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By Joanna Gaitens, Ph.D.

As a broker, you know that purchasing a home can be an exciting time for your clients and one of their biggest investments, both financially and emotionally. But did you also know that properly maintaining a home after the sales transaction can be an important investment in their overall health? Let’s look at how housing and health are linked, and educate your agents accordingly.

As early as the 1800’s, Florence Nightingale recognized that “the connection between health and the dwelling of the population is one of the most important that exists.” Today, given that Americans spend an estimated 90% of their time indoors, we want to make certain that their homes are safe and healthy places in which to live.

Besides causing a potential decline in property value, an improperly maintained home can contribute to various health and safety hazards, including exposure to allergens, mold, poor indoor air quality, pesticides, other chemicals, and physical hazards. While these potential hazards can affect the health of all individuals living in a home, young children, the elderly, and individuals with pre-existing health conditions are often most at-risk.

Overall, poor housing quality has been associated with adverse health conditions such as asthma, respiratory disease, injuries, and allergic reactions. It has also been linked to emotional stress, which can lead to increased symptoms of anxiety, irritability, and depression. However, improving one’s living environment has been shown to have positive effects. For example, individuals suffering from chronic mental illness have lower medical care costs when living in newer or properly maintained buildings.

What can brokers and Realtors do to advise their clients about the connection between housing and health?

Fortunately, the answer is simple. Relatively inexpensive routine maintenance activities that focus on inspecting, cleaning, replacing and repairing various systems can help eliminate many potential health and safety hazards. To maintain a safe and healthy home, your clients can follow these basic healthy housing essential maintenance practices:

Keep it dry
• Keep it well ventilated
• Keep it free of contaminants
• Keep it pest free
• Keep it safe
• Keep it clean

Keep It Dry
Excess moisture in the home can result in mold growth, pest infestations, and other unhealthy conditions. Researchers have found sufficient evidence to link housing conditions, such as damp indoor environments and the presence of mold, with upper respiratory tract symptoms, asthma, and wheezing and coughing. To avoid such moisture-related problems, homeowners can routinely check to ensure that:

• Rain and ground water are kept away from the house.
o Mulch, shrubbery, or other materials that retain moisture are not placed directly against the house.
o Gutters and downspouts are frequently cleaned and drain away from the foundation.
o The roof is frequently inspected for areas that could lead to water infiltration (i.e., deteriorated or missing shingles).
o Proper grading and drainage are maintained around the exterior of the house.
• Plumbing and appliances are maintained and are free of leaks.
o Pipes are monitored for signs of sweating or condensation.
o Washer and dishwasher hoses and connections are frequently inspected.
o Boilers and hot water heaters are monitored for signs of deterioration.
• Items are in place to assist with moisture control.
o Kitchen and bath fans are vented to the outside (not to attic spaces).
o Catch pans designed to capture overflow or leaks from equipment such as washing machines are free of cracks and debris.
o Caulk and/or grout are maintained in bathrooms and kitchen areas to prevent water seepage.
o Materials that retain water remain out of areas with high humidity (i.e., wall-to-wall carpeting is not installed in areas such as bathrooms and basements).
o Vapor barriers are intact in crawlspaces to help control moisture intrusion.

Keep It Well Ventilated
According to the US EPA, indoor contaminants are typically two to five times higher than those found outdoors. Proper ventilation is necessary to dilute or remove contaminants, such as volatile organic compounds (from dry cleaned clothes, carpets, and other materials), radon (a naturally occurring gas), allergens (from cockroaches, mice, and other pests), moisture, mold, environmental tobacco smoke, carbon monoxide, and particulate matter (fine air particles), and to remove humidity. Homeowners can promote proper ventilation by making sure that:

• Chimneys are routinely checked for blockage and professionals are hired periodically to clean them.
• Kitchen and bathroom fans are vented to the outside whenever possible (not to the attic space) and are regularly checked so that all exhaust ducts are clear of debris.
• Professionals are hired annually to clean and fine-tune heating and air conditioning units, and hot water heaters.
• Filters are frequently checked and replaced on hot air furnaces in the fall and on air conditioners in the spring (or more often according to the manufacturer’s instructions).
• All windows and doors are inspected periodically to ensure proper functioning.

