The Texas Department of Health (department) proposes the repeal of §§297.1 - 297.6 and proposes new §§297.1 - 297.10, concerning voluntary guidelines for indoor air quality (IAQ) in government buildings. The repeal of §§297.1 - 297.6 is necessary because House Bill 2008 (HB 2008), passed in the 77th Legislature, 2001, amended the Health and Safety Code, Subtitle C, Title 5, Chapter 385, to require the Texas Board of Health (board) to establish voluntary guidelines for indoor air quality in government buildings rather than only in public school buildings. The proposed new sections include the changes necessary to cover other government buildings as well as public schools. The sections include recommendations for implementing an IAQ program; considerations regarding building design, construction, renovation, maintenance and operation; responsibilities of building occupants; guidance for assessing and resolving IAQ problems; guidelines on comfort and minimum risk levels; lease agreements; and special considerations.

Government Code §2001.039 requires that each state agency review and consider for readoption each rule adopted by that agency pursuant to the Government Code, Chapter 2001 (Administrative Procedure Act). Sections 297.1 - 297.6 has been reviewed and the department has determined that the reasons for adopting the sections continue to exist; however, revisions to the rules are necessary as the existing rules will be repealed and new rules proposed.

The department published a Notice of Intention to Review for §§297.1 - 297.6 regarding the agency review of rules in Government Code, §2001.039 in the Texas Register (27 TexReg 4745) on May 31, 2002. No comments were received by the department on this sections.

Mr. Alan Morris, Director, Toxic Substances Control Division (TSCD), has determined that for each year of the first five-year period the new sections are in effect, there will be no significant fiscal implications on state or local governments. There were no funds appropriated to the department for administering the sections, however, there will be some impact on the Indoor Air Quality Branch, TSCD, as the existing staff will be required to shift program priorities in order to educate stakeholders about the new guidelines, and respond to increased inquiries on the topic. Because these proposed guidelines are voluntary, i.e., governmental entities are not required to comply with the guidelines, specific costs to governmental entities cannot be determined. Each governmental entity can choose how much, if any, fiscal resources will be allocated to this. Costs could vary tremendously from one governmental entity to another that may choose to implement all or portions of the guidelines. Possible costs will depend upon the number of building facilities operated by a government entity, the present condition of the air quality in the affected buildings, the present or future resources in personnel, equipment, and available budget to allocate to improve IAQ, and the need or desire to improve IAQ. Many government entities already have programs in place to manage IAQ issues. Some may only refer to sections of the guidelines when they are faced with an IAQ problem.

Mr. Morris has also determined that for each year of the first five-year period that the new sections are in effect, the benefits to the public when governmental entities follow the guidelines and improve the IAQ could include a reduction in the incidence of health effects related to poor IAQ among the building occupants, resulting in a better working and learning environment, higher attendance, fewer illnesses, and increased productivity. Taking steps to manage IAQ should help preserve and improve the efficiency of the physical plant and equipment. As an example, large sums of money that are being spent by many government entities to clean up mold, for instance, could be saved in the future if steps are taken early on to prevent the conditions that allow such situations to develop. If IAQ problems are reduced, more cost effective use of resources could result. Furthermore, government entities that implement the guidelines have less potential of being closed or the occupants temporarily relocated due to serious IAQ problems. Improved relationships among administrations, building occupants, and parents of school children, reduced risk of negative publicity, and reduced potential liability could also result if the guidelines are followed. There will be minimal to no effect on micro-businesses or small businesses. There could be some positive benefits from selling additional products to improve the IAQ in government buildings, such as contractors, janitorial services, etc. There may be some negative impact on some businesses, such as property owners and property management companies from whom a government entity may lease office space, if IAQ considerations are in a lease agreement. There is no anticipated significant impact on local employment.

