A Guide to Healthy Homes

for Housing Professionals –

American Indian and Alaska Native Communities

■ Covers the health-related hazards that can impact residents 

■ The Eight Principles of a Healthy Home 

www.hud.gov/healthyhomes OFFICE OF LEAD HAZARD CONTROL AND HEALTHY HOMES

Healthy 

Children Healthy Families Healthy Communities
U.S. Department of Housing and Urban Development

Office of Lead Hazard Control and Healthy Homes

April 2020

OFFICE OF

LEAD HAZARD CONTROL

AND HEALTHY HOMES

Healthy 

Children

Healthy

Families

Healthy

Communities

Introduction

 “Many tribal communities have a traditional understanding of inter-dependent ties with 

the land, and it can be said that when the environment (dwelling) is “sick,” the people 

may become sick.

It is important to be aware of certain concerns when communicating with residents 

on the operation and maintenance of their home. Good housekeeping practices can 

alleviate many of the conditions associated with an “unhealthy home.’”

— National Tribal Air Association, 

in Letter to HUD’s Office of Lead Hazard Control and Healthy Homes
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A Guide to Healthy Homes

for Housing Professionals 

Helping American Indians and Alaska 

Natives Have Safe and Healthy Homes

This guide offers many ways that housing directors, home inspectors, 

maintenance workers, and others can ensure families have a safer and 

healthier home. The publication covers moisture related problems such as 

mold, combustion issues creating carbon monoxide poisoning, drinking 

water impurities such as lead, toxins like household chemicals and solvents, 

radioactivity presence from radon, and other difficulties that can degrade the 

residents’ health and/or can degrade the dwelling itself.

It is important that housing professionals have a knowledge base to safeguard 

those especially susceptible to contaminants leading to later health problems - 

especially developing children! 

This guide’s content was developed by the U.S. Department 

of Housing and Urban Development’s Office of Lead 

Hazard Control and Healthy Homes (HUD/OLHCHH), in 

collaboration with the U.S. Department of Agriculture’s 

National Institute of Food and Agriculture (USDA/NIFA); 

the U.S. Environmental Protection Agency (EPA); and the 

U.S. Department of Health and Human Services (HHS), 

including the Indian Health Service (IHS). Housing offices 

are sometimes small, with staff wearing many hats. To help, 

three other companion publications were developed for tribal 

leaders, family members, and medical and health workers. 

Please visit www.hud.gov/healthyhomes.

Housing professionals can reach out to HUD’s Office of Native American Programs. 

ONAP administers six programs specifically targeted to Native American, Alaska 

Native, or Native Hawaiian individuals and families, and federally recognized tribal 

governments. A newsletter contains Federal News, Trainings, Funding Announcements 

for Tribes/Tribal Entities, a very extensive listing of resources, as well as federal 

partners, and Tribal News. The ONAP website is www.hud.gov/codetalk.
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Helping Native Americans Have Safe and Healthy Homes

Who should use this guide?

➤ Tribal Environmental Professionals/Planners

➤ Architects and Builders

➤ Tribal Air Quality Staff

➤ Trainers

➤ Energy Efficiency & Weatherization Professionals

➤ Property Owners

➤ Home Inspectors

➤ General Contractors and Remodelers

➤ Housing Directors and Managers

➤ Building Maintenance Supervisors/Workers

➤ Housing Developers and Consultants

➤ Field Supervisors

Housing professionals can also learn from other companion publications 

for tribal leaders, family members, and medical and health workers. 

Please visit www.hud.gov/healthyhomes. These publications were 

developed for tribal leaders of American Indian and Alaska Native 

communities, and community health workers also serving Native 

Americans. There is an extensive resource section in all four publications. 

A key reference is the Healthy Homes Program Guidance Manual, 

developed by HUD/OLHCHH and our partners. It is a “one-stop shopping” 

resource for building local programs. Although the manual takes a broad 

approach, housing professionals will find coverage of healthy homes 

rating systems, case studies, and other sections of substantial assistance. 
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A Guide to Healthy Homes

for Housing Professionals 

What is a Healthy Home?

A healthy home is one that is maintained to avoid injuries and illnesses to occupants. Common indoor health concerns are lead hazard 

control, air quality, mold and moisture, pest management, and injury 

prevention. The Eight Principles of a Healthy Home, below, explain 

more about these and other hazards, and actions needed for prevention. 

Reduction of negative health impacts from improper ventilation and poor 

indoor air quality are especially serious concerns in many households. 

More information, including technical materials and scientific research, is 

available on HUD’s Healthy Homes website.

Tribal traditions and cultures are diverse and unique. Indoor and 

outdoor health-related housing hazards can also vary significantly by 

region, due to differences in climate, weather events, sizes and types of 

homes, building materials, home construction techniques, and other 

factors. Housing professionals must also account for local issues, such as 

water quality and allergens. Finally, some hazards, such as outside wells 

and soil in yards and around foundations, are outside the home but can 

impact occupants’ health greatly.

Historically, homes in Native American communities were more than 

physical shelter. The building materials, ground footprint and shapes vary 

drastically from the longhouses and wattle/daub in the Northeast, sod/log 

houses and Igloos in the Arctic, cliff dwellings and Hogans in Southwestern 

lands, plank houses in the Pacific Northwest and the Tipi of the Great 

Plains and Rockies regions. Climate, the surrounding animals, and nearby 

plants dictated the dwelling style and to what extent the people felt they 

were a part of the landscape.

The bond to the home and land was present with those in tipis covered 

by buffalo skins, building/blessing wood houses and those subsisting in 

rock formations. Thus, houses built in one region of tribes would have 

been impractical and uncomfortable physically (as well as in folkways) to 

inhabit in other regions. 

Over time, there has been a significance to homes that goes beyond 

building materials science, mechanical diagnostics and engineering 

practicality. It is important to be aware of this when educating the residents 

on the operation and maintenance of their dwelling. There is a clear link

“But going back 

to the traditional 

understanding of 

dependent ties with 

the land, it can 

be said that when 

the environment 

(dwelling) is ‘sick’, 

the people may be 

sick.“
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Helping Native Americans Have Safe and Healthy Homes

between housing and our personal health. Going back to the 

traditional understanding of dependent ties with the land, it 

can be said that when the indoor environment (dwelling) is 

sick, the residents may be sick.

Getting Started

Housing professionals have extremely busy jobs. Your staff, 

community, leadership, and residents look to you to address a 

myriad of housing issues. You have responsibilities for staffing, 

budgeting, and managing your housing programs. It may 

feel like there is not enough time in the day to address all that 

needs to be done.

So why add another task to your already busy agenda?

Implementing a Healthy Homes initiative for your residents 

has multiple benefits to you and your residents:

A safe and healthy home results in:

• Healthy families 

• A reduction of illnesses, such as asthma and allergies that 

can result from indoor air pollutants/pests.

• Fewer calls from tenants to address mold or major home 

repairs. 

A practical approach to ensuring healthy homes for families is 

to begin with an overall home assessment (see Environmental 

History below) related to the family’s vulnerabilities. The 

assessment is a very important first step to prevent diseases 

and injuries that result from housing related hazards.

The home assessment and intervention process begins 

the first time a housing professional talks with a resident 

(client). Referrals are made, or people call directly because of a 

perceived health concern. An example of a home assessment 

can be found at this website: https://anthc.org/wp-content/

uploads/2018/04/ANTHC-Healthy-Homes-Checklist.pdf

Part of this conversation is to educate tribal residents about 

the Eight Principles of a Healthy Home. These fundamental 

concepts will help keep occupants focused on their dwellings 

so that there is less need for immediate maintenance.
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A Guide to Healthy Homes

for Housing Professionals 

❶Keep it dry:Prevent water from entering 

the home through leaks 

in roofing systems, prevent 

rainwater from entering the 

home due to poor drainage, 

and check interior plumbing for any leaking.

❷Keep it clean:

Control the source of dust 

and contaminants, creating 

smooth and cleanable 

surfaces, reducing clutter, 

and using effective wetcleaning methods.

