Healthy Homes Leader Awards Nomination
Organization: Environmental Health Watch
Nominated for: Healthy Homes Pioneer Award
Nominated by: Dorr Dearborn, MD, PhD and Jim LaRue
Since 1980, Environmental Health Watch (EHW) has helped the Northeast Ohio public and policy-makers address critical health concerns related to our urban and industrial environments. EHW helps devise, assess, demonstrate and promote programs to prevent and reduce exposures to harmful substances indoors and outdoors that cause or aggravate serious health conditions.
EHW’s mission is to offer information, assistance and advocacy to help people protect themselves from serious environmental threats and to influence corporate, government and personal actions to promote human health and sustain the natural environment, avoiding both imprudent complacency and unnecessary alarm. Our programs encompass two broad and interrelated areas: Healthy and Green Housing and Community Environmental Health, with an overarching focus on greenhouse gas reduction and environmental justice.
The Healthy and Green Housing program aims to:
- Make homes healthier by reducing health hazards and improving indoor air quality, with a focus on children and the elderly living in substandard housing;
- Increase the affordability of housing by lowering utility costs and improving durability; and
- Reduce adverse environmental impacts, principally greenhouse gases and local-impact air pollution.
Much of this work is through EHW’s Affordable Green Housing Center, established in 2006. The Center, an Enterprise Green Communities technical assistance provider, is working with the City of Cleveland to implement its green building standards.
To advance the healthy house effort, EHW has worked with local and national health, housing and environmental organizations, including locally the Cleveland and Cuyahoga County Health Departments and Community Development Departments, Swetland Center for Environmental Health-Case School of Medicine, Cleveland Housing Network, Community Housing Solutions, Cleveland Tenants Organization, Cleveland Museum of Natural History, American Lung Association, Neighborhood Leadership Institute, and numerous community organizations. EHW has been a founding member and leader of the area Asthma/COPD Coalition, Lead Poisoning Advisory Council, Clean Air Campaign, the Healthy Homes Advisory Council, and many ad hoc campaigns.
EHW’s diverse, trained and experienced program staff of nine includes: licensed lead risk assessors and contractors, certified asthma educators, licensed pest control technicians, LEED professional, BPI building analysts, and certified healthy house practioners. Offices are in Cleveland’s first LEED-certified historic renovation office building.
Nominee’s Achievements and Distinguishing Attributes
Since 1985, through conferences, publications, demonstration projects, and technical studies, EHW pioneered the articulation of the HH concept and strategy. EHW has been instrumental in the implementation and evaluation of the HH strategy, along with advocacy for public and corporate action to improve housing health. Funded by HUD, EPA, CDC and local foundations, EHW has been a local and national leader and innovator in HH demonstration projects and technical studies, and in bringing together health and housing organizations to promote healthy, green affordable housing.
EHW has made key contributions to broadening the evolving concept of healthy housing and to educating physicians-in-training:
- Working with the Swetland Center for Environmental Health-Case School of Medicine, expanding the focus of HH interventions to include the elderly and recognizing that interventions to reduce residential asthma triggers can also be used to address COPD triggers.
- Also with the Swetland Center, providing education on housing health hazards for medical student, medical residents, and MPH students. This is done through classroom instruction and participation in visits to patients’ homes.
- Since 1990, EHW has included environmental concerns (and related health impact), including housing’s contribution to greenhouse gases, as part of a broad construction of the HH concept.
- A central theme of EHW’s HH work has been the division of responsibility among building owners, government and occupants and their separate roles in achieving healthy housing.
Blueprint for a Healthy House Conferences & Healthy House Catalog
- Along with the Housing Resource Center (Jim LaRue’s organization at the time), EHW held five Blueprint for a Healthy House conferences in Cleveland (1985-91). These were the first national meetings to bring together health and housing organizations. Speakers included Amory Lovins (Rocky Mountain Institute), Joe Lstiburek (Building Engineering Corp), Terry Brennan (Camroden Associates), Steve Loken (South Wall Builders), John Spears (National Association of Home Builders).
- In association with the Blueprint Conferences, in 1990, EHW and the Housing Resource Center published the Healthy House Catalog – National Directory of Indoor Pollution Resources. Topics included IAQ – Pollution comes Indoors, Health Hazards of Remodeling, Builder’s Guide to Health Housing, Get Out the Lead –But Cautiously, Radon- Insidious Intruder, Tobacco Smoke – Major Indoor Polluter, Alternatives to Hazardous Products, Disposal of Household Hazardous Waste. 
EHW Healthy House Projects (EHW Grantee)
- EHW’s Lead + Asthma Project, was conducted with Cleveland Department of Public Health, and Cleveland Housing Network (1997-99) and was funded by HUD, EPA, and Ohio weatherization funds combined lead, weatherization and asthma interventions. This was one of the first healthy house intervention projects in the county, as cited by HUD in its Healthy Homes Initiative: A Preliminary Plan (1999).  A Technical Advisory Committee, included Nick Farr (National Center for Lead-Safe Housing), Joe Lstiburek (Building Science Corporation), Thad Godish, (Indoor Air Quality Laboratory– Ball State University), Richard Krammer (Innovative Pest Management), and Dennis Livingston(Community Resources Baltimore) met in Cleveland in 1997 to develop an integrated healthy house intervention strategy, which was captured in the attached drawing by Dennis.
- EHW’s Cockroach Allergen Reduction Project  (1999-2002, HUD Technical Study), in partnership with the Cleveland Metropolitan Housing Authority and the Greater Cleveland Asthma Coalition. This project demonstrated the effectiveness of precision-targeted IPM in reducing previously intractable cockroach infestation and of the lead dust final clean protocol in decontaminating roach allergen. The resulting Cockroach Control Guide has had thousands of downloads from the EHW website. 
