HEALTHY HOMES IN 3 ACKNOWLEDGEMENTS AHFC would like to acknowledge the following agencies and...

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    HEALTHY HOMES IN ALASKA

    Final Report

    Prepared for:

    U.S. Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control

    Prepared by:

    John Davies Scott Waterman Mimi Burbage

    Grant # AKLHH0086-1

    ALASKA HOUSING FINANCE CORPORATION 4300 Boniface Parkway

    Anchorage, Alaska 99517 907-338-6100

    March 21 2005

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    The contents of this report are the views of the authors, and do not necessarily reflect the views or policies of the U.S. Department of Housing and Urban

    Development or the U.S. Government

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    ACKNOWLEDGEMENTS AHFC would like to acknowledge the following agencies and individuals that helped to bring this project to a successful conclusion. Cold Climate Housing Research Center (CCHRC) coordinated the various agencies in the testing, training, implementation, and reporting throughout the life of the grant. John Davies served as project coordinator from CCHRC and proved a dedicated and diligent contributor. His help was invaluable in keeping the project going through the rough spots. Also, from CCHRC assistance was provided from Jack Hebert, Phil Kaluza, Rose Baumes and Gail Koepf. The medical testing protocols and research were handled by Dr. Tim Foote of the Tanana Valley Clinic and Dr. Mary Ellen Gordian at the Institute of Circumpolar health Services of the University of Alaska Anchorage, who both proved persistent in their quest to maximize this research opportunity despite endless obstacles and much more work than anticipated. The environmental testing and research was coordinated and implemented by Ron Johnson, Satish Dinakaran and Jack Schmid of the Institute of Northern Engineering, University of Alaska Fairbanks. Training consultation was provided by Rich Seifert of the Cooperative Extension Service of the University of Alaska Fairbanks and Mac Pearce of Mold Analysis in St. Paul, Minnesota. Ginny Moore of the Alaska Building Science Network produced the very attractive educational brochure, “Help Your Family To A Healthy House”.

    Two agencies that took on the huge task of finding the homes, testing the homes, determining a strategy of improvement for the homes, and then implementing that strategy, proved to be the real heroes of the project, overcoming the huge logistical barriers of working and traveling in rural Alaska. These agencies are Rural Alaska Community Action Program (RCAP) that worked in Hooper Bay and Interior Weatherization (IWX) that worked in Fairbanks. Lead staff members for RCAP include Ralph Lee, Marla Tomblinson, Mert Stromire, Victor Night and Robert Reekie. Critical staff for IWX include Jim Lee, Cathy Daunias, Kathy Nichols, Rod Bogush, Charles Davis, and Tony Mora.

    At AHFC Scott Waterman and Mimi Burbage were the overall project coordinators. They tenaciously fought to keep the project on track regardless of the barriers that materialized on the road to completion. Elaine Mello was the Grants Administrator. Bob Brean, Director of Research and Rural Development at AHFC contributed staff time and oversight to the project. Thanks to Mark Romick, Planner II of Planning.

    Special thanks to all of our clients from Hooper bay and Fairbanks who had to put up with multiple visits from assessors, testers, inspectors, and who complied when necessary to the medical testing requirements, which often necessitated extra trips to the doctor. Most of our clients were very gracious in accommodating the time consuming activities surrounding the rehab work, and most were quite vocal about the improvements that were seen in their children’s health.

    Thanks also to Dale Darrow for monitoring our project while in progress and for accompanying us to Hooper Bay and Fairbanks to meet the clients and see first hand the conditions which make implementing Healthy Homes in Alaska a particularly difficult challenge, while no where is it needed more.

