MonroeCounty.gov; Adam Bello, County Executive

Health Frequently Asked Questions (FAQs)

 

Asbestos

Q. What are some of the health effects of asbestos?

The most dangerous asbestos fibers are too small to be visible. After they are inhaled, they can remain and accumulate in the lungs. Asbestos can cause lung cancer, mesothelioma—a cancer of the chest and abdominal lining, and asbestosis—irreversible lung scarring that can be fatal. Symptoms do not show up until many years after exposure began. Most people with asbestos-related disease were exposed to elevated concentrations on the job.

Q. What is asbestos and why should I be concerned about it?

Asbestos is a mineral fiber that has been used commonly in a variety of building construction materials for insulation and as a fire retardant. It is commonly found in older homes, in pipe and furnace insulation materials, mineral siding, roofing paper and shingles, millboard, gray coat in plaster, spackle used for repairing plaster or wallboard, wallboard joint compound, textured paints, other coating materials and vinyl floor tiles. Major concerns with asbestos are deteriorating, damaged or disturbed materials. Elevated concentrations can occur after asbestos containing materials are disturbed by cutting, sanding, and other remodeling activities or by improper removal attempts.

There are no immediate symptoms from excessive asbestos exposure, but there is a long-term risk of chest and abdominal cancers and lung disease. Smokers are at a higher risk of developing asbestos-induced lung cancer.

Combustion Pollutants

Q. How can I reduce the risk from combustion gases?

The most important practice is to keep all combustion equipment well maintained and inspected for safety. Experts recommend having your combustion heating system inspected by a trained professional every year. Look for blocked openings to flues and chimneys, cracked or disconnected flue pipe, sooty air filter, rust or cracks in the heat exchanger, soot or creosote build-up, and exhaust or gas odors. Always operate combustion equipment for its intended purpose and make sure that it has been installed correctly. Never use unvented combustion appliances indoors without following manufacturer’s recommendations.

Q. How can I determine if combustion gases are affecting my health?

They may be the culprits if you feel bad only when you’re inside the home and the symptoms disappear when you leave or if more than one person in the home has similar symptoms.A noticeable increase in moisture, like excessive condensation on windows, can also be a sign.

Remember carbon monoxide related symptoms are similar to those of flu. Carbon monoxide detectors can be purchased and installed to alert you to dangerous levels. The detector must be properly located according to directions and maintained to assure accurate sensing. However such a detector will not detect other combustion by-products that can still make you ill.

Q. How do combustion pollutants get into the home?

Combustion pollutants enter the home from a variety of sources. Any heating appliance that burns fuels—furnaces, boilers, water heaters, fireplaces, stoves, space heaters, ranges and clothes dryers—may introduce combustion gases. These pollutants are also produced by tobacco smoking, burning of candles, automobile exhaust entering from a garage, and activities involved in the use of the internal combustion engines, burning, welding or soldering.

Combustion gases and particles also come from chimneys and flues that are improperly installed or maintained and from cracks in furnace heat exchangers. Pollutants from fireplaces and wood stoves with no dedicated outdoor air supply can be back-drafted from the chimney into the living space, particularly in weatherized homes.

Carbon monoxide buildup can occur several ways: when flues or chimneys become blocked so exhaust can not be vented to the outside; when a fuel burning furnace has a cracked or rusted heat exchanger allowing combustion gases into the living spaces; when fuel-burning space heaters, ovens, ranges or grills are operated in the home without adequate ventilation; when a car exhaust from an attached garage enters the home; when combustion equipment is not working properly and causes incomplete combustion; and when there is negative pressure balance between the inside and outside of the home that prevents adequate venting of combustion gases.

“Backdrafting” can be a problem. It occurs when the air pressure inside the home is less than the air pressure outside, causing combustion by-products to spill back into the room rather than being vented outside. It can also occur when natural draft appliance exhaust is pulled back into the house by mechanical ventilation –like the use of a kitchen or bathroom exhaust fan.

Q. Why should I be concerned about combustion pollutants?

Carbon monoxide, an odorless gas can be fatal. Nitrogen oxides can damage the respiratory tract and sulfur dioxide can irritate the eyes, nose and respiratory tract. Smoke and other particulate irritate the eyes, nose and throat and may cause lung cancer. Too much water vapor can lead to moisture problems in the home, including the growth of mold.

Carbon Monoxide is a colorless, odorless gas that interferes with the delivery of oxygen throughout the body. At high concentrations it can impair judgement, cause paralysis or coma, and death. Lower concentrations can cause a range of symptoms from headache, dizziness, weakness, nausea, muscle ache, confusion and disorientation, to fatigue in healthy people and episodes of increased chest pain in people with chronic heart disease. The symptoms of carbon monoxide poisoning are sometimes confused with flu or food poisoning. Fetuses, infants, elderly people and people with anemia or with a history of heart or respiratory disease can be especially sensitive.

