Ethical Considerations for Research on Housing-Related Health Hazards Involving Children (2005) / Chapter Skim
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2 Housing and Health
2 Housing and Health
Pages 24-40
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From page 24... ...
Although hazards may be present in the homes of people at all income levels, children in low-income families, who have limited housing options, are at increased risk for many housing health hazards. Children are more susceptible than adults to hazards in the home in four ways.
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From page 25... ...
HOUSING HAZARDS The state of knowledge about housing health hazards varies widely. For example, there are decades of research on the effects of lead, including the accepted finding that lead in house paint is a leading cause of lead poisoning, while the effects of exposure to pesticides in the home is a relatively new field of study with few definitive findings.
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From page 26... ...
concluded that there is a causal relationship between exposures to allergens produced by cockroaches and dust mites and asthma exacerbations in sensitized individuals as well as between exposure to environmental tobacco smoke and exacerbations of asthma in preschool children. One study reported that exposure to environmental tobacco smoke may account for 150,000 to 300,000 excess cases of asthma in preschool children (Lanphear et al., 2001b)
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From page 27... ...
Lead In the 1950s and 1960s hospitalizations of children for acute lead encephalopathy led government actions to prohibit lead in interior paint, gasoline, and tin cans. Although the average blood lead concentrations of U.S.
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From page 28... ...
The HPHI is a collaborative including the Harvard School of Public Health, the Boston University School of Public Health, the Tufts University School of Medicine, and a wide variety of actively involved partners that include public housing residents, the Boston Housing Authority, two tenant task forces, the Boston Public Health Com mission, the Committee for Boston Public Housing, a pediatric asthma specialist, and specialists in energy efficiency and housing policy and finance. Three pilot surveys conducted revealed that many environmental health prob lems reported by residents are associated with the physical conditions of housing, such as water leaks, moisture and mold growth, insufficient ventilation, and pest infestation.
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in enrolled children improved significantly during the health education phase and again over the course of the intervention. Based on these results, the Boston Housing Au thority intends to develop a comprehensive integrated pest management program that includes resident educators.
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From page 30... ...
. An extensive body of research links exposure to lead in the home with elevated blood lead levels in children (Charney et al., 1983; Clark et al., 1985; Rhoads et al., 1999; Lanphear et al., 2002)
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From page 31... ...
However, research showed the importance of how lead paint abatement was carried out. Lead paint abatements, if improperly conducted or if not followed with meticulous postabatement cleanups, actually dispersed lead in dust in homes, resulting in increased blood lead levels in children (Chisholm, 1986; Farfel and Chisholm, 1990; Amitai et al., 1991; Rey-Alvarez and Menke-Hargrave, 1987; Swindell et al., 1994; Aschengaru et al., 1997; Centers for Disease Control and Prevention, 1997a)
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From page 32... ...
During the second growing season, the intervention was an in-depth pesticide education program with farm worker house holds specifically aimed at prevention exposure to children. Results to date include the demonstration of higher levels of urinary pesticide metabolites in the pregnant women in comparison with national reference data, an association of maternal pesticide metabolite levels and shorter gestational dura tion, and abnormal reflexes in the neonates.
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From page 33... ...
Pesticide exposure in rural agricultural environments may be compounded by spray drift or take-home exposure when farm workers track agricultural pesticides into their homes on their shoes or clothing (Bradman et al., 2005; Fenske, 1997)
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From page 34... ...
For example, for a given exposure to environmental tobacco smoke, African American children have significantly higher blood lead levels, cotinine levels, and DNA adducts (an altered form of DNA that occurs as the result of exposure to a carcinogen) (Pirkle et al., 1998; Wilson et al., 2005; Richie et al., 1997)
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From page 35... ...
. reduce exposure in homes will have to focus on household decision makers, possibly by educating them about the risks to children from environmental tobacco smoke and ways to eliminate exposures.
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In contrast, studies of passive regulation of household water temperature by limiting the settings on hot water heaters proved effective in reducing scald burns (Webne et al., 1989)
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A 2001 study found that almost 52 percent of all housing units for farm workers were crowded, and 74 percent of the units included children (Housing Assistance Council, 2000)
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. RISK DISPARITIES As discussed above, the scientific literature documents that certain housing health hazards are more common in poor-quality housing, which is more prevalent among the homes of children in low-income families and that outcomes such as asthma, fatal injuries, and lead poisoning are also more prevalent among these children.
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From page 39... ...
Public resources to ameliorate housing hazards are limited at the same time that operating costs are higher for older properties and low-income housing, the very properties most likely to contain health hazards and to be occupied by low income families; see Box 2-3. Low-income families cannot usually afford to move to better housing.
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From page 40... ...
The economics of lowincome housing suggests that even if it were technically feasible to eliminate all housing health hazards to children, doing so might exacerbate existing private-market shortages or push up housing costs. Thus, under current housing policies, there is a need for research to identify interventions that are not only effective at ameliorating housing health hazards but also cost effective.
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