Indoor Pollution: Status of Federal Research Activities (Chapter Report,
08/31/1999, GAO/RCED-99-254).
Pursuant to a congressional request, GAO provided information on the
status of federal agencies' research activities on indoor environmental
air quality.
GAO noted that: (1) the Environmental Protection Agency officials and
others have consistently identified indoor pollution as one of the most
serious environmental risks to public health; (2) pollutant exposures
encountered indoors can result in some of the most serious pollutant
exposures people receive as they go about their daily lives; (3) this is
explained by the fact that concentrations of pollutants in indoor air
can exceed those found in outdoor air by a factor of 2 to 5, by the
sheer amount of the time most people spend indoors, and by the
peculiarities of the indoor environment; (4) federal agencies reported
that they will have spent a total of almost $1.1 billion on indoor
pollution-related research from fiscal years 1987 through 1999; (5) just
over half of the agencies' actual and planned expenditures went for
research related to indoor air, while about one-quarter went for
research related to the hazard posed by lead in the indoor environment;
(6) the remaining spending was for research relating to the hazards
presented by radon and asbestos; (7) during this period, about 64
percent of the spending went for research conducted or sponsored by four
institutes of the National Institutes of Health to provide a better
understanding of the health effects associated with indoor pollution;
(8) while some of the agencies have experienced an increase in indoor
pollution-related research funding over this period, funding for such
research has declined in other agencies, including the Department of
Energy; (9) as a result of research funded by the federal government, a
few state governments, and others since the early 1970s, notable
progress has been made in understanding the problem of indoor pollution
and in devising strategies for mitigating pollutant exposures; (10)
consumer products have been reformulated, and building materials and
practices have been altered; (11) guidance documents have also been
developed for use by building managers, homeowners, and consumers to
help them better understand the causes and the sources of indoor
pollution and enable them to take steps to prevent pollution problems or
remedy them when they occur; and (12) notwithstanding the progress that
has been made in understanding and managing the problem of indoor
pollution, GAO's review of the scientific literature as well as comments
provided by agency officials and other experts clearly showed that many
gaps in knowledge and understanding of the problem remain.
--------------------------- Indexing Terms -----------------------------
REPORTNUM: RCED-99-254
TITLE: Indoor Pollution: Status of Federal Research Activities
DATE: 08/31/1999
SUBJECT: Air pollution
Pollution monitoring
Health hazards
Budget outlays
Health research programs
Public health research
Environmental policies
Federal/state relations
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Cover
================================================================ COVER
Report to the Ranking Minority Member
Committee on Government Reform
House of Representatives
August 1999
INDOOR POLLUTION - STATUS OF
FEDERAL RESEARCH ACTIVITIES
GAO/RCED-99-254
Indoor Pollution
(160448)
Abbreviations
=============================================================== ABBREV
ASHRAE - American Society of Heating, Refrigerating and
Air-Conditioning Engineers
BASE - Building Assessment Survey and Evaluation
CDC - Centers for Disease Control and Prevention
CIAQ - Committee on Indoor Air Quality
CPSC - Consumer Product Safety Commission
DDT - dichloro-diphenyl-dichloro-ethane
DHHS - Department of Health and Human Services
DOE - Department of Energy
EPA - Environmental Protection Agency
HUD - Department of Housing and Urban Development
MCS - multiple chemical sensitivities
NCI - National Cancer Institute
NHLBI - National Heart, Lung, and Blood Institute
NIAID - National Institute of Allergy and Infectious Diseases
NIEHS - National Institute of Environmental Health Sciences
NIH - National Institutes of Health
NIOSH - National Institute for Occupational Safety and Health
NIST - National Institute of Standards and Technology
OSHA - Occupational Safety and Health Administration
PAH - polycyclic aromatic hydrocarbon
PCB - polychlorinated biphenyl
TIME - Temporal Indoor Monitoring and Evaluation
VOC - volatile organic compound
Letter
=============================================================== LETTER
B-283193
August 31, 1999
The Honorable Henry A. Waxman
Ranking Minority Member
Committee on Government Reform
House of Representatives
Dear Mr. Waxman:
This report responds to your request for information on the status of
federal agencies' research activities on indoor environmental
quality.
We are providing copies of this report to other appropriate
congressional committees; the Director, Office of Management and
Budget; the Administrator, Environmental Protection Agency; the
Chairman, Consumer Product Safety Commission; and the Secretaries of
the departments of Commerce, Energy, Health and Human Services,
Housing and Urban Development, and Labor. We will also make copies
available to others upon request.
If you or your staff have any questions regarding this report, please
contact me at (202) 512-6111. Key contributors to this assignment
are listed in appendix IV.
Sincerely yours,
David G. Wood
Associate Director, Environmental
Protection Issues
EXECUTIVE SUMMARY
============================================================ Chapter 0
PURPOSE
---------------------------------------------------------- Chapter 0:1
Over the past two decades, particularly since the energy crisis of
the 1970s, there has been a growing understanding of the hazards to
human health posed by exposures to the pollutants commonly
encountered in homes, schools, offices, and other indoor
environments---places where most people spend the major portion of
their lives. Initially, scientific interest focused on indoor air
pollutants, primarily because of suspicions, later confirmed by
research, that some of the measures taken to improve the energy
efficiency of buildings could increase indoor air concentrations of
pollutants, such as carbon monoxide and other by-products of
combustion, as well as concentrations of toxic emissions from
products and materials widely used in building construction and
furnishings. While indoor air quality remains a matter of
considerable public and scientific concern, research has also shown
that the health risks posed by pollutants present in the indoor
environment extend beyond inhaling air contaminants. Many of the
products routinely used and stored indoors, such as paints, solvents,
cleaning products, and pesticides, as well as contaminants that are
frequently tracked indoors from the outside pose potential health
risks through other means, such as skin contact and ingestion.
Concerned about the pace of progress in understanding and devising
effective solutions to the problem of indoor pollution, the Ranking
Minority Member of the House Committee on Government Reform asked GAO
to (1) characterize the current scientific understanding of the
health risks of pollutants commonly found in indoor environments and
the sources of exposure to these pollutants; (2) provide information
on the federal funding of indoor pollution-related research in recent
years and the advances in the scientific understanding of indoor
pollution and the ability to control it that have resulted from this
spending; and (3) identify the significant gaps in the knowledge and
understanding of the problem and the solutions for dealing with it,
as well as the implications of these gaps for future research.
BACKGROUND
---------------------------------------------------------- Chapter 0:2
Although the Environmental Protection Agency (EPA), the Consumer
Product Safety Commission, the Department of Energy, and other
federal agencies had conducted limited research related to various
aspects of indoor pollution in the 1970s and early 1980s, the first
legislation to deal specifically with this problem was not enacted
until 1986. Title IV of the Superfund Amendments and Reauthorization
Act of 1986 called for EPA to establish a formal program of research
with respect to radon, a naturally occurring radioactive gas, and
indoor air quality.\1 It also called for EPA to disseminate the
results of its research and to establish an advisory committee
composed of federal agencies to help it carry out its research and
information dissemination activities. To meet this latter
requirement, EPA relied on an interagency consultative body, the
Committee on Indoor Air Quality, composed of agencies, such as the
Department of Housing and Urban Development and the Consumer Product
Safety Commission, whose missions were in some way related to the
healthfulness of indoor environments.\2 In 1989, as required by the
1986 legislation, EPA submitted a report to the Congress on indoor
air quality and radon. The report described the research that EPA
and others had conducted up to that time and the general
understanding of the problem. It also outlined a broad agenda of
research that EPA, in consultation with others, had concluded would
be needed to increase the scientific understanding of the problem and
the ability to devise effective solutions for it.
In October 1991, GAO reported on the progress by EPA and other
federal agencies in implementing the 1986 legislation and advancing
its objectives.\3 GAO concluded that EPA's emphasis on indoor air
pollution, as reflected by the amount of funding for research and
related activities, was not commensurate with the health risks posed
by the problema high comparative risk ranking made by the agency and
endorsed by its Science Advisory Board.\4 GAO also concluded that
better coordination was needed among federal agencies in their indoor
air-related activities, including research. GAO reported that EPA's
indoor air-related research had been, and likely would continue to
be, constrained by a lack of funding, largely due to an increase in
the agency's overall program responsibilities over the years that was
not accompanied by a corresponding increase in its budget. Also
contributing to this problem was the fact that the indoor air
program, unlike other statutorily mandated EPA programs, did not have
the kinds of legislatively mandated time frames and goals that tend
to drive the resource allocation process and set research funding
priorities. With respect to cooperation and coordination among
members of the Committee on Indoor Air Quality, GAO found that the
limited participation by agencies other than EPA and the lack of a
clear charter for the body had inhibited its effectiveness as a means
to coordinate federal indoor air pollution efforts and avoid
duplication.
In its 1991 report, GAO made several recommendations intended to (1)
ensure that the funding of indoor air pollution-related activities,
including research, would be commensurate with the high public health
risk posed by the problem and (2) enhance the effectiveness of the
Committee on Indoor Air Quality as a mechanism for planning and
coordinating research. GAO also suggested actions that the Congress
might take to enhance the effectiveness of the Committee as it
considered proposed legislation to enlarge the federal role in this
area. This review provided little evidence that EPA implemented
GAO's recommendations in that report. In addition, the proposed
Indoor Air Quality Act of 1991 was not enacted by the Congress.
--------------------
\1 P.L. No. 99-499, 100 Stat. 1613, 1758 (1986) (codified at 42
U.S.C. Sec. 7401 note (1995)).
\2 The Committee was first set up in 1979, disbanded during the
tenure of EPA Administrator Anne Gorsuch, and reinstituted in 1984 in
response to an appropriation giving EPA funds to conduct research on
indoor air issues. Current members of the Committee on Indoor Air
Quality are listed in app. II.
\3 Indoor Air Pollution: Federal Efforts Are Not Effectively
Addressing a Growing Problem (GAO/RCED-92-8, Oct. 15, 1991).
\4 A public advisory group established within the Office of the EPA
Administrator to provide independent, expert advice on scientific
matters related to EPA's mission responsibilities.
RESULTS IN BRIEF
---------------------------------------------------------- Chapter 0:3
EPA officials and others have consistently identified indoor
pollution as one of the most serious environmental risks to public
health. Pollutant exposures encountered indoors, resulting from
natural causes, such as radon gas; from commonly used consumer
products, such as cleaners, deodorizers, paints, and solvents; or
from a variety of indoor activities, such as cooking, showering, and
smoking, can result in some of the most serious pollutant exposures
people receive as they go about their daily lives. This is explained
by the fact that concentrations of pollutants in indoor air can
exceed those found in outdoor air by a factor of 2 to 5 (and
sometimes much more); by the sheer amount of time most people spend
indoors (an average of 80 to 90 percent, even more for certain
particularly vulnerable population groups, such as the very young,
the infirm elderly, and the chronically ill); and by the
peculiarities of the indoor environment, such as the presence of
materials and surfaces that can act as emitters and reservoirs of
pollutants.
Federal agencies reported that they will have spent a total of almost
$1.1 billion on indoor pollution-related research from fiscal years
1987 through 1999 (in 1999 constant dollars).\5 Just over half of the
agencies' actual and planned expenditures went for research related
to indoor air, while about one-quarter went for research related to
the hazard posed by lead in the indoor environment. The remaining
spending was for research relating to the hazards presented by radon
and asbestos. During this period, about 64 percent of the spending
went for research conducted or sponsored by four institutes of the
National Institutes of Health to provide a better understanding of
the health effects associated with indoor pollution, including
allergies, asthma, and infectious diseases. While some of the
agencies, such as the National Institute for Environmental Health
Sciences,\6 have experienced an increase in indoor pollution-related
research funding over this period, funding for such research has
declined in other agencies, including the Department of Energy.
As a result of research funded by the federal government, a few state
governments, and others since the early 1970s, notable progress has
been made in understanding the problem of indoor pollution and in
devising strategies for mitigating pollutant exposures. Consumer
products have been reformulated, and building materials and practices
have been altered. Guidance documents have also been developed for
use by building managers, homeowners, and consumers to help them
better understand the causes and the sources of indoor pollution and
enable them to take steps to prevent pollution problems or remedy
them when they occur.
Notwithstanding the progress that has been made in understanding and
managing the problem of indoor pollution, GAO's review of the
scientific literature as well as comments provided by agency
officials and other experts clearly showed that many gaps in
knowledge and understanding of the problem remain. These include
gaps and uncertainties with respect to (1) the identity and the
sources of pollutants; (2) the mechanisms by which people are exposed
to them; (3) the health effects resulting from prolonged and
intermittent exposure to low-level concentrations of chemical and
biological pollutants as well as complex pollutant mixtures; and (4)
the most cost-effective strategies for reducing pollutant sources,
exposures, and consequent health effects. The consensus of experts
GAO consulted is that significant progress in filling these gaps and
resolving these uncertainties will require a comprehensive and
coordinated research effort involving multidisciplinary research
teams composed of experts in such areas as epidemiology, exposure
assessment, medicine, chemistry, microbiology, and building systems.
--------------------
\5 Agencies' spending is expressed in constant dollars to account for
inflation and to facilitate interyear comparisons.
\6 The National Institute for Environmental Health Sciences engages
primarily in basic research designed to increase the scientific
understanding of the toxic, mutagenic, and other effects of a broad
range of chemical and other substances found in the outdoor as well
as indoor environments. Thus, its research efforts are often less
specific to the indoor environment than those of other agencies.
PRINCIPAL FINDINGS
---------------------------------------------------------- Chapter 0:4
CURRENT UNDERSTANDING OF THE
RISKS OF INDOOR POLLUTION
-------------------------------------------------------- Chapter 0:4.1
In 1987, EPA officials ranked indoor radon and other indoor air
pollution among the top 5 of 31 enumerated environmental risks. This
comparative risk ranking was based, in large part, on an
understanding of (1) the health risks posed by radon and such other
indoor air pollutants as asbestos fibers and environmental tobacco
smoke (secondhand smoke) and (2) how some of the measures taken to
conserve energy use in homes and other buildings might increase
concentrations of indoor pollutants and result in other indoor
conditions threatening to the health of the occupants. Since 1987,
research has broadened scientific understanding of the indoor
environment and provided strong additional evidence that pollutant
exposures encountered indoors can, by virtue of peculiarities of the
indoor environment and the sheer amount of time spent there,
constitute some of the most serious environmental exposures people
receive. The sources of these exposures include not just those that
commonly come to mind, such as radon gas seeping into a house through
cracks in its foundation, or by-products of combustion, such as
carbon monoxide and nitrogen oxides from cooking on gas stoves or
burning wood in fireplaces. They also include inhalation, skin
contact, and ingestion exposures to toxic substances contained in
cleaning and disinfecting products, pesticides, paints, solvents, air
fresheners, moth repellants, arts and crafts materials, and a variety
of other substances widely used and stored in homes, schools,
offices, and other buildings.
Health-threatening indoor exposures can also result from a variety of
biological contaminants that often occur indoors. Such exposures
often result from poor building maintenance and housekeeping
practices; excessive moisture resulting from the tightening of
buildings to make them more energy efficient; the inadequate venting
of humidity sources, such as bathrooms, kitchens, and laundry rooms;
or water leaks through a building's exterior shell into the interior.
Biological contaminants include allergens from such sources as dust
mites, cockroaches, and pets;\7 bacteria and other infectious disease
agents; fungi and their products, including volatile organic
compounds; and other toxins. The mixtures of toxic chemicals and
other contaminants often found in house dust that becomes embedded in
carpets, upholstery, and other indoor surfaces also present serious
hazards. These exposures, which can result from disturbing dust on
indoor surfaces, may occur by inhaling fine particles, having skin
contact with them, ingesting them, or any combination of these means.
Exposures to pollutant-laden house dust are believed to be
particularly problematic for toddlers and small children who spend a
large amount of time on or near the floors of their homes, day care
centers, and schools and often put things in their mouths.
--------------------
\7 Allergens are foreign substances, often plant and animal proteins,
such as pollens, excretions from cockroaches and dust mites, and
dander from household pets. In susceptible individuals, allergens
induce a specific type of immune response that produces allergic, or
IgE, antibodies. The production of allergic antibodies can result in
the symptoms of allergies.
FUNDING OF RESEARCH RELATED
TO INDOOR POLLUTION BY
FEDERAL AGENCIES
-------------------------------------------------------- Chapter 0:4.2
From fiscal year 1987 through fiscal year 1999, the federal agencies
covered by our review will have spent a total of almost $1.1 billion
for research designed to improve the understanding and the control of
pollution in the indoor environment.\8 The major portion of these
research expenditures, about 78 percent, has been for research
related to a wide range of indoor air quality issues as well as the
health risks posed by lead in the indoor environment. The remaining
22 percent of spending has been devoted to research related to the
hazards presented by radon and asbestos indoors. Total annual
spending for indoor pollution-related research peaked in fiscal year
1995 at about $103 million and then declined somewhat in the 3
succeeding fiscal years, averaging about $87 million per year.
However, total planned spending for fiscal year 1999 represents,
essentially, a return to the fiscal year 1995 level. The National
Institute for Environmental Health Sciences, a component of the
National Institutes of Health, accounted for about 37 percent of the
nearly $1.1 billion in total federal spending since 1987. Four
institutes within the National Institutes of Health together
accounted for about 64 percent of the total federal spending for that
13-year period. EPA, the Department of Energy, and the Department of
Housing and Urban Development were the next largest spenders, each
accounting for 7 to 13 percent of the total spending. The Consumer
Product Safety Commission, the National Institute for Occupational
Safety and Health, and the National Institute of Standards and
Technology each accounted for 2 percent or less of the total federal
spending for that period.
--------------------
\8 See app. I for a list of agencies.
PROGRESS RESULTING FROM
RESEARCH RELATED TO INDOOR
POLLUTION
-------------------------------------------------------- Chapter 0:4.3
During the past two decades, notable progress has been made through
federally funded research to understand the sources, the exposure
mechanisms, and the potential health risks of pollutants in the
indoor environment; to devise strategies for controlling pollutant
sources and mitigating exposures; and to disseminate information to
the public on actions to provide protection from the hazards of
indoor pollution. As a result of research on the sources and the
dangers of indoor exposure to radon, mitigation techniques were
developed to reduce that threat. Thousands of homes have been tested
for radon and modified, as necessary, to prevent high indoor air
concentrations of this pollutant. As a result of research
demonstrating the health risks of exposure to environmental tobacco
smoke, policies have been adopted by federal, state, and local
governments and by businesses to greatly reduce involuntary exposure
to secondhand smoke in offices, theaters, arenas, and other public
spaces and in public transportation. With public education and
changes in attitudes regarding smoking, experts believe (although
there is not yet good empirical data for confirmation) that there has
also been a reduction in involuntary exposures to secondhand smoke in
private homes, particularly exposures of children.\9
As a result of research to measure indoor exposures to pollutants and
to identify and quantify sources, many important indoor pollutants
and their major sources have been identified, and measures have been
taken to reduce human exposures through source reduction and control.
