Passive 9moking 12.5
Chloroform 12.5
Randon 12
Asbestos 12
Combustion Products 10
Chlordane 7.5
Formaldehyde 7.5
VDCs 5
(Public Concern + Agency and Org. Perception)
Radon 6
Asbestos 6
Passive Smoking 4
VDCs 3
Combustion Products 3
Chlordane 2
Formaldehyde 2
Chloroform f 2
-11-
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Looking at the results of the ranking under each of the two
factors we concluded that:
0 passive smoking, radon, and asbestos are the highest-
priority pollutants;
0 chlordane and formaldehyde are the lowest-priority
pollutants and
0 combustion products, VOCs, and chloroform fait some-
where in the middle.
Our ranking of the pollutants does not state, nor is it
intended to imply, that passive smoking is first and formal-
dehyde is eighth. It only shows the relative positions of
the pollutants when we examined potential exposure to them
(population potentially exposed, health effects), and Balti-
more's local perception of the indoor air pollution issue
(public concern, agency/organization perception).
Considering population potentially exposed and health
effects, chloroform is a relatively high-priority polluant.
Because of the disparity between this ranking and the rela-
tively low ranking for perception, we thought that chloro-
form should be ranked somewhere between the highest and
lowest priorities. We also based our decision on the
following reasons:
0 Chloroform monitoring recently conducted at indoor
swimming pools and spas in Baltimore County showed
measured concentrations well below the threshold
values established by the American Conference of
Governmental Industrial Hygienists. (See Appendix
5 of the chloroform background information document),
Since the formation of the chloroform is enhanced at
indoor pools and spas by heating and agitation of
the water, and by the addition of chlorine disin-
fectants, we reasoned that finding significantly
higher concentrations in residences would be unlike-
ly.
0 Calculation of indoor chloroform levels in the
Baltimore study area using an indoor air quality
model suggests that ingesting and inhaling chloro-
form may be of equal importance in human exposures.
(See Appendix 3 of the chloroform background infor-
mation document.)
Monitoring conducted during EPA's Total Exposure Assess-
ment .Methodology (TEAM) study in Baltimore County included
measurement of indoor chloroform concentrations in several
private residences. The results of these measurements, to be
available in 1988, may provide a clearer picture of the re-
lative significance of chloroform as an indoor air pollutant
in the study area.
-12-
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Current Activity Level
Having established the relative importance of the pollut-
ants for further consideration, we next used the criterion of
current activity level to conduct a secondary ranking. We se-
lected this criterion to help an agency or organization with
limited resources, focus on the pollutants for which there is
little ongoing activity and on which the limited resources would
best be concentrated.
We applied this criterion to the highest-priority pollutants
identified by the first ranking scheme: asbestos, passive smok-
ing, and radon. As shown in Table 1, asbestos is rated as "high"
with a score of 3, while passive smoking and radon are both scored
as "medium." Thus, we eliminated asbestos from further consider-
ation at this point because numerous programs were already being
conducted in this area. We felt our effort would be better con-
centrated on radon and passive smoking.
Step 6;_ Identify Potential Programs
For passive smoking and radon, we next created a list of
potential programs and activities that would reduce exposures
and/or further assess the pollutant, as appropriate. Nothing
was "off-limits" at this point; we were generating a working
list and did not want to eliminate any possibilities prematurely.
We drew our initial lists of potential programs from the
Control Techniques/Technologies section contained in the back-
ground information documents. (Appendix 3 summarizes this infor-
mation.) We then expanded each list with suggestions made by
work group members.
We designed the pollutant overview chart, which proved to
be a very helpful tool in generating the program lists. The
chart helps ensure that no potential programs for a particular
pollutant are overlooked. As we completed our initial program
lists, we entered them into the chart under the general program-
matic categories of:
o public education
o pollutant assessment
o increased enforcement of existing regulations
o new regulations/codes
o economic incentives
o product controls/standards
o interagency information/communication
o indoor air pollution standards
o technical control
o research
Once completed, this chart allowed us to identify program
gaps and duplications. For example, the absence of a program
-13-
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for a particular pollutant under the general category of "assess-
ment" could trigger a reconsideration of the need for a monitor-
ing program for that pollutant. The chart could also indicate
which potential programs would affect more than one pollutant-—
e.g., public education may be a pertinent program for all pollu-
tants. (Appendix 6 shows the overview chart completed for passive
smoking and radon.)
Potential Programs for Passive Smoking
We identified the following potential programs for reducing
exposures to passive smoking:
1. Create a public education program. This program would
point out the adverse health effects associated with exposure
of nonsmokers to the sidestream smoke from burning tobacco
products. The program would reduce the source of exposures by
encouraging smokers to refrain from smoking in the presence of
nonsmokers or, ideally, to quit smoking.
2. Establish smoking policies in government and nongovern-
ment buildings. Government agencies and other organizations can
establish nonsmoking policies in their public buildings and office
buildings. The program can also include efforts to educate, en-
courage, and offer guidance to private entities to establish
similar policies in their facilities.
3. Increase enforcement of building codes and standards and
existing smoking regulations. As we noted in the background
information document on passive smoking, several regulations in
effect in the study area restrict smoking in certain areas and
types of buildings. These regulations would benefit from increased
enforcement efforts. In addition, increased enforcement of venti-
lation, air exchange, and similar requirements in building codes
will reduce levels of tobacco smoke in indoor environments.
4. Pass state and/or local laws restricting smoking. State
and local authorities can pass legislation to restrict or prohibit
smoking in areas to which the general public has access.
5. Sponsor smoking cessation programs. Such methods as
stop-smoking clinics, self-help sessions, and hypnosis sessions
can reduce the number of smokers and, therefore, the risks from
passive smoking.
6. Offer funding for the expenses of stop-smoking programs.
As part of their health care insurance packages, agencies and
organizations can provide some form of coverage for the expenses
of stop-smoking programs. They can do this in conjuction with
or in place of agency-sponsored stop-smoking methods. Coverage
might include paying the full cost or part of the cost before
employees start the program, or reimbursing employees after
they successfully complete the program and after a specified
smoke-free probation period.
-14-
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7. Increase state c igarette exc ise taxes .
Potential Programs for Radon
We identified the following potential programs for assessing
and/or reducing exposures to radon:
1. Offer a j>u b I i c edu ca t i on^ pjr gg r^m f^ r th e gene ra l_pu bli .c,_
developers, and builders. The program would provide information
in the following areas:
2.
issue.
the health effects of radon
the nature of radon, its entry into hones, and mitiga-
ive and preventive techniques
identification of potential radon problem areas (to
the extent that limited available data allow)
encouragement for individual homeowner testing for radon
awareness of developers and builders of potential radon
problem areas and building techniques for mitigation
and prevention
Educate elected and government officials about theradon
Government authorities can be educated about the health
effects of radon, its nature and characteristics, areas of the
nation where where serious problems exist, the potential for
problems in the Baltimore area, and the need for definitive
survey and testing data. Officials can be encouraged to provide
for assessment activities.
3. Conduct a state- and/or locally funded radon survey of
homes. State and local government agencies can survey homes to
generate a comprehensive data base and identify areas that have
or could have elevated radon levels.
4. Conduct a state- and/or locally funded radon survey of
schools. If available resources for a radon survey of homes are
limited, attention can be focused initially on schools, where
young children spend much of their time.
5. Provide free jradqn testing for citizens. Agencies can
provide free radon tests for citizens upon request. For example,
they can provide free monitors for citizens to use, or can send
state or local personnel to citizens' homes with testing equip-
ment. The test results would add to the current data base, but
would not be , as comprehensive as a carefully designed survey.
6. Conduct an epidemiological study to determine the health
effects from radon in the area.
-15-
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Note that the lists of potential programs for passive smoking
and radon have different emphases. Those for passive smoking focus
on activities that reduce potential exposures, while those for
radon focus more on surveys, testing, and further study. Radon is
a significant problem in many parts of the U.S. (see the background
information document) , but this is not yet determined to be the case
in the Baltimore study area due to a paucity of test data (see
radon summary in Appendix #3). Therefore, the programs for radon
address the immediate need for more testing and monitoring. Pas-
sive smoke, on the other hand, is unarguably a pervasive problem
in the Baltimore study area to which the entire nonsmoking popu-
lation is potentially exposed (see passive smoking summary in
Appendix #3). The program list, therefore, focuses immediately on
reducing potential exposures.
Step 7; Develop Criteria for Evaluating the Potential Programs
We next identified the following five criteria to use to
evaluate the feasibility of each of the programs:
0 cost
0 time frame
0 legal considerations
0 acceptability
0 political sensitivity
Following are definitions, rating schemes, and brief discussions
of each of the criteria.
Cost
The costs we considered were costs to the consumer (general
public) and/or the provider (agencies, nongovernmental organiza-
tions), incurred when putting the program in place. Examples are
costs for materials (pamphlets, brochures), and public education
costs (TV or radio time).
It is difficult to put a dollar figure on the potential
programs because the ultimate cost is very much influenced by the
other criteria. For example, a program that the public considers
unacceptable may take more time and effort to implement than a
program that the public generally embraces. Therefore, we defined
the cost factor for agencies and organizations in terms of the
anticipated level of funding that would be necessary within the
context of budget levels—i.e., new budget allocations, transfer
of resources, or adequacy of existing resources. We rated the
cost to the general public according to the relative levels of
time, effort, and money required.
High: For government agencies and nongovernmental organi-
zations (includes advocacy groups, professional
organizations such as The American Lung Association
of Maryland), the program requires a specific budget
authorization and/or other resources (staffing,
equipment, etc).
-16-
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For the general public, the program requires a signif-
icant outlay of time, personal effort, and/or money.
Medium: For government agencies and nongovernmental organi-
zations, the program requires the transfer or re-
assignment of resources to the program, and/or a
change in program priorities.
For the generaljgublic, the program requires the
commitment of time and personal effort, and/or a
moderate outlay of money.
Low: For government agencies and nongovernmental organji-
zaj: ions, the program can operate with existing
budget and personnel.
For the general public, the program requires little
time, personal effort, or personal expenditures.
Time Frame
We interpreted this criterion as the length of time needed
for starting up this program and for continued effort, if needed.
However, because of the interdependence of all the criteria, we
also considered other factors. For example, a program that needs
a new budget allocation or that is politically sensitive is likely
to take longer to implement. We based the following time ranges
on our own opinions and experiences, within the context of the
criteria.
Long >5 years
Medium 2-5 years
Acceptability
Legal Considerations
This factor is relatively straightforward. It considers what
would be required from a legal standpoint to implement the programs.
Public education programs, for instance, would not be subject to
regualtions, codes, or other possible legal constraints. On the
other hand, a program requiring testing of indoor air in homes would
require new legislation. The rating define the relative level
of potential legal requirements and issues.
High: The program requires new legislation or regulations,
Medium: The program requires union negotiations or some pos-
sible revisions of existing regulations
Low: The program requires signing -an Executive Order,
making minor modifications to the Code, and/or
adopting internal policy.
Minimal: Minimal or known legal considerations.
-17-
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Acceptability
This criterion is simultaneously the most difficult to predict
and one of the most critical of the criteria. Implementing the
majority of the indoor air programs proposed will affect both
the public and private sectors in a way they have rarely been
touched before. These programs are not dealing with traditional
sources of air pollution—i.e., an industrial or commercial
source with pollutants coming from a stack. Rather, they are
attempting to control sources of pollution that are found inside
people's homes, places of work, private businesses, and in
leisure spaces, such as theaters, restaurants, and other public
places.
Control strategies for industrial smokestacks are gene-
rally considered by the public to be acceptable and, in fact,
very desirable in many instances. On the other hand, the pub-
lic may perceive control strategies or regulations for sources
found inside private residences or businesses as being intrusive.
Therefore, "acceptability" becomes a very important consid-
eration. A program projected to be largely unacceptable to the
constituencies will require considerable effort to implement.
Conversely, a program that is widely embraced will have a much
greater opportunity for succeeding. It will require less time
and cost to implement than will a program that is unacceptable
to the majority of the constituencies. For these reasons, we
have developed the following rating system.
High: The program is acceptable to the majority of
constituencies.
Medium: There is no consensus of opinion on the program.
Low: This program is unacceptable to the majority of
constituencies.
Political Sensitivity
Political sensitivity can be a dominant factor in the
feasibility of a program. If elected officials object to,
or at least do not support a particular program, the level of
effort required for implementing the program (e.g., obtaining
funding or legislation) can increase dramatically.
High: The program is a very sensitive issue to elected
officials.
Medium: The program is a moderately sensitive issue to
elected officials.
Low: The program carries very little or no political
implications.
-18-
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The work group's original list of program criteria included a
specific factor for the effectiveness of the potential programs.
