The Latest From THHN

January 25, 2018 - General

THHN 2018 Calendar – Healthy Homes Checklist

Houses often contain invisible, hidden and odorless hazards. For example, radon, an odorless gas, is the second-leading cause of lung cancer. Mold, often hidden, can cause allergies, asthma attacks and frequent infections. Lead, an unseen component of house dust, affects the intelligence learning ability and behavior of children. Carbon monoxide, an odorless gas produced by combustion appliances, can kill. what we bring into and use in our houses can also bring dangerous gases and fumes. Examples include burning wet wood, cleaning with strong store-bought products or storing points and solvents inside the home.

Download the calendar here:  Renters Healthy Home Calendar - Final

July 5, 2016 - THHN Partner Profiles

Tribal Healthy Homes Network Partner Profile – Nancy Bernard, WA State Department of Health

What is your role, and how does a state health department work with the public during a smoke event?   

My role is to work with local health jurisdictions and with K-12 schools. I do indoor air quality education and work to ensure improved ventilation during wildfire and smoke events.

When you work with schools about IAQ, what are the most important messages you want the schools to know?

It’s unusual for us to have serious wildfire smoke while k-12 school is in session, however we’ve had two recent episodes – one in 2012 and one again in 2015 that have been bad.

In terms of specific messages, if the smoke is severe, we encourage schools to turn off their air conditioner, which stops bringing in outside air. We’re also trying to encourage better filtration of their air intake. Normally, you’re bringing in outside air on a regular basis, which dilutes the indoor air and keeps the CO² levels down.

We also recommend a MERV 8 or higher filter, particularly with a deeper pleat so you can actually clean and filter the air as it’s brought into the building. For sensitive populations, we recommend using a properly-sized air filter to improve the air.

We’ve also developed an activities guide for schools that talks about when to limit outdoor activities when PM 2.5 readings are high. (Click here to see the guide – it’s in the Air Quality section) The guide was heavily used last year because the wildfires were still burning in August, when outdoor sports were starting up. This mean a lot of student athletes were impacted. The guide has been out for a couple of years now, we send it out to the school nurses regularly.

What are some of the specific measures that Department of Health recommends people take to protect themselves?

1. Follow the activities guide in terms of outdoor activity and other steps listed on the document.

2. Pay special attention to sensitive populations.

3. As one nurse said, it would be great if we could remind parents that their children should always have their inhaler with them during these episodes. Parents should also notify their school’s nurse if their child has particular problems with smoke.

July 5, 2016 - THHN Partner Profiles

Tribal Healthy Homes Network Partner Profile – Kris Ray, Colville Tribe

Please tell us about your public health response during previous wildfire or smoke episodes, including what has been effective in reaching the public and reducing their risk, and what you would like to see done in the future.

Half a million acres were burned by the fires, which affected the reservation and the entire surrounding Okanagan and Ferry county communities. Within the boundaries of the reservation, Colville Tribe lost more than 250,000 acres of land and forest. There was a lot of smoke in the air for quite a long period, which means the health effects may be chronic – taking place over time.

One of the actions I took was to purchase a particulate monitor so I could measure indoor and outdoor particulate matter (PM). I measured numerous facilities and was pretty startled by the results: they were all well above the hazard zone - close to 1,000 micrograms per cubic meter (ug/m³) inside the buildings. (Hazard level measures start at 250ug/m³ on the air quality index.)

Using the PM monitor, I went around and measured particulate levels, sent the data to our administrators, and educated people about the health effects of hazardous indoor air quality. Consequently, the administrators sent everyone home and gave people administrative leave for three days because of our measurements and outreach.

That led us to look at how we were managing our buildings for indoor air quality. As an example, we made sure that all the air conditioning units in our tribal facilitates were shut off, as they were pulling in air (from the outside). Not only that, the filters weren’t capable of filtering out smoke with readings that high. Another example is that I went to each building and recommended they use only use one door, make sure fans are set in the right spot. and that they were using our air filtration units. Additionally, our department ended up giving out thousands of N-95 masks to wear, which can prevent inhalation of fine particles. The masks were mostly donated from entities off the reservation. Along with the masks, I created an instructions document on how to properly wear a mask, using a tribal elder as a model.

