Public Health Essay 7page

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Chamberlain University MPH506

Do-it-yourself Home Environmental Assessment List (HEAL) with Action Plan

This do-it-yourself home environmental assessment will help you identify ways to make your home environment healthy. The Assessment is made up of two parts: The Survey and the Action Plan. To perform a HEAL on your home, follow the directions below.

Set aside a time when the residents of your home can do the assessment together. Then:

1. Complete the Survey

a. Walk through your home and make observations.

b. Read the labels on your household products.

c. Answer the Survey questions.

i. NOTE: Survey answers are grouped under three categories of concern. While the survey cannot absolutely determine high or low risk, these are what the categories mean:

1. “Higher Concern” strongly suggests that action(s) should be taken to lower the home health risk.

2. “Medium Concern” suggests a careful look at action(s) that could be helpful to your health.

3. “Lower Concern” implies that the need for action is low.

2. Complete the Action Plan

a. Go line by line through the Survey (pp 2-6) and wherever an answer falls in the “higher concern” category, note the numbers listed in the column on the right. Then go to the Action Plan (pp 7-9) and check the boxes that have the corresponding numbers.

b. Prioritize each checked item on the Action Plan based on:

i. Your willingness to implement it.

ii. Its significance to the residents of your household.

iii. Its significance to your overall home issues. If many concerns are in one category, for example “Moisture Problems,” you may wish to focus your efforts there.

iv. The advice of experts (if appropriate). For any actions where major home alterations are involved, it’s prudent to consult with professionals before making final decisions.

c. Commit to taking three actions within the next six weeks.

i. Choose at least one that requires behavior change (creating a new habit).

ii. Choose at least one that can be finished quickly and with little expense or effort.

d. Record these three actions in the space provided at the end of the Action Plan.

