linking public health, housing, and indoor environmental policy: successes and challenges at local and federal agencies in the united states. - best air purifier for mold

We describe the successes and challenges faced by federal and local government agencies in recent years in trying to connect public and environmental health, housing, community development and architectural design with the environment, housing and construction laws, regulations and policies.
These policies may contribute or adversely affect the physical and mental health of human beings and have an important impact on economic vitality, research, policy development and stability and progress of society as a whole.
Policy barriers include tensions between housing affordability and health investment, which leads to low cost efficiencies
Transfer, privacy issues, unclear statutory authority, and gaps in responsibility for housing, indoor air and the building environment.
We compare this with other environmental frameworks such as environmental air and water quality regulations, where the concepts of "shared commons" and "paid for by polluters" are more solid. The U. S.
Experiences in preventing lead poisoning in children, indoor air and mold provide useful insights into policies.
Local projects can effectively build healthy home capacity through local laws and housing regulations.
In kaihuojia County, Ohio, Shi Guang coordinates the experience of mold, asthma triggers, weather forecasts and other health housing improvements. The U. S.
Experience has shown that the following measures should be taken by decision makers:
Governments at all levels adopt an object-oriented, integrated, multi-disciplinary approach to prevent unhealthy buildings, houses and communities.
Key words: building environment, healthy residence, residence, indoor air quality, indoor environment quality, policy, public health
115: 976-Environmental Health982 (2007). doi:10. 1289/ehp.
Provided by [8990]
Online January 25, 2007
Introduction This paper explores the policy challenges faced by federal and local governments in addressing the adverse health consequences of substandard housing, construction and other indoor environments.
Specific experience in the United StatesS.
Department of Housing and Urban Development (HUD), the U. S.
Environmental Protection Bureau (EPA)
Health department of hooga County (
Near Cleveland, Ohio)
As an example of how a multi-disciplinary approach can make significant progress in the field of environmental health, it highlights areas where scientific research and legal authorities are still relatively underdeveloped compared to existing building regulations, environmental laws and public health practices.
There was renewed interest in the link between sub-standard housing, poor indoor environment quality and unsustainable community development models and public health (HUD 1999a;
Sharfstein and Sandel1998).
Sustainability, affordability and health are highly relevant and interdependent.
On the most basic level, housing and buildings below the standard are unhealthy, unsustainable and affordable (Jacobs 2005; Sandel et al. 2004).
The origin of health and housing connections.
Fundamentally, linking housing to health is not a new idea.
Nightingale said, "the link between health and population residence is one of the most important links in existence "(Lowry 1991).
There is no doubt that the improvement of housing in developed countries has greatly promoted public health.
Early housing standards provide better ventilation, hygiene, congestion reduction, sound structure, lighting and other habitable standards, in part for the emergence of concentrated slum housing around factories and large cities during the Industrial RevolutionRiis 1890;
Center for Disease Control and Prevention (CDC)1976].
The public health campaign and the housing campaign have common roots in the community campaign a century ago, which is committed to cleaning up the dirty environment in housing.
For example, there is still a lack of indoor plumbing in most parts of the developing world, which has much to do with improving sanitation and controlling cholera and other similar diseases in the developing world.
Today, however, housing, health and the environment are considered as independent and unrelated subjects (HUD 1999a;
Krieg and Higgins 2002Lowry 1991).
In developed countries, despite changes in background and certain disease outcomes, inadequate housing remains (
Scrub and Jacobs 2000).
A century ago in the United States, inadequate ventilation and housing congestion led to the prevalence of tuberculosis (Stein 1950)
Today remains a major problem in developing countries, killing two million people in 2002.
World Health Organization (WHO)2004].
Although the TB problem does not seem to be resolved, improvements in lighting, fresh air and housing congestion have helped to reduce the incidence of TB.
Today, inadequate ventilation and moisture management in housing remains the cause of asthma, Mold
Induced Diseases, carbon monoxide poisoning and other diseases and injuries (
Craig and higins2002;
Scrub and Jacob 2000).
Although this mini-
The monograph is about housing conditions in Europe and the United States, and it is worth mentioning that unqualified housing conditions are indeed a global problem.
According to a recent UN report,
Among all urbandwellers living in slums in developing countries (
Nearly a billion people)
This proportion is rapidly increasing and the number of slum dwellers is expected to double by 2030 (
United Nations 2003).
