Overview

The Master Home Environmentalist© (MHE©) Program supported by ALAW is an innovative approach to addressing issues of indoor pollution that can damage health and the environment. It is efficient to assess exposure to pesticides, allergens, molds, tobacco smoke, lead, and home chemicals in one visit rather than through separate programs and an integrated in-home intervention may help to reduce total exposure to many pollutants. The overall mission is to promote health by reducing pollutants in the home through volunteer-based education and action.

The MHE program trains volunteers to visit homes at no cost and to assist residents in assessing and managing environmental health problems. The MHE volunteer utilizes a survey form called the Home Environmental Assessment List© (HEAL©) to identify potential problems and develop, in conjunction with the resident, an action plan to reduce exposure to pollutants. The personalized action plan can lead to steps such as use of efficient vacuums and quality door mats, shoe removal at the door, ventilation, integrated pest management, and allergen control. Most of these measures are low cost. Some measures to improve ventilation and control moisture may require some time and money to implement.

Indoor pollution has been identified by the United States Environmental Protection Agency Science Advisory Board (EPA, 1987, 1990) and the Centers for Disease Control (CDC, 1991) as a high environmental risk. And according to the EPA, currently we spend about 90% of our time indoors and our indoor air can be up to five times as polluted as our outdoor air. The problems with exposure to pollutants in the home often are not addressed due to lack of awareness of their prevalence and significance. Home pollutant exposure may result in asthma, retarded growth, learning disabilities, allergies, cancer, lung disease, symptoms of sick building syndrome, and other illnesses.. Important new information about the alarming rise in childhood asthma cases and hospitalizations has added new urgency to addressing indoor pollution.

The Master Home Environmentalist program is designed to assist people in identifying health and environmental concerns at home and to make recommendations that help them to reduce their exposure to indoor pollutants.

Background

The MHE Program was established in early 1992 under part of the Home Toxics Task Force that was formed by a large group of non-governmental organizations in Seattle including the [Washington Toxics Coalition, The Sierra Club, and the Audobon Society among others. The first volunteer training program was established a year later and expansion of the program followed. The American Lung Associations of Oregon, Central California, Rhode Island, South Dakota and numerous more states and health departments began their own MHE Programs.

The MHE Program has won numerous awards including being desginated by the American Lung Associationin 2001 as a "Best Practices Program". Additionally, it received the EPA's 2005 Children's Environmental Health Excellence Award, and the Seattle City Council in 2005 proclaimed May 3 to be MHE day.

Goals

1. To increase awareness of environmental and health risks from pollutants in and around the home.

2. To train volunteers in the knowledge required to conduct Home Environmental Assessment Lists (HEALs) that will lead to a reduction in exposures to pollutants in and around their own home and the homes of other people.

3. To organize and conduct educational outreach activities.

4. To evaluate the effectiveness of the program in reducing home exposures and changing environmental health behaviors.

Key Concepts

Below are a few key concepts the MHE Program addresses:

Risk

Risk is associated with the nature of a substance, its concentration, and the exposure that people have to it. A highly toxic substance can cause harm at lower levels of concentration and less exposure. Chemical sensitivity is a variable that can cause people to have problems at significantly lower levels of concentration or exposure.

Indoor Pollutants

A key pathway for exposure to hazardous substances is house dust. House dust contains lead, pesticides, dust mites, and other potentially toxic substances. It can be controlled by reducing track-in and by effective and regular cleaning.

Cleaners, paints, pesticides, and other hazardous household substances need to be chosen and managed with care. Choose non-toxic or less toxic alternatives, securely store hazardous products, and dispose of them properly, usually at hazardous waste collection sites.

Indoor air carries dust and potentially tobacco and wood smoke and fumes from combustion appliances and building materials. Radon and outdoor pollutants can also present health risks. If an assessment of indoor air quality indicates a problem, then sources of pollutants should be controlled and proper ventilation provided.

Biological concerns include living organisms or their waste products, as well as diseases and allergies. The best remedies are to keep humidity low, clean and maintain areas where molds and other organisms are likely to grow, and wash hands often.

Evaluation of Program

A University of Washington study of homes visited by Master Home Environmentalist volunteers found that the visits led to changes in people's behavior to improve the home's environmental health. Three months after the volunteers' visits, 32 out of 36 households had made at least one positive change while only four households made no change.

Households made more changes when visited by volunteers wit more experience, The more recommendations the volunteer made, and the more likely the family was to make a behavior change. All 36 thought the HEAL visit was beneficial and would recommend the visit to their friends and families.

The results of this study were published in Environmental Health Perspectives, October 1997, pp.1132-1135, titled #Behavioral Changes Following Participation in a Home Health Promotional Program in King County, Washington.

Families who request a Home Environmental Assessment are asked to participate in the evaluation study to determine behavior change and perceived benefits of the intervention. Between 1998 and December 2000, a total of 58 families completed both the Intake and Follow-up surveys. The summary below is a preliminary report on data analyzed.

Asthma severity was reported on a total of 46 children (Q # 7). Of those with a rating of asthma severity, 26% (n=12) of the children had mild asthma (wheezing, cough, one to two attacks a year); 43% (n=20) had moderate asthma (seasonal with weather changes and colds, 3-4 attacks per year); and 30% (n=14) had severe asthma (requires hospitalizations, school absences, activity limited, more than four attacks per year). Fourteen children had been hospitalized or had gone to the emergency room in the past year for asthma. Twenty children took medications on a daily basis for their asthma.

95% (n=55) of families found the home environmental assessment visits useful in helping them understand sources of asthma and allergy triggers.

Regarding behavior change, 94% (n=54) of families made at least one of the changes recommended by the volunteers. Most important, 87% (26 of the 30 families who responded to the question) reported that the home environmental visit made improvements in their child's asthma or allergies.

The results of this study were presented at the ATS Conference 2003 and Chest Conference 2003.

Additional Resources on MHE

• MHE Program Guide
  
  

References

Leung, Rainbow, Jane Q. Koenig, Nancy Simox, Gerald van Belle, Richard Fenske, Steven G. Gilbert. "Behavioral Changes Following Participation in a Home Health Promotional Program in King County, Washington", Environmental Health Perspectives 10, (Oct, 1997), pp. 1132-1135.