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Office of the Surgeon General (US). Report of the Surgeon General's Workshop on Healthy Indoor Environment: January 12–13, 2005, National Institutes of Health, Bethesda, MD. Rockville (MD): Office of the Surgeon General (US); 2005.

Cover of Report of the Surgeon General's Workshop on Healthy Indoor Environment

Report of the Surgeon General's Workshop on Healthy Indoor Environment: January 12–13, 2005, National Institutes of Health, Bethesda, MD.

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Charge and Goals

VADM Richard H. Carmona, M.D., M.P.H., F.A.C.S.

U.S. Surgeon General

VADM Richard Carmona emphasized the role of health literacy for success in addressing priority health areas. The Surgeon General and public health professionals must disseminate their wealth of knowledge to both the public and practitioners in as timely a fashion as possible to effect behavioral change and improve the health of the populations they serve. The Surgeon General defined indoor environments as built, non-industrial structures. This includes work-places, schools, offices, houses, and apartment buildings.

He also stated that the data clearly indicate the need for this workshop. According to a recent study, we Americans spend 85%–95% of our time indoors (Rauh VA, Chew GR and Garfinkel RS. Deteriorated Housing Contributes to High Cockroach Allergen Levels in Inner-City Households. Environmental Health Perspectives 2002,110(Supplemental 2):323–7). So while we need to be cognizant of and concerned about our outdoor environment, including pollution and smog, we must put at least equal emphasis on the long-overlooked issue of indoor environment.

In just the past 25 years, the percentage of Health Hazard Evaluations (HHE) that the National Institute for Occupational Safety and Health (NIOSH) at the Centers for Disease Control and Prevention (CDC) has conducted related to indoor air quality has increased from 0.5% of all evaluations in 1978 to 52% of all evaluations since 1990. This means that in those years, the evaluations related to air quality concerns have increased from one of every 200 evaluations to one of every two.

The problem is adversely affecting our children’s health: the General Accountability Office (GAO) has indicated that one in five schools in America has indoor air quality (IAQ) problems (GAO 1995, 1996, and 1999). This can trigger various allergies and asthma. Asthma alone accounts for 14 million missed school days each year. The rate of asthma in young children has risen by 160% in the past 15 years, and today one of every 13 school-age children has asthma. Asthma alone costs the United States economy at least $11 billion annually.

VADM Carmona presented three major goals for the workshop:

  1. Identify relevant scientific data that establish a basis for assessing and interpreting indoor environment hazards.
  2. Identify research needs and areas where scientific information is lacking or inconclusive.
  3. Establish common goals for implementing measures that are known to be effective for improving indoor environmental quality.

Beyond these specific goals, he stated that it is important to illuminate HIE issues in the context of larger public health concerns and related issues such as lead paint toxicity, and to move the public health agenda forward using sound scientific evidence.


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