The Survey

	Level of Concern	Action Steps
	Lower	Medium	Higher
Building
When was the building constructed?	After 1978	1978-1951	Before 1951	14
Has there been remodeling or paint removal in the last two years?	No	Unknown	Yes	14
Are you or your landlord planning to remodel or repaint within the next 12 months?	No	Unknown	Yes	15
Has a next-door neighbor removed external paint?	No	Scraping	Sanding	14
What daytime indoor temperature do you maintain during heating season?	60-68	55-60 68-75	Below 55 Over 75	7 8
Nearby Environment
How far is your home from the following: factory, gas station, dry cleaners, auto body shop, airport, railway station, bus station.	>1 mile	1 mile	<4 blocks	11 14
How many blocks is your home from a busy street or highway?	>4	1-4	<1	14
Are there unpaved roads, shoulders, or driveways adjacent to the home?	No	Yes		14
During the heating season, how often do you smell smoke from neighboring woodstoves or fireplaces?	0-5/year	1-2/month	>2/week	12
Dust and Lead Control
Is any paint peeling or flaking inside or outside the home?	No	Unknown	Yes	16
If yes, is the paint lead-based?	No	Unknown	Yes	13, 17, 20, 23, 27
What percentage of the living space is carpeted?	0-25%	26-75%	76-100%	18, 20
If any rooms are carpeted (Circle all that apply)	Area Rugs	Level Loop	Shag/Plush	18, 19, 20
How do you control tack-in of dust or dirt?	Remove shoes	Doormat/hall rug	I don’t	14
Does every door have a doormat?	Yes	No	None do	14
What types of doormats do you have?	Commercial	Rubber/plastic	Rope	14
What kind of vacuum cleaner do you use?	Powerhead/upright	Canister	None	20
How often do you check the belt and/or bag?	Monthly	1-2/year	Rarely	21
How Often Do You:
vacuum home	>4/ month	1-3/ month	<1/ month	23
dust	>4/ month	1-3/ month	<1/ month	23
scrub bathrooms	>4/ month	1-3/ month	<1/ month	23
shake rugs/doormats	>4/ month	1-3/ month	<1/ month	23
wash beddings/sheets with hot water	>4/ month	1-3/ month	<1/ month	23
air out home/open windows	>4/ month	1-3/ month	<1/ month	29
How do you clean area rugs?	Send out	Vacuum surface	Vacuum w/canister	24
If you work with toxics on the job, do you wash work clothes separately?	N/A	Yes	No	26
How many times per day do you wash hands with soap & warm water?	>6	4-5	0-3	27
If anyone in the home has allergies, do you have plastic covers on their pillows and/or mattresses?	Yes		No	28
Are bedroom windows open at night when sleeping?	Yes	No		29
What is your major heat source?	Electric	Gas/oil	Woodstove
If you have a furnace, when was the ductwork last cleaned?	0-1 years	2-4 years	>4 years	32
How often do you change the furnace filters?	<1 years	1-2 years	>2 years	33
Does furnace have an outside combustion air supply?	Yes/ N/A	Unknown	No	34
Moisture Problems
Do you clean the refrigerator coils and/or drip pan?	Often	Sometimes	Rarely	35, 36
Are there any water leaks or damp areas in kitchen or bath?	No		Yes	37
Is there carpeting in the kitchen or bathroom?	No		Yes	39
Do you use fan or open bathroom window during and after showering or bathing?	Yes	Sometimes	No	40
Is fan vented to the outside?	Yes	Unknown	No	41
Are there signs of mold growth in corners/windows?	Rarely	Sometimes	Often	9, 38, 40, 43, 54
Has there been any sewage backup into the building or the surface of the ground in the last 5 years?	No	Unknown	Yes
Was the material removed and the area disinfected?	Yes/ N/A	Unknown	No	45
Is the basement damp (musty odor; water or mildew; discolored walls, damp carpets or furniture?)?	No/ N/A	Some	Yes	46/44/48/51
If there is a crawl space, is it ventilated?	Yes/ N/A		No	50
If there is a crawl space, is soil covered with plastic?	Yes/ N/A	Unknown	No	49
If you have a dryer, is it vented to the outside?	Yes/ N/A	Unknown	No	52
Is your home well insulated and without drafts (weather-stripped doors and windows, double paned windows)?	Yes	Somewhat	No	53, 54
