1. U.S. Environmental Protection Agency, Office of Air and Radiation. Report to Congress on Indoor Air Quality, Volume II: Assessment and Control of Indoor Air Pollution, pp. I, 4-14. EPA 400-1-89-001C, 1989.
  2. The U.S. Environmental Protection Agency sets and enforces air quality standards only for ambient air. The Toxic Substances Control Act (TSCA) grants EPA broad authority to control chemical substances and mixtures that present an unreasonable risk of injury to health and environment. The Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) authorizes EPA to control pesticide exposures by requiring that any pesticide be registered with EPA before it may be sold, distributed, or used in this country. The Safe Drinking Water Act authorizes EPA to set and enforce standards for contaminants in public water systems. EPA has set several standards for volatile organic compounds that can enter the air through volatilization from water used in a residence or other building. As to the indoor air in workplaces, two Federal agencies have defined roles concerning exposure to (usually single) substances. The National Institute for Occupational Safety and Health and Human Services (NIOSH), part of the Department of Health and Human Services, reviews scientific information, suggests exposure limitations, and recommends measures to protect workers' health. The Occupational Safety and Health Administration (OSHA), part of the Department of Labor, sets and enforces workplace standards. The U.S. Consumer Product Safety Commission (CPSC) regulates consumer products which may release indoor air pollutants. In the United States there are no Federal Standards that have been developed specifically for indoor air contaminants in non-occupational environments. There are, however, some source emission standards that specify maximum rates at which contaminants can be released from a source.
  3. Leaderer, B.P., Cain, WS., Isseroff, R., Berglund, L.G. "Ventilation Requirements in Buildings II". Atmos. Environ. 18:99-106.
    See also: Repace, J.L. and Lowrey, A.H. "An indoor air quality standard for ambient tobacco smoke based on carcinogenic risk." New York State Journal of Medicine 1985; 85:381-83.
  4. American Society of heating, Refrigeration and Air-conditioning Engineers. Ventilation for Acceptable Air Quality; ASHRAE Standard 62-1989.
  5. International Agency for Research on Cancer. IARC Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man, Vol. 38: Tobacco Smoking. World Health Organization, 1986.
  6. U.S. Department of Health and Human Services. Reducing the Health Consequences of Smoking: 25 Years of Progress, A Report of the Surgeon General. DHHS Publication No. (CDC) 89-84". 1989.
  7. U.S. Department of Health and Human Services. The Health Benefits of Smoking Cessation, A Report of the Surgeon General. DHHS Publication No. (CDC) 90-8416. 1990.
  8. U.S. Environmental Protection Agency, Office of Air and Radiation and Office of Research and Development. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders. EPA 600-6-90-006F. 1992.
  9. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Smoking, A Report of the Surgeon General. DHHS Publication No. (PHS) 87-8398. 1986.
  10. National Research Council, Environmental Tobacco Smoke: Measuring Exposures and Assessing Health Effects. National Academy Press. 1986.
  11. National Institute for Occupational Safety and Health. Environmental Tobacco Smoke in the Workplace: Lung Cancer and Other Health Effects. U.S. Department of Health and Human Services, Current Intelligence Bulletin 54. 1991.
  12. U.S. Environmental Protection Agency. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders.
  13. U.S. Environmental Protection Agency. Respiratory Health Effects of Passive Smoking. Lung Cancer and Other Disorders.
  14. U.S. Environmental Protection Agency. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders.
  15. Pope,C.A. III, Schwartz,j. and Ransom, MR. "Daily Mortality and PM 10 Pollution in Utah, Salt Lake, and Cache Valleys". Archives of Environmental Health 1992: 46:90-96.
  16. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Smoking, A Report of the Surgeon General.
  17. National Research Council. Environmental Tobacco Smoke: Measuring Exposures and Assessing Health Effects.
  18. American Heart Association Council on Cardiopulmonary and Critical Care. "Environmental Tobacco Smoke and Cardiovascular Disease." Circulation 1992; 86:1-4.
  19. Samet, J.M., Marbury, Marian C., and Spengler, J.D. "Health Effects and Sources of Indoor Air Pollution, Part I." American Review of Respiratory Disease 1987; 136:1486-1508.
  20. American Thoracic Society. "Report of the ATS Workshop on Environmental Controls and Lung Disease, Santa Fe, New Mexico, March 24-26, 1988." American Review of Respiratory Disease 1990; 142:915-39.
  21. Lipsett, M. "Oxides of Nitrogen and Sulfur." Hazardous Materials Technology 1992; 000:964-69.
  22. U.S. Environmental Protection Agency. "Review of the National Ambient Air Quality Standards for Sulfur Oxides: Updated Assessment of Scientific and Technical Information; Supplement to the 1986 Staff Paper Addendum (July 1993)."
  23. Burge, Harriet A. and Feely, J.C. "Indoor Air Pollution and Infectious Diseases." In: Samet, J.M. and Spengler, J.D. eds., Indoor Air Pollution, A Health Perspective (Baltimore MD: Johns Hopkins University Press, 1991), pp. 273-84.