Some of the key policy obstacles in this area include tensions between housing affordability and health, privacy issues, unclear statutory powers, and gaps in responsibility for the building and indoor environment.
Indoor air pollution and the problem of "shared space.
Clean Air Act in the United States (1970)
Authorize a complex regulatory system to support outdoor air quality and top-tier networks
Derived from the downward mandate of national legislation and standard-setting, it extends to the implementation and monitoring of states, counties and localities.
In general, the system is widely supported by the state in terms of clean and healthy outdoor air.
However, such a consensus has not yet been formed to support indoor air quality, and people do more breathing indoors.
Indoor air pollution is one of the four major environmental health risks identified in the United States. S.
EPA and the Science Advisory Committee authorized by the US CongressS.
Technical issues of the Environmental Protection Bureau (U. S. EPA 1990). On average, U. S.
The public spends about 90% of the time indoors, and the indoor pollutant content may be two to five times higher than that outside, and occasionally 100 times higher.
Indoor pollution is estimated to cause thousands of cancer deaths and thousands of respiratory health problems every year.
Millions of children have increased blood pollutant levels due to exposure to indoor pollutants (U. S. EPA 1997).
Other health effects include irritation of the eyes, nose and throat, as well as more neurotoxic and behavioral and other adverse effects.
In addition to public health problems, indoor air pollution has also caused huge economic losses. Cost-
Welfare estimates in the United StatesS. EPA (2001b)
Indicates that the avoidable net cost associated with indoor air pollution exceeds $100 billion per year and is more likely to be between $150 billion and $200 billion (
All dollar amounts in this article are calculated in the USS. dollars).
About 45% of these costs can be attributed to avoidable deaths from radon and environmental tobacco smoke, about 45% to loss of productivity, and about 10% to avoidable respiratory diseases.
Indoor air pollution can be defined as a chemical, physical or biological pollutant in the air that is breathable in a residential structure or transportation, including workplace, school, office, home and vehicle (
Indoor Environment).
Indoor air pollution includes the following:products; * ozone; * allergens (
Including mold spores);
* Volatile organic matter and particulate matter;
* Paint, finishes, furniture, adhesives, caulking and pre-pressure wood products found in building materials;
* Cleaning supplies, personal care products, air fresheners and pesticides commonly used in the room;
* Activities of smoking, hobbies, cooking and other occupants, including taking home dryClean clothes; * bioeffluents;
Soil Gas intrusion (e. g. , radon).
To address indoor air quality issues across states across the United States, local legislatures typically authorize public agencies to carry out voluntary projects aimed at raising public awareness of indoor air issues and taking appropriate action, at the same time, a mandatory regulatory plan for external environmental pollution is implemented.
The impetus for this contrasting public policy may come from historical, attitude and technical considerations that may help to curb the formation of a broad social and political consensus on the control of indoor air quality issues.
Historically, the legal structure of the American environmental movement is based on two basic principles of the common law of the United Kingdom: "shared commons" and "paid by polluters "(Hardin 1968).
Shared space originated from the practice of managing the community's use of public resources in the Middle Ages.
Although everyone can graze on the normal green grass, no one's cattle overgraze resources and deprive others of their use.
In the current application of the law, this principle means that if private activities deprive the public of their rights and rely on shared resources, such as breathable external air, the community can take action to protect its interests.
The polluters pay principle believes that the beginning of pollution, not the injured public, is responsible for the cost of pollution control.
In this knowledge and legal context, in the late 1960 s, events of historical development and emotional excitement aroused public anger at the increasingly apparent outdoor pollution.
For example, on 1969, the kaihoga River in Cleveland, Ohio caught fire with combustible garbage.
Although the fire was quickly extinguished, the spectacle was enough to cause national media reports of external environmental degradation in many other areas of American national life.
Regarding the external air quality, at about the same time, the private charity called the Fresh Air Fund was widely supported as they promised to send urban children to camp for a week, let some people if it's just a brief episode, the air pollution outside the city is getting worse and worse.
As these events stir up the antipathy of ordinary citizens to increasingly apparent environmental insults, the first Earth Day of 1970 took millions on the streets and expressed widespread and profound public anger over the issue.
President Nixon's response was to establish the United States. S.
Executive order EPA of December 1970 (
1970 office of the President).
By that time, AmericaS.
