The only good is knowledge and the only evil is ignorance.  
Norman Vincent Peale

It is our mission to offer the knowledge about indoor air quality issues and how they affect occupants of those spaces. What is Indoor Air Quality? Why is it important? Our website and publications have sources of information and cientific research from various sources including but not limited to Medical Associations, University Research Centers, Indoor Air Quality Experts, Environmental Protection Agency and the Pew Environmental Health Commission. Through the use of our publications and educational programs, we will educate the community about the symptoms and the short-term and long-term health consequences of poor indoor air quality. We will also educate on recognizing activities that may cause indoor air problems.

What is Indoor Air Quality? 
How does it affect you?
Why is it important to you? 
What causes it? 
Should we be concerned with Indoor Air Quality in our schools? 
Who is regulating Indoor Air Quality in our schools? 
How may it affect our children? 
What are the long term health consequences for our children?

What is Indoor Air Quality?
Indoor Air Quality is listed by the Environmental Protection Agency (EPA) as a top environmental threat. The major cause of indoor air pollution are the particles released into the air that come from a
variety of sources. The key factors to "healthy air" is: it must be clean, it must be fresh it must have the proper relative humidity. In order to have "clean air" outside air must be filtered to remove
biological and airborne allergens as well as chemicals. Pollutants accumulate to unhealthy levels if too little outdoor air enters the space. depending on the source and level of toxic emission it releases, "Tight buildings" in construction methods in the 70’s, 80’s and 90’s are sometimes blamed on not allowing enough air to escape. This was not an issue in older construction where air movement occurred through openings, joints and cracks in the walls, floor, ceilings, windows and doors. Air conditioners are now used and natural ventilation is not used as much to "air out" toxins that build up in a space. It is imperative that ventilation systems be maintained properly so no microorganisms be distributed throughout a building. Our environments fresh air is constantly mixed with pollution. We are exposed on a daily basis to organic chemicals found in the ingredients of common household products also known as volatile organic compounds . These toxins build up in our environment to unhealthy levels that stay in the air long after the activity is completed. Many building products and furnishings in our interiors "off-gas" harmful toxins over a long period of time. Another environmental factor that impedes our fresh air is second-hand tobacco smoke. Many understand the health risks involved with smoking and we are just understanding the second-hand smoking hazards to our fresh air. The key to mold growth is moisture contol. By controlling the relative humidity (moisture), the growth of some of the biological organisms can be minimized. A relative humidity under 55% is recommended in most climates while in colder climates it should be around 35% in order to prevent the condensation on windows. This will help prevent biological pollutants such as dust mites, mold and mildew growth, bacteria. Infectious illnesses such as influenza, measles, and chicken pox are also transmitted through the air and much more contagious in moist warm air. According to Biological Pollutants In Your Home (Jan. 1990 (402-F-90-102) prepared by the American Lung Association and the U.S.Consumer Product Safety Commission, one third of all structures have damp conditions that may encourage development of pollutants such as mold and bacteria, which can cause allergic reactions -including asthma- and spread infectious diseases.

How does it affect you?
The effects of indoor air quality problems are often non-specific symptoms rather that clearly defined illnesses. Please understand that every immune system reacts differently and may not have symptoms that are listed below. Note if the symptoms seem to “go away” or dissipate over time once removed from a potential source of problem may indicate a potentiat indoor air quality problem.

Some symptoms commonly attributed to indoor air quality problems include:
•  Head: Headaches, Migraines, Stuffiness, Confusion, Dizziness.
•  Nose: Watery nose, Sneezing, Nose rubbing, Stuffiness, Sinus congestion/Infection, Nosebleeds.
•  Ears: Repeated fluid formation behind eardrums. Ringing in ears. Dizziness
•  Face: Pallor, Dark eye circles and puffiness below eyes
•  Glands: Tender, swollen lymph nodes in neck
•  Chest: Congestion, Cough, Shortness of breath, Respiratory problems, exacerbating asthma
•  Aches: Fatigue, Lethargic, aches in head, legs, back, muscles, or joints.
•  Intestines: Nausea, Vomiting, Bloating, or other gastrointestinal symptoms.
•  Bladder: Accidents in the daytime or night time, need to rush to urinate, burning or pain with urination, excessive thirst.
•  Skin: Itchy, rashes, hives, excessive perspiration, night sweats, cold hands or feet, eczema.
•  Behavioral: Disorientation, Moodiness, withdrawn, Aggressive or Angry.
Some complaints by building occupants are clearly related to the discomfort end of the spectrum.

The most common complain: “ There’s a funny smell in here.”

