Findings from the Integrated Pest Management Intervention in NYC Public Housing

Transcription

1 Findings from the Integrated Pest Management Intervention in NYC Public Housing Dan Kass 2, Wendy McKelvey 2, David Evans 1, Ginger Chew 1, Elizabeth Carlton 1, Sean Nagle 1, Ingrid Peterson 2, Marta Hernandez 2, Julius Tiven 3, Brian Clarke 3 1 Columbia Center for Children s Environmental Health 2 New York City Department of Health and Mental Hygiene 3 New York City Housing Authority

2 IPM and our research partnership NYCHA conducted IPM intervention based on positive results from a pilot IPM study in NYCHA buildings. CCCEH and NYC Department of Health are evaluating the IPM program s impact on pests, allergens, pesticides and asthma

3 NYCHA s IPM Intervention The IPM intervention involves: Professional cleaning to remove food sources and cockroach frass in kitchen and bathrooms. Caulking and sealing kitchen cabinets and other points of entry. Use of MaxForce gels & bait stations, and boric acid powder. Residents receive a garbage can with a lid, food storage containers, and cleaning supplies.

4 Research Design Intervention Buildings Baseline Evaluation NYCHA IPM 3 Month Evaluation 6 Month Evaluation Control Buildings Baseline Evaluation 3 Month Evaluation 6 Month Evaluation NYCHA IPM Data collected during each home visit: Questionnaire about pest sightings, pesticide use, asthma symptoms, and opinions of building conditions Cockroach and mouse populations monitored for 1 week Dust sample from kitchen floor and up to 3 beds

5 Participation and Retention across Apartments IPM Control Total (% of baseline) (% of baseline) (% of baseline) Baseline Months 158 (81%) 104 (81%) 262 (81%) 6 Months 150 (77%) 106 (82%) 256 (79%)

6 Effect of IPM on cockroach populations

7 Mean Cockroaches Captured in 5 Kitchen Traps over 7 Days 50 Baseline to 3 Months 50 Baseline to 6 Months Baseline 3 Month 0 Baseline 6 Month IPM to control ratio = 0.57 (0.33, 1.00) IPM to control ratio 0.86 (0.56, 1.33)

8 Percent of Apartments with 25% Reduction in Trapped Cockroaches Month 6 Month IPM Control OR = 3.09 (1.22,7.82) OR =2.13 (1.00, 4.53)

9 Mean cockroaches seen per week in last 3 months reported by residents Baseline to 3 Month Baseline to 6 Month Baseline 3 Month 0 Baseline 6 Month Difference = -40 (-61, -19) Difference = -33 (-69, 3)

10 Effect of IPM on cockroach allergen in the kitchen and bedroom

11 Ratio of IPM to control cockroach allergen levels at follow up Outcome Ratio 95% CI P Value Kitchen at 3 months , Kitchen at 6 months , Bedroom at 3 months , Bedroom at 6 months ,

12 Summary and Questions IPM delivered by housing authority pest control staff, without a significant family education component, reduced: cockroach populations in the kitchen cockroach allergen levels in the kitchen and bedroom Can this maintenance personnel model be replicated in other settings? Does IPM continue to control cockroaches and allergen 1-2 years later? Is IPM cost-effective compared to traditional pest control?

13 CCCEH IPM Potential Spin-offs: Managed Care Organizations Housing Advocacy Groups

14 MCO Spin-Off Despite Asthma Disease Management (DM) efforts, MCOs still have many asthmatics whose asthma is difficult to control Studies show sensitivity to pest allergen + high home environmental exposure = more ED visits & hospitalizations The success of IPM programs has prompted MCO interest in combining IPM with DM.

15 CCCEH and Community Premier Plus Partnership to assist high risk, high cost families: frequent fliers in ED Deliver IPM combined with DM Evaluate allergen & pest levels, morbidity, health care utilization

16 Housing Advocacy Spin-Off Northern Manhattan Improvement Corp. works in over 300 building to remove housing code violations, improve stock. NMIC has pioneered partnerships to address adverse housing conditions that affect health the Lead Model. NMIC now trains residents for building maintenance & weatherization jobs.

17 CCCEH & NMIC Partnership Provide additional training to residents, maintenance crews in IPM and mold abatement. Focus work in building with high #s of asthmatics NMIC teams deliver building wide IPM CCCEH evaluates allergen, pest & mold levels, QOL indicators, & asthma symptoms

18 Intervention to reduce insecticide exposure during pregnancy: Results from a pilot IPM study by Robin Whyatt and Megan Williams

19 Cohort: 25 intervention and 27 control homes from our study area enrolled from STUDY DESIGN: Women who reported using high toxicity pesticides during pregnancy were enrolled into the study during the third trimester of pregnancy and followed until delivery. WEEKS OF PREGNANCY IPM PRE IPM SET-UP Questionnaire 2-week integrated indoor air Pest infestation levels FOLLOW UP POST-IPM SET-UP Questionnaire 2-week integrated indoor air Pest infestation levels Maternal and cord blood Williams et al, EHP, 2006

20 A. Integrated pest management (IPM) C. Seal cracks and crevices Repair holes in walls and ceilings Repair water damage Extensive professional cleaning using low toxicity cleaning products Targeted application of low toxicity pesticide gels Education to address high risk behaviors and distribution of educational materials Supply plastic containers for food and garbage storage

21 Reduction in cockroach A. infestation levels following IPM intervention C. Mean (+/- SE) cockroaches (adults + nymphs) in traps collected over a two-week period pre- and post-intervention. 250 TOTAL COCKROACHES (mean +/- SE) * B. pre post 0 INTERVENTION CONTROL *Wilcoxon Signed Rank, p = Williams et al, EHP, 2006

22 Reduced exposure to pyrethroids in ambient air following IPM intervention LOD (ng/m3) PRE Mean ± SE POST Mean ± SE p-value** Piperonyl butoxide* ± ± cis- Permethrin ± ± trans- Permethrin ± ± * Pyrethroid synergist used as proxy for pyrethroid use, ** Wilcoxon signed rank There were no significant corresponding changes in control air samples Williams et al, EHP, 2006

23 Reduced internal dose of pyrethroids following IPM intervention in plasma LOD Intervention % > LOD Control % > LOD Chi- Squared p-value (pg/g) cis-permethrin trans-permethrin Pesticide levels (mean ± SE, median) (pg/g) in maternal plasma samples collected at delivery in intervention group (n = 21) and in control group (n = 17).