❸Keep it safe:

Store poisons out of the 

reach of children and 

properly label. Secure loose 

rugs and keep children’s play 

areas free from hard or sharp 

surfaces. Install smoke and carbon monoxide 

detectors and keep fire extinguishers on 

hand.

❹Keep it well ventilated: 

Ventilate bathrooms and 

kitchens and use wholehouse ventilation for 

supplying fresh air to 

reduce the concentration of 

contaminants in the home.

The Eight Principles of a Healthy Home - The Cornerstone

HUD’s Office of Lead Hazard Control and Healthy Homes defines Eight Principles of a Healthy Home. 

Briefly, they are:

❺Keep it pest-free:

All pests look for food, water, and 

shelter. Seal cracks and openings 

throughout the home; store food 

in pest-resistant containers. If 

needed, use sticky-traps and baits 

in closed containers, along with least-toxic 

pesticides such as boric acid powder.

❻Keep it contaminant-free:

Reduce lead-related hazards 

in pre-1978 homes by fixing 

deteriorated paint and keeping 

floors and window areas clean 

using a wet-cleaning approach. Test the 

home for radon, a naturally occurring 

dangerous gas that enters homes through 

soil, crawlspaces, and foundation cracks. 

Install a radon removal system if levels 

above the EPA action level are detected.

❼Keep it well maintained:

Inspect, clean, and repair the 

home routinely. Take care of 

minor repairs and problems 

before they become large 

repairs and problems.

❽Keep it thermally controlled:

Houses that do not maintain 

adequate temperatures may 

place the safety of residents at 

increased risk from exposure 

to extreme cold or heat.
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Helping Native Americans Have Safe and Healthy Homes

In a nutshell, a healthy home assessment starts with taking an 

Environmental History with the residents which educates on these 

Principles. In this process, housing and other professionals systematically 

gather some basic but vital information about the client’s home and 

behavior. There are common reported health concerns related to homes. 

Some symptoms may only be evident when the client is at home. Or, the 

client wakes up feeling bad, but is better after leaving the home. 

Reported health concerns are often of two types:

Acute Symptoms:

Dry or burning mucous membranes in the nose, eyes, and throat; sneezing; 

stuffy or runny nose; fatigue or lethargy; headache; dizziness; nausea; 

irritability.

Chronic Symptoms

Allergies, asthma, neurological symptoms, lethargy, infections, cancer.

Take an Environmental 

History as Part of the Home 

Assessment Process

The environmental history will 

help to determine if a home 

assessment is appropriate, 

necessary, or whether there are 

alternatives. An environmental 

history documents home hazards 

and their effect on occupant 

health. 

Other tools and techniques 

are available. Here is a simple 

and fast way to help your clients. 

The Healthy Homes Do-It-Yourself 

Assessment Tool walks users through 

each room and provides simple, 

low, and no-cost solutions to 

many common healthy housing 

problems. https://healthyhomes.

fcgov.com/

To learn if the occupants' health 

concerns could be related 

to housing, conducting an 

Environmental History is 

invaluable. The goal is to better 

understand more about client 

activities and site concerns:

■ The clients' physical surroundings

■ The type, age, and condition of the home they live in. 

This includes:

➤ The heating/cooling systems

➤ Where the client spends time

➤ The client's routine activities - for example, hobbies,

chemicals used in and around the home, and occupation

➤ Potential hazards, identity risks, and/or exposure times
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A Guide to Healthy Homes

for Housing Professionals 

The U.S. Department of Energy did 

a study to determine the most cost–

effective measures to assist with mobile 

homes in cold climates. DOE made five 

suggestions for your staff to retrofit the 

home after it is moved in place or even 

before:

➤ Seal air leaks around any furnace ducts. 

➤ Tune–up the furnace when first 

commissioning, and every year afterward.

➤ Provide adequate ventilation.

➤ Add skirting around the trailer’s bottom 

area. Most mobile homes also need a 

vapor barrier between the earth and 

trailer before skirting is assembled to keep 

moisture from the ground from rotting 

out home from underneath.

➤ Install interior film over the windows (or 

provide storm windows outside) during 

winter months.

Manufactured or Mobile 

Home Considerations 

Manufactured/modular housing is common in many 

tribal communities. A portable or 

mobile home can be brought onto a 

family member’s lot or in a trailer 

park. Mobile homes, tiny houses 

or campers in moderate climates 

may be long term dwellings for 

many Native Americans. Some 

healthy homes principles become 

particularly important for residents 

in these homes.

Challenges can arise in controlling how mobile 

homes are constructed. Ventilation and indoor 

air quality are some paramount considerations. 

Occupant education on operations and 

maintenance is crucial to the residents’ well-being. 

Once the home is delivered, it must be secured 

to the ground, and leveled on the foundation. 

This is recommended for a site of dry ground with 

proper gutters/drainage. If not level, or the ground 

is too moist, there could be stability troubles, as 

well as deterioration of the metal frame that is 

acting as the foundation. 

Please keep in mind that the location will be 

important for shade from nearby vegetation, as 

insulation from cold and heat are not going to 

be plentiful in a pre-manufactured home. Also, 

clearance from trees or large bushes is important 

to not only avoid limbs possibly falling on the 

structure, but also to keep pests from having easy 

access. 

Housing professionals should be aware that the 

operational costs of manufactured homes may be 

quite a bit more when compared to a traditional 

home.
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Helping Native Americans Have Safe and Healthy Homes

Danger Spots Summary

Here are “top danger spots,” often present or of major concern in many 

residences. More information about these and other individual hazards is 

found after the summary. Next, there are some suggested questions to ask 

of residents, or that they can ask themselves, about housekeeping habits, 

physical features of the home, and more. 

Lead Poisoning: 

Lead exposure can have a devastating effect on fetuses, newborns, 

toddlers, and young children below the ages of six and seven. Dust from 

lead paint is the biggest threat. It is critical for families to find out if their 

homes have lead in or around it. Lead piping and lead in pipe solder in a 

pre-1986 home can also greatly contribute to lead poisoning.

In line with the CDC’s recommendation, HUD/OLHCHH recommends 

that children, especially children enrolled in Medicaid should be screened 

with a blood lead test at ages 12 months and 24 months old, or, if they 

have not previously been screened, within the 36 to 72 months old period. 

Of course, if a child has an elevated blood lead level, their healthcare 

provider will decide how much more frequently the child should be tested.

Volatile Organic Compounds (VOCs): 

Many household products, such as paints, cleaners, and air fresheners 

release volatile organic compounds (VOCs) into the air. VOC levels can be 

ten to even 100 times higher indoors than outdoors. Residents exposed to 

VOCs may experience short-term health effects like headaches, nausea, 

or fatigue, or long-term health effects such as damage to liver, kidney, 

and central nervous system. For housing professionals and residents alike, 

more VOC information is at www.epa.gov/indoor-air-quality-iaq/volatileorganic-compounds-impact-indoor-air-quality.

Wood Smoke: 

Smoke from wood burning contains a mixture of gases and particulate 

matter (PM) that can cause health problems, such as burning eyes, runny 

nose, and illnesses, such as bronchitis. The smoke contains several toxic 

air pollutants, including benzene, formaldehyde, acrolein and polycyclic 

aromatic hydrocarbons (PAHs). 
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A Guide to Healthy Homes

for Housing Professionals 

Wood smoke can affect everyone, but children, teenagers, older adults, 

people with lung disease (including asthma and COPD), and people with 

heart disease are the most vulnerable. Share this site with residents: www.

epa.gov/burnwise/wood-smoke-and-your-health.

Fire Safety: 

A properly installed and maintained smoke alarm is one of the best and 

cheapest ways to be alerted to a fire, or incomplete burning in a fireplace 

or combustion appliance (such as a gas stove or water heater). It is also 

important to burn wood safely. If residents can afford one, a combination 

smoke, fire, and carbon monoxide detector is preferred. A unit should be 

installed in every room that has a fireplace or other combustion source, 

and outside of bedrooms. Residents can learn about safe wood burning 

practices at https://www.epa.gov/burnwise/learn-you-burn-wood-whatyou-can-do

Smoke: 

Smoke from tobacco products can create residue that sticks on surfaces; 

this residue is commonly being referred to as thirdhand smoke. 