We soon reached the conclusion, however, that definition of such
a criterion and, in fact, the absolute determination of the effec-
tiveness of a potential program is very difficult to accomplish.
All of the potential programs identified will certainly be effec-
tive in reducing potential exposures, or in assessing the problem,
to some degree. It is very difficult, however, to assess the
effectiveness of a program ahead of time. The absolute effect-
iveness will not be known until the program has been implemented
and evaluated. Since the Phase II indoor air pollution study does
not use a quantitative evaluation approach such as risk assessment,
it is impossible to make comparisons to see which programs will
give the highest yield quantitatively. In addition, the absence
of exposure data and measured airborne concentration data for the
study area precludes a quantitative evaluation of programs.
The effectiveness of a particular program is the qualitative
"sum" of the criteria. Because all of the program criteria are
very dependent upon one another, the relative effectiveness of
a program must be judged by considering all of the criteria
together. Thus, the ideal program under this evaluation would
receive the optimal score for each of the primary criteria—i.e.,
low cost, short time frame, minimal legal considerations, high M
acceptability, and minimal political sensitivity. However, few . to
programs, if any, will match these ideal ratings. They generally ' o!
will perform well for some of the criteria and not as well for H
others. What is most effective for one agency, therefore, may
not be equally effective for another. Cost may be a major obstacle
for one agency and may render a program relatively ineffective
if implemented, while the same program may be very effective for
another agency because cost is not a problem.
Other Considerations
Many implications associated with the programs could have
a significant bearing on their feasibility. For example, pas-
sage of new legislation, may result in difficulties or exces-
sive demands on resources from an enforcement standpoint, or a
public education program may generate citizen reaction and in-
quiries that require agency or organization response. An organi-
zation contemplating the implementation of a program should seri-
ously consider all of the potential implications of that program.
Step 8; Apply the Criteria tothe Potential Programs
We applied the program criteria to each of the potential programs
previously identified for radon and passive smoking. The program
ratings for each of the criteria are shown in Tables 4 and 5.
Appendices 5a and 5b contain the reasoning and justification for
the program ratings for passive smoking and radon.
-19-
-------
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Step 9; Set Priorities for Implementing the Programs
Choosing programs for implementation requires making trade-
offs among the criteria. For example, is it worth
the cost of a program to increase its acceptance?
to questions like these will vary from person to
agency to agency.
increasing
The answers
person and
To reach a consensus on implementation priorities, we
started with the program close to the ideal, progressing to
programs that diverged to an increasing extent from that ideal.
As with the pollutant evaluation process, the program evaluation
process is necessarily subjective, but the methodology is help-
ful in structuring and guiding the evaluation.
Implementation Priorities for Programs to
Control or Assess Passive Smoking
For passive smoking, the
the programs is as follows:
relative ranking for implementing
1. Smoking
cause the
cessation seems close to the ideal program be-
costs are low, the time frame is short, the legal
considerations are minimal, the acceptability is high, and the
political sensitivity is minimal. In addition, we identified
no other considerations that may detract from this program.
2.
for a second.
five criteria.
must prepare
program.
erations
ployee
Public educationand smoking policies in buildings
tied
of the
They both have the ideal rating for four
Public education has high costs, and agencies
to respond to citizen inquiries resulting from the
Smoking policies is rated as medium for legal consid-
because of the possible need for negotiations with em-
unions over the policies. In addition, agencies may
have to address a vocal minority opposed to such policies.
3_.a Increased enforcement ranked third, primarily due to
the high costs associated with this approach.
4. Increased excise taxes
frame and
had a medium rating for its time
a high rating for both legal considerations and polit-
ical sensitivity. This program is attractive, however, because
the increased revenues could be used specifically to support
smoking cessation clinics.
5. Health insurance coverage and passage of state and local
laws ranked fifth. Health insurance showed medium ratings for
cost, time frame, acceptability, and political sensitivity. Most
important, legislation may be required to mandate insurance cover-
rage. Passage of state and local laws showed high costs, a long
time frame, high legal considerations, and high political sensi-
tivity. Additionally, if such laws are passed, enforcing them
22
-------
The above order could vary, depending on an organization's
ratings. For example/ if! cost is not considered to be important,
public education could be ranked higher.
Implementation Priorities for
Programs to -Control or Assess Radon
The relative ranking of programs for radon is as follows:
1. Education of officials has the ideal rating for all of
the criteria. This program could help obtain financial and
manpower resources for implementing other programs.
2. Public education ranked second, primarily because of the
high cost factor. Agencies would have to respond to citizen in-
quiries.
3. Surveys of homes and schools ranked third. Testing in
schools would have a medium cost, and its political sensitivity
is rated as medium. A survey of homes would have a high cost
and a medium time frame. Additionally, Cor the home survey,
agencies would have to address the issue of confidentiality of
test results.
4. Free radon testing ranked fourth because of its high
cost and lack of comprehensiveness.
5. Epidemiological study is ranked lowest because of its
high costs and long time frame. However, such a study would
be very valuable in the long term by characterizing the extent
of adverse health effects from radon and by providing a basis
for future regulatory policy and control programs.
CONCLUSIONS AND RECOMMENDATIONS
The purpose of this study was twofold: to determine
which indoor air pollutants in the study area should be further
evaluated, and to identify and evaluate potential programs that
could effectively and efficiently reduce exposure to these pollu-
tants. Using professional judgement and limited national and local
data, the work group concluded that the following nine indoor air
pollutants warranted further examination: asbestos, chlordane,
chloroform, formaldehyde, lead (later assigned to another work
group), products of combustion, radon, passive smoking and volatile
organic compounds (VOC). The work group then collected and
evaluated extensive amounts of information on each pollutant.
This information is presented in full separately from this report
in the volume Baltimore IEMP Indoor Air Pollutiont Support Docu-
ments; a summary for each appears in the Appendix 3 of this report.
The work group then established the relative importance among
the nine pollutants by ranking them according to the following
criter-ia: potential population exposed, known or suspected human
health effects, governmental/interest group perception of risk,
and public concern.
-23-
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The work group concluded that the pollutants of relative
highest concern were passive smoking, radon, and asbestos; chlor-
dane and formaldehyde the lowesb; and chloroform, combustion pro-
ducts, and VOCs in between.
The work group focused its attention on the pollutants of
highest concern. It discovered that there were already numerous
efforts under way (e.g., detection and abatement programs) to control
asbestos. Thus it eliminated this pollutant from further consider-
ation. For passive smoking and radon, it proceeded to identify
and evaluate potential programs for implementation. Its recommen-
dations for each are presented below.
Program Recommendations for Passive Smoking
Of the seven potential programs examined for passive smoking,
government and nongovernment agencies should seriously consider
the following three programs:
1. smoking cessation programs,
2. public education programs, and
3. smoking policies in government and nongovernment build-
i ngs.
Program Recommendations for Radon
Because of the paucity of monitoring data on the actual
nature and extent of the radon issue in the Baltimore study area,
we felt a definite need for education and testing to effect better
assessment and characterization of the problem. All six programs
considered for radon, therefore, focused on further assessment
activities. We recommend the following:
1. education of elected and government officials
2. public education, and
3. a state or local survey of homes and schools to establish
a radon profile of the area.
Some Observations on the Evaluation Process
The process relied heavily on qualitative information, subjec-
tive analysis, and the consensus of qualified professionals. Addi-
tional quantitative data specific to the study area would be very
valuable. The following observations ace made to point out strengths
and weaknesses of the process.
1. A very important product of this study is the foundation
established for continued interagency cooperation and integration
in the Baltimore area. We identified numerous contacts and estab-
lished .lines of communication. This groundwork could greatly en-
hance a continuing cooperative effort in the area of indoor air
pollution. We recommend that the agencies and organizations that
participated should formalize this- communication network.
-24-
-------
2. Since the methodology is largely. subjectivef the makeup
of the work group is critical. The members should have extensive
expertise and experience in the area of indoor air pollution and
should represent appropriate federal, state, and local agencies,
as well as pertinent nongovernment organizations. The broad mem-
bership enhanced our access"to information; it also provided a
valuable diversity of perspectives during discussion.
3. The lack of monitoring data on indoor concentrations for
the study area makes it extremely difficult to project the effec-
tiveness of programs with any certainty. We wrestled with an ob-
jective, quantitative measure of effectiveness, which would have
been ideal, but determined that a subjective, consensus approach
was the best possible method available at this time. As the data
from further research on indoor air become available, this will
allow agencies to develop guantitative measures of program ef-
fectiveness .
4. The overall process is very lengthy. The collection,
review, and synthesis of information can be very time consuming.
Once the information base has been established, however, use of
the evaluation criteria to identify pollutant and program prior-
ities proceeds at a reasonable pace.
5. Keeping the background information documents up to date
is difficult and time consuming. The status of proposed legisla-
tion and regulations on indoor air pollution is constantly chang-
ing, new research results are rapidly becoming available, and
studies are being initiated regularly.
-25-
-------
REFERENCES
[1]
[2]
[3]
[4]
[5]
Preston E. McNall, Jr., P.E., Ph.D., "Indoor Air Quality,"
ASHRAE Journal, June 1986.
John E. Yocom, "Indoor-Outdoor Air Quality Relationships.
A Critical Review," Journal of the Air Pollution Control
Association, May 1982.
Ken Sexton, "Indoor Air Quality: An OverVlyv/ of Policy
and Regulatory Issues," presented at the Air Pollution
Control Association Conference, Detroit, Michigan, June
16-21, 1985.
40 CFR Part 50.1 (E), revised July 1, 1978.
Superfund Amendments and Reauthorization Act of 1966 (PL99-
499).
[6] General Accounting Office, "Indoor Air Pollution: An
Emerging Health Problem," CED-80-111, September 24, 1980.
[7] U.S. EPA, Report to Congress on Indoor Air Pollution and
Radon Under Title IV Superfund Amendments and Reauthoriza-
tion Act of 1986, April 1987.
[8] American Journal of Public Health, vol. 74 (1984).
[9] Thomas J. Haley, "Toxicology" in Dangerous Properties of
I_nd us t r i a 1 Ma t e r i a Is , 6th ed. Part of the "Toxicology"
section of. this book is attached in Appendix 4a.
-26-
-------
APPENDICES
-------
-------
Appendix 1
INTEGRATED ENVIRONMENTAL MANAGEMENT PROJECT (IEMP)
Indoor Air Pollution Survey
AGENCY/ORGANIZATION:
Name of Person Completing the Survey:_
Position:
Telephone Number:
Please complete the attached survey and return it by
to:
Please indicate with "N/A" those questions which do not apply to your agency or
organization.
If you have any questions, please call
at
Thank you.
-------
-------
INTEGRATED ENVIRONMENTAL MANAGEMENT PROJECT
The State of Maryland (Department of Health and Mental Hygiene,
Office of Environmental Programs), the City of Baltimore, Baltimore County,
Anne Arundel County, and the U.S. Environmental Protection Agency have joined
together to undertake a project in the metropolitan Baltimore region known
as the Integrated Environmental Management Project (IEMP) The integrated
approach to environmental management looks simultaneously at pollution problems
in all environmental media, as opposed to the more traditional medium-by-medium
approach. Human health risks, ecological impacts, and potential control options
will be identified and analyzed during the project.
The objectives of the IEMP are, tirst, to assist State and local
governments in addressing site-specific environmental problems; second, to
develop methodologies for evaluating and solving problems in all media; and
third, to derive recommendations for policy and programs in the light of the
study results.
It is intended that the project be useful to EPA policy-makers and
to public health and environmental decision makers within Maryland and the
Baltimore region. Since it is the State and local officials who must directly
carry out and who are most directly affected by environmental decisions, the
priorities of the project and the environmental issues examined will reflect
State and local concerns.
Phase I of the Baltimore IEMP is completed. This portion consisted
of an evaluation and diagnosis of potential problems in the study area in all
environmental media. Six issues were identified for possible further study
in Phase Two:. Ambient Air Toxics, Multimedia Metals, Underground Storage Tanks,
the Harbor, Trihalomethanes in Drinking Water, and Indoor Air Pollution. Workr
groups for each of the issues have been formed to develop Work Plans for inves-
tigation and analysis of the respective issues.
The Indoor Air Pollution Workgroup has developed a Work Plan to learn
more about the indoor air quality in the metropolitan Baltimore area. The
goal is to investigate and support the implementation of possible programs
to reduce exposure to indoor pollutants and to expand the State and local govern-
ment capabilities to respond to indoor air pollution inquiries.
In order to begin assessing the indoor air quality in the Baltimore
area the workgroup has developed a questionnaire for agencies and organizations
which are, or may be, involved in indoor air pollution matters. The informa-
tion collected from the questionnaire will be included in an assessment of
the nature and extent of indoor air pollution in the Baltimore area.