One important example is formaldehyde, an acute irritant and
suspected human carcinogen, which was found to be emitted by a number
of indoor sources. Research has led to changes in the manufacturing
practices for many indoor products and materials, including paints,
insulation, carpeting, and pressed wood products that had been
identified as major sources of this pollutant. As a result, highly
elevated indoor concentrations of formaldehyde are now less common
than in the past.
Federally funded research has also resulted in the development of
measuring and modeling tools to diagnose and solve indoor pollution
problems and design healthier buildings. For example, research has
advanced the basic understanding of the process by which outside air
infiltrates through cracks in the exterior shells of single-family
residential structures. Currently, this infiltration is the major
means of ventilation for these buildings and strongly influences
pollutant removal as well as the energy needed to heat or cool them.
Similarly, many findings from research on the relationship of indoor
air quality to heating, ventilating, and air conditioning
technologies and practices have been incorporated in
industry-developed guidelines, standards, and handbooks. Educational
and guidance materials for building operators have also been
developed and widely used.
--------------------
\9 Under a cooperative agreement with EPA, a telephone survey was
conducted in 1994 and 1996 that found that that 29 percent and 27
percent, respectively, of children age 6 and under were exposed to
environmental tobacco smoke in their homes.
ADDITIONAL RESEARCH IS
NEEDED TO FILL GAPS IN
KNOWLEDGE AND RESOLVE
UNCERTAINTIES
-------------------------------------------------------- Chapter 0:4.4
Despite the progress in understanding and managing the problem of
indoor pollution that has been achieved through research over the
past two decades, many important gaps in knowledge of the problem
remain, including significant uncertainties related to exposures and
health effects. Many of the agency officials and other experts GAO
contacted commented that the progress made to date in understanding
this problem has only enhanced the appreciation of its complexity,
the broad range of its potential impacts on human health, and the
difficulty of devising effective and affordable solutions. There are
a number of major research needs implicit in these knowledge gaps and
uncertainties that must be addressed to reduce the many remaining and
significant health risks in the indoor environment. These risks
include cancer, the indoor transmission of such diseases as colds,
influenza, and tuberculosis; such building-related illnesses as
Legionnaire's disease and hypersensitivity pneumonitis;\10 the range
of nonspecific health symptoms associated with sick building syndrome
and multiple chemical sensitivities; allergies; and the growing
problem of asthma.
Experts GAO consulted were in general agreement that further
reductions in exposures to and adverse health effects from indoor
pollutants will require continued efforts to develop a sound
scientific and quantitative understanding of the complex
relationships among building factors, indoor pollutant exposures, and
health effects. Exposure assessment, particularly to improve the
understanding of the relative contributions of indoor and outdoor
exposure to total human exposure to particular pollutants or
pollutant classes, will be needed to resolve some of the uncertainty
that currently clouds risk assessment for indoor pollutants.
Additional research on health effects will also be needed to reduce
uncertainty in risk assessment and to highlight those risks that
merit priority attention for mitigation. There was consensus among
these experts that continued progress in dealing with the indoor
pollution problem requires research that promotes a clear
understanding of cause and effect relationshipsnot just
documentation of phenomena, as has often been the case up to now.
There was also agreement that achieving this understanding will
require multidisciplinary research teams that bring together experts
in such areas as building systems, indoor pollutants and sources,
exposure assessment, epidemiology, health effects assessment, and
pollution control technologies.
--------------------
\10 A chronic respiratory distress syndrome characterized by a
delayed immune response to a substance that sensitizes the immune
system.
RECOMMENDATIONS
---------------------------------------------------------- Chapter 0:5
GAO is not making any recommendations in this report.
AGENCY COMMENTS
---------------------------------------------------------- Chapter 0:6
We provided the departments of Energy and Housing and Urban
Development, the Environmental Protection Agency, the National
Institutes of Health, the Occupational Safety and Health
Administration, the Consumer Product Safety Commission, the National
Institute for Occupational Safety and Health, and the National
Institute of Standards and Technology with a draft of this report for
review and comment. The departments of Energy and Housing and Urban
Development, the Occupational Safety and Health Administration, and
the National Institute of Standards and Technology agreed with the
contents of the report and had no comments. The Consumer Product
Safety Commission, the Environmental Protection Agency, the National
Institute for Occupational Safety and Health, and the National
Institutes of Health also agreed with the report and provided
technical and editorial comments that have been incorporated in the
report, as appropriate.
INTRODUCTION
============================================================ Chapter 1
Research related to the pollutants found in the indoor environment
and the health hazards they present is currently carried out by a
number of federal agencies. The specific research activities
conducted or sponsored by these agencies and the focus of their
research are largely determined by their organizational missions and
mandates. A major impetus for federal involvement in research on
indoor pollution was the energy crisis of the early 1970s and the
concern about the impact of some energy conservation measures on the
quality of indoor air. This concern led the Congress in 1986 to
enact legislation assigning a formal indoor air research role to the
Environmental Protection Agency (EPA) and mandating the creation of a
mechanism to facilitate coordination among federal agencies of
research and other activities related to indoor air quality.
THE FEDERAL ROLE IN RESEARCHING
INDOOR ENVIRONMENTAL PROBLEMS
AND THEIR SOLUTIONS
---------------------------------------------------------- Chapter 1:1
The involvement of federal agencies in research on the causes and the
effects of human exposures to indoor pollutants and the options to
manage the health risks posed by them has evolved over the years as
awareness and understanding of the indoor pollution problem has
grown.\1 The research of such federal agencies as EPA, the Department
of Energy (DOE), the Consumer Product Safety Commission (CPSC), and
the National Institute for Occupational Safety and Health (NIOSH)
trace their beginnings to the energy crisis of the 1970s and its
aftermath, specifically nationwide measures to make buildings more
energy efficient. As steps were taken to conserve energy use in
residential, office, and other types of buildings, through such means
as insulating, sealing to prevent the infiltration of outside air,
and lowering ventilation rates, their occupants began to experience
increased health symptoms suggestive of increased exposures to
irritating and perhaps harmful substances in the indoor air.
Research conducted by CPSC and others revealed that many of the
substances that were suspected of causing these problems and which
were found in higher concentrations in tighter, more energy-
efficient buildings were emitted by some of the very materials used
to improve energy efficiency, as well as by building materials,
interior furnishings, and products routinely used in homes, offices,
schools, and other public buildings.
During the late 1970s and early 1980s, increasing public concern
about indoor air pollution and growing scientific understanding of
the problem resulted in passage of the Radon Gas and Indoor Air
Quality Research Act of 1986,\2 which, for the first time, required
EPA to establish a formal program of research with respect to radon
and indoor air quality. This legislation also required EPA to
disseminate the results of its research, establish an advisory
committee comprised of federal agencies to help carry out its
research and information dissemination program, and report to the
Congress on indoor air-related activities. In 1989, EPA issued a
report to the Congress on indoor air quality and radon,\3
detailing the research that it and others had conducted up to that
time. This report also discussed EPA's general understanding of the
indoor pollution problem and outlined a broad agenda of research that
agency officials believed would be needed to increase understanding
of the problem and the ability to devise effective solutions to it.
Although a number of bills have been introduced in the Congress since
1986 to extend the federal role in researching and managing the
problem of indoor air pollution, to-date none has been enacted.
While there have been specific appropriations measures and
legislative directives related to the research activities of
individual agencies, the federal involvement in this issue has
remained essentially unchanged since passage of the 1986 legislation.
Agency officials and other experts who offered opinions on the
adequacy of federal funding of indoor pollution-related research were
in agreement that this funding has been quite modest in relation to
the seriousness of the problem and its effects on public health and
productivity. Within EPA, in particular, research related to the
problem of indoor pollution has not fared well in the competition for
limited resources. Explanations for this, provided by agency
officials and cited in our prior work,\4
include the following: (1) the federal role with respect to indoor
pollution remains essentially nonregulatory (i.e., one of
disseminating, to the public, information resulting from research
rather than using research findings as a basis to promulgate
regulations); (2) the federal role does not involve significant
amounts of grant moneys (apart from grant programs available for a
few hazardous indoor pollutants, such as radon and lead); and (3)
there are no specific forcing mechanisms (such as legislatively
mandated time frames or goals) for most indoor pollution-related
research like those that exist for research carried out under other
legislative authorities, such as the Clean Air Act or the Safe
Drinking Water Act. In 1991, we reported that federal indoor
pollution-related research, including EPA's research program, had
been constrained by the lack of funding. We noted that contributing
to this situation were (1) the lack of a clear definition of research
responsibilities among federal agencies, including an absence of
specific research mandates for most federal agencies involved in
research related to indoor pollution and (2) a substantial increase
in EPA's overall program responsibilities over the years, while its
budget remained essentially level. These factors have not changed in
the intervening years and continue to serve as a constraint on
federal research activities in this area.
In 1991, we also reported that the interagency Committee on Indoor
Air Quality (CIAQ), established to coordinate the indoor air-related
programs and activities of EPA and other federal agencies, had shown
only limited effectiveness in performing this role. We attributed
this to the limited participation by agencies other than EPA and to
the lack of a clear charter for the organization, one that would
define the roles and responsibilities of agencies and how they should
work together to address indoor air issues. Agency officials
familiar with CIAQ's recent operation told us that while it has
functioned fairly effectively as a mechanism for agencies to inform
one another of their respective indoor pollution-related activities
and programs, including ongoing and recently completed research, it
has not functioned well as a mechanism for developing a coordinated
national research agenda or setting priorities for federally
supported research related to the indoor environment.
--------------------
\1 The long-standing focus of research in this area has been on
indoor air pollutants and related indoor air quality issues.
However, as the scientific understanding of indoor contaminant
exposures and exposure-related risks has improved, there has been a
growing tendency to view the indoor environment more comprehensively.
It is this more expansive understanding of the indoor environment
that is the focus of this report.
\2 Title IV of the Superfund Amendments and Reauthorization Act, P.L.
No. 99-499, 100 Stat. 1613, 1758 (1986) (codified at 42 U.S.C.
Sec. 7401 note (1995)).
\3 EPA, Report to Congress on Indoor Air Quality (Aug. 1989) 3 Vols.
\4 Indoor Air Pollution: Federal Efforts Are Not Effectively
Addressing a Growing Problem (GAO/RCED-92-8, Oct. 15, 1991).
FUNDING OF INDOOR POLLUTION
RESEARCH HAS NOT MATCHED THE
WIDELY RECOGNIZED RISK POSED BY
INDOOR POLLUTION AND THE COSTS
IT IMPOSES ON INDIVIDUALS AND
SOCIETY
---------------------------------------------------------- Chapter 1:2
Many federal and state agencies, as well as other authoritative
bodies, have recognized the significant risk to human health posed by
the problem of contaminants in the indoor environment and have
consistently ranked it among the top environmental health threats.
In 1987, a comparative assessment of environmental risks conducted at
the direction of EPA's Administrator by senior agency scientists,
engineers, and managers concluded that indoor radon and other indoor
air pollution ranked among the top 5 of 31 enumerated environmental
problems in the risks they posed to human health.\5 EPA's Science
Advisory Board, which was established in the Office of the EPA
Administrator to provide independent, expert advice on scientific
matters related to EPA's responsibilities, reviewed and endorsed this
comparative risk ranking and called upon the agency to give a higher
priority to funding such high-risk environmental problems.\6 On
numerous occasions since then, the Board has reiterated its view that
indoor pollution represents a comparatively high risk to human health
and has called on the agency to devote greater funding to researching
and improving the scientific understanding of the problem.
In an August 1989 report to the Congress, EPA stated that . .
.indoor air pollution represents a major portion of the public's
exposure to air pollution and may pose serious acute and chronic
health risks. This evidence warrants an expanded effort to
characterize and mitigate this exposure.
In December 1989, EPA published the results of studies of
environmental priority setting in three regions of the country where
indoor air pollution was recognized as a serious problem. The agency
concluded in this report that the
. . .risk associated with most environmental problems does not
differ much across the [geographic] areas studied. For example,
indoor air pollution consistently causes greater health risks than
hazardous waste sites whether one is concerned with New England, the
Middle Atlantic Region, or the Pacific Northwest. Such consistent
findings should play an important role in setting national
environmental priorities.
In 1997, the Presidential and Congressional Commission on Risk
Assessment and Risk Management considered the relative risks posed by
various environmental problems and concluded that indoor pollution
can pose a substantial public health risk.\7 The Commission's report
contained a number of recommendations addressing the risks posed by
pollutants in the indoor environment, including a recommendation that
the Congress and the administration develop legislation mandating a
coordinated strategy by EPA, CPSC, the Occupational Safety and Health
Administration (OSHA), and other federal agencies to address this
issue. The Commission noted that while outdoor air pollution is
extensively regulated, problems in offices, public buildings, and
homes remain relatively unrecognized and unaddressed. The Commission
also observed that a more effective and coordinated approach to
dealing with this issue was unlikely to emerge without a mandate from
the Congress and cooperation from stakeholders.
There is also a disparity between federal funding for indoor
pollution-related research and the costs that indoor pollution
imposes on individuals and society, according to estimates of these
costs by EPA and other federal and private sector researchers. The
costs associated with indoor pollution include the costs of medical
treatment for those adversely affected by exposure to contaminants in
the indoor environment as well as reduced productivity caused by
workers' absences due to illness and by their impaired performance on
the job as a result of exposure-related symptoms, such as headaches,
eye and respiratory tract irritation, allergies, asthma, chronic
fatigue, and a reduced ability to concentrate. Researchers at DOE's
Lawrence Berkeley National Laboratory have estimated these costs, for
the United States alone, in the tens of billions of dollars.\8 These
same scientists have put the savings that might be realized as a
result of improved indoor environments, achieved through a better
understanding of the problem of indoor pollution and the development
of more effective control and risk mitigation strategies, at a
similarly high level. For example, nationwide savings and
productivity gains from reduced respiratory disease have been
estimated at between $6 billion and $19 billion annually. From
reduced allergies and asthma, a subset of respiratory diseases, such
savings and gains have been estimated at between $1 billion and $4
billion annually. From reductions in the health symptoms that are
associated with sick building syndrome, such savings and productivity
gains have been estimated at between $10 and $20 billion annually.
Finally, from direct improvements in workers' performance that are
unrelated to health (because indoor environmental factors can affect
comfort and productivity without producing discernible health
effects) estimates of productivity gains have been put at between $12
billion and $125 billion annually. According to the DOE scientists,
a comparison of the potential economic benefits of improving indoor
environments with the costs of achieving such improvements suggests
that benefits exceed costs by a very large factor.
--------------------
\5 EPA, Unfinished Business: A Comparative Assessment of
Environmental Problems (Feb. 1987).
\6 EPA Science Advisory Board, Reducing Risk: Setting Priorities and
Strategies for Environmental Protection (Sept. 1990).
\7 The Presidential and Congressional Commission on Risk Assessment
and Risk Management, Risk Assessment and Risk Management in
Regulatory Decision-Making, 2 Vols. (Jan. 29, 1997).
\8 William J. Fisk and Arthur H. Rosenfeld, Estimates of Improved
Productivity and Health From Better Indoor Environments, Indoor
Environment Program, Lawrence Berkeley National Laboratory, Office of
Energy Efficiency and Renewable Energy, DOE (May 1997). Also
published in Indoor Air, Vol. 7 (Sept. 1997) pp. 158-172.
FROM A FOCUS ON INDOOR AIR TO A
COMPREHENSIVE VIEW OF THE
INDOOR ENVIRONMENT
---------------------------------------------------------- Chapter 1:3
This report goes beyond the traditional focus on indoor air quality
and embraces the broad definition of the indoor environment adopted
in recent years by such agencies as EPA and NIOSH and by others,
including EPA's Science Advisory Board and its Integrated Human
Exposure Committee. This more encompassing and inclusive definition
considers total human exposure (i.e., all pollutant sources, media
pathways, and exposure routes) and takes account of the relative
contributions of both indoor and outdoor sources to total exposure
and risk. The definition is based on a recognition that factors
influencing human health indoors go beyond inhalation exposures to
pollutants found in indoor air, important as that particular medium
and exposure route may be.
In embracing this more inclusive concept of indoor pollution, EPA has
defined the indoor environment and its potential effects on human
health by two guiding principles. First, exposures must occur within
or be exacerbated by the building; the health impacts of concern need
to be directly related to pollutant exposures that occur in the
building or other enclosed space, such as an aircraft cabin. The
exposures may result from inhaling pollutant-containing indoor air or
may result from other exposure routes, such as skin contact or
ingestion, or a combination of them. Impacts on human health and
methods for reducing exposures and risks will vary by building type,
use, and activities. Second, risk reduction must be achieved through
better building design and construction, through development of less
polluting products for indoor use, or through mitigation of existing
exposures within the building or in its immediate vicinity. The
second principle is intended to exclude some risks that, although
they may occur indoors, originate outside the building and are best
mitigated by actions at a distance from the site of exposure. For
example, risks would be excluded if the source of the pollutants were
industrial discharge, such as drinking water contaminated by lead
tailings from a mine or air pollutants entering the environment from
industrial smokestacks.\9 Risks would be included if the pollutants
were added indoors, for example, drinking water contaminants from
lead solder in indoor plumbing or air pollutants emitted from
combustion or other sources within a building. Pesticide residues on
food resulting from the spraying of crops would be excluded, while
pesticides that are used directly indoors or that are used near the
home and are tracked indoors would be included.
The indoor environments of concern, or microenvironments as they are
often called, comprise buildings of diverse types, including homes,
office buildings, schools, day-care facilities, nursing homes,
hospitals, restaurants, hotels, and public buildings. They also
include such self-contained interior spaces as aircraft, train, and
automobile interiors, where people also spend considerable amounts of
time and could be exposed to a variety of potentially harmful
contaminants originating from interior sources. Specifically
excluded from consideration in this report are industrial work
environments, which often present unique hazards to human health and,
because of that, are governed by regulatory requirements and
standards which, for the most part, do not exist for other indoor
environments.
--------------------
\9 While many people believe that exposures to ambient air pollutants
take place only outdoors, such pollutants do not stop at a building's
exterior shell. In fact, exposures to outdoor air pollutants largely
take place indoors, with some modification by the building's
interaction with the specific pollutants.
RELATED GAO PRODUCTS
---------------------------------------------------------- Chapter 1:4
In a 1988 report dealing with the management of EPA and its mission
of protecting the environment and human health,\10 we reported that
EPA must have the best possible information on the nature of
environmental problems and the effectiveness of measures taken to
deal with them. We also noted that the agency needs to use such
information in allocating its limited resources where they will do
the most goodto those problems that pose the greatest risk and are
most amenable to remedy. We recommended, among other actions, that
EPA identify the critical research needs for implementing the
agency's recently adopted initiative of managing for measurable
environmental results and that it assess the status of methods and
activities for determining human exposures to pollutants to provide a
basis for deciding what additional research would be needed.
