Indoor environmental quality complaints to state health departments: The unrecognized challenge

Indoor environmental quality (IEQ) complaints are commonly presented to state and local health authorities. There is no systematic surveillance associated with these complaints, in part because of an absence of specific regulatory authority or prevention activities, and in part because of an absence of resources to address the complaints. Beginning in January of 2011, 15 state health departments catalogued the location, hazard, health concerns, and outcomes associated with IEQ complaints, as well as the resources required to respond to the complaints. The participating states represented a broad cross-section of the country by location, degree of urbanization, size, and presence or absence of specific programs or authority to respond to IEQ complaints. The results show considerable state-to-state variation in the proportion of complaints that come from private residences, rental properties, schools, businesses, and government buildings. Preliminary analysis showed that the most frequent complaints involved sanitation, radon (only in some states), lead, mold, and asbestos, followed by other chemical, physical, and biological hazards. The most frequent health concerns involved cancer, lead poisoning, allergies, asthma, and carbon monoxide exposure. Many complaints could be successfully resolved even without specific authority, but there were significant aggregate costs in personnel resources required to resolve the issues. We discuss the implications and need for authority and resources required to respond to IEQ complaints.