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Essentials for Healthy Homes Practitioners

Keep It Safe

Key References

Reference Topics

________

Overview

Start With People

Keep It Dry

Keep It Clean

Keep It Pest-Free

Keep It Ventilated

Keep It Safe

Keep It Contaminant-Free

Keep It Maintained

Making It Work

All References

The National Center for Healthy Housing (NCHH) operates the National Healthy Housing Clearinghouse.  The Clearinghouse consists of hundreds of journal articles, reports, and publications related to healthy homes.  This section links you to the documents organized by healthy homes topic based on the modules in the National Healthy Homes Training Center's flagship course called Essentials for Healthy Homes Practitioners.  See the list of topics in the box to the right.  Make sure you scroll down past the introductory text.   

Please note that NCHH has not sorted the documents within the html page.  The most recent documents are at the top.  Use the Find (Control-F) function in your browser to seek out a particular document or issue.

For basic information on the topic, check out the PDF version of the Keep It Safe presentation from the course.

What do I do when link to document doesn't work?  Sometimes, you will get an error when you click on the document title.  In this situation, the full document is not available because NCHH has not received permission from the publisher to post it.  If you encounter this error, go to the clearinghouse search page to find the document.  When you get the search results, click on "Article Details" in the abstract for the document to get a link to the publisher.  You will need to get the article directly from the publisher.

Are the references current? NCHH will update the references at least every other month.  So it is a good idea to use the Clearinghouse's search engine for recent additions. 


 

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Carbon monoxide poisoning - garages

Authors: T.H. Greiner

 

How dangerous is it to operate an engine in a closed building? So dangerous that it must NEVER be done, even for a short time. The extremely high concentrations of carbon monoxide produced by an engine can raise CO concentrations in a closed building so quickly that a person may collapse before they even realize there is a problem. Carbon monoxide reduces the amount of oxygen to the brain, causing CO intoxication, and lack of reasoning. Studies by the Centers for Disease Control found that CO co

 


 

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Carbon Monoxide Poisoning - Checking for Complete Combustion

Authors: Thomas H. Greiner

 

Fossil fuels contain carbon (C) and hydrogen (H). During complete combustion carbon and hydrogen combine with oxygen (O2) to produce carbon dioxide (CO2) and water (H2O). During incomplete combustion part of the carbon is not completely oxidized producing soot or carbon monoxide (CO). Incomplete combustion uses fuel inefficiently and the carbon monoxide produced is a health hazard. A properly designed, adjusted, and maintained gas flame produces only small amounts of carbon monoxide, with 400 pa

 


 

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Carbon Monoxide Poisoning: Downdrafting (Backdrafting)

Authors: Dr. Thomas Greiner

 

What is Carbon Monoxide? Carbon monoxide (CO) is a colorless, odorless, tasteless, deadly gas. You can't see, smell or taste it. Carbon monoxide is slightly lighter than air and quickly spreads throughout an entire house. What causes carbon monoxide production? Carbon monoxide gas is produced when fossil fuel burns incompletely because of insufficient oxygen. During incomplete combustion, the car and hydrogen in the fuel combine to form carbon dioxide, water, heat, and deadly carbon monoxide. In

 


 

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Carbon monoxide (co) poses silent and serious threat for families during winter months

Authors: Home Safety Council

 

Often known as a silent killer, carbon monoxide (CO) is a colorless and odorless gas that poses a substantial risk to families using fuel-burning heating sources during the winter months. In fact, according to the Home Safety Council’s State of Home Safety in America™ report, CO poisoning accounted for more than 100,000 medical visits in the year studied. The high number of poisonings documented by the Council’s research may be explained by the fact that sixty-seven percent (67 percent) of house

 


 

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American Lung Association – Carbon Monoxide Fact Sheet

Authors: American Lung Association

 

Americans spend approximately 90 percent of their time indoors, where hazardous air pollutants can exist at higher levels than outdoors. Children, pregnant women, the elderly, and people with lung disease are particularly at high risk for adverse health effects caused by indoor air pollution, including carbon monoxide (CO). CO is a colorless, odorless gas that is produced as a result of incomplete burning of carbon containing fuels. Exposure to CO reduces the blood's ability to carry oxygen.