A 1996 United States General Accounting Office report to Congress indicated that 12% of the Texas schools that responded to a questionnaire survey had unsatisfactory IAQ and 16% had unsatisfactory ventilation. United States Environmental Protection Agency (EPA) studies of human exposure to air pollutants show that indoor levels of pollutants may be two to five times, and occasionally more than 100 times, higher than outdoor levels. Since most people spend about 90% of their time indoors, indoor air pollutant exposures are generally of greater concern than outdoor pollutant exposures. The EPA and its Science Advisory Board have consistently ranked indoor air pollution among the top five environmental health risks to the public.

Poor indoor air quality (IAQ) can cause illness requiring absence from the workplace and school, and can cause acute health symptoms that decrease performance while at work or school. In addition, recent data suggest that poor IAQ can reduce a person's ability to perform specific mental tasks requiring concentration, calculation, or memory.

Air in most indoor environments contains a variety of particles and gaseous contaminants. These contaminants are commonly referred to as indoor pollutants when they affect human health and performance. Indoor temperature and relative humidity can also affect health and performance directly, and can affect human performance indirectly by influencing the airborne level of molds and bacteria.

Most often, poor indoor air quality results from the failure to follow practices that help create and maintain a healthy indoor environment. Common examples include failure to: control pollution sources such as art supplies and laboratory activities; control temperature and humidity; ventilate each workspace and classroom adequately; adequately perform housekeeping and maintenance operations; and the use integrated pest management to minimize the use of pesticides. Failure to deal adequately with any of these issues may go unnoticed, but can and often does take its toll on health, comfort, and performance.

Over the last ten years, the department has responded to hundreds of requests for assistance with IAQ problems in buildings owned or leased by state agencies, county, and city governments, and public school districts. Most of the requests were due to complaints that the indoor environment appeared to cause or contribute to health problems of the building occupants, including allergies, asthma, headaches, fatigue and irritation of the eyes or respiratory system. Many of the problems could have been prevented by providing adequate fresh outside air; using better cleaning, operational, and maintenance practices; preventing water intrusion in the building; using proper building materials and furnishings; and having better knowledge and concern about the causes of poor IAQ. Two independent surveys of major building tenants, conducted by the Building Owners and Managers Association (BOMA) and the International Facility Management Association (IFMA), place indoor air quality and component issues of thermal comfort and heating, ventilation, and air condition (HVAC) systems performance high on the list of major tenant complaints.

Pursuant to the Health and Safety Code, §385.002(b), the Texas Board of Health (board) considered four statutory criteria in establishing these guidelines: (1) the potential chronic effects of air contaminants on human health; (2) the potential effects of insufficient ventilation of the indoor environment on human health; (3) the potential costs of health care for the short-term and long-term effects on human health that may result from exposure to indoor air contaminants; and (4) the potential costs of compliance with a proposed guideline. The literature was reviewed regarding these four considerations, and some applicable information is summarized below.

1. The potential chronic effects of air contaminants on human health:

It is well documented that common indoor air contaminants that can/may be found in public buildings, (e.g., biological agents, such as molds, animal dander, and dust mites), volatile organic compounds known as VOCs (found in solvents and cleaning agents), formaldehyde, pesticides and combustion products) can cause chronic health effects. Biological agents in indoor air are known to cause three types of human disease: infections, where pathogens invade human tissues; hypersensitivity diseases, where specific activation of the immune system causes disease; and toxicoses, where biologically produced chemical toxins cause direct toxic effects. In addition, exposure to conditions conducive to biological contamination (e.g., dampness, water damage) has been related to nonspecific upper and lower respiratory symptoms. A major concern associated with exposure to biological pollutants is allergic reactions, which include rhinitis, nasal congestion, conjunctival inflammation, urticaria, and asthma.

Some of the documented health effects from VOCs and formaldehyde exposure include eye and upper respiratory irritation, rhinitis, nasal congestion, rash, pruritus, headache, nausea, vomiting, and dyspnea. Some VOCs are known carcinogens, (e.g., benzene) and many others are classified as probable and/or possible human carcinogens. The health effects from pesticide exposure include headache, dizziness, nausea, vomiting, and muscle weakness. Exposure to combustion products can cause headache, dizziness, nausea, emesis, tachycardia, wheezing and bronchial constriction.

