Environmental Justice and The Indoor Environment

With these words, President Clinton issued Executive Order 12898
on February 11, 1994 to establish environmental justice as a national
priority.

What is Environmental Justice?

According to the United States Environmental Protection Agency (EPA,
1994), environmental justice means that, “all people should be treated
fairly under environmental laws without discrimination based on
race, ethnicity, culture or economic status.”

Studies document that certain groups have been exposed to higher
levels of environmental pollutants than the general public. Historically,
race and socioeconomic status have correlated with unequal distribution
of environmental health risks. It is important to note, however,
that environmental justice means that “all people should have an
opportunity to live in a healthy environment. All people should
be able to breathe clean air, drink clean water, and consume uncontaminated
foods” (EPA, 1994).

What Are Some Examples of Indoor Environmental
Inequities?
Radon. Radon is the second leading cause of lung cancer in
the US, and is the leading cause of lung cancer in non-smokers.
EPA estimates that nearly one in 15 or six million homes in the
US may have indoor radon levels at or above 4 pCi/L (picocuries
per liter), the level at which EPA recommends action should be taken.
Nearly one in five schools in the US has at least one room, or more
than 73,000 schoolrooms in all, with radon levels above 4 pCi/L
(EPA, 1993 School Measurement Guidance). Radon exposure coupled
with smoking significantly increases the risks of developing lung
cancer. A 1996 study by the Conference of Radiation Control Program
Directors (CRCPD) found that people of color, with the exception
of Native Americans, and low-income groups tend to be less aware
of the effects of radon, and less likely to test for radon. People
of color and/or low-income groups are proportionately over-represented
among the ranks of smokers. Additionally, lower income groups are
more likely to allow smoking in their homes (CRCPD).

Environmental Tobacco Smoke. Environmental tobacco smoke
(ETS), or second-hand smoke, causes 3,000 lung-cancer deaths in
non-smoking Americans each year (EPA, 1995). Nearly 9 out of 10
non-smoking Americans are exposed to ETS. Exposure to ETS is higher
among children, African Americans, and males (Third National Health
and Nutrition Examination Survey). A 1996 study by the American
Lung Association (ALA) found that children exposed to ETS at home
were 70% more likely to have wheezing with colds, 60% more likely
to go to emergency rooms for wheezing, and 40% more likely to have
persistent wheezing, compared with children in homes without ETS.
Not surprisingly, the EPA estimates that each year, ETS exacerbates
the asthma condition in 200,000 to 1 million asthmatic children,
and may contribute to thousands of new childhood asthma cases.

Asthma. Asthma is the leading serious chronic illness of
children in the US. Asthma can be aggravated by exposure to pollutant
“triggers” such as ETS, molds, and allergens such as cockroaches,
animal dander, and dust mites. Asthma triggers may be more prevalent
inside homes with indoor air quality (IAQ) problems such as inadequate
ventilation, accumulation of allergens, or mold and mildew problems
resulting from cracks and leaks in building surfaces. Poor IAQ,
often found in deteriorating housing units, combined with outdoor
air pollution will further exacerbate an asthma condition. Disproportionate
numbers of people of color and of low-income live in areas of high
outdoor air pollution, and may be exposed to more environmental
asthma triggers. These exposures, along with factors such as lack
of access to preventative health care, may explain why the ALA found
that although African Americans represent one in eight of the US
population (12.5%), they account for one in five deaths due to asthma
(21.5%). In addition, Hispanic children are more likely to have
suffered from asthma at some point in their lives than children
of any other ethnic group (American Journal of Public Health, 83:4,
1993).

School Indoor Environmental Quality. Asthma is the number
one cause of school absences due to a chronic condition in the US.
It is essential that schools have a healthy indoor environment,
especially since children spend so much time in schools. Poor IAQ
can increase the potential for long and/or short term health problems,
reduce productivity for school employees and students, and accelerate
deterioration of and/or reduce efficiency of ventilation equipment.
A 1995 school facilities survey by the US Government Accounting
Office found that about half of US schools, serving 21 million students,
reported at least one unsatisfactory environmental condition, such
as air quality, poor ventilation, or heating and lighting problems.
Lack of resources and existing school facility problems can be obstacles
to improving IAQ in schools.

Carbon Monoxide. An estimated 1,000 people die each year
as a result of carbon monoxide (CO) poisoning and thousands of others
end up in hospital emergency rooms (EPA). At high concentrations,
carbon monoxide can cause coma and death within minutes. Two common
causes of fatal or near-fatal CO poisoning are misuse or malfunction
of heating devices and motor vehicle exhaust. Between 1979 and 1988,
unintentional deaths due to carbon monoxide were almost three times
higher for males than for females. Race-specific death rates were
more than 20% higher for African Americans than for whites (Journal
of the American Medical Assoc., 266:5, 1991).