Do windows fog up during the heating season?	Rarely	Sometimes	Often	9, 53, 54
Can you open a window in each room?	Yes		No	53
Does the home have a musty odor or is there visible mildew?	No		Yes	7, 9, 54, 44, 56
Does the home have any drainage problems?	No	Unknown	Yes	55
Has there been any water damage to the building or contents in the last 5 years?	No	Unknown	Yes
If yes, was the damaged material removed?	Yes/ N/A	Unknown	No	56
Indoor Air
Is this a mobile home or trailer?	No	Yes
Is there any knows particleboard in the floor, built-in cabinets or furniture?	No	Minimal	Yes	57, 58, 59
Does your building have asbestos (furnace insulation, popcorn ceiling, siding, sheet vinyl flooring)?	No	Unknown	Yes	60 if unknown
If yes, is the asbestos in good condition (i.e., not damaged, loose, or flaking)?	Yes/ N/A	Unknown	No	63 if no 61 or 62 if yes
Is this home in an area where radon is common?	No	Unknown	Yes	64
If yes or unknown, has radon level been measured?	Yes		No	64
If yes, was the level above 4 pico Curies/liter air?	No		Yes	65
If you have a garage, is it attached to the home?	No/ N/A	Yes		66, 68
How long do you let car idle in garage before driving off?	<15 seconds	15-30 seconds	>30 seconds	67
What kind of kitchen stove do you use?	Electric	Gas/Propane
Do you sometimes smell fuel from furnace or stove?	No	Unknown	Yes	69
Do you use a stove fan when cooking?	Yes	Sometimes	No	71
Is fan vented to the outside?	Yes		No/ N/A
Is there an unvented kerosene or gas heater?	No	Unknown	Yes	73
Do you use a wood stove during cold weather?	Rarely	Once a week	Daily
Do you smell smoke indoors when the stove/fireplace insert is in use?	Never	Sometimes	Usually	74
Hazardous Household Products
How often do you use the following products:
oil -based paint, stain, varnish, thinner, stripper	Never	Monthly or Yearly	Daily or Weekly	74
spray-on adhesives, paints or lubricants	Never	Monthly or Yearly	Daily or Weekly	75
rubber or contact cement, plastic glue, or epoxy	Never	Monthly or Yearly	Daily or Weekly	75
permanent markers or whiteboard markers	Never	Monthly or Yearly	Daily or Weekly	75
ammonia or chlorine-based cleaners	Never	Monthly or Yearly	Daily or Weekly	75
auto products (degreaser, carburetor cleaner)	Never	Monthly or Yearly	Daily or Weekly	85
solder (for electrical or stained glass work)	Never	Monthly or Yearly	Daily or Weekly	88, 89
photo chemicals	Never	Monthly or Yearly	Daily or Weekly	88, 89
If yes, what precautions do you usually take to avoid inhaling these products:
nothing special				76
use them outside or wear a respirator				76
open a window				76
open at least 2 windows or use fan
How often do you use any of the following products?
drain cleaner, oven cleaner or toilet cleaner with the word DANGER on the label?	Never	Monthly or Yearly	Daily or Weekly	75
do you wear gloves when using them?	Always	Sometimes	Never	77
do you wear goggles or glasses?	Always	Sometimes	Never	77
Are any flammable products stored near fire or heat?	No		Yes	79
Are any hazardous products within reach of children?	No		Yes	80
Are there any damaged, rusting, or open containers?	No		Yes	81
Are there any banned or restricted products?	No		Yes	82
How often do you or a commercial service apply pesticides (insecticides, weed killers, rat poison) inside or outside the home? (Traps do not count)?	Never	<1/year	>1 /year	83, 84
If you use pesticides, which of the following safety precautions do you wear?
gloves	Always	Sometimes	Never	77
long sleeved shirt and pants	Always	Sometimes	Never	78
hat	Always	Sometimes	Never	78
goggles or glasses	Always	Sometimes	Never	77
dust mask (powers) or respirator (solvents)	Always	Sometimes	Never	82
How do you dispose of leftover pesticides?
Use up or take to a household hazardous waste collection site
Put them in the trash				81
Pour them down the drain				81
Keep them				81