In a 1991 report concerned with the challenge of meeting public
expectations with limited resources,\11
we noted that despite EPA's progress in addressing environmental
needs, numerous environmental problems, including the problem of
indoor air pollution, remained. We concluded that federal budget
priorities should reflect the scientific understanding of relative
risks to the environment and public health, as well as the
feasibility and the cost-effectiveness of various approaches to
reduce them, rather than relying on often inaccurate public
perceptions of risks. We recommended that EPA work with the Congress
to identify opportunities to shift resources from problems posing
less severe risks to problems whose risks are greater and initiate
actions to educate the public about relative environmental risks.
--------------------
\10 Environmental Protection Agency: Protecting Human Health and the
Environment Through Improved Management (GAO/RCED-88-101, Aug. 16,
1988).
\11 Environmental Protection: Meeting Public Expectations With
Limited Resources (GAO/RCED-91-97, June 18, 1991). See also,
Environmental Protection Issues (GAO/OGC-93-16HR, Dec. 1992).
OBJECTIVES, SCOPE, AND
METHODOLOGY
---------------------------------------------------------- Chapter 1:5
This report responds to a request from the Ranking Minority Member,
House Committee on Government Reform, for GAO to assess the progress
made by EPA and other federal agencies in enhancing the understanding
of the public health risks posed by pollutants present in the indoor
environment and in developing solutions for controlling or mitigating
them. Specifically, we were asked to (1) characterize the current
scientific understanding of the health risks of pollutants commonly
encountered in indoor environments and the sources of exposures to
them; (2) provide information on the federal funding of indoor
pollution-related research in recent years and on the advances in
understanding of the nature of the problem and the ability to control
it that have resulted from this spending; and (3) identify
significant gaps in knowledge and understanding of the problem, the
solutions for dealing with it, and the implications of these gaps for
future research.
To address these objectives, we undertook an extensive review of the
published scientific literature on indoor environmental pollution as
well as such key related topics as exposure assessment and risk
assessment. We also reviewed EPA's public and internal documents
dealing with these subjects, including reports to the Congress,
guidance documents intended to disseminate knowledge obtained through
research activities, and a variety of internal reports and memoranda
dealing with strategic planning, staff assessment of research needs,
and proposed plans to address these needs. To identify federal
agencies for inclusion in our review, we drew on the knowledge gained
from prior work in this area and reviewed EPA's documents and
proceedings of the interagency CIAQ, the interagency advisory and
coordinating body relied upon to meet the requirements of the 1986
Superfund amendments. We also attended quarterly meetings of the
Committee.
In our review, we included those agencies with the greatest stake in
research related to indoor pollution, either as participants in or
sponsors of such research or as major users of its results. These
agencies are the Environmental Protection Agency (EPA), the
Department of Energy (DOE), the Department of Housing and Urban
Development (HUD), the Consumer Product Safety Commission (CPSC), the
National Institute for Occupational Safety and Health (NIOSH), the
National Institute of Standards and Technology (NIST), the National
Institute of Environmental Health Sciences (NIEHS), the National
Institute of Allergy and Infectious Diseases (NIAID), the National
Heart, Lung, and Blood Institute (NHLBI), the National Cancer
Institute (NCI), and the Occupational Safety and Health
Administration (OSHA).
To obtain the detailed information needed to address each of our
objectives, we interviewed key agency officials, requested and
reviewed pertinent agency documents, and submitted extensive written
questions for formal responses from agency officials. In many
instances, these questions were supplemented with follow-up questions
and interviews to obtain additional details or clarifications on
selected aspects of the agencies' activities. We requested
information on expenditures for indoor pollution-related research
from the agencies we reviewed for fiscal years 1987 through 1998 as
well as anticipated spending for fiscal year 1999. Generally, the
agencies were able to provide the requested expenditure data,
however, in a few cases, agencies told us that they could provide
only estimates of spending for the earliest years (see app. I for
details of spending by individual agencies and explanations and
qualifications on reported expenditure data). To account for
inflation and to facilitate interyear comparisons, we have expressed
all expenditure amounts in this report in 1999 constant dollars.\12
To provide the broadest possible perspective on our objectives, in
particular, the crucial questions of (1) the advances resulting from
research conducted to-date and (2) the remaining knowledge gaps and
research needed to fill them, we also sought the views of recognized
authorities working outside the specific federal agencies included in
the scope of our review. These experts were identified for us by
officials of the agencies we reviewed as individuals that the
agencies themselves frequently call upon for expert advice and were
often the authors of the peer-reviewed scientific journal articles
that we consulted. They included prominent researchers in academia,
environmental medicine, state government, and national laboratories
affiliated with DOE.\13 In addition, the pertinent views of some of
these agency-identified experts, as well as those of other
authorities in this field, were obtained from a detailed review of
the extensive hearing record compiled by OSHA in connection with its
proposed rule-making on indoor air quality.
We conducted our review from August 1998 through August 1999 in
accordance with generally accepted government auditing standards.
--------------------
\12 We used the Department of Commerce's chain-type price index for
gross domestic product to convert figures on expenditures to their
1999 constant dollar values.
\13 We sought the views of a large number of experts who were
recommended to us or who were identified by us through our review of
the peer-reviewed scientific literature. A much smaller number of
experts actually responded to our requests, however. Those
individuals whose contributions were particularly helpful in the
preparation of this report are listed in app. III.
AGENCY COMMENTS
---------------------------------------------------------- Chapter 1:6
We provided the departments of Energy and Housing and Urban
Development, the Environmental Protection Agency, the National
Institutes of Health, the Occupational Safety and Health
Administration, the Consumer Product Safety Commission, the National
Institute for Occupational Safety and Health, and the National
Institute of Standards and Technology with a draft of this report for
review and comment. The Departments of Energy and Housing and Urban
Development, the Occupational Safety and Health Administration, and
the National Institute of Standards and Technology agreed with the
contents of the report and had no comments. The Consumer Product
Safety Commission, the Environmental Protection Agency, the National
Institute for Occupational Safety and Health, and the National
Institutes of Health also agreed with the report and provided
technical and editorial comments which have been incorporated in the
report, as appropriate.
THE EMERGENCE OF INDOOR POLLUTION
AS A PUBLIC HEALTH CONCERN AND A
FOCUS OF RESEARCH
============================================================ Chapter 2
Research supported by federal agencies and others in the 1980s and
1990s expanded the scientific understanding of the problem of indoor
pollution and demonstrated that, for a broad range of hazardous
chemical and biological pollutants, indoor exposures can greatly
exceed exposures received outdoors. This research also showed that,
in addition to inhalation risks, many building materials;
furnishings; and products routinely used in homes, offices, schools,
and other buildings; as well as many commonplace activities carried
out in these buildings could pose health risks through such other
routes of exposure as skin contact and ingestion.
While indoor environmental pollution is a matter of concern for all
who spend a large portion of their time indoors, it poses special
risks for particularly susceptible groups, such as the very young,
the infirm elderly, and those with chronic health problems, such as
cardiovascular and respiratory diseases. Infants and small children
are at special risk from indoor pollutants because of their still
developing (hence more vulnerable) body systems, because of their
behaviors which bring them into closer contact with pollutants, and
because they eat more food, drink more water, and breathe more air in
proportion to their body weight than do adults.
THE GROWING UNDERSTANDING OF
HEALTH RISKS POSED BY
POLLUTANTS IN THE INDOOR
ENVIRONMENT
---------------------------------------------------------- Chapter 2:1
In 1970, when the Clean Air Act was massively overhauled to address
the problem of air pollution caused by increasing urbanization,
industrial development, and automobile use, there was relatively
little awareness of the health hazards posed by pollutants present in
indoor air and elsewhere in the indoor environment. Indeed, the
indoor setting was widely viewed as a refuge from the environmental
hazards encountered outdoors. As a consequence, the Clean Air Act
was designed to apply only to ambient air, that is the air external
to such structures as homes, schools, offices, and other public and
private buildings.
Following the energy crisis of the mid-1970s, concern about the
potential health risks of pollutants found indoors began to grow.
Nationwide measures to improve the energy efficiency of buildings
(such as added insulation, reductions in ventilation rates, and
general tightening to reduce infiltration of outside air and energy
loss) soon led to an increase in complaints by occupants of
commercial and residential buildings about the quality of indoor air
and an increase in reports of health and comfort problems. Commonly
reported health symptoms included mucous membrane irritation, in
particular, irritation of the eyes, nose, and throat; nasal
stuffiness and drainage; chest symptoms, such as coughing, wheezing,
and chest tightness; headaches; chronic fatigue; and difficulty in
concentrating. During this period, CPSC identified formaldehyde as
the source of acute irritant reactions in individuals whose homes
were insulated with a common type of foam insulation or constructed
of large amounts of particleboard or plywood that contained
formaldehyde. Concern over naturally occurring radon also began to
increase, particularly when very high levels of radon were found in
homes constructed in the Reading Prong geological formation in
Pennsylvania, New Jersey, and New York. This led to radon becoming a
major indoor air pollution program within EPA.
Complaints among office workers increased exponentially between the
mid-1970s and the mid-1980s. During this period, NIOSH received a
growing number of inquiries and requests for health investigations of
indoor workplaces, such as office buildings and schools, which had
previously been considered free of the contaminants found in
industrial workplaces. NIOSH identified inadequate ventilation and
moisture incursions as common problems in these workplaces and
published recommendations for moisture control, pollutant source
control, and scrutiny of building ventilation systems.
By the early 1980s, research had begun to demonstrate that the levels
of many pollutants in indoor air were often higher than the levels in
outside air (indoor concentrations typically were 2 to 5 times those
found outdoors and sometimes much more). This understanding, coupled
with knowledge of the high percentage of time most people spend
indoors, gave rise to concern that indoor air pollution could
constitute a greater risk to the general population than had been
previously thought. Subsequent research sponsored by federal
agencies and others has shown conclusively that indoor air can often
contain far higher levels of hazardous pollutants than outside air
and can thus pose a more serious threat to health. At the same time,
research has increasingly pointed to the need to consider not only
the hazards posed by inhaling contaminants in indoor air but other
hazardous pollutants present in the indoor environment that could
contribute to exposure through skin contact and ingestion. Such
hazardous pollutants would include complex chemical mixtures
contained in household dust, biological contaminants (including
allergens, infectious disease agents, molds, and biotoxins),
pollutant laden films and residues on indoor surfaces, chemical
by-products of disinfection contained in tap water, and a variety of
potentially harmful chemicals contained in a wide array of products
routinely used in homes, schools, offices, and other indoor
environments. Despite this increased knowledge, however, NIOSH has
reported that satisfactory environmental explanations have yet to be
found for the health complaints reported by the occupants of many
buildings.
THE CONTRIBUTORS TO HEALTH
RISKS IN THE INDOOR ENVIRONMENT
---------------------------------------------------------- Chapter 2:2
During normal daily activities, people come into contact with
environmental pollutants in the air they breathe, in the water they
drink and wash in, in the food they eat, and in the materials and
surfaces they touch. To present a health threat, however, a
pollutant must make direct contact with a person by some route or
combination of routes, such as inhalation, ingestion, or absorption
through the skin. Exposure is quantified by taking into account (1)
the routes of exposure to the pollutants; (2) the magnitude or
concentration of the pollutant (e.g., parts per million or micrograms
per cubic meter); (3) the duration of the exposure; and (4) the
frequency of exposure.
Several factors contribute to making indoor environmental pollution
the significant risk to human health that EPA and others have deemed
it to be. These include (1) the large number and the variety of
chemical and biological contaminants commonly encountered indoors,
often in concentrations exceeding those typically found outdoors; (2)
the proximity of a building's occupants to the indoor sources of
pollutants, which facilitates actual contact with the pollutants
through inhalation, ingestion, or absorption through the skin; and
(3) the very high percentage of time most people spend in their
homes, offices, schools, day care centers, and other indoor
environments. Generally accepted estimates of this time, used by EPA
and others, range from 80 to 90 percent. For certain population
groups, including the very young, the infirm elderly, and the
chronically ill (groups which are also among the most susceptible to
the harmful effects of pollutant exposures), the percentage of time
spent indoors is even greater. The large percentage of time spent
indoors means that, even at relatively low concentrations, the
contribution to total exposure by indoor pollutants from both indoor
and outdoor sources can be much greater than the contribution from
pollutants encountered outdoors.
Among the scientific developments that have made it possible to more
accurately evaluate exposures to hazardous chemical pollutants
indoors are monitoring devices and analytical techniques that have
made it much easier to assess the total exposure of the general
population to toxic substances in daily life. Monitoring
devices--small and light enough for people to wear as they perform
their daily activities--have allowed scientists to conduct studies
that show which pollutants exist nearby, for example in the wearer's
breathing zone, and in what concentrations. In addition, techniques
have been developed to collect accurate samples of pollutants in the
dust and the fine particles embedded in carpets and upholstery and
deposited on floors and other indoor surfaces. Analytical techniques
have also been developed that permit the determination of blood
levels of pollutants and pollutant by-products from analysis of
breath samples. Other innovative analytical techniques permit
identification of pollutant exposures through analysis of biological
markers (biomarkers) present in blood, urine, and tissue samples.\1
For example, the National Cancer Institute (NCI) has supported
research on the molecular epidemiology of human cancer in which lung
tumor tissues from nonsmokers are examined for genetic evidence
linking exposure to environmental tobacco smoke to mutations in a
particular tumor suppressor gene.\2 This research builds on the
growing evidence that shows that environmental carcinogens, such as
environmental tobacco smoke and radon, can leave fingerprints or
molecular signatures of genetic damage in the tumor suppressor gene
within human tumors.
As a result of total human exposure studies initiated by EPA in
1980 and subsequently expanded, the exposures to volatile organic
compounds (VOC), carbon monoxide, pesticides, and dangerous particles
of more than 3,000 people have been examined. Individually, these
studies were designed to be representative of North Americans living
in urban and suburban areas. Chemical analyses of samples taken in
the studies identified the specific chemicals to which study
participants were routinely exposed, including some 30 or so VOCs,
many of which are known to cause cancer in people or animals.\3
Among the surprising and often disquieting results of these studies
was the finding that most people are likely to have the greatest
contact with potentially toxic pollutants inside the places that they
usually consider to be unpolluted--their homes, offices, and
automobiles. Exposures stemming from sources normally targeted by
the nation's environmental laws, such as Superfund sites and factory
emissions, were found to be much smaller in comparison. This was
true even in localities with an abundance of chemical manufacturing
plants. The primary sources of these indoor chemical pollutants
appeared to be ordinary consumer products, such as air fresheners,
moth repellants, insecticides, paints, solvents, adhesives, cleaning
compounds, personal care products, and building materials and
furnishings, as well as fumes generated by such everyday activities
as bathing, laundering, cooking, and heating. Use of tobacco
products was also confirmed to be a significant contributor to indoor
pollution.
In 1985, EPA researchers consolidated information about how several
hundred people in five states were exposed to benzene, a highly toxic
chemical present in gasoline and known to cause leukemia in workers
continually exposed to high concentrations. EPA's analysis revealed
that the average concentration of benzene these people inhaled was
nearly three times higher than typical outdoor levels. The
researchers estimated that about 45 percent of the total exposure of
the U.S. population to benzene comes from smoking (or breathing
environmental tobacco smoke); 36 percent from inhaling gasoline fumes
or from using various common products, such as glues; and 16 percent
from other home sources, such as paints and gasoline stored in
basements or attached garages.\4 Only about 3 percent of the average
person's exposure to benzene was attributable to industrial
pollution. Hence, eliminating all industrial releases of benzene
would reduce health risks very little. On the other hand, even a
modest decrease in cigarette smoking and exposure to environmental
tobacco smoke would significantly reduce the likelihood of
benzene-caused disease. For example, studies carried out at the time
these findings were published showed that children of smokers died of
leukemia at two to four times the rate of children of nonsmokers.\5
Many other VOCs that are very toxic at high concentrations are
similar to benzene in that they contribute to greater
exposure-related risk indoors than outdoors. Two of these are
tetrachloroethylene (also known as perchloroethylene or perc) and
chloroform, both of which cause cancer in animals exposed to high
concentrations. Perc is used to dry-clean clothing. For most
people, the greatest exposure to perc occurs when wearing recently
dry-cleaned clothes or as a result of storing such clothing in their
homes.\6 The major sources of exposure to chloroform (a by-product of
the use of chlorine to disinfect drinking water) are drinking tap
water, showering, boiling water, and washing clothes and dishes. The
only way to minimize exposures to chloroform from these sources is to
drink contaminant-free bottled water (or tap water filtered through a
high-quality charcoal filter) and to improve ventilation in the
bathroom, kitchen, and laundry to remove and dilute chloroform-laden
vapors.
Carbon monoxide, one of a number of hazardous by-products of
incomplete combustion, seriously interferes with the ability of the
blood to carry oxygen. In addition to being capable of causing death
at high concentrations (it is the nation's leading cause of death by
poisoning),\7 it can be harmful to people with heart ailments at
levels that are not unusual indoors. While it has long been known
that carbon monoxide exposures can increase precipitously when people
are in or near operating motor vehicles, other research has shown
that indoor sources, such as poorly adjusted or improperly used
indoor combustion appliances, such as gas stoves, space heaters, and
water heaters, can also cause harmful, even fatal, levels of this
hazardous air pollutant. Moreover, even when properly adjusted and
used as intended, under certain conditions, these appliances can be
significant sources of carbon monoxide as well as other hazardous air
pollutants.\8
Several developments in U.S. housing have contributed to reducing
the performance reliability of gas furnaces and water heaters vented
to the outdoors, thus making them potential sources of carbon
monoxide: (1) energy efficiency of the devices has increased, thus
reducing the temperature of the combustion exhaust gases; (2) houses
have become tighter, increasing the depressurization caused by the
use of exhaust fans in kitchens, bathrooms, and elsewhere in houses;
and (3) more and larger exhaust fans are now included in a typical
house. All three factors can lead to flow reversal (backdrafting) in
the vents of gas-burning appliances during operation and make them
significant sources of carbon monoxide. Headaches, lethargy, nausea,
and dizziness have been noted in individuals exposed to moderately
elevated doses of carbon monoxide. Flu-like symptoms have been noted
in individuals in whose homes gas stoves and unvented gas space
heaters are used for heating during cold periods. On the whole, the
U.S. population now receives greater exposure to carbon monoxide
indoors than outside, in part, as a result of reductions in ambient
levels achieved through regulatorily mandated reductions in
automobile emissions of this toxic pollutant.