 


 

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American Lung Association – Carbon Monoxide Fact Sheet

Authors: American Lung Association

 

Americans spend approximately 90 percent of their time indoors, where hazardous air pollutants can exist at higher levels than outdoors. Children, pregnant women, the elderly, and people with lung disease are particularly at high risk for adverse health effects caused by indoor air pollution, including carbon monoxide (CO). CO is a colorless, odorless gas that is produced as a result of incomplete burning of carbon containing fuels. Exposure to CO reduces the blood's ability to carry oxygen.

 


 

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Pesticides: Health and Safety

Authors: U.S. Environmental Protection Agency

 

Following is a list of pesticide state lead agencies. In general, the first Web site listed is a general site for the state's environmental agency. The second Web site is specific to certification and training programs. If two agencies are listed, the state department of agriculture or equivalent usually certifies most categories of applicators, while the structural pest control agency certifies on for structural pest control.

 


 

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Pesticides Outreach Material Catalogue: Information for Your Home and Community

Authors: The U.S. Environmental Protection Agency (EPA), Office of Pesticides Programs

 

The U.S. Environmental Protection Agency (EPA), Office of Pesticides Programs (OPP) Outreach Publications Catalogue, is a comprehensive listing of more than 50 outreach publications and 70 fact sheets available free of charge to the public. These publications are intended for use by the general public, including homeowners, parents, and urban community leaders. All publications listed in this catalogue provide useful information on responsible pesticide use, storage, and disposal practices. Many

 


 

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Third national report on human exposure to environmental chemicals

Authors: Department of Health and Human Services Centers for Disease Control and Prevention

 

Using advanced laboratory science and innovative techniques, scientists in CDC’s Environmental Health Laboratory at the National Center of Environmental Health (NCEH) have helped change the face of environmental public health in this country. By recognizing chemicals that enter the body from environmental exposure, by responding to terrorism and public health emergencies involving chemicals, and by improving laboratory methods to measure chemical exposure, the laboratory has greatly enhanced th

 


 

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Carbon Monoxide Poisoning OSHA Fact Sheet

Authors: U.S. Department of Labor Occupational Safety and Health Administration

 

What is carbon monoxide? Carbon monoxide (CO) is a poisonous, colorless, odorless, and tasteless gas. Although it has no detectable odor, CO is often mixed with other gases that do have an odor. So, you can inhale carbon monoxide right along with gases that you can smell and not even know that CO is present. CO is a common industrial hazard resulting from the incomplete burning of natural gas and any other material containing carbon such as gasoline, kerosene, oil, propane, coal, or wood. Forg

 


 

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Fatalities Associated With Carbon Monoxide Poisoning From Motor Vehicles, 1995-1997

Authors: U.S. Department of Transporation National Highway Traffic Safety Administration

 

NHTSA’s National Center for Statistics and Analysis (NCSA) recently completed a second study of data from the National Center for Health Statistics (NCHS) to obtain an estimate of the number of persons killed as a result of carbon monoxide (CO) poisoning by exhaust gases of motor vehicles. This note updates the results of the study done in 1996 to assess the extent of fatalities associated with CO poisoning from motor vehicles using the NCHS data for the 1993 calendar year (NHTSA, 1996). This

 


 

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Consumer Product Safety Review C.O. Poisoning

Authors: U.S. Consumer Product Safety Commission

 

According to the latest data compiled by staff of the U.S. Consumer Product Safety Commission (CPSC), heating systems continue to be one of the major causes of non-fire, non-motor vehicle carbon monoxide (CO) poisoning. An estimated 217 people died as a result of this kind of CO poisoning during 1996, the most recent year with complete death certificate data. Of these deaths, heating systems were involved in 163 fatalities, or about 75% of all consumer product-related CO poisoning deaths (Fig

 


 

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Home Is Where the Harm Is: Inadequate Housing as a Public Health Crisis

Authors: Samiya A. Bashir

 

For many breadwinners of low-income families, going home at the end of a long workday can be a challenge, but it is a challenge they look forward to from the moment they arrive at work. The battle might begin with stepping off site into a city block filled with diesel exhaust. Perhaps a hard worker straps into a car for a fight with congested traffic on the long commute home, constantly alert to each potential danger the modern roadways present. Or maybe this breadwinner walks through the exha

 


 

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A multihazard, multistrategy approach to home remediation: results of a pilot study

Authors: Susan klitzman, Jack Caravanos, Candice Belanoff and Laura Rothenberg

 

Many residential hazards are disproportionately concentrated in older, urban dwellings and share common underlying causes, such as uncorrected moisture problems and inadequate maintenance and cleaning. Comprehensive and affordable approaches to remediation are needed, but the feasibility and efficacy of such approaches has not been well documented. To address this gap, a multihazard, multimethod intervention, addressing deteriorated lead-based paint and lead dust, vermin, mold, and safety hazard

 


 

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2002 Annual Report of the American Association of Poison Control Centers

Authors: Willian A. Watson, et al.

