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New Emphasis on Healthy Housing

Sustainable materials, non-wasteful practices and energy efficiency are hallmarks of eco-friendly housing efforts. Now, one organization and a federal program are looking more directly at how these efforts can make homes healthier for their occupants.

Following Seven Steps
The National Center for Healthy Housing, a nonprofit corporation based in Columbia, Md., and formed in 1992, took on the problem of childhood lead


The National Center for Healthy Housing offers seven steps to having a safe, healthy home for children.
The National Center for Healthy Housing offers seven steps to having a safe, healthy home for children.

Morley says that the center has received “mostly positive reactions” to the report and feedback on how some criteria will be strengthened. “We have seen improvement in the health components of these programs since our 2006 report,” she says. “This suggests that our advocacy is working. If everyone receives an A+ the next time, we will know that we have succeeded.”

The steps, selected by leaders in the field, are known as the Seven Principles of Healthy Housing. The principles recommend keeping homes dry, clean, pest-free, ventilated, safe, contaminant-free and maintained. Each principle addresses multiple areas of a home and together they create a framework for understanding how elements within a home are interrelated, says Executive Director Rebecca Morley.

Though NCHH’s effort on lead poisoning is a textbook case of a public health success, the center says there is still work to be done. “There are millions of children suffering the long-term effects of lead poisoning and hundreds of thousands who are newly exposed each year,” Morley says. “Along with lead poisoning, asthma and injuries are critical issues for children in their home environments. Asthma is a perfect example of why a holistic healthy homes approach is needed since a broad array of factors within the home can lead to the development and exacerbation of asthma. And injuries in the home are second only to automobile accidents as the leading cause of death for young children.”

Teaching professionals about healthy homes has been one way to get across the message. Through its affiliated National Healthy Homes Training Center, NCHH offers health and housing professionals an educational opportunity to earn a Healthy Homes Specialist credential.

Making Green Homes Healthier
NCHH also has addressed the growing green building effort. In September 2008, it released its recent analysis of four major green building programs.

Its report, "How Healthy are National Green Building Programs?", compared guidelines of those building programs with its own healthy housing criteria. NCHH wanted to learn if the programs, from its perspective, adequately protect residents from housing conditions known to affect health status, such as asthma and respiratory disease, unintentional injuries, allergic reactions, cancer and other health effects from contaminants and allergens.

The analysis examined guidelines of both the public and private sectors. The four programs were Enterprise Community Partners’ Green Communities, National Association of Home Builders’ Green Home Building, the U.S. Environmental Protection Agency’s Energy Star with Indoor Air Package and the U.S. Green Building Council’s LEED for Homes.

The results show that while all the programs have components aimed at improving resident health, many miss critical elements. For example, NCHH’s

Morley says, injury prevention is omitted from all guidelines and protection from contaminants such as lead, radon and pesticides is not uniformly covered.


An EPA program that focuses on indoor air quality will soon be launched nationally.
An EPA program that focuses on indoor air quality will soon be launched nationally.

Only one program, Green Communities, focuses on affordable existing housing, an important consideration since low-income families are disproportionately impacted by housing-related health problems, Morley says.

Overall, the analysis suggests that green building programs offer a significant opportunity to achieve public health benefits and have the potential to transform the housing market toward healthier building. It suggests ways for the programs to strengthen their criteria so that they may deliver even greater benefits.

Morley says that the center has received “mostly positive reactions” to the report and feedback on how some criteria will be strengthened. “We have seen improvement in the health components of these programs since our 2006 report,” she says. “This suggests that our advocacy is working. If everyone receives an A+ the next time, we will know that we have succeeded.”

Launching Indoor AirPLUS
The U.S. Environmental Protection Agency is also taking on occupant health and indoor air quality with its indoor air package (IAP). Now operating in five states, the program will be launched nationally in 2009.

According to Dave Ryan, EPA spokesperson in Washington, D.C., “the EPA plans to expand the program, now called Indoor AirPLUS, with promotional materials for builders, technical guidance and increased communication efforts in 2009.”

Here are some surprisingly unsafe aspects of our homes:

• “Everyone knows how unsafe the roads are and wouldn’t dream of driving their children around without a seat belt or car seat,” NCHH’s Morley says. “I don’t think people are fully aware of the dangers in the home.” NCHH says an estimated 2,446 children 14 years and under die each year in a motor vehicle incident and home injuries claim an average of 2,096 children ages 14 and under each year. Fires, suffocation and drowning are the leading causes of unintentional home injury death among children in this age group.

• According to the American Housing Survey for 2007, there were 1,806,000 occupied housing units in the U.S. with severe physical problems. Of those, 784,000 were single-family homes. In addition, there were 3,965,000 occupied units, 1,798,000 of them single-family homes, that had moderate physical problems. Severe problems can include such things as lacking hot or cold piped water, having no electricity or such problems as exposed wiring and holes in the floors, walls or ceiling. Moderate physical problems are similar but less severe. They would include having all the flush toilets broken at the same time for six hours or more for three times in three months; unvented gas, oil or kerosene heaters as the primary heat; or lack of an inside kitchen sink, refrigerator or cooking equipment.

• According to the Centers for Disease Control and Prevention, many things can impact health and safety. Lead-based paint and dust may contribute to lead poisoning in children. Water leakage and mold may contribute to asthma episodes. Improper use and storage of pesticides may result in unintentional poisoning. And lack of working smoke, ionization and carbon monoxide alarms may cause serious injury and death. The CDC has noted that the impact of energy conservation measures on the home environment is still unfolding. Simple, affordable construction techniques and materials that minimize moisture problems and indoor air pollution, improve ventilation and promote durability and efficiency continue to be uncovered. Its Basic Housing Inspection manual, revised in 2006 and renamed the Healthy Housing Reference Manual, is available online. It helps to ensure that a homeowner’s investment “is a sound one that promotes healthy and safe living.”


Indoor AirPLUS is a set of EPA specifications for newly constructed homes designed to help builders decrease the risk of poor indoor air quality. According to the EPA, the builder will have to use a variety of construction practices and technologies to earn an Indoor AirPLUS label. Those practices would include taking extra precautions to prevent rain from getting into the roofs, walls and foundation; bringing in fresh, filtered outside air on a periodic basis and sealing the home from pollutants in the garage.

“Indoor AirPLUS verification and labeling was designed to fit seamlessly with the Energy Star homes verification and labeling process,” Ryan says. “A home energy rater conducts the same two inspections required for Energy Star and at the same time verifies IAP requirements.”

“Since not all IAP requirements can be verified in these two inspections, some items such as the foundation and material selection on the IAP checklist may have to be verified by the builder. Once the IAP checklist has been signed by both the builder and the verifier, the home has earned the label and is eligible to be marketed as an EPA Indoor AirPLUS qualified home.”

Ryan says the program will only apply to new homes although the specifications and technical guidance can be used when remodeling or renovating an existing home. “EPA would like to extend the program to include existing homes, however, the expanded program is not in place yet. We have piloted an effort with the National Center for Healthy Housing to use and adapt the specifications in a 24-unit assisted housing retrofit project.”

He suggests that energy efficiency and indoor air quality features will be an increasingly important way to maintain value in the marketplace.

“It is important to combine energy efficiency with home features that support good indoor air quality,” Ryan says. “By living ‘green’ and making smart purchases including a new home, consumers can take positive steps towards protecting their health. The Indoor AirPLUS label is one way for consumers to know they are making wise decisions during the home-buying process and afterwards when they are living in their home.”

Credit: Renovate Your World