Nitrogen Dioxide is a colorless, odorless gas that irritates the mucous membranes in the eye, nose, and throat and causes shortness of breath after exposure to high concentrations. There is evidence that high concentrations or continued exposure to low levels increase the risk of respiratory infection and that repeated exposures to elevated levels may lead, or contribute to the development of lung disease such as emphysema. People at particular risk from exposure include children and individuals with asthma or other respiratory diseases.

Particles, released when fuels are incompletely burned, can lodge in the lungs and irritate or damage lung tissue. A number of pollutants, which can cause cancer, attach to small particles that are inhaled and then carried deep into the lung.

Q. What are combustion pollutants?

They include gases or particles that come from the burning of fuels—natural gas, propane, wood, oil, gasoline, kerosene and coal. The resulting harmful gases include carbon monoxide, nitrogen oxides, sulfur dioxide, acid aerosols, particulate and excess water vapor.

Environmental Tobacco Smoke (ETS)

Q. What can I do to reduce my family’s risk from ETS?

Do not smoke in your home or permit others to do so. If a family member insists on smoking indoors, increase ventilation (open windows or use exhaust fans) in the area where smoking is to take place. Do not smoke if children (who are particularly susceptible) are present, especially infants and toddlers.

Q. What about the risks to children?

Secondhand Smoke is a serious risk to children. EPA estimates that passive smoking is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children less than 18 months of age annually, resulting in between 7,500 and 15,000 hospitalizations each year. Children exposed to secondhand smoke are more likely to have reduced lung function and symptoms of respiratory irritation like cough, excess phlegm and wheeze.

Passive smoking can lead to the buildup of fluid in the middle ear, the most common cause of hospitalization of children for an operation. Asthmatic children are especially at risk. Exposure increases the number of episodes and severity of symptoms in hundreds of thousands of asthmatic children. EPA estimates that between 200,000 and 1,000,000 asthmatic children have their conditions made worse by exposure to secondhand smoke. Passive smoking may cause thousands of non-asthmatic children to develop the condition each year.

Q. How does secondhand smoke affect my health?

Secondhand smoke has been classified by the US Environmental Protection Agency (EPA) as a known cause of lung cancer in humans (Group A carcinogen). It causes eye, nose and throat irritation; headaches; may contribute to heart disease; increased risk of lower respiratory tract infections such a bronchitis and pneumonia; increased severity and frequency of asthma episodes and decreased lung function. Homes with one or more smokers may have particles levels several times higher than outdoor levels.

Q. What is secondhand smoke?

Secondhand Smoke is a mixture of the smoke given off by the burning end of a cigarette, pipe or cigar and the smoke exhaled from the lungs of smokers. This mixture contains more than 400 chemicals, more than 40 of which are known to cause cancer in humans or animals and many of which are strong irritants. Exposure to secondhand smoke is called involuntary smoking or passive smoking.

Formaldehyde

Q. What can I do to reduce formaldehyde problems?

High humidity and elevated temperatures cause formaldehyde release. Humidity may be controlled through air conditioning and dehumidification. Elevated levels can be reduced by increased ventilation, particularly after bringing new sources into the home. When remodeling and in new construction, select low formaldehyde containing materials. It cannot penetrate plastic laminate and is at least partially blocked by coatings, varnishes and special formaldehyde sealants.

Q. Why should I be concerned about formaldehyde?

Formaldehyde is a strong irritant that causes watery eyes and at low doses, causes burning sensations in the eyes, nose and throat. Wheezing and coughing, fatigue, shin rashes, headaches, loss of coordination and nausea are other symptoms. Larger doses can cause asthma attacks as well as damage the liver, kidneys and central nervous system. Some people are highly sensitive and react to formaldehyde concentrations that don’t bother other people.

Q. What are the major sources of formaldehyde?

Sources in the home include building materials, smoking, household products and the use of unvented fuel-burning appliances like gas stoves or kerosene space heaters. It is used to add permanent press qualities to clothing and draperies, as a component of glues and adhesives, in cosmetics, in veneered or laminated furniture, as a preservative in some paints and coating products.

In homes, the most significant source of formaldehyde are likely to be pressed wood products made using urea-formaldehyde (UF) resins. Pressed wood products made for indoor use include: particleboard used as a sub flooring and shelving, formica countertops and in cabinetry and furniture; hardwood plywood paneling used for decorative wall covering and used in cabinets and furniture; and medium density fiberboard used for drawer fronts, cabinets and furniture tops. Medium density fiberboard contains a higher resin-to-wood ratio than any other UF pressed wood product and is generally recognized as being the highest formaldehyde emitted pressed wood product.

During the 1970s, many homeowners had urea-formaldehyde foam insulation (UFFI) installed in wall cavities of their homes as an energy conservation measure. Many of these homes were found to have relatively high indoor concentrations of formaldehyde.

Q. What is formaldehyde?

Formaldehyde is a chemical widely used by industry to manufacture building materials and numerous household products. It is a good preservative, makes an excellent adhesive, widely used in buildings and furnishing industries and found in small amounts in some textiles as an anti-wrinkle agent. It is also a by-product of combustion and certain other natural processes and may be present in substantial concentrations both indoors and outdoors. Formaldehyde has been shown to cause cancer in laboratory animals and there is some limited evidence that is causes cancer in humans.