Why is it important to you?
We spend 90% of our time indoors. While the indoor air is 3 to 5 times more polluted than outside air, most of us do not understand the health risks we are exposed to on a daily basis. Our lungs act as a filter to the world and are being exposed to unhealthy toxins with every breath that is taken. Air pollution contributes to 60,000 deaths every year and gives long-term health consequences for many adults and children. Children breathe in more dust and inhale more air per pound than adults, and their lungs and other organs are more sensitive than adults making their health risks much greater. People with weakened immune systems such as lung disease may be particularly susceptible to disease-causing biological agents in the indoor air.

Indoor air pollution often trigger allergic reactions including hypersensitivity pneumonitis, allergies, asthma, and many other symptoms. Allergic reactions occur after the exposure is repeated. One may notice only mild reactions, or none at all and may suddenly find themselves "hyper-sensitive" to particular allergens due to multiple exposures over a period of time. This may also happen after one main exposure.

We do not know the health hazards arising from our exposure to environmental contaminants. We have made much progress in protecting our natural environment of our air and water yet we have lost sight of our environmental exposures in our living environment, which is essential to healthy living. There is no tracking system for environmental health as there is for Infectious Disease.

According to the Pew Environmental Health Commission at the Johns Hopkins School of Public Health, we need to track levels of hazardous toxins in people in order to make the right decisions about protecting the health of our communities. Our researchers, policymakers and citizens need to know more about how the environment impacts our health. In the Commission’s own words, environmental health represents" those aspects of human health, including quality of life, that are determined by interactions with physical, chemical, biological and social factors in the environment. It also refers to the theory and practices of assessing, correcting, controlling and preventing those factors in the environment that may adversely affect the health of present and future generations."

According to the Pew Commission:
Childhood asthma is one of the most chronic diseases affecting 5.5 million children. Rates have doubled in the last 20 years and increased 160% between 1980 and 1994 for children under five. Asthma mortality for children increased 13% for children less than five between 1981 and 1995. The cost to our economy has been estimated over 14 billion in 1996, a 126% increase since 1990. Environmental factors are implicated in asthma exacerbation and development. Reducing exposure to these triggers is an important role in asthma prevention.

Birth defects are the leading cause of infant mortality and constitute a large fraction of morbidity. Birth defects account for more than 5% of all years potential life lost before age 65. There has been an increase in infants deaths due to birth defects from 7% in 1916-1919 to 20.5% in 1986. Costs to the economy directly and indirectly account for billions of dollars due to birth defects. Over 60% may be preventable if we could identify etiologies. Although there has been much progress in the war on childhood cancer, between 1973 to 1991, the incidence has increased at almost 1 percent a year with no apparent explanation. A national surveillance system for childhood cancer would allow for the examination of environmental factors in understanding the etiology of this disease.

What causes it?
Although there are many sources of indoor air pollution, the single most important fact is at what level and how hazardous the emissions are. Somesources release pollutants continuously while other sources are related to activities carried out within the space. Biological contaminants arenaturally occurring and release disease-causing toxins. They can become airborne making them easily distributed throughout a ventilation system. There are many other sources listed below with information regarding health effects and solutions on controlling your exposure to indoor air pollution.

Sources of Indoor Air Pollution:

Asbestos is mainly found in older homes in insulation materials, shingles, floor tiles, millboard and other construction materials as a fire-retardant. Several products were banned by the EPA several years ago. Asbestos becomes airborne after being damaged or disturbed by cutting, sanding or other remodeling activities. It is best to leave undamaged asbestos material along if it is not likely to be disturbed. If you need to remove or clean up asbestos, use only a professionally trained contractor. There are many programs and hotlines provided to help in this problem.

There are usually no immediate symptoms but there are long-term risk of chest and abdominal cancers and lung disease. Smokers are at a much higher risk of developing lung cancer. Once these tiny fibers are inhaled, they remain and accumulate in the lungs sometimes not showing up until many years after exposure began. Exposures have been traced from clothing and equipment with the asbestos fibers on them. Many people do not show symptoms of disease until many years after exposure.

Biological Pollutants are naturally occurring in the environment. Molds, mildew, bacteria and viruses dust mites, pollen, cockroaches and animal dander and cat saliva are a few of these pollutants that trigger allergic reactions in many people.

One example of the most powerful biological allergens is the dust mite. They have been identified as the single most important trigger for asthma attacks. It is the protein in the fecal product of the dust mite that is the source of the allergen. It is estimated that one in five Americans have allergies making over 10 percent of the population is allergic to dust mite extracts. Mites thrive and multiply by the thousands in warm and humid spaces where the relative humidity is above 45% with the temperature above 65%. They absorb the moisture out of the air. By controlling the moisture in a space, you in turn control dust mites.
Dust mites live on dead human skin cells in bedding, upholstery and carpeting. The average bed can easily have over 10,000 mites living in it and one-tenth of the weight of an old pillow can be attributed to dust mites and their droppings. There are environmental controls that are suggested such as using a central vacuum vented to the outside and encasing bedding in dust mite proof covers.