Thirdhand smoke can be hard to remove because it can withstand 

vacuuming and wiping. It can irritate the airways of people with allergies 

or asthma and may be associated with long-term health problems such 

as cancer. More information is available at https://www.healthychildren.

org/English/health-issues/conditions/tobacco/Pages/How-Parents-CanPrevent-Exposure-Thirdhand-Smoke.aspx

Sources of Often Overlooked Health Problems in Homes

➤ Lead: Was the home built before 1986? 1978? 1950?

➤ Radon: Was the home ever tested for radon?

➤ Carbon Monoxide: Do residents have a carbon monoxide detector?

Sources of Often Ignored Health Problems

➤ Environmental Tobacco Smoke: Does anyone in the family smoke? Do they want help quitting?

➤ Consumer Chemicals: What cleaning chemicals are being used? Where are they stored?
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Helping Native Americans Have Safe and Healthy Homes

Protecting Against Lead Exposure

Housing professionals must be aware that for those homes built before 1978, the paint may have lead in it, which is very dangerous for 

young children. Flaking paint with lead can be picked off by children and 

ingested. However, sanding to remove it can also create a dust that, if left 

and not cleaned up, can cause lead to be absorbed through breathing. 

Lead exposure can cause serious learning 

and behavior problems. It may also damage 

hearing and the nervous system, including the 

brain. Many older homes have lead-based paint 

or pipes that were made from lead (or solder 

for joints that had lead in it if plumbing was 

installed or the base-coat of paint was applied 

before the 1970’s).

Housing professionals will want to ask 

questions of the residents about improvements 

they have made. Check tribal housing records 

and requisition orders if they are still available 

for original materials.

Checklist: Things to ask current residents if they have any layer of 

paint applied before the 1970’s, are:

➤ Are there any cracking, chipping or flaking paint areas?

➤ Are there any places on the window or door jams where paint is being 

rubbed down to the wood?

➤ If paint on the outside of the house was ever scraped off, do you know if 

the soil along the foundation was covered by plastic or drop cloths?

➤ Have the water pipes been tested for lead?

Help residents by suggesting they keep down the lead dust when 

housekeeping, by wiping window sills and hard floors with soapy water 

and paper towels rather than using a vacuum. Create barriers to keep 

kids from chewing on window sills. And if residents ever repaint, suggest 

that they never dry-scrape areas or use a torch to heat up the paint. In 
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A Guide to Healthy Homes

for Housing Professionals 

fact, encourage residents to not remove lead 

paint on their own. It should be done by trained 

and certified workers. 

If you locate lead pipes or lead solder joints 

that cannot be replaced, suggest that hot water 

never be used for drinking and cooking. And 

when it has been a couple of hours since using 

the cold water, let it run for a few minutes to clear 

any water from the pipes that has been sitting. 

Be sure to refer to the Office of Environmental 

Health to run tests for metals, nitrates, and 

coliform bacteria.

Additional help, for both the generalpublic and professionals, is available by calling the National Lead 

Information Center. This toll-free telephone hotline is maintained by the 

US Environmental Protection Agency and HUD/OLHCHH, at 1-800-424-

LEAD (5323). The phone number may also be reached by individuals who 

are deaf or hard of hearing, or who have speech disabilities, through the 

Telecommunications Relay Service at 711.

Improving Indoor Air Quality

Most people spend much of their time indoors. This means that Indoor Air Quality (IAQ) is one of the most critical issues facing many 

housing residents. Improving IAQ can result in significant health benefits 

to occupants, which can reduce medical costs and improve residents’ 

quality of life. 

Families can be exposed to air that, unnoticeably, is affected by 

mechanical operation, such as carbon monoxide from combustion of 

furnaces or boilers. Or family members may be breathing air that is 

radioactive from natural means such as radon. From a maintenance point 

of view, invisible, odorless, and tasteless health hazards must be detected 

by taking the extra time to bring testing equipment into the home, take 

samples and then decide whether the contamination level is high enough 

to have you, your crew, (or the homeowner) intervene and make timely 

adjustments. 
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Helping Native Americans Have Safe and Healthy Homes

Depending on the levels detected, as a housing professional, 

you may be able to advise the resident to simply tune their 

furnace or change how they ventilate the home. Or, you 

may need to share with the homeowner or your crew how to 

fix or replace a flue pipe.

At some point, a housing professional’s job may include 

having to make recommendations or referrals to outside 

vendors coming in and replacing furnaces or putting in 

chimney flues and vents below the basement floor through 

to the top of the roof for radon gas evacuation. Without your 

help in discerning the quantity of these pollutants, residents 

may never know they are living with carbon monoxide's 

blood poisoning or radon's radioactive cancerous effects. 

Checklist: Some basic questions you may ask residents 

concerning carbon monoxide are: 

➤ Do some of the burners on the kitchen stove burn yellow 

or orange?

➤ Does smoke from the fireplace sometimes come back into 

the room?

➤ Are the vent pipes on the furnace, boiler, and water heater 

rusty or falling apart?

➤ Is there a gas water heater that does not have a vent?

➤ Is there rust, soot, or dirt on the furnace, boiler, or water 

heater?

Carbon monoxide (CO) alarms or detectors will go a long 

way to help protect families from sickness or death. If a 

family can afford one, a combination smoke detector and 

carbon monoxide detector is preferred. A detector should 

be installed in every room that has a fireplace or other 

combustion source, and outside of bedrooms. Detectors 

should be tested every six months, and after six years 

replaced. An effective alarm will make a loud noise when 

CO levels become too high or smoke is detected, and should 
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A Guide to Healthy Homes

for Housing Professionals 

have a battery backup (even if it is hardwired 

into a dedicated circuit on the breaker box). A 

CO monitor will show a reading of the actual 

parts per million concentration of carbon 

monoxide at any time. Be sure to suggest 

and/or supply models of alarms, detectors 

or monitors that have been approved by a 

respected laboratory, at the very least by 

the Underwriters Laboratory (UL). Carbon 

monoxide is lighter than air, so placement of 

the detector is important in the installation or 

use of a detector. The detector should be placed 

near or on the ceiling, if possible. Also, attached 

garages MUST have the entry door to the home 

interior closed and door seals working properly to keep exhaust gases 

from entering

Overall, a housing specialist can learn a lot about hazards 

or potential hazards, just by asking a few simple questions of 

residents (below). The Room by Room checklist in this booklet can be 

used by professionals and residents alike. 

Another option is the online Healthy Homes Do-It-Yourself 

Assessment (DIY) Tool at https://healthyhomes.fcgov.com. The DIY tool is 

patterned after the Healthy Homes in-home assessment and focuses on 

the “Eight Principles of a Healthy Home.” This tool was created to help 

meet the health needs of the community and optimize staff time, by the 

City of Fort Collins, CO. The DIY tool allows for greater access to pivotal 

information related to enhancing the indoor air quality of homes, and 

helps the program scale up to potentially unlimited usage. 

Interactive and customizable, the tool walks people through each 

area of their home, asking specific questions as it relates to indoor air 

quality problems, such as ventilation, mold, chemical contaminants, 

cleanliness, pests, home maintenance and safety.

Within each question, there is a picture of the problem, a description 

of the cause of the problem, the related health implications, and 

recommendations on how to resolve any issues. Based on the answers 

provided, the user is given an indoor air quality score and a complete, 

prioritized list of recommendations that are categorized by ‘Act Now,’ 

‘Act Soon,’ and ‘Be Aware.’ The tool is user-friendly and is designed to 

work for all homes.
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Helping Native Americans Have Safe and Healthy Homes

Here’s a helpful checklist of questions you may have them answer 

when first arriving or making contact. This is integral to the home 

assessment process. 

➤ Do some areas in the home smell damp or musty?

➤ Have residents seen cockroaches in their home?

➤ Do residents know how to safely use their fuel-burning appliances?

➤ Do residents allow cigarette smoking in the home?

➤ Do residents have furry pets in their home?