-------
-------
1. Please describe your intloor air pollution program or activities:
YES
Formal Program
Line Item Budgeted Program
Part of Another Program (e.g. complaint handling)
Provide On Site Investigation
Provide Sampling/Monitoring
Provide Telephone Consultation .
Provide Referral Service
Other Activities
NO
2. a.
3. a.
What are the main indoor air pollution problems identified by persons
calling your agency/organization? Please indicate the relative frequency
of occurrences IN COLUMN A beginning with the most frequent (1).
What are the main indoor air pollution problems identified or confirmed
by personnel of your agency/organization? Please indicate the relative
frequency of occurrences IN COLUMN B beginning with the most frequent (1).
COLUMN A
COLUMN B
Aeroallergens
Aeropathogens
Asbestos
Benzene
Chlordane
Chloroform
Electromagnetic/Microwa/es ,
Formaldehyde
Lead (including lead paint)
Odors .
Other Pesticides
Products of Incomplete Combustion (PIC)
Radon
Specific Symptoms of Unknown Origin
Tobacco Smoke
Ventilation
Volatile Organic Compounds (VOC) '
OTHER
On the average, how many calls/complaints per month relating to indoor air
pollution has your agency received during the past year?
Less than 10 per month
10-20 per month
20-50 per month
Greater than 50 per month
-------
b. On the average, what was the total number of calls/complaints per month
received by your agency/organization during the past year?
calls/complaints per month
a. In your opinion, does the number of calls increase dramatically following
a television or newspaper story or other form of public education regarding
indoor air pollution?
Yes
No
No Opinion
b. If you have observed such an increase, please estimate the percent increase.
% increase
c. Can you give an example of such an occurrence?
5. Please identify the sections in your organization where indoor air-pollution
problems are handled.
Aeroallergens
Aeropathogens
Asbestos
Benzene
Chlordane
Chloroform
Electromagnetic/Microwaves
Formaldehyde
Lead (including lead paint)
Odors
Other Pesticides
Products of Incomplete Combustion
Radon
Specific Symptoms of Unknown Origin
Tobacco Smoke
Ventilation
Volatile Organic Compounds
OTHER
-------
-3-
6. Of the calls/complaints received:
a. For what percentage do you make an on-site investigation?
b. What percentage are resolved over the telephone? (excluding referrals)
%
c. What percentage are referred to other agencies?
Please check those agencies/organizations to which calls are referred.
Fire Department
Physicians
Gas and Electric Company
American Lung Association
Occupational Safety and Health
Independent Laboratories or Consultants
Unions
Agencies of the Federal Government :
Agencies of the State Government
Agencies of the Local Government
OTHER
d. Please check those agencies/organizations from whom you receive referrals
regarding indoor air pollution.
Fire Department
Physicians
Gas and Electric Company
American Lung Association
Occupational Safety and Health
Independent Laboratories or Consultants
Unions ' ,
Agencies of the Federal Government •
Agencies of the State Government
Agencies of the Local Government
OTHER
-------
-4-
7. Of the calls/complaints investigated by your agency/organization:
a. For what percentage are you able to identify the source of the problem?
b. For what percentage are you able to identify a solution?
c. For what percentage do you call on expertise outside of your agency/organ-
ization for assistance in the investigation?
d. For what percentage do you find no problems from indoor air pollution?
8. What do you consider to be your greatest need(s) in the area of indoor air
pollution capabilities? (please rank in order of priority)
Manpower
Indoor Air Pollution Line Item Budget Appropriation
Legislation
Enforceable Regulations/Codes
Indoor Air Pollution Standards (non-occupational)
Funding
Equipment
Training
Access to Laboratory
Informational Resources
Organizational Changes Within Your Own Agency/Organization
Institutional Arrangements Outside Your Agency/Organization (Governmental,
public, academic, etc.)
OTHER
9. Would you please provide copies of the following?
a. Forms used in relation to indoor air pollution.
b. Examples of on-site investigation reports. (Names, addresses, and other
confidential information should be deleted.)
-------
-5-
10. Do you have any additional comments describing your indoor air pollution
activities which the survey did not cover?
-------
-------
Appendix 2
191
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CHLORDRNE Summary.
Appendix #3
11/19/86
1. STATEMENT OF THE PROBLEM; Improper use and/or applicaticai of chlordane/chlordane
mixture may expose household residents to airborne concentrations of these
coitpounds in indoor air.
2. EXPOSUPE;
Seminary of Exposure Routes;
a. Misapplication by conmercial applicator allowing intrusion of pesticide into
the home (e.g., accidental piercing of ventilation ducts during application).
b. Misuse/misapplication by homeowners and/or noncommercial applicators
(e.g., using product for other than specified purpose).
c. Structural characteristics of building allow intrusion of Chlordane after
proper application (e.g., cracks in foundation, footings, etc.).
Population Potentially Fxposured in Efaltimore Study Area:
a. Homes/year in Maryland treated with termiticides = 250,000.
b. Current U.S. termiticide usage is roughly 70% chlordane or a chlordane/
heptachlor mixture: 250,000 homes/year X 70% = 175,000 homes treated
with chlordane or chlordane mixture.
c. Chlordane Use in Baltimore Study Area in 1982 = 76,648 Ibs (22% of Md. use):
175,000 homes X 22% = about 3R,500 homes in Baltimore Study Area treated
with chlordane or chlordane mixture.
d. Number of people potentially exposed in the Baltimore Study Area = 106,000.
B. City = 43% households = 38,500 X 43% = 16,555 X 2.7 people/hh = 44,698.5 people
P. Co. = 37% households = 38,500 X 37% = 14,245 X 2.7 people/hh = 38,461.5 people
A.A. Co.= 20% households = 38,500 X 20% = 7,700 X 3.0 people/hh = 23,100.0. people
(Bait. City + Bait. Co. + A. A. Co. = 44,698.5 + 38,461.5 + 23,100 = 106,260.)
e. Number of Chlordane misapplications in Md. (reported to Md. Dept. of Agric.) -
15 cases in past 4 years (9 suspected misapplication cases).
No. of Chlordane misapplications by homeowner/noncommercial applicators - Unknown.
3. HEALTH EFFECTS;
a. Carcinogenic!ty.
o Group B2, FPA Carcinogenic Assessment Guidelines - Probable Human
Carcinogen (inadequate human evidence, sufficient animal
evidence).
o Group 3, IARC - Cannot be classified as carcinogen (inadequate human
evidence, limited animal evidence).
b. Other Health Effects.
o Acutely toxic to Central Nervous System
o Teratogenicity, Reproductive Effects, Mutagenicity - Inconclusive.
4. CONTROL TECMJIQUES/TECHNDLCIGIFS;
a. Mechanical alteration during construction (e.g., avoiding soil/wood contact?
increase crawlspace ventilation).
b. Alternative termiticides (experimental included).
c. Pretreatment of new homes (e.g., treat soil before building house).
5. CURRENT ACTIVITY LEVEL;
aT U.S. EPA/OPP - gathering data to restrict Chlordane use to certified applicators.
b. Md. Legislation (5/13/86) - Pesticide applicators must undergo training in
first thirty days of employment (Effective July 1, 1986).
c. If EPA does not restrict use to licensed applicators, Md. Dept. of Agriculture
may attempt to accomplish this.
-------
-------
FORMALDEHYDE Summary.
11/19/86
1. STATEMENT OF THE PROBLEM: Formaldehyde present in building materials,
insulation, consumer products, etc. can offgas in the indoor environment.
2. EXPOSURE;
Stannary of Exposure;
Pressed wood products containing urea-formaldehyde (UF) resins and
urea-formaldehyde foam insulation (UFFI) are the major sources of elevated
indoor air concentrations. UFPI use has decreased dramatically since 1982
(CPSC tan); main concern, therefore, is UFFI use between 1975-1981.
Formaldehyde emissions from TJFFI depend upon nature of the product, age of the
source, indoor temperature and humidity, and improper installation.
Formaldehyde emissions from pressed wood products depend on a number of factors,
e.g., type of product resin content, indoor temperature and humidity, age of
product, surface area of product relative to indoor air volume (loading rate).
Population Potentially Exposured in Baltimore Study Area;
UFFI; Major building type of concern is residential. Most concern is with UFFI
installed between 1975-1981.
- Since UFFI has declined in use since 1981 (CPSC ban), there is little
potential for exposure in homes 1-5 years old, or new homes in future.
- Therefore, potential concern is for homes 5 years old or older (prior to
CPSC ban). However, off gassing of formaldehyde decreases with age of the
product. There is a significant reduction in formaldehyde levels after
the first year or two. therefore, there is little potential for broad
exposure from past or current use of UFFI.
Pressed Vtood Products: Pressed wood products are of concern in all building
types; however, it is of more concern in mobile homes due to the greater
surface area of wood products/indoor air volume of the mobile home. (There
were about 5,300 mobile homes in the Baltimore Study Area in 1985.) It is
very difficult to characterize exposures in buildings because the sources
of formaldehyde can be continuously renewed, e.g., new pressed wood furniture
in an office or new kitchen cabinets in a 30-year old home.
However, some 1985 national data do give potential exposures to certain
formaldehyde-containing products used in construction of new single-family
detached homes:
- About 11,600 homes were built in 1985 in the Baltimore Study Area, of which
about 5,000 were single-family detached homes, 3,600 were single-family
attached homes, and 3,000 were multi-family homes.
- Of the 5,000 single-family detached homes;
24% (about 1200 hones) used both particleboard underlayment and/or
hardwood plywood wall paneling;
15% (about 750 homes) used particleboard underlayment flooring; and
12% (about 600 homes) used hardwood plywood wall paneling.
- Of the 3,600 single-family attached homes;
16% (about 580 homes) used particleboard underlayment flooring; and
6% (about 220 homes) used hardwood plywood wall paneling.
- Of the 3,000 multi-family homes:
8.5% (about 250 homes) used particleboard underlayment flooring; and
2% (about 60 homes) used hardwood plywood wall paneling.
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POFMALDEHYDE
-2-
- Nearly all single-family hones (about 8,900 hones) used kitchen cabinets.
- About 30-40% of new single-family homes (about 2,600 - 3,500 homes) used
hardwood plywood doors.
- About 47% of new single-family homes (about 4,100 hones) used
particleboard closet shelves.
- The use of particleboard underlayment has the nost significant impact on the
average concentration in the home.
- The potential exposed population to formaldehyde in new homes in the Baltimore
Study Area is: (11,600 homes, 1985) X (2.8 people/household) = 32,480 people.
Mobile homes = 5,300 x 2.8 people/household = 14,840 people.
New Homes (32,480) + Mobile hones (14,840) = 47,320 people.
3. HEALTH EFFECTS;
a. Oarcinogenicity.
Group Bl, Probable Human Carcinogen (CAG) - limited
human evidence, sufficient animal evidence.
b. Other Health Effects.
- Toxicity: irritation of the eye, nose and throat at low level exposure.
Irritant of upper and lower airways and pulmonary effects.
- Some evidence as potential animal nutagen.
- Not a potential human or animal teratogen.
CONTROL TEX3!NIC3UES/TEX3M)LOGIES;
a~IRemoval of formaldehyde-emitting materials, e.g., UEFI.
b. Avoid using building products and furnitures with high formaldehyde levels.
c. Change UP resin formulation.
d. Use substitute resin.
e. Post-cure product treatments, e.g., ammonia fumigation, scavenger- and
non-scavenger-containing barriers.
f. Increase building air exchange rate.
g. rise of dehumidifier, air cleaners, air conditioning coil.
5. CURRENT ACTIVITY LEVEL;
a. FPA investigating regulatory options for: fabrics treated with formaldehyde
resins, and construction materials.
b. CPSC recommended working with industry to develop voluntary standards to
control formaldehyde emissions from pressed wood products and to inform
appropriate organizations of health effects information.
c. CPSC plans to write, in 1987, a booklet for consumers on remedies of
formaldehyde emissions.
d. Several ongoing studies monitoring formaldehyde in mobile and conventional
housing are being conducted.
-------
VOLATILE OKGMJIC COMPOUNDS (VOCs) Sumtary.
STATEMENT OF THE PROBLEM!
11/19/86
Thousands of chemicals present in household and office products and furnishings
can Vie released into the indoor air in varying concentrations. The average
home contains some 45 aerosol containers, each of which nay contain up to 15
different VOCs.
2. EXPOSURE;
Summary of 'Exposure;
The primary sources of VDCs in the indoor environment are various products and
materials which contain a VOC of potential concern. These products include:
persona] hygiene and cosmetic products, building materials, cleaning products,
biocidal treatments, hobby materials, molded household wares, drycleaned
clothing, refrigerants, aerosol propellents, gasoline, and office products such
as reproduction solutions.