  24. Brunekreeff, B., Dockery, D.W. et al. "Home Dampness and Respiratory Morbidity in Children." American Review of Respiratory Disease 1989; 140:1363-67.
  25. Berstein, R.S., Sorenson, W.G. et al. "Exposures to Respirable Airborne Penicillium from a Contaminated Ventilation System: Clinical, Environmental, and Epidemiological Aspects." American Industrial Hygiene Association Journal 1983; 44:161-69.
  26. Burge, Harriet A. "Bioaerosols: Prevalence and Health Effects in the Indoor Environment." Journal of Allergy and Clinical Immunology 1990; 86:687-704.
  27. Burge, Harriet A. "Risks Associated With Indoor Infectious Aerosols." Toxicology and Industrial Health 1990; 6:263-73.
  28. Brundage,J.F., Scott, R. et al. "Building-Associated Risk of Febrile Acute Respiratory Disease in Army trainees." Journal of the American Medical Association 1988; 259:2108-12.
  29. Nolan, C.M., Elarth, A.M. et al. "An Outbreak of Tuberculosis in a Shelter for Homeless Men: A Description of Its Evolution and Control." American Review of Respiratory Disease 1991; 143:257-61.
  30. American Lung Association. Lung Disease Data 1993. Publication No. 0456, 1993.
  31. Centers for Disease Control and American Thoracic Society. Core Curriculum on Tuberculosis. Second Edition, 1991.
  32. Nardell, E.A., Keegan, Joann et al. "Airborne Infection: Theoretical Limits of Protection Achievable By Building Ventilation." American Review of Respiratory Disease 1991; 144:302-06.
  33. Lee, T.C., Stout, Janet E. and Yu, V.L. "Factors Predisposing to Legionella pneumophila Colonization in Residential Water Systems." Archives of Environmental Health 1988; 43:59-62.
  34. Weissman, D.N. and Schuyler, M.R. "Biological Agents and Allergic Diseases." In: Samet, J.M. and Spengler, J.D. eds., Indoor Air Pollution, A Health Perspective (Baltimore MD: Johns Hopkins University Press, 1991), pp. 285-305.
  35. Arlian, L.G. "Biology and Ecology of House Dust Mite, Dermatophagoldes spp. and Euroglyphus spp." Immunology and Allergy Clinics of North America 1989;9:339-56.
  36. Platts-Mills, T.A. E. and Chapman, M.D. "Dust Mites: Immunology, Allergic Disease, and Environmental Control." Journal of Allergy and Clinical Immunology 1987; 80:755-75.
  37. FinkJ.N." Hypersensitivity Pneumonitis." In: Middleton, E., Reed, C.E. and Ellis, E.F. eds., Allergy Principles and Practice (St. Louis: C.V. Mosby, 19xx), pp. 1085-1100.
  38. Fink J.N. "Hypersensitivity Pneumonitis." In: Middleton, E., Reed, C.E. and Ellis, E.F. eds., Allergy Principles and Practice (St. Louis: C.V. Mosby, 19xx), pp. 1085-1100.
  39. Burge, Harriet A., Solomon,W.R. and Boise, J.R. "Microbial Prevalence in Domestic Humidifiers." Applied and Environmental Microbiology 1980; 39:840-44.
  40. Baxter, C.S., Wey, H.E. and Burg, W.R. "A Prospective Analysis of the Potential Risk Associated with Inhalation of Aflatoxin-Contaminated Grain dusts." Food and Cosmetics Toxicology 1981; 19:763-69.
  41. Croft, W.A.,Jarvia, B.B. Yatawara, C.S. 1986. Airborne outbreak of trichothecene toxicosis. Atmosph. Environ. 20:549-552. See also Baxter, C.S. Wey, H.E., Burg, W. E. 1981. A prospective analysis of the potential risk associated with inhalation of aflatoxin-contaminated grain dusts. Food Cosmet Toxicol. 19:763-769.
  42. U.S. Environmental Protection Agency, Office of Acid Deposition, Environmental Monitoring and Quality Assurance. Project Summary: The Total Exposure Assessment Methodology (TEAM) Study. EPA-600-S6-87-002, 1987.
  43. Marks, J.G., Jr. Traudein, J.J. et al. "Contact Urticaria and Airway Obstruction From Carbonless Copy Paper." Journal of the American Medical Association 1984; 252:1038-40.
  44. LaMarte, F.P., Merchant, J.A. and Casale, T.B. "Acute Systemic Reactions to Carbonless Copy Paper Associated With Histamine Release." Journal of the American Medical Association 1988; 260:242-43.
  45. U.S. Environmental Protection Agency, Office of Air and Radiation. Report to Congress on Indoor Air Quality, Volume II: Assessment and Control of Indoor Air Pollution, pp. I, 4-14. EPA-400-I-89-001C, 1989.
  46. U.S. Environmental Protection Agency, U.S. Public Health Service, and National Environmental Health Association. Introduction to Indoor Air Quality: A Reference Manual, p. 87. EPA-400-3-91-003, 1991.
