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Issues Related to the Social & Policy Environment

Respiratory conditions affect a growing proportion of children and adults with a range of breathing problems including chronic respiratory health problems such as emphysema, allergic reactions, asthma and multiple chemical sensitivity.  Although some people are born with breathing difficulties, most are acquired over the course of time. Growing numbers of people experience their first problem episodes well into adulthood.

People with respiratory conditions have limitations that are commonly made worse by the behavior of others who contribute, often unknowingly, to discomfort and disability. Inadequate knowledge and attention to the risks can be corrected with training and the development of policies. 

Protecting indoor air quality is central to ensuring health and safety for people with respiratory problems. Americans spend an average of 90% of their time indoors, where levels of pollutants may be two to five times -- and occasionally more than 100 times -- higher than outdoor levels, according to the U.S. Environmental Protection Agency.”

Examples of Problems

  • The smoking policy at the rape crisis program permits smoking out of doors only.  Unfortunately, all of the smokers congregate at the front entrance making it necessary for everyone to pass through.  Additionally, smoke filters into adjacent rooms and rooms above the entrance.  
  • A survivor wants to attend support group but it is held in the basement.  The survivor is allergic to any level of mold so she requests that the group be moved.  The provider explains that they have no other place to hold the group.  
  • A survivor with Multiple Chemical Sensitivity (MCS) experiences pressured breathing and dizziness while doing routine cleaning chores, leaves the area to lie down and is penalized by shelter staff for abandoning required chores.
  • A member of the staff routinely buys scented air fresheners with her own money as an amenity in the bathrooms.  A survivor with a non-apparent respiratory condition complains but the program takes a vote and the majority of the residents say they enjoy the scented air freshenters.  The provider decides to keep them and, after a few more days, the survivor decides to leave the program. 

Suggested Solutions

  • Educate all staff and program participants about the program’s commitment to good indoor air quality.  Emphasize that success requires everyone's participation.
  • Develop a smoking policy that assumes the need to protect people with respiratory conditions from second-hand smoke even outside. The Center for Disease Control (CDC) offers practical tips and guidance on developing a no-smoking policy. This link will open a new browser window.
  • Develop a fragrance policy and make sure that all staff and survivors are apprised of expectations related to the use of fragrances.  Refer to the sample policy This link will open a new browser window. used by the U.S. Access Board.
  • Learn how to improve and preserve indoor environmental quality (IEQ) to protect people with respiratory conditions, including multiple chemical sensitivity. A primary resource for creating an IEQ policy is the report and recommendations funded by the U.S. Access Board. This link will open a new browser window. It contains detailed guidance including specifics about safe cleaning and disinfecting products, safe pest control, and creating “clean air rooms.”