Your Home Action Plan

A Residents
	1	Pay special attention to managing dust and other indoor pollutants if you have a large household, small children, pregnant women, older people present or if there is chronic illness.
	2	Smoking is inconsistent with clean air and good health. Stop smoking or restrict it to outside the home.
	3	Seek medical advice regarding chronic or frequent illnesses. Identify specific allergies.
	4	Keep pets, pet beds, and associated spaces clean. Flea comb cats or dogs.
	5	Vacuum areas frequented by pets, reduce pet access to some parts of home.
	6	Seek additional information on least-toxic control of fleas from your veterinarian.
B Building
	7	Raise indoor temperatures to 60-68 F to reduce moisture.
	8	Lower indoor temperatures to 60-68 F to save energy.
	9	Lower humidity levels to 50-60%.
	10	Raise humidity levels to 50-60%.
C Nearby Environment
	11	Identify potential source of pollution and ensure that it is in full compliance with air pollution laws.
	12	Identify source of smoke and ask for correction. Help neighbors learn about health risks from wood smoke and persuade them to control it.
D Dust and Lead Control
	13	Seek expert advice on reducing lead levels in the home.
	14	Reduce track-in of dust and lead. Take off shoes or install high quality door mats at all entrances.
	15	Before remodeling, learn safety procedures for limiting exposure to lead and dust.
	16	Have paint tested for lead if home is pre-1978, and especially if there are children present.
	17	Repair or remove damaged lead-based paint. Contact your local health department.
	18	If anyone in household has allergies or asthma, consider removing carpeting.
	19	When choosing new carpeting, select level loop carpets (tight weave) rather than plush or shag. Consider not gluing carpet down. Choose carpet with cloth backing rather than rubber.
	20	Vacuum with an upright or powerhead vacuum.
	21	Check back and/or belt more often to help make sure vacuum cleaner is working properly.
	22	Consider wearing a dust mask when vacuuming.
	23	Increase frequency of vacuuming or cleaning.
	24	Vacuum area rugs with a power head vacuum or send out for cleaning.
	25	Pay special attention to vacuuming upholstered furniture and consider removing very old cloth covered furniture.
	26	Wash work clothes separately.
	27	Wash hands more frequently.
	28	Consider covering pillows and/or mattresses with plastic.
	29	Open windows more frequently and keep bedroom window open at night whenever possible, provided it is safe to do so.
	30	Have furnace checked for proper operation.
	31	Call the gas company immediately to check possible leak.
	32	Have furnace ductwork cleaned regularly (about every 5 years).
	33	Change furnace filters at least twice a year.
	34	Have an outside combustion air supply installed for furnace.
E Moisture Problems
	35	Clean drip pan at least every three months.
	36	Clean refrigerator coils at least every six months.
	37	Repair water leaks and remove or repair any damaged material.
	38	Reduce kitchen humidity by covering pots, running ventilating fan, or opening windows.
	39	Consider removing kitchen or bathroom carpeting.
	40	Use fan or open windows to reduce bathroom moisture.
	41	Bathroom fan should be vented to the outside and preferably have a timer.
	42	Repair water leaks in bathroom.
	43	Clean up mold with chlorine bleach solution (1 cup per gallon of water).
	44	Remove carpeting if possible.
	45	Clean and disinfect areas contaminated by sewage backup.
	46	Check drainage, downspouts, and foundation dampproofing.
	47	Remove basement carpeting.
	48	Use a dehumidifier in basement.
	49	Cover crawlspace floor with 6 mil polyethylene, anchor with sand, gravel, or bricks.
	50	Ventilate crawlspace.
	51	Consult with a specialist on correcting a basement moisture problem.
	52	Vent clothes dryer to outside.
	53	Ventilate home by opening windows whenever weather permits. Repair or replace windows that cannot be opened.
	54	Minimize water producing activities: take shorter showers, keep lids on pots, use exhaust fans.
	55	Correct specific drainage problems. Check downspouts, foundation, slope, etc.
	56	Remove water damaged materials.
F Indoor Air
	57	Have air test for formaldehyde levels.
	58	Seal sources of formaldehyde that cannot be removed. Use a polyurethane or acrylic sealer.
	59	Remove sources of formaldehyde if levels are very high and/or sources cannot be sealed.
	60	Test material for asbestos.
	61	Leave asbestos in place.
	62	Cover/isolate asbestos (qualified professional).
	63	Inquire about asbestos removal by a qualified professional.
	64	Have home tested for radon.
	65	Visit the radon resource page for more information on reducing radon levels: https://www.epa.gov/radon/radon-hotlines-and-information-resources
	66	Clean garage floor, remove hazardous products to shed.
	67	Avoid idling car in garage. Drive off immediately after starting.
	68	Install door mat between garage and home.
	69	Call the gas company about possible gas leak in stove.
	70	Install stove fan.
	71	Use stove fan when cooking.
	72	Vent stove fan to outside.
	73	Avoid using unvented kerosene or gas heater inside the home.
	74	Have fireplace/stove checked.
G Hazardous Household Products
	75	Use less hazardous products if possible.
	76	Use hazardous solvent-based products outdoors or open two windows and use a fan.
	77	Wear gloves and goggles when using corrosive products or pesticides (consult the product guide for correct type of gloves)
	78	Wear appropriate protective gear when applying pesticides: long-sleeved shirt and long pants, a non-permeable hat, and a dust mask for powders or a respirator for solvents.
	79	Move flammable materials away from source of ignition.
	80	Move hazardous products to area protected from children.
	81	Contact your local health department about removal of hazardous products.
	82	Contact your local health department about removal of banned products.
	83	Reduce or eliminate use of indoor pesticides by employing non-chemical controls or using less-hazardous products.
	84	Avoid calendar application of pesticides. Treat specific problems only when necessary and use non-chemical controls or less-hazardous chemicals if possible.
	85	Consider performing activity outdoors.
	86	Consider performing activity in garage.
	87	Consider performing activity in room separate from home.
	88	Consider installing ventilation system in room where activity is done.
	89	Learn more about the risks and investigate safety equipment for engaging in this activity.
	90	Do not put pesticides down the drain or in the trash. Contact your local health department.

Your Home Action Plan Summary

To Improve the health of my/our home, I/we will take these actions in the next six weeks:

Now consider your evidence-based recommendations for remediation across a health systems perspective and complete the following table:

Recommendations for Remediation from a Microsystem perspective (Home or Community Point-of-Care)	Recommendations for Remediation from a Mesosystem perspective (Education of Direct or Indirect Care Providers)	Recommendations for Remediation from a Macrosystem perspective (Legislative or Regulatory)

*Note. Adapted from https://www.hud.gov/sites/dfiles/HH/documents/5d_HHAI_MOD1_Ex3_HEAL.pdf