Another environmental hazard that poses a significant threat indoors
is the presence of fine particles suspended in the air. These are
particles of 2.5 microns or less in diameter that can be inhaled and
can penetrate deep into the lungs, where they can cause damage to
tissues. Studies conducted by NIEHS and others have associated
elevated concentrations of fine particles in ambient air with
premature death, although the mechanism by which these particles
contribute to disease and death is not yet clearly understood. In
one exposure study carried out in California, subjects carried
devices capable of capturing these particles as they went about their
daily activities.\9 The study found that exposures during the day
were about 60 percent greater than would be expected on the basis of
particulate levels in samples of indoor and outside air taken at the
same time. The higher than expected exposures were attributable, in
part, to the fact that as people move about they tend to stir up
personal clouds of particle-laden dust from their surroundings.
The researchers demonstrated that most of these fine particles
resulted from combustion occurring indoors, such as smoking, cooking,
and using fireplaces and wood-burning stoves.
Most pesticides, including those commonly used in and around the home
and in schools, offices, and other indoor settings, are
well-documented toxins that pose potential health hazards. In
studies conducted in the late 1980s in Florida and Massachusetts,
researchers studying indoor air contaminants found that indoor air
contained at least five (but frequently ten or more) times higher
concentrations of pesticides than the outside air they sampled.
Surprisingly, the indoor concentrations included pesticides approved
only for outdoor use. Apparently, chemicals applied to the
foundations of these houses to attack termites had found their way
indoors, either through seepage through the soil and the buildings'
exterior shells as a gas or by being tracked in on people's shoes.
Subsequent research has shown that pesticides and herbicides applied
to lawns and other outside areas can easily be tracked into houses.
Moreover, these substances persist in the indoor environment far
longer than they would outdoors and thus prolong the period of
exposure.
Pesticides and herbicides that breakdown or otherwise dissipate
within days outdoors, through the action of sunlight, bacteria, and
weather, can persist for years in indoor carpeting where they are
protected from such degradation. This has been shown by indoor
measurements of the pesticide DDT
(dichloro-diphenyl-dichloro-ethane), which was banned in the United
States in 1972 because of its toxicity and environmental effects.
Researchers examining indoor contaminants in Midwestern houses in
1992 and 1993 found that 90 of the 362 houses they examined had
traces of DDT in their carpets.
This research also demonstrated, as have other studies, that
carpeting is an effective reservoir for contaminants other than
pesticides. For example, the researchers found that concentrations
of seven toxic organic chemicals that are produced by incomplete
combustion, called polycyclic aromatic hydrocarbons (PAH), were
present in older carpets at levels above those that would trigger a
formal risk assessment for soil on residential properties near a
hazardous waste site.\10 These chemicals have been proven to cause
cancer in animals and are suspected of being capable of causing
cancer in humans.
Indoor exposures to microbiologic organisms (e.g., fungi, bacteria,
and viruses) or their products are related to a variety of health
problems, including Legionnaire's disease and asthma, and probably
also to allergies, nonspecific symptoms, and communicable respiratory
infections. Less is known about the measurement of these exposures,
however, than is known about the measurement of indoor toxic chemical
exposures.
Although the foregoing examples are merely suggestive of the types of
pollutant hazards commonly found in the indoor environment, they
illustrate why EPA, its Science Advisory Board, the Presidential and
Congressional Commission on Risk Assessment and Risk Management, and
others have assigned indoor environmental pollution a relatively high
environmental risk ranking. While people tend to view their homes,
offices, and most other indoor environments (with the exception of
industrial workplaces) as refuges from pollutants found in ambient
air and elsewhere in the outdoor environment, this view may often be
unwarranted. A wide variety of activities that people routinely
perform in their homes, schools, offices, and other indoor
environments can make their own particular, and often substantial,
contributions to overall pollutant exposures and to the health risks
that they represent. A few of the ordinary activities that can
contribute to exposures include cooking; doing crafts and hobbies;
interior painting and other building renovation activities; cleaning
and polishing metal, wood, and other indoor surfaces; furniture
refinishing, especially using solvents for stripping paints and
varnishes; using carbonless copy paper; using computers, printers,
and other electronic office equipment; using air fresheners and
bathroom deodorizers; and operating humidifiers.
The healthfulness of the indoor environment is also often adversely
affected by a failure to follow practices important in maintaining a
healthy indoor environment. These include (1) good housekeeping
practices to maintain cleanliness and discourage proliferation of
cockroaches and their allergy producing products; (2) controlling
indoor humidity and taking other measures to discourage growth of
dust mites and reduce exposures to dust mite allergens\11 ; (3)
proper operation and maintenance of heating, air-conditioning, and
ventilation systems; (4) avoiding use of gas stoves and unvented
combustion appliances to warm indoor spaces in cold weather; (5) care
in the use and storage of paints, pesticides, cleaning agents and
other toxic chemical substances; and (6) preventive maintenance aimed
at protecting the integrity of the building's external shell of roof,
windows and exterior walls and preventing the infiltration and
intrusion of moisture that could encourage the growth of molds.
Maintenance, preventive and routine, is especially important in
commercial and institutional buildings, with their high occupant
densities and large and complex ventilation systems. Investigations
by NIOSH of problem buildings show that inadequate ventilation and
dirt or moisture in ventilation systems are associated with increases
in occupant symptoms. Figure 2.1 depicts the complex, multifactor
nature of the problem of indoor pollution and illustrates the
relationships among these factors.\12
Figure 2.1: Relationship Among
Building and Human Factors,
Human Exposures, and Health
Effects
(See figure in printed
edition.)
Source: GAO's presentation of information from the Ernest Orlando
Lawrence Berkeley National Laboratory, DOE.
--------------------
\1 Measurements in breath, blood, urine, or tissue samples of
environmental pollutants or of their biological consequences after
contaminants have crossed one of the body's boundaries and entered
human tissues.
\2 This gene is known as the p35 tumor suppressor gene.
\3 NIEHS' National Toxicology Program has conducted the bulk of
federally funded testing of substances for carcinogenesis and other
toxic effects.
\4 CPSC eliminated the use of benzene in paint strippers in 1977 by
persuading industry to voluntarily reformulate these products.
\5 L. A. Wallace, Human Exposure to Environmental Pollutants: A
Decade of Experience, Clinical and Experimental Allergy, Vol. 25
(1995) pp. 4-9.
\6 In recent years, the dry cleaning industry has voluntarily made
changes to the cleaning process to reduce exposures to perc.
\7 Deaths attributable to carbon monoxide have declined in recent
years. Possible explanations for this include greater public
awareness of the hazard resulting from public information campaigns
and the development and use of safety devices, including carbon
monoxide detectors, for home use.
\8 Blocked or defective flues, cracked heat exchangers, and
improperly-sized appliances, among other conditions, can result in
dangerously high levels of carbon monoxide even when the appliances
are used as intended.
\9 EPA and the California Air Resources Board sponsored this study in
Riverside, California, in 1990. This study was the first
probability-based survey of personal exposures to inhalable
particles. The study's 178 participants, representing 139,000
nonsmoking Riverside residents, carried personal monitors for a day
to measure their exposures to particles, elements, and nicotine.
\10 Advantages of carpets include the fact that they can serve as
effective noise dampers and covers for wood and other floors in poor
condition. They also provide better traction than bare floors, which
can be slippery when wet. Additionally, while carpets take more time
to keep clean, if they are kept very clean, they may remove more
pollution from the indoor air than they add. However, carpets tend
to collect deep dust as they age, even if they receive regular
cleaning. Moreover, wetted carpets serve as an effective cultivation
medium for molds, bacteria, and dust mites.
\11 Dust mites thrive in environments with high humidity. They and
the allergens they produce also collect in carpets, upholstery,
bedding, and other soft surfaces where they are more difficult to
control than on smooth, hard surfaces, such as tile or hardwood
floors. Effective reduction of exposures of sensitive individuals to
dust mite allergens may also require such additional measures as
frequent washing of bed linens in water of at least 130 degrees
(hotter than that provided by typical domestic hot water systems) and
encasing mattresses and pillows in covers impermeable to dust mites.
\12 For simplicity in presentation, indoor allergens, such as dust
mite, cockroach, and pet allergens, are included here as indoor
pollutants. In fact, these substances are often considered
separately, since they are naturally occurring, nontoxic substances
(proteins) that constitute a health concern only for those
individuals (albeit a substantial segment of the population) who have
become allergic to them because their immune systems make an allergic
immune response. Sensitization to allergens appears to be
genetically influenced.
INDOOR POLLUTANTS CONSTITUTE A
PARTICULAR THREAT TO INFANTS
AND CHILDREN
---------------------------------------------------------- Chapter 2:3
The pesticide residues and VOCs found in the indoor environment are
estimated to cause as many as 3,000 cases of cancer a year in the
United States. This makes these indoor pollutants a significant
health threat, similar, if not equal in magnitude to, radon and
secondhand tobacco smoke.\13 Moreover, research has shown that
toddlers and young children who crawl and play on the floor and
regularly place their hands in their mouths are at even greater risk
than the rest of the population from these substances and from the
toxic mixtures of household dust found on floors and other surfaces
and embedded in carpets in their homes, schools, and day-care
centers. Their still developing neurological, immunologic,
digestive, and other bodily systems make them particularly
susceptible to harm from exposure to indoor pollutants. In addition,
toddlers and young children are potentially exposed to much higher
levels of indoor pollutants because they eat more food, drink more
fluids, and breathe more air in proportion to their body weight than
do adults and engage in risky behaviors, such as mouthing toys,
furnishings, and other nonfood objects.
Lead, a common environmental contaminant found in household dust,
pipe solder, old paint, some ceramics and glassware, and certain
other consumer products, has long been known to cause health problems
at high doses. Until relatively recently, however, there was little
appreciation for the devastating effect of low-level exposures early
in life on the fetus and developing child. In the mid- to
late-1980s, research supported by NIEHS showed that, even at levels
previously thought safe, children can suffer neurological problems
and reduced intelligence from lead exposure. Lead in house dust in
houses built before 1950 is a major source of exposure of children
under 5 years of age. Also, it has been found that the quantity of
lead on the surface of a carpet is one of the best predictors of the
amount of lead in an infant's blood.
Similarly, children's lungs are more susceptible to the harmful
effects of environmental tobacco smoke than those of adults. In
infants and young children up to 3 years of age, exposure to
secondhand smoke causes an approximate doubling in the incidence of
pneumonia, bronchitis, and bronchiolitis. There is also strong
evidence of increased middle ear infections, reduced lung function,
and reduced lung growth as a result of such exposure.\14 In addition,
it has been estimated that infants, possessing a tiny fraction of an
adult's body weight, may ingest five times more pesticide and other
pollutant containing dust per day on average than adults. Improved
sampling and measurement techniques have made it possible to estimate
the exposure of infants to a variety of indoor pollutants with much
greater confidence. For example, scientists are now able to estimate
that in 1 day the average urban infant will ingest 110 nanograms of
benzo(a)pyrene, a very toxic PAH. This amount is equivalent to what
the child would get from smoking three cigarettes in a day. While it
is not currently possible to assess the potential health risk of such
exposures,\15 research has clearly established that, for young
children, house dust is a major source of exposure to a variety of
toxic substances, including heavy metals, polychlorinated biphenyls
(PCB) and other persistent organic pollutants.\16 Again, carpets and
similar soft, porous materials may be matters of concern, because
they can serve as reservoirs for these toxic compounds, as well as
breeding grounds for bacteria and molds and collectors of allergens,
such as dust mite, cockroach, and dog and cat allergens, all of which
are closely linked to allergies and the growing problem of asthma.\17
For reasons that have not been fully explained, in recent years, the
incidence of asthma among both children and the general population
has increased dramatically, as have asthma-related deaths. These
increases have occurred at the same time that ambient air pollution
has decreased. Sensitization to house dust mites in early childhood
has been established as one of the key risk factors in the
development of asthma, and dust mites find ideal conditions for
proliferation in houses and other buildings exhibiting the high
levels of relative humidity that can result from measures designed to
make them more tight and energy efficient.\18 NIAID supported
research has shown that controlling the environment to prevent or
greatly reduce exposure to allergens is critical for symptom
improvement. In addition, biocontaminant and chemical pollutants
have been shown to interact to produce greater than expected impacts
in animals and humans. For example, studies show that indoor sources
of combustion pollutants, such as gas stoves, wood stoves, and
fireplaces, have a statistically significant association with the
exacerbation of asthma. Recent studies have also shown that
respiratory virus infections are strongly associated with asthma
attacks in children and that building factors, such as ventilation,
are associated with the risk of respiratory infections. According to
NIOSH officials, it is because of findings such as these that
children and asthma are now generally included in the topic of indoor
environmental quality, whereas before about 1990 this connection was
not generally made.
--------------------
\13 L. A. Wallace, Human Exposure to Environmental Pollutants: A
Decade of Experience Clinical and Experimental Allergy, Vol. 25
(1995) pp. 4-9; L. A. Wallace, Comparison of Risks From Outdoor
and Indoor Exposure to Toxic Chemicals" Environmental Health
Perspectives, Vol. 95 (1991) pp. 7-13.
\14 EPA, CPSC, American Lung Association, and American Medical
Association, Indoor Air Pollution: An Introduction for Health
Professionals (1994) pp. 3-5.
\15 Although it has been estimated that the ingestion of foods
accounts for most of the exposures to PAHs, exposures through skin
contact and inhalation appear to have more significant effects on
human health. The concern over inhalation exposure to airborne PAHs
centers on the potential of these compounds to cause lung cancer.
\16 Robert G. Lewis, Christopher R. Fortune, Robert D. Willis,
David E. Camann, and Jeffrey T. Antley, Distribution of Pesticides
and Polycyclic Aromatic Hydrocarbons in House Dust as a Function of
Particle Size," Environmental Health Perspectives, Vol. 107 (Sept.
1999) pp. 721-726.
\17 There are simple, low-cost ways to reduce exposures. For
example, the tracking-in of pesticides, PAHs, lead, and other
contaminants can be greatly reduced by the use of commercial grade
doormats and, especially, by removing shoes upon entering a house.
\18 DOE-supported researchers are exploring the effectiveness of
various dehumidification strategies in reducing allergen exposures.
Although this research has reported important findings, it has not
yet delivered definitive solutions.
FEDERAL AGENCIES' FUNDING OF
INDOOR POLLUTION RESEARCH AND
ADVANCES RESULTING FROM THIS
RESEARCH
============================================================ Chapter 3
From fiscal year 1987 through fiscal year 1999, federal agencies
reported that their actual and planned expenditures for indoor
pollution research totaled almost $1.1 billion in 1999 constant
dollars. During this period, about two-thirds of the spending went
for research conducted or sponsored by four institutes of the
National Institutes of Health (NIH), primarily to provide a better
understanding of the health effects associated with indoor pollution,
including allergies, asthma, and infectious diseases.
The scientific understanding of indoor environments has advanced
significantly over the past two decades. This progress results from
an international research effort in which research funded by the U.S.
government and a few state governments has played an important part.
There has been notable progress in characterizing the problem of
indoor environmental pollution, in developing measurement and
modeling tools to study the interrelated factors that contribute to
the problem, and in identifying and developing strategies to mitigate
it. The scientific knowledge resulting from this research has been
widely disseminated in a variety of documents aimed at a range of
audiences, including the general public, building designers, building
managers, public health professionals, school administrators, product
manufacturers, and service providers. The benefits of this research
include reduced exposures to and adverse health effects from some
indoor pollutants (and concomitant savings in health care costs) and
the emergence of a variety of new businesses and jobs to provide
services related to ventilation, indoor environmental quality, and
energy-efficient buildings.
OVERVIEW OF FEDERAL FUNDING FOR
INDOOR POLLUTION RESEARCH
---------------------------------------------------------- Chapter 3:1
Federally funded research on indoor pollution includes both basic and
applied research. Basic research is designed to answer fundamental
questions about the sources and the characteristics of indoor
pollutants, the environmental pathways and exposure routes by which
people come into contact with them, the mechanisms by which they
operate to adversely affect human health, and, where health effects
in buildings are not well understood, the nature, the magnitude, and
the causes of these health effects. Applied research is more
problem-specific in nature. It includes research to identify and
evaluate techniques for eliminating or controlling specific pollutant
sources and exposures.\1
The federally funded research we reviewed included both intramural
research (performed internally by an agency's own professional staff)
and extramural research (performed outside an agency on a
contractual, grant, or other basis by researchers affiliated with
national laboratories, universities, or other organizations). Also
included was research involving partnerships and cooperative
agreements between agencies and with private-sector organizations.
Each agency was asked to survey past activities and identify the
research and funding amounts that it considered as contributing to
the scientific understanding and improvement of indoor
environments.\2
Annual spending for indoor pollution research peaked in fiscal year
1995 at about $103 million and then declined to an average of about
$87 million per year over the 3 succeeding fiscal years. However,
planned spending for fiscal year 1999 represents, essentially, a
return to the fiscal year 1995 level (see fig. 3.1). Just over half
of the agencies' actual and planned expenditures went for research
related to indoor air, while about one quarter went for research
related to the hazard posed by lead in the indoor environment. While
spending for research related to radon has declined in recent years,
spending for research related to indoor air and lead has generally
increased.
Figure 3.1: Total Federal
Expenditures for Indoor
Pollution Research by Category
of Research, Fiscal Years 1987
Through 1999
(See figure in printed
edition.)
Notes: Amounts are expressed in constant 1999 dollars.
Amounts for fiscal year 1999 represent planned expenditures.
See appendix I for details of the individual agencies' spending and
explanations and qualifications of reported expenditure data.
Source: GAO's analysis of data from the CPSC, DOE, EPA, HUD, NCI,
NHLBI, NIAID, NIOSH, NIEHS, and NIST.
NIEHS accounted for about 37 percent of the nearly $1.1 billion in
federal spending for indoor pollution research from fiscal year 1987
through fiscal year 1999 (see fig. 3.2). Taken together, four
institutes within NIH accounted for about 64 percent of the total
federal spending for that period. EPA, DOE, and HUD were the next
largest spenders on research related to indoor pollution. These
three agencies' actual and planned expenditures for the period ranged
from 7 percent to 13 percent of total federal spending. CPSC, NIOSH,
and NIST each accounted for 2 percent or less of the total federal
spending for that period.
Figure 3.2: Total Federal
Expenditures for Indoor
Pollution Research by Agencies,
Fiscal Years 1987 Through 1999
(See figure in printed
edition.)
Notes: Amounts are expressed in constant 1999 dollars.
Amounts for fiscal year 1999 represent planned expenditures.
Spending amounts do not add to total because of rounding.
See appendix I for details on the individual agencies' spending and
explanations and qualifications of reported expenditure data.
Source: GAO's analysis of data from the agencies cited.
--------------------
\1 Although basic and applied research are commonly distinguished, it
may be more accurate and useful to view research as a continuum
leading from basic understanding of a given problem to the
development of a solution to the problem. The head of the Indoor
Environment Department of the Lawrence Berkeley National Laboratory
told us that some research needed to bridge between basic and applied
research falls into an intermediate, gray area (which researchers
sardonically refer to as the valley of death) and never gets
funded. The result is that solutions do not get into the
marketplace.