➤ Do residents read the label on household products and follow the 

directions for using them safely?

➤ Do residents open windows or turn on fans when doing hobbies or 

projects that make dust or odors?

➤ Do they choose furniture, carpet, and building products that are made with 

non-toxic chemicals and materials? 

➤ Does the household seem stuffy or stale? Can you smell cooking odors the 

next day?

➤ Do bathroom and kitchen have exhaust fans? When are they used?

➤ Is there a humidifier that is operating correctly?

➤ Is there a drip pan under the refrigerator and hot water heater drain? 

Overcoming the Potential Serious Health Impacts of Mold

Another significant issue for which housing professionals may likely be called to check out is mold, which grows in wet or damp places. 

Though mold is almost everywhere, it will not be healthy to live in a 

home where mold is growing. Many people can have allergic reactions

to it. 

Encourage residents to try to keep their homes and everything in it 

dry (less than 50% humidity). Mold, which often smells musty, needs 

moisture to grow. Some types of mold are toxic and encountering large 

amounts of mold may cause health problems. 

From a maintenance perspective, though the resident may want you 

to test and then identify types of mold from a sample in their home, 

(www.epa.gov/mold/mold-testing-or-sampling) the EPA emphasizes that, 

in most cases, if visible mold growth is present, sampling is unnecessary.
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A Guide to Healthy Homes

for Housing Professionals 

Your concern should be to: 

1. Limit the conditions that allow it to grow.

2. Kill what is there.

3. Fix plumbing leaks and other water problems as soon as 

possible. Dry all items completely.

4. Scrub mold off hard surfaces with detergent and water, 

and dry completely.

5. Absorbent or porous materials, such as ceiling tiles and 

carpet, may have to be thrown away if they become 

moldy. Mold can grow on or fill in the empty spaces and crevices of porous 

materials, so the mold may be difficult or impossible to remove completely.

You will want to find the source(s) of moisture allowing the mold to grow, whether it is 

leaky faucets, misdirected gutters and drains, a pipe that has a bad solder joint, vapor 

from inside the house, or other sources. 

Fixing the leak is crucial, as reoccurring moisture will not only degrade the wood 

and drywall, but also continue to support mold growth. Mold can be cleaned using a 

dilute bleach solution or a mild detergent solution. If you use bleach, the U.S. Centers 

for Disease Control and Prevention recommends a solution of no more than 1 cup of 

common laundry bleach to 1 gallon of water. Staining left behind is inevitable and 

will not worsen the condition of the residence if the cleaning solution is well removed, 

and drywall/wood dried as well. 

It is important to remember that the health effects of mold can be allergies and 

other sensitivities. However, most residents are not born with an allergy or sensitivity 

to mold but develop these responses after chronic exposure. Sensitization is common 

in the mold-impacted housing units, as the mold contamination is often present for 

years before it is treated. 

Checklist: When inspecting a home for potential mold, look in the areas below: 

➤ In bathrooms, especially around the shower or tub, and on the walls, ceiling, or floor.

➤ In wet or damp basements and crawl spaces.

➤ Around leaky bathroom and kitchen sinks.

➤ In attics under leaking roofs.

➤ On wet clothes that are not dried quickly.

➤ On windows and walls where condensation collects.

➤ In closets.

➤ Under wallpaper or carpet.

➤ In air conditioners.
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Dealing with Tobacco Smoke and Other Potential Hazards

Tobacco smoke, whether used for ceremonies or leisure, can cause severe problems for everyone, but especially those who already have 

breathing problems. Even for people who have had no prior lung problems, 

tobacco smoke is the leading cause of lung cancer (with radon gas being 

second). Most importantly, it can trigger asthma attacks. It is unsafe for 

children to be around people who smoke cigarettes or any kind of tobacco 

inside homes and vehicles. Second-hand smoke can also raise children’s 

risk of ear infections and breathing problems. 

Although people’s smoking habits are not directly a housing issue, 

one suggestion is to advise residents not to smoke inside. Suggest that they 

build a sheltered all-season smoking area outside the home. This will keep 

the tars and pollutants of the smoke from clinging to the inside walls and 

residing in the carpeting. 

Housing professionals should educate residents that vapors created in 

the home can be held in floor coverings, furniture and some even absorbed 

into the drywall. This is especially dangerous in homes where meth has 

been cooked and has let off vapors that get absorbed by the building 

materials. Cleaning meth impacted homes is very expensive and often 

leads to complex rehabilitation or demolition of the unit. 

Another counsel you can give residents on building materials is that 

any time new carpet, vinyl floor covering, or furniture is about to be 

installed, they should unroll the new carpet outside. Place the new 

furniture without the packaging outside (if not raining or snowing) for a 

couple of days before bringing it into the home, due to chemicals that will 

off-gas. Be sure to thoroughly shake out items where snakes or pests could 

be hiding.

The housing professional’s work may also involve helping residents 

who already have a pre-existing condition, like asthma (a lung disease). 

Though you cannot do anything about the disease itself, your expertise 

can help to limit the irritants in the home (which jumpstart the 

symptoms of the disease). A good example of asthma control in homes 

can be found at: www.maine.gov/dhhs/mecdc/public-health-systems/

tribal/documents/2011-fall-intertribal-health-newsletter.pdf

Unfortunately, even beloved family pets cause problems for some 

residents, as they can make asthma and allergies act up, especially if kept 
www.hud.gov/healthyhomes 17

A Guide to Healthy Homes

for Housing Professionals 

in sleeping areas. 

Remind residents that sanding, painting, or using solvent chemicals 

(like varnish or paint strippers), may result in dust or harmful volatile 

organic compounds that can trigger lung symptoms. 

Consider counseling residents to make sure their gas appliances and 

fireplace, furnace, or wood-burning stoves have yearly checkups to keep 

down soot (and protect from the dangers of carbon monoxide). Encourage 

residents to check the filter in their furnace and air conditioner about 

4 times a year, more often if residents have pets. Suggest buying filters 

that cost a little more than the most economical ones. And, encourage 

residents to check out HEPA filter systems, as these filters will clean air 

more efficiently. 

The Tribal Healthy Homes Network recently published a Renter's 

Healthy Home calendar that includes checklists and reminders for 

keeping their home safe and healthy. A copy can be found here: http://

thhnw.org/

Protecting Against Chemical and Pesticides Hazards

Assessing, and then securing the home from pests coming in is one key way to reduce the hazard. For example, cockroach and dust mite 

droppings can cause asthma attacks. And while residents or housing 

professionals might immediately think of applying pesticides to help 

kill these pests, the chemicals themselves can be dangerous to inhale, 

especially for children. The chemicals may get on them as they navigate 

floors where the overspray falls. Suggest ways to adapt or fortify the 

structure to keep pests out or advise the residents on various traps and how 

and where to set them.

Bleach, rat poison, mothballs, charcoal lighter fluid, oven cleaner, 

batteries, mercury thermometers, gas, oil, wood polish, toilet and drain 

cleaners, shoe polish, and bug spray can all be helpful to homeowners. 

Some may help to keep the home and yard safe from harmful pests where 

only one sting may kill due to severe allergic reactions. Yet these chemicals 

and pesticides can also be toxins or dangerous when stored in the home 

especially if children have access to them. Household products like 

these are very dangerous for children!
18 www.hud.gov/healthyhomes

Helping Native Americans Have Safe and Healthy Homes

Though safe to use when applied by the directions, residents can run 

into trouble by using too much of a product or by mixing two products 

together. Tools known to be safe for use in place of chemicals are plungers 

to unclog sinks, baking soda for scrubbing or vinegar for cutting grease. 

Housing professionals should have safe disposal phone numbers and 

websites handy; residents will likely ask for them. Check with your tribal 

or local health department to see if there is a collection point for chemicals 

and pharmaceutical drugs, so that residents don’t end up pouring them 

down the toilet or sink drain for disposal. Mixing chemicals and substances 

can cause major problems.