It is important to realize that many health effects associated with indoor air quality problems are often non-specific symptoms, such as headaches, fatigue, allergy symptoms, and dizziness, rather than clearly defined illnesses. People with allergies, asthma, or damaged immune systems may be more susceptible to certain indoor contaminants. This is noteworthy, since there has been a significant increase in the prevalence of asthma in children in recent years. Asthma-related illness is one of the leading causes of school absenteeism, accounting for over ten million missed school days per year. Persons with asthma or other sensitivities may have reduced performance in the presence of environmental factors that trigger their asthma. There are also some people who appear to be more susceptible to indoor air contaminants, yet have no known underlying health condition.

2. The potential effects of insufficient ventilation of the indoor environment on human health:

Ventilation is the process of supplying and removing air by natural or mechanical means to and from any space. The air may or may not be conditioned. Insufficient ventilation means inadequate circulated air and/or outside fresh air in an occupied building. Acceptable indoor air quality is achieved within an occupied space by controlling known and specific contaminants. One of the least expensive and effective means of lowering the concentration of indoor air contaminants from non-localized sources, (such as the occupants themselves, building products and materials), is by dilution ventilation, i.e., adding outside fresh air to the recirculated building air. The lower the concentration of air contaminants, the less likely the chance that the occupants will experience adverse health effects. A study of student performance and carbon dioxide (CO₂ ) levels showed a correlation between high CO₂ levels and lower student performance on tests, including simple reaction time and choice reaction time on multiple choice tests. CO₂ levels can build up quickly in a crowded classroom with insufficient ventilation. Infectious diseases are more likely to be spread in indoor environments that are overcrowded and inadequately ventilated.

One study noted that as the ventilation rate decreases, the concentration of products generated from reactions between indoor pollutants increases. Many times these products are more toxic than the original air contaminants. For example, the air oxidation of limonene (found in many products containing oils of lemon, orange, caraway and dill) produces potent allergens. Another study attempted to show that increases in the supply of outdoor air did not appear to affect workers' perceptions of their office environment or their reporting of symptoms considered typical of the "sick building syndrome." However, this study was flawed in that the amount of outdoor air introduced into the buildings was two to three times the commonly recommended levels and there were no "sick" people in the study buildings to measure possible improvement of health effects. Also, while not a health consideration, another study found that insufficient ventilation with outside air led to concentrations of air contaminants that resulted in faster building equipment failures, such as corrosion of switch contacts.

3. The potential costs of health care for the short-term and long-term effects on human health that may result from exposure to indoor air contaminants:

A 1989 EPA study quantified some of the health care costs for the effects on human health that may result from exposure to indoor air contaminants. The study reviewed data on the following contaminants: radon, environmental tobacco smoke (ETS), biological contaminants, volatile organic compounds (VOCs), asbestos, combustion gases, and particulate matter. The annual direct medical costs of cancer caused by radon was $426 million; ETS, $274-$385 million; and for only six of the hundreds of VOCs, $25-$125 million. The study determined the annual non-cancer costs for ETS were $447-$516 million. The lost productivity costs for radon at $1,991 million and for ETS were $2,457-$2,974 million. The combined total cost for these air contaminants was between $5,713 and $6,880 million. The cost estimates developed for this study are incomplete and understated due to lack of complete information and are subject to great uncertainty. However, the study does conclude that the available evidence suggests the costs imposed by indoor air contaminants are very high.