\2 We received spending data on indoor pollution-related research
from 10 of the 11 federal agencies included in our review. OSHA
advised us that, although it uses findings resulting from the
research of others, it performs no scientific research of its own on
indoor pollution.
ADVANCES RESULTING FROM INDOOR
POLLUTION RESEARCH
---------------------------------------------------------- Chapter 3:2
Research sponsored or conducted by federal agencies has (1) advanced
the scientific understanding of the multifaceted problem of indoor
environmental pollution, (2) led to the development of methods to
mitigate the problem, and (3) resulted in the protection of public
health while, at the same time, generating savings in health care
costs and benefits in productivity.
CHARACTERIZATION OF THE
PROBLEM OF INDOOR POLLUTION
-------------------------------------------------------- Chapter 3:2.1
As a result of research conducted by federal agencies, important
indoor pollutants have been identified.\3 Indoor sources of many
chemical pollutants have been identified and, to some extent,
quantified. For several indoor pollutants, a general quantitative
understanding of the relationships among indoor pollutant
concentrations, indoor sources, and building and occupant
characteristics has been developed, providing the basis for effective
pollutant control measures. In addition, indoor moisture problems,
resulting from leaks, water incursions, and condensation of indoor
humidity, have been identified as important contributors to indoor
environmental problems, in particular, the proliferation of fungi,
bacteria, and dust mites that are associated with the development and
exacerbation of allergies, asthma, and other diseases. Although
adequate measurements to characterize the resulting adverse exposures
are not yet available, NIOSH reports that promising work is being
performed on such substances as toxins produced by bacteria.
Research conducted by NIAID and others has demonstrated that indoor
allergens, such as those from house dust mites, cockroaches, and
pets, are particularly important in the development and exacerbation
of allergies in genetically susceptible individuals. Individuals
become sensitized or allergic to the allergens when their immune
systems produce allergic antibodies. When allergens interact with
these antibodies in the lungs, an inflammatory reaction and asthma
may result. Research has shown that individuals who have produced
antibodies to these indoor allergens have a substantially increased
risk of developing asthma. In many parts of the United States and
elsewhere in the world, the predominant allergen is from house dust
mites. Research has also shown that, in susceptible children, high
levels of exposure to this allergen in early childhood substantially
increase the likelihood of both sensitization and asthma.
In the United States, illness due to asthma is disproportionately
high among inner-city residents. Research has shown that one risk
factor that is unique to many inner cities is exposure to cockroach
allergen. Among children with asthma who live in inner cities, the
combination of allergy to cockroach allergen and exposure to high
levels of it is associated with increases in both hospitalizations
for asthma and unscheduled asthma-related medical visits. Exposure
to high levels of cockroach allergen in early childhood not only
increases the risk for more severe asthma, but also increases the
likelihood of the development of asthma before age 6. Current
research by NIH institutes and others is directed at reducing both
exposures to and the effects of indoor allergens, thereby reducing
the burden of asthma.
Results of federally funded research on the VOC formaldehyde
illustrate the progress that has been made in chemical pollutant and
source characterization. Research on indoor formaldehyde sources and
emission processes, conducted by several federal agencies and others,
has demonstrated that formaldehyde emissions from urea formaldehyde
foam insulation, pressed wood building materials, paints, and many
other common indoor sources have been responsible for many of the
complaints about poor indoor air quality, including such health
symptoms as eye, nose, and throat irritation and respiratory
distress, that followed efforts to make buildings more energy
efficient in the 1970s. The findings of their research have
stimulated industry to develop products and building materials with
much lower emissions of formaldehyde. As a result, high indoor
concentrations of formaldehyde are less common today than in the
past.
Federally funded research on radon, sponsored by DOE, EPA, and HUD,
among others, has led to the identification of the major source of
radon in homes. Prior to this research, it had been generally
believed that building materials were the principal source of indoor
radon. This research, however, demonstrated that emissions from
building materials were not large enough to account for the radon
levels found in many U.S. homes and that the major source of radon
in most homes was the radon contained in soil gasses. These gasses
can enter the building as a result of interactions of its shell with
wind and temperature differentials between its interior and exterior.
As a result of federally sponsored research, a dynamic model was
developed that could quantitatively account for the variations in
indoor radon concentrations attributable to these forces. Without
such a sound, quantitative scientific understanding of the source and
entry mechanism for radon into buildings, it would not have been
possible to design effective mitigation technologies to reduce radon
in homes and its associated health risks.
--------------------
\3 However, research by DOE, NIOSH, and others on nonspecific
symptoms in buildings has shown that other important pollutants have
not yet been identified. These pollutants have been found to be
associated with inadequate ventilation and poor ventilation system
design and maintenance.
DEVELOPMENT OF MEASUREMENT,
MODELING, AND OTHER
INVESTIGATIVE TOOLS
-------------------------------------------------------- Chapter 3:2.2
As a result of federally funded research, methods to measure indoor
pollutant concentrations, pollutant emission rates, ventilation
rates, and indoor air distribution patterns have improved greatly
over the last two decades. Mathematical models for air leakage and
air flow in buildings, both of which affect indoor environmental
quality, have been developed and validated to aid research and
building design. Protocols and procedures have been developed and
standardized to investigate suspected environmental quality problems
in a variety of building types.
As a result of research supported by several federal agencies,
measurement methods involving the use of small and large
environmental chambers and test houses have been developed to advance
understanding of the emission characteristics of different indoor
pollutant sources over time and under different indoor environmental
conditions, including temperature and humidity. EPA researchers have
developed measurement methods to test a variety of building and
furnishing materials and consumer products. This research has
resulted in guidance that has been adopted by the American Society of
Testing and Materials (an industry standard-setting organization) and
is now used by the private sector in the United States and
internationally to characterize organic emissions from indoor
materials and consumer products. Manufacturers of office furniture,
carpets, adhesives, and other materials use the test methods to
evaluate their products and provide emissions information to
architects and consumers.\4 In addition, EPA has designed and
constructed a state-of-the-art room-sized indoor air research
facility that permits characterization of emissions from products and
processes that cannot readily be studied using small chambers. The
facility allows researchers to study, under controlled environmental
conditions, such indoor activities as the use of paints, solvents,
cleaners, and other consumer products that can adversely affect
indoor environmental quality. EPA, CPSC, and other agencies have
also devoted considerable research to developing models that are used
to simulate indoor pollutant concentrations and exposures under
varying use scenarios.
NIST has developed techniques for measuring building ventilation
performance, which have included the use of tracer gas and automated
systems to measure building ventilation rates. NIST has also
developed and demonstrated techniques to assess air distribution
effectiveness in mechanically ventilated buildings as well as
building airflow and indoor air quality models that permit assessment
of the indoor air quality impacts of a number of contaminant sources.
DOE has developed innovative ventilation measurement strategies
intended for broader use in research on the relationship between
ventilation and health.
NIOSH, which has conducted hundreds of investigations of suspected
indoor environmental quality problems in office buildings, schools,
and other institutional settings, has developed, with EPA,
standardized protocols for conducting such investigations and
eliciting information from a building's occupants regarding their
health symptoms and perceptions of indoor environmental quality.
These protocols are now widely used in diagnosing suspected problems
in buildings and responding to the occupants' complaints. Since
1992, NIOSH has also undertaken an epidemiologic research program on
the health effects of indoor environmental quality in nonindustrial
indoor workplaces.\5 Products have included (1) a comprehensive
review and synthesis of the worldwide epidemiologic literature on
this topic to summarize what is known and to identify the best future
research strategies; (2) a study showing that, in buildings with
indoor environmental quality complaints, low ventilation rates and
poor design and maintenance of their ventilation systems are
associated with increased building-related breathing symptoms; and
(3) a recent study documenting a strong association between elevated
temperatureswithin the conventional comfort rangeand increased
reporting by a building's occupants of health symptoms and
discomfort.
--------------------
\4 Notwithstanding progress in this area, EPA officials expressed the
opinion that product testing for emissions is still in its infancy
and that while emissions data are available for some products from
some manufacturers, much more remains to be done.
\5 This epidemiologic research is intended to identify relationships
between office workers' symptoms and a range of indoor environmental
characteristics. Inadequate ventilation, inadequate air
distribution, dirt in duct work, and moisture in mechanical systems
are the primary problems found to be associated not only with eye,
nose, and throat irritation but also with asthma-like symptoms.
While often no specific pollutant or pollutants could be identified,
research points to the kinds of pollutants that could have caused
such problems. NIOSH reported that sampling strategies and
analytical techniques are being developed to identify the pollutant
components that are the cause of symptoms in over 30 percent of U.S.
office workers.
DEVELOPMENT OF MITIGATION
METHODS
-------------------------------------------------------- Chapter 3:2.3
For many indoor pollutants, source reduction or elimination has been
shown to be the most effective and cost- and energy-efficient method
to mitigate or prevent problems. Effective control measures have
been developed for some, but not all, indoor pollutant sources.
Research has also demonstrated the effectiveness of several
energy-efficient ventilation and air distribution technologies in
controlling pollutant exposures, and high performance technologies,
such as particle and gaseous filtration and dehumidification, have
been identified. The importance of avoiding low rates of ventilation
has also been clearly demonstrated through research and communicated
widely. Research has also shown that mechanical ventilation systems
can themselves be a source of indoor pollutants (e.g., dust and
molds) as well as a means to disseminate pollutants throughout a
building.
Federally funded research on the health effects of secondhand tobacco
smoke has helped stimulate local and state smoking ordinances,
employer policy changes regarding smoking in the workplace, and
changes in individuals' behavior. By conducting comprehensive risk
assessments of environmental tobacco smoke and publicizing these
risks, federal agencies have contributed to the reduction of this
source of pollution in a variety of indoor environments. As a
result, involuntary exposure of nonsmokers to tobacco smoke, at least
outside of private homes, has decreased dramatically over the past
decade.
Research supported by NIEHS and others on the health effects of
low-level exposures of children to lead has resulted in the Centers
for Disease Control and Prevention (CDC) lowering the acceptable
blood lead level for children. NIEHS has also supported research
investigating promising treatment and intervention strategies for
low-level lead exposures, including a clinical trial to determine the
efficacy of treatment with drugs designed to bond with lead in human
bodies and, thus, prevent or reduce neurobehavioral problems in
children. Another NIEHS-supported study has provided preliminary
evidence that dietary calcium might reduce the release of previously
absorbed lead from the bones of pregnant and lactating women, thereby
significantly reducing the transmission of lead to the fetus and
developing child. If additional work verifies this finding, it
offers a significant and inexpensive technique to reduce lead
exposure in infants.
EPA, HUD, and other agencies have sponsored research to develop and
demonstrate cost-effective radon mitigation and prevention
technologies for use in homes, schools, and other buildings. These
techniques, which have been widely applied, include (1) soil
depressurization (installing suction pipes beneath a building's
foundation to passively vent radon or using such pipes in conjunction
with a fan to actively pull the radon-containing soil gas away from a
building before it can enter); (2) sealing cracks and other openings
in a building's foundation to help prevent radon from entering; and
(3) increasing a building's pressurization (using a separate fan or a
building's ventilation system to create positive pressure to prevent
the entry of radon).
DISSEMINATION OF RESEARCH
FINDINGS
-------------------------------------------------------- Chapter 3:2.4
A number of federal agencies have played an important part in broadly
disseminating the findings and the practical applications of research
on indoor environmental pollution--including its sources, its health
effects, and the most effective methods for controlling it. This has
been done thorough a variety of means, including agency web sites,
information clearinghouses, and published materials of a general and
specialized nature. Drawing on the results of their own research and
that of others, such as DOE and NIST, and on the vast amount of
information on indoor environmental problems gleaned from
investigations of problem buildings, EPA and NIOSH collaboratively
published an indoor air quality guide for use by commercial building
owners and facility managers.\6 In cooperation with nonfederal
partners, including the American Lung Association and the National
Education Association, EPA later published a similar guidance
document for use in schools by school administrators, facility
managers, and others.\7 EPA and CPSC, in cooperation with the
American Medical Association and the American Lung Association,
published a guide to indoor environmental health problems and risks
for use by health professionals to provide them with information to
aid in understanding the indoor environmental dimension of many
commonly encountered health conditions.\8 CPSC has disseminated
knowledge gained from research on the indoor environmental impacts of
consumer products in a variety of public advisories and other
publications, which deal with subjects as diverse as asbestos,
biological pollutants, combustion appliances, formaldehyde, lead, and
paint strippers.
On a more technical level, EPA has collaborated with the American
Institute of Architects to develop a comprehensive, environmentally
focused resource document, the Environmental Resource Guide,\9
which provides technical information to architects and other design
professionals on a range of issues to help them evaluate the
environmental impacts of their design decisions and specifications.
Indoor pollutant sources that can affect indoor environmental quality
are a major component of the guide. The guide disseminates EPA's
research results on source characterization and indoor air modeling
and provides guidance that architects, designers, builders, and
manufacturers can use in selecting and manufacturing building
materials, furnishings, and products.
Federally supported researchers, in particular those associated with
DOE and NIST, have been active resources in industry standard-setting
organizations, such as the American Society of Heating, Refrigerating
and Air-Conditioning Engineers (ASHRAE) and the American Society of
Testing and Materials. These organizations have made significant
contributions to establishing or revising standards that can have an
important influence on indoor environmental quality and public
health--such as ASHRAE's proposed standard, currently under
development, relating to ventilation requirements for residential
buildings.\10 Much information resulting from federally sponsored
research is also communicated to industry and professional
organizations via conference presentations, newsletters, and trade
and scientific journals.
--------------------
\6 EPA and DHHS (NIOSH), Building Air Quality: A Guide for Building
Owners and Facility Managers (Dec. 1991).
\7 EPA, Indoor Air Quality: Tools for Schools (May 1995).
\8 EPA, CPSC, American Lung Association, and American Medical
Association, Indoor Air Pollution: An Introduction for Health
Professionals (1994).
\9 EPA, Environmental Resource Guide (undated).
\10 This standard, currently under development and consideration by
ASHRAE, is referred to as ASHRAE Standard 62.2, Ventilation and
Acceptable Indoor Air Quality in Low-rise Residential Buildings.
THE HEALTH AND ECONOMIC
BENEFITS OF FEDERALLY FUNDED
RESEARCH ON INDOOR
ENVIRONMENTS
-------------------------------------------------------- Chapter 3:2.5
There is consensus among the agency officials and experts we
contacted that federally funded research on indoor environments has
resulted in improvements in public health with concomitant savings in
health care spending and reduced absences from work and school due to
indoor environment-induced illnesses. As a result of the wide
dissemination of research findings, building professionals have begun
to modify building designs, material selections, and building
operation and maintenance practices in ways that improve the indoor
environment and protect the health of a building's occupants.\11 As a
result of broader public understanding of indoor pollution issues,
many individuals are now more aware of potential health hazards in
the indoor environment and are making behavioral and consumer choices
based on perceptions of their impact on exposures and risks. With
improved understanding of the indoor environmental factors that can
affect health, health care professionals are better able to diagnose
and treat indoor pollution-related illnesses and recommend changes in
individuals' behaviors and surroundings that promote good health. An
increasing number of manufacturers are making decisions regarding
their products that are based on an understanding of potential indoor
pollution problems. Some are even turning public concern for indoor
environmental quality into a marketing advantage, emphasizing the
indoor environment friendly nature of their products.
Federally supported research has also helped to stimulate a
multifaceted and steadily growing indoor environmental quality
industry that employs a substantial number of people and offers a
broad range of products and services. Participants in this
burgeoning industry include (1) manufacturers and installers of
residential ventilation systems; (2) manufacturers of new products
for ventilation systems in commercial buildings; (3) manufacturers of
air-cleaning equipment, high-efficiency air filters, and pollutant
detection and control devices; (4) consultants who investigate,
diagnose, and remediate indoor environmental problems in commercial
and institutional buildings; (5) radon, asbestos, and lead mitigation
contractors; and (6) consultants who guide the building design and
construction processes in a manner that promotes good indoor
environmental quality.
--------------------
\11 Nevertheless, EPA officials and others told us that much remains
to be done in this area.
DESPITE PROGRESS IN UNDERSTANDING
AND MANAGING THE RISKS POSED BY
INDOOR POLLUTION, MANY
UNCERTAINTIES AND KNOWLEDGE GAPS
REMAIN
============================================================ Chapter 4
Over the past decade and a half, significant strides have been made
in identifying and understanding the risks posed by chemical and
other contaminants commonly found in homes, offices, schools, and
other indoor environments. Fifteen years ago, the scientific
understanding of indoor environmental pollution--including the
sources of indoor contamination, people's exposures to various
pollutants and allergens, the potential health effects, and building
dynamics--was relatively limited. Notwithstanding the considerable
progress in understanding and addressing these issues, however, the
consensus of the experts we consulted and the scientific literature
we reviewed is that much remains to be learned regarding virtually
every aspect of the problem of indoor environmental pollution. The
progress that has been made has increased the awareness of the
problem's complexity, the broad range of its potential effects on
humans, and the variability of individual susceptibility to its
effects. Improved scientific understanding of the problem has also,
we were told, underscored the importance of devising comprehensive,
multidisciplinary approaches to investigating and controlling
pollution in a diversity of indoor environments.
Although pioneering studies of total human exposure to environmental
pollutants have provided evidence of the significant contribution of
indoor sources to overall pollutant exposure, our review of the
scientific literature and of information provided by agency officials
and outside experts showed that many gaps and uncertainties remain in
the assessment of exposures to known indoor pollutants. These gaps
relate to such factors as the specific sources of exposures; the
magnitude of exposures; the relative importance of various routes of
exposure (inhalation, ingestion, and skin contact); the nature, the
duration, and the frequency of human activities that contribute to
exposures; and the geographic distribution of exposures to specific
indoor pollutants for the U.S. population as a whole. Such gaps in
understanding currently limit the ability to perform comprehensive
risk assessments for most pollutants found indoors.\1 Similarly,
while progress has been made in identifying many indoor pollutants,
research continues to bring to light additional pollutants, such as
chemical-laden fine particles, chemical compounds that are capable of
mimicking human hormones and interfering with the human endocrine
system, toxins from indoor fungi and bacteria,\2 and infectious
disease agents whose presence and potential for harm in indoor
environments have not been fully explored or appreciated.