Foster Care Pediatrics

Q. Who will my child see at Foster Care Pediatrics?

The staff includes:

  • Moira Szilagyi,MD, Ph.D.; Medical Director
  • Nancy Crevalier, NP
  • Elizabeth McMahon, NP
  • Daria Pratt, MSW
  • Pat LeClair, RN
  • Pam Rademacher, CHN
  • Claire Ovenshire, CHN
  • Lisa Yockel, RN
  • Karen Hall, PHA
  • Ernestine Lockett, Clerk
  • Linda Elliott, Clerk

Q. How do I contact the Foster Care Clinic?

Location:
111 Westfall Rd.
Room 183
Hours: 8:30 until 4:30, Monday through Friday; (Open until 7:00 p.m. every other Wednesday)
Phone: 585 753-5927
After Hours Number: 585 753-5927 and you will be transferred to our after hours service.

Q. How do I make an appointment for my foster child?

Appointments: Call the main number any day during office hours to schedule appointments for well-child care (physicals ), acute illness, chronic illness, behavior problems, developmental issues, adolescent health care including pelvic examinations, and evaluations for physical or sexual abuse.

Q. What about medical emergencies?

Emergencies:
If you have a child with a life-threatening emergency; call 9-1-1.

Urgent Health Problems:
Most "emergencies" fit into this category, in that they require urgent attention, but are not immediately life-threatening. Examples include moderate to severe asthma attacks, fractures on long bones, etc.

If you feel a child needs immediate medical attention:

  • During office hours, call 585 753-5927 as soon as you are aware of problems as early in the day as possible and explain the problem to the secretary.
  • After office hours, call 585 753-5927. You will be referred to the answering service. Call and ask to speak to the nurse or doctor on call. Identify the problem for the answering service.
  • If you have not spoken with someone within about 10 minutes after your call, please call back and stress the urgent nature of your call.
  • Call our office the following day to let us know the status of the situation.

Acute illness, non-urgent:
Call the office as early as possible in the day during office hours, or the answering service after hours. A nurse or doctor will call you back as soon as possible.

Q. What about prescriptions for a foster child?

Routine prescription refills:
Call at least one week prior to prescriptions running out. Call during office hours and leave your name, child’s name, name of the medication, and pharmacy’s name and number. Most refills are done by mail and it takes 4-5 days for turn around. When you have a child on any medication you need to keep a record of the administration on a medication log form. A copy is available at the office. Please bring this log with you to each visit.

Q. How soon do you need to see a child entering or returning to foster care?

New admissions (or returns to care):
We feel it is very important to see children and teens soon after they enter foster care. This allows us to document growth, development, signs of abuse, and neglect and acute medical problems.

We ask you to call us within 48 hours after a child enters your home so that we can schedule an examination within a few weeks of entry to care whenever possible.

Admission evaluations are usually a two-step process. We usually see the child shortly after entry to care and then about eight weeks later to ensure that all medical, developmental and behavioral issues have been addressed.

Q. What happens when a child leaves foster care?

Discharges from care:
We ask you, whenever possible, to notify us when a child is scheduled to leave foster care. This enables us to schedule a discharge visit, identify a new physician for the child, and ensure that medical records are transferred.

Q. What about behavioral issues in foster children?

Behavioral issues:
Many children in foster care have behavioral and mental problems. If the child has a therapist, the therapist is the logical person with whom to discuss those issues. The caseworker can also he helpful.

If you identify a new problem or a worsening of existing problem you may speak to us about these types of issues. We now have a Social Worker on staff who can assist you in identifying and accessing services for children. Many times, problems are identified that might respond to medication. We are bound by DSS policy to seek parental permission prior to beginning a child on medication for mental health or behavioral problems. We will work with you and the caseworker to facilitate this.

Q. What about HIV screening for foster children?

HIV Screening:
Caseworkers are mandated by law to complete a risk assessment for HIV infection on every child admitted to foster care. Physicians and nurse practitioners are required by law to do the same at each well-child care visit. If a risk factor is identified, the caseworker will attempt to obtain consent for a test on the child involved. In some cases, where there is a risk factor identified, and the parent or guardian is unwilling or unable to consent to screening, DSS may provide consent. HIV test results are available to foster families, except in rare circumstances. HIV test results can not be given over the telephone.

Q. Who handles child abuse evaluations?

Abuse Evaluations:
Dr. Szilagyi, of our staff, is a recognized expert in the area of child abuse and neglect. Most abuse evaluations can be conducted in our office. Occasionally, it may be necessary to refer a child to the REACH Program at Strong Memorial Hospital for further evaluation.

Q. How does the clinic handle consent and confidentiality?

Consent:
Foster parents may not consent for medical procedures, medication or the release of medical records, except in the rare circumstance where the foster parent is also the legal guardian. Always ask the provider to contact the child’s caseworker or caseworker supervisor if you are asked to sign something.