VDCs are also present, but to a lesser degree, in the combustion products of
furnaces, fireplaces, woodstoves, and Verosene heaters. Other sources include
the volatilization of organic compounds from drinking water use indoors, and
intrusion of VOTs indoors from the outdoor air.
The most significant source is, however, by far the myriad of consumer products
and materials and their chemical ingredients.
Two major studies on exposures to volatile organic compounds indoors have revealed
that: (1) concentrations indoors are generally higher than the concentrations
found outdoors; (2) the sources are numerous, and (3) ranges of concentrations
vary greatly, often by factors of 10 or 100. Volatile organic compounds have
been found in the air inside coimiercial buildings, public buildings, schools,
office buildings, and hospitals, as well as private homes.
Population Potentially Exposured in Baltimore Study Area:
Given the ubiquitous presence of chemical containing products and materials in
indoor environments, the entire study area population will at one time or another,
be exposed to volatilized organics in indoor air. The extent of the exposure will
depend on several factors, including: time spent in a particular location,
presence of certain products and their chemical compositions, extended use of a
particular product, and characteristics of the environment such as temperature,
humidity, air exchange rates, etc.
In 19R7, the EPA will be conducting a Total Exposure Assessment Methodology (TEAM)
study in the Baltimore IEMP study area which will shed some guantitative light
on the exposures of individuals to specific VOCs in the indoor environments.
3. HEALTH EFFECTS;
Human health effects of indoor non-occupational exposures to VOCs are not yet
well understood. The large number of chemicals found indoors makes it extremely
difficult to associate health effects with exposures to specific compounds.
Various compounds found indoors have been associated with headache, irritation
of eyes, mucous membranes, and respiratory system, drowsiness, fatigue, and
general malaise. Occupational exposure studies have documented health effects
from VOCs including cancer, mutagenicity, respiratory ailments, heart disease,
allergic reactions, and other toxic effects. In general, concentrations of '\tOCs
measured in the non-occupational environment are one or two orders of magnitude
lower than the Occupational Safety and Health Administration's Permissible
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VOLATILE ORGANIC COMPOUNDS (VDCs)
-2-
Exposure Limits (PFL) and American Conference of Governmental Industrial
Hygienists' (AOGIH) Threshold Limit Values (TLV). The lower levels, however,
may still be excessive and cause serious health effects, althrough the effects
of chronic and acute exposures to these lower concentrations are not yet
generally Icnown.
A. CONTROL
a. Reformulation of consumer products to reduce or eliminate VOC content.
b. Removal or sealing of building materials.
5. CURRENT ACTIVITY LEVEL ;
a. CPSC has authority to ban or regulate hazardous substances produced for
use by consumers. CPSC actions to date include:
o ban of vinyl chloride from hairsprays /aerosols .
o ban of carbon tetrachloride in household products.
o pending action to require warning label on products containing
methylene chloride.
o warning labels are required on furniture polishes, oven and drain cleaners,
turpentine, lighter fluid, ethylene glycol, methyl alcohol, solvents,
kerosene, varsol and other petroleum distillates, perchloroethylene.
b. Federal research, coordinated by the Interagency Committee on Indoor Air
Quality (CIAQ), is being conducted to characterize indoor concentrations
and sources.
EPA Office of Toxic Substances is researching the use of consumer products,
VOC content, and personal exposures.
c. Baltimore TEAM study is currently being planned and designed; sampling
will be conducted in 19fl7.
Maryland Department of Health and Mental Pygiene (DHMH) activities include:
o investigation of citizen complaints.
o enforcement of CPSC actions.
o public information and creation in conjunction with CPSC.
o research and surveys in conjunction with CPSC.
American Lung Association of Maryland (ALAM) offers seminars and other forms
of public education to persons who utilize art materials.
-------
COMBUSTION PRODUCTS Surrroary.
11/19/86
1. STATEMFTSTT OF THE PROBLEM;
Biomass and fossil fuels are burner* indoors for heating, cookinq, and
recreational purposes. Combustion at less than optimal conditions produces
gases and particulate products, including nitrogen oxides, carbon dioxide,
carbon monoxide, organic and inorganic particulates, and various metals and
organic vapors. Inadequate venting of these products results in increased
indoor concentrations, often substantially higher than outdoor concentrations.
2. EXPOSURE:
Summary of Exposure;
Coiqpound
Nitrogen Oxides . . .
Carbon Monoxide . . .
Carbon Dioxide . . .
Respirable Suspended.
Particulates
Sulphur dioxide . . .
Source
Natural gas appliances and unvented kerosene heaters.
Gas cooking ranges, ovens, and furnaces? tobacco smoke;
vehicle emissions from attached garages.
Combustion sources; tobacco products; metabolic processes.
Tobacco smoke; gas ovens and furnaces; kerosene heaters;
fireplaces.
Ose of improper or low grade fuels in unvented kerosene
heaters; fuel oil or natural gas appliances. Main source
is infiltration of contaminated outside air.
Combustion of fossil fuels results in a rich array of organic compounds. In
most cases, however, the concentrations of organic compounds from combustion are
small compared to other indoor sources of such compounds. Polycyclic Aromatic
Hydrocarbons (PAHs) are an exception, however, where combustion is the major source.
A combination o^ combustion sources is often found in the same building or home.
The concentrations of pollutants found indoors depend on a complex interaction
of the following factors:
o type of appliance, e.g., gas appliances, wood stoves, etc.
o fuel quality and type.
o combustion conditions, i.e., optimal or poor conditions.
o age, physical design, condition and maintenance of the appliances.
o air exchange rate in the home or building.
o nature and duration of appliance usage.
o pollutant generation rate.
Population Potentially Exposured in Baltimore Study Area;
The 1984 Baltimore Gas & Klectric Residential Appliance Survey and 1985
Regional Planning Council household estimates give the following estimates of
residential combustion appliance usage:
Appliances
o Ranges - Natural Gas
Ranaes - Bottled Gas
o Clothes Dryer - Natural Gas
o Hot Water Heater - Natural Gas
Hot Water Heater - Bottled Gas
Hot Water Heater - Oil
o House Heating - Natural Gas
House Heating - Bottled Gas
House Heating - Oil
Kerosene Heater
Wood Stove
Fireplace
Households in the Baltimore Study Area
431,998
26,626
157,608
421,928
13,140
53,738
364,724
2,737
201,693
27,413
31,609
66,665
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COMBUSTION PRODUCTS
-2-
According to these statistics, of 668,900 households in the Baltimore Study Area:
o 569,154 households (or 85%) have a combustion device- for primary heating.
o 488,806 households (or 73%) have a combustion appliance for hot water heating.
o 157,608 households (or 24%) have a natural gas fired clothes dryer.
o 458,624 households (or 69%) have a gas fired range.
If one includes electric appliances, the relative use of fossil or biomass fuels
fired appliances to the total number of households is:
Appliance
Ranges
Clothes Dryer
Hot Water Heater
House Heating*
Percent Using Contoustion Fuel vs Electric
67% (vs 33% electric)
40% (vs 60% electric)
79% (vs 21% electric)
90% (vs 10% electric)
*This does not include kerosene heaters, wood stove, or fireplaces.
1?5,687 households have one or more of these devices as a secondary heating
appliance in addition to a primary gas, oil, or electric furnace.
Given these statistics, it is apparent that the vast majority of the households
have at least one combustion appliance which is a potential source of indoor
air pollutants. In reality, most household have more than one of these devices.
In addition:
o Of the 668,900 households in the Baltimore Study Area, 549,498 households
(or 82%) were over 10 years old.
o Jurisdiction
Baltimore City
Baltimore County
Anne Arundel County
Combustion-Fired Primary Heating Systems
Older than 10 years Old _
~
(or 189,327)
68% (or 141,043)
58% (or 57,295)
o 10% of the households in the Baltimore Study Area (or 66,890 households)
had a person less than 5 years of age.
o 17% of the households in the Baltimore Study Area (or 100,335 households)
had a person 65 years of age or older.
Inasmuch as heating systems require more maintenance to operate optimally
as they get older, and well over 50% of the heating systans are over 10 years old,
a large segment of the population is potentially exposed to combustion products
from an aging furnace. There also is a significant number of especially
susceptible persons, under 5 years and over 65 years of age, potentially exposed.
3. HEALTH
Nitrogen Oxides. Nitrogen oxides produce immediate short-term effects on
airway reactivity, resulting in increased vulnerability to other pollutants.
o Asthmatics appear to be most susceptible.
o Exposed children may be at increased risk of chronic lung disease.
o Persons at special risk are those with chronic bronchitis, emphysema,
asthma, and children under 2 years old.
o Nitrogen dioxide affects host defenses against bacterial pulmonary
infections in animals - relevance to humans not yet established.
o One study found association between gas range use and severe cases of
chest illness in children before age two.
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-3-
COMBUSTION PRODUCTS
d.
e.
f.
Carbon Monoxide.
o Carbon Monoxide causes tissue hypoxia brought on by a reduced ability
of the blood to carry oxygen to body tissues.
o Asphyxiation occurs at greater than 1800 ppm for 1 hour.
o Loss of alertness, impaired perception, loss of normal dexterity, re-
duced learning ability, drowsiness, confusion, and finally coma and
death.
o At relatively low levels, persons with heart problems may be at partic-
ular risk due to high oxygen demand of the heart.
Carbon Dioxide.
o Carbon dioxide causes adverse health effects at very high concentrations,
o Slight elevations in the blood level increases the breathing rate.
o Health effects in guinea pigs were observed at 3000 ppm.
o Carbon dioxide is not a significant health effect pollutant from com-
bustion.
Respirable Suspended Particulates. Major effects of concern attributed to
particle exposure include:
o Impairment of respiratory mechanics, and lung functions.
o Aggravation of existing respiratory and cardiovascular disease.
o Altered lung defense mechanisms.
o Carcinogenesis due to polycyclic aromatic hydrocarbons adsorbed on the
particle surfaces.
o Increased susceptibility to infectious diseases.
Organic Compounds.
o Many organic compounds have been identified with cancer, mutagenicity,
respiratory ailments, heart diseases, and other toxic effects.
o PAHs carried by particulates are considered to be a cause of lung can-
cer; risk is assumed to be directly proportional to accumulated exposure.
Sulphur Dioxide. Sulphur dioxide is an irritant and causes significant
bronchoconstriction in asthmatics.
CONTROL TECHNIQUES/TECHNOLOGIES;
a. Source removal.
b. Source use restriction.
c. Modification of equipment and factors, e.g., fuels.
d. Use of air cleaning devices.
e. Ventilation improvements.
f. Proper maintenance and operation of sources.
g. Combustion efficiency testing.
CURRENT ACTIVITY LEVEL;
a. Consumer Product Safety Commission (CPSC).
o Proposed survey that will target high exposure groups.
o Study was completed on space heaters; it will be available in Summer 1986.
b. Environmental Protection Agency (EPA).
o Proposed New Source Performance Standard (NSPS) for woodburning stoves
is expected by January 1987 and promulgation in 1988. Effect on indoor
air quality is unclear.
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-4-
COMBUSTION PRODUCTS
o Tennessee Valley Authority (TVA) study found that increased ambient
fine particulate concentrations result in increased indoor concentra-
tions; thus, the NSPS for woodburning stoves could reduce indoor par-
ticulate levels as well as ambient levels.
c. Gas Research Institute (GRI).
O Study on unvented gas space heaters has been completed; data are being
analyzed.
. o Ongoing study of gas ranges and associated health effects.
o Major study of problem of indoor air pollution from gas appliances.
d. Other Research.
o Federal CIAQ proposing a study on combustion products.
o American Society for Testing Materials (ASTM) studying PAHs.
o Health Effects Institute (HEI), Cambridge, Mass, is overseeing research
on health effects of low exposures to carbon monoxide and nitrogen
dioxide.
e. Baltimore Study Area.
o Baltimore City has a ban on unvented space heaters (gas and kerosene).
o Baltimore County restricts use of unvented kerosene heaters to single-
family dwellings with owner consent.
o Maryland DHMH regulations restrict sulphur in fuel content:
1.0% by weight for solid fuels and residual oil; 0.3% in distillate oil.
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RADON Summary. 11/19/86
1. STATEMENT OF THE PROBLEM:
Radon, a naturally occurring gas produced by radioactive decay of uranium,
can become dissolved in water or released with soil gas. Exposure from
elevated indoor air levels may lead to adverse health effects (lung cancer).
2. EXPOSURE;
Summary of Exposure:
The two primary sources of naturally-occurring radon in buildings are soil
gas and groundwater; less significant contributions may come fron building
materials, outdoor air, and homeheating fuels. In most situations, the major
contributor to indoor radon concentrations is from soil and rocks.
The main mechanism of radon gas transport into the hone is pressure driven
flow. The most important pathway into the home is through cracks and other
openings in the building substructure. The amount of radon entering the home
depends on many factors, such as building type and characteristics, soil .
factors (e.g., presence of radium, permeability, etc.) and meteorology.
