The Healthy Homes Screening Tool (HHST) is being tested by the Wayne State University Center for Urban Studies as a tool to examine the health risks in homes. This screening tool is intended to help non-housing professionals to provide a first indication of the extent of risks that tend to increase sickness, injuries, and death among inhabitants of the home.  The first version of this survey was administered on paper, either during a face-to-face interview or completed by the resident and returned by mail.  If a resident was unable to participate in a face-to-face interview the survey was then administered by an interview over the phone.  A total of 519 households in a central city neighborhood of Detroit were surveyed using the first version of the HHST.  Below are five graphs from the preliminary analysis of the HHST indicating some of the greatest health risks within homes surveyed. We are now improving this instrument and preparing to test the reliability and validity of that version. In the long range we expect that the HHST may indicate when a more thorough examination of housing risks must be completed using the HUD-sponsored Healthy Homes Rating System.

The households surveyed within Detroit showed elevated  rates  of asthma diagnosis among both adults and children.  Of the 516 households that responded, 28.1% reported an adult in the household had been told they had asthma. Nearly a quarter (23.1%) of the 368 households that answered the question reported that children (under 18) had been told by a doctor or other medical professional that they had asthma.  Chronic breathing problems were also reported in children in 21.6% of all households surveyed.  In the state of Michigan in 2007 the Michigan Department of Community Health reported a statewide prevalence of asthma at 9.5%.

Certain household allergens such as dust mites, cockroaches, mold, furry pets, tobacco smoke, and certain chemicals may potentially trigger or increase the severity and frequency of asthma attacks.  Volatile organic compounds (VOCs), which can be found in air fresheners, candles, plug-ins and incense, may also increase the severity and frequency of these attacks.  The HHST found that 43.5% of households included at least one person who smoked.  The survey also found 54.8% of households used candles, 46.3% used plug-in air fresheners, and 37.8% used incense.  These conditions may contribute to the high proportion of households reporting asthma and chronic breathing problems.

A large proportion of homes surveyed, 39.1%, reported water had leaked into their home from the outdoors in the last 12 months, excluding plumbing or other inside leaks.  Such water leaks can cause dampness and high humidity, leading to an increase in dust mites, mold, and fungal growth.  These conditions can cause an increase in both the prevalence and severity of allergy and asthma symptoms.  The population most affected by these conditions is children under 14 years of age, according to the Department of Housing and Urban Development, Healthy Homes Rating System – Operating Guidance.  This high proportion of water leaks from outdoors likely contributes to the high proportions of asthma reports demonstrated in the graphs above.

Lead is a heavy metal that can cause lead poisoning and have “toxic effects on the nervous system, cognitive development and blood production.”  The population most severely affected by lead is children under 6 years of age, according to the Department of Housing and Urban Development, Healthy Homes Rating System – Operating Guidance.  Lead was commonly used in household paint until it was banned in 1978.  Of the households in Detroit, 87.3% were built before 1978, meaning a majority of these homes likely contain lead-based paint.  When this paint chips or peels, it becomes easy for children to ingest, causing irreversible damage to their cognitive development.  Lead also has a sweet taste, encouraging children to ingest the toxic substance.  Having your home tested for lead and regularly having your children tested for lead poisoning is recommended if your home was built prior to 1978.

Chipping or peeling paint was visible in 60.4% of the homes surveyed with the HHST, the vast majority of which were built prior to 1978. However, only 44.3% of homes had been tested for lead, and only 50% of households had their children tested for lead poisoning.

Home fires kill many people in Detroit and Michigan every year as well as injuring people through burns and smoke or gas inhalation.  Ensuring there is a working smoke detector present on every level and in every sleeping area of a home can help make sure residents are alerted in time to safely escape.  However, 29% of homes surveyed did not have a smoke detector on every level and in every sleeping area.  Sleeping with a bedroom door closed will also delay the spread of fire and smoke into a bedroom, allowing extra time to escape. However, only 46.2% of homes surveyed reported using this practice.  Making sure exits from the building are accessible in the event of a fire and having fire extinguishers present and readily accessible for use are also important fire safety practices and were largely reported to be followed among those surveyed.

Carbon monoxide is a toxic gas that, at high concentrations, can cause “headaches, dizziness, weakness, nausea, confusion”, disorientation, fatigue, and even “unconsciousness and death.”  Due to the fact it is both colorless and odorless, a working carbon monoxide detector is one of the few ways to detect a leak besides physical symptoms just mentioned.  Common sources of carbon monoxide include improperly vented gas, oil, or solid fuel burning appliances such as dryers and stoves.

Of the 515 homes that responded to the above question in the survey, 81.6% reported they had gas appliances such as a stove or dryer, but 27.6% reported the appliance was not vented to the outside . Only 38.1% of households surveyed reported having a carbon monoxide detector in their home.