Program Purpose

The mission of the Lincoln/Lancaster County Health Department is to protect and promote the health of the people and the environment of Lincoln and Lancaster County. In accord with this mission, the purpose of the Indoor Air Quality/Occupational Health Program is to minimize health risks posed by airborne and other environmental hazards in worksites, homes, and private and public buildings. Risks are assessed through investigation, surveys and environmental monitoring and abated or reduced via technical assistance and promoting pollution prevention.

PROGRAM OVERVIEW - Indoor Air Quality (IAQ)

Poor indoor air quality is an important environmental health concern because the average person spends more than 90% of her/his time indoors. Indoor air quality studies have found recurring correlations between indoor air pollution and human illness. Common symptoms associated with contaminated indoor air include headaches, eye irritation, respiratory irritation and gastrointestinal distress. Causes of indoor air pollution include lack of ventilation, improper venting of combustion exhaust, environmental tobacco smoke, off-gassing of building materials and improper use of hazardous materials. Poor indoor air quality has a huge impact in terms of productivity and lost work time.

Currently, there are no federal, Nebraska or local regulations which require indoor air quality to be protective of human health in public buildings. Consequently, education and technical assistance are the primary tools used in this program. The program is based on hazard identification and providing technical assistance to home or building owners on how to reduce the hazard. This may be accomplished through over-the-phone consultation, distribution of educational materials or on-site investigation. A typical on-site investigation includes evaluation of possible sources of pollution, a survey of occupants to identify patterns of illness and/or environmental monitoring. The program's monitoring capability includes ambient screening for temperature, humidity, formaldehyde, volatile organic compounds, carbon dioxide, carbon monoxide, hydrogen sulfide and testing of air handling unit(s) for air velocity/flow rates. A report of on-site findings and recommended solutions is provided to the home or building owner. In most cases the report and recommendations are accepted and implemented voluntarily.

Trends in IAQ

A review of the IAQ investigations performed reveal that some conditions and situations are common to indoor air quality problems.

1. Improperly designed, operated or maintained heating, ventilating and air conditioning systems are the source of about 50% of indoor air quality problems. Specific problems include: poorly maintained equipment contaminated with standing water or dirt; deteriorating mechanical parts; poor air filtration; lack of fresh air; fiberglass lined duct work in deteriorated condition, insect and animal infestation; poor design; and improper location of fresh air intakes near outdoor air contamination sources.

2. Remodeling activities cause about 30% of indoor air quality problems. Problems include: use of products containing volatile organic chemicals without regard to label restrictions; lack of adequate ventilation; escape of dust and chemical vapors from remodeling area into adjacent occupied areas of buildings resulting in exposure to the public and building occupants; and ongoing emissions of chemical vapors from installed materials after completion of remodeling projects.

3. Miscellaneous problems cause about 20% of indoor air quality problems. These include: smoking in public places, in multi-family dwellings and dormitories; exposures resulting from home hobbies; contamination of the general air in multi-use office buildings by a single tenant's activities; and microbiological contamination due to flooding, water leaks, condensation, ground water and other water sources. Recent studies point to a single organism, Stachybotryus atra, or black mold, as a common cause of indoor air quality problems in many commercial and residential structures.

Factors likely to increase or decrease requests for services include: 1) Successful litigation of cases involving contaminated indoor air increase public interest in indoor air quality. 2) Proposed building and ventilation standards may improve IAQ in new or extensively remodeled buildings. 3) Consumers are more aware of IAQ issues and many consumer products to improve air quality are now on the market (e.g. HEPA filters on vacuum cleaners, new high-efficiency furnace filters).

The technical expertise of the LLCHD IAQ program is routinely sought by in and out of state individuals, agencies and organizations.

As the program's experience has increased based on the outcome of previous tests, a pattern of problems has emerged. Consequently, not nearly as many environmental tests are now required to characterize IAQ problems.

Radon

Radon is categorized by the EPA as one of the less than 20 known human carcinogens. It is also considered a distant second to cigarette smoking as a leading preventable cause of lung cancer. The risk of lung cancer increases with exposure to increasing levels of radon in the indoor environment. A combination of cigarette smoking and long term exposure to increased levels of radon increases individual risk exponentially. The LLCHD provides long term (one year) test devices to the general public, businesses, schools, and government agencies at cost. The testing service includes analysis of the test devices by a certified laboratory and a report issued by LLCHD with interpretation of the results and recommendations for hazard mitigation. During the last year 19 test devices were sold and 12 reports issued. Sixteen (16) of the 19 tests revealed results above the EPA action level of 4 pic/L. Mitigation recommendations are provided to the home or building owners in order to assist them in reducing the risk to building occupants. We are in the process of following up with home or building owners to determine if mitigation occurred.

Carbon Monoxide

Carbon monoxide (CO) is a potentially lethal indoor air pollutant. Exposure can also cause significant non-lethal illness. With the increasing use of CO detectors, many calls on this subject are received, including those from people who assume that the detector is malfunctioning when it begins alarming soon after it is installed. The Lincoln Fire Department (LFD) responds to situations where a detector is sounding and stabilize the situation as necessary.

