Housing interventions and control of health-related chemical agents: a review of the evidence.
Subject matter experts systematically reviewed evidence on the effectiveness of housing interventions that affect health outcomes associated with exposure to chemical agents, such as pesticides, lead, volatile organic compounds, as well as the radon gas. Particulates were also examined, and the role of ventilation on exposures was assessed. The review included both published literature and peer-reviewed reports from the US Environmental Protection Agency. Four of the 14 interventions reviewed had sufficient evidence to demonstrate their effectiveness and are ready for implementation: radon air mitigation by using active soil depressurization systems, integrated pest management to reduce exposures to pesticides, smoke-free home policies making indoor areas smoke-free (ie, no smoking allowed anywhere at any time), and residential lead hazard control. Four interventions needed more field evaluation, 3 needed formative research, and 3 either had no sufficient evidence of effectiveness or had evidence the interventions were ineffective. This evidence review shows that housing improvements are likely to help reduce radon-induced lung cancer, cardiovascular mortality related to secondhand smoke, and neurological effects from exposure to pesticides and lead paint. Investing in housing interventions may yield important savings from reduced disease and injury from avoidable exposures to chemical agents.
Sandel
Megan
M
Boston University School of Medicine, Boston, Massachusetts 02118, USA. megan.sandel@bmc.org
Baeder
Andrea
A
Bradman
Asa
A
Hughes
Jack
J
Mitchell
Clifford
C
Shaughnessy
Richard
R
Takaro
Tim K
TK
Jacobs
David E
DE
D016902:Air Pollution, Indoor / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D006798:Housing / Q000592:standards*; D006801:Humans; D007287:Inorganic Chemicals / Q000009:adverse effects; D010575:Pesticides / Q000009:adverse effects; D017751:Safety Management / Q000379:methods*; D014481:United States; D014484:United States Environmental Protection Agency; D014691:Ventilation; D055549:Volatile Organic Compounds / Q000009:adverse effects
D007287:Inorganic Chemicals; D010575:Pesticides; D055549:Volatile Organic Compounds