738: Kevin Kennedy, MPH, CIEC – The Healthy Homes Initiative: Where has it been? Where is it going?

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Show Resources:

• Show Page
• Blog
• YouTube Video
• Podcast

Show Discussion:
12:05:46 From Don Weekes : Dr. Portnoy - 12-11-2020
12:09:45 From J David Miller : When I was invited to speak at AAAAI in 2000, 99% of allergist were sure that dampness & mold was a nothingburger.
12:11:18 From Danny Gough : Someone coined the phrase describing the chronic illness issues in our society as “we dont spend enough time on the other side of the window”.
12:13:49 From Paula Schenck : And post covid with all the well meaning but not effective disinfecting protocols in schools have added to exposures and respiratory issues for both staff and students!!!
12:19:38 From Danny Gough : I learned the seven (7) principles of healthy homes when Kevin had more hair. But he slipped in an eighth one, “Keep it Comfortable”. According to consumer research by Decision Analyst (American Home Comfort Study) and others, more than half of 66 million homeowners in the U.S. report some dissatisfaction with their home’s comfort level.
12:29:42 From J David Miller : House dust mites did not exist in houses in the US and Canada before the late 1960s. It was too cold and too dry.
12:38:02 From Don Weekes : Kevin and Joe: Can you make these slides available for the viewers?
12:38:03 From ralphsmacbook : Industrial hygienists routinely measure formaldehyde and acrolein, though usually in industrial settings.
12:39:38 From Danny Gough : @J David Miller - Interesting. As you know, the AIHA green book says in the Preface that the indoor temp in homes was much colder in years past. It mentions as low at 15-17C.
12:40:11 From ralphsmacbook : Is there a definition of acceptable Indoor Air Quality that identifies acceptable maximum concentrations of air contaminants?
12:40:15 From J David Miller : I have measured acrolein on a large scale. It is a cooking oil pyrolysis product. Bad ventilation over the stove.
12:40:19 From J David Miller : https://www.canada.ca/content/dam/hc-sc ... ein-en.pdf
12:42:21 From J David Miller : well as long as the electricity doesn't come from coal
12:43:05 From Danny Gough : J David Miller - And those ventilation range hoods do NOT work very well in substantially airtight homes without some form of make up air. That introduces lots of humidity in my neighborhood. I’ve also seen a clothes dryer take 2 cycles to properly dry the clothes because of no make up air.
12:43:31 From J David Miller : yep
12:48:57 From Tom Martin III : Based on my experiences with respiratory issues and low organ function, I can attest to the silent risks of poor indoor air quality. Air monitoring is essential and a no brainer for holding stakeholders and cut rate contractors accountable.
FYI-Taking cardiovascular medication while exposed to high levels of indoor CO2, formaldehyde, and total volatile organic compounds (TVOCs) can lead to serious side effects, especially given that the recommended thresholds from organizations like AAFA and the American Lung Association define unbalanced indoor air quality.. Unfortunately, many states do not recognize indoor air quality as a critical issue, resulting in patients suffering and expiring early directly linked to unmonitored environmental risks over time.. TM3
12:52:17 From Paula Schenck : Just be sure you are monitoring the correct items in air.... Air measurements for fungus is usually NOT helpful!!!!
12:55:51 From Paula Schenck : Great session... thank you.
12:56:02 From Host Computer : Reacted to "Great session... tha..." with
13:00:59 From Danny Gough : Time has flown....
13:03:55 From Danny Gough : No one is interested in Geology until the day after the earthquake.
13:05:11 From Paula Schenck : You are right on! There have been improvements in IH training .. the AGCIH update guidance for biological assessment is a huge step forward!
13:05:33 From Paula Schenck : OOPS ACGIH
13:06:56 From IAQ Dotty : Great Show!
13:07:37 From Danny Gough : I agree Dotty!

[CliffZ]

IAQ RADIO+

Show Number: 738 DRAFT BLOG
Kevin Kennedy, MPH, CIEC
The Healthy Homes Initiative: Where has it been? Where is it going?

Good Day and welcome to the IAQ Radio+ episode 738 blog. This week we welcomed Kevin Kennedy to talk about The Healthy Homes Initiative: Where has it been? Where is it going? Kevin Kennedy is a legend in the healthy homes movement and continues to educate people around the country on the importance of healthy housing!