Confidentiality:
Foster parents have access to all of the medical information concerning children in their care with limited exceptions. Adolescents may choose to keep information related to sexual issues (sexually transmitted diseases, birth control), pregnancy (and abortion), drug and alcohol use, and HIV infection confidential. Unless an adolescent behaves in such a way as to pose harm to themselves or others, medical providers are bound by law to protect their confidentiality in these areas. Our staff always encourages adolescents to share information with their caseworker and their foster parent, both of whom are also bound by confidentiality rules.

Household Products

Q. What are some ways that I can minimize potential health problems from household products?

  • Always read the labels of the products that you are considering buying. Note the product ingredients and beware of any warnings of its use.
  • Always use household products only for their intended purpose and according to the manufacturer’s instructions.
  • Use the product in a well-ventilated area. Choose products that are packaged to reduce the chances of spills, leaks and child tampering.
  • Keep household products in their original containers so that safety information and directions for use are always with the product.

NOTE: Some products may be labeled “environmentally safe,” but any product that evaporates into the air has the potential to be an indoor air pollutant, depending on the quantity used, the method of use, the products toxicity and the sensitivity of the user.

Q. What are some of the health effects of organic chemicals?

The ability of organic chemicals to cause health effects varies greatly—from those that are highly toxic, to those with no known health effect. As with other pollutants, the extent and nature of the health effect will depend on many factors including level of exposure and length of time exposed. Eye irritation, headaches, dizziness, visual disorders and memory impairment are among the immediate symptoms that some people have experienced soon after exposure. Long-term exposure can cause loss of coordination; nausea; and damage to the liver, kidneys and the central nervous system. Many organic chemicals are known to cause cancer in animals; some are suspected of causing or are known to cause cancer in humans.

Q. What are the particular household product ingredients that I should be concerned about?

The products to watch are those containing volatile organic compounds (i.e., petroleum distillates, mineral spirits, toluene, xylene) which are organic compounds that easily evaporate into the air. Some may be flammable while other can be a hazard if they are used improperly. Some of the ingredients not specifically listed or listed as “inert” may also have some unhealthful side effects. People using products containing organic chemicals can expose themselves and others to very high pollutant levels, and elevated concentrations can persist in the air long after the activity is complete.

Q. What are some of the household products that I should be concerned about?

These include:

  • solvents;
  • paints;
  • varnishes;
  • paint strippers;
  • waxes;
  • wood preservatives;
  • aerosol sprays;
  • moth repellents;
  • air fresheners;
  • stored fuels;
  • automotive products;
  • hobby supplies;
  • pesticides;
  • dry-cleaned clothing;
  • adhesives and fabric additives used in carpeting, draperies and furniture;
  • and some cleaners, degreasers and disinfectants.

Indoor Air Quality

Q. What can be done to improve indoor air quality?

There are three basic strategies for improving indoor air quality. Usually the most effective way to improve indoor air quality is to eliminate individual sources of pollution or to reduce their emissions. Another approach is to lower the concentration of indoor air pollutants in your home by increasing the amount of outdoor air coming indoors. The third is the purchase and installation of air cleaning equipment.

Source Control:
Some sources, like those that contain asbestos, can be sealed, enclosed or removed; others, like gas stoves, can be adjusted to decrease the amount of emissions. In many cases, source control is a more cost-efficient approach to protecting indoor air quality than increasing ventilation because increasing ventilation can increase energy costs.

Ventilation Improvements: Most home heating and cooling systems, including forced air heating systems, do not mechanically bring fresh air into the house. Opening windows and doors, operating window and attic fan, when the weather permits, or running a window air conditioner with the vent control open increases the outdoor ventilation rate. Local bathroom or kitchen fans that exhaust outdoors remove contaminants directly from the room where the fan is located and also increases outdoor ventilation rate.

It is particularly important that you take as many of these steps as possible while you are involved in short-term activities that can generate high levels of pollutants—for example, painting, paint stripping, heating with kerosene heaters, cooking or engaging in maintenance and hobby activities such as welding, soldering, or sanding. You might also choose to do some of these activities outdoors, if weather permits.

Advanced design of new homes are starting to feature mechanical systems that bring outdoor air into the home. Some of these designs include energy-efficient heat recovery ventilators that are also known as air-to-air heat exchangers.

Air Cleaners:
There are many types and sizes of air cleaners on the market, ranging from relatively inexpensive tabletop models to sophisticated and expensive whole-house systems. Some air cleaners are highly effective at particle removal, while others, including tabletop models, are much less so. Air cleaners are not generally designed to remove gaseous pollutants but some can to various degrees of efficiency.

The effectiveness of an air cleaner depends on how well it collects pollutants from indoor air (expressed as a percentage efficiency rate) and how much air it draws through the cleaning or filtering element (expressed as cubic feet per minute). A very efficient collector with a low air circulation rate will not be effective, nor will a cleaner with a high circulation rate but a less efficient collector. The long-term performance of any air cleaner depends on maintaining it according to the manufacturer’s directions.