 

Toxic Exposure Surveillance System (TESS) data are compiled by the American Association of Poison Control Centers (AAPCC) on behalf of US poison centers. These data are used to identify hazards early, focus prevention education, guide clinical research, and direct training. TESS data have prompted product reformulations, repackaging, recalls, and bans; are used to support regulatory actions; and form the basis of postmarketing surveillance of newly released drugs and products. From its inceptio

 


 

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Risk and Protective Factors for Fires, Burns, and Carbon Monoxide Poisoning in U.S. Households

Authors: Carol W. Runyan, et al.

 

Background: More needs to be known about the prevalence of risk and protective factors for fires, burns, and carbon monoxide poisoning in U.S. households. Methods: A random-digit-dial survey was conducted about home safety with 1003 respondents representing households in the continental United States. Descriptive statistics assess the prevalence of risk and protective factors for fires, burns, and carbon monoxide overall, and by demographic characteristics, household structure, region, and resi

 


 

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Carbon Monoxide Poisoning from Portable Electric Generators

Authors: Neil B. Hampson Jennette L. Zmaeff

 

Background: While the overall death rate from unintentional carbon monoxide (CO) poisoning has decreased in the United States due to improved automobile emissions controls and a decline in CO poisonings from motor vehicles, exposures have not changed from some sources of CO. One of these is the operation of portable electrical generators in poorly ventilated spaces. This study sought to describe the population poisoned from CO produced by portable electric generators, and to determine the reaso

 


 

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Surveillance for Carbon Monoxide Poisoning Using a National Media Clipping Service

Authors: Jack C. Clifton, II

 

Using a novel method to review carbon monoxide (CO) exposures in the US, the role of CO detectors in prevention of CO-related deaths was studied. Using a national media clipping service, CO poisonings reported in the US were analyzed. The impact of CO detectors was investigated through nonfatal outcomes attributable to the presence of CO detectors and case fatality rate comparison among cities with and without CO detector ordinances. There were 4,564 CO exposures resulting in 406 (8.9%) fataliti

 


 

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Identifying and managing adverse environmental health effects: 6. Carbon monoxide poisoning

Authors: Alan Abelsohn, Margaret D. Sanborn, Barry J. Jessiman

 

CARBON MONOXIDE POISONING IS AN ENIGMATIC ILLNESS. The symptoms are often nonspecific or masked by an exacerbation of an underlying illness, such as congestive heart failure, that has been triggered by carbon monoxide inhalation. The effects can range from mild, annoying symptoms relieved by removal of the source to severe morbidity with profound central nervous system dysfunction, acute complications and delayed sequelae. Estimates suggest that about one-third of nonfatal cases of carbon monoxi

 


 

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Housing and Health: Time Again for Public Health Action

Authors: James Krieger and Donna L. Higgins

 

Poor housing conditions are associated with a wide range of health conditions, including respiratory infections, asthma, lead poisoning, injuries, and mental health. Addressing housing issues offers public health practitioners an opportunity to address an important social determinant of health. Public health has long been involved in housing issues. In the 19th century, health officials targeted poor sanitation, crowding, and inadequate ventilation to reduce infectious diseases as well as fire

 


 

142.

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Use of unvented residential heating appliances -- United States, 1988-1994

Authors: Morbidity & Mortality Weekly

 

Many heating appliances rely on combustion of carbon-based fuels and therefore are potential sources of health-threatening indoor air pollution. Most combustion heating appliances are vented to the outside of buildings to facilitate removal of the products of combustion, which include carbon monoxide (CO), carbon dioxide, nitrogen dioxide, and water vapor ( 1 ). However, some combustion heating devices may be unvented (e.g., kerosene- and propane-fueled space heaters, some gas-fueled log se

 


 

143.