Another asthma trigger is cockroach droppings. They are commonly found in crowded cities and the southern United States and play a significant role in triggering asthma in many inner-city areas. Keeping areas clean of any food source such as using airtight containers, washing dishes as soon as you are done with them, along with fixing moisture problems will help control an infestation. Since pesticides are also a concern for indoor air quality, try using traps and boric acid first.

One example that has received much media attention is mold. Mold, mildew and yeasts are necessary for plants and animals in their role of decomposition of organic living things. Although mold is present everywhere, it requires moisture, the presence of mold spores, cellulose food sources, and warmth in order to live. Indoors, it grows on surfaces such as carpet, drywall, wood, insulation and cloth.

Hidden mold is suspected if a building smells moldy but you cannot see the source. According to EPA the most frequent phrase is "something smells funny in here." The musty mildew odor is the product of molds munching on organic matter. This emits water, carbon dioxide and VOC’s (volatile organic compounds) like alcohols and aldehydes. Molds can be controlled indoors by controlling moisture indoors. Otherwise, they may produce allergens, irritants and in some cases toxins that may cause reactions in humans. These spores can become airborne, which in turn are inhaled or touched by persons within a space.

All molds have the potential to cause health effects. The severity of symptoms depends on the types and levels of toxicity of the molds, the individuals exposure, and the health conditions of those exposed. Those with heightened sensitivities, compromised immune-systems and persons with asthma and allergies are the canaries in the coalmine. Because this group is has heighten sensitivities, they are the first to react to indoor air pollution. Also, researchers at the University of Minnesota report that exposure to mold has been linked to hair loss, bronchial spasms and pulmonary emphysema. (see link to symptoms)

Molds can sometimes produce chemicals called mycotoxins. While many mycotoxins can be measured in environmental samples, it is not yet possible to measure mycotoxins in human or animal tissues. For this reason, exposure measurements rely on circumstantial evidence combined with the symptoms to establish an association with illness. Indoor environments are dynamic ecosystems that change over time as moisture, temperature, food sources and the presence of other microorganisms change. It is not known of the effects of multiple exposures to mixtures of mycotoxins in air combined with other toxic pollutants.

Carbon Monoxide is a colorless gas or liquid used in unvented kerosene and gas space heaters, gas water heaters, wood stove and fireplaces and automobile exhaust from garages attached to the building. Recently the EPA has warned users of gas-powered tools such as high-pressure washers, concrete cutting saws, power trowels, welders and other products because of the people being poisoned by carbon monoxide. Make sure products are vented properly and keep gas appliances properly adjusted. Do not idle the car inside the garage. Because it is practically odorless, it goes undetected. At low levels, it causes fatigue in healthy people and chest pain in people with heart disease. In high levels, it causes impaired vision and coordination, dizziness, confusion, headaches and nausea. At very high levels, it is fatal.

Formaldehyde is a chemical used in the building industry in manufactured products and also in household products. It has many uses such as being a component of glues and adhesives in and a preservative in some paints, as well as being used in permanent-press in clothing and other goods.

Pressed wood products such as particleboard, plywood paneling and fiberboard are some sources of formaldehyde. These products "off-gas" and have higher concentrations when they are new and in high humidity. Emissions well generally decrease as products age. Ways to reduce exposure is increasing ventilation in a space especially when new products are installed. Also, using air conditioning and dehumidifiers to maintain moderate temperatures and reduce humidity levels will help with the emissions.

Unvented fuel-burning appliances such as gas stoves and kerosene space heaters are other products that release formaldehyde. Dry-cleaned products should be taken out of their plastic to "air-out" in a well ventilated area prior to storing in a closet. Health effects include burning sensations in the eyes and throat as well as watery eyes and nausea. It may cause wheezing, coughing, fatigue, skin rashes and severe allergic reactions. High levels of exposure may trigger an asthma attack. It may also cause cancer.

When Lead becomes airborne from dust it becomes indoor air pollution. It has been long recognized as a harmful environmental pollutant and was considered the "number one environmental threat to the health of children in the United States" in 1991 according to the Secretary of the Department of Health and Human Services. Old lead-based paint it the most significant source of lead exposure in the America today. When lead-based paint is improperly removed by scraping, sanding or open-flame burning, the concentrations can become harmful.

