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Assessing Allergens and Respiratory Irritants within Public Housing. Gabriella Kusko Environmental Health Specialist Children’s Mercy Hospital. Asthma in Kansas City. The American Lung Association estimates that more than 80,000 people, including 23,500 children
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Assessing Allergens and Respiratory Irritants within Public Housing Gabriella Kusko Environmental Health Specialist Children’s Mercy Hospital
Asthma in Kansas City • The American Lung Association estimates that more than 80,000 people, including 23,500 children in the Kansas City area have asthma
Validating the Healthy Homes Checklist • Objective: Develop a survey tool to predict residential allergy and asthma triggers • Short • Easy to read • Teaching tool
Major Indoor Asthma Triggers • Cigarette smoke • House Dust Mites • Molds (urban) • Pet allergens (suburban) • Cockroach allergens (urban)
The Healthy Homes Checklist • 20 question survey used as a tool to identify potential problems in a home • Air Quality • Moisture • Dust • Lifestyle • Pests
The Survey Population • Public Housing Residents’ Utilization and Asthma rates • Housing construction - New/rehab/old • Random enrollment in study
Procedure • Conduct the survey in 200 homes • Collect information on residents ages and their asthma and allergy history • Vacuum floor, furniture and bedding.
Method of Analysis • 300 micron sieve • Water extraction • Centrifuge • Filtered • Stored in 50% glycerol @-20o C • Polyclonal Inhibition Assay- Enzyme Immunoassay
Report Results • Hold community meetings for participants • Invite Allergist to talk about asthma and answer questions • Present Results in Micrograms antigen/gram dust • Discuss results and how to reduce allergens in home
Moisture -7 Allergen sinks - 3 Pets - 2 Pests - 2 Alternaria, Aspergillus, Cladosporium, Penicillium Dust mites Cat & Dog American Cockroach 13 Survey Questions and Corresponding Antigens
Survey Results for Moisture Questions in 112 homes • Water Leaks - 28% • Air conditioner Leaks - 9% • Moisture on Walls/windows - 30% • Visible Mold - 12% • Rotted Wood - 5% • Wet Basement - 1% • Humidifier Use - 19%
Survey Results for Respiratory Irritants in 112 homes • Gas Stove (50%) • Fireplace (3%) • Kerosene Heaters (1%) • Smoking in home (54%) • Hobbies (4%) • Pesticide Use (39%)
Survey responses from 487 CMH patients in KC Area 40% Gas stoves 21% Carpet kit/bath n n 17% Fireplace 78% Carpet in bdrm n n 1% Kerosene 25% Vacuum </wk n n 24% Leaks 22% Smoke in home n n 3% AC leaks 52% Pets n n 17% Moisture visible 20% Pets in bed n n 8% Visible mold 6% Hobbies n n 15% Wet basement 19% Mice or Rodents n n 5% Rotted wood 45% Insects n n 30% Humidifier 31% Use Pesticides n n 5/30/01 Children's Mercy Hospital Section of Allergy, Asthma and Immunology 11
Conclusions • Public Housing units lacked some of the features needed to validate the Healthy Homes Checklist • Preliminary data suggests several questions may be used to predict Cat, Dust Mite and Cockroach allergens in house dust. • Smoking in the home and gas stoves without exterior exhaust account for the majority of indoor respiratory irritants in the homes studied.
Recommendations for Reducing Asthma and Allergy triggers in the Home • Air Quality • Moisture • Dust • Lifestyle • Maintain Appliances • Install CO monitor • Avoid using humidifiers • Fix leaks immediately • Remove water damaged furnishings • Vacuum Frequently • Use high efficiency filters • Reduce clutter • Do no allow smoking • Ventilate hobby areas • Do not allow pets in bedrooms
Healthy Homes and Indoor Air Quality Resources • Environmental Protection Agency • Tools for Schools • HUD • Healthy Home Initiative • American Lung Association • Open Airways • Consumer Product Safety Commission • Healthy Furnishings • Montana State University • Healthy Indoor Air for America’s Homes