Congress has passed the Clean Air Act (1970)
It complements the Clean Water Act (1972)
Authorization to take urgent measures to solve external environmental problems.
Compare this with indoor air and indoor environment.
None of the public here believes that common interests and responsibility are common.
The indoor air, whether it is clean or contaminated, is located in enclosed spaces of its own or other independent buildings.
Often, contaminants cannot be easily identified and remediation costs are incurred.
If the surrounding external air is shared by everyone, then the ownership of the indoor air is a more vague issue.
So for indoor air, despite a good set of circumstances, we do not have dramatic moments to identify, such as the rivers on fire, to stimulate public action.
Publicize serious indoor problems such as lead poisoning, radon, asbestos and mold in children.
In addition, the responsibility of the building is decentralized, including architects, maintenance personnel, designers, employers, code and building inspectors, occupants and others.
There is no clear-
Reduce the villain who can reduce the burden of correction, and the public has fewer and fewer requirements for controlling indoor pollution.
This is not to say that there is neither anger nor evil in the indoor air.
But in this case, the victim is usually an individual acting for himself or a small group, not an angry public acting through a political process.
As far as these countries are concerned, owners of private homes or tenants of buildings often seek compensation for specific injuries from the courts, rather than developing laws that apply to a broad standard of space allocation.
Despite these obstacles, more and more local housing and health regulations law enforcement agencies are improving indoor air quality through local regulations (
Institute of Environmental Law
The foundation is increasingly supporting the "green" community (
Enterprise Foundation 2004).
Indirectly, the federal government of the United StatesS.
Laws and regulations do involve indoor environmental quality. The U. S.
Administration of toxic substances by the Environmental Protection Agency (1976)
Federal pesticide, Fungal Killer and rodenticide (1996)
And the Safe Drinking Water Act (1974)
Although not the indoor air itself, each substance limits the quality of harmful substances entering the indoor environment.
Back in 1937, the United StatesS. Housing Act(1937)
Calls for "decent, safe and hygienic housing", enacted by Congress
Based on the Paint Poisoning Prevention Act (1971)
And 1992 Residential Lead Hazard Reduction Act (Title X 1992).
The Consumer Product Safety Committee has enacted regulations prohibiting the sale of lead.
Paint and other dangerous consumer goods.
Health or housing regulations are in place in most local jurisdictions, which prohibit broadly defined public health nuisance.
There are several examples of success and limiting the success of government intervention in the indoor environment, which resulted in a significant improvement in environmental health, although in each case the improvement also highlights the fact that, that is, there are still too many people who are at risk and need further intervention.
Here we consider the experiences of lead poisoning, radon and mold in children.
Lessons learned from lead poisoning prevention in the United States.
Policy Lessons learned from lead paint experience provide the basis for addressing other housing issues
Related health hazards
The need for primary prevention (
Take action before the damage occurs);
Affordable exposure assessment and hazard control techniques; surveillance;
Targeted public investment;
Statement of the national plan; cost-
Benefit analysis; enforcement; and policy-
All relevant scientific research works here.
Public health officials warned more than 100 years ago that this is one of the most obvious examples of the link between health and housing (Gibson 1904; Turner 1897)
Opposed to allowing the use of lead paint in housing, alegacy was only recently in the United States (Jacobs 1995;
Markowitz and Rosener 2002)and in France (
Faxin and Naude 2004).
Unfortunately, lead paint is still in use in many developed countries, which constitutes a new housing problem (
1994 Alliance of children's lead poisoning and environmental protection fund; Clark etal. 2006).
Many countries have not yet determined the prevalence of lead paint hazards in housing (Howson et al. 1996).
While lead poisoning in children remains a major environmental disease, prevention of lead poisoning has become an important public health success story in the United States.
Quantity of lead-
After the United States government has taken action to remove lead from new paint, gasoline, canned food and recently from housing, poisoned children have steadily declined and lead is at risk in housing.
In particular, the removal of lead in gasoline and the control of industrial emissions significantly reduce the exposure of lead in the air.
Due to these measures and other measures, 1-
The blood lead level is 6 years old [
Less than or equal to]10 [micro]
G/dL dropped from 88% at 1980 s to about 1. 6% (
316,000 children)in1999-2002 (Brody et al. 2005; Meyer et al. 2003).
The number of homes using lead paint in the United States also dropped from 64 million in 1990 to 38 million in 2000 (Jacobs et al. 2002).