Likewise, while research has shed light on the carcinogenic potential
of some toxic contaminants encountered indoors (e.g., radon and
environmental tobacco smoke), much less is known about the multiple
noncancerous health effects of indoor exposures to low-level
concentrations of indoor contaminants, for example neurological,
immunologic, developmental and other effects.\3 Similarly, very
little is known about how to convert descriptions of nonspecific
symptoms into objective, quantitative data; the relationship between
symptoms and disease in the context of the indoor environment; and
the impact of comfort on the productivity of office workers. There
are also significant gaps in the understanding of the health effects
of biocontaminants and the mixtures of chemical pollutants to which
people are exposed in indoor environments, including the extent to
which the actions of the pollutants may be additive or synergistic,
or even antagonistic. For the nonspecific symptoms reported since
the 1970s in some commercial and institutional buildings (sick
building syndrome symptoms), neither the nature of the disease (e.g.,
immunologic, toxic, or irritant) nor the specific exposures
responsible are yet well understood. This is true also of the
variable cluster of symptoms that have been most commonly referred to
as multiple chemical sensitivities (MCS) or environmental illness.\4
Such gaps in the scientific understanding of health effects, like
those relating to exposure assessment, also limit the ability to
perform comprehensive risk assessments of most indoor environmental
pollutants.
According to our review of the scientific literature and our contacts
with agency officials and outside experts, other areas needing
additional research include
-- the relationships among the factors that affect the indoor
environmental quality of residential, small office, and school
buildings and the occupants' perceptions of the quality of their
indoor environments to allow the development of strategies to
improve these environments and protect the health of the
occupants;
-- the tools to better measure and control ventilation to help
those who design and operate buildings ensure that their efforts
result in healthier indoor air;\5 and
-- the motivations of key decisionmakers who influence indoor
environmental quality to develop strategies and techniques to
influence them to make choices that are conducive to good indoor
environmental quality.
These areas of research were identified by agency officials; by
prominent academic and other researchers we contacted; and through
examination of agency reports and published, peer-reviewed scientific
literature. They do not constitute a comprehensive catalog of indoor
pollution-related research needs or a prioritized list of them.
Instead, they are intended to illustrate the scope and the variety of
research that is needed to address the uncertainties and fill the
gaps in the current understanding of the problem of indoor
environmental pollution and provide the tools to effectively manage
the risks it poses. In addition to being broad and resource
intensive, most of the research requires sophisticated,
multidisciplinary approaches. We were told that this could best be
ensured through a coordinated, cooperative effort involving multiple
federal agencies, state and local governments, universities, and,
where feasible and appropriate, industry, professional associations,
standard-setting groups and other private sector organizations. EPA
officials told us that an additional compelling reason for such a
comprehensive and concerted research effort is the fact that very
strong and persuasive data are needed to motivate voluntary risk
management actions in a largely unregulated area, such as indoor
environments, in contrast to other environmental areas that are
subject to extensive federal, state, and local government regulation.
--------------------
\1 For indoor allergens, which cause disease only in individuals who
become sensitized or allergic to the allergens, risk assessment is
more complex. Allergic inflammatory reactions and asthma result from
the interaction of allergens with allergic antibodies in the lung and
other organs. The levels of both allergens and antibodies determine
the magnitude of the response. Genetic factors, as well as levels of
allergen exposure early in life, affect the degree of sensitization.
\2 For example, ongoing research conducted by CDC suggests that one
of several causes of infant pulmonary hemorrhage may be toxins from a
specific type of mold in an infant's environment.
\3 Most chemicals in commercial use have not been tested for their
potential to cause adverse health effects; less than one-third of
regulated, high-production chemicals, including many found indoors,
have undergone even a preliminary screening level of testing for
adverse health effects.
\4 MCS is a controversial issue. Some medical groups, such as the
World Health Organization and the American Academy of Allergy,
Asthma, and Immunology, prefer the name idiopathic environmental
intolerances for these symptoms because, in their opinion, the term
MCS makes an unsupported judgment on causation (i.e., environmental
chemicals), does not refer to a clinically defined disease, and is
not based on accepted theories of underlying mechanisms nor validated
clinical criteria for diagnosis.
\5 EPA officials told us that research is also needed to develop cost
estimates for various risk management options to improve indoor air
as well as cost/benefit analyses for their implementation.
EXPOSURE ASSESSMENT
---------------------------------------------------------- Chapter 4:1
Estimating the health risks associated with a pollutant is based on
two activities, exposure assessment and effects assessment. In
exposure assessment, the sources, the media concentrations, the
exposure, and the received dose are evaluated. A principal goal is
to estimate exposure levels and the number of people exposed (e.g.,
the population exposed to particular air pollutants at concentrations
that exceed national ambient air quality standards or occupational
safety standards).
The series of events depicted in figure 4.1 serves as the conceptual
basis for understanding and evaluating the impacts of environmental
pollution on human health. It shows exposure as a key element in the
chain of events that begins with the release of a pollutant into the
environment and that can lead, ultimately, to environmentally induced
disease or injury.
Figure 4.1 Relationship of
Exposure Assessment and Effects
Assessment to the Environmental
Health Paradigm
(See figure in printed
edition.)
Source: Ken Sexton, Sherry G. Selevan, Diane K. Wagener, Jeffrey
A. Lybarger, Estimating Human Exposure to Environmental Pollutants:
Availability and Utility of Existing Databases, Archives of
Environmental Health , Vol. 47, No.6 (Nov.-Dec. 1992) pp. 398-406.
Despite the obvious importance of exposure data in evaluating
environmental hazards, our review of scientific literature, agency
documents, and information provided by outside experts showed that
such data have not been collected in a systematic or comprehensive
manner. Only limited information is available for environmental
exposures of populations and selected subpopopulations, such as
children, the chronically ill, and other particularly susceptible
groups. Consequently, understanding historical trends, estimating
current levels, predicting future directions, and making comparisons
among geographic locations are difficult. Gaps in information
concerning exposures to pollutants in indoor environments are a part
of the larger problem of gaps in the data on exposure. These gaps
impede evaluating the relative contributions of indoor and outdoor
sources to total human exposure to specific pollutants. They also
impede evaluating the public health risks posed by various indoor
pollutants as well as the need for actions to mitigate them.
Much of the current scientific understanding of the potential health
risks posed by pollutants in indoor environments stems from
pioneering field studies conducted a decade or more ago. While these
early studies provided important insights on the health hazards in
the indoor environment, they did not constitute a definitive
assessment of the indoor environment's contribution to total human
exposure to the large number of pollutants of potential concern.
They pointed to the need for a much larger, more strategic and
integrated research effort designed to improve the understanding of
human exposure to pollutants. Such a comprehensive effort would need
to consider and assess such key factors as (1) the sources of
pollutant exposures; (2) the magnitude of exposures; (3) the routes
of exposure; and (4) the nature, the duration, and the frequency of
human activities that contribute to exposures. It would identify
more precisely the relative contributions of indoor and outdoor
pollutant sources to total exposure and highlight variations in
exposures among geographic regions and particularly susceptible
subgroups, such as infants and young children.
Such a comprehensive and integrated body of research was actually
defined and planned as a result of work in the mid-1980s by the Total
Human Exposure Research Council (composed mostly of EPA scientists),
but it was never carried out. The Council's report laid out an
agenda of short-term and long-term research to address key
uncertainties and knowledge gaps concerning the risks posed by human
exposure to hazardous environmental pollutants, including identifying
where and how exposures occur.\6 Among the numerous research needs
identified in the report were
-- improved methods and instrumentation to measure individuals'
exposures to specific pollutants and pollutant classes;
-- additional field studies to supplement and confirm information
obtained from earlier studies;
-- the development of total human exposure models based, in part,
on the recorded activity patterns of real populations and
subgroups; and
-- improved biological markers and other techniques to account for
exposure by all routes and integrate the consequences of
intermittent and continuous exposures.
According to current and former EPA officials who participated in or
were familiar with the Council's report and the body of research that
it laid out, the reasons for the failure to implement that research
included the large, long-term commitment of resources that would have
been required as well as shifts in research emphases at EPA. EPA has
recently taken steps to improve the scientific understanding of human
exposures to environmental pollutants through cooperative efforts
with other agencies and through initiatives of its own, such as the
National Human Exposure Assessment Survey and the Cumulative Exposure
Project. These initiatives are still in the early stages of
implementation, however, and have yet to produce significant results.
NIOSH officials told us that any comprehensive program on exposure
assessment in indoor environments must recognize that some indoor
exposures with important health effects, whether chemical or
biological, have either not yet been identified or are not currently
measured in a way that correlates with the human health effects of
interest.
--------------------
\6 EPA, Total Human Exposure Research Council, Research Needs in
Human Exposure: A 5-Year Comprehensive Assessment (1990-1994) Sept.
1988.
RESEARCH ON SPECIFIC INDOOR
POLLUTANTS AND THEIR HEALTH
EFFECTS
---------------------------------------------------------- Chapter 4:2
Our review of the scientific literature, agency documents, and
information obtained from a range of experts indicated that many gaps
remain in the scientific understanding of indoor pollutants and their
effects on human health. Improving the healthfulness of indoor
environments requires a better understanding of the heath risks and
the effects resulting from indoor pollutants. In many cases, we
found, a lack of the kind of scientifically rigorous and quantitative
information on causal relationships between health symptoms,
exposure, and dose response relationships that is needed to establish
health standards for the general population and susceptible
subpopulations and inform policies and guidance for remedial actions.
To facilitate the development of cost-effective and energy-efficient
methods for improving indoor environmental quality and aid research
on health effects, a better scientific understanding of the nature
and the behavior of selected indoor pollutants is essential. The
dependence of indoor pollutant concentrations and exposures on
characteristics of building design, operation, maintenance, and
furnishings also must be better understood to permit mitigation of
the effects of indoor pollutant exposures..
Knowledge gaps, while numerous, appear to be greatest for indoor
particles, in particular, biological aerosols (bioaerosols)--liquid
or solid particles containing biological materials, such as viruses;
bacteria; molds; pollens; and pet, cockroach, and dust mite
allergens. Although the specific causal exposures have not been
identified in many cases, such airborne particles have, in general,
been implicated as a cause of allergic diseases, asthma, infectious
diseases, and some of the nonspecific symptoms characteristic of sick
building syndrome. Increases in disease and mortality are also
associated with elevated concentrations of particles in ambient air,
but the exposures to these particles appear to occur predominantly
indoors and vary with a building's characteristics. Our analysis of
published and other data indicated that substantial additional
research would be required to
-- better identify indoor sources of particles,
-- quantify rates of particle emission from sources as well as
rates of particle removal through such processes as deposition
on indoor surfaces,
-- better understand how a building's characteristics (e.g., the
type of ventilation and ventilation rates) affect indoor
concentrations of particles from outdoor air, and
-- develop the capability to model and predict indoor particle
exposures.
Our review also identified gaps in the scientific understanding of
the degree to which indoor sources and concentrations of bioaerosols
are influenced by such factors as indoor humidity levels; heating,
ventilation, and air-conditioning system design features and
maintenance; water incursions and leaks; moisture condensation;
interior cleaning practices; and types of indoor surfaces. NIOSH
officials told us that these influences would be most critical for
the bioaerosols that are ultimately implicated as causing indoor
health effects.
The specific exposure mechanisms for particles, especially
bioaerosols, also need to be understood in much greater detail. For
bioaerosols associated with infectious or allergic disease,
information on size distributions is currently very limited. Data on
particle size are important because size greatly influences the
natural indoor particle removal processes, the effectiveness of
control options (e.g., ventilation and air filtration) and the
location of particle deposition in the human respiratory system. For
infectious bioaerosols (those containing viruses, molds, or
bacteria), there are also gaps in the scientific understanding of how
the period of viability is affected by indoor temperatures and
humidity levels. As with many indoor pollutants, it is not currently
feasible to establish quantitative standards for exposures to
bioaerosols, because of the inadequacies of current measurement
methods for most bioaerosols and the lack of information on the
relationship between exposure and response. After epidemiologic
research identifies exposure assessment strategies for specific
bioaerosols and their associated health effects, progress towards
developing health standards will be possible.
According to the scientific literature and experts we consulted, VOCs
and semivolatile organic compounds are two additional classes of
indoor pollutants for which additional research will be required to
resolve scientific uncertainties related to health risks. To fill
gaps in current understanding, research needs to focus on the
particular compounds and mixtures of such compounds that have been
shown or are suspected to be the most irritant and toxic (including
neurologic effects). Research objectives would include identifying
sources, quantifying emission rates, and providing a better
understanding of how building factors modify exposures through such
mechanisms as absorption and adsorption. Other objectives would
include the evaluation of the relative significance of various routes
of exposure. While most effects may result from the inhalation of
gases, these compounds might also have effects by binding to
particles, such as floor dust. Thus, exposures could also occur
through skin contact and ingestion, especially in infants and small
children engaging in hand-to-mouth behavior.
Recent findings that indoor chemical reactions can take place between
VOCs and ozone (present in ambient air, largely as an indirect result
of automobile, utility, and other industrial emissions) raise
additional questions concerning the significance of these reactions
to the overall problem of indoor environmental pollution. Indeed,
the chemistry of the indoor environment, including chemical reactions
of indoor pollutants with indoor materials (perhaps generating new
pollutants), interactions of chemical pollutants from indoor and
outdoor sources,\7 and interactions of chemical and biological
pollutants was shown by our review to be a broad area requiring
research to resolve uncertainties and fill gaps in the scientific
understanding of this issue.
Until the mid-1980s, the primary emphasis of indoor environmental
research was on pollutants linked to serious health effects
experienced by a relatively small proportion of the population, for
example, cancer resulting from exposures to carcinogens. However,
there is now considerable evidence that the indoor environment
substantially affects a number of less severe health problems
frequently experienced by a much larger proportion of the population.
These problems include (1) communicable diseases, including such
respiratory illnesses as common colds and influenza, which are
experienced frequently throughout life by virtually everyone;\8 (2)
allergies, which affect the health of approximately 20 percent of the
U.S. population; (3) asthma, a debilitating condition, which is
experienced by an estimated 6 to 12 percent of the U.S. population;
and (4) a set of nonspecific irritation and central nervous system
health symptoms (generally referred to as symptoms of sick building
syndrome), which are often experienced in the workplace by an
estimated 20 to 30 percent of U. S. office workers\9 and are a
major source of complaints in schools as well.\10
At present, there are limited federal research efforts on nonspecific
symptoms. There is also limited research aimed at determining the
influence of indoor environments on communicable respiratory
illnesses. With regard to the association of asthma with indoor
environmental conditions and allergies unaccompanied by asthma, there
has been a significant amount of research in recent years, but much
more is required to fill gaps in the scientific understanding of
these problems. NIAID officials told us that current research
includes attempts to reduce the levels of indoor allergens, including
those from house dust mites, cats and dogs, cockroaches, and molds,
and to determine whether reduction of these allergens mitigates the
severity of allergy and asthma. The officials noted that available
methods to control exposure to certain allergens, such as cockroach,
appear to be of limited effectiveness. An alternative method to
control responses to allergens is to block the production of
antibodies to allergens, but currently available approaches, chiefly
immunotherapy, have limited effectiveness. We were told that
additional research is needed to develop new approaches to block the
production of antibodies to allergens and determine the effectiveness
of this in preventing and treating asthma and allergic diseases.
African-American and Hispanic children in inner cities bear a
disproportionate burden of asthma-related illness, and their
responses to cockroach and other allergens account for a substantial
part of their high rate of illness. Thus, in the opinion of NIAID
officials, a major focus of research efforts to block the production
of antibodies to allergens should be on inner city children.
--------------------
\7 In addition to ozone, sulfur dioxide and nitrogen dioxide are
examples of ambient air pollutants that infiltrate indoor
environments and present potential health risks to occupants.
\8 As well as some more serious respiratory diseases, including
tuberculosis and Legionnaire's disease.
\9 Researchers at DOE's Lawrence Berkeley National Laboratory have
estimated the percentage of office workers who experience these
symptoms at 20 percent. NIOSH has estimated the percentage at 30
percent.
\10 Joan M. Daisey and William J. Angell, A Survey and Critical
Review of the Literature on Indoor Air Quality, Ventilation, and
Health Symptoms in Schools (Lawrence Berkeley National Laboratory,
Mar. 1998).
BUILDING STUDIES
---------------------------------------------------------- Chapter 4:3
EPA, in coordination with a number of other federal agencies, has
sponsored major studies of commercial and governmental office
buildings in recent years.\11 These studies included developing
questionnaires and exposure assessment methods and were intended to
provide baseline data on building characteristics, occupants'
perceptions of indoor environmental quality, occupants' health
symptoms, and other factors relating to large office buildings
representative of such buildings nationwide. Future analyses of
these data may identify relationships between occupants' responses
and building factors or specific indoor exposures that will help in
formulating policies for healthier indoor environments. Similar data
are currently lacking, however, for the nation's residential
buildings; for small office buildings, which house a significant
fraction of the nation's office workers; and for schools. A better
scientific understanding of the factors contributing to pollutant
exposures and associated health risks in these indoor environments as
well as the measures that might be taken to mitigate these hazards
would be facilitated by a coordinated series of studies of
representative samples of residential, small office, and school
buildings. Such studies, by providing quantitative data on key
building characteristics and aspects of building operation and
maintenance believed to influence occupants' exposures to pollutants,
would permit the epidemiologic analyses necessary to define
environment and response relationships. Factors of interest would
include
-- the type of building and its age;
-- the materials of construction;
-- the type of ventilation;
-- the ventilation rate (the rate of indoor air exchange with
outside air);
-- the presence of soft surfaces, such as carpets, draperies,
upholstery, or fibrous insulation within ventilation systems
that can act as reservoirs for indoor pollutants;
-- the control of moisture and the evidence of excessive moisture
within the buildings and their ventilation systems;
-- the indoor storage and use of potentially polluting products;
-- the presence of indoor combustion sources;
-- the methods and frequency of maintenance and cleaning of
buildings and their ventilation systems; and
-- the indoor activities of occupants (e.g., cooking, crafts,
hobbies, printing, or photocopying).
According to the experts and the scientific literature we consulted,
ensuring that appropriate methodologies are used in research to
clarify the influence of building characteristics on health effects
requires research teams that are multidisciplinary in nature, with
individuals trained in such disciplines as epidemiology, medicine,
chemistry, building systems, exposure assessment, and microbiology.
Among the objectives of such research would be to learn how building
design features, furnishings, and operations and maintenance
practices influence both exposures to pollutants, allergens, and
infectious disease agents and health. Collecting such data, using
appropriate epidemiologic and statistical strategies, and developing
databases to analyze this information would permit the development
and the validation of predictive models of exposures to environmental
pollutants by the occupants of residential, small office, and school
buildings. These models would, in turn, allow the identification of
specific building factors or exposures related to health effects of
interest. It would then be possible to develop cost-benefit analyses
for steps designed to mitigate exposures associated with adverse
health effects, including analysis of economic benefits to building
owners who are willing to undertake the necessary remediations. This
information would also permit the development of educational tools
for occupants and owners as well as optimal approaches for
manufacturers, architects, builders, and building managers to design,
construct, and operate buildings and ventilation systems for
effective pollutant exposure control.
--------------------
\11 These studies are, respectively, the Building Assessment Survey
and Evaluation (BASE) study and the Temporal Indoor Monitoring and
Evaluation (TIME) study. The BASE study is a multiyear study
designed to define the status of indoor air quality and occupants'
perceptions in a cross section of at least 100 commercial office
buildings nationwide. The TIME study is a study over a period of
time encompassing seasonal changes of the status of federal
government office buildings with respect to indoor air quality and
occupants' perceptions of their indoor environment.
