Healthy Homes

Background

The place where we live has a large impact on our overall health and well-being. 

Housing conditions are directly linked to adverse health outcomes such as asthma, lead poisoning, lung cancer, and unintentional injuries. Having a 'healthy home' can prevent disease and injury for individuals and families. Despite the majority of health hazards occurring in older homes, newer homes may have hazards lurking within. With some of the oldest housing stock anywhere in the United States (U.S.), New Hampshire (NH) families are at risk for a variety of health concerns related to environmental hazards.

Children are the most vulnerable to environmental hazards in the home, with millions harmed each year. Creating healthier homes in NH and the Greater Nashua Public Health Region (GNPHR) can save money in health care costs, lost future earnings, special education costs, and juvenile justice costs. Healthier homes can also contribute to a decrease in lost school and work days associated with uncontrolled asthma and injuries.

Healthy Homes Data Overview

Check out the points below for the main takeaways from this page.

• Southeast Nashua was the most impacted part of the GNPHR in regards to Asthma ED visits in 2019 (454.9 visits per 100k). 

• Only 25.7% of children under six were tested for blood lead levels in 2018.

• While NH passed a law requiring testing at ages one and two, only 74.2% of one year olds and 56.8% of two year olds were tested for blood lead levels in 2018.

• Radon is a cancer causing radioactive gas, the second leading cause of lung cancer in the U.S. 

• Each year in the U.S., there are 39.5 million physician office visits and 29.4 emergency room visits due to unintentional injuries.

Asthma

Asthma is a chronic disease that directly affects the lungs. While adults can have asthma, it is one of the most common long-term diseases in children. Asthma causes wheezing, breathlessness, chest tightness, and coughing at night or early in the morning. People living with asthma always have the disease, but only experience asthma attacks when a trigger bothers the lungs.

It can be be difficult to determine if someone has asthma, especially in children five years of age and younger. It is important to have a health care provider check your families lungs and check for allergies to find out if you have asthma.

Asthma Triggers

Individuals living with asthma can experience an asthma attack when they are exposed to asthma triggers. Asthma triggers can be different for everyone, making it important for people living with asthma to know their triggers and learn how to avoid them. Common asthma triggers include tobacco smoke, dust mites, outdoor air pollution, pests, mold, pets, and cleaning disinfectants. Other asthma triggers can include infections linked to flu, colds, and respiratory syncytial virus (RSV), sinus infections, allergies, pollen, acid reflux, physical exercise, medicine, bad weather (such as thunderstorms or high humidity), breathing in cold or dry air, some foods or food additives, fragrances, and even strong emotions that lead to very fast breathing.

Indoor Air Quality

The quality of air within and around buildings and structures can impact the health and comfort of its occupants. Identifying and controlling common air pollutants found indoors can reduce risk of health concerns. Health effects caused by indoor air pollutants are not always immediate, as they can also be experienced years later.

Indoor environments are complex, causing occupants to have possible exposure to many contaminants in public spaces. Contaminants in the form of gases and particles can be produced from office machines, cleaning products, construction activities, carpets, perfumes, cigarette smoke, water-damaged building materials, microbial growth (fungal, mold, and bacterial), insects, and outdoor pollutants. Indoor temperatures, humidity, and ventilation levels can also affect the indoor air quality.

Carbon Monoxide

Carbon monoxide (CO) is a colorless, odorless, and toxic gas. It is produced by incomplete combustion of carbon-containing materials occurring when insufficient oxygen is used in the fuel burning process. Examples of carbon monoxide production include vehicle exhausts, fuel burning furnaces, coal burning power plants, small gasoline engines, portable gasoline-powered generators, power washers, fire places, charcoal grills, marine engines, forklifts, propane-powered heaters, gas water heaters, and kerosene heaters.

Each year, more than 400 people in the U.S. die from unintentional carbon monoxide poisoning (CDC). Exposure to carbon monoxide is a health concern as it inhibits the blood’s ability to transport oxygen to body tissues and vital organs. Common symptoms of carbon monoxide exposure include headache, nausea, rapid breathing, weakness, exhaustion, dizziness, and confusion. Although carbon monoxide exposure does not discriminate, infants, older adults, and people with chronic conditions are more prone to illness or death due to carbon monoxide poisoning.

Radon

Radon is a cancer causing radioactive gas, the second leading cause of lung cancer in the U.S. (EPA). You can’t see, smell, or taste radon, but inhaling it in your lungs is a significant health hazard. In total, radon is responsible for about 21k lung cancer deaths every year, 2.9k among non-smokers. Radon comes from the natural breakdown of uranium in soil, rock, and water and spreads into the air. It can get into any type of building, but the greatest risk of exposure is at home where people spend most of their time. 

Testing is the only to know if there is radon in your home. 30% of homes tested in New Hampshire report elevated radon concentrations. New Hampshire state law does not mandate radon testing for real estate transactions. 

The map to the right, created by NH Environmental Public Health Tracking Program (NH EPHT), depicts the probability that a home will report a test result above 4.0 pCi/L, the EPA recommended action level. In general, southeastern and eastern regions of New Hampshire have the highest probability of experiencing elevated radon levels. 

Check out the State of NH's website for more information on testing your home for radon.