While this progress is substantial, it will take nearly a century to ease by recognizing the development of the necessary infrastructure to begin addressing the problem. Too many children will be poisoned by unnecessary leadership in the coming years, unless additional action is taken.
In fact, the United States has not reached the goal of eliminating blood lead levels in children. micro]g/dL by 2000 (Meyer et al. 2003).
How is the progress of lead poisoning prevention?
Advances in science and policy make it possible?
What does this experience mean for solving other housing problems?
Related health hazards?
After years of paralysis, there was a political consensus in the early 1990 s in the United States that the housing market chaos was caused by increased household safety costs, which was not important, and the cost is much lower than the impact on children's health and society.
This led to the adoption of the Housing Act by public health and environmental legislation (Title X 1992).
Exposure pathway studies show that children are most exposed to worsening lead
Paint and the contaminated house dust and soil it produces (
Bornschein, etc. 1987; Charney 1983;
1997 Lanfield and Roman; Lanphear et al. 1998)
Although the most serious research also shows the importance of paint contamination of dustand and soil (Gibson 1904).
This led to the development of standardized dust
Sampling procedures related to significant blood lead levels in children (Lanphear et al. 1995).
These procedures were subsequently incorporated into the health field.
Standard for exposure of paint, dust and bare soil for house foundation repair, renovation or repainting (U. S. EPA 2001a).
In the past, the lack of such standards sometimes caused adverse consequences --
It may actually increase the goodwill reduction efforts of some children's blood lead levels (Amitai et al. 1987;
Aschengrau metal. 1997).
The lack of such standard emission reduction methods has caused the policy paralysis described earlier.
After all, what kind of policy makers would want to implement a process that, no matter how well-intentioned it is, will exacerbate the problem?
These standards also help to consolidate the legal definition of the conditions that constitute a leading position
Danger of house paint (U. S. EPA 2001a)
How are they controlled?
National Center for Healthy Housing 2004).
Congress asks the stateof-the-
The publication and extensive implementation of artistic procedures in subsidized housing and local laws (HUD 1995).
The establishment of standardized procedures contributes to the establishment of a viable, professional inspection and remediation workforce that promotes competition in the private sector in a fair competitive environment, thereby reducing the average cost of lead paint hazard control
These standardized procedures also provide for the Prohibition of hazardous forms of lead paint, such as burning lead paint with a torch, sandblasting and strong sanding (HUD 1995; Jacobs 1998)
Despite the United StatesS.
The Environmental Protection Agency recently proposed to allow such dangerous practices (U. S. EPA 2006).
According to the data, the cost of lead hazard control is far lower than that of monetization.
For example, with federal assistance (i. e. ,subsidized)
In the United States, the cost of lead hazard control is estimated at $0. 253 billion, but the revenue is estimated at $1. 143 billion ($1. 1 billion)
In the first year of implementing the new lead paint regulations (HUD 1999b). For all high-riskU. S.
Housing, eliminating incremental costs of lead
The base painkillers from 2000 to 2010 were $2.
3 billion, but the benefits are at least $11. 2 billion (Jacobs et al. 2000).
In addition, a retrospective study quantified the economic benefits of improving workers' productivity due to decreased blood lead in children from 1976 to 1999.
Discount lifetime income for $2-$723,300
The year-old said in the US dollar of 2000 that the estimated economic benefits of three people per year. 8 million 2-
Children aged between US $110 billion and US $319 billion (Grosse et al. 2002). These cost-
Benefit analysis, coupled with the development of fly-able infrastructure and compelling scientific research, makes keyfederal US.
Including the Department of Housing and Urban Development, the Centers for Disease Control and Prevention, the United StatesS.
The EPA, the Department of Justice and other departments will develop a 10-
Annual Plan covering 2000-
2010 identified the resources needed to eliminate the hazards of house paint and protect children (Jacobs et al. 2000).
The plan estimates how many children will be poisoned over the age of 10
If no action is taken and the cost of unsafe leadership is estimated.
From 2000 to 2005, the plan will cost a total of $1.
Invest 15 billion, but only $0.
Actual allocations for the fiscal year 2005 amounted to 8 billion euros.
Unless additional resources are available, this deficit may be further postponed to the goal of achieving child safety by 2010.
Lessons from indoor air activities in the United StatesS. EPA. In 1989 theU. S.
