Closing and Action Steps

VADM Richard H. Carmona, M.D., M.P.H., F.A.C.S.
U.S. Surgeon General

The Surgeon General, VADM Richard Carmona, closed the workshop with his impression of what was said over the past 2 days. He indicated that the workshop presentations have made the case that the time has come to take action in this area. Some workshop participants have spent 25-30 years doing anonymous indoor environment research and advocacy. The Surgeon General complimented those who have worked so hard for their passion and dedication to making the world a better place in which to live. The indoor environment, where we spend 85%-95% of our time, is a complex, multifactorial issue that requires a multidisciplinary approach. He indicated that the time has come for moving forward on this issue.

He noted that presentations at this workshop are like "preaching to the choir." For the public at large, however, indoor environment issues are not widely recognized or understood. In dealing with other environmental and health issues, he has come to feel that our society is mostly "health illiterate." He stated that what we really need to do for the public is to provide clear information that will effect behavioral changes. More research is indeed needed, but there is already enough good information that can be used to make practical improvements in the indoor environment. What we are lacking is the "translational element" needed to overcome health illiteracy. The outcome we are seeking is to effect behavioral changes that improve morbidity and mortality and reduce health care costs. This task is made more complex because, for indoor environmental issues, the public this group is trying to reach is not only the home owner but also the builder, the maintenance staff, the architect, and the city planner; therefore, a very broad outreach is needed.

The next action step will be determined by a continuum of processes that starts with the issuance of the Summary Report for this workshop. Based upon the discussions that occurred during these 2 days, the Summary Report, and guidance from various federal, state, and local public health stakeholders, a Surgeon General's Call to Action may be the appropriate next step. A Surgeon General's Call to Action helps to focus the nation's attention on issues that impact health. As we move forward with trying to achieve a healthy indoor environment, there may be the development of a Surgeon General's Report, which takes greater effort and commitment of resources than what it took to develop this workshop.

VADM Carmona closed the workshop by thanking the workshop participants. He indicated his commitment and his feeling that this is the right issue at the right time.