Keep it Free of Contaminants
Contaminants such as formaldehyde, pesticides and carbon monoxide can irritate the eyes, nose and throat, and cause more severe allergic reactions or chronic effects. Other contaminants, such as lead-based paint and asbestos, can have more serious health impacts. Homeowners can address these and other contaminants by:

• Using low volatile organic compound paints and primers.
• Ensuring that floor surfaces are smooth and cleanable whenever possible.
• Using wire shelving instead of composite wood products.
• Tightly sealing the garage from the living space.
• Venting all combustion-fueled equipment (i.e., gas appliances) to the outside.
• Ensuring that septic systems are cleaned every two years.
• Following “lead-safe work practices” when renovating, repairing or painting homes built before 1978.

Keep It Pest Free
Homes that have deteriorated foundations or a poorly maintained exterior may have increased pest infestations. In addition to being a nuisance and potentially damaging the building, exposure to pest allergens is associated with asthma symptoms. To avoid or eliminate pests, homeowners frequently apply pesticides. But if used improperly, these chemicals can be dangerous to humans and lead to a variety of acute or chronic problems, such as rashes, stomach cramps, and eye, nose, and throat irritations.

To maintain a pest free environment, homeowners can follow integrated pest management activities that restrict a pest’s access to food, water, and nesting opportunities. Integrated pest management includes:

• Conducting periodic checks to identify and seal all holes and cracks that lead to the exterior.
• Ensuring good sanitation practices, including using sealed garbage cans.
• Using low toxicity pesticide baits (if needed).
• Inspecting periodically for signs of rodents, bats, ants, roaches, termites, and other pests.

Keep It Safe
According to the National Safety Council, our homes are the source of many injuries and even deaths each year. Falls and poisonings are common among all age groups. Unsafe conditions can result from improperly functioning equipment, poor lighting, poor maintenance, and the lack of safety devices, such as smoke and carbon monoxide detectors and anti-scald devices. Steps homeowners can take to keep their homes safe include:

• Installing arc fault circuit interrupters.
• Installing smoke and carbon monoxide detectors on all floors, and replacing batteries and checking the units at least twice a year to ensure they are properly functioning.
• Repairing structural defects, such as broken or cracked porch steps or loose railings.
• Checking the hot water heater to ensure that it is set at an appropriate temperature (120 degrees) and installing an anti-scald device.
• Inspecting electrical cords for damage at least twice a year.
• Testing ground fault interrupters yearly.
• Routinely cleaning dryer vents and screens to prevent fire hazards.
• Checking the yard, exterior, and interior of the home for trip, fall, choking, and sharp edge hazards.

Keep It Clean
A clean home can reduce one’s exposure to allergens, pests, pesticides, chemicals, and other hazards. In addition, a clean environment that is uncluttered can help reduce injuries for those with impaired vision or mobility. Steps homeowners can take include:

• Installing walk-off mats near all doors leading to the outside.
• Making surfaces smooth and cleanable whenever possible.
• Using wet cleaning methods rather than dry dusting or dry sweeping whenever possible.
• Eliminating clutter and properly storing belongings.
• Avoiding the overuse of antimicrobial cleaning products, sanitizers, and air fresheners.
• Keeping the yard free of animal waste which can attract pests and introduce disease.

By regularly maintaining their homes, your clients can ensure the growth and stability of their real estate investment and contribute to their overall health and safety. You can share these simple and relatively inexpensive healthy housing essential maintenance practices with your clients after the sales transaction is complete so that they and their families can more fully enjoy and live comfortably in their newly acquired homes.

Joanna Gaitens, Ph.D., is with Healthy Housing Solutions, Inc. The National Center for Healthy Housing has developed a Healthy Homes Maintenance Checklist, which can be downloaded and distributed for free to your clients. To obtain the checklist, please visit