Be Aware of What's in the Air at Your House

From the WebMD Archives

July 14, 2000 -- What parents don't know can hurt their children -- at least when it comes to the "fatal four" indoor air pollutants: carbon monoxide, mold spores, tobacco smoke, and mercury, one expert says.

"Parents need to know that these four pollutants can be very dangerous for infants and children," Ruth A. Etzel, MD, PhD, director of the division of epidemiology and risk assessment at the Food Safety and Inspection Service, tells WebMD. "Once you are aware of these indoor air pollutants, it's not rocket science, and you can prevent exposure," says Etzel, whose article on this subject was published in the journal Pediatric Annals.

These days, parents are the ones responsible for looking for indoor pollutants, Etzel says. Before World War II, most doctors saw patients in their homes, enabling them to identify possible risks and give advice about prevention. "Because we no longer visit the patient's home, we usually have little understanding of the environment in which the family lives," she writes.

For example, carbon monoxide (CO), an odorless, colorless, and tasteless gas that may cause headache, dizziness, fatigue, weakness, nausea, and vomiting, may seep out of fuel-burning appliances such as furnaces. "If you have a furnace or appliance capable of producing gas in the home, make sure it is checked on a yearly basis," Etzel says.

Every home should have a CO detector, but this is no substitute for professional, yearly checks of fuel-burning devices, Etzel says.

"CO is not something you can see, taste or smell, but it can kill you. It accounts for more poisoning deaths than any other single agent in the U.S.," says Sophie J. Balk, MD, chairperson of the American Academy of Pediatrics' Committee on Environmental Health and an associate professor of pediatrics at the Albert Einstein College of Medicine in New York.

"Make sure that all of your appliances are properly maintained," she says. "Don't leave your car running in the garage, even if the door is open, because CO can rise and poison someone."

Also, don't use space heaters that are not vented. "Charcoal or Hibachi grills should never be used indoors," Balk says.


When it comes to "toxic" molds, "trust your nose," Etzel says. "If you detect a musty smell, there may be mold somewhere in your house, such as under wallpaper."

A Mayo Clinic Health study has linked nearly all chronic sinus infections -- which affect 37 million Americans -- to molds, and doctors say this is one reason why the asthma rate has more than tripled in the last 20 years. The most common allergy-causing indoor molds are Cladosporium, Penicillium, Alternaria, Aspergillus, and Mucor. But some molds, including the black mold Stachybotrys atra, may cause potentially deadly bleeding in the lungs, especially among toddlers.

Molds can vary in shape, size and color. They grow by releasing millions of spores, which can stay suspended in the air almost indefinitely. They tend to thrive in environments with water damage, Etzel says.

"Clean up and remove all water-damaged items (including carpets) within 24 hours of a flood or leak," she says. If this is done, [toxic] molds, which usually take approximately two weeks to grow, will not have the opportunity to do so."

Molds can best be cleaned using a solution of one part bleach to four parts water, Balk says. "Make sure to wear protective gloves when touching mold," she tells WebMD.

The health effects of exposure to tobacco smoke are well known. In the early 1990s, about 43% of children ages 2 months to 11 years lived in a home in which at least one person smoked cigarettes, Etzel says. Exposure to tobacco smoke increases a child's risk for many health problems, including sudden infant death syndrome (SIDS) or unexplained death in the first year of life, Etzel notes.

"Children's homes should be smoke-free -- both before and after birth," she says.

If parents can't or won't quit smoking, Balk says, they should not smoke in the house or in the car. And, "choose a babysitter who does not smoke," Balk says.

The fourth indoor air villain, mercury, is fortunately being phased out of use in thermometers, Etzel says. If you have an old one containing mercury, you should dispose of it. And to assure that mercury stays out of the home, "don't let your kids bring mercury home from science class," she says.


Mercury poisoning can be fatal. When inhaled, mercury can cause shortness of breath, tightness and burning pains in the chest, and inflammation of the lungs.

To find out what indoor air pollutants are in their homes, all parents should ask themselves these questions, Etzel says:

  • Does anybody smoke in your home?
  • Do you have a fireplace or gas stove? If these are not correctly installed, they may emit CO during use.
  • Do you make arts and crafts at home? Arts and crafts materials commonly used in painting or drawing may contain lead or mercury.
  • Do you have any water damage or visible mold in any part of your home?

If the answer to any of these questions is yes, you should bring it to the attention of your pediatrician.

Vital Information:

  • The fatal four indoor air pollutants -- carbon monoxide, tobacco smoke, molds, and mercury -- are potentially deadly to children and infants.
  • Parents need to be aware of these hazards and take steps to remove them form the home.
  • Fuel-emitting devices should be regularly checked, water damage to the home should be cleaned up immediately, parents shouldn't smoke in the house or car, and children should not be allowed to have contact with mercury.

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