The Environmental Protection Agency has established the Federal inter-agency Committee on indoor air quality (CIAQ)
Under section 403 (c)
Super Foundation and re-authorization act (1986).
The purpose of CIAQ is to coordinate the activities of the federal government on issues related to indoor air quality.
Since the 1980 s, the United StatesS.
EPA in section 103rd (a)and (b)
Clean Air Act (1970)
Establish a non-regulatory program for the indoor environment, analyze relevant research, and communicate indoor air quality risks and steps for citizens to protect themselves and their families.
Key priorities for indoor air quality in the United StatesS.
EPA is the prevention of lung cancer caused by radon in homes and schools, reducing respiratory diseases and related diseases such as asthma.
Here are some of the highlights of progress to date. Radon.
By 1996, it was estimated that 880,000 families had implemented
Reduced functionality.
These achievements have led to an estimated 285 deaths from cancer each year.
As of the end of 2003, it is estimated that 1.
7 million households have radon-
Reduced functionality (
515,000 active mitigation and 1.
2 million homes with radon-
(New)
Prevent 470 premature deaths from cancer every year.
In 2004, the number of reductions per year increased to more than 75 000, and the total number of future lives saved each year increased to 5.
Indoor causes of asthma
Results of the United StatesS.
EPA 2003 National Survey on environmental management of environmental tobacco smoke in asthma and children (U. S. EPA 2003)
Shows that about 30% of asthma patients have taken all the basic measures recommended by the United States. S.
EPA will reduce exposure to indoor triggers. Schools. U. S. EPA data (U. S. EPA 2005)
22% of the population in the United StatesS.
Now the school has an indoor air quality management plan that meets American standards. S.
EPA standards for effectiveness.
Implement a local healthy family program in the County of kehooga, Ohio.
High prevalence of poverty, child density and substandard housing in the Cleveland area expose children to a high risk of pediatric diseases associated with the home environment.
The region has the largest population (1. 4 million)
And some of the oldest housing stock, inOhio, built 42% of the housing units by 1950, and almost half of the population is classified as very low, low or middle-income people (U. S.
Census Bureau 2000).
The primary lung of the baby is iron and blood (IPHI)
A problem that first appeared in Grand Cleveland.
Geographical grouping of 10 confirmed cases in 1993
1994, water was found in subsequent analysis-
Damaged building materials, molds and ventilation systemsDearborn et al. 2002).
Between 1993 and 2005, 59 infants in the greater Cleveland area were diagnosed with iPhones and 16 died (Dearborn 2005).
Prevention Plan for pulmonary iron-containing blood (PHPP)
Established in 1996 by the local public health community and funded through public health institutions and local foundations.
As a result, PHPP conducted 2,874 inspections over the past decade and 37% of the housing units were classified
Risks, and some remedies are needed to mitigate water penetration and environmental pollution, as well as mold and other diseases that may cause asthma in the home environment.
Another important risk factor is the specific forcing.
The air furnace design, where all the supplied air comes from the basement and there is no living space.
This resulted in a large amount of air being transferred from the basement space to the occupied area of the housing unit.
Asthma triggers, irritation, pathogens, and other exposure risks collected in humid basement air are subsequently allocated to the breathing air in the living space.
A study of a house in Cleveland found that due to water penetration and the above-mentioned furnace structure, the dry wall of the basement contains a large amount of water-Su fish, and the air samples collected in the upstairs living area contain 5-
In S.
The chartarum spores at the active cycle of the furnace and blower compared to the stationary conditions (Vesper etal. 2000).
The basement is usually the highest incidence of water seepage, water damage and mold growth in any other room in the house structure.
A high
Children with asthma who are hospitalized or recently treated in an emergency or doctor's office have water stains/mold at home to study the effects of controlling asthma triggers, excessive moisture, and lead paint hazard control at the same time.
Average cost of intervention (
11 of the 33 subjects in the control group needed hospital care, while only 1 of the 29 subjects in the remediation group needed hospital care (b)
Integration of financial resources, scientific assessment, regulation and remediation; and c)
Programme cooperation between local health organizations and housing organizations was achieved.
The experience of kaihuojia County shows that local public health programs can respond to the little-known pediatric diseases associated with housing.
While specific legislation is desirable, it is also possible to use existing housing regulations and local government units to implement housing strategies and improve the quality of the indoor environment.