Lead Poisoning

Lead is a toxic metal that occurs in environments both inside and outside the home. Lead poisoning occurs when too much lead gets into the body through the skin, breathing, eating, or drinking. The lead builds up in the body, usually over a course of months or years, becoming toxic. High levels of lead in the body can harm the brain, damage speech and hearing, and result in learning and behavior problems. Soil, paints, toys, and spices may all contain levels of lead that are unsafe for children. 

Children aged six and younger are at highest risk for lead poisoning because they can absorb lead more easily than older kids and adults, and due to ongoing brain development, lead is more harmful to them. Despite lead poisoning being preventable, nearly one million children in the U.S. have elevated blood lead levels. According to the CDC, childhood lead poisoning can cause adverse health effects such as damage to the brain and nervous system, slowed growth and development, learning and behavior problems, and hearing and speech problems resulting in lower IQ, decreased ability to pay attention, and under performance in school. 

Lead & Housing

Children in the GNPHR are at particular risk for lead poisoning, as identified in the 2017 Greater Nashua Community Health Assessment (CHA). The most common source of childhood lead poisoning is lead paint in older homes. According to the U.S. Environmental Protection Agency (EPA), housing built before 1978 may contain lead based paint and housing built before 1950 is likely to have lead based paint. 

In the GNPHR, over 50% of homes were built before lead paint was banned in 1978. The State of NH has some of the oldest housing stock in the U.S., and Nashua has an estimated 23,329 (64%) homes built prior to 1979 and 8,807 (24%) of homes built prior to 1949. As these houses age, lead paint cracks and chips, resulting in dangerous lead chips and dust, which can be poisonous to anybody, especially children. Deteriorating lead-based paint is a hazard and needs immediate attention.

Lead Poisoning Risk Factors

There are several risk factors that put children in the GNPHR at increased risk for lead poisoning. Rental housing and units built before 1978 are the greatest risk factors for lead exposure. Living under the federal poverty level and moving in the last year are also risk factors for lead poisoning.

Lead poisoning most frequently occurs when lead dust or paint chips are ingested from paint containing lead; therefore older homes in disrepair or under renovation frequently create environments where children are at risk for lead exposure.

Lead Testing

All children are at risk of lead poisoning. Blood lead level testing is an integral part the health and safety of our children. Many parents may be unaware of potential lead exposures in their homes, which is why blood lead level testing is highly recommended for children one and two years of age, as well as children aged three to six who have not been previously tested. The Greater Nashua Leading Education and Awareness on Lead (L.E.A.D.) initiative is working to increase blood lead level testing for children under six years of age in the GNPHR through educational opportunities and educational materials for health care providers, child care providers, and the general public. For more information and resources on childhood lead poisoning prevention and blood lead level testing, click the button below. 

Safety at Home

Injuries at home and during leisure can be prevented. It is a public health priority to ensure that all people have safe and healthy homes and places to play.

Unintentional Injuries

Injuries are not accidents as they are both predictable and preventable. Unintentional injuries, such as traffic-related injuries, falls, burns, poisonings, and drownings, are responsible for lost lives, decreased quality of life, and substantial healthcare costs. Each year in the U.S., there are 39.5 million physician office visits and 29.4 emergency room visits due to unintentional injuries (CDC). While unintentional injuries affect everyone, people of color and low-income populations are particularly at risk. Improving strategies necessary to prevent unintentional injuries from occurring keeps communities safe and thriving.

 In 2018 there were 1,277 injury-related deaths in New Hampshire, affecting families, schools and workplaces, and communities. These fatal injuries cost over $1 billion in lifetime medical expenses and work lost, which translates to $771 per capita in New Hampshire (DHHS).

Childhood Injuries 

Unintentional injuries contribute to over three-fourths of deaths in NH children ages 5-9. The most common cause of childhood unintentional injury in New Hampshire is drowning (ages 1-9) and traffic incidents and crashes (ages 10-19). 

Slips, Trips & Falls

Falls are the leading cause of injury deaths among adults age 65 and older. On average, more than 100 older people die each year in New Hampshire as a result of a fall.

Unintentional Poisoning

Each day, over 300 children 19 years of age and younger in the U.S. are treated due to being poisoned. Items in your home, such as cleaners and medicines, can poison children. A common cause of poisoning is unsupervised ingestions. 

For information on unintentional injuries in youth, visit our Healthy Kids page

For more information on unintentional injuries, visit the NH Injury Prevention Program

Health Equity & Healthy Homes 

A person's health can be seriously impacted by their race, ethnicity, gender, income level, education, and other socioeconomic factors. In regards to healthy homes...

• Women are more likely than men to have Asthma.

• Multi-Racial and Hispanic individuals face the highest burden of asthma in NH.

• People with less than a high school degree are more than 2 times as likely to have Asthma than college graduates.

• Lower income individuals are up to 3 times more likely to have Asthma than higher income individuals.

• Children who live in households at or below the federal poverty level and those who live in housing built before 1978 are at the greatest risk of lead exposure (CDC).

• Communities of color are at a higher risk of lead exposure due to insufficient access to safe, affordable housing or discrimination when trying to find a safe, healthy place to live (CDC).

• Women who are pregnant and children who are immigrants, refugees, or recently adopted from outside of the U.S. are at risk for higher lead exposure (Burden of higher lead exposure in African-Americans starts in utero and persists into childhood).

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