Population Potentially Exposured in Baltimore Study Area;
Few data have been received by the Maryland Department of Health and Mental
Hygiene (DHMH); as of July 1, 1986, 210 Maryland measurements were available,
of which 18 measurements were from the Baltimore Study Area:
Of the 18 measurements, 6 had levels <4 pCi/1; 10 had levels between 4-20
pCi/1; and 2 had levels between 21 - 50 pCi/1.
No other data are presently available for the Baltimore Study Area.
A number of monitoring studies have been conducted in Maryland:
o 1980 sampling of 58 homes in Mt. Airy area using grab samples.
Average concentration was 3.8 pCi/1.
o 1982 sampling of 41 homes in Damascus area using passive activated
carbon integrating devices. Average radon concentrations for living
areas (41 homes) were 3.9 pCi/1 and for basements (37 homes) were 9.6 pCi/1.
o 1985/1986 sampling of 22 towns in Md. using passive activated carbon devices.
Wintertime: 31% of homes had >_ 4 pCi/1 in the living area, and
51% of homes had _>_ 4 pCi/1 in the basement.
Summertime: 7% of homes had >_ 4 pCi/1 in the living area, and
39% of homes had >_ 4 pCi/1 in the basement.
Other Md. data include:
o Terradex Corporation reported 16 hones tested:
31% with levels > 4 pCi/1; the highest reading was > 20 pCi/1.
Potential exposure in Maryland is unknown. Many factors are involved: location
and condition of the house, seasonal variations, etc. More will be known after
Md. DHMH receives more measurements from homes in the Baltimore Study Area and
after the proposed Md. survey of radon in homes.
3.
4.
HEALTH EFFECTS;
Carcinogenicity. The primary site is the lung, due to exposure to alpha
radiation from inhaled decay products of radon.
a.
b. The interaction of exposure to radon with exposure to tobacco smoke may
result in a disproportionate increase in risk.
COMTROL TECHNIQUES/TECHNOLOGIES;
a. Prevent radon from entering the home, e.g., seal major radon entry routes,
prevent radon entry into the home by collecting radon gas at the source
and ventilating away from the house.
-------
-2-
Reroove radon and its decay products from the home through ventilation.
c. Remove radon decay products from the home through filtration/ionization,
e.g., air cleaners. *
d. Remove the source of radon, i.e., remove building materials containing radon.
5. CURRENT ACTIVITY LEVEL;
a. Interagency Committee on Indoor Air Quality (CIAQ), Radon Workgroup.
This group is primarily responsible for coordinating federal research and
activities on indoor radon.
b. EPA Radon Action Program:
o Has developed a quality assurance program to test indoor radon monitoring
devices for accuracy;
o Is developing measurement methods and procedures;
o Is supporting demonstrations and evaluations of selected mitigation techniques;
o Is developing a training program for federal and state employees on measurement
diagnosis, and mitigation of radon problems;
o Is identifying elevated radon areas through geological and other data;
o Is providing state assistance (design of radon surveys, management and
evaluation of survey data, etc.);
o Is preparing various publications;
o Is conducting information dissemination programs and evaluation;
o Will" conduct a national survey of radon in U.S. homes; and
o Will examine new home design and construction techniques to reduce potential
exposure.
c. KPA Office of Drinking Water Activity. A Maximum Contaminant Level (MCL) is
being developed for radon in public drinking water supplies.
d. Department of Energy.
o Conducting research on radon sources, variability of radon levels, radon
entry mechanism into and behavior within buildings, control techniques/
mitigation, health effects;
o Producing documents on radon; and
o Conducting survey work.
e. Other Organizations. Various activities such as developing and distributing
information (both to building industry members and the public), and collecting
measurements.
f. Baltimore Study Area.
o Md. DHMH Division of Radiation Control is collecting data for Maryland;
Md. Geological Survey will plot these test results to look for unusual
patterns or clusters of homes in Maryland having elevated levels.
o Md. is making available to the public both general information on radon
and its health effects, and specific information on indoor sampling kits.
o Md. State Community Health Programs has requested budget (FY 1988) for
a radon survey in Maryland. If funding is approved, the survey will
beqin 7/1/87.
o American Lung Association of Md. (ALAM) is going to distribute radon
information to the public in Maryland.
*not recommended by EPA due to controversy over effectiveness for the fraction
of radon decay products unattached to airborne particles.
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PASSIVE POKING Suntnary.
11/19/86
1. STATEMENT OF TOE PROBLEM;
Exposure of a nonsmoker to indoor air polluted with sidestream smoke (that
which comes directly from the burning end of the tobacco product) and exhaled
mainstream smoke (that which the smoker -inhales directly into the lungs)
may cause adverse health effects.
2. EXPOSURE;
Population Potentially Exposuredin Baltimore Study Area;
1985 Population Estimate Total Adult*
Baltimore City 760,000 544,300
Baltimore County 665,200 502,950
Anne Arundel County 396,300 281,900
TOTAL 1,821,500 1,329,150
* An adult is defined here as 20 years and older;
here as 12 - 19 years old.
Teenager*
78,900
66,900
45,670
191,470
a teenager is defined
National Percentage of U.S. 19R5 Adult Pop. that smoke: about 31%.
National Percentage of U.S. 1985 Teenage Boys that smoke: about 11%
National Percentage of U.S. 1985 Teenage Girls that smoke: about 13%
Data provided by Baltimore City Health Dept.: 43% of Baltimore City pop.
smoke. Therefore, estimated Baltimore City population that smoke:
623,200 (adults + teens) X 43% = 267,976 or about 268,000.
To estimate the number of smokers in Baltimore County and Anne Arundel County,
the national percentages are used:
Bait. Co. adult pop. + A. A. Co. adult pop. = 784,850 X 31% = 243,304.
Bait. Co. teen pop. + A. A. Co. teen pop. = 112,570 X 12% = 13,508.
Therefore, the estimated Baltimore County and Anne Arundel County population
that smokes: adults + teens = 256,812 or about 256,800.
Total estimated population in Baltimore Study Area that smokes (excluding pre-
teen smokers) = 268,000 + 256,800 = 524,800.
Estimate of Nbnsrookers (potentially exposed to tobacco smoke) in the Baltimore
Study Area:Total population - Smokers = 1,821,500 - 524,800 = 1,296,700.
3. HEALTH EFFECTS;
a. Carcinogenicity. Lung cancer and other potential cancer sites.
b. Other Health Effects.
o Passive smoking may increase symptomatic coronary heart disease and has
been associated with impaired pulmonary function.
o Evidence also exists that physical growth and development deficiencies
are more likely to occur in children of smokers.
4. CONTROL TECMNIQUES/TECMTOLCXSIES;
a~iUse of air cleaning devices.
b. Ventilation Improvements.
5. CURRENT ACTIVITY LEVEL;
a. U.S. Department of Health and Human Services. Clearinghouse to collect
scientific and legislative information on smoking and disease in order to
provide worldwide reference standards on which to base public health
and other programs.
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PASSIVE SMOKING
-2-
b. Private Businesses.
o In 1986, 36% of U.S. businesses had established smoking policies.
o In 1979, 42% of blue collar conpanies had designated smoking areas and
28% had prohibited smoking completely; 15% of white collar conpanies
had designated areas for smoking and 11% had prohibited smoking completely.
c. Other Organizations. Other national organizations provide: legislative
actions against smoking, public education and awareness, legal support,
and clearinghouse for state and local clean indoor air information and
cigarette excise tax legislation.
d. Baltimore Study Area.
Current Smoking Restrictions;
o MD HEALTH & ENV. CODE ANN. Section 11-205 (1982).
Regulates smoking on premises of hospitals, nursing homes, health
clinics, and physicians' offices.
********
o MD TRANS?. CODE ANN. Section 7-705 (Supp. 1984).
Prohibits smoking or carrying lighted tobacco products in public mass
transit bus, railcar, or transit station.
o MD ANN. CODK Article 70, Section 35A (1980).
Prohibits smoking in intrastate motor bus carrier.
o Baltimore County Code Section 18-27, Smoking on Public Transit Vehicles
prohibited (1973).
o Anne Arundel County Code Section 17-313.
Prohibits taxicab driver from smoking without consent of the passenger.
******
o MD ANN. Code Article 89, Section 64 (1979).
Prohibits smoking on public elevators.
******
o State Fire Prevention Code Section F-310.0, Smoking Conditions (1984
Edition BOCA Fire Prevention Code). Prohibits smoking where conditions
are such as to make smoking a hazard.
o Baltimore City Fire Prevention Code Section F-310.0> Smoking Conditions
(1978 Edition BOCA Fire Prevention Code). Prohibits smoking where
conditions are such as to make smoking a hazard. This is being updated
to coincide w/1984 BOCA Fire Prevention Code.
o Baltimore County Code Section 28.3, Precautions against Fire, General
(1976 Edition of American Insurance Association (AIA) Fire Prevention
Code). Prohibits smoking where conditions are such as to make smoking
a hazard. This is being updated to coincide with 1984 BOCA Fire
Prevention Code.
*******
Local Organizations;
o The Healthy Majority. Statewide coalition of over 23 health agencies
and individuals with the goal of supporting the establishment of
smoking and nonsmoking sections in public places. 1986 legislation
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PASSIVE SMOKING
-3-
was introduced, which prohibited smoking in retail stores, restaurants,
and state office buildings. It did not pass. In addition to planned
introduction of legislation at the state level in 1987, they have
targeted two counties for legislation at the local level.
o Mary landers for Nonsrrokers1 Rights, Incorporated, Baltimore, MD.
o American Lung Association of MD, Lutherville, MD.
Programs are concerned with the prevention of onset of cigarette
smoking and reducing the number of current smokers, as well as increasing
the number of smoke-free facilities and activities. Activities include:
curricula development and comprehensive stroking prevention programs
in schools; public education; education and referral service for
medical care providers; cessation clinics and programs; legislative
support; nonsmoking policy assistance.
o Bowie GASP. Bowie GASP is a local nonprofit voluntary organization,
involved with public education, legislative activities concerning
smoking in public places, etc.
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ASBESTOS Summary.
11/19/86
!• STATEMENT OF THE PROBLEM.
Asbestos, a group of naturally occurring minerals that separate into fibers,
is used in many products in the home, public and commercial buildings, and
schools. If asbestos fibers are released to the air indoors, they may easily
be inhaled or swallowed, thus creating a hazard to building occupants.
Inhalation is the main route of exposure.
2. EXPOSURE.
Summary of Exposure.
Potential exposure to asbestos depends on:
o location of the asbestos-containing material (ACM) in the structure,
e.g., boiler room vs cafeteria, or in ceiling spaces used as return air
plenums with high potential for fiber release and distribution.
o Type of ACM, e.g., boiler lagging and insulating pipe wrapping vs floor tile.
o Physical condition of the material, i.e., friable (easily crumbled or
reduced to powder by hand pressure) material vs nonfriable material.
o potential for contact with the ACM, which may release airborne fibers,
i.e., areas subject to accidental damage or vandalism (such as high traffic
halls, utility rooms, etc.) vs located behind solid wall or ceiling.
o exterior ambient air levels.
The most important factor listed above is friability of the ACM.
Three forms of asbestos are generally found in buildings:
o sprayed or troweled-on surfacing materials;
o insulation on pipes or boilers, and ducts? and
o miscellaneous forms, such as wallboard, ceiling tiles, and floor tiles.
Materials in the first two categories above can be friable. Those in the
third category are nonfriable; however, any ACM that is damaged during repair
or renovation may release asbestos fibers.
4.
Population Potentially Exposured in Baltimore Study Area;
Government Owned Buildings and Boards of Education Buildings:
see chart
Private Buildings:
Baltimore City
Baltimore County
Anne Arundel County
3. HEALTH EFFECTS.
No. of Demolition
Permits Reviewed/Yr
190
50
No. of Renovation
Permits Reviewed/Yr
1,400-1,500
Unknown
Total
1,590-1,690
about 1,000
50+
a. Carcinogenicity. EPA GAG Group A, Known Carcinogen
o Mesothelioma - tumor of cells of membranes covering lungs and other body
organs.
o Lung and other cancers, such as larynx, pharynx, oral cavity, esophagus,
stomach, colon, rectum, kidney, and ovary.
o Exposure to both asbestos and tobacco smoke can increase the risk of
developing lung cancer.
b. other Health Effects.
o Asbestosis - irreversible lung scarring; can be fatal in occupationally
exposed persons.
CONTROL TECHNIQUES/TECHNOLOGIES.
a. Use substitute material, (new buildings)
b. Use proper abatement method and techniques, i.e., removal, encapsulation,
enclosing material, (existing buildings)
-------
ASBESTOS
—2—
5. CURREOT ACTIVITY LEVEL.
a. Environmental Protection Agency (EPA).