Other activities such as stained-glass making and soldering. It is best to leave lead-based paint undisturbed. If it needs to be removed, hire a professional. Keep areas where children play as clean and dust-free as possible. Lead affects all systems within the body. In high levels it can cause convulsions, coma and even death. In lower levels it can cause adverse health effects on the central nervous system, kidney and blood cell damage. It can also impair physical and mental development. Young children and fetuses exposed to lead are more likely to have severe effects due to their growing bodies. They are more likely to have higher exposures since they tend to put their hands or objects that may contain lead into their mouths. Their development in their physical and mental health as well as lower IQ levels, behavioral problems and shortened attention spans are all symptoms of lead exposure.

Nitrogen Dioxide is a source of indoor air pollution that comes from kerosene heaters. Unvented gas stoves and heaters as well as environmental tobacco smoke. In homes where there are gas stoves, kerosene heaters or un-vented gas space heaters, the levels indoor often exceed outdoor levels. While the average level in homes without combustible appliances, it is about half that of outdoors. Like carbon monoxide, appliances should be properly adjusted and installed. Exhaust fans should be vented to outdoors over a gas stove. Health effects may be irritation of the eyes, nose and throat. It may cause increased respiratory infections in young children and impaired lung function for others.

Organic Gases are also known as Volatile Organic Compounds or VOC’s. These are released into the air during their use, since they are commonly used as ingredients in household products. Cleaning products, cosmetics, hobby products, paints, varnishes and waxes. Fuels are also made up of organic gases. Mogh repellents, air fresheners, automotive products and dry-cleaned products are also sources. The EPA found levels of a dozen common organic pollutants to be 2-5 times higher inside homes than outside. The levels of exposure can be extremely dangerous after certain activities such as paint stripping, having levels 1,000 times outdoor levels.

The cosmetic industry has very little supervision and the FDA does not require manufactures to register their products or file safety data on ingredients used in their personal care products. Make sure when using these products, make sure there is plenty of fresh and and adequate ventilation. Only use the products according to the manufacturers directions.

Air out dry-cleaned items after removing them from their plastic in a well ventilated area prior to storing in your closet. Keep all potential toxic products out of reach of children and pets. Properly throw away unused containers since the gases leak from them and they may unknowingly enter your indoors. Store partially filled containers away from your space, in a detached garage or storage unit. Never mix household care products unless directed on the label.

 The health effects will largely depend on many factors including level of exposure and length of time exposed to the extent and health of the person exposed. Eye, nose and respiratory tract irritation, memory impairment, nausea, headaches, dizziness and visual disorders are some immediate symptoms. Damage to the liver, kidney and central nervous symptoms are more long-term damage. Some organic gases such as those in dry-cleaned items cause cancer and other organic gases are suspected or known to cause cancer in humans.

Pesticides are described as products used to kill pests including insects, termites and germs. The products used on lawns and gardens that drift or are tracked back inside our indoor environment are also considered a source of indoor air pollution. Studies show that there are more pesticides in the average carpet of a house who uses a monthly lawn service than there are outside. Outdoors there is rain and the environment that will break down the chemicals used, which does not happen inside a home. Once tracked inside, they stay on top of the surface, re-exposing occupants. These chemicals also add to the levels of airborne organics inside a space.

The term cide in pesti-cide means "to kill". Pesticides, insecticides, and disinfectants must be used according to the manufacturers label. Studies have shown that 80% of most people’s exposure to pesticides occurs indoors and that levels of up to a dozen pesticides have been found in the air inside homes. One pesticide of great concern is in moth repellents. Although EPA requires labels to warn "avoid breathing vapors" due to short-term toxic effects, these are routinely used by homeowners in closets and inside storage trunks. They should be stored in areas separate from the home such as detached garages or attics.

Radon is the second leading cause of lung cancer in the United States, warns the Surgeon General. It is a radioactive gas that results from the radioactive decay of uranium. It is odorless, tasteless, colorless, and invisible so the only way to detect it is to test for it. It primarily enters a space from the ground through cracks in the foundation. All types and ages of homes can have radon and there have been high levels found in every state. Radon tests are available and reliable as well as easy to use. The preventable health risks are lung cancer and the most at risk are persons who smoke.

Second-hand Smoke also known as Environmental Smoke includes the exhale smoke from smokers and the smoke from the end of a cigarette, cigar, or pipe. There are 40 chemicals of the 4,000 linked to cancer. Children are at most risk of this air pollution as they are still developing, breathe more air per body weight and have little control over their indoor environments. It is known to trigger asthma by irritating the bronchial passages unlike most triggers which have allergic effects. Second-hand smoke makes asthma symptoms more severe in children who already have asthma and creates a risk for new cases in children who have not shown symptoms of asthma. Since this is caused by an voluntary activity the person smoking could prevent exposure to others by not moking indoors.