Pesticides like bug spray, pet flea collars, rat poison, and garden weed 

killer can prevent and kill pests. Yet, pesticides can pose a real danger to 

people and pets if not used in the right way. Some may cause poisoning, 

birth defects, nerve damage, and even cancer. They can make allergies or 

asthma worse. Breathing fumes or dust from pesticide powders and sprays 

can be harmful. The biggest danger is poisoning. Thus, if while you are 

working in a home with residents and see pesticides being accessible, make 

similar suggestions as you would with other household cleaning chemicals 

for storage to keep them from children.

Tackling Other Home Safety Concerns

Though housing professionals are most likely concerned with the structure of the home, safety in the home, to an extent, is dependent 

on how the residents furnish the home and how they live in it. One 

safety practice you should encourage residents to enact is placing a 

smoke or combination smoke/carbon monoxide alarm on every floor and 

in every sleeping area. Keeping safety devices and safe storage places 

for matches, lighters, stoves, or heaters is a good reminder for residents. 

Have information for families to practice fire escape routes (especially 

with lights that turn on when the power goes out).

Problems with pests are largely contained not only by pesticides 

but also “housekeeping” practices. Fleas can be kept at bay by washing 

bedding often, shampooing pets, and vacuuming floors. Encouraging 

residents to cover their garbage cans tightly and to get rid of stacks 

of newspaper, papers, bags, and cardboard boxes helps to keep the 
www.hud.gov/healthyhomes 19

A Guide to Healthy Homes

for Housing Professionals 

residents’ homes from becoming homes for pests. 

When investigating a home, have staff keep an eye out for breaks in 

the building materials and fill any cracks and crevices where pests can 

get in. Bags and boxes should be checked for roaches before bringing 

them inside from a disconnected garage or shed.

Falls kill more people than any other type of accident beside car 

crashes, and most happen at home. Most people trip and fall at floor 

level, not going up or down stairs. Floors, especially hallways and stairs, 

should be free of things that might make people slip or trip and ought to 

have handrails on the walls when possible.

Throw rugs that are not tacked down are always a tripping hazard as 

are hallways and stairs without proper lighting. If there are rugs in the 

household, encourage the use of nonskid matted throw rugs. Cords for 

window coverings can be very dangerous for children and pets, 

especially the very young, due to the potential for strangulation. 

Encourage cordless windows coverings in homes with young children.

Special Concern – Helping Elders 

A difference in design or remodeling that can especially help elders is to build stairs with twelve-inch runners, six-inch risers and 

no bullnose. Tighter muscles, and inflamed joints often cause a lack 

of flexibility, and make it more difficult for elders to lift their legs. In 

addition, providing stable grab bars attached directly to studs is very 

useful near the toilet and in the tub/shower. Outside, check for loose or 

broken handrails, stairs or decking. If renting, report any problems to 

property managers.

 If they are living in homes without effective heating or cooling, 

consider finding temporary shelter for elderly or ill family members

during extended periods of hot or cold indoor temperatures. 

Lower thresholds in doorjambs and sweeps attached to the interior 

side of the exterior doors are easy to put in and help wheelchair 

occupants. Pocket doors are also helpful and increase mobility with those 

using walkers and/or wheel chairs. Inset lighting helps to reduce glare 

and direct light where needed which usually is at the entry way, over the 

kitchen sink and above the bathroom mirror. 
20 www.hud.gov/healthyhomes

Helping Native Americans Have Safe and Healthy Homes

Helping to Ensure Safe Drinking Water

The water in most U.S homes comes from a public water supply. Even public water can still become unhealthy if the home has lead or 

copper water pipes or faucets, or the pipe solder contains lead. Testing tap 

water annually for nitrates is important before giving it to babies and 

children. Every year, water companies are required to give their water 

test results to customers. Families and housing professionals can call the 

water company to ask what chemicals are in the water and also ask how 

they treat it to make it safe. 

About a quarter of Americans have private water supplies mostly from 

wells on their property. Housing professionals should recommend that 

homeowners and residents have well water tested every year by a state 

certified laboratory. Families can go online or call a local or state health 

department or Cooperative Extension Service to find out what tests are 

needed.

Protecting Against Asbestos

Asbestos, like lead, was banned from being installed in homes and buildings in the 1970’s but may be still present in older homes. It is 

especially crucial that asbestos not be inhaled or disturbed. 

Asbestos can cause very serious long-term health problems such as lung 

disease and cancer. Common uses in the past were to insulate pipes and 

attics. It also could be used in or around floor tiles, sheet vinyl flooring, 

cement shingles or roofing, plaster and joint compounds, and gaskets. Since 

asbestos fibers are very light and easily carried through the air, they can 

be inhaled without a person realizing it. The asbestos remains in the lungs. 

Smokers have a higher risk from asbestos exposure. Removal should be 

done by a licensed professional. Asbestos-containing materials that are not 

damaged or disturbed are not likely to pose a health risk. Advise residents 

that, usually, the best thing is to leave it alone if it is in good condition, 

and to keep activities in any areas having damaged material that may 

contain asbestos to a minimum. For example, advise them not to saw, 

sand, scrape, dust, sweep, drill holes in, or vacuum debris from materials 

that may contain asbestos. Refer them to www.epa.gov/asbestos
www.hud.gov/healthyhomes 21

A Guide to Healthy Homes

for Housing Professionals 

When A Natural Disaster Occurs 

A home damaged by natural disasters, such as floods, is likely to pose serious health risks. A common problem is mold. Polluted water 

and many other possible unsafe conditions will likely be present. Such 

damaged homes are dangerous. Improper restoration methods can worsen, 

or even cause, some hazards. 

Wildfires can cause severe indoor air quality problems. A good example 

of health tips for dealing with wildfire smoke can be found at this website: 

www.cct-enr.com/smoke

HUD’s Rebuild Healthy Homes Guide to Post-Disaster Restoration for 

a Safe and Healthy Home app covers restoration “A-Z” in plain language. 

Anyone doing rebuilding after winter storms, hurricanes, earthquakes, 

hail, droughts, even mudslides should consult this reference. Clean up must 

be done according to the techniques described in the smartphone app: 

https://apps.apple.com/us/app/rebuild-healthy-homes/id980660616?mt=8. 

The publication can be found at: https://www.hud.gov/sites/documents/

HH_REBUILD_2015_DR.PDF

Incorporating and Implementing Tribal 

Green Building Codes for Tribal Housing

Building codes can help prevent environmental health problems for all tribal residents, especially the most vulnerable members of the 

community: children, pregnant women, elders and those with pre-existing 

health conditions.

Tribes have shown strong interest in developing healthy, green 

affordable housing, and in many tribal communities, there is a great need 

for such housing. The U.S. Environmental Protection Agency has created 

the Tribal Green Buildings Toolkit www.epa.gov/green-building-tools-tribes/

tribal-green-building-toolkit to support a tribe’s decision-making process 

in determining whether to adopt, adapt or develop green building codes. 

Housing professionals can become key members throughout the process 

in updating, adapting, or adopting green building codes. For example, 

housing professionals can help research what building codes, standards, 

or guidelines are being used by nearby tribes, local and state government, 

and registered architects and engineers.
22 www.hud.gov/healthyhomes

Helping Native Americans Have Safe and Healthy Homes

Some potential benefits include: 

• Reduction of asthma, cancer, and other illnesses.

• Prevention of radon in buildings: a cancer-causing, radioactive gas.

• Restriction of the use of toxic building materials.

• Prevention of mold that can lead to poor air quality and poor health.

This publication comprehensively covers the organizational process 

of green building codes, respectful of tribes’ unique sovereignties and 

traditions. The core is an assessment tool to guide adoption, adaption or 

creation of codes. A highly valuable and practical component is the set 

of more than 25 different case studies of green building on reservations 

of varying sizes, land differences, number of dwellings, budgets, and 

much more. Strategies for establishing green standards for manufactured 

housing are suggested. 

Summary

Whether for babies and young children, teenagers, or for the elders who most often want to stay in their generational homes, housing 

and other professionals can improve the quality of life for all tribal 

residents. As a housing professional, you perform vital roles in providing, 

connecting with, and/or implementing healthy homes assessments, 

information, repairs and referrals for families. 