Programs to address asbestos include: National Emissions Standards for
Hazardous Air Pollutants (NESHAPs); Asbestos in Schools Program; Technical
Assistance Program: Contractor Certification; Asbestos Information and
Training Centers; and Worker Protection Rules (during abatement).
The 1986 Asbestos Hazard Emergency Response Act passed, which will require
EPA to set standards for identification andabatement of asbestos in
schools; require public and private elementary and secondary schools to
develop management plans describing abatement actions to be undertaken;
requires states to develop accreditation programs and review the management
plans prepared by schools, and requires schools to implement management
plans and complete them in timely fashion.
EPA has also proposed a rule under TSCA §6 to prohibit the manufacture,
importation, and processing of asbestos in certain products and to phase
out the use of asbestos in all other products.
b. Consumer Protection Safety Commission (CPSC).
o CPSC banned the use of asbestos in certain consumer products.
o CPSC will be drafting enforcement policy to notify the public that labelling
requirements of the Federal Hazardous Substances Act, §2(p), apply to
consumer products containing asbestos.
o CPSC conducted a Homes Investigation of asbestos in homes in Philadelphia,
Cleveland, and San Francisco. 61 of 66 (older) homes sampled (bulk
sampling) were confirmed to contain asbestos. 45 hones will follow up
with airborne sampling,
o CPSC is developing educational information for the consumer (booklet).
c. Other Organizations.
o White Lung Association provides public education concerning asbestos
hazards.
o American Lung Association performs educational, referral, and legislative
activities.
o Asbestos Information Association represents asbestos manufacturers and
importers in the U.S. and Canada.
o National Asbestos Council is a trade association of abatement contractors.
o Safe Building Alliance publishes information (health effects, exposure,
occurrences of ACM, technical management action), and performs regulatory
and legislative monitoring and liaison.
d. Baltimore Study Area.
GOVEPM1EOT OWNED BUILDIN5S.
a. State of Maryland. Survey of state owned buildings, with abatement
performed as necessary with funds allowed.
b. Baltimore City.
o Neighborhood Progress Administration (NPA). NPA acquires for Baltimore
City property for demolition, development/renovation purposes.
Properties must be inspected prior to demolition, renovation, etc.
o Baltimore City Asbestos Task Force. Purpose - develop a comprehensive
asbestos management program for government owned buildings, including
Board of Education facilities. Performed survey of school system
and government owned buildings; personnel protection; maintenance
workers' training and awareness program.
-------
ASBESTOS
-3-
c. Baltimore County.
o Asbestos Coordinating Committee. Purpose - enhance communication
and coordination among agencies with buildings that contain asbestos.
Performed survey of government owned buildings.
d. Anne Arundel County.
o Survey of government owned buildings.
BOARDS OF EDUCATION
a. State of Maryland.
o Performed survey of school buildings, with abatement performed as
necessary with funds allowed.
o Developing set of contractor credentials and specifications hired to do
school inspections.
o Developing set of procedures used to conduct school inspections.
o Conducts asbestos workshops for school systems personnel.
o Collects data from school boards each year on asbestos activity status.
b. Baltimore City. (see Government Owned Buildings)
o Performed survey of school buildings, with abatement performed as
necessary with funds allowed.
c. Baltimore County.
o Performed survey of school buildings, with abatement performed as
necessary with funds allowed.
o Provides information updates to school personnel.
Provides Board personnel with training on asbestos removal.
Provides oversight of school/government owned building projects.
o
o
d. Anne Arundel County.
o Performed survey of school buildings, with abatement performed as
necessary with funds allowed.
o Provided training of in-house personnel concerning minor abatement jobs.
e. Other Organizations.
o Private and church schools are independent and responsible for asbestos
management in their own schools.
o Archdiocese of Baltimore has surveyed its member schools; abatement was
performed as necessary.
PRIVATE BUCDIHGS
a. State of Maryland.
o Department of Health and Mental ftygiene (DHMH) - Licensing of businesses
involved in asbestos project; asbestos training course certification
program; and enforcement and support activities.
o State Employees Program - specifies equipment, procedures, and type of
work a State employee can perform. Training program established.
b. Baltimore City.
o Enforces State Air Quality Asbestos regulations, with enforcement actions
taken through the State.
o No local regulations or ordinances specifically address asbestos.
o Responds to citizen complaints.
o Office of Building Engineer issues demolition/renovation permits; sites
are not inspected prior to issuing the permits.
-------
ASBESTOS
o Baltimore City Health Dept. receives job notices from M3. DFWH;
if job is significant, City inspectors will monitor the work.
o Baltimore City Council Bill 925, Building Code Asbestos Removal, is
being reviewed for conment; it would require any structure certified
free of asbestos before demolition removal or rehabilitation.
Baltimore County.
o Enforces State Air Quality Asbestos regulations. Enforcement actions
for NESHAPs projects are taXen by the State DHMH; enforcement actions
for Non-NESHAP projects are taken under Baltimore County Code §13-18,
Health Nuisances.
o No local regulations or ordinances specifically address asbestos.
o Responds to citizen complaints.
o Baltimore County Building Permit Applications (for renovation/razing of
buildings erected before 1978) are reviewed by Baltimore County Health
Department as part of the permit review system. On-site inspection is
required for all projects, to determine presence of asbestos. Monitoring
is performed from beginning of abatement work through to completion/
reoccupancy, as well as transport and disposal of asbestos waste.
Inspections and
d. Anne Arundel County.
o Enforces State Air Quality Asbestos regulations;
enforcement actions are taken by State DHMH.
o No local regulations or ordinances specifically address asbestos.
o Responds to citizen complaints.
o Office of Inspections and Permits issues demolition/renovation permits.
Sites are not inspected, prior to issuing the permit.
o Anne Arundel County receives job notices from M3. DHMH but does not
routinely inspect these projects.
-------
CHLOROFORM Summary.
2/24/R7
1. ffTAtiMEOT OF TOE PROBLEM; Volatile oroanic compounds have been shown to
transfer from water to air When heated or aerated. This is continuous,
leading to an enrichment of air at the point of use, and diffusion through the
"House. In water disinfected with chlorine, trihalomethanes are formed through
chemical reaction. tXiring household water use, e.g., showers and washing
machines, chloroform is volatilized into the indoor air.
2. EXPOSURE; Fxposure to indoor airborne concentrations of chloroform can result
from several sources, such as showers, baths, dishwashers, laundry machines,
and humidifiers. Airborne chloroform has also been masured at indoor swimming
pools.
the concentrations of volatilized chloroform found in indoor air are dependent
on a number of factors, including:
o frequency and duration of water appliance use
o pollutant volatilization rate
o home air volume and air recirculation rate
o air infiltration and exfiltration rate
o air mixing factor
o outdoor pollutant concentration
o volume of water use
o indoor temperature.
A. Inhalation from Various Types of Water Uses.
Research has shown that the fraction of a VOC released to the air is
about the same as radon. The research on radon volatilization has shown
that *or laundry and dishwshing machines, the transfer efficiency can be
as high as 90%. Hie comparable figure for showers was 63%, and for tub
baths 43%. Thus, the volatilization of chloroform would take place at
these same transfer efficiencies.
Using a single-compartment indoor air quality model and various assumptions
(e.g., daily respiratory volume of 20 m^ and daily water intake from
0.15L to 2L) exposure from the air route can be as significant as that from
water ingestion. It is shown that the relative uptakes ^rom the inhalation
and ingestion routes point to the possibility of substantial air exposures
of volatile organic compounds from water use in the home.
1. Inhalation from Showers and Tub Baths. In one study utilizing a
laboratory bath-shower system, volatilization of chloroform and
trichloroethylene was found to be greater than 50%. The air concentrations
of chloroform were measured for both use of the shower and filling of
the bath tub, with concentrations during showering found to be higher.
?. Inhalation from Humidification of the Building. Humidifiers add
moisture to interior air From the drinking water supply. Moisture is
added by evaporation of water, or disspelling aerosols, either directly
into the "home or into furnace duct systems tJiat provide air to the
home interior. Chloroform in the water supply is likely to approach
100% release into the indoor air because of its high volatility.
-------
CHLOROFOM -2-
Exposure to chloroform via home humidifiers is relatively small.
Using a chloroform concentration of 60 ppb (worst case scenario for
Baltimore) and several assumptions ("house air volume of ?0,000 cu.
ft., air infiltration of 20,000 cfm/hr, and humidification rate of
13 gals/day), the airborne chloroform levels would only be about 2 X
10 -7 g/m3.
3. Inhalation from Indoor Swimming Fbols. Indoor swimming pools and spas
are a possible source of airborne chloroform exposure from the use of
chlorine as a disinfectant in the pool water.
Bromine is also used *br disinfection in some swimmina pools and spas.
Therefore, inhalation of bromoform, another trihalomethane, is a
possible question.
Exposure depends on the chemical competitions between the bromine and
chlorine reactions, which are based on a number of factors, including
the amount o^ chlorine or bromine added to the pool water, the amount
of chlorine already in the water, water temperature, room volume, air
circulation, agitation of the water in spa hot tubs, etc. Exposures,
therefore, are difficult to characterize.
One recent study measured chloroform and bromoform concentrations 2 cm
above the water. surface at indoor swimming pools and spas. The maximum
measured concentrations were as follows:
Pools, Chlorinated only
Pools, Brominated only
Pools, Chlorinated and Brominated
Spas, Chlorinated only
Spas, Brominated only
Spas, Chlorinated and Brominated
B. Exposures in the Baltimore Study Area.
Chloroform (mg/m-*) Bromoform (mg/m3)
.900 .0001
.013 .051
.215 .054
.699 .0001
.102 .167
.255 .142
1. R&ta Pertaining to the Baltimore Study Area.
population in Baltimore City and Baltimore County served by the
Ashburton and Montebello Filtration Plants: 1,381,500 (100% of
Baltimore City population and 90% of Baltimore County population.
o 1980 population in Anne Arundel County served by Anne Arundel County
public water system or Baltimore City water system: 209, 224
(about 56% of total population).
o 1980 population in the Baltimore Study Area potentially exposed to
chloroform in indoor air: 1,590,724 (PP% of total population).
Modelling of Potential Exposure in Baltimore Study Area. Utilizing
a simplified single compartment indoor air quality model, an estimate
of the maximum indoor air concentrations resulting from volatilization
of oroanic chemicals in water can he calculated. Then, utilizing
Baltimore Metropolitan data on chloroform in drinking water, the
relative air and water exposures for a home in the Baltimore area can
be determined.
-------
CHDOPOPOFM
-3-
Tfie model hone has the following characteristics:
o air volume is 450 nP
o air recirculation is 1350 m3/hr
o infiltration and exfiltration rates are 33« m^/hr
o typical water use is 30 L/hr (family of four)
o temperature indoors is 77 degrees P.
Based on worst case Baltimore metropolitan treated drinking water THM
•^ata from January 1984 to September 1985, a chloroform concentration
in water of 60 ppb is used.
Assuming the pollutant is continuously generated and 100% volatilized,
the maximum indoor air concentration in the model home is calculated
to be 0.001 ppm.
Assuming a respiratory volume of 20 rtP/day for an adult male:
Daily inhalation exposure = 0.10 ing/day.
Assuming a daily total water intake" of 2 liters:
Daily ingestion exposure .= 0.12 ing/day,
or, assuring a daily tap-water intake of 0.15 liters:
Daily ingestion exposure = 0.009 ing/day.
This comparison is based on worst case numbers and a very specifically
defined home. The model does confirm, however, that inhalation
exposure can be as significant as ingestion exposure.
3. HEALTH Eb'WTTS.
B.
C.
Carcinogenicity. Chloroform is considered to be a Probable Human Carcinogen
by EPA GAG and IARC. Although it was evaluated by the ingestion route,
and not inhalation, it is believed that the carcinogenic response is not
dependent on the route of exposure to the body. The main target organs
are the liver and kidney.
Non-Carcinogenic Effects. Acute exposures to chloroform through inhalation
have demonstrated toxicity to the central nervous system, liver, kidney,
and heart. Chronic inhalation studies revealed toxicity to the liver,
and kidney and possibly the central nervous system.
Teratogenic and Reproductive Effects. No data for humans are available.
Inhalation animal tests showed chloroform to be a potential development
toxicant. There is the potential of causing fetal development delays,
adverse effects in pregnancy maintenance, and lab animal terata.
D.
Mutagenicity. No definite conclusion can be reached.
mutagenicity is possible.
Studies show that
-------
CHLOROFORM
4. COOTPQL TECHNIQUES AND TECHNOLOGIES.
A. Removal of trihalonBthanes by aeration or adsorption.
B. Removal of trfhalomethane precursors.
C. Use of Disinfectants other than free chlorine.
s. CURRENT AND FUTURE ACTIVITY LEVEL.