Another important factor in determining the effectiveness of an air cleaner is the strength of the pollutant source. Tabletop air cleaners, in particular, may not satisfactorily remove pollutants from strong nearby sources. People with sensitivity to particular sources may find that air cleaners are helpful only in conjunction with concerted efforts to remove the source.

Over the past few years, there has been some publicity suggesting that houseplants have been shown to reduce levels of some chemicals in laboratory experiments. There is currently no evidence, however, that a reasonable number of houseplants remove significant quantities of pollutants in homes and offices. Indoor houseplants should not be over watered because overly damp soil may promote the growth of microorganisms, which may affect certain individuals.

Q. What are the signs of possible home indoor air quality problems?

  • Unusual and noticeable odors, stale or stuffy air
  • Noticeable lack of air movement
  • Dirty or faulty central air or air conditioning equipment
  • Damaged flue pipes or chimneys
  • Unvented combustion air sources for fossil fuel appliances
  • Excessive humidity
  • Tightly constructed or remodeled home
  • Presence of mold and mildew
  • Health reaction after remodeling, weatherizing, using new furniture, use of household or hobby products, or moving into a new home
  • Feeling noticeably healthier outside the home

Q. How does outdoor air enter a house?

Outdoor air enters and leaves a house by: Infiltration, natural ventilation and mechanical ventilation. Infiltration is the process where outdoor air flows into a house through openings, joints, and cracks in walls, floors, and ceilings and around windows and doors. In natural ventilation, air moves through open windows and doors. Air movement associated with infiltration and natural ventilation is caused by air temperature differences between indoors and outdoors and by wind. There are a number of mechanical ventilation devices, from outdoor-vented fans that intermittently remove air from a single room such as bathrooms and kitchens, to air handling systems that use fans and duct work to continuously remove indoor air and distribute filtered outdoor air to strategic points throughout the house. The rate at which outdoor air replaces indoor air is described as the air exchange rate.

When there is little infiltration, natural ventilation, or mechanical ventilation, the air exchange rate is low and pollutant levels can increase.

Q. What causes indoor air problems in homes?

Indoor pollution sources that release gases or particles into the air are the primary cause of indoor air quality problems. Inadequate ventilation can increase indoor pollutant levels by not bringing in enough outdoor air to dilute emissions from indoor sources and by not carrying indoor pollutants out of the building. High temperature and humidity levels can also increase concentrations of some pollutants.

Pollutant Sources: There are many sources of indoor air pollution in any home. These include combustion sources such as oil, gas, kerosene, coal, wood and tobacco products; building materials and furnishings as diverse as deteriorated asbestos containing pipe, duct insulation, floor tiles, wall and ceiling coatings and exterior siding; wet or damp carpets and cabinetry or furniture made of certain pressed wood products; products for household cleaning and maintenance, personal care or hobbies; central heating and cooling systems and humidification devices; and outdoor sources such as radon, pesticides and outdoor air pollution.

The relative importance of any single source depends on how much of a given pollutant it emits and how hazardous those emissions are. In some cases, a factor of how old the source is and whether it is properly maintained is significant. For example an improperly adjusted gas stove can emit significantly more carbon monoxide than one that is properly adjusted.

Some sources such as building materials, furnishings and household products like air fresheners release pollutants more or less continuously. Other sources, related to activities carried out in the home, release pollutants intermittently. These include smoking, the use of unvented or malfunctioning stoves, furnaces or space heaters, the use of solvents in cleaning and hobby activities, the use of paint and strippers in redecorating activities, and the use of cleaning products and pesticides in housekeeping. High pollutant concentrations can remain in the air for long periods after completion of some of these activities.

Ventilation: If inadequate outdoor air enters a home, pollutants can accumulate to levels that can pose health and comfort problems. Unless they are built with special mechanical means of ventilation, homes that are designed and constructed to minimize the amount of outdoor makeup air may have higher pollutant levels than other homes. However, because some weather conditions can drastically reduce the amount of outdoor air that enter a home, pollutants can build up even in homes that are normally considered “leaky.”

Q. How do I know if my home has significant concentrations of radon?

The only way to know is to have your home tested. Radon detection kits are inexpensive and easy to use. You can purchase a kit at your local hardware store or other retail outlet, the local office of the American Lung Association ($20 per kit containing 2 tests) or we have a form to order a kit (single test) costing $6.25 from the New York State Department of Health (or you can call them at 1-800-458-1158).

Mold

Q. If I’m concerned about biological contaminants in my home, what can I do to deal with the problem?

There are no practical tests for biological contaminants for use by non-professionals. However there are signs to watch for. You can sometimes see and smell mold colonies growing on surfaces. Mold growth should be suspected wherever there are water stains, standing water or moist surfaces. Prevent mold growth by keeping basements, bathrooms, and other rooms clean and dry. Use a disinfectant to clean surfaces that have mold on them. If carpeting or furnishings become wet, they must be quickly and thoroughly dried or discarded.