All of these examples show that government policy development in this area requires a solid scientific foundation.
The basis must include data on specific adverse health effects related to specific housing and construction conditions, as well as data on interventions that are practical, effective and do not inadvertently lead to a reduction in further investment
Income, quality housing, workplace, schools and other buildings.
In the case of lead and radon, scientific research showing significant harm to public health is particularly notable and powerful.
Despite significant progress, the United States still does not have an integrated system to determine which substances and systems should be allowed into buildings and houses during construction, renovation and maintenance, and whether the construction method can effectively prevent the accumulation of natural toxic substances such as radono to dangerous levels.
Unfortunately, most efforts to control the building
Related diseases and injuries are largely reactive rather than preventive.
The introduction of materials and construction methods still rarely considers adverse health outcomes.
People rarely think of the possibility of lead poisoning, lead paint into the house.
Urea Formaldehyde Foam Insulation, asbestos and other similar substances are also examples of materials that cost much more than they save in reducing construction or maintenance costs or improving durability.
Improvements in weather and energy conservation initially resulted from similar adverse moisture management consequences due to the sealing of building envelopes, with little or no planning for indoor drying or ventilation (Engvall et al. 2003; Hirsch et al. 2000).
In addition, existing research methods still fail to separate specific housing features from a range of complex variables to discern their effects on disease causation and deterioration.
In many studies, the factors of inadequate housing were simply classified as "socio-economic status" and included in covariates in optimal conditions.
If we are going to be more comprehensive, we need to look at specific housing and construction conditions and the impact of housing and community interventions to predict how changes in housing and communities affect prevention systems for physical and mental health. Former U. S.
Surgeon General Le Roy Bernie, known for his statement on the link between smoking and lung cancer, said that in the field of public health, unlike the law, the suspect was guilty before he was acquitted.
Examples of several areas where such research is needed are discussed below.
Asthma and other respiratory diseases, mold and moisture.
In the United States, the incidence of asthma has increased by 73.
9% from 1980 to 1996 (Mannino et al. 2002).
There is growing evidence that factors in the family environment play an important role in making children sensitive to asthma and trigger attacks.
In indoor environments, long-term exposure of mold, pets, mice and rats, cockroaches and dust insects to allergens is associated with asthma (Breysse et al. 2004).
For example, a recent exhaustive review found sufficient evidence of a causal relationship or association between some respiratory diseases, including asthma (
Or aggravated asthma)
There are mites, cockroaches, fungi and molds, pet dandruff, tobacco smoke and other substances [
National Academy of Sciences (NAS)2000], and dampness(NAS 2004).
There is also new evidence that housing interventions are not desirable in reducing the onset and severity of asthma.
Large-scale controlled trials in seven states of the United StatesS.
937 children with asthma were registered in the city.
The experimental group received allergen remediation at home: provided mattresses and pillowcases; use of aHEPA (high-
Air filter)vacuum cleaner;
If there is environmental tobacco smoke, use the aHEPA air purifier;
Pestcontrol if needed. Follow-
Up showed that the number of symptom days in the intervention group decreased within 2 years (p < 0. 001)
And within two years, there has also been a significant decrease in allergens for mites and cockroaches (p < 0. 001)(Morgan et al. 2004).
Another study showed the proportion of doctors
The proportion of children living in deteriorating public housing diagnosed with asthma was 25%, compared with only 8% in other housing (p< 0. 01).
The same trend was observed in self.
Reported health status (Howell et al. 2005).
Many other studies have examined the link between home allergens and asthma, but evidence of clinical significance and symptoms
Effectiveness of the family
Further confirmation of basic intervention is required (Morgan et al. 2004; NAS 2000).
Accidental injury
About 55% of unintentional deathsS. children 0-
19 years old at home (
(Motor vehicle accidents are not included)
More than 4 million people were injured in the home (39%)
Need to go to the emergency department, resulting in more than 70,000 people in hospital every year (Nagaraja et al. 2005; Phalen et al. 2005).
Home falls are the most common mechanism of injury, while the Falson staircase is the most common, but we are almost entirely dependent on educational work, with little comprehensive assessment of the effects of changing the physical environment.
Evidence that does exist suggests that in order to prevent burns, reduce the temperature of the water heater, window protection is installed at high temperatures
The installation and maintenance of high-rise buildings, smoke alarms and carbon monoxide alarms and the installation and isolation of cabinet locks and the locking of poison all have beneficial effects (Breysse et al. 2004).