A. EPA.
The FPA Office of Drinking Water is writing criteria documents on
Disinfectants, including TFMs. The External Review Draft is expected
by the end of FY 19P7? the Final Draft is expected by the end of FY 1988.
Draft Maximum Contaminant Levels Goal (MCLG) will then be developed,
based on health effects.
According to the 1986 amendments of the Safe Drinking Water Act, Final
MCLGs and MCLs will be published in the.Federal Register in 1989.
B. Baltimore TEAM Study.
An FPA Total Exposure Assessment Methodology (TEAM) study will be conducted
in 1987. Chloroform levels will be measured by personal monitors, indoor
and outdoor fixed site monitors, breath samples, and water samples.
C. Chloroform Monitoring at Swimming Pools.
The Baltimore County Health Department has conducted a monitoring study at
indoor swimming pools and spas for both chloroform and bromoform. Results
are found in the Appendices to the Chloroform Background Information Document.
-------
Appendix #4a
SECTION 1
Toxicology
Thomas J. Haley, Ph.D.
Honorary Professor of Pharmacology
University of Arkansas for the Medical Sciences
Little Rock, Arkansas
TOXICOLOGY DEFINED
Toxicology is the science of poisons, their effects on the
body, various antidotes for their action, and their detec-
tion in body fluids and tissues. It is considered a new
science, even though Hippocrates, the father of medicine,
advised his students on the toxic properties of the drug
Veratnun alba, and Paracelsus, in the sixteenth century,
pointed out that the difference between a therapeutic dose
and a toxic one was only a matter of quantity. The degree
of toxicity of chemicals is shown in the Hodge-Sterner
Table.
Exper. LDto;Dose
per Kilogram of
Body wt
<1.0 mg
1-50 mg
50-500 mg
0.5-5 gm
5-15 gm
>!5gm
Degree of
Toxicity
Dangerously toxic
Seriously toxic
Highly toxic
Moderately toxic
Slightly toxic
Extremely low
toxicity
Probable
Lethal Dose for
a 70 kg Man
A taste
A teaspoonrul
An ounce
A pint
A quart
More than a
quart
Since all chemicals can be toxic, it is necessary to define
the conditions of an exposure as well as the amount of
chemical involved in an exposure to compare toxicities.
TOXICITY RATING SYSTEM
In Section 6, the following system of toxicity rating is
used to indicate relative hazard:
U —unknown
This rating covers chemicals for which insufficient data
are available to enable a valid assessment of toxic hazard
to be made. Such chemicals usually are in one of the
following categories:
1. No information has been discovered in the literature,
and none is known to the authors.
2. ijmitod informatioo from •i»»«"«i experiments is
available, but it is not possible to relate it to human
exposure. The data are mentioned to indicate to the
reader that fnjf««i experiments have been done.
3. The validity of published toxicity data was ques-
tioned by the authors.
s None = no toxicity (0)
This designation is for chemicals that fall into the fol-
lowing categories:
1. Chemicals that produce no toxic effects under any
conditions of normal usage.
2. Chemicals that require overwhelming doses to pro-
duce any toxic effects in humans.
Low = slight toxicity (1)
1. Acute local Chemicals that on a single exposure
lasting seconds, minutes, or hours cause only slight
effects on the skin or mucous membranes or eyes,
regardless of the extent of exposure.
2. Acute systemic. Chemicals that can enter the body
by inhalation, ingestion, or dermal contact and pro-
duce only slight toxic effects, regardless of the dura-
tion of exposure or following the ingestion of a single
dose, regardless of the amount absorbed or the extent
of the exposure.
3. Chronic local Chemicals that on repeated or contin-
uous exposure covering days, months, or years cause
only slight and reversible damage to the skin or
mucous membranes. The extent of the exposure can
be great or small.
4. Chronic systemic. Chemicals that on repeated or
continuous exposure covering days, months, or years
cause slight and usually reversible toxic effects on
the skin, mucous membranes, or eyes. The exposure
can be by ingestion, inhalation or skin contact and
may be great or small. Slightly toxic chemicals pro-
duce changes readily reversible once the exposure
ceases with or without medical intervention.
Mod = moderate toxicity (2)
1
Acute local Chemicals that on a single exposure
lasting seconds, minutes, or hours produce moderate
toxicity to the skin, mucous membranes, or eyes.
The effects can be the result of an intense exposure
for seconds or a moderate exposure for hours.
2. Acute systemic. Chemicals mat after being absorbed
by inhalation, ingestion, or skin contact produce
moderate toxicity after a single exposure lasting sec-
onds, minutes, or hours or after the ingestion of a
single dose.
3. Chronic local CTt**nir?** Out on continuous or re-
-------
a sicriofii
petted exposure over days, months, or yean •
moderate toxicity to the skin, mucous membranes,
or eyes.
4. Chronic systemic. Chemicals that on absorption by
ingestion, inhalation, or skin contact cause moderate
toxicity after continuous or repeated exposures over
days, months, or years.
Under the moderate classification are chemicals that
can cause reversible or irreversible changes in the human
body not necessarily severe enough to cause serious physi-
cal impairment or threaten life.
High = severe toxicity (3)
1. Acute local Chemicals that on a single exposure
covering seconds or minutes can cause injury to
the skin, mucous membranes, or eyes of sufficient
severity to threaten life, cause permanent physical
impairment or disfigurement.
2. Acute systemic. Chemicals that after a single expo-
sure by inhalation, ingestion, or skin contact cause
injury of sufficient severity to fhreaten life. The expo-
sure may last seconds, minutes, or hours or may
be a single ingestion.
3. Chronic local. Chemicals that on continuous or re-
peated exposures covering days, months, or years
can cause injury to the skin, mucous membranes,
or eyes of sufficient .severity to threaten hie or pro-
duce permanent impairment, disfigurement, or irre-
versible change.
4. Chronic systemic. Chemicals that on continuous or
repeated exposures by inhalation, ingestion, or der-
mal contact to small amounts for days, months, or
years can produce death or serious physical impair-
ment.
TOXICTTY AND HAZARD
Toxicity is defined as the ability of a chemical to cause
injury once it reaches a susceptible site in or on the body.
Hazard is defined as the likelihood that a chemical will
cause injury under circumstances of ordinary use.
EXPOSURES
1. Acute exposure, which entails a short duration, means
exposure to chemicals absorbed by inhalation, dermally,
or by ingestion with the duration of total exposure mea-
sured in seconds, minutes, or hours. As applied to inges-
tion it means a single dose.
2. Subchronic exposure means intermediate exposures
between acute and chronic and may be for up to 90 days.
3. Chronic exposure means exposures of long duration
and as applied to dermal and inhalation covers prolonged
or repeated exposures with durations of days, months,
or years. With ingestion, it means repeated doses of the
chemical for days, months, or years.
EFFECTS
It is essential to differentiate between acute and chronic
effects of chemicals and acute and chronic exposures.
Chronic toxicity mint be related to chrome illness pro.
duced by exposure to chemicals regardless of the duration
of such exposure; even an acute exposure may produce
a chronic illness, i.e., heavy metals and carcinogens. Re-
peated exposure to such chemicals accentuate chronic
illness. On the other hand, exposure to cyanides or sulfides
does not produce chronic illness but instead produces
acute poisoning and death.
Toxic effects may be local or systemic, depending on
the area exposed. Local exposure affects the nose, eyes,
mouth, throat, skin, and various parts of the respiratory
and gastrointestinal tracts; absorption does not have to
occur. With chronic exposure, however, absorption does
occur, and the site of damage may be remote from the
site of contact. In many cases both local and systemic
damage occurs.
DOSAGE
Dosage is the most important factor in determining
whether a given chemical will produce a toxic effect. There
is a large variation in the toxicity of chemicals, and even
water can cause illness under certain circumstances. For
comparisons of the toxicities of different chemicals, the
median lethal dose (LOW) is usually used as the yardstick
and is stated as weight of poison per unit body weight
or surface area. The median lethal dose is a statistical
estimate of the amount of .chemical required to kill 50%
of a given population of test animals. It is useful also
to make a comparison of the susceptibility of various
animal species regardless of size. To be meaningful, the
LDM must specify the experimental conditions, route of
administration, species, age, sex. number of doses, and
the time of the measurement in days or weeks. Other
factors may include the route of exposure, i.e., ingestion,
inhalation, or dermal; type of formulation, temperature,
humidity, barometric pressure, physiologic state of the
subject, and the possible interaction between two or more
administered chemicals. This last factor requires knowl-
edge of body enzymes that may be stimulated or de-
pressed, which then causes rapid or delayed elimination
of a given chemical.
TOXIC LEVELS
Everyone is interested in the highest level of exposure
to toxic chemicals at which no deleterious effect is noted.
The American Conference of Governmental Industrial
Hygienists (ACGIH) has set such levels for human expo-
sure in industry. They are called Threshold Limit Values
(TLV's) and formerly were known as Maximum Allowa-
ble Concentrations (MAC's). As new information be-
comes available, they may be revised upward or down-
ward, and as soon as the information becomes available
other compounds are added to.the list. The TLV's refer
to air concentrations of a given chemical to which an
individual can be repeatedly exposed for 8 hours per day,
5 days per week. Because some individuals can experience
hypersensitivity even at the TLV level, all workers should
be pre-employment tested. Because the TLV's are time-
-------
Justification for the Pollutant Rating Scores.
FORMALDEHYDE:
Appendix I4b
12/2/86
1. Population Potentially Exposed; 3 (50,001 - 250,000 population).
Population potentially exposed to formaldehyde in new hones = 11,600 hares (1985)
X 2.8 people/household = 32,480 people?
Mobile homes = 5,300 hones X 2.8 people/household = 14,840 people;
Total = 32,480 + 14,840 = 47,320 people.
Added to this figure are those people in older homes potentially exposed to new .
formaldehyde-containing products. This would push the population over into
Category 3, at a minimum.
2. Health Effects; 2.5
GAG Group Bl Probable Human Carcinogen with other toxic effects.
Some controversy on carcinogenicity (EPA Study/ National Cancer Institute -
Formaldehyde Institute Study).
3. Public Concern*; 1 LOW.
4. Agency/Org. Perception of Health Threat*; 1 LOW.
5. Current Activity Level; 2 MEDIUM - Federal regulatory and research activities;
national monitoring studies; formaldehyde industry activities;
little local activities (local inspections upon complaint).
ASBESTOS;
1. Population Potentially Exposed; 4 (250,001 - 1,000,000 population)
At a minimum, school children potentially exposed:
(1980) Age 5 - 19; Baltijnore City - 190,500
Baltimore County = 95,900
Anne Arundel Co. = 147,300
433,700
These population figures are in Category 4, + children not exposed and other
sources of exposure (residential).
2. Health Effects; 3 - CAG Group A Known Carcinogen-
3. Public Concern*: 3 HIGH.
4. Agency/Org. Perception of Health Threat*; 3 HIGH.
5. Current Activity Level;- 3 HIGH - Nfcny federal, state, and local activities.
* Rankings for Categories (3) Public Concern and (4) Agency/Org. Perception of
Health Threat were based on the experience and professional judgement of the
IAP Workgroup members.
-------
JUSTIFICATION -2-
COMBUSTION PRODUCTS t
1. Population Potentially Exposed; 5 (>1,000,000 population)
70% of population have gas fired range = 458/624 X 2.8 people/household =
1,284,147. Population > 1,000,000 = Category 5.
2. Health Effects; 2
A number of caipounds are involvedr largely based on N02 effects (adverse
effects at low concentrations) as well as other pollutants. Discount effects
of PAHs as they are a minor part of the Combustion Products.
3. Public Concern*; 1 LOW.
4. Agency/Org. Perception of Health Threat*; 2 MEDIUM.
5. Current Activity Level; 2 MEDIUM - Some Federal surveys, studies; seme local
restrictions (e.g.,Baltimore City has restriction on unvented space heaters).
***********
VOLATILE ORGANIC COMPOUNDS (VOCs);
1. Population Potentially Exposed; 5 (>1,000,000 population)
The average home contains some 45 aerosol containers, each of which tray
contain 15 VOCs. Considering the number of products on the market, the
workgroup came to the concensus that a large portion of the population was
potentially exposed.
2. Health Effects; 1
Sane toxic effects at lower concentrations. Primarily irritant effects,
exacerbating pre-existing diseases. Discounted carcinongens because there
are few in the whole group of VOCs.
3. Public Concern*; 1 LOW.
4. Agency/Org. Perception of Health Threat*; 2 MEDIUM.
5. Current Activity Level; 1 LOW - A few Federal regulatory and research activities?
little local activities.
