Indoor air quality is an important predictor of health, especially in low-income populations. It is unclear how recent trends in "green" building affect the indoor exposure profile. In two successive years, we conducted environmental sampling, home inspections, and health questionnaires with families in green and conventional (control) apartments in two public housing developments. A subset of participants was followed as they moved from conventional to green or conventional to conventional housing. We measured particulate matter less than 2.5 μm aerodynamic diameter (PM2.5), formaldehyde, nitrogen dioxide (NO2), nicotine, carbon dioxide (CO2), and air exchange rate (AER) over a seven-day sampling period coincident with survey administration. In multivariate models, we observed 57%, 65%, and 93% lower concentrations of PM2.5, NO2, and nicotine (respectively) in green vs control homes (p=0.032, p<0.001, p=0.003, respectively), as well as fewer reports of mold, pests, inadequate ventilation, and stuffiness. Differences in formaldehyde and CO2 were not statistically significant. AER was marginally lower in green buildings (p=0.109). Participants in green homes experienced 47% fewer sick building syndrome symptoms (p<0.010). We observed significant decreases in multiple indoor exposures and improved health outcomes among participants who moved into green housing, suggesting multilevel housing interventions have the potential to improve long-term resident health.
IntroductionThe Surgeon General reports that there is no risk-free level of exposure to secondhand smoke and that it can cause premature death and disease in nonsmokers.1 Previous research has demonstrated that levels of fine particulate matter (PM 2.5 ) in the air are three times higher in smoke-permitted homes than in smoke-free homes and that confining smoking to certain living spaces does not offer protection from AbstractIntroduction. Secondhand smoke remains a health concern for individuals living in multiunit housing, where smoke has been shown to easily transfer between units. Building-wide smoke-free policies are a logical step for minimizing smoke exposure in these settings. This evaluation sought to determine whether buildings with smoke-free policies have less secondhand smoke than similar buildings without such policies. Furthermore, this study assessed potential secondhand smoke transfer between apartments with and without resident smokers. Methods. Fine particulate matter (PM 2.5 ), airborne nicotine, and self-reported smoking activity were recorded in 15 households with resident smokers and 17 households where no one smoked in 5 Boston Housing Authority developments. Of these, 4 apartment pairs were adjacent apartments with and without resident smokers. Halls between apartments and outdoor air were also monitored to capture potential smoke transfer and to provide background PM 2.5 concentrations. Results. Households within buildings with smoke-free policies showed lower PM 2.5 concentrations compared to buildings without these policies (median: 4.8 vs 8.1 µg/m
Participants living in green homes had improved health outcomes, which remained consistent over the study period. Green housing may provide a significant value in resource-poor settings where green construction or renovation could simultaneously reduce harmful indoor exposures, promote resident health, and reduce operational costs.
Housing quality, which includes structural and environmental risks, has been associated with multiple physical health outcomes including injury and asthma. Cockroach and mouse infestations can be prime manifestations of diminished housing quality. While the respiratory health effects of pest infestation are well documented, little is known about the association between infestation and mental health outcomes. To address this gap in knowledge and given the potential to intervene to reduce pest infestation, we assessed the association between household pest infestation and symptoms of depression among public housing residents. We conducted a cross-sectional study in 16 Boston Housing Authority (BHA) developments from 2012 to 2014 in Boston, Massachusetts. Household units were randomly selected and one adult (n = 461) from each unit was surveyed about depressive symptoms using the Center for Epidemiologic Study-Depression (CES-D) Scale, and about pest infestation and management practices. In addition, a home inspection for pests was performed. General linear models were used to model the association between pest infestation and high depressive symptoms. After adjusting for important covariates, individuals who lived in homes with current cockroach infestation had almost three times the odds of experiencing high depressive symptoms (adjusted OR = 2.9, 95% CI 1.9-4.4) than those without infestation. Dual infestation (cockroach and mouse) was associated with over five times the odds (adjusted odds = 5.1, 95% CI 3.0-8.5) of experiencing high depressive symptoms. Using a robust measure of cockroach and mouse infestation, and a validated depression screener, we identified associations between current infestation and depressive symptoms. Although the temporal directionality of this association remains uncertain, these findings suggest that the health impact of poor housing conditions extend beyond physical health to include mental health. The study adds important information to the growing body of evidence that housing contributes to population health and improvements in population health may not be possible without addressing deficiencies in the housing infrastructure.
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