Humidifiers, dehumidifiers and air conditioning condensing units should be regularly cleaned with a disinfectant such as chlorine bleach. Keep humidity at acceptable levels (between 30% and 50%) and make sure there’s plenty of ventilation, especially in area where moisture tends to build up. People who are sensitive to dust mites may need to replace carpeting in their homes with hard surfaced flooring and use area rugs that can be removed and cleaned.

Vacuums with high efficiency filters or central vacuum systems can help reduce the airborne dust generated by vacuuming.

RECOMMENDATIONS

Install and use exhaust fans that are vented to the outdoors in kitchens and bathrooms and vent clothes dryers outdoors. This can eliminate much of the moisture that builds up from everyday activities. Another benefit is that they can reduce the levels of organic pollutants released during cooking or vaporized from hot water used in showers and dishwashers.

Keep the house clean. House dust mites, pollen, animal dander and other allergy causing agents can be reduced, although not eliminated, through regular cleaning. People who are allergic to these pollutants should use allergy-proof mattress encasements, wash bedding in hot (130° F) water, and avoid room furnishings that accumulate dust, especially if they cannot be washed. Allergic individuals should also leave the house while it is being vacuumed because vacuuming can actually increase the airborne level of mite allergen and other biological contaminants.

Ventilate the attic and crawl spaces to prevent moisture buildup. Keeping humidity levels in these areas below 50% can prevent water condensation on building materials.

Thoroughly clean and dry water-damaged carpets and building materials (within 24 hours if possible) or consider removal or replacement.

Q. How are biological contaminants transported through the house?

Molds and dust mites thrive in areas of high humidity. Mold grows on organic materials such as paper, textiles, grease, dirt and soap scum. Mold spores float throughout the house, forming new colonies where they land.

Dust mites thrive on dead human skin cells and in textiles such as bedding, carpeting and upholstery. When these textiles are disturbed during vacuuming, making beds or walking on carpet, dust particles become airborne. Pollen, plant material can enter through windows or on pets while animal dander becomes airborne when disturbed.

Infectious diseases caused by bacteria and viruses are generally passed from person to person through physical contact, but some circulate through indoor ventilation systems.

Q. What are some of the health effects of mold?

Allergic reactions are the most common health problems associated with biological pollutants. Symptoms often include watery eyes, runny nose and sneezing, nasal congestion, itching, coughing, wheezing, shortness of breath, headaches, and dizziness, lethargy and fatigue, fever and digestive problems. Dust mite residues have been identified as an important trigger for asthma attacks.

Some biological contaminants trigger allergic reactions including hypersensitivity pneumonitis, allergic rhinitis, and some types of asthma. Infectious illness such as influenza, measles, and chicken pox are transmitted through the air. Molds and mildew can also release disease-causing toxins.

Allergic reactions occur only after repeated exposure to a specific biological allergen. However that reaction may occur immediately upon re-exposure or after multiple exposures over time. As a result, people who have noticed only mild allergic reactions, or no reactions at all, may suddenly find themselves very sensitive to particular allergens.

Q. What biological problems with mold should I be concerned about?

Molds and mildew also known as fungi, bacteria and dust mites are some of the main biological pollutants inside the house. Some, such as pollen, are usually generated outside the home. Mold and mildew generated in the home may release volatile organic compounds and spores into the air. They are often found in areas of the home that have high humidity level, such as bathrooms, kitchens, laundry rooms or basements. Dust mites and animal dander are problematic when they become airborne during vacuuming, making beds or when carpeting or textiles are disturbed.

Biological contaminants include bacteria, molds and mildew, viruses, animal dander and cat saliva, house dust mites, cockroaches and pollen. There are many sources of these pollutants. Pollen originates from plants; people and animals transmit viruses; bacteria are carried by people, animals, soil and plant debris; and household pets are sources of saliva and animal dander. The protein in urine and feces from rats, mice, cockroaches and house dust mites is a potent allergen, and when dry, can easily become airborne. Contaminated central air handling systems can become breeding grounds for mold, mildew or other sources of biological contaminants and can then distribute these contaminants through the home.

By controlling the relative humidity level in the home, the growth of some sources of biologicals can be minimized. A relative humidity of 30% to 50% is generally recommended for homes. Standing water, water-damaged materials, or wet surfaces also serve as breeding ground for molds, mildew, bacteria and insects. House dust mites, the source of some the most powerful biological allergens, grow in moist and warm environments.

Pesticides

Q. How can I reduce the risk of pesticide exposure in the home?

Use only the pesticides approved for use by the general public and then only in recommended amounts. Increasing the amount does not offer more protection against pests and can be harmful to you, your pets and your plants. Read the Label and follow directions.

Ventilate the area well after pesticide use. Mix or dilute pesticides outdoors or in a well-ventilated area and only in the amounts that will be needed immediately. If possible, take plants and pets outside when applying pesticides to them. Minimize children’s exposure by keeping them away from the applied material for several days.

Keep pesticides in their original labeled containers. Do not store pesticide products within reach of children.

