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Americans spend approximately 90% of their time indoors, much of that at home. Unfortunately, it may not be healthy to do this. Contaminants in the air within our homes and workplaces are increasingly recognized as threats to respiratory health.

In fact, studies show that the concentrations of many pollutants indoors are far greater than those outside. What's more, infants, the elderly, persons with chronic ailments and urban residents in particular are at great risk.

This is why the American Lung Association (ALA), in cooperation with three major government and health organizations, has published Indoor Air Pollution: An Introduction for Health Professionals. The guide provides physicians, public health officials and medical schools with basic information to help them diagnose respiratory and other physical illness caused by indoor air pollution.

Working together with ALA are the U.S. Environmental Protection Agency, U.S. Consumer Product Safety Commission and American Medical Association.

"Almost everyone can experience some type of indoor air pollution," says ALA president Dr. Joseph H. Bates. "Indoor Air pollution can be a serious and underdiagnosed cause of illness that most commonly affects the lungs. Exposure to high levels of indoor air pollution can contribute to lung disease, the third leading cause of death in America today."

The "lung disease" referred to by Dr. Bates includes respiratory tract infections, asthma and lung cancer. Altogether these afflictions claim more than 300,000 lives in America every year, making them the third leading cause of death in the U.S. Over the last decade, the death rate for lung disease has risen faster than almost any other major disease.

A fact sheet about indoor air pollution produced by the ALA notes that:

*A 10-year study of a dozen U.S. cities representing approximately 3 million people indicates that levels of cancer-causing hazardous air pollutants can be higher indoors than outdoors.

*Studies of office buildings and homes in the U.S. and Canada indicate that 30-50% of all structures have damp conditions that may encourage the build-up of biological pollutants, including Legionnaire's Disease. More common biological pollutants such as molds and bacteria promote poor indoor air quality and may be a major cause of days lost from work and school.

*Nearly 1 out of 15 homes in the U.S. have radon levels above the EPA's recommended remedial action level. Radon gas can enter the home through cracks in the foundation floor and walls, drains, foundations and other openings. Indoor radon exposure is estimated to be the second leading cause of lung cancer, responsible for thousands of deaths each year.

*Second-hand tobacco smoke is a major indoor air pollutant. It contains about 4,000 chemicals, including 200 known poisons such as formaldehyde and carbon monoxide, as well as 43 carcinogens. Second-hand tobacco smoke causes an estimated 3,000 cases of lung cancer in non-smokers and 150,000 to 300,000 cases of lower respiratory tract infections in children under 18 months of age each year.

*Formaldehyde is a commonly used chemical compound, used primarily in adhesive or bonding agents for many materials found in homes and offices. Formaldehyde has been identified as a powerful irritant that may cause health problems.

*Asbestos fibers are light and small enough to remain airborne, where they can be inhaled into the lungs to cause asbestosis (scarring of the lung tissue), lung cancer and mesotheliomas, a relatively uncommon cancer of the lining of the lung or abdominal cavity. Many asbestos products are found in the home, including roofing and flooring materials, insulation, spackling compounds, cement and coating materials.

*Carbon monoxide is an odorless, colorless gas given off by combustion inside furnaces, boilers, space heaters, water heaters and other appliances. Very high levels can kill. Lower levels can impede coordination, worsen cardiovascular conditions and produce fatigue, headache, confusions, nausea and dizziness.

*Nitrogen dioxide is a colorless, odorless gas that irritates the mucous membranes in the eye, nose and throat. Exposure to high concentrations causes shortness of breath. Prolonged exposure can damage respiratory tissue and may lead to chronic bronchitis.

*Household cleaning agents, personal care products, pesticides, paints, hobby products and solvents may be sources of hundreds of potentially harmful chemicals that can cause dizziness, nausea, allergic reactions, eye/skin/respiratory tract irritation, and cancer.

Here are some of the remedial actions recommended in Indoor Air Pollution: An Introduction for Health Professionals.

Professional Heating Maintenance - "Periodic professional inspection and maintenance of installed equipment such as furnaces, water heaters and clothes dryers are recommended. Such equipment should be vented directly to the outdoors. Fireplace and wood or coal stove flues should be regularly cleaned and inspected before each heating season."

Carbon Monoxide Detectors - "Individuals exposed to combustion sources should consider installing carbon monoxide detectors that meet the requirements of Underwriters Laboratory (UL) Standard 2034. No detector is 100% reliable, and some individuals may experience health problems at levels of carbon monoxide below the detection sensitivity of these devices."

Water-borne Contaminants - "Keep equipment water reservoirs clean and potable water systems adequately chlorinated, according to manufacturer instructions. Be sure there is no standing water in air conditioners. Maintain humidifiers and dehumidifiers according to manufacturer instructions."

Air Cleaners - "Generally speaking, existing air cleaners are not appropriate single solutions to indoor air quality problems, but can be useful as an adjunct to effective source control and adequate ventilation."

Duct Cleaning - "As awareness of the importance of indoor air quality grows, more people are looking at duct cleaning as a way to solve indoor air quality problems. Individuals considering having ducts cleaned should determine that contaminated ducts are the cause of their health problems. Even when contaminants are found in ducts, the source may lie elsewhere, and cleaning ducts may not permanently solve the problem...

"Individuals who employ (duct cleaning) services should verify that the service provider takes steps to protect individuals from exposure to dislodged pollutants and chemicals used during the cleaning process. Such steps may range from using HEPA filtration on cleaning equipments, providing respirators for workers, and occupants vacating the premises during cleaning."

Individual copies of Indoor Air Pollution: An Introduction for Health Professionals are available from the EPA's Indoor Air Quality Clearinghouse at 1-800-438-4318.

For further information on how indoor air pollution impacts lung health, contact your local ALA at 1-800-LUNG-USA (1-800-586-4872).




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