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Breathe Easy Home used a pre-post design to examine the benefits of a new home designed to reduce asthma triggers and improve clinical outcomes among 35 low-income children with asthma. Features of the new homes included: an insulated construction slab, insulated glass, extensive flashing, minimal carpet, low emission materials, filtered air ventilation and attention to dry construction materials which added an estimated $6,000 in cost. Up to $10,000 was available for eligible families. Families also received home visits from community health workers who provided self-management education and support.

Access full article and supplemental material: The Breathe Easy Home: The impact of asthma-friendly home construction on clinical outcomes and trigger exposure, American Journal of Public Health-Jan. 2011.

Appendix 1 - Features of the Breathe Easy Home

The Breathe Easy Home (BEH) design integrated best practice strategies recommended by nationally known groups such as the American Lung Association1, the Energy Efficient Building Association2, and the United States Green Building Council3. The design team's work also included the use of local guidelines such as BuiltGreen™ of King and Snohomish Counties4 and SeaGreen: Greening Seattle's Affordable Housing5 that make these recommendations specific to the Pacific Coast maritime climate and the needs of the community being served. The contractors who built the BEH homes were trained on the purpose of the home and how construction practices would be modified to meet these goals, especially regarding moisture control of materials, use of volatile compounds and ventilation. Seattle Housing Authority and the investigators provided oversight during construction.

1 American Lung Association. (November 2002). Home Control of Asthma and Allergies.
2 Energy Efficient Building Association. (n.d.). Built Green Features.
3 United States Green Building Council. (n.d.).
4 BuiltGreen of King and Snohomish Counties. Built Green Features.
5 Office of Housing, City of Seattle. (November 2002). SeaGreen: Greening Seattle's Affordable Housing.

Exterior Envelope. The exterior envelope was designed as a durable modified rain screen with air and moisture tight construction beyond code to insure that air and moisture entering the home was tightly controlled. The envelope includes an exterior drainage plane behind durable cement board siding over taped and sealed rigid insulation, over high r-value blow-in insulation in a wall constructed of 2x6 advanced framing, which also ensures low energy use. Other exterior design elements such as walk off mats and shoe storage at the entry minimize the entry of contaminants into the homes. Additionally, the landscape minimizes outdoor asthma triggers in yards and outdoor spaces using plants with low allergen ratings and specifies maintenance with integrated pest management strategies that minimize or eliminate the use of toxic pesticides.

Interior Furnishings and Flooring. Low VOC and non-toxic interior furnishings, materials, and flooring choices were used. The majority of the flooring is a resilient Marmoleum™ linseed product, with no PVC. Low emission adhesives were used throughout.

Ventilation System. The upgraded ventilation system is powered by a Broan-Nutone Guardian Plus (Model No. GSHH3K) and includes an energy recovery component and HEPA filtration (MERV 15) of both outdoor and indoor air. The unit filtration efficiency when operated at the recommended setting is >87% at 0.3 micron particle size with 270 cubic feet per minute of fresh and filtered air (up to 105 CFM of fresh air), equivalent to a MERV value of 15. The heating system complements the ventilation system and is a hydronic radiant baseboard system that minimizes the dust circulating in the air. Spot ventilation is present in all bathrooms, utility and kitchen areas and vents directly to the outside.

All High Point Homes features

  • Gas-fired high efficiency closed-loop boiler for both on-demand domestic hot water and radiant baseboard heaters to reduce heating bills.
  • Quiet whole house fan with 2-speed timing switch to remove moisture.
  • Filtered fresh air intake ports in all living spaces and bedrooms to improve indoor air quality.
  • Airtight drywall installation to reduce moisture penetration and inhibit mold growth.
  • Low E coated and argon filled Energy Star .33 maximum U-value vinyl windows to reduce heating bills and block UV rays.
  • Low off-gas vinyl flooring with recycled content in baths and kitchens.
  • Low VOC paint throughout.
  • Sealed cabinet construction to reduce emissions.

Breathe Easy Home features

  • Positive-pressure house ventilation system with air filtering. Tempered fresh air supply and heat recovery to improve indoor air quality.
  • Linoleum flooring in living areas and bedrooms, recycled content vinyl flooring in baths and kitchen and low pile carpeting at stairs and halls to reduce allergens.
  • Low/no off-gas and millwork to reduce urea formaldehyde bonding agents.
  • Low/no off-gas or VOC cabinet construction.
  • HEPA filter vacuums to remove allergens.
  • "Walk-off" doormats to reduce dirt in home.
  • Construction sequence includes extra dry-out time to minimize mold growth, weather protection of on-site materials, ductwork protection to minimize dust, extra cleaning cycles with low/non-toxic and non-allergenic cleaners, and flushouts to allow evaporation and off-gassing of materials.

Figure 2. FEV1 in liters for subjects with spirometry at 2 or 3 time points (n=22)

Figure 2. FEV1 in liters for subjects with spirometry at 2 or 3 time points (n=22)



Figure 3. Environmental measures in house dust from child's bedroom (aggregated geometric mean)

Figure 3. Environmental measures in house dust from child's bedroom (aggregated geometric mean)