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Deaths from motor-vehicle-related unintentional carbon monoxide poisoning --Colorado, 1996, New Mexico, 1980-1995, and United States,1979-1992

Authors: Morbidity & Mortality Weekly

 

Carbon monoxide (CO) is a colorless, odorless, toxic gas that is a product of incomplete combustion. Motor vehicles, heaters, and appliances that use carbon-based fuels are the main sources of this poison. Most fatal unintentional CO poisonings associated with motor vehicles are preventable and can result from differing mechanisms of exposure: 1) operation of a motor vehicle with a damaged or malfunctioning exhaust system and an inadequately ventilated passenger compartment, 2) operation of a mo

 


 

144.

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Use of Unvented Residential Heating Appliances -- United States, 1988-1994

Authors: Morbidity & Mortality Weekly

 

Many heating appliances rely on combustion of carbon-based fuels and therefore are potential sources of health-threatening indoor air pollution. Most combustion heating appliances are vented to the outside of buildings to facilitate removal of the products of combustion, which include carbon monoxide (CO), carbon dioxide, nitrogen dioxide, and water vapor ( 1 ). However, some combustion heating devices may be unvented (e.g., kerosene- and propane-fueled space heaters, some gas-fueled log sets,

 


 

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Non-Fire Carbon Monoxide Deaths Associated with the Use of Consumer Products 2001 Annual Estimates

Authors: U.S Consumer Product Safety Commission

 

This report provides information about the number of unintentional non-fire deaths attributed to carbon monoxide (CO) poisoning that were associated with the use of consumer products in 2001. In 2001, there were an estimated 130 unintentional non-fire CO poisoning deaths associated with consumer products under the jurisdiction of the U.S. Consumer Product Safety Commission (CPSC). From 1999-2001, there were an average yearly estimated 126 unintentional non-fire CO poisoning deaths associated wi

 


 

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Non-Fire Carbon Monoxide Deaths Associated with the Use of Consumer Products

Authors: Susan A. Vagts

 

This report provides information about the number of unintentional non-fire deaths attributed to carbon monoxide (CO) poisoning that were associated with the use of consumer products in 1999 and 2000. From 1999-2000, there were an average yearly estimated 124 unintentional non-fire CO poisoning deaths associated with consumer products under the jurisdiction of the U.S. Consumer Product Safety Commission (CPSC). This average estimate is based on an estimated 109 and 138 non-fire CO poisoning deat

 


 

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Non-Fire Carbon Monoxide Deaths Associated with the Use of Consumer 1998 Annual Estimates

Authors: Jean C. Mah

 

This report provides information about the number of unintentional non-fire deaths attributed to carbon monoxide (CO) poisoning that were associated with the use of consumer products in 1998. According to the National Center for Health Statistics (NCHS) totals, between 1994 and 1998, the total number of unintentional non-fire CO poisoning deaths, including those associated with consumer products under the jurisdiction of the U.S. Consumer Product Safety Commission (CPSC) and those associated wi

 


 

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Unintentional Non–Fire-Related Carbon Monoxide Exposures — United States, 2001–2003

Authors: Centers for Disease Control and Prevention

 

Carbon monoxide (CO) is a colorless, odorless, poisonous gas that results from incomplete combustion of fuels (e.g., natural or liquefied petroleum gas, oil, wood, coal, or other fuels). CO sources (e.g., furnaces, generators, gas heaters, and motor vehicles) are common in homes or work environments and can put persons at risk for CO exposure and poisoning. Most signs and symptoms of CO exposure are nonspecific (e.g., headache or nausea) and can be mistakenly attributed to other causes, such as

 


 

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Carbon Monoxide Poisoning Associated with Use of LPG-Powered (propone) Forklifts in Industrial Settings - Iowa, 1998

Authors: Center for Disease Control and Prevention

 

In 1998, the Iowa Department of Public Health (IDPH) and Iowa State University (ISU) Extension Department, with the assistance of local health departments, investigated a series of carbon monoxide (CO) poisonings associated with the use of liquified petroleum gas (LPG)-powered forklifts in light industry. In each episode, forklifts emitting high CO concentration levels were operated in inadequately ventilated warehouse and production facilities, which resulted in high CO accumulations. Employe

 


 

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Carbon Monoxide Poisoning from Hurricane-Associated Use of Portable Generators — Florida, 2004

Authors: Centers for Disease Control and Prevention

 

The four major hurricanes that struck Florida during August 13–September 25, 2004, produced electric power outages in several million homes (1). After the hurricanes, the Consumer Product Safety Commission (CPSC) investigated six deaths in Florida attributed to carbon monoxide (CO) poisoning (CPSC, unpublished data, 2004). The Florida Department of Health and CDC analyzed demographic and CO exposure data from these fatal poisoning cases and from nonfatal poisoning cases among 167 persons treate

 


 

165.

