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Damp mold-hlth+policy hb-2012-jm

Damp mold-hlth+policy hb-2012-jm



Producing a Science-Based Policy Statement (California) on Indoor Dampness, Mold, and Health

Producing a Science-Based Policy Statement (California) on Indoor Dampness, Mold, and Health



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  • This slide template is for the title slide of a presentation. Consider repeating a key image from one of the slides later in the presentation. The image helps orient the audience to the key words in the title. This image also gives you the opportunity to say a few things about your work—perhaps addressing the work’s importance or providing key background information. Forcing yourself to spend more time with this slide is good because a common mistake in presentations is not to leave the title slide on long enough. Because of this mistake, many in the audience do not have the chance to comprehend the key details of the title. See pages 66, 69-71, and 177 of The Craft of Scientific Presentations ( CSP ). This template shows one layout for the slide. You might want to rearrange the placement of the body’s wording to accommodate a different sized image.
  • Mapping slide for the presentation (note that a background slide or a slide justifying the importance might precede this slide). A common mistake with mapping slides is to give the audience simply a boring and unmemorable vertical list of topics (including the names “Introduction” and “Conclusion” and “Questions”). Such a list is quickly forgotten after the slide is removed. On a mapping slide, take the opportunity to show a key image or perhaps a representative image for each major section of the presentation. In the second case, each image would be repeated on the first visual of the corresponding section and would remind the audience that they have arrived to a major section of the presentation’s middle. In regards to the names “Introduction” and “Conclusion,” every talk has those sections, and the names are ignored by audiences. So why state them? Also, for the divisions that you do have, find a logical and parallel grouping. Note that groups of two’s, three’s, and four’s are much easier to remember and are not so nearly intimidating as groups of five’s, six’s, and seven’s. See the example mapping slide in the textbook. (CSP, pages 55-56, 74-75, 86, 143, 147, and 148)
  • Blank slide for drafting mapping slide
  • Sample conclusion slide. Use the headline (no more than two lines) to state your most important conclusion. Begin the headline with In summary or In conclusion to ensure that the audience knows they have come to the presentation’s end. Support that headline with an image and with words, if necessary. This slide should be your last slide. Audiences lose patience when they believe that they have come to the end, but other slides follow. Notice that the word Questions animates in at the bottom of this slide. That strategy is much more effective than burning a slide with just the word Questions . This slide allows the audience to look at the most important slide of the presentation during the question period. See CSP, pages 65, 150, 151-152. Notice how the presenter showed the connection between words blocks on this slide—a strategy that is much more effective than a bullet list, which hides the connections between details. Reference: Manning Seltzer, “Failure Analysis of the Ice Detector in the Austria 13 Helicopter,” presentation (Hartford, CT: Sikorsky Helicopter, 30 April 2004).

Damp mold-hlth+policy hb-2012-jm Damp mold-hlth+policy hb-2012-jm Presentation Transcript

