NADD - An association for persons with developmental disabilities and mental health needs

From the NADD Bulletin Volume X Number 5

Safe and Healthy Indoor Air is for Everyone!

Laura Abulafia, MHS Director, Environmental Health Initiative

American Association on Intellectual and Developmental Disabilities

People with developmental disabilities and mental health needs have the right to live, work, learn, worship and play in environments that are healthy and safe. The health impacts of contaminated homes, work places, and communities pose a greater risk for the children and people who already have compromising health issues and are faced with health disparities greater than the general population. Persons with developmental disabilities and some forms of mental illnesses are more vulnerable to further injury from toxins compared to the general population because they often spend more time indoors, they may have less control over exposure to and escape from toxins, they may have more vulnerable immune responses to toxicant exposure, and they may be taking more pharmaceutical medications than other exposed populations.

For many people, clean indoor air actually smells like fragrance — the fresh scent of Formula 409, the flowery smell of air fresheners, fabric softeners, and cleaning products. But many of these fragrance particles, relatively harmless on their own, react with ozone, a smog ingredient and byproduct of traffic, to create carcinogenic particles. Some of these products may also cause irritation to the eyes, lungs, or skin in case of contact. Instead of spraying some air freshener, open a window and remove the source of the odors.

To improve indoor air quality, the single most important thing you can do is not smoke in your home and not allow others to smoke in your home. Beyond the smell, smoking releases tiny particles that attach to curtains, upholstery, carpets, and walls. These particles are eventually inhaled. There are over 4,000 chemicals in cigarette smoke, and at least 50 of these are known cancer-causing toxicants.

Studies link cigarette smoking and tobacco use directly with multiple mental health outcomes such as alcohol dependence, drug dependence, schizophrenia, depression, attention-deficit hyperactivity disorder (ADHD), and anxiety disorders (Williams & Ziedonis, 2004). Cigarette smoking among individuals with a mental illness or an addiction is a tremendous problem that often is ignored. One author notes that "Persons with mental illness are about twice as likely to smoke as other persons" and, "Persons with a currently active mental disorder consumed 44 per cent of all the cigarettes smoked in this nationally representative sample" (Lasser, Boyd, Woolhander, Himmelstein, McCormick, et al., 2000).

Environmental Tobacco Smoke (ETS), or secondhand smoke, has been linked with many adverse health outcomes in the general population, even at extremely low levels of exposure. Low levels of ETS exposure are associated with reduced cognitive abilities among children and adolescents (Yolton, Dietrich, Auinger, Lanphear & Hornung, 2005). Even more alarmingly, children and teenagers have heavier burdens than older people of cotinine, a product of ETS. In a study done by the Centers for Disease Control and Prevention (CDC), more than half of all nonsmokers in the United States older than 3 had detectable amounts of cotinine in their blood. This means that children are very vulnerable to ETS exposure, and this is particularly important since their brains and bodies are still developing, making them easier targets for adverse health outcomes. This exposure is unnecessary and preventable.

ETS is not only a well known carcinogen, but is also linked with heart disease. Nicotine in particular is also linked to acute increases in heart rate and blood pressure. ETS exposure is shown to nearly double the risk of having a heart attack. Nonsmokers who have high blood pressure or high blood cholesterol are at even greater risk of developing heart diseases from exposure to ETS. Persons with disabilities can reduce their risk of having secondary health problems associated with exposure to these chemicals simply by living in a smoke-free environment.

We can all play a part in protecting our vulnerable populations from unnecessary harm caused by ETS exposure. One way is to ban smoking in all indoor areas, especially group homes and institutions where people with developmental disabilities are likely to live. Opening a window or stepping into another room is not enough; until a person can quit smoking, he or she must step outdoors to minimize ETS exposures in the home. We can reduce the use of air fresheners to cover up the smell of ETS, and instead keep windows open to allow fresh air to flow through the indoor space. And most of all, we can teach others that smoking indoors can have serious health effects on those sharing the space, and that these health effects can be prevented by not smoking.

Persons with disabilities suffer from a wide range of secondary health conditions, including asthma, diabetes, emphysema, respiratory diseases, and other circulatory diseases. These health problems make this population especially vulnerable to ETS sensitivities, and it is therefore important to encourage smoke-free environments wherever persons with disabilities may reside, work or play. The right to live in a healthy, safe, and smoke-free environment is a right that must be shared by all persons.

Links:

American Heart Association: http://www.americanheart.org/presenter.jhtml?identifier=4521

Protecting People with Disabilities from ETS in Australia: http://www.ashaust.org.au/pdfs/protecting_disabled_ets.pdf

Environmental Health Center: http://www.nsc.org/EHC/indoor/ets.htm

Centers for Disease Control and Prevention: http://www.cdc.gov/tobacco/data_statistics/Factsheets/SecondhandSmoke.htm

Environmental Protection Agency: http://www.epa.gov/smokefree/

References:

Williams, J. M. & Ziedonis, D. (2004). Addressing tobacco among individuals with a mental illness or an addiction, Addictive Behaviors, 29, 1067-1083.

Lasser, K., Boyd, J. W., Woolhander, S., Himmelstein, D. U., McCormick, D., & Borr, D. H. (2000). Smoking and mental Illness: A population-based prevalence study. Journal of the American Medical Association, 284, 2606-2610.

Yolton, K., Dietrich, K., Auinger, P., Lanphear, B. P., & Richard Hornung, R. (2005). Exposure to environmental tobacco smoke and cognitive abilities among U.S. children and adolescents. Environmental Health Perspectives, 113 (1), 98-103.

For further information, please contact Laura Abulafia, MHS, Director, Environmental Health Initiative, American Association on Intellectual and Developmental Disabilities (formerly AAMR), 444 North Capitol Street, NW, Suite 846, Washington, D.C. 20001-1512, email, Laura@aaidd.org .