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Carbon Monoxide Poisoning Associated with Use of LPG-Powered (propone) Forklifts in Industrial Settings - Iowa, 1998

Authors: Center for Disease Control and Prevention

 

In 1998, the Iowa Department of Public Health (IDPH) and Iowa State University (ISU) Extension Department, with the assistance of local health departments, investigated a series of carbon monoxide (CO) poisonings associated with the use of liquified petroleum gas (LPG)-powered forklifts in light industry. In each episode, forklifts emitting high CO concentration levels were operated in inadequately ventilated warehouse and production facilities, which resulted in high CO accumulations. Employe

 


 

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Use of Carbon Monoxide Alarms to Prevent Poisonings During a Power Outage — North Carolina, December 2002

Authors: Department of Health and Human Services

 

Each year in the United States, approximately 500 persons die from unintentional carbon monoxide (CO) poisoning (1), often during electric power outages caused by severe storms (2–4). Use of residential CO alarms has been recommended to reduce the incidence of CO poisoning (5,6). In September 2000, Mecklenburg County, North Carolina (2002 population: 722,367), adopted a public health ordinance requiring a CO alarm in the majority of residences; all-electric residences without attached ga

 


 

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Pesticide storage and use patterns in Minnesota households with children

Authors: John L. Adgate, et al.

 

As part of the National Human Exposure Assessment (NHEXAS), residential pesticide storage and use patterns were evaluated in a population-based sample of Minnesota households with children ages 3-13. In-home interviews and inventories were conducted to identify pesticide products stored and used in and around 308 households. This statisfically based sample represents more than 49,000 urban and rural households in the census tracts sampled. More than 850 unique products were identified using Envi

 


 

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Chemicals in the Environment and Developmental Toxicity to Children: A Public Health: A Public Health and Policy Perspective

Authors: Lynn R. Goldman and Sudha Koduru

 

There are numerous pesticides and toxic chemicals in the environment that have yet to be evaluated for potential to cause developmental neurotoxicity. Recent legislation and testing initiatives provide an impetus to generating more information about potential hazards to children. In the United States, the 1996 Food Quality Protection Act (FQPA) required the U.S. Environmental Protection Agency (U.S. EPA) to make a finding that a pesticide food use is safe for children. In addition, the law requ

 


 

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Healthy Homes Brochure

Authors: U.S. Department of Housing and Urban Development

 

The U.S. Department of Housing and Urban Development's (HUD) Healthy Homes Program helps make our home safer. The Program provides homeowners and rental property owners with practical information about how to prevent health and safety hazards.

 


 

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Home Safety Factsheet

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

 

Did you know...? Home accidents kill one person every 16 minutes and injure one person every four seconds in the U.S.? More than 1.2 million poisonings among children under age 5 were reported to U.S. poison control centers in 2002? Nearly 40,000 children under age 14 are injured by fires each year? Home Safety includes preventing unintentional injuries. Unintentional injuries in the home include poisoning, fires and burns, choking, drowning, suffocation, strangulation, firearms, and falls

 


 

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Carbon Monoxide Poisoning Factsheet

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

 

Did you know...? Over 500 people in the United States die from accidental carbon monoxide (CO) poisoning each year? Over 10,000 people seek medical attention for CO poisoning each year? Infants, people with lung or heart disease, or people with anemia are more seriously affected? What is it? Carbon monoxide is a gas that cannot be seen, smelled or tasted, and can be fatal when breathed. The symptoms that occur with carbon monoxide poisoning are similar to those of the flu and allergies.

 


 

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Developing a Healthy Homes Training Center and Network

Authors: Rebecca L. Morley

 

There is a growing awareness among health and housing experts that a coordinated, comprehensive, systematic, and holistic approach to residential health and safety hazards is more cost effective and prevention effective than a categorical approach. The National Healthy Homes Training Center and Network cross-trains environmental, health, and housing professionals in the discipline of “healthy housing.” The training initiative takes into account the scientific evidence connecting housing and heal