Lead. Lead poisoning in children causes impaired physical
and mental development, including learning disabilities and reduced
attention spans. The main source of lead poisoning is the ingestion
of deteriorating lead-based paint in older housing. Lead dust that
is inhaled poses an additional danger, as it is almost completely
absorbed into the lungs. A blood lead level of 10 mg/dL (micrograms
of lead per deciliter of blood) is the level above which some action
should be taken. Phase 2 of the Third National Health and Nutrition
Examination Survey (NHANES III), conducted from 1991 to 1994, found
that blood lead levels for Americans have declined dramatically,
with about one in 23 children in the US having blood lead levels
greater than the current action level. However, blood lead levels
remain higher among children in low-income families. Many inner
city buildings and low-income housing units contain deteriorating
lead-based paint. These buildings often contain lead in the drinking
water from pipes and fixtures, and lead in soils. More than one
in five African American children living in older homes have elevated
blood lead levels (NHANES III).

Recommended Actions

• Encourage parents to test for lead exposure in all children in
  the primary grades and younger.
• Encourage community members to test their homes and schools for
  radon, and contact their state radon office if high radon levels
  are found.
• Encourage parents to restrict smoking inside their homes, especially
  if their children are asthmatics.
• Reduce potential asthma triggers in your home if family members
  are asthmatics.
• Educate yourself and others about CO poisoning.
• Encourage schools to implement EPA’s IAQ Tools for Schools Action
  Kit to remediate as well as prevent potential IAQ problems.

  Consider Children
  Environmental justice means that all people should have an opportunity
  to live in a healthy environment — including children. Intergenerational
  equity means “that younger or older generations, or future generations,
  should not bear greater environmental burden” (EPA).

  EPA’s Environmental Health Threats to Children report (1996)
  recognizes that children are particularly at risk from environmental
  health hazards in three ways:

  1. Children are more susceptible to environmental threats. Their
     bodies are experiencing rapid changes in growth and development.
     Their immune systems are also developing, and they may be less
     able than healthy adults to recover rapidly from illnesses and
     stressors.
  2. Children are more exposed to environmental threats. They eat
     proportionately more food, drink more fluids, breathe more air,
     and play outside more than adults. This means that children
     may breathe in or ingest more pollutants per pound of body weight.
     For example, children absorb and retain a larger percentage
     of ingested lead than adults, which increases the toxic effects
     of the lead (Journal of Pediatric Health Care, 2:1, 1988).
  3. Children are exposed to different environmental hazards. Children
     are least able to protect themselves, and their natural curiosity
     and tendency to explore leaves them open to health risks adults
     can more easily avoid. When children crawl on the ground or
     floor, or play outside, they are more exposed to potentially
     contaminated dust and soil, lead paint, household chemicals,
     and other hazardous substances.

  Working With Communities
  As you reach out to your school or community, there are several
  things that you should do:

• Learn more about the health issues of concern. An understanding
  of the possible environmental health risks in the school or community
  is a first step to action. Contacting the local health department
  and environmental organizations in the community, and the appropriate
  informational hotlines provides a better understanding of local
  environmental health issues.
• Learn about the school or community. Familiarize yourself
  with the members of the school or community. An understanding of
  the diversity of the community will help determine how to solve
  potential problems. Getting a sense of what community members’ priorities
  are will help you assess what needs to be done and how to approach
  the school or community.
• Identify the respected leaders in the community. Work with
  the respected leaders in the community to better understand the
  history and needs of the community. Experienced leaders can share
  insight into effective community outreach.
• Identify and work with communication channels. Build a
  strong line of communication within the school or community to raise
  awareness about potential environmental health risks. Effective
  lines of communication increase participation and can ease fears
  and misconceptions.
• Make meetings accessible. Increasing community participation
  requires scheduling meetings and events at convenient times and
  in places that are perceived as safe and welcoming to all community
  members. When appropriate, make sure that bilingual services and
  publications are available.
• Involve children. Children are often the most at risk from
  environmental health hazards. It is important to include children
  in your efforts not only because their health is so important, but
  also because it can be an effective way to reach adults.
• Work with established grassroots coalitions. Identify organizations,
  leaders, and community members who are working on environmental
  health issues. Working in a coalition is an effective way to maximize
  materials, personnel, informational, and financial resources to
  address a wide range of environmental health issues.