Some of the other departments, including Tribal Health and Indian Health Service brought in extra nursing staff and volunteers to visit community members to ensure that everybody was okay. They also distributed brochures on the effects of wildfire smoke. The document included guidelines on what constitutes high concentrations of smoke and how it affects your health. Additionally, the health clinics made inhalers easy to obtain in case people were running out of medication.

 Gearing up for this next season, is there anything that you learned from last year that you’re implementing this season? Currently, we are updating our wildfire and smoke brochure. We’ve also written Standard Operating Procedures for sampling facilities, creating a methodical way for going out and recording data. The process will be standardized and will include data analysis and reporting to tribal administration.

We have three permanent continuous monitors on the reservation to measure PM^2.5. I’ve also done an Emissions Inventory, including data from the last nine years. It showed that wildfire smoke is the largest source of particulates and health risks to the people on the reservation. So a lot of our work is geared towards helping people cope with the wildfire smoke.

 What are the specific communication channels you use to reach out to your community during a wildfire or smoke event?

I did a lot of educational outreach on indoor and outdoor air quality, as well as sending out air quality alerts and warnings for ambient air quality. I also worked with the Air Resource Advisors that were brought into the area. We also put out messaging for the general public including on reservation These messages we developed were sent over a broadcast system through our tribal government which reaches 1,200 people. The messages also went out over several Facebook pages, our tribal tribune, emergency management/emergency services Facebook page, and the Okanagan emergency services page. We also use bulletin boards and our website.

In addition to our wildfire brochure, we have public announcements during wildfire season on how high the concentrations are and what that means for people’s health. One of the staff in our department is the public information officer for fire control, and together we send out a lot of air quality information, to the public and to the fire camps.

 Who are the specific audiences you reach out to? We send out information to all at-risk populations: elders, kids, anyone with heart disease, lung disease, or asthma. There’s specific language in all of our literature which details precautions to stay healthy if you have any of these diseases.

We also have a lot of communications with other tribal departments, such as our tribal health, EMS, Emergency services, and IHS. As the program grows, we’re getting more attention which is really good so that people take note that there are effects of wildfire smoke.

We’ve sent materials to all the schools and the surrounding area, including a guide that Washington State put out based on Idaho and Oregon, giving school districts guidance on what they should be doing during wild fire smoke incidents.

 What are the specific measures you recommend to people when they are inside their home? And if they are tangible items (masks, stand-alone air filters, etc), do you pay for them or provide for them at cost?

I don’t run an indoor air quality program in this department so most of my work has been with tribal facilities. It is challenging to get in and talk to people individually. I haven’t done anything specifically for individual homes.

All of our fact sheets have a couple goals in mind for the message. First off – to make it culturally appropriate. If you do a web search and you get some of these federal documents it’s just basic language that is exactly the same as every other population, it just has a salmon motif behind it and they call that a tribal approach. Well, it’s not. Our goal is to make it culturally appropriate and make it so that somebody will read it. And then we figure we are ahead of the game. We had about 600 wildfire smoke brochures that we put together. We put about 450 of these right into somebody’s hand.

July 5, 2016 - THHN Partner Profiles

Tribal Healthy Homes Network Partner Profile – Kyle Wright, Tanana Chiefs Conference

How does Tanana Chiefs Conference (TCC) assist tribes in dealing with smoke episodes? There’s not a whole lot you can do to eliminate the smoke, so we’ve created some educational resources for our members.

Occasionally we’ve evacuated elders with medical needs to prepare for smoke events. We also recommend that tribes establish a smoke free building or smoke reduced building, in a clinic or a building that can be air conditioned and where the windows can be closed.

We also developed educational brochures about creating a smoke shelter in a tribal building and put information and wildfire guidelines from the state on our Facebook page and our website.

Were there any key lessons from last year’s wildfires – and the relocation that TCC helped with – that you feel other communities should know?

You don’t know how long evacuations are going to last, it might be a week or it might be a month. We hadn’t expected evacuees from Tanana to have to be out of town for so long. Evacuating is not an automatic easy button. Last year, smoke conditions were actually worse in Fairbanks than they were in the village. But there is more advanced health care in Fairbanks, which helps if somebody had an actual medical condition.

We are specifically focusing on the role of ventilation as a way to protect residents when they are indoors. Do you have specific measures you recommend around ventilation?