    HUD Government Technical Representative Alan Daly

    HUD Government Technical Monitor

    Dale Darrow

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    TABLE of CONTENTS

    Volume I – Healthy Homes in Alaska, Main Report - March 21, 2005 Section Page No. Inside Cover………………………………………..………………….……….1 Acknowledgements……………………………………………………………3 Table of Contents………………………………………...……………………4 Abstract..…………...………………………………………………………… 5 Executive Summary..……..………………………………………………….. 6 Introduction.………………………………………………..……….………..17 Goals and Objectives………………………………………...……………….23 Tasks and Timeline………………………………………………...……..…..25 Results & Deliverables

    A. Coordination and Training Meetings …………………...……..……..36 B. IRB proposal and clearance………………………………...………...39 C. IAQ Testing (UAF) ………………………………………...…….…..58 D. Remediation of homes

    1. Ralph Lee, RurAL CAP …………………………..…….….109 2. Jim Lee, Interior Weatherizaion, Inc.……………...….…….116

    E. Individualized guide for homeowners (ABSN) ………….….…...…123 F. Questionnaire on client satisfaction …………………….….……….124 G. Health Outcomes (Mary Ellen Gordian)…………………….…...….126

    Conclusions /Recommendations………………….……………..….….……131 Volume II – House-by-House Results, Hooper Bay Clients Volume III – House-by-House Results, Hooper Bay Controls Volume IV – House-by-House Results, Fairbanks Clients Volume V – House-by-House Results, Fairbanks Controls

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    Volume I - Healthy Homes Alaska

    Main Report – March 21, 2005

    ABSTRACT The Healthy Homes Project was designed to test whether improving the indoor environmental quality of homes for children with asthma might improve their health. Only children who lived in low-income homes were eligible, and the parent or guardian of the child was required to own the home. Another goal of this project was to increase the capacity of the Low-income Weatherization Program to remove possible respiratory hazards in the homes of low-income people who have children with asthma or other upper respiratory diseases. The Healthy Homes in Alaska project was conducted in two areas in the state. Fairbanks is Alaska’s second largest city and is located in the Interior. Hooper Bay is a larger bush community of 1014 residents on the Bering Sea coastline. These communities were selected because they have residents with diagnosed asthma, an involved health provider in the region, and are generally representative of conditions and housing stock throughout the state. The project provided indoor air quality assessment, health screenings of affected children, and housing remediation to selected homes. We identified and studied a total of 36 homes: 10 eligible participants in the Fairbanks area, 9 participants in Hooper Bay, and 8 and 9 control homes in Fairbanks and Hooper Bay, respectively. The remediation in the control homes consisted of the standard weatherization items such as improving insulation, replacing windows and doors, sealing air leaks, as well as providing some safety items such as smoke and CO detectors. In the participants houses the weatherization protocol was augmented by items designed to remove possible asthma triggers such as moldy window sills, bedding, or furniture. Some changes in the home were made to prevent the moisture and temperature conditions that lead to the growth of mold such as adding cloths dryers, installing shelving and bed frames to improve air circulation by the walls and floors, and installing quiet bath and kitchen fans to remove moist air from the house. Qualitatively, the clients in the healthy homes reported improved comfort and health as well as reduced energy bills. While the quantitative results of this study were based on a small number of research subjects, and asthma is a disease with multiple causes, there are some interesting suggestive results: (1) It is possible that the homes of children with asthma have higher levels of indoor air pollution than the homes of similar people without asthma; and (2) The remediation may have helped to improve the pulmonary function tests and the IgE levels of asthmatic children, although the numbers were not sufficient to reach statistical significance.

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    EXECUTIVE SUMMARY Introduction The Healthy Homes Project was designed to test whether improving the indoor air quality of homes for children with asthma might improve their health. Only children who lived in low- income homes were eligible, and the parent or guardian of the child was required to own the home. The low-income standards were set to meet both the requirements of the Healthy Homes and the Low-income Weatherization programs. Another goal of this project was to increase the capacity of the Low-income Weatherization Program to remove possible respiratory hazards in the homes of low-income people who have children (ages 5-17) with asthma or other upper respiratory diseases. This goal was accomplished by training the workers in the weatherization programs and subcontractors of the program in the techniques adopted