As a housing professional, you can enhance residents’ awareness of 

how the home environment can affect their health and guide them to 

make their homes healthier. Home assessments are a form of risk assessment. Work with residents to determine and establish the scope of the 

home assessment and include these steps. The following Path and Room 

by Room Checklist highlights the home assessment process.
www.hud.gov/healthyhomes 23

A Guide to Healthy Homes

for Housing Professionals 

Putting Tribal Members on the Path to a Healthy Home

❶ Step 1 Hazard Identification

 ➤ You make initial contact and gather information about your client’s home and behaviors. 

 ➤ Learn about health/environmental history as appropriate.

 ➤ Establish a clear purpose for the assessment. 

 ➤ Alternatively, with the Fort Collins DIY Home Assessment (https://healthyhomes.fcgov.com/). 

 tool, almost any resident can learn about common potential hazards and solutions.

❷ Step 2 Exposure Assessment and Risk Criteria

 ➤ You conduct the household site visit and walk through. This is the opportunity to discuss 

 the purpose of the site visit and goals, with residents.

 ➤ Develop qualitative and quantitative assessment - is a basic, intermediate or advanced 

 assessment needed?

 ➤ Risk criteria for assessing can be either health, environment based, or both.

 ➤ Encourage and facilitate a cleaning plan for families, based on an overall assessment 

 related to their vulnerabilities.

 ➤ Look for and educate residents on keeping the home dry and well ventilated; which will 

 involve counseling and referrals.

 ➤ Generate assessment report with actions needed.

❸ Step 3 Other Potential Follow Ups

 ➤ Consider ways of including healthy homes practices and green building into tribal housing 

 programs.

 ➤ Conduct staff training from maintenance perspective. Continue to educate for solutions.

 ➤ Reach out to other professionals to integrate healthy home principles into housing.
24 www.hud.gov/healthyhomes

Helping Native Americans Have Safe and Healthy Homes

 Room by Room Checklist for a Healthy Home

This checklist is a great way to learn more about health related hazards in homes. For housing 

professionals, it can be used to establish a healthy homes assessment protocol with the families you 

serve. For more information on this material and recommended actions please visit www.hud.gov/

healthyhomes or download the Healthy Homes Basics App to have as a resource at your fingertips 

whenever you are ready.

1. Living, Dining, and Family Rooms

 If the home was built before 1978, check 

painted doors, windows, trim, and walls for 

lead (find a lead risk assessor through www.

epa.gov/lead).

 Vacuum carpets regularly to reduce asthma 

triggers.

 Replace corded blinds with un-corded (pole) 

blinds, or move window blind cords out of 

reach of children to prevent strangulation.

 Check lighting and extension cords for fraying 

or bare wires.

 Avoid having lighting and extension cords in 

floor pathways.

 Discard children's toys that have small parts 

for choking or contain lead.

 Secure heavy items (televisions, bookcases) to 

walls to prevent tip overs.

 If the living room has a fireplace, make 

sure it has a working smoke-alarm - carbon 

monoxide detector.

2. Kitchen

 If the home was built before 1978, check painted doors, windows, trim, and walls for lead.

 Use a range hood exhausted to the outside 

(or open window) to ventilate while cooking.

 Clean up liquids and foods right after spills.

 Keep matches, glassware, knives, and 

cleaning supplies out of reach of children.

 Avoid leaving food and water out overnight. 

 Mop floors at least weekly.

 Place Poison Control Hotline number (800) 

222–1222 on the refrigerator and in every 

room (TTY 711).

 Do not allow children to be in the kitchen 

unsupervised when the range or oven is on.

3. Bedroom(s)

 If the home was built before 1978, check 

painted doors, windows, trim, and walls for 

lead.

 Replace corded blinds with un-corded (pole) 

blinds, or move window blind cords out of 

reach of children to prevent strangulation.

 Make sure room has a working smoke 

detector.

 Make sure the hall outside of bedrooms has a 

working carbon monoxide detector.

	If a bedroom has a fireplace, make sure it has 

a working smoke-alarm - carbon monoxide 

detector.

 Use mattress and pillow covers, and vacuum 

carpets regularly to reduce asthma triggers.
www.hud.gov/healthyhomes 25

A Guide to Healthy Homes

for Housing Professionals 

4. Entry

 Use floor mats by entry doors to reduce 

bringing lead dust and other toxins into the 

home.

 Remove shoes at entry if lead is present in the 

soil or paint. 

	  Repair or install weather seals around the 

 perimeter of doors. 

5. Bathrooms

 If the home was built before 1978, check 

painted doors, windows, trim, and walls for 

lead.

 Use an exhaust fan to ventilate after shower or 

bath use.

 Use slip resistant mats in showers and tubs.

 Clean up water from floors right after spills.

 Keep medicines and cleaning supplies locked 

away and out of reach of children.

 If an older adult or someone with mobility or 

balance concerns is present in the home, install 

grab bars at toilets, showers, and tubs.

6. Laundry

 Vent clothes dryer to the outside (through roof 

or wall, not into the attic).

 Keep laundry soaps and detergents out of 

reach of children.

 Wash sheets and blankets weekly to reduce 

asthma triggers.

 Remove lint from dryer screen before each 

load.

7. Attic

 Clean up clutter to prevent rodents and insects 

from finding places to nest.

 Check exposed attic insulation for asbestos 

and consult with an asbestos professional for 

removal.

 Make sure eave and roof vents are not blocked 

with insulation.

8. Basement (or Crawlspace)

 If the home was built before 1978, check 

painted doors, windows, trim, and walls for 

lead.

 Seal holes in walls and around windows and 

doors to keep rodents and pests out of living 

spaces.

 Clean up clutter to prevent rodents and insects 

from finding places to nest.

 Test the home for radon. If test shows radon 

above EPA action levels, implement a radon 

mitigation strategy.

 Keep pesticides and cleaning supplies locked 

away and out of reach of children.

 Seal all cracks in slabs and foundation walls for 

moisture, radon, and pest protection.

9. Garage

 Never run lawnmowers, cars, or combustion 

equipment inside the garage.

 Keep gasoline, pesticides, and cleaning 

supplies out of reach of children.

 Clean up oil, gasoline, and other spills 

immediately. Hardware stores sell products 

that can absorb the spill safely.

 If a floor drain is present, make sure it drains to 

well beyond the outside of the home.

10.Outside

 If the home was built before 1978, check 

painted doors, windows, trim, and walls for 

lead.
26 www.hud.gov/healthyhomes

Helping Native Americans Have Safe and Healthy Homes

 If painted walls, doors, windows, or trim may 

contain lead, keep children away from peeling 

or damaged paint and prevent children from 

playing around the ground next to the walls. 

 Remove leaves and debris from gutters 

regularly and extend downspouts to drain 

away from the house.

 Replace missing or broken shingles or 

flashings.

 Clean window wells of trash and debris.

 Install and maintain fences completely around 

pools with openings less than 1/4 inch.

 If the home was built before 1978, check 

hardboard siding for asbestos.

 Make sure private wells are sealed and capped.

 Consider testing well water for pesticides, 

organic chemicals, and heavy metals before 

you use it for the first time.

 Test private water supplies annually for nitrate 

and coliform bacteria.

 Do not leave open garbage containers near 

the home.

 Repair broken glass in windows and doors.

 Seal holes in walls and around windows and 

doors to keep rodents and pests out of living 

spaces.

11. General

 If the home was built before 1978, use leadsafe work practices for all renovation and 

repairs and test children in the home for lead 

exposure.

 Check piping connecting the home to the 

water main and the piping in the home for 

lead (lead pipes are dull and can be scratched 

easily with a penny). Lead pipes are more likely 

to be found in homes built before 1986. If the 

piping connecting the home to the water main 

is lead, replace it.

 No smoking inside the home.

 Have a professional maintain yearly all gas 

appliances and check for carbon monoxide 

leaks and proper venting.

 Do not use candles or incense in the home 

when adult supervision is not present.

 Secure balcony and stair railings, and install 

no-slip nosings.

 Replace burned-out bulbs in lights over stairs 

and landings.