Dispose of unwanted pesticides safely. If you have unused or partially used pesticide containers that you want to get rid off, dispose of them according to directions on the label or on special household hazardous waste collection days.

Q. What signs can help me determine if pesticides are affecting my health?

Both active and inert ingredients in pesticides can be organic compounds; they both add to the levels of airborne organics inside the home.

Exposure to high levels of pesticides commonly associated with misapplication have produced various symptoms, including headaches, dizziness, muscle twitching, tingling sensations and nausea. They can cause long-term damage to the liver and central nervous system, as well as increased risk of cancer. As with other household products, there is insufficient understanding at present about what pesticide concentrations are necessary to produce these effects.

Q. Why should I be concerned about pesticides?

Pesticides are used around the home to control insects, termites, rodents, fungi-mold, mildew, and microbes (disinfectants) They are sold as sprays, liquids, sticks, powders, crystals, balls and foggers. It is important to remember that the “cide” in pesticides means to “kill.” These products are dangerous if not used properly. In addition to the active ingredient, pesticides are made of ingredients that are used to carry the active agent. These carrier agents are called “inerts” because they are not toxic to the targeted pest. Nevertheless, some inerts are capable of causing health problems.

Radiological Health/Radon/Basement Radon Levels

Q. If I’m concerned about asbestos in my home, what can I do to deal with the problem?

If you think your home may have asbestos, don’t panic. Usually it is best to leave asbestos materials that are in good condition alone. Generally, material in good condition will not release asbestos fibers.

Do not cut, rip, or sand asbestos containing materials. Leave undamaged materials alone and, to the extent possible, prevent them from being damaged, disturbed or touched. Repairs can be made by the homeowner but we recommend that you do not apply duct tape directly onto the asbestos material. Duct tape can make future removal more dangerous and, as the adhesive dries out over time, the tape can pull away and actually create a more hazardous situation. Homeowners should contact the Indoor Air and Toxics Section of the Health Department for guidance on repairs they can undertake themselves.

If asbestos-containing material is more than slightly damaged, or if you are going to make changes to your home that might disturb it, you should consider repair or removal by a professional.

Asbestos contractors are required to be licensed by the New York State Department of Labor. Licensed contractors are knowledgeable and understand abatement regulations (Rule 56).

Contact the Monroe County Health Department to find out about proper handling and disposal procedures.

Radon

Q. How do I test my home?

There are two general ways to test for radon: The quickest way to test is with short-term testing (1-3 days) using charcoal canisters. Because radon levels vary from day to day and season to season, a short-term test is less likely to tell you your year round average radon level. If you need results quickly, a short-term test followed by another short-term test may be used to decide whether to fix the home. Continuous scintillation cell radon monitors can be used by contractors to record hourly or total integrated average radon concentrations (sampling period should not be less than 24 hours).

Be sure to close windows and outside doors at least 12 hours before beginning the test and not conduct tests during unusually severe storms or periods of unusually high winds. Place the test kit in the lowest lived-in level of the home at least 20” above the floor in a location where it won’t be disturbed, away from drafts, high heat, high humidity and exterior walls. Follow package instructions.

Long-term tests remain in your home more than 90 days and use alpha track or electret ion chamber detectors (recommended by New York State Department of Education for use in schools). Follow package instructions.

The best time to test is in winter when the heat is on and negative pressures inside are likely to be their highest.

Q. How does radon enter your home?

Because radon is a gas, it can leak into your house through the basement or crawl space –via adjacent or exposed soil and rock- or through well water. In a small number of homes, the building materials can give off radon. Radon enters homes through dirt floors, cracks in concrete walls and floors, floor drains, and sumps. When radon becomes trapped in buildings and concentrations build up indoors, exposure to radon becomes a concern. Any home may have a radon problem, from new and old homes, well sealed and drafty homes, and homes with and without a basement.

Q. How does radon affect my health?

Radon gas decays into radioactive particles that can get trapped in your lungs when you breathe. These particles release bursts of energy that can damage lung tissue and lead to lung cancer. EPA estimates about 14,000 deaths per year in the United States; but this number could range from 7,000 to 30,000 deaths per year. If you smoke and your home has high radon levels, your risk of lung cancer is especially high.

Q. What is radon, where does it come from, why should I be concerned?

Radon is an odorless radioactive gas that results from the breakdown of uranium. Uranium is present in most of the soil and rock around the world. It is especially concentrated in areas with lots of granite, shale, phosphate and pitchblende.

Exposure to radon can increase your chances of getting lung cancer. Scientists are more certain about radon risk than risks from most other cancer causing substances. Smoking combined with radon is an especially dangerous health risk.

Q. What do test results mean?

The outdoor radon level normally found in outside air is about 0.4 pCi/L (picocuries per liter). The average indoor radon level is estimated to be 1.3 pCi/L. USEPA recommends that levels do not exceed 4 pCi/L. However, EPA believes that any radon exposure carries some risk – no level is safe. The U.S. Congress has set a long-term goal that indoor radon levels be no more than outdoor levels. While this goal is not yet technologically achievable in all cases, most homes today can be reduced to 2 pCi/L or below.