  • Producing a Science-BasedPolicy Statement (California)on Indoor Dampness,Mold, and Health Mark J. Mendell (Mark.Mendell@cdph.ca.gov) Janet M. Macher (Janet.Macher@cdph.ca.gov) Kazukiyo Kumagai Jed WaldmanIndoor Air Quality Section, EHLBCalifornia Department of Public Health (CDPH) 2012 July 1
  • This presentation will describe thebackground to a CDPH statementon dampness, mold, and health in California CA Toxic Mold Protection Act The mandate for a mold policy of 2001 What we know now “CDPH has concluded that the presence of water damage, dampness, visible mold, or mold odor in … indoor environments is unhealthy What we did We recommend against measuring indoor microorganisms ...” 2
  • 1990s: Great public concern aboutindoor molds and health, butlimited scientific knowledge “My Toxic Mold Story” 3
  • Dampness, Mold, and Health — Policies • CA Toxic Mold Protection Act, 2001 (SB 732, )  CDPH mandated to assess feasibility of setting health- protective limits for mold exposure, analogous to chemicals  If feasible, to set exposure limits with consideration of technological and economic feasibility • No funding provided • CDPH response, 2005  Not feasible to set measured “mold” limits  Insufficient scientific evidence available  No standards set • http://www.cdph.ca.gov/programs/IAQ/Documents/SB732-LegReport-Final.pdf • http://www.cdph.ca.gov/programs/IAQ/Documents/SB%20732%20Implementation%20U 4
  • D, M, H — Background What was known about dampness, mold, and health? • Long-recognized effects of mold  Allergy in susceptible persons  Respiratory sensitization, at high occupational levels  Infections, in immunocompromised individuals • Recent research and multiple reviews 2004–2011  Expand and clarify what we know  Evidence links dampness/mold to a wider range of respiratory health effects, including non-allergic ones 5
  • D, M, H — How do we know? • What is the scientific basis of what we now know about d,m,h?  Two expert panel reviews — • Institute of Medicine (IOM) 2004 ( www.nap.edu/openbook.php?isbn=0309091934 ) • World Health Organization (WHO) 2009 ( http://www.euro.who.int/__data/assets/pdf_file/0017/43325/E92645.pdf)  Mendell, Mirer, Cheung, Tong, and Douwes, Environ Health Perspect 2011* • Updated WHO review • Summarized 145 studies with two kinds of exposure metrics  Evident indoor dampness or mold (qualitative)  Measured microbiologic factors (quantitative)• Available online at EHPhttp://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.1002410? 6
  • D, M, H — How do we know?• Evident dampness or • Measured microbiologic mold (any) factors (50+ metrics)  Visible water damage  In air or dust • Total culturable fungi  Visible moisture • Specific culturable fungi  Leaks (now or past) • Mold spore counts  Visible mold • 1-3-beta glucans  Mold odor • Total culturable bacteria • Endotoxin, etc, etc = qualitative = quantitative 7
  • D, M, H — What do we know about risk? • Qualitative dampness/mold exposures and health  NO documented “causal” relationships  Documented “associations” (i.e., sufficient evidence) o Asthma development* o Respiratory infections* o Current asthma* o Dyspnea* o Asthma exacerbation o Wheeze o Cough evidence strongly o URT symptomssuggestive of * new conclusion since 2004 IOM review causation 8
  • D, M, H — What do we know about risk? • Quantitative microbial exposures ! Paradox  NO documented “causal” relationships  NO documented “associations”  “Limited/suggestive” associations — NONE with air, but several with microbial compounds in dust  Few studies available  Both increased and decreased risks! !Paradox  Recently, DNA-based assay (PCR index) of fungi in house dust predicted asthma, but this is the only strong study • Quantified microbial exposures not consistently associated with adverse health effects 9
  • D, M, H — What can we do? • Expert review on housing remediation (Krieger et al., 2010)  Combination of • Elimination of moisture intrusion and leaks and • Removal of moldy items • Sufficient evidence of effectiveness for reducing respiratory symptoms from asthma and allergies, and • Ready for widespread implementation 10
  • D, M, H — What we know SUMMARY • Health effects associated with evident dampness or mold (qualitative)  Asthma development, exacerbation, and current asthma  Respiratory infections  Upper and lower respiratory symptoms 11
  • D, M, H — What we know SUMMARY • Specific causal agent(s) have not been identified  The inconsistent associations with measured microbial factors are not yet understood • Best current public health strategy  Prevention / remediation of evident dampness or mold  Not decisions based on microbiologic measurements To provide guidance, CDPH released a “Statement on Dampness, Mold, and Health” See full 2-page statement at: www.cal-iaq.org http:// www.cal-iaq.org/phocadownload/statement_on_building_dampness_mold_and%20health2011.pdf 12
  • CDPH Statement on Building Dampness,Mold, and Health (September 2011) • The presence of water damage, dampness, visible mold, or mold odor in schools, workplaces, residences, and other indoor environments is unhealthy • We recommend against  Measuring indoor microorganisms  Using the presence of specific microorganisms to determine the level of health hazard or the need for urgent remediation 13
  • CDPH Statement on Building Dampness,Mold, and Health (September 2011) • We strongly recommend addressing water damage, dampness, visible mold, and mold odor  Identify and correct the source of water that may allow microbial growth or contribute to other problems  Rapidly dry or remove damp materials  Clean or remove mold and moldy materials, as rapidly and safely as possible, to protect the health and well-being of building occupants, especially children 14
  • In summary, CDPH has made a science-basedrecommendation to the publicabout dampness and moldAssess dampness and mold these ways: Not this way: Questions? 15