Resolution of a problem typically involves Peoples Natural Gas, which can examine furnaces, water heaters and stoves to determine if any defects are causing a build-up of CO. The Program's role is in educating the public on how CO is formed and how its build-up can be prevented. Second, the Program provides technical assistance to LFD on policies related to handling CO detector alarm calls.

HIGHLIGHTS

In the past year, technical assistance for the reduction of indoor air hazards was provided by phone to 1,113 citizens. On-site consultations were provided in 89 of 113 cases which were investigated. Approximately 450 environmental tests were conducted. Educational information was distributed along with 90 reports and 43 educational packets.

A brochure was produced describing the symptoms of CO poisoning, sources of CO and how to respond when a build-up of CO is suspected. This was distributed to licensed childcare facilities and made available to others upon request.

PROGRAM OVERVIEW - Occupational Health

The Occupational Health component of the program consists of the investigation of airborne chemical exposures in business and local government worksites. In addition, technical support is provided by researching information on the specific hazards of chemicals in use in businesses, the associated health risks, and possible less toxic alternatives. Information provided may also include handling, storage, and disposal recommendations for specific chemicals, the impact of extreme temperature exposure, exposure to light and noise, organic/inorganic dust exposures, mechanical hazards, and ergonomics. The occupational health program also provides inspection and monitoring services to City and County worksites upon request. Although LLCHD has no authority in enforcing Occupational Safety and Health Administration regulations, limited consultation on these requirements is provided.

HIGHLIGHTS

In FY 1995-96, technical assistance related to occupational health and safety was provided by phone to 131 callers from local government and 361callers from business. Thirty-four cases were investigated which resulted in 29 on-site investigations. Recommendations were provided in 25 reports and 24 information packets were distributed.

Some of the businesses and local government worksites which received assistance in resolving occupational health/indoor air problems include: Lincoln Fire Department (quarterly testing of air compressors and resolution of radon concerns), Belmont Shopping Center, Southeast Community College, HairMarket Junction, Centrum Building and Garage, Piedmont Shopping Center, Sandoz, Bryan Hospital, City-County Building, UNL-Polar Ice Core Research, Nebraska Department of Roads, Library Commission in the Atrium, and Wendy's Restaurant.

Emergency Response

Role in Emergency Response

In Fiscal Year 1995-96, the Program staff responded to 19 emergencies. These were situations where there was an immediate and significant public health risk. Examples included: The contamination of three downtown buildings caused by the use of highly volatile material near the fresh air intakes for the buildings; high carbon monoxide levels at an indoor shopping center, caused by the use of propane powered machinery; and solvent vapor exposure of store patrons and staff resulting from the removal of asbestos floor tile.

Lead

Prior to LLCHD garnering grant funds for an Environmental Health Specialist position in the Lead Program, the IAQ/OH program provided consultation and technical assistance on environmental lead hazards. The lead poisoning prevention program component focused on providing information and technical assistance to homeowners, landlords, property owners and managers, and contractors regarding remediation of lead paint hazards in the indoor environment. Services included onsite screening assessments for the presence of deteriorated lead paint, investigation of the indoor environment of lead poisoned children upon referral from the LLCHD Childhood Lead Poisoning Prevention Program and reports to clients regarding hazard mitigation. Technical assistance was also provided to the public and realtors on the new EPA and HUD Real Estate Notification and Disclosure Rule.

HIGHLIGHTS

In conjunction with the Lead Grant, technical assistance related to environmental lead hazards was provided to 69 people. Ten (10) lead poisoning cases were investigated, 75 lead paint remediation information packets were mailed, and more than a 100 EPA and HUD Real Estate Notification and Disclosure Rule information packets were mailed to landlords and tenants.

RESOURCES, FUNDING AND PROGRAM COSTS

The program is staffed by 1 FTE and is funded 100% by the Health Fund. Because the investigations are initiated as a result of complaints from exposed individuals, user fees are not assessed for services. Direct program costs for FY 95-96 were $76,000 which includes costs of new monitoring equipment, calibration and replacement parts for existing monitoring equipment and environmental testing costs. If Environmental Health and Departmental Administrative costs are included, the total IAQ/OH program costs were $102,000.

GOALS AND OBJECTIVES

Continue to respond to service requests based on degree of risk.

Become more proactive by assuring that:

• appropriate officials from all city and county school districts, both public and private, receive "Tools for Schools" materials and are working to implement those indoor air quality guidelines

• managers of all public buildings in Lincoln and Lancaster County have received "Building Air Quality" materials and are working to implement those guidelines

• Complete revision of "Indoor Air Quality Assessment Guidelines"

• Meet with the Lincoln Fire Department to re-examine response to carbon monoxide calls, recommendations on detectors and prevention of CO problems

Environmental Quality