 Run a dehumidifier if indoor humidity is 

above 50 percent or there is condensation on 

windows.

 Make sure all gas burning appliances, 

furnaces, heaters, and fireplaces ventilate to 

the outside.

 Replace the furnace filter with a MERV 8 or 

higher filter every three months.

 If mold is visible in any room, refer to mold 

removal guidelines from the EPA, CDC, or 

HUD.

 Install child-proof locks on cabinets and childproof covers on electrical outlets.

 Keep water temperature at less than 120 

degrees

 Keep firearms in locked safes.

 Use pest management recommendations or 

safer alternative products before applying 

pesticides.

 Keep all cleaning products in original 

containers and do not mix two products 

together.

 Keep all hazardous products and chemicals in 

locked cabinets away from children.
www.hud.gov/healthyhomes 27

A Guide to Healthy Homes

for Housing Professionals 

Important Resources

This is a selection of a wide range of organizations, websites, and educational materials, that expand 

upon this publication. Housing professionals may want to visit OLHCHH’s website at https://www.

hud.gov/program_offices/healthy_homes/Tribal_Healthy_Homes to view some unique tribal healthy 

homes digital stories. These relate directly to the health of Native Americans. Each story describes 

the importance of traditional Native American housing. 

Overview:

The Healthy Homes Program Guidance 

Manual (July 2012): This comprehensive 

manual (260 pages) was developed by HUD/

OLHCHH and many select partners and offers 

guidance and tools to help users establish or 

improve healthy homes/housing programs. It 

provides a broad range of practical information 

that will be of interest to organizations, 

programs, and individuals concerned about 

the need for healthy housing. The content 

takes into account that no “one size fits all” in 

designing healthy homes programs at the local 

level. https://www.hud.gov/sites/documents/

HHPGM_FINAL_CH1.PDF.

Tribal Green Building Toolkit (2015)

This publication (160 pages) is designed to help 

tribal officials, planners, architects, builders, 

housing developers, community members, and 

others develop and/or adapt building codes to 

support green building concepts and practices. 

Tribes with and without building codes can 

utilize the toolkit. The toolkit was created by 

the U.S. Environmental Protection Agency, with 

extensive involvement and contributions of 

Native Americans.

The implementation of “green building” offers a 

significant opportunity to revitalize sustainable 

cultural practices, by integrating with tribal 

traditions and values. Tribes can help maintain 

natural resources that historically sustained 

them, through these green building codes. This 

product can be downloaded at: https://www.

epa.gov/green-building-tools-tribes/tribalgreen-building-toolkit

HUD/OLHCHH Hazard-Specific Factsheets:

➤ Asbestos: https://www.cancer.gov/aboutcancer/causes-prevention/risk/substances/

asbestos/asbestos-fact-sheet

➤ Asthma: https://www.hud.gov/program_

offices/healthy_homes/healthyhomes/

asthma

➤ Allergy: https://www.hud.gov/program_

offices/healthy_homes/healthyhomes/

allergies

➤ Home Safety: https://www.hud.gov/

program_offices/healthy_homes/

healthyhomes/homesafety

➤ Mold: https://www.hud.gov/program_offices/

healthy_homes/healthyhomes/mold

➤ Lead: https://www.hud.gov/program_offices/

healthy_homes/healthyhomes/lead
28 www.hud.gov/healthyhomes

Helping Native Americans Have Safe and Healthy Homes

➤ Radon: https://www.hud.gov/program_

offices/healthy_homes/healthyhomes/radon

➤ Carbon Monoxide: https://www.hud.

gov/program_offices/healthy_homes/

healthyhomes/carbonmonoxide

Interactive Healthy Homes Apps

➤ Healthy Homes Basics App: This HUD/

USDA product is for the general public. It 

introduces users, in clear terms, to healthy 

homes concepts. Content also covers many 

ways to have a healthy home. Download 

the app at https://apps.apple.com/us/app/

healthy-homes-basics/id1092367352.

➤ Healthy Homes Youth App: This HUD/USDA 

product is for middle schoolers and helps 

them learn about healthy homes. Available 

at https://itunes.apple.com/us/app/healthyhomes-youth/id1434450117?mt=8.

➤ Healthy Homes Do-It-Yourself Assessment 

Tool: The Healthy Homes Do-It-Yourself 

Assessment Tool walks users through each 

room and provides a simple, low, and nocost solution to many common healthy 

housing problems. https://healthyhomes.

fcgov.com/.

➤ Healthy Homes Partners App: This HUD/

USDA product is for stakeholders. It is 

non technical but goes beyond the above 

consumer version. https://itunes.apple.

com/us/app/healthy-homes-partners/

id1244368357?mt=8.

Key Hotlines

All the phone numbers below may also be 

reached by people who are deaf or hard of 

hearing, or who have speech disabilities, by 

teletype at 711.

➤ Poison Control Centers, (800) 222-1222

➤ HUD and EPA National Lead Information 

Center, 1-800-424-LEAD, (800) 424-5323

➤ EPA Safe Drinking Water Hotline,

(800) 426-4791

➤ National Pesticide Information Center, 

(800) 858-7378

➤ FDA, Food Safety Information Service 

Hotline, (888) SAFE-FOOD, (888) 723-33663

➤ Centers for Disease Control and 

Prevention (cigarette smoking), 1-800- 

QUIT-NOW, or (800) 7848-669

➤ National Radon Information, (800) SOSRADON, (800) 767-7236

➤ Window Covering Safety Council,

(800) 506-4636

General Safe and Healthy Homes 

Information Sources (for both the 

public and professionals)

➤ Indian Health Service, www.ihs.gov/

➤ IHS' local Urban Indian Health Program, 

www.ihs.gov/urban/nationalprograms/

➤ Tribal Healthy Homes Network,

http://thhnw.org/
www.hud.gov/healthyhomes 29

A Guide to Healthy Homes

for Housing Professionals 

➤ Institute for Tribal Environmental 

Professionals,

www7.nau.edu/itep/main/Home/.

➤ Tribal Public and Environmental Health 

Think Tank, https://www.apha.org/topicsand-issues/environmental-health/partners/

think-tank.

➤ Tribal Epidemiology Centers, 

https://tribalepicenters.org/.

➤ Indian Health Service, 

https://www.ihs.gov/dehs/.

➤ Local or state health department

➤ U.S. Department of Housing and Urban 

Development, www.hud.gov.

➤ Office of Lead Hazard Control and 

Healthy Homes,

https://www.hud.gov/healthyhomes.

➤ Office of Native American Programs, 

www.hud.gov/codetalk.

➤ U.S. Department of Agriculture, National 

Institute of Food and Agriculture, 

https://nifa.usda.gov/.

➤ Cooperative Extension Service for 

Healthy Homes Extension educators,

https://nifa.usda.gov/extension or 

https://impact.extension.org/.

➤ National Healthy Homes Partnership,

https://extensionhealthyhomes.org/

➤ U.S. Environmental Protection Agency, 

www.epa.gov.

➤ U.S. Centers for Disease Control and 

Prevention, www.cdc.gov, (800) 232-4636

➤ U.S. Consumer Product Safety Commission,

www.cpsc.gov, (800) 638-2772

➤ U.S. Department of Energy,

www.energy.gov.

➤ National Center for Healthy Housing, 

https://nchh.org/

➤ Children’s Environmental Health 

Partnership, https://cehn.org/.

➤ National Safety Council,

https://www.nsc.org/.

➤ Pediatric Environmental Health Specialty 

Units, https://www.pehsu.net/.

National Tribal Air Association,

https://www.ntaatribalair.org/indoor-airquality/

Lead

There is no safe level of lead in blood. Even low 

levels of lead can affect a child’s IQ, ability to 

pay attention, and academic achievement. A 

blood lead level of 3.5 micrograms per deciliter 

or greater identifies a child who has been highly 

exposed to lead. Lead can be found in various 

places. The Protect Your Family from Lead (from 

HUD, EPA, and the CPSC) booklet has tips to 

help you protect your family from exposure to 

lead: https://www.epa.gov/lead/protect-yourfamily-lead-your-home.