Should we be concerned with indoor air quality in our schools?

Simple answer: YES.
As parents, we assume that the air our children are breathing in our schools is "clean". We make sure our children eat healthy, we put on their seat belts, we hold their hands while crossing a busy street. Yet, we are unknowingly allowing them to be exposed to harmful air! Children breath in more air per pound than adults and since their bodies are just developing, are more affected by air pollution. According to the US Government Accounting Office, in their 1995 report, a survey indicated that over half of our schools have problems which affect indoor air quality. All types of schools, new and old are experiencing an array of problems. The EPA states that our indoor air quality is 2 to 5 times more polluted than outside air…….in some cases up to 10 times!!!

Our children spend a minimum of 6 hours a day in school. Biological pollutants such as mold and mildew are particularly pronounced in the Southeast where the humidity levels are high. In a radon-related EPA investigation, it was reported that most of the schools had inadequate ventilation. Their investigation included 29 schools across the country. It was also reported that one in five schools has at least one room with radon above the recommended level. We do not presently know the long-term health consequences of exposure to air pollution. It is in our children’s best interest to provide them with the cleanest learning environment possible.

They have no voice, they have no choice………..we must be theirs.

Who is regulating indoor air quality for our children?  Answer: No One
NO ONE is regulating our children’s indoor air quality!!! Although there are "standards" or "codes" for ventilation at the time of construction that must be met, there is no independent agency monitoring the quality of the air our children are breath. EPA has no regulatory or enforcement authority regarding indoor air quality in our nations schools.

The mission of our schools is to educate our students and the quality of the indoor air is essential in meeting this objective. There are recommendations by the EPA to prevent and resolve IAQ problems such as the IAQ "Tools for Schools." There is no cost for the Kit, and the program is completely voluntary. The guidance can be followed, modified or ignored depending on the schools needs and desires. Any information gathered as a result of using the Kit is for the use and benefit of the local school or school district.
The EPA does not require retention or submission of any information gathered. Meanwhile, our children spend a minimum of six hours (and up to ten hours a day at school including after-school programs) breathing potentially harmful air!

How may it Affect Our Children?
Children are particularly susceptible since their young bodies and minds are still developing. Their airways are smaller in diameter making a pollutant significantly irritate and narrow the airway in comparison to an adults airway that may only be slightly irritated by the same air. This can produce wheezing, asthma or hypersensitivity to allergens. Also, because children are more active, they take in more air and ingest more pollutants per pound of body weight, yet their bodies are less capable of detoxifying pollutants. A child’s lungs are still growing since their lungs don’t reach maturity until age 20.

Repeated exposure to air pollution and repeated asthma problems can limit the growth of a child’s lungs leaving them predisposed to chronic lung disease.

Allergic reactions occur only after repeated exposure to a specific allergen. However, that reaction may occur immediately upon re-exposure or after multiple exposures over time. As a result, one may have noticed only mild allergic reactions, or no reactions at all, but my suddenly find themselves very sensitive to particular allergens. Our children are particularly susceptible to disease-causing biological agents in the indoor air.

What long term health risks are there for our children?
It is not known.

How long did it take science to conclusively say that second-hand smoke is just as dangerous as smoking?

We do know that when children are exposed to even low levels of allergens, it can lead to allergic sensitization. For this reason alone, ensuring our children have clean indoor air in our schools is crucial. Effects from even low level or chronic low level exposures of poor air quality have not been studied and are unknown.

Asthma is the number one cause of absenteeism (over 10 million missed days a year) and kills more than 300 children a year, hospitalizing over 150,000. It is the most common chronic respiratory condition and has increased 50% each decade. One in thirteen school-aged children has asthma, and studies expect this to increase to one in five by the year 2020.   Most deaths are preventable with proper diagnosis and treatment. Environmental controls of limiting exposures to triggers such as dust mites and molds play an important role in asthma development and symptomatic severity in early life.  It can reduce the asthma severity in later life. Limiting exposure may even cure or prevent asthma.

Few inhalation experiments have been performed regarding mycotoxins (a toxin release by molds). Some evidence has suggested that the respiratory route produces more severe responses. How long did it take to prove second-hand smoke is dangerous? Early exposure to air pollution may predispose our children to developing disease. Our children have a lifetime ahead of them, they deserve to be surrounded in the healthiest environment possible.  Indoor environments are dynamic ecosystems that change over time so even air sampling for testing may be inconclusive.