- EHW’s Making Health a Consideration for Key Housing Decisions – Leveraging Opportunity Points (2009-11), is funded by CDC’s Strategic Alliance for Healthy Housing Program. Our overall goal is to institutionalize healthy house-related considerations in the wide range of housing decisions and actions throughout the house life-cycle, with the long term impact of reducing housing-related hazards and their associated disease and injury. Our concept of “healthy house” is broadly construed to encompass health, safety, security, accessibility, affordability (including utility costs), environmental impact (e.g., contribution to local and climate change-related air pollution), in a sustainable and health-promoting community. 
- EHW’s Deep Green & Healthy Houses Project (2010-13 HUD Green & Health Technical Study), in partnership with Swetland Center for Environmental Health – Case School of Medicine, Cleveland Housing Network, and Intwine Connect (local technology company), compares two home energy-efficiency retrofit strategies in 12 gut renovations of low-income houses– DOE’s Energy Star and EHW’s Deep Energy Retrofit. Utilizing innovative remote monitoring of indoor air quality and energy use, the homes are continuously monitored during 12-months of occupancy. 
- EHW is the local coordinating organization for the national Green & Healthy Housing Initiative.
Healthy House Projects in which EHW Has Been a Major Partner
- For the HUD-funded Urban Mold & Moisture Program  (1999-2003), City-County Healthy House Initiatives (2004-12), and Urban Mold & Moisture Program-Follow-up (2008-2011) EHW helped develop, refine, and evaluate moisture treatments for older, substandard housing. 
- For the HUD-funded Case Healthy Homes & Patients Program  (2006-11), EHW healthy house specialists conduct home hazard assessments along with Family Medicine and Pediatric residents at the homes of their patients, to educate the physicians about housing conditions and health.
- For the EPA-funded Tenants for Healthy Housing projects (2004-10) and the HUD-funded Community Environmental Health Resource Center (2002-04), EHW worked with the Cleveland Tenants Organization and the Alliance for Healthy Housing to educate tenants and building managers about residential health hazards and to use joint action through tenant councils to secure health-related repairs or improvements.
Lead Hazard Control Projects
- EHW and the Cleveland Department of Public Health operated the Cleveland Lead Abatement Center from 1992-94. With CDC and CDBG funding, the Center trained marginalized workers in lead hazard control and conducted lead abatement work in the homes of low-income lead-poisoned children.
- EHW conducted the evaluation of Cleveland’s Round 1 (1995), HUD-funded Lead Hazard Control Program. The evaluation was part of a large, multi-city lead work assessment project of the National Center for Lead-Safe Housing and the Department of Environmental Health-University of Cincinnati. Subsequently, EHW has participated in numerous lead hazard control grants with the Cleveland and Cuyahoga County Health Departments.
- EHW has conducted the field work for several HUD Lead Technical Studies, including follow-up assessment of the effectiveness of soil-lead remediation for the Department of Environmental Health-University of Cincinnati (2004-08)  and window repair/replacement for the National Center for Healthy Housing (2008-09).
 From the Healthy House Catalog- Introduction: If you are buying, selling, renting, building, repairing, financing, rehabbing, weatherizing, redecorating, inspecting, remodeling, or just plain living in a house, life has become a great deal more complicated over the past several years. Indoor pollution has emerged as a concern for consumers as well as housing industry and health professionals…The risks associated with exposure to hazardous materials in our homes –where we expect to be safest from harm – are increasingly apparent. Lead poisoning is one of the most serious of preventable childhood diseases, and much of it is traceable to dust and dirt contaminated by lead from painted surfaces in older houses. Radon exposure at home is now recognized as a significant risk factor for lung cancer. Perhaps 10% of the population is sensitive to formaldehyde, a ubiquitous chemical found in hundreds of building materials and consumer products. Mold, mildew, and other biological contaminants related to excessive moisture in the house contribute to respiratory illnesses. And each winter, there are tragic reports of people killed in their own homes by carbon monoxide from unvented space heaters…Linked to our concern with making houses healthy places to live, is the growing awareness of a global environmental crisis connected to our lifestyle and consumer decisions. The refrigerators and air conditioners in our houses and many of the building materials and consumer products that we use contribute to ozone depletion….The energy to heat and light our houses produces carbon dioxide, the major greenhouse gas contributing to global warming. We need substitutes for the ozone depleting materials and we need increased energy-efficiency, all of which will impact indoor environmental quality.
 Healthy Homes Initiative: A Preliminary Plan, U.S. Department of Housing and Urban Development – Office of Lead Hazard Control – Executive Summary (April 1999, first paragraph): In the FY 1999 Budget, HUD proposed a Healthy Homes Initiative that would protect children from housing conditions that are responsible for multiple diseases and injuries…This approach has been implemented successfully in at least two locales: New York State’s “Healthy Neighborhoods Program” and Cleveland’s “Lead + Asthma Program.” http://www.hud.gov/offices/lead/library/hhi/HHIFull.pdf; Building a Framework for Healthy Housing – Conference (2008) “Moving from Lead to Healthy Housing- Cuyahoga County’s Experience” See slides #3, #6-12
 Environmental Health Watch’s Collaboration with Cuyahoga Housing Authority Demonstrates the Difference Integrated Pest Management Can Make, EPA IPM Case Study, Cockroach Allergen Reduction Using Precision-Targeted IPM and the Lead Dust Cleaning Protocol
 Reduction in Asthma Morbidity in Children as a Result of Home Remediation Aimed at Moisture Sources, Environmental Health Perspectives
 Teaching Home Environmental Health to Resident Physicians, Public Health Reports
 Longevity of the effectiveness of interim soil lead hazard control measures and influencing factors, Environmental Research