Based on the review of the literature, the board believes that the following health effects could lead to significant medical costs for occupants of buildings with poor air quality: asthma in children from exposure to particulates and other lung irritants; pneumonia and other respiratory illnesses from exposure to biological contaminants and conditions conducive to biological contamination (e.g., dampness, water damage); and neurological damage and development of increased chemical sensitivity from exposure to neurotoxic chemicals. An estimated 17 million Americans suffer from asthma. In addition, about 5,000 deaths occur yearly from asthma - an increase of 33% in the last decade. Consequently, the social and economic costs are large. Among chronic diseases, asthma is the number one cause of absenteeism from school. Asthma cost an estimated $6.2 billion in the U.S. in 1990, including direct medical and indirect non-medical costs combined. An update of this figure would fall in the range of $7 to $9 billion in 1998 dollars.

4. The potential costs of compliance with a proposed guideline:

As these are voluntary indoor air quality guidelines, there is no requirement for compliance. Therefore, the cost may range from $0 if no compliance is done to the cost of the level of compliance implemented. As indicated earlier, the potential cost of voluntary compliance with a proposed guideline cannot be specifically determined due to the wide variation in the present indoor air quality of each government building. The cost to make selected improvements will depend upon each government entity's desire and ability to acquire funding to implement the voluntary guidelines. It is not the intent of the board or the department to require implementation of these guidelines, but rather to encourage the use of sound, cost-effective management practices to provide the best indoor air quality possible in government buildings. Testing for various indoor air contaminants when the samples require laboratory analysis can be very expensive and is only recommended if and when there is need to do so. The department encourages implementation of those portions of the guidelines that a governmental entity determines that it needs and can fund. The implementation of written policies and procedures to help prevent indoor air problems is encouraged. The department realizes that implementing these guidelines may take years, based on the availability of financial and other resources. Some entities that already have a proactive preventive maintenance program, may incur lower costs (probably in the thousands of dollars) to complete full implementation of the guidelines. Government buildings with very poor air quality where significant renovation and replacement of major equipment may be needed could incur costs of several hundreds of thousands of dollars. However, EPA and other studies have determined the health and productivity benefits of improved air quality in the workplace appear to always exceed the cost to implement improvements. Generally, the costs are recovered in a few months to a few years. Additionally, the costs of preventing indoor air quality problems are likely to be less than the costs of resolving problems after they develop.

There are tools available to assist building owners and operators with cost analyses, such as the U.S. EPA computer software program, I-BEAM (Indoor Air Quality Building Education and Assessment Model). This free program allows a user to document IAQ program activities, tally expenditures, and assess potential productivity and revenues impacts of an IAQ program.

In developing these guidelines, the board also considered the potential loss of productivity among workers and school children due to poor indoor air quality. EPA and other studies have estimated the cost of loss of productivity in the billions of dollars. One study indicated that thermal indoor conditions could reduce by 5% to 15% of human efficiency, such as in reading, thinking logically, and performing arithmetic. Loss of productivity in school children can affect their ability to learn and understand, which could have long term consequences on their ability to advance in school and to get better paying jobs.

Comments on the proposed sections may be submitted to Mr. Alan Morris, Director, Toxic Substances Control Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756, (512) 834-6600. Comments will be accepted for 30 days following publication of this proposal in the Texas Register. In addition, a public hearing on the proposed sections will be held at 9:00 a.m., Friday, September 6, 2002, in the Texas Department of Health Auditorium, Room K100, 1100 West 49th Street, Austin, Texas.

Individuals needing additional information should contact Quade Stahl, Ph.D., Chief, Indoor Air Quality Branch, at (512) 834-6600 or (800) 572-5548. The hearing impaired may contact Ms. Suzzana Currier, ADA Coordinator at (512) 458-7627, toll free (888) 388-6332 or T.D.D. (877) 432-7232.

The new sections are proposed under the Health and Safety Code, §385.002, which provides the Texas Department of Health with the authority to establish voluntary guidelines for indoor air quality in government buildings, and §12.001, which provides the board with the authority to adopt rules for the performing of every duty imposed by law on the board, the department, and the Commissioner of Health.

The new sections affect the Health and Safety Code, Chapter 385.