Community Design, obesity, poverty and income segregation.
The way our communities are geographically aligned also has an important health impact, which has not been clear until now.
In the United States, the incidence of obesity and diabetes has risen sharply (Mokdad et al. 2001).
New communities are rarely designed to encourage walking, exercise and entertainment.
The development of the suburbs is more aimed at car traffic than walking or cycling.
Unplanned community growth (sprawl)
It is unlikely that it will continue and have an important impact on health, such as obesity and diabetes, and these studies have matured (
Dannberg and others. 2003; Frumkin etal. 2004).
In a random trial called "towards opportunity", the family lives inpoverty U. S.
Coupons for public and assisted housing in 5 cities (subsidies)
Move to a privately owned house. poverty areas (the pre-war period.
Br J Soc Med4: 143-169.
Revision and revision of super fund
Authorization Act. 1986. 42 U. S. C. 9601. Available: [
May 2007). Title X. 1992.
The Residential Lead Hazard Reduction Act of 1992.
1992 Chapter 10 of the Housing and Community Development Act. Public Law102-550.
The Toxic Substances Control Act. 1972. 15 U. S. C. 2601. Available: [
Visit May 12, 2007]. Turner JA. 1897.
Lead poisoning in Queensland children
Olympic MedGaz month: 475479. United Nations. 2003.
Slum challenge: Global Report on Human Settlements 2003. HS/726/04E. New York:UN-
UN-Habitat. U. S. Census Bureau. 2000.
Kaihoga County, Ohio. U. S.
US Bureau of Economic and Statistics CensusS.
Ministry of Commerce. Available: [
Visit November 26, 2005]. U. S. EPA. 1990.
Risk Reduction: identify priorities and strategies for environmental protection.
Washington, D. C. S.
Environmental Protection Bureau. U. S. EPA. 1997.
Report of the President/Congressional committee on risk assessment and risk management.
Washington, D. C. S.
Environmental Protection Bureau. Available:[
Visit March 20, 2006]. U. S. EPA. 2001a. Lead;
Identification of the degree of danger of lead; Final Rule.
40 CFR Part 745, January 5.
Washington, D. C. S.
Environmental Protection Bureau. Available:[
Visit May 21, 2007]. U. S. EPA. 2001b.
Healthy Buildings, healthy people: the vision of the 21 st century. EPA 402-K-01-003.
Washington, D. C. S.
Environmental Protection Bureau. U. S. EPA. 2003.
National Survey of asthma environmental management and children's exposure to environmental tobacco smoke.
Washington, D. C. S.
Environmental Protection Bureau. Available: [
8-12 May2007]. U. S. EPA 2005.
School tools. EPA 402-F-05-2005.
Provided: Washington, DC: United StatesS.
Environmental Protection Bureau. Available: [
Access 8May 2007]. U. S. EPA (U. S.
Environmental Protection Bureau). 2006. Lead;
Decoration, maintenance, painting project.
Fed Reg 71: 14871636. U. S.
Housing Act of 1937. 1937. 42 U. S. C. 1437. Available: [
Visit May 8, 2007].
Visas SJ, Dearborn DG, Ike me, Alan, Sobolewski J, Hinkley SF, etc. 2000.
Assessment of Water-Su fish in the House of infants with pulmonary bleeding: Pre-repair, duration, and post-repair quantitative assessment.
City health 77: 68-85. WHO. 2004.
Overview of tuberculosis
World Health OrganizationAvailable: [
October 2004). David E. Jacobs, (1)Tom Kelly, (2)
John Sobolevski3)(1)
National health Housing Center, Columbia, Maryland, USA; (2)U. S.
Washington, D. C. Environmental Protection Agency; (3)
Cleveland County Health Council, Ohio, USA This article is part of the Mini
A monograph on "policies to improve the quality of indoor environment.
"Address communication with D. E.
Jacobs, national health Housing Center, 10320 Patuxent Parkway, 500 suites, Columbia, MD 21044 usa. Telephone: (443)539-4157. Fax: (443)539-4150. E-
Email: djacobs @ nchh
The findings and opinions expressed in this paper are only the author's, not any government agency's.
The authors claim that they have no competing economic interests.
Received on January 9, 2006;
Accepted April 19, 2006