title: Health outcomes and green renovation of affordable housing.
abstract: OBJECTIVE
  This study sought to determine whether renovating low-income housing using "green" and healthy principles improved resident health and building performance.
  
  
  METHODS
  We investigated resident health and building performance outcomes at baseline and one year after the rehabilitation of low-income housing using Enterprise Green Communities green specifications, which improve ventilation; reduce moisture, mold, pests, and radon; and use sustainable building products and other healthy housing features. We assessed participant health via questionnaire, provided Healthy Homes training to all participants, and measured ventilation, carbon dioxide, and radon.
  
  
  RESULTS
  Adults reported statistically significant improvements in overall health, asthma, and non-asthma respiratory problems. Adults also reported that their children's overall health improved, with significant improvements in non-asthma respiratory problems. Post-renovation building performance testing indicated that the building envelope was tightened and local exhaust fans performed well. New mechanical ventilation was installed (compared with no ventilation previously), with fresh air being supplied at 70% of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers standard. Radon was < 2 picocuries per liter of air following mitigation, and the annual average indoor carbon dioxide level was 982 parts per million. Energy use was reduced by 45% over the one-year post-renovation period.
  
  
  CONCLUSIONS
  We found significant health improvements following low-income housing renovation that complied with green standards. All green building standards should include health requirements. Collaboration of housing, public health, and environmental health professionals through integrated design holds promise for improved health, quality of life, building operation, and energy conservation.
authors.affiliation: National Center for Healthy Housing, Columbia, MD, USA. jbreysse@nchh.org
authors.forename: Jill
authors.initials: J
authors.lastname: Breysse
authors.forename: David E
authors.initials: DE
authors.lastname: Jacobs
authors.forename: William
authors.initials: W
authors.lastname: Weber
authors.forename: Sherry
authors.initials: S
authors.lastname: Dixon
authors.forename: Carol
authors.initials: C
authors.lastname: Kawecki
authors.forename: Susan
authors.initials: S
authors.lastname: Aceti
authors.forename: Jorge
authors.initials: J
authors.lastname: Lopez
mesh_terms: D000328:Adult; D002648:Child; D003247:Conservation of Natural Resources / Q000379:methods*; D005160:Facility Design and Construction / Q000592:standards; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D008910:Minnesota; D011203:Poverty; D015397:Program Evaluation; D011634:Public Health / Q000592:standards*; D011638:Public Housing / Q000592:standards*