In the summer, ventilation can be a tough challenge. It can get up to 80-90 degrees in the interior of Alaska - houses here are in the sun and they have to be ventilated to keep cool. In particular, I recommend turning off your HRV and closing your windows. We also recommend that tribes buy portable air conditioning units for one of their buildings as a smoke respite facility.

What channels of communication do you use to communicate with tribal departments and members?

Facebook is really popular up here, especially among the interior tribes and individual members, and gets more use than twitter or other social media forms. With our TCC Facebook page, we focus on short snippets of information with a link for people to learn more. We then use our website to post more detailed articles and provide documents that members can download.

Do you have specific resources you want tribes to have in hand?

I’d like to emphasize that having an emergency plan does have its benefits - beyond flood evacuation plans, which are our most common hazard.  More specifically, we would like them to have a plan for having a smoke respite center. Have a location, have an air conditioning unit and maybe have some shelter supplies.

July 5, 2016 - THHN Partner Profiles

Tribal Healthy Homes Network Partner Profile – Carolyn Kelly, Quinault Tribe

Please tell us about your public health response during previous wildfire or smoke episodes, including what has been effective in reaching the public and reducing their risk, and what you would like to see done in the future.

There are many public health responses we use when trying to address the threat of wildfire and subsequent smoke hazards. Our first step entails educating the community about what to expect during wildfire season and keeping them up to date with the latest wildfire information from fire smoke professionals. Additionally, these professionals are available throughout the season, which helps boost community morale and preparedness. We also partner with our local air agency, who lends us a monitor and helps us set it up in our community. This enables us to better monitor the smoke to determine how our community is affected and which parts need more immediate attention and action. We also have a permanent monitor established at our school, though that area is rarely effected by wildfire smoke.

Our next step is developing a smoke management and community outreach plan. Unfortunately, our smoke management plan does not keep public health as a priority, as we have a small window when our community is dry and when rainy season begins. In order to protect those who are vulnerable to smoke, we have a comprehensive community outreach plan that informs community members about when and where the burns are held (prescribed burning). We also work with our business community members to see if there are opportunities for tribal members to stay at the casino instead of having to stay in their homes or a place nearby.

I’ve also had the opportunity to work as an air resource advisor, which entails going out to wildfires and measuring their impact through monitoring, modeling and messaging for communities affected by smoke. This is incredibly beneficial because when you know that wildfire season is coming you can take action to protect those most important to you; your family, friends and your home. Especially those who have children with asthma, or mom or dad or somebody who is on oxygen or has an underlying illness. So by being able to provide outreach and information, that’s been a tremendous help in helping our community members stay safe.

As someone who works for a tribe, I thought it was really important to have people with that kind of background able to work with our community. When tribes like Colville or Yakama and Spokane are affected by smoke, people outside of tribal areas often don’t know that the tribes have their own air quality programs, or how tribal governments work. Yet a lot of tribes have really great information, have monitors running, are aware of the smoke-impacted areas, and are aware of who is at risk in the community. All of that tribal knowledge is just tremendous information for trying to help our communities stay safe.

What are the specific communication channels you use to reach out to your community during a wildfire or smoke event? 

On reservation, we can post in public places if it’s advanced notice. We also have our monthly newsletter and an internet E-Board where we can give people updates. So it’s everything from “here’s some upcoming bad weather” to “happy birthday” to the smoke thing. Word of mouth is a big way spread things around, so if I just talk to people in my department or in my division, then word will certainly spread.

And then on a broad scale, we’ve done public meetings, inviting community members to participate. Our community is really interested in what the incident management team has to say about how to manage fires. So we try to add on to their information by giving a quick update and providing a list of resources available. One of those resources is the Washington smoke blog with updates and forecasts. They have similar blogs in Oregon and Idaho and are a really good way for people to stay up to date, every day. And we usually add photos and have a link to a webcam where viewers can see what the smoke looks like. Then there are public information officers who forecast and post photos.

Do you work with your health clinics?

We have the common issue here of information being in silos and in different departments. Though I think our health clinic and I have done a really good job of trying to work together. I also work with our environmental health specialist and we’ll send each other articles and create fact sheets together. We haven’t worked much on smoke or fire yet, but have started collaborating on presentations for tribal staff on wildfires and health impacts.