  47. U.S. Environmental Protection Agency Office of Research and Development. Final Report: Nonoccupational Pesticide Exposure Study (NOPES), p. 60. EPA-600-3-90-003, 1990.
  48. Needleman, H.L. Schell, A. et al. "The Long-Term Effects of Exposure to Low Doses of Lead in Childhood: An 11-Year Follow-up Report." The New England Journal of Medicine 1990; 322:83-88.
  49. American Academy of Pediatrics. "Lead Poisoning: Next Focus of Environmental Action." Statement issued January 1991.
  50. Bellinger, D., Sloman, J. et al. "Low-Level Lead Exposure and Children's Cognitive Function in the Preschool Years." Pediatrics 1991; 87:219-27.
  51. "Lower "Threshold of Concern" for Children's Lead Levels". FDA Consumer, December 1991. p.6.
  52. Centers for Disease Control. "Preventing Lead Poisoning in Young Children". October 1991.
  53. Agocs, Mary M., Etzel, Ruth A. et al. "Mercury Exposure from Latex Interior Paint." The New England Journal of Medicine. 1990; 323:1096-11011.
  54. Consumer Product Safety Commission. Safety Alert: Mercury Vapors.
  55. A professional group, the American Society of Heating, Refrigerating, and Air-conditioning Engineers (ASHRAE), has established standards of ventilation for the achievement of acceptable indoor air quality. These criteria do not have the force of law, are typically invoked only for new or renovated construction, and even when met do not assure comfortable and healthy air quality under all conditions and in all circumstances.
  56. U.S. Environmental Protection Agency, Office of Air and Radiation. Indoor Air Facts No. 4: Sick Building Syndrome, revised, 1991.
  57. Kreiss, Kathleen. "The Sick Building Syndrome: Where Is the Epidemiologic Basis? "American Journal of Public Health 1990; 80:1172-73.
  58. The first death attributed to occupational asbestos exposure occurred in 1924; the details were recently recounted: Selikoff, I.J. and Greenberg, M. "A Landmark Case in Asbestosis." Journal of the American Medical Association 1991; 265:898-901.
  59. For a detailed discussion of asbestos-related pulmonary disease, see: Rom, W.N., Travis, W.D. and Brody, A.R. "Cellular and Molecular Basis of the Asbestos-related Diseases." American Review of Respiratory Disease 1991; 143:408-22.
  60. U.S. Environmental Protection Agency, Office of Research and Development. Airborne Asbestos Health Assessment Update. EPA-600-8-84-003F. June 1986.
  61. "Asbestos in Your Home", American Lung Association, U.S. Consumer Product Safety Commission, U.S. Environmental Protection Agency. September 1990. ALA Publication No. 3716.
  62. See Samet, J.M., Marbury, Marian C. and Spengler, J.D. "Health Effects and Sources of Indoor Air Pollution, Part II." American Review of Respiratory Disease 1988; 137:221-42. This continuation of the overview cited earlier provides a table of commercial sources of testing equipment for sampling and monitoring levels of a variety of indoor air pollutants, including radon.
  63. Black, D.W. Rathe, Ann and Goldstein, Rise B. "Environmental Illness: A Controlled Study of 26 Subjects With '20th Century Disease." Journal of the American Medical Association 1990; 264:3166-70.
  64. Fiedler, N., Maccia, C., Mpen, H. "Evaluation of Chemically Sensitive Patients". Journal of Occupational Medicine. 1992. 34:529-538.
  65. Heuser, G., Wojdani, A., Heuser, S. "Diagnostic Markers of Multiple Chemical Sensitivity". Multiple Chemical Sensitivities: Addendum to Biologic Markers in Immunotoxicology. 1992. pp. 117-138. National Research Council. National Academy Press. Washington D.C.
  66. See Ducataman et al. "What is Environmental Medicine?" Journal of Occupational Medicine 1990; 32: 1130-32. Also see American College of Physicians Health and Public Policy Committee. "Occupational and Environmental Medicine: The Internist's's Role". Annals of Internal Medicine 1990; 113:974-82.
  67. For further specifics, see: U.S. Environmental Protection Agency, Office of Air and Radiation. Residential Air Cleaning Devices - A Summary of Available Information. EPA-400-1-90-002,1990.
  68. Residential Carpet Installation Standard. The Carpet and Rug Institute. First Edition. 1990. CRI Publication No. 105-1990.
  69. National Aeronautics and Space Administration. Interior Landscape Plants for Indoor Air Pollution Abatement. September 15, 1989.

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Acknowledgments

The sponsors thank the following people for the time and effort contributed to the creation of this publication: Steven Colome, Ph.D., Integrated Environmental Services, Irvine, CA; Robert J. McCunney, M.D., University Medical Center, Boston, MA; Jonathan M. Samet, M.D., University of New Mexico, Albuquerque, NM; David Swankin, Esq., Swankin and Turner, Washington, DC.

Appreciation is also extended to the many additional reviewers who contributed their valuable expertise.

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