* Rankings for Categories (3) Public Concern and (4) Agency/Org. Perception of
Health Threat were based on the experience and professional judgement of the
IAP Workgroup members. . . - ""
-------
JUSTIFICATION -3-
RADCN;
!• Population Potentially Exposed: 4 (250,001 - 1,000,000 population).
Limited data are available from Baltimore Study Area. 12 out of 18 samples
had levels >_ 4 pCi/1. 12.5% of hones in U.S. contain significant amounts
of radon.
492,000 hones X .125 » 61,875 hones X 2.8 people/household - 173,250 people.
Group felt that this was low due to geological structures found in the
Baltimore area (ex: Baltimore Gneiss etc.). Therefore, the workgroup came
to a concensus to place this in Category 4.
2. Health Effects; 3 - Known Carcinogen, lung cancer. (IARC)
3. Public Concern*; 3 HIGH.
4. Agency/Organization Perception of Health Threat*; 3 HIGH.
5. Current Activity Level; 2 MEDIUM - Seme federal research and information
development/public education activity; little local activity.
PASSIVE SMOKING:
1. Population Potentially Exposed; 5 (>1,000,000 population)
Estimate of nonsmokers = 1,296,700; See Matrix sumaries for calculations.
2. Health Effects; 2.5 - Potential Carcinogen - lung cancer. {1937 Surgeon
General's Report)
3. Public Concern*; 2 MEDIUM.
4. Agency/Organization Perception of Health Threat*; 2 MEDIUM.
5. Current Activity Level; 2 MEDIUM - Some Federal, private business, and
other organizational activities; most local restrictions are for safety-
purposes. More activity could be done on local basis.
* Rankings for Categories (3) PubTic*Concern and (4) Agency/Org. Perception of
Health Threat were based on the experience and professional judgement of the
IAP Workgroup members.
-------
JUSTIFICATION
CHLORDANE:
1. Population Potentially Exposed; 3 {50,001 - 250,000 population)
From commercial applicator use, about 106,260 people are potentially exposed.
(See Summary sheets for calculations.) Homeowner and nonconmercial applicator
use will increase the potential population number but will not push the number
into the next Category.
2. Health Effects; 2.5 - CAG Group B2 Probable Human Carcinogen (inadequate human
evidence, sufficient animal evidence); IARC Group 3 Not a Carcinogen (inadequate
human evidence, limited animal evidence).
3. Public Concern*; 1 LOW.
4. Agency/Organization Perception of Health Threat*; 1 LOW.
5. Current Activity Level; 1 LOW - Most of activity is Federal/Maryland State
'ity
dnii
pesticide training of certified applicators required for all pesticides.
************
CHLOROFOBM;
!• Population Potentially Exposed; 5 (>1,000,000 population)
1980 Population served by a public water system in the Baltimore Study Area =
1,591,000 (88%).
2. Health Effects; 2.5 - CAG Group B2 Probable Human Carcinogen (inadequate human
evidence, sufficient animal evidence); IARC Group 2B Probable Human Carcinogen
(inadequate human evidence, sufficient animal evidence).
3. Public Concern*; 1 LOW.
4. Agency/Organization Perception of Health Threat*: 1 LOW.
5. Current Activity Level; 1 LOW - EPA is developing chloroform MCL (Maximum
Contaminant Level); Baltimore TEAM Study; Baltimore monitoring for chloroform
and brcmqform at a few pools/spas.
* Rankings for Categories (3) Public Concern and (4) Agency/Org,. „Perception of
Health Threat were based on the experience and professional" judgement of the
LAP Workgroup members.
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Passive Sacking; Justification for Ratings of
1. Public Education.
Appendix I5a
2/6/87
a. Cost - HIGH. A considerable amount of effort and resources would be
required by government and/or nongovernment agencies.
b. Time^rame - SHORT/COMTNUOUS. Fstablishing a public education program
could be done in less than 2 years. After it is established, it would
be an ongoing program.
c. Legal Considerations - Minimal. To establish a public education program
would not require any legal effort.
d. Acceptability - HIGH. Majority of people in Maryland are nonsrookers
(71%). See the Passive Smoking Background Document.
e. Political Sensitivity - LOW. Little or no political implications.
f. Other Considerations - Agencies must be able and available to respond to
inquiries.
2. Smoking Policies in Government and Nongovernment Buildings.
a^Cost -ICW.Would require little or no expenditure of resources.
b. Timeframe - SHORT. Once the jurisdiction has committed to smoking
policies, the policies can be established and implemented very quickly
(e.g., Executive Order).
c. Legal Considerations - MEDIUM. May involve union contract negotiations.
d. Acceptability - HIGH. Majority of people in Maryland are nonsmckers.
See the Passive Smoking Background Document for smoking policies presently
in place in government agencies.
e. Political Sensitivity - LOW. Little or no political sensitivity.
f. Other Considerations - Expect a vocal minority to object to smoking
policies.
Increased Qif<
nent of Building Codes and Standards/Existing Smoking
Regulations.
a. Cost - HIGH. Agencies must dedicate increased numbers of personnel
to raise level of enforcement.
"h. Tameframe - SHORT/COWTINUCUS. The enforcement program is an established
program. To increase the level of effort within that enforcement program
could be done in less than 2 years. Once the increased level of enforcement
was in place, this would be an ongoing effort.
c. Legal Considerations - Minimal. This would involve enforcing existing
regulations.
d. Acceptability - HIGH. Majority of people in Maryland are nonsmokers.
See Passive Smoking Background Document for description of existing
snoking regulations.
-------
Passive Smoking -2-
Political Sensitivity -
budget requirements.
MEDIUM. Moderately sensitive issue due to increased
4.
^. Other Considerations - Expect a vocal minority concerning the passive
smoking issue.
Passage of New State or Local Laws on Smoking Restrictions.
a. Cost - HIGH. Long-term effort to overcome political and legal
considerations could be expected to lead to significant costs.
H. Time^rarne - LONS. Efforts in the last 5 years have been unsuccessful
and met with considerable resistance and opposition. Gaining and
generating support for passage will likely take many more years.
Approach is being changed to generate efforts on a local level (rather
than on the state level).
c. Legal Considerations - HIGH. Requires new legislation on state or local level.
d.
e.
f.
Acceptability - HIGH. Majority of people in Maryland are nonsmdkers
(71%). See the Passive Shaking Background Document for a description of
present restrictions/prohibitions in public places.
Political Sensitivity - HIGH. Very sensitive issue due to opposition
from strong tobacco lobby in Maryland.
Other Considerations - Difficult enforcement of restrictions; expect a
vocal minority.
5.
Smoking Cessation (Clinics, Self-Help Sessions, etc.).
a. Cost - LOW. A low cost to organizations to sponsor cessation activities
due to their commitments to weilness programs. TTie cost to individuals
ranges from $35 - $450/person. Employee may lose some working hours if
he/she goes to the clinic during working hours; however, ultimately
employee absenteeism and sicktime would decrease, thus further reducing
the cost.
For the American Lung Association population, it has been shown that
57% of people are able to stop smdking at the end of a smdking clinic;
one year after a smdking clinic, 36% of people have stopped smoking.
b. Timeframe - SHOOT. Most of the sessions to quit smoking are short-term.
Cessation clinics oenerally run 5-7 weeks. Hypnosis may consist of
1-3 sessions. Employee turnover would ultimately make this a continuous
c. Legal Considerations - Minimal.
d. Acceptability - HIGH. Majority of people in Maryland are nonsnckers.
In addition, smokers (who would like to quit) would be favorable of this
program.
e. Political Sensitivity - LOW. No political implications.
f. Other Considerations -
-------
Passive Stacking -3-
6. Health Insurance to Cover Cessation Methods (Clinicsi Self-Help Sessions, etc.)
a. Oast - MEDIUM. Costs would be increased for agencies/companies with SORB
slight increase for individuals. Some Jnsvirance companies do provide
discounts to individuals (that do not strike) and ccnpanies (with smoking
policies in place).
b. Timeframe - MEDIUM. Timeframe is difficult to estinate, but could take
2-5 years to establish (if not longer).
c. Legal Considerations - Minimal.
*. Acceptability - MEDIUM. This option would be very acceptable
if the employer bears the full cost; it would be less aceptable if costs
were scared by employer/employee.
e. Political Sensitivity - MEDIUM. Government agencies that implement this
program would require increased budget for their agencies.
f. Other Considerations - In the event, that insurance companies would not
cover cessation methods voluntarily, legislation would be necessary to
mandate coverage by the insurance company.
7. Increased Excise Tax to Support Smoking Cessation Activities'.
a. Cost - LCW. Majority of population in Maryland are nonsmokers and would
be unaffected by the tax. This program would require minimal effort
and resources by government agencies and other organizations.
b. Timeframe - MEDIUM. This "program-could he done in 3 - 5 years.
c. Legal Considerations - HIGH. This effort would require new legislation.
d. Acceptability - HIGH. Majority "of people in Maryland are nonsmokers.
e. Political Sensitivity - HIGH. Raising taxes is a highly sensitive issue.
f. Other Considerations •>- More effective with young people. See the Passive
Smoking Background Document, Section III.C. for a discussion of Excise Tax
effects.
-------
-------
Radon; Justification for Ratings of Potential Programs. Appendix #5b
2/11/87
1. Public Education.
a. Cost - HIGH. Considerable amount of effort and resources would be
required by government and/or nongovernment agencies.
b. Timeframe - SHOOT/CONTINUOUS. To establish a public education program
would take less than 2 years. After the program has been established,
it would be an ongoing program.
c. Legal Considerations - Minimal.
d. Acceptability - HIGH. The entire Maryland population may be potentially
exposed.
e. Political Sensitivity - LOW. Little or no political implications.
f. Other Considerations - Education would include both awareness of potential
problem and mitigation where problems are found. It would also require
agencies to respond to inquiries.
2. Education of Elected and Government Officials.
a. Cost - LOW. Training/seminars are not expensive, less than $100/person.
b. Timeframe - SHORT. Time needed for training would <2 years, Many current
seminars are available. See the Radon Background Information Document for
activities available.
c. Legal Considerations - Minimal.
d. Acceptability - HIGH. Acceptable by all groups.
e. Political Sensitivity - LOW. No political implications.
f. Other Considerations - Educating elected and government officials may
result in resource support of studies, surveys, and/or public education.
3. state or LocalFunded Survey of Homes.
a. Cost - HIGH. Statewide survey could cost between $750,000 - $1,000,000.
Local survey would cost less.
b. Timeframe - MEDIUM. Survey would take 2-3 years.
c. Legal Considerations - Minimal.
d. Acceptability - HIGH. Majority of popultion would be very interested in
the results; participation would be voluntary.
e. Political Sensitivity - LOW. No political implications.
f. Other Considerations - Must obtain cooperative release of test results
from citizens and deal with the issue of confidentiality of the data.
-------
Radon -2-
4. State or Local Funded Testing in Schools.
a. Oost - MEDIUM. Agencies most ocmiat time and resources to establish
and run the program.
b. Timeframe - SHORT. Survey would take <2 years.
c. Legal Considerations - Minimal. Public done in.
d. Acceptability - HIGH. Constituencies would be interested in the results
because of the health implications to children.
e. Political Sensitivity - MEDIUM. This could be a potentially sensitive
issue, if a problem is found in the schools, because people will want
the government to mitigate the problem (which takes money, etc.).
This issue is similar to the asbestos issue (asbestos in schools).
f. other Considerations -
5. Free Radon Testing for Citizens.
a~iCost - HIGH. Testing devices, analyses, etc. would be costly. The cost
would range from $25 - $50/house, depending on the number and type of
monitors.
b. Timeframe - SHORT. Once the resurces are committed, implementation of
the program would take <2 years. Program would then be ongoing.
c. Legal Considerations - Minimal, Given that this would be a voluntary
program, a release or cooperative agreement would be needed. May
still have liability for inaccurate results.
d. Acceptability - HIGH. This would be a 'no cost service1.
e. Political Sensitivity LOW. There are very little implications when
providing free testing for citizens (voluntary).
f. Other Considerations - Confidentiality of data issue; agencies must be
prepared to follow up testing with information and advice on mitigation.
Infrastructure must be in place for agencies/organizations to be responsive
to problem houses quickly so that demand and public reaction do not build
up to cause panic.
6. Epidemiological Study.
a. Cost - HIGH, this would require a great deal of effort and resources.
b. Timeframe - LONG. 3+ years.
c. Legal Considerations - Minimal.
d. Acceptability - HIGH. Majority of people would be interested in the
results.
e. Political Sensitivity - LOW. No political implications. Some people
may question spending this large amount of money for limited usefulness.
f. Other Considerations - An epidemiological study would indicate the extent
of adverse health effects from radon in the area.
-------
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U.S.
Environmental Protection
8404 PM-21L-A
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S.fl.
DO 20400
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