The U.S. Food and Drug Administration (FDA) 

and Consumer Product Safety Commission (CPSC) 

issue recall alerts when unsafe levels of lead are 

detected in food items, children’s toys, or other 

products. More information is available on the 

FDA recalls (https://www.fda.gov/safety/recallsmarket-withdrawals-safety-alerts) and CPSC 

recalls (https://www.cpsc.gov/recalls) online.
30 www.hud.gov/healthyhomes

Helping Native Americans Have Safe and Healthy Homes

Healthy Homes Principles: The Healthy Homes Principles serve as 

a guide for addressing many of the topics discussed in this booklet. The 

Everyone Deserves a Safe and Healthy Home guides summarize the 

Healthy Homes Principles and have room-by-room checklists:

• For a quick but thorough overview of healthy homes, Everyone 

Deserves a Safe and Healthy Home: A Consumer Action 

Guide (weblink at https://www.hud.gov/sites/documents/

SAFEANDHEALTHYHOME.PDF) is a 12-page booklet written for the 

general public. It outlines the eight principles of healthy housing and 

provides a useful overview of key healthy homes issues, including 

lead-based paint, asthma and allergies, mold and moisture, radon, 

household chemicals, pests, carbon monoxide, home safety, asbestos, 

home temperature control, and indoor air quality.

 For each hazard, this publication provides critical action steps. It 

also includes a room-by-room checklist. Housing Professionals can 

use this guide to educate themselves and their clients. For those who 

prefer an online resource, the Healthy Homes Basics App (weblink at 

 https://apps.apple.com/us/app/healthy-homes-basics/id1092367352) 

teaches the same information in an interactive format and provides 

quizzes to reinforce key messages.

• For a more in-depth view, Everyone Deserves a Safe and Healthy 

Home: A Stakeholder Guide (weblink at https://www.hud.gov/sites/

documents/STAKEHOLDER_EDSHH.PDF) is a 40-page guide that 

provides additional detail on each of the hazards described in 

the Consumer Action Guide. It is written for stakeholders, such as 

housing counseling agencies, that assist people in maintaining and 

improving their safety and health. This guide also has a companion 

app, the Healthy Homes Partners app, (weblink at https://apps.apple.

com/us/app/healthy-homes-partners/id1244368357) which includes 

the same information as the guide and a room-by-room checklist.

• The Protect Yourself from Lead in Your Home (weblink at https://

www.epa.gov/lead/protect-your-family-lead-your-home) pamphlet 

was created specifically to educate homebuyers and renters about 

lead-based paint and the protections provided by federal law. It is 

available in several languages, and it walks through the key things 

a homebuyer or renter must know about lead-based paint, the rules 

that protect consumers from lead-based paint, and the measures 

people can take to protect themselves from lead exposure.

A stakeholder guide for protecting the health of children and families

Lead  

Mold and Moisture 

Asthma and Allergies 

Radon 

Carbon Monoxide 

Indoor Environmental Quality 

Unsafe Drinking Water 

Household Chemicals

Pests 

Home Safety 

Home Comfort 

Asbestos 

Everyone Deserves a

Safe and 

Healthy Home

www.hud.gov/healthyhomes

Protect the health of children and families

a consumer action guide www.hud.gov/healthyhomes

Everyone Deserves a

Safe and 

Healthy Home

OFFICE OF

LEAD HAZARD CONTROL

AND HEALTHY HOMES

Healthy 

Children Healthy Families Healthy Communities
www.hud.gov/healthyhomes 31

A Guide to Healthy Homes

for Housing Professionals 

➤ HUD and EPA National Lead Information

Center, (800) 424-LEAD, (800) 424-5323 

➤ U.S. Environmental Protection Agency, 

https://www.epa.gov/lead.

➤ U.S. Centers for Disease Control and 

Prevention, https://www.cdc.gov/nceh/lead/.

Asthma and Allergies:

➤ American Lung Association, https://www.

lung.org/ (800) LUNG-USA

➤ American Cleaning Institute, https://www.

cleaninginstitute.org/ (202) 347-2900

➤ Allergy and Asthma Network, https://www.

allergyasthmanetwork.org/ (800) 878-4403

➤ U.S. Environmental Protection Agency, 

https://www.epa.gov/asthma.

Indoor Air Quality

Volatile Organic Compounds (VOC):

➤ Learn how to reduce exposure to VOCs at 

https://www.epa.gov/indoor-air-quality-iaq/

volatile-organic-compounds-impact-indoorair-quality.

Wood Smoke:

➤ Learn more about the health effects of wood 

smoke at https://www.epa.gov/burnwise/

wood-smoke-and-your-health.

➤ Learn how to protect your family at https://

www.epa.gov/burnwise/learn-you-burn-woodwhat-you-can-do.

Fire Place Safety:

➤ Learn about safe wood-burning practices at 

https://www.epa.gov/burnwise/best-woodburning-practices#safe.

Third hand Smoke:

The California Department of Public Health 

(CDPH) states that all tobacco products such 

as cigarettes, e-cigarettes, hookah, and even 

smokeless tobacco can contribute to this harmful 

residue. More information is available at

➤ California Department of Public Health,

https://www.cdph.ca.gov/Programs/CCDPHP/

DCDIC/CTCB/CDPH%20Document%20

Library/Community/EducationalMaterials/

ThirdhandSmokeFactSheet.pdf.

➤ American Academy of Pediatrics, https://

www.healthychildren.org/English/healthissues/conditions/tobacco/Pages/How-ParentsCan-Prevent-Exposure-Thirdhand-Smoke.

aspx.

Scented Products:

Some people may feel discomfort around 

scented personal care products and household 

products with fragrance. Also, some of these 

products, such as air fresheners, may contain 

VOCs. Consider using unscented products when 

possible.

Vacuuming:

On carpets, using a vacuum cleaner that has a 

high-efficiency particulate air (HEPA) filter will 

help control the very fine dust and particles.
32 www.hud.gov/healthyhomes

Helping Native Americans Have Safe and Healthy Homes

Mold and Moisture:

➤ U.S. Environmental Protection Agency, 

https://www.epa.gov/mold.

➤ U.S. Centers for Disease Control and 

Prevention, https://www.cdc.gov/mold/.

Carbon Monoxide:

Additional information is available online from 

the CDC (https://www.cdc.gov/co/) and EPA

(https://www.epa.gov/indoor-air-quality-iaq/

carbon-monoxides-impact-indoor-air-quality). 

Another important tip is to never use a 

portable generator indoors; they should only be 

used outside. The Consumer Product Safety 

Commission has additional information on 

using portable generators at: https://www.cpsc.

gov/safety-education/safety-guides/carbonmonoxide/portable-generator-related-carbonmonoxide-deaths.

Radon:

➤ U.S. Environmental Protection Agency,

https://www.epa.gov/radon

➤ State radon contacts, https://www.epa.gov/

radon/find-information-about-local-radonzones-and-state-contact-information

➤ National Radon Program Services (KSU), 

https://sosradon.org/, (800) 767-7236

Drinking Water:

If you have questions or concerns about your 

drinking water, call the EPA Safe Drinking Water 

Hotline at 1-800-426-4791 or visit https://www.

epa.gov/ground-water-and-drinking-water. 

Information about protecting private drinking 

water wells is available at https://www.epa.gov/

privatewells.

➤ U.S. Environmental Protection Agency,

https://www.epa.gov/ground-water-anddrinking-water/basic-information-about-yourdrinking-water (800) 426-4791

➤ Centers for Disease Control and Prevention, 

https://www.cdc.gov/healthywater/drinking/

Household Chemicals:

➤ U.S. Environmental Protection Agency, 

https://www.epa.gov/pesticides and https://

www.epa.gov/saferchoice

➤ Poison Control Centers, (800) 222-1222

➤ Household Products Database, https://hpd.

nlm.nih.gov/

Pests:

➤ U.S. Environmental Protection Agency, 

https://www.epa.gov/bedbugs and https://

www.epa.gov/pesticides

Integrated Pest Management (IPM):

Traditional