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James Krieger, MD, MPH, Epidemiology, Planning and Evaluation Unit, Public Health - Seattle & King County, 999 Third Ave, Suite 1200-EPE, Seattle, WA 98104, 206-296-6817, james.krieger@metrokc.gov and Tim Takaro, MD,, MPH, Department of Environmental Health, University of Washington, P.O. Box 354695, Occupational and Environmental Medicine Program, Seattle, WA 98195-7234.
The interaction of housing characteristics and resident behaviors affects indoor environmental quality, exemplified by the generation of asthma triggers. We will describe efforts to integrate behavioral and housing remediation approaches for reducing levels of indoor asthma triggers and asthma morbidity. We initially conducted a randomized, controlled trial in which we assigned 274 low-income asthmatic children to a high or low intensity group. Community health workers visited all homes to assess exposures, develop an action plan, promote behavior change and provide bedding encasements. The high group received cleaning equipment and 5-9 additional visits over a year while the low group received only the initial visit. Asthma symptom days and caregiver quality of life improved significantly among both groups while unscheduled health care utilization improved only in the high intensity group, with the improvement being significantly greater (p<0.05) in the high intensity group for the latter two measures. Intermediate measures such as floor dust loading and proportion regularly vacuuming child’s bedroom improved only in the high intensity group. We next began testing the impact of low-cost housing remediation strategies ($7000 per unit to include ventilation fans, removing carpeting, eliminating leaks and water-damaged materials, etc.) and will report on the process of remediating 40-50 homes. We are now assessing the impact of incorporating healthy homes specifications into the construction of 30 new “Breathe Easy” units. Key specifications include hard floors, enhanced ventilation systems, more moisture-resistant building envelopes, no or low-emission finishing materials, and improved under-floor insulation at an estimated added cost of $6000.
Learning Objectives:
Keywords: Asthma, Housing
Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am employed by Seattle and King County Department of Health and will be discussing grant-funded research that was implemented by my employer.