STD/HIV Disease Control Program

Q. What is gonorrhea?

Gonorrhea, a bacterial disease, is spread through sexual activity. The bacteria which causes gonorrhea grows in warm moist areas of the reproductive tract, including the cervix, uterus, and fallopian tubes in women; and in the urethra in women and men. The bacteria can also grow in the mouth, throat and anus.

Q. How do people get gonorrhea?

Gonorrhea is spread through any sexual contact with an infected person. Gonorrhea can also be spread from mother to child during birth and to other unlikely parts of the body. For example, a person can get an eye infection after touching infected genitals and then the eyes. Individuals who have had gonorrhea and received treatment may get infected again if they have sexual contact with an infected person.

Q. How many cases of Gonorrhea were reported in Monroe County in 2001?

There were 2,102 cases of gonorrhea reported in Monroe County in 2001. This is a decrease from the number of cases reported in 2000.

Q. Who is at risk for gonorrhea?

Any sexually active person can be infected with gonorrhea. According to the Centers for Disease Control (CDC), the highest rates of infection are usually found in people under the age of thirty.

Gonorrhea is spread through sexual contact with an infected person.

Q. What are the signs and symptoms of gonorrhea?

When initially infected, the majority of men have some signs or symptoms, including a burning sensation when urinating and a yellowish white discharge from the penis. Sometimes men with gonorrhea develop painful or swollen testicles.

In women, the early symptoms of gonorrhea are often mild, and many women who are infected have no symptoms. The initial symptoms in women include a painful or burning sensation when urinating and a vaginal discharge that is yellow or occasionally bloody. Women with no or mild symptoms are still at risk of developing serious complications from the infection. Untreated gonorrhea in women can develop into pelvic inflammatory disease which can lead to infertility.

Q. Is there a cure for gonorrhea?

Yes, antibiotics are used to kill the germs. But, while medicines can cure the disease, they can not repair any damage that may have already been done to the body. That's why it is important to start treatment as quickly as possible.

It is important to take all of the medicine prescribed to cure gonorrhea, even if the symptoms stop before all the medication is gone.

Q. What sexually transmitted diseases (STDs) are reportable to the New York State Health Department?

All newly diagnosed cases of Gonorrhea, Chlamydia and Syphilis are reported to the New York State Health Department.

Q. For providers, how can I report a new sexually transmitted disease?

For confidential reporting of gonorrhea, chlamydia or syphilis, call the STD clerk at 585 753-5481. Leave a confidential voice message any time. Information regarding the patient, diagnosis and treatment are required.

Q. Is HIV reported to the New York State Department of Health?

Yes, beginning in June 2000, medical providers are required to report HIV to the New York State Department of Health.

Tuberculosis (TB)

Q. What causes TB?

TB is caused by bacteria that usually affect the lungs, but other parts of the body can also be affected.

Q. Who gets TB infection?

Anyone at any age can become infected with bacteria that cause tuberculosis. Some people at higher risk include:

  • people who spend time with a person who has TB disease in the lungs
  • the homeless
  • the incarcerated
  • people who are from countries where TB is endemic
  • the elderly
  • people who are chemically dependent
  • people with poorly managed HIV disease
  • people who have medical conditions which impair their immune systems (i.e., cancer, diabetes, silicosis.)

Q. What are the symptoms of TB disease?

Symptoms of TB disease include:

  • fever
  • night sweats
  • fatigue
  • weight loss
  • persistent productive cough, and sometimes, coughing up blood.

TB disease can occur in other parts of the body and show different symptoms, depending on the site.

Q. How do you test for TB?

A simple, painless skin test is used to screen for tuberculosis. This test is offered by the Health Department.

Should the test be positive, you may have a chest X-ray to see if there are any abnormalities in the lungs.

Q. What is the difference between latent TB infection (LTBI) and TB disease?

People with latent TB infection test positive on their skin test for TB but they are not sick and they can not spread the disease to anyone else.

People with active TB disease are sick and usually have symptoms.

ONLY PEOPLE SICK WITH ACTIVE TB DISEASE CAN SPREAD IT TO OTHERS.

Q. How is tuberculosis spread?

TB is spread in the air. When an untreated person with active TB disease in their lungs coughs, the germs are spread in the air. If a person breathes in the germ which causes TB, they MAY get infected with TB. However, it usually takes exposure over many days before the person becomes infected.

Remember, a person with TB infection and no disease cannot spread the disease.

Q. If infected, who is most likely to develop active TB?

  • Medically underserved populations
  • Alcoholics and IV drug users
  • People whose resistance is low due to conditions such as HIV infection, diabetes, some cancers, and chemotherapy

Q. What is the treatment for TB?

  • A person with TB infection is prescribed medication for several months to prevent the development of active TB disease.
  • People with active TB disease are given medications for six months or more.
  • Regular follow-up by TB clinic staff and directly observed therapy (DOT) are part of the treatment plan as well.

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