Kevin Kennedy has over 30 years’ experience as an environmental health scientist, including 21 years’ working at Children’s Mercy Kansas City (CMKC), where he retired in 2023. At CMKC he led the establishment of the Environmental Health Program (EHP). The program has assessed thousands of homes and schools, providing patient families, childcares, and schools with resources to assist them in identifying and reducing indoor environmental exposures that may result in health problems for children.

Nuggets mined from today’s episode:

Let’s catch our audience up on your current activities. You retired from Children’s Mercy but are now doing consulting and teaching healthy housing classes. Kevin retired in 2023, he commented that once retired he found people came out of the woodwork looking for him. While he no longer has a formal schedule; Kevin is teaching and training folks to assess and working with Kate Hastings consulting for HUD. Kevin has learned that the work he has been doing isn’t a job and rather a career; doing whatever is needed to make work the best it can be.

How have things changed? Kevin began his career as an analytical chemist where he met and worked with Luke Gard. He then stepped into working with Dr. Jay Portnoy, MD (Children’s Mercy Hospital, Kansas City, MO). Dr Portnoy sent Kevin to attend and present at medical conferences. At that time, only 20% of allergists believed the indoor environment was related to allergy. Kevin’s evidence-based presentations hinted about mechanisms by which environmental exposure effects people. Kevin’s early presentations were sparsely attended (10 people) while his later were attended by 1,000 people. Pediatric surveys done by Children’s Mercy were shared with allergists, pediatric allergists were much more receptive the role of the indoor environment on a child’s life than to allergist who treated adults. Until recently less than half of general practitioner physicians believed that indoor combination of biological and chemical agents (“environmental soup”) played a role in human health.

The indoor generation. People under 40 who as children were drawn indoors by TV and lack full respiration. (Dr. Steven Platts-Mills, MD UVA Health, Charlottesville, VA)

The “OGs”-We’re old, we entered the field before Building Scientists Joe Lstiburek & Terry Brennan became influential. We have institutional knowledge and we’re retiring. The science is much clearer now than ever before. A huge opportunity exists to take advantage of funding made available under the Inflation Reduction Act to improve homes the indoor environment.

What are you doing these days? There are 1,000s of new college graduates who are entering the field with little to no knowledge about indoor environment, building science and building systems (airflows, pathways and moisture dynamics). Kevin is passionate about bringing new and interesting information to these students who are excited and enlightened by it. Positively influencing these young people is important as they will be the policymakers of the future. HUD has significantly increased their research grants. The EPA and Environmental Justice Law has low income-high risk funding to improve long term health effects and environmental justice.

Last time we talked we spent some time on the BPI HHE certification program. Please tell our audience how that is going and if there is anything else in the pipeline? Building Performance Institute (BPI.org) was historically more energy focused and has expanded to provide Healthy Home training. BPI’s visionary leader; Larry Zarker, CEO is retiring this fall. Kevin, whose career began in industrial hygiene where the focus is on workplace and worker safety, opined that BPI is geared to a more common workforce and thereby better positioned to provide the needed training for future Health Home Assessors than AIHA (American Industrial Hygiene Association) focused on commercial.

What do you think about the national strategy for IAQ and decarbonization? Combustion byproducts- Carbon monoxide, nitrogen dioxide, are not totally removed by ventilation and buildup in homes.
Decarbonization- immediate benefits. Less exposure should lead to fewer premature births or low birth weights, cognitive or behavioral disorders, mental health problems, risks of asthma, or respiratory problems, long term cardiovascular disease, risk of cancer. These health benefits translate into improving kids ability to learn and contribute productively to society.

I remember when you presented at our Healthy Buildings Summit here on the “mountain” a few years back on your work using mapping of large health and housing data sets to develop predictive indices of indoor environmental health impacts on children. How is that work coming along? Mapping data sets to predict future impacts community perspective lead poisoning pre 1978 homes KC. MO remediated 5K homes, some remediated by owners, many, more need remediated. Be smart about identifying risks. Can learn about the inside of the home by looking at the outside. Mapping sufficiently accurate to pinpoints individual home. As a hospital they had access to health data. Published the geocoding and health data.
Street address, connect to location on map, create heat map.
Found sufficient association to apply for grants from HUD to do more mapping. Developed a lead prediction index which combined age of dwelling + outside inspection to determine likelihood of lead contamination. Reliance upon data not kids to predict lead contamination.

You have a new report on the impact of weatherization on acute care visits for asthma that is getting a lot of attention, please tell our audience more about that. A before and study, by contractors, demonstrated up to a 40% drop in asthma visits.

Key Points from Kevin’s Slides:
“The Chasm”- Kevin who learned from others and translated that knowledge into practical protocols and coursework to help others Kevin works in the chasm between Building Research and Building Practice, his focus is improving and protecting children’s health. His goal is preventing children from being canaries. He chooses research to guide the environment not the kids.

“Big Jeremy-Little Jeremy”- There are big differences between young children and older children. Little kids- eat more, drink more, breathe faster, have higher metabolisms and are more susceptible to exposures because their natural defenses are underdeveloped. They crawl and play close to the ground, breathe from a different breathing zone, put hands in mouths.

“Young Jeremy”- accumulates risks and stressors: poverty, lead paint, roaches, squalid neighborhood, lacks access to fresh produce, mom works multiple jobs, nearest park is 5 miles away.

“Poison 2020”- 50% more calls to poison centers in 2020 due to exposures to antimicrobial products used to battle the Covid virus.

“Jeremy Comfort”- thermal comfort is important for adults, children’s comfort is more complicated involving multiple factors.

“Healthy Housing Principles”; Keep it principles: clean, dry, pest-free, contaminant free, safe, ventilated, comfortable and maintained. (BPI added comfortable)

“Thermal Comfort for Seniors”- seniors suffer mortality due to insufficient thermal comfort. The inability of senior adults to maintain body temperature or release heat result in tragic losses of life.

“40%”- of school kids and adolescents have at least 1 chronic health condition: asthma, diabetes, obesity, behavior or learning problem.

“Cell Danger Response”- have seen a 2-100 time increase in CDR. The mitochondria produce ATP (adenosine triphosphate) the primary energy currency of cells. When threatened ATP is converted to cell defense. Freeze- decision making stalled due to exposures. 30,000 chemicals have been identified in homes, and some entire classes of chemicals found in homes haven’t been counted. Kids are consuming 1 teasppoon-1 tablespoon of dust per day.

“Preliminary assessment of health impacts of indoor contaminants using daily adjusted life years (DALY) metric”- The sum of years of life lost and time lived with a disability attributable to a cause. Estimated value is $700K by EPA and HHS: particles (10 and 2.5). formaldehyde, nitrogen dioxide, radon, ozone, sulfur dioxide, acrolein. These chemicals are rarely tested for in homes.

ROUND UP
• The US DOE (Dept. of Energy) is heavily invested and provide Community Action Funding for low income weatherization funding. The initial program performed poorly and has been revised and improved to address lessons previously learned.

• Kevin is still involved in trying to get Health Insurance Companies to reduce healthcare claim costs through preemptive investment invest in fixing problems in home. Health Insurance carriers are reluctant to invest in preemptive home repairs citing a “wrong products problem”; the investment isn’t movable when occupants move. There has been some success in Healthcare Insurance Carriers willingness to invest in mobile interventions; products such as HEPA vacuums and air cleaners.
• Kevin is working with BPI to obtain new certifications for healthy home evaluators and assessors and practitioners. He is excited about the prospect of BPI and IAQA working together.
KEVIN’S FINAL THOUGHTS:
• WE are not doing a good job of training our replacements.
• WE should be working with younger people to train the trainers.
• BPI has a large testing network.
• Becoming an Indoor Air Professional, industrial hygiene is focused on work and worker exposures. Residential Indoor Air Professionals need building science /building systems knowledge and people skills; BPI and IAQA are better positioned to recruit and train them.
• Collaboration with technical high schools and community colleges. Healthy Home principle should be taught in high schools.
• A national program is needed to oversee these programs: who will oversee, who will implement, where will they get training.
• Building managers (with children occupants) and school facility managers are often resistant to recommendations made by building assessors.
• Improving a home improves the lives of all children in the home.
• Benefits of electrification (reduction of indoor carbon sources, reduction of reliance upon fossil fuels.)
• Healthy Homes Training programs, “build it and they will come.”
Z-Man signing off

Trivia-
Who was Kevin Kennedy’s former boss at Children’s Mercy Hospital?
Answer: Dr. Jay Portnoy

Answered by Don Weekes: Ottawa, Ontario, Canada