NEHA October 2022 Journal of Environmental Health

October 2022 • Journal of Environmental Health 29 ponents can be particularly relevant in older housing, where repairs and renovations over time can replace select components while leaving other related surfaces behind. For example, Las Vegas LHCHHP risk assessors routinely found a door had been replaced, but that original door jambs, stops, frames, or casings were left in place. This consideration is essential for surfaces that are frequently subject to deterioration from impact and/or friction. Another important consideration is the lead-based paint hazard burden of the oldest housing units: one Las Vegas LHCHHP home built in the 1940s had >100 lead-based paint hazards. At the time of submission no other Lead Hazard Control and Healthy Homes Grant had published findings about the frequencies of healthy homes hazards by in-home location. Some of our findings are straightforward by design (e.g., hazards involving falls in bathtubs and showers were restricted to bathrooms). Other findings, however, highlighted the possibility of hazards across multiple locations in the home, such as hazards related to domestic hygiene, falls, electricity, fire, and structural issues that were found throughout the homes. Even volatile organic compounds were observed across all location categories. Observing these healthy homes hazards throughout homes underscores the importance of thorough visual assessments and occupant education about these types of hazards, particularly for the most at-risk residents. Strengths As previously mentioned, our study of the Las Vegas LHCHHP findings o‘er a better understanding of Las Vegas’s diverse and low-income resident population and the condition of the housing units in which they live. The novel presentation of results here provides more detail about types and locations of hazards; this information can inform future program activities, community education e‘orts, and even program guidance for future grantees. After initial refinement of the Las Vegas LHCHHP healthy homes visual assessment, tools and measurement equipment were used consistently throughout the course of the program, facilitating these comparisons across housing units. Our findings also highlight the importance of following HUD guidelines for identification of leadbased paint, dust, and soil hazards to prevent children of current and future residents from being exposed to lead. Another unique strength of the Las Vegas LHCHHP was its ability to not only identify these hazards but also coordinate remediation, thus improving the condition of vulnerable housing stock. The assessment and remediation of lead-based paint and other healthy homes hazards simultaneously amplifies the lasting impact of these improvements, as many hazards examined occur together and are related (e.g., a water leak contributing to lead-based paint deterioration, structural issues, and mold growth). Outreach and recruitment e‘orts by Las Vegas LHCHHP also extended community education e‘orts regarding lead-based paint and other in-home health hazards, fostering community partnerships, and building rapport with interested potential participants. As the program required significant participant time and involvement, these relationships were essential. Our study is descriptive in nature to fill an existing gap in the available literature and data about in-home hazards in Southern Nevada. Limitations There were, however, limitations of our study and of the Las Vegas LHCHHP. First, for the Healthy Homes Hazard Frequency by Room in Housing in the Las Vegas Lead Hazard Control and Healthy Homes Program (N = 39) Category Bathroom Bedroom Kitchen Exterior Other Asbestos, silica, and MMF 2 83 11 9 66 Biocides 33 9 36 8 30 Carbon monoxide 0 5 16 22 37 Collision and entrapment 17 60 17 33 32 Crowding and spacing 3 30 1 4 25 Damp and mold growth 107 51 38 60 60 Domestic hygiene 157 356 116 140 261 Electrical hazards 55 157 52 63 93 Entry by intruders 24 71 36 17 53 Excess cold 35 92 32 4 104 Excess heat 44 105 36 4 105 Explosions 1 2 1 13 19 Falls in baths 104 0 0 0 0 Falls on level surfaces 73 195 60 113 214 Fire 23 153 78 1 122 Flames and hot surfaces 12 13 2 3 10 Food safety 0 0 5 0 1 Lighting 23 65 1 6 56 Noise 5 19 9 21 17 Operability of amenities 28 88 25 11 53 Personal hygiene 9 1 19 0 1 Structural 190 386 120 334 382 Uncombusted fuel gas 0 1 5 7 13 Volatile organic compounds 78 42 42 58 51 Water supply 27 0 6 2 0 Note. Excludes lead, radon, falling on stairs, and falling between levels. MMF = manufactured mineral fibers. TABLE 4

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