VENTILATION MEASUREMENT AND
CONTROL
---------------------------------------------------------- Chapter 4:4
Despite considerable research related to ventilation, many of aspects
of building ventilation require further research. According to the
published literature we reviewed and experts we consulted, there is a
particular need for research to provide satisfactory answers to the
question of how the exchange of indoor and outdoor air relates
quantitatively to health effects, specifically the relationship of a
building's ventilation rates with the health of its occupants. Such
information has great importance and usefulness for organizations
that specify minimum building ventilation rates in standards and
codes.
Those who design and operate buildings require better tools to help
ensure that their efforts result in healthful indoor air for building
occupants. Such tools include practical guides based on the use of
sophisticated air flow models (ideally integrated with pollutant
exposure models), improved sensors for important classes of indoor
pollutants that can be linked to ventilation control systems, and a
wide array of standard practices and guidelines that cover everything
from building diagnostics through building operation and maintenance
practices. We were told that there is a particular need to develop,
evaluate, and demonstrate improved methods for measuring and
controlling ventilation rates in commercial and institutional
buildings. While source control (pollution prevention) is always the
preferred method of avoiding unhealthy exposures, in practical terms,
it is ventilation with outside air that is the primary means used in
office buildings, schools, and other large buildings to maintain
acceptable levels of indoor air pollutants. However, ventilation
rates in buildings ventilated with mechanical systems are typically
difficult to measure and sometimes poorly controlled. According to
the limited data available, average ventilation rates appear to vary
widely among buildings of the same type (e.g., office buildings);
and, within large buildings, rates can differ greatly between rooms,
floors, and zones. As a result, some buildings may have ventilation
rates below the minimum levels specified in building codes and
industry standards, while others have ventilation far above the
specified rates. Reducing indoor air quality problems without
wasting energy and increasing costs depends on improving ways to
control ventilation in the nation's buildings.
Residential buildings present a different set of problems requiring
research. The vast majority of homes have no mechanical ventilation
systems to bring outside air into them to dilute concentrations of
indoor pollutants. The ventilation rates in homes typically depend
on the number and the size of accidental air leaks in their shells,
the occupants' actions with respect to opening windows and doors, the
use of exhaust fans, and the weather conditions. With the current
emphasis on energy conservation, building tightness, and climate
control to provide year-round comfort to occupants, the need for
research to develop affordable, robust, and energy-efficient
ventilation systems for residential use was cited by a number of
authorities. Ideally, such systems would be automated and would
incorporate sophisticated filtration, monitoring, and sensing
capabilities (for indoor air pollutant and humidity control) to help
ensure healthful indoor air on a continual basis.
STRATEGIES AND TECHNIQUES FOR
INFLUENCING KEY DECISIONMAKERS
---------------------------------------------------------- Chapter 4:5
Decisions that can have profound effects on indoor environmental
quality and, consequently, on the health, the comfort, and the
productivity of a building's occupants, are made by a multitude of
nongovernmental decisionmakers. These include architects, builders,
engineers, maintenance contractors, building owners and operators, as
well as the occupants themselves. We were told by experts who have
performed or reviewed studies in this area that these individual
decisionmakers frequently do not appreciate the impacts of their
decisions on indoor environmental quality and, when this is the case,
may need to be provided with appropriate information and guidance.\12
However, even when the decisionmakers do have some understanding of
the potentially adverse impacts of their choices and actions, they
may nevertheless make decisions that do not appropriately balance the
societal costs and benefits of ensuring a high level of indoor
environmental quality. Additional research is needed, we were told,
to clarify the reasons why decisionmakers are often not motivated to
protect the quality of indoor environments and to identify strategies
to motivate them to make concern about indoor environmental quality a
more integral part of their decision-making. Such research would
include the identification of techniques and incentives for
influencing motivation.
Some of the reasons why decisionmakers are often not motivated to
value and promote good indoor environmental quality are already
known, if insufficiently studied. In the case of many large office
buildings, the owners are not the employers of the workforce that
occupies the buildings. Thus, the owners do not directly benefit
from improvements in the workers' health, comfort, and productivity.
The owners are primarily motivated to maximize profits by minimizing
costs for building design, construction, and operation. Likewise,
architects and design engineers of speculative investment buildings,
owners of apartment buildings, contractors who make repairs and
renovations, and maintenance and pest control contractors often
receive little or no benefit from making decisions that improve or
protect the indoor environment. Even within a company that owns and
operates its own buildings, the department responsible for their
operation does not typically benefit from improvements in the health,
the comfort, and the productivity of the workforce. The prevailing
incentives tend to influence all of these decisionmakers to focus
primarily on minimizing short-term or initial costs.
We were told that additional research is required to improve the
understanding of the range and the mechanism of influence of various
decisionmakers on indoor environmental quality and of the
institutional barriers that often motivate them to neglect it. A
related need, cited by federal agency officials and others, is to
evaluate policy options and other techniques to overcome the low
priority often given to indoor environmental quality, for example by
shifting the costs of poor indoor environmental quality to the
decisionmakers. Possible methods for accomplishing this, which were
identified and will require further assessment, include (1) insurance
policies that would reduce health and other insurance costs when
practices conducive to good indoor environmental quality and health
are implemented, (2) model leases that would require lessors to
operate and maintain their buildings in a manner consistent with good
indoor environmental quality, and (3) various regulatory approaches.
To better inform and motivate decisionmakers, we were told, research
is also needed to develop improved quantitative information on the
economic costs and benefits of implementing technologies and
practices that improve indoor environments. The reason for this is
that, in many instances, the financial benefits associated with
improved health and productivity will be very large relative to the
costs. As these benefits become more generally known and understood,
an increased demand for good indoor environmental quality should
result.
--------------------
\12 For example, parents of infants and small children need
information on currently available ways to protect their children
from chemical and other contaminants in house dust, dust mite and
other allergens, molds, and other indoor pollutants. This
information and that which will be developed in future research will
be of little value until it is used to reduce exposure. Thus,
research is also needed on methods that are effective in bringing
about behavioral changes that contribute to reducing exposures.
CONCLUSIONS
---------------------------------------------------------- Chapter 4:6
Agency officials and other experts we consulted were in general
agreement that additional reductions in exposures to and adverse
health effects from indoor pollutants will require continued efforts
to develop a sound scientific and quantitative understanding of the
complex relationships among building factors, indoor pollutant
exposures, and health effects. Significant progress, we were told,
will require research to understand cause and effect
relationshipsnot just to document phenomena. Without a sound
understanding of causality, it will not be possible to develop
cost-effective solutions to indoor pollution problems.
These experts were also in general agreement that filling the major
remaining gaps in the scientific knowledge and understanding of
indoor environmental pollution and devising effective solutions to
this problem will necessitate comprehensive, coordinated,
multidisciplinary programs of research along the lines of those
described in this report. Accomplishing these endeavors will require
research teams that bring together expertise from a variety of
disciplines, including building systems, ventilation, chemistry,
epidemiology, exposure assessment, health effects assessment, and
pollution control. We were also told that, because the private
sector has little economic incentive to conduct such research, the
major portion of this research will, of necessity, have to be
supported by the federal and state agencies that have been the
primary sponsors of this research to-date, including those agencies
that were the subject of our review. The magnitude of this research
effort suggests that accomplishing it in the most expeditious,
effective, and efficient manner will require coordination,
consultation, and cooperation among agencies--in developing a
consensus research agenda, setting and prioritizing research
objectives, and identifying ways to collaborate so that their
respective skills, assets, and expertise are optimally utilized. An
example of this, conducted within the occupational health community
by NIOSH, is the National Occupational Research Agenda process. A
multidisciplinary, multisector team is working to define and
facilitate a priority research agenda that will improve the health of
U. S. workers in indoor environments, such as offices and
schools.\13
While research has shed considerable light on the problem of indoor
environmental pollution since it first became a prominent issue, the
pace of progress in understanding and controlling the problem has not
been as rapid as many experts believe it should be, particularly in
view of the seriousness of the potential health effects and the
sizeable potential benefits of effective solutions to the problem.
As one experienced and widely respected academic researcher told us,
in describing the need for a comprehensive body of research on U.S.
residential buildings, without such a coordinated and extensive
effort, the nation will still be nibbling at the edges of [this]
problem and its substantial public health impacts for at least
several more decades.
--------------------
\13 While agreeing that coordination, consultation, and cooperation
among agencies is needed to develop a consensus research agenda and
set broad priorities for indoor pollution-related research, CPSC
cautioned that individual federal agencies must retain the ability to
set their own research priorities in light of the activities and the
identified needs that relate to their respective missions and areas
of responsibility.
EXPENDITURES OF TEN FEDERAL
AGENCIES FOR RESEARCH ON INDOOR
POLLUTION
=========================================================== Appendix I
Following is a table and a discussion about ten federal agencies'
spending on indoor pollution-related research for fiscal years 1987
through 1998, as well as planned spending for fiscal year 1999.\1 We
asked the agencies to take a broad view of indoor pollution-related
research. For example, aside from such widely recognized indoor
pollutants as carbon monoxide, radon, lead, asbestos, formaldehyde,
and volatile organic compounds, we asked agencies to consider such
other indoor pollutants as pesticides, ozone, and biological
contaminants, including allergens and infectious bioaerosols. We
also asked the agencies to take a broad view of their research
activities. We asked them to report, in addition to expenditures for
basic research, spending on activities broadly related to improving
the scientific understanding of indoor environments, including
building studies and investigations of indoor pollution-related
complaints in problem buildings. Also requested was spending related
to the development of pollution prevention and control strategies for
indoor environments and economic studies to estimate the costs
associated with indoor pollution and the potential benefits from
improving indoor environmental quality . Each agency was given the
discretion to identify the specific research activities and
associated spending that it considered to be germane to our request.
For purposes of presentation, we have grouped the reported research
expenditures into four categories: indoor air, lead, radon, and
asbestos.
Table I.1
Total Spending for Indoor Pollution-
Related Research by Ten Federal
Agencies, Fiscal Years 1987 Through 1999
(Dollars in thousands)
Expenditures, by fiscal year Expenditures, by fiscal year
---------------------------------------------------------------------- ------------------------------------------------------------------------------------------
Agency 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999\a Total
----------------- ---------- ---------- ---------- ---------- ---------- ---------- -------- -------- -------- -------- ---------- ---------- ------------ ------------
Consumer Product
Safety
Commission
(CPSC)
Indoor air $1,681 $776 $1,922 $1,571 $1,267 $1,222 $1,561 $1,424 $571 $593 $643 $788 $1,011 $15,030
Lead 96 8 21 176 174 229 222 235 30 31 71 87 53 1,432
Asbestos 141 50 103 17 311
Subtotal $1,918 $834 $2,045 $1,764 $1,441 $1,451 $1,783 $1,659 $601 $624 $714 $875 $1,064 $16,773
Department of
Energy (DOE)
Indoor air 2,597 2,544 1,792 1,707 1,882 1,871 2,193 2,097 1,734 1,437 1,028 1,015 1,200 23,096
Radon 4,571 14,056 17,095 16,646 12,884 11,724 10,526 9,836 9,285 3,770 2,980 \b 113,374
Subtotal $7,168 $16,600 $18,887 $18,353 $14,766 $13,595 $12,719 $11,933 $11,019 $5,206 $4,008 $1,015 $1,200 $136,469
Department of
Housing and
Urban
Development
(HUD)
Indoor air 28 195 86 115 56 161 102 8,800\c 9,542
Lead 841 6,754 3,271 987 356 5,375 7,213 9,178 8,168 8,941 3,959 10,100\d 65,145
Radon 54 90 236 460 109 89 1,038
Subtotal $28 $1,089 $6,844 $3,358 $1,223 $931 $5,431 $7,484 $9,267 $8,168 $8,941 $4,061 $18,900 $75,725
Environmental
Protection
Agency (EPA)
Indoor air\e 3,340 3,971 4,413 3,909 4,265 9,255 11,006 10,765 11,713 8,199 9,444 11,873 6,775 98,926
Lead 931 1,556 1,543 1,169 784 615 109 60 6,767
Radon 4,064 3,533 4,606 4,592 3,986 3,814 2,082 1,882 1,418 586 174 173 30,910
Asbestos 237 999 627 1,143 368 297 77 74 3,822
Subtotal $7,404 $7,504 $9,256 $9,499 $8,878 $15,143 $15,011 $14,487 $14,377 $9,644 $10,233 $12,155 $6,835 $140,425
National Cancer
Institute (NCI)
Indoor Air 1,208 268 819 1,129 1,096 562 270 307 195 345 242 247 252 6,939
Radon 199 390 288 1,758 1,175 1,169 1,066 1,266 660 1,171 1,228 1,245 989 12,603
Subtotal $1,407 $657 $1,107 $2,888 $2,271 $1,731 $1,336 $1,573 $855 $1,515 $1,470 $1,491 $1,241 $19,541
National Heart,
Lung, and Blood
Institute
(NHLBI)
Indoor Air \f 17,959 17,290 14,957 15,801 15,641 16,353 15,412 16,564 16,579 8,079 9,780 10,787 175,202
National Institue
of Allergy and
Infectious
Diseases (NIAID)
Indoor air 5,672 4,620 4,938 3,673 7,358 7,654 8,582 8,114 7,880 6,286 7,129 10,815 10,973 93,695
National
Institute of
Environmental
Health Sciences
(NIEHS)
Indoor air 5,309 6,074 2,524\g 3,619\g 2,887\g 9,317 8,972 7,985 13,623 16,430 15,517 23,415 26,035 141,707
Lead 11,694 10,580 8,563 8,702 10,556 12,916 14,165 13,923 21,097 20,129 19,699 16,697 17,022 185,742
Radon 530 1,570 3,096 3,560 3,151 3,557 4,310 1,663 1,635 1,768 1,149 1,188 1,211 28,390
Asbestos 2,260 2,727 2,762 2,834 3,259 3,541 3,592 4,021 4,339 4,087 3,680 3,657 3,078 43,838
Subtotal $19,794 $20,950 $16,946 $18,714 $19,852 $29,332 $31,039 $27,592 $40,695 $42,414 $40,045 $44,957 $47,346 $399,677
National
Institute for
Occupational
Safety and
Health (NIOSH)
Indoor air 389 447 414 672 1,085 1,678 3,063 1,259 1,030 766 1,101 1,191\h 1,477\h 14,572
National
Institute of
Standards and
Technology
(NIST)
Indoor air\i 391 261 257 247 331 291 336 328 515 578 642 818 864 5,859
=====================================================================================================================================================================================
Total spending by
type of research
Indoor air 20,614 37,113 34,370 31,570 35,972 47,606 52,391 47,852 53,827 51,212 43,825 60,044 68,173 584,568
Lead 11,789 11,428 15,338 12,149 11,716 14,432 21,317 22,915 31,474 29,112 29,326 20,853 27,235 259,086
Radon 9,364 19,603 25,175 26,556 21,432 20,725 17,985 14,756 13,086 7,294 5,532 2,606 2,200 186,314
Asbestos 2,402 2,776 3,102 3,850 3,886 4,685 3,960 4,318 4,416 4,161 3,680 3,657 3,078 47,971
=====================================================================================================================================================================================
Total $44,170 $70,920 $77,985 $74,125 $73,007 $87,448 $95,653 $89,841 $102,803 $91,779 $82,363 $87,159 $100,686 $1,077,938
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Notes: All amounts are expressed in constant 1999 dollars.
Amounts for fiscal year 1999 represent planned expenditures.
Numbers may not add to subtotals and totals because of rounding.
Source: GAO's analysis of data from the agencies listed.
\a The amounts for fiscal year 1999 represent planned expenditures.
\b DOE's indoor radon research program was replaced in fiscal year
1998 by a new, but related, research program on the effects of
low-dose radiation.
\c HUD officials said that because their plans for spending fiscal
year 1999 funds for the Healthy Homes Initiative have not yet been
finalized, it is difficult to predict whether all of the planned
expenditures will specifically relate to indoor air research or
possibly one of the other categories of indoor pollution-related
research. However, they believe that the majority of the planned
expenditures will relate to indoor air research.
\d Included in HUD's fiscal year 1999 planned expenditures for lead
research is a carry-over of $3.2 million from its fiscal year 1998
appropriations. HUD had planned to spend about $7.2 million for lead
research in fiscal year 1998 but was able to obligate only about $4
million of these funds prior to the close of the fiscal year.
\e EPA has historically tracked research expenditures only for indoor
air activities. Because indoor pollution-related research might be
conducted under several EPA programs, EPA conducted a special survey
to estimate expenditures for indoor pollution-related research. The
activities included in the survey may include more than those
historically tracked and included by EPA in its research budget line
item for indoor air.
\f NHLBI was not able to provide its expenditures for research
related to indoor pollution for fiscal year 1987.
\g NIEHS was not able to provide its expenditures for intramural
resources devoted to indoor air research for fiscal years 1989, 1990,
and 1991. Also, NIEHS cautioned that information on expenditures for
fiscal year 1987 through fiscal year 1991 for indoor air research had
to be estimated and, consequently, is not as reliable as the
expenditure information the agency provided for this category of
research for fiscal year 1992 through fiscal year 1999. NIEHS
officials believe that expenditures reported for other categories of
indoor pollutants (i.e., radon, lead, and asbestos) should be
reliable for all the years reported.
\h The spending data for NIOSH does not include any reimbursements
that it may have received from other agencies. NIOSH received about
$372,000 in reimbursements from other agencies in fiscal year 1998
and anticipates reimbursements of $195,000 in fiscal year 1999.
\i Only expenditures for indoor pollution-related research made from
NIST's appropriations are shown; reimbursements from other federal
agencies and contributions made by private sector research groups are
not shown. All of NIST's spending has been for research related to
indoor air. However, NIST has received funding from other agencies
for lead and radon research.
--------------------
\1 Our review covered the activities of eleven federal agencies.
However, the Occupational Safety and Health Administration (OSHA)
advised us that they do no scientific research on indoor
pollution-related issues. Instead, they rely on the research of the
National Institute for Occupational Safety and Health and other
federal and state agencies in administering their regulatory
functions. Accordingly, we received no information on expenditures
for indoor pollution-related research from OSHA.
CONSUMER PRODUCT SAFETY
COMMISSION
------------------------------------------------------- Appendix I:0.1
During fiscal years 1987 through 1999, the Consumer Product Safety
Commission (CPSC) told us that its actual and planned expenditures
for indoor pollution-related research has totaled about $16.8
million. From fiscal years 1987 through 1994, CPSC's budget for this
research averaged about $1.6 million annually. However, by fiscal
year 1995, its budget for indoor pollution-related research had
dropped to about $600,000 and has been less than $900,000 through
fiscal year 1998. In fiscal year 1999, CPSC's spending for this
research is expected to reach $1 million for the first time since
fiscal year 1994, primarily because of increased work relating to
carbon monoxide poisoning. CPSC has had its overall budget trimmed
some 60 percent since the mid-1970s, after adjustment for inflation.
Also, staff levels have been reduced by over 40 percent. Despite
these cutbacks, CPSC believes that it is able to maintain an
effective indoor pollution research program. According to CPSC
staff, the agency is allocating sufficient resources to address the
hazards associated with consumer products used indoors (e.g., lead
hazards; carbon monoxide poisoning; and chemicals and materials used
in children's apparel, toys, and other articles).
DEPARTMENT OF ENERGY
------------------------------------------------------- Appendix I:0.2
During fiscal years 1987 through 1999, the Department of Energy (DOE)
told us that its actual and planned expenditures for indoor
pollution-related research has totaled about $136.5 million. About
83 percent of the funds were devoted to indoor radon research. The
remaining funds, about $23.1 million, went toward research on
ventilation and energy.
DOE's expenditures for indoor pollution-related research reached
their peak in fiscal year 1989 at about $18.9 million. However, by
fiscal year 1997, the last year for a separate indoor radon research
program within the Department, funding had declined to about $4
million.\2 Actual and planned expenditures for ventilation and
energy-related research for fiscal years 1997 through 1999 have been
about $1.1 million annually, about 42 percent of what they had been
in fiscal years 1987 and 1988. Furthermore in fiscal year 1999, the
budget line item for indoor pollution research was eliminated as part
of DOE's efforts to consolidate and streamline its budget. According
to a DOE official, it is difficult to estimate what impact the
elimination of the line item will have on future research related to
indoor environments. However, he believes there is a good
possibility that research on indoor environments may get less funding
in the future. For fiscal year 2000, he stated, DOE is requesting an
estimated $1.3 million for indoor pollution-related research,
slightly more than the $1.2 million it plans to spend in fiscal year
1999.
--------------------
\2 DOE's indoor radon research program was replaced in fiscal year
1998 by a new, but related, research program on the effects of
low-dose radiation. Although the goal of DOE's indoor radon research
program was to understand the health effects resulting from exposure
to indoor radon, the research program has covered a broad array of
research topics ranging from geology to aerosol physics to the
molecular biology of radiation-induced cancer.
DEPARTMENT OF HOUSING AND
URBAN DEVELOPMENT
------------------------------------------------------- Appendix I:0.3
During fiscal years 1987 through 1999, the Department of Housing and
Urban Development (HUD) told us that its actual and planned
expenditures for research related to indoor pollution has totaled
about $75.7 million. Over 85 percent of the funds were devoted to
lead research; the remaining funds were spent for indoor air and
radon research.
HUD saw a dramatic increase in its indoor pollution-related research
program in fiscal year 1999 with the implementation of its Healthy
Homes initiative. This initiative will use television commercials,
newspaper ads, brochures, and a toll-free information line to help
parents protect their children from the potentially deadly hidden
dangers in their homes. The initiative will offer information
concerning such hazards as lead paint, carbon monoxide, radon, and
electrical and fire hazards. In fiscal year 1999, HUD will devote
$8.8 million to indoor pollution-related research under this
initiative. Of this amount, the Congress directed that at least $4
million be devoted to preventive measures to correct moisture and
mold problems in inner-city housing where toxic mold exposure has
been linked to acute pulmonary hemorrhage and infant death.
Aside from research on lead and the Healthy Homes initiative, HUD's
remaining research has largely focused on indoor radon and on
ventilation requirements and moisture control in manufactured
housing.
A new program, the Partnership for Advancing Technology in Housing,
has the potential for making a contribution to research on indoor
environments. This program, which is a partnership between HUD and
industry, is aimed at spurring the creation and the widespread use of
advanced technologies to improve the quality, the durability, the
energy efficiency, the environmental performance, and the
affordability of the nation's housing. Although research is an
important part of the program, a HUD official stated that most of the
$10 million appropriated for the program for fiscal year 1999 has
been allocated for uses other than indoor pollution-related research.
ENVIRONMENTAL PROTECTION
AGENCY
------------------------------------------------------- Appendix I:0.4
During fiscal years 1987 through 1999, the Environmental Protection
Agency (EPA) told us that its actual and planned expenditures for
indoor pollution-related research have totaled about $140.4 million.
Almost $99 million, or about 70 percent, of the funds were devoted to
indoor air research and $30.9 million, or about 22 percent, to radon
research. Lead and asbestos research have accounted for about $6.8
million and $3.8 million, respectively, of the actual and planned
expenditures since fiscal year 1987.
EPA's expenditures for indoor pollution-related research reached
their peak during fiscal years 1992 through 1995, averaging about
$14.8 million over this 4-year period. However, from fiscal years
1996 through 1998, spending for this research dropped to an annual
average of about $10.7 million, representing an average decline of
about $4 million annually during this 3-year period. In fiscal year
1999, EPA's spending for this research is expected to decline even
further, to less than $7 million. Despite the prominent role in
research and information dissemination assigned to EPA by the
Superfund Amendments and Reauthorization Act of 1986, indoor
pollution-related research will receive only about 1.3 percent of the
$520 million that EPA's Office of Research and Development will spend
for research in fiscal year 1999.
EPA's Science Advisory Board has expressed concern that EPA has not
committed sufficient funds to indoor pollution-related research. In
April 1998, the Board stated that EPA's fiscal year 1999 budget
request for research was not likely to be sufficient to meet the
indoor pollution-related research goals in the agency's strategic
plan. The Board questioned the allocation of research funds between
ambient and indoor air, particularly given their respective risk
profiles. The Board stated that the scientific understanding of
indoor pollutants is still in its infancy when compared to
environmental science for the outdoor environment. The Board said
that there is a need for some intermediate to long-term research to
better understand the nature of indoor pollutants, their sources, and
their dynamic behavior. The Board concluded that budget constraints
appeared to be driving the budgeting process and not the actual
scientific needs.
Despite the Board's concern, EPA eliminated the budget line item for
indoor air research in its fiscal year 2000 budget to fund what it
views as higher priority activities based on risk and statutory
mandates. While acknowledging that there will be a decreased
emphasis on indoor pollution-related research, EPA officials stated
that such research will continue under other programs, such as
children's health, particulate matter, and air toxics. In March 1999
testimony before the Subcommittee on Energy and Environment, House
Committee on Science, the Board reiterated its concerns about the
adequacy of EPA's fiscal year 2000 funding for indoor
pollution-related research. The Board, however, said that it was
hopeful that its concerns could be minimized by the steps that EPA
has taken to incorporate certain aspects of indoor pollution-related
research into other broader research projects.
NATIONAL CANCER INSTITUTE
------------------------------------------------------- Appendix I:0.5
During fiscal years 1987 through 1999, the National Cancer Institute
(NCI) told us that its actual and planned expenditures for research
on health risks posed by indoor pollutants has totaled about $19.5
million. NCI supports research on the health effects of radon and
environmental tobacco smoke with respect to the cause, the diagnosis,
the prevention, and the treatment of cancer.
NCI has played a major role in clarifying the carcinogenic hazard
posed by radon through its epidemiologic studies of underground
miners and the general population. To assess the risks of domestic
radon exposure, a series of population-based, case-controlled studies
of lung cancer in populations, including nonsmoking women, are being
conducted. One of these studies examines the radon exposure of
residents living in underground dwellings in China. Another study is
attempting to validate the use of miner-based models for radon risk
assessment. Almost 65 percent of NCI's actual and planned
expenditures for indoor pollution-related research has gone towards
radon research.
The remainder of NCI's research related to indoor environmental
health risks has primarily concerned the relationship between
environmental tobacco smoke and lung cancer. One on-going study by
NCI involves examining tumor tissues from the lungs of nonsmokers for
genetic evidence linking the tumors to exposure to secondhand smoke.
According to NCI, there are many important and unanswered research
questions concerning the cancer risk posed by environmental tobacco
smoke, and plans are being developed to expand research to provide
answers to these questions.
Since fiscal year 1987, NCI has devoted about $1.5 million annually
to research on health risks posed by pollutants in the indoor
environment. While spending has fluctuated somewhat over the years,
we were told that these fluctuations were more a function of the
competitive grant process than changes in program emphasis by NCI.
NATIONAL HEART, LUNG, AND
BLOOD INSTITUTE
------------------------------------------------------- Appendix I:0.6
During fiscal years 1988 through 1999, the National Heart, Lung, and
Blood Institute (NHLBI) told us that its actual and planned
expenditures for research related to the health effects of indoor
pollutants has totaled about $175.2 million. NHLBI supports a wide
spectrum of research on the health effects of indoor air in support
of its mission to advance scientific understanding of the cause, the
diagnosis, and the treatment of heart, lung, and blood diseases.
Some of its exposure assessment and health effects research is
concentrated on ozone, environmental tobacco smoke, particulate
matter, and other factors that might alter the inflammatory response
and the susceptibility to lung disease.
NHLBI's indoor pollution-related research supports a wide range of
asthma research, such as investigating how different indoor
environmental exposures in early life interact with genetic factors
and the developing lung to cause asthma. Medication to control
asthma and its effects on lung growth and development are also being
studied by NHLBI as are strategies for reducing children's exposure
to indoor allergens and irritants, particularly in school settings.
NHLBI officials estimate that, historically, about 75 percent of its
total indoor pollution-related research expenditures has gone toward
research on asthma and allergens.
From fiscal years 1988 through 1996, NHLBI's spending for indoor
pollution-related research averaged about $16.3 million annually.
However, in fiscal year 1997, spending for this research decreased to
about $8.1 million and through fiscal year 1999 is expected to remain
below $11 million. NHLBI officials told us that the recent decrease
in yearly funding for indoor pollution-related research is
attributable to a change in research emphasis from the broad category
of chronic diseases of the airways to a greater focus on chronic
asthma. According to NHLBI officials, research on environmental
exposures received a greater emphasis under general research related
to chronic diseases of the airways than under research focusing on
chronic asthma.
According to NHLBI, its health effects research has wide
applicability. For example, its current research on the cellular,
molecular, and genetic mechanisms in asthma will enhance the
understanding of inflammatory and immune processes in other lung
diseases. NHLBI officials told us that regardless of the trigger,
understanding the mechanistic basis of disease is essential to the
development of preventive and therapeutic strategies.
NATIONAL INSTITUTE OF
ALLERGY AND INFECTIOUS
DISEASES
------------------------------------------------------- Appendix I:0.7
During fiscal years 1987 through 1999, the National Institute of
Allergy and Infectious Diseases (NIAID) told us that its actual and
planned expenditures for indoor pollution-related research have
totaled about $93.7 million. During fiscal years 1987 through 1990,
NIAID's annual expenditures averaged about $4.7 million. However,
beginning in fiscal years 1991 through 1997, NIAID's expenditures for
this research increased to an average of about $7.6 million annually.
According to NIAID officials, the increase in research spending
during fiscal years 1991 through 1997 was largely attributable to an
increased emphasis on research relating to asthma among inner-city
children. Specifically, from fiscal years 1991 through 1995, NIAID
funded the National Cooperative Inner City Asthma study, which
demonstrated a number of risk factors associated with increased
asthma severity, especially exposure to cockroach allergens. A
follow-on study, the Inner City Asthma Study (1996-2000), is now
testing the impact that a comprehensive environmental intervention
program involving the reduction of levels of indoor allergens, such
as cockroach, house dust mite, and mold, would have on asthma
morbidity. Historically, about 78 percent of NIAID's expenditures
for indoor pollution-related research have gone toward research on
asthma and allergens.
NIAID's actual and planned expenditures for indoor pollution-related
research have continued to increase, reaching almost $11 million
annually in both fiscal years 1998 and 1999. While some of these
increases are attributable to new grants, NIAID officials told us
that, in part, the increases are attributable to having a broader
definition of what constitutes indoor air quality research. Based on
new scientific understandings, certain grants are now considered
indoor air quality research that had not previously fit that
definition. While much of NIAID's research on health effects covers
outdoor as well as indoor exposures to disease-causing agents, NIAID
officials told us that it appears that indoor sources, such as
cockroach and house dust mite allergens, are, in general, more
important causes of asthma than outdoor allergens.
NATIONAL INSTITUTE OF
ENVIRONMENTAL HEALTH
SCIENCES
------------------------------------------------------- Appendix I:0.8
Among the agencies covered by our review, the National Institute of
Environmental Health Sciences (NIEHS) has devoted the greatest amount
of funding to indoor pollution-related research. During fiscal years
1987 through 1999, NIEHS told us that its actual and planned
expenditures for this research have totaled about $400 million.
NIEHS has, for the most part, experienced a steady growth in its
funding for this research. For example, planned funding of $47.3
million for indoor pollution-related research for fiscal year 1999 is
over 60 percent greater than the $29.3 million that was expended in
fiscal year 1992.
NIEHS' actual and planned expenditures for indoor air research from
fiscal years 1987 through 1999 have totaled about $141.7 million. A
significant portion of its indoor air researchabout 31 percenthas
been related to asthma because its incidence, morbidity, and
mortality have increased over the last decade, especially among
children. Indoor air research, including research into asthma and
allergens, has seen the largest increase in funding over the years
that were examined. In fiscal year 1999, NIEHS expects to spend
about $26 million on indoor air research compared to a funding level
of about $9.3 million in fiscal year 1992.\3 Also, NIEHS has devoted
significant resources to studying the health effects of leadwith
actual and planned expenditures for lead-related research totaling
about $185.7 million since fiscal year 1987. In fiscal year 1995,
NIEHS launched a major clinical trial designed to determine if
children's learning and behavior problems can be reversed or reduced
after exposure to lead.
NIEHS' basic research on heath effects is aimed at gaining a better
understanding of various diseases and illnesses that are triggered by
both indoor and outdoor pollutants. Thus, NIEHS' research has broad
applicability to both indoor and outdoor sources of pollutants.
--------------------
\3 Approximately $11.7 million of this amount will go specifically
for research on asthma and allergens.
NATIONAL INSTITUTE FOR
OCCUPATIONAL SAFETY AND
HEALTH
------------------------------------------------------- Appendix I:0.9
During fiscal years 1987 through 1999, the National Institute for
Occupational Safety and Health (NIOSH) told us that its actual and
planned expenditures for indoor pollution-related research have
totaled about $14.6 million. Almost 60 percent of these expenditures
went towards evaluating health hazards relating to nonindustrial
indoor work environments. NIOSH considers these workplace
investigations of reported health symptoms, potential occupational
exposures, and problems of building operation and maintenance to be
an important part of its indoor pollution-related research.
NIOSH's annual expenditures for indoor pollution-related research
reached a peak in fiscal year 1993 when about $3.1 million was
expended. The significant increase in expenditures for that year was
attributable to a fivefold increase in the number of requests from
workers for health hazard evaluations, largely the result of a
national news broadcast that highlighted the problems of indoor air
quality and provided NIOSH's toll-free telephone number. From fiscal
years 1994 through 1996, NIOSH's expenditures for research on indoor
environments steadily declined. However, beginning with fiscal year
1997, indoor pollution-related research spending has been increasing.
In fiscal year 1999, NIOSH plans to spend about $1.5 million for this
research, as the Institute undertakes priority projects identified
through its National Occupational Research Agenda.
NATIONAL INSTITUTE OF
STANDARDS AND TECHNOLOGY
------------------------------------------------------ Appendix I:0.10
The National Institute of Standards and Technology (NIST) has had a
limited, but growing budget for indoor pollution-related research.
Its overall spending has ranged from a low of about $247,000 in
fiscal year 1990 to a high of about $864,000 in planned expenditures
for fiscal year 1999. NIST told us that during fiscal years 1987
through 1999, its actual and planned expenditures for indoor
pollution-related research have totaled about $5.9 million. However,
because NIST does much of its research on a reimbursement basis on
behalf of other federal agencies, such as DOE and HUD, the total
funding for indoor pollution-related research under the control of
NIST is much higher. During fiscal years 1987 through 1999, NIST was
responsible for administering almost $14.4 million on indoor
pollution-related research, of which about 59 percent was provided
through reimbursements from other federal agencies.
CURRENT MEMBERS OF THE COMMITTEE
ON INDOOR AIR QUALITY
========================================================== Appendix II
COMMITTEE CO-CHAIR AGENCIES
-------------------------------------------------------- Appendix II:1
Environmental Protection Agency
Consumer Product Safety Commission
Department of Energy
National Institute for Occupational Safety and Health, Department of
Health and Human Services
Occupational Safety and Health Administration, Department of Labor
OTHER FEDERAL AGENCIES
-------------------------------------------------------- Appendix II:2
Bonneville Power Administration
Department of Agriculture
Department of Defense
Department of Housing and Urban Development
Department of Interior
Department of Justice
Department of State
Department of Transportation
Department of Treasury
General Services Administration
National Aeronautics and Space Administration
National Institute of Standards and Technology, Department of
Commerce
Office of the Architect of the Capitol
Small Business Administration
Tennessee Valley Authority
U.S. Information Agency
EXPERTS ON INDOOR ENVIRONMENTS WHO
CONTRIBUTED TO THIS REPORT
========================================================= Appendix III
Dr. Joan M. Daisey
Head, Indoor Environment Department, Environmental Energy
Technologies Division
Lawrence Berkeley National Laboratory
Berkeley, California
Dr. William J. Fisk
Staff Scientist, Indoor Environment Department
Lawrence Berkeley National Laboratory
Berkeley, California
Dr. Alfred T. Hodgson
Staff Scientist, Indoor Environment Department
Lawrence Berkeley National Laboratory
Berkeley, California
Ms. Peggy Jenkins
Manager, Indoor Exposure Assessment Section, Research Division
California Air Resources Board
Sacramento, California
Mr. Hal Levin
Research Architect
Building Ecology Research Group
Santa Cruz, California
Dr. Morton Lippmann
Professor, Department of Environmental Medicine
New York University School of Medicine
Tuxedo, New York
Dr. Wayne R. Ott
Visiting Scholar, Department of Statistics
Stanford University
Stanford, California
Mr. John W. Roberts, M.S., P.E.
Engineering Plus, Inc.
Redmond, Washington
Dr. Jonathan M. Samet
Professor and Chairman,
Department of Epidemiology
School of Hygiene and Public Health
Johns Hopkins University
Baltimore, Maryland
Dr. Max H. Sherman
Staff Scientist, Indoor Environment Department
Lawrence Berkeley National Laboratory
Berkeley, California
GAO CONTACTS AND STAFF
ACKNOWLEDGMENTS
========================================================== Appendix IV
GAO CONTACTS
Edward Kratzer, (202) 512-6553
Ralph L. Lowry, (202) 512-6539
ACKNOWLEDGMENTS
In addition to those named above, Jean Brady, Jay Cherlow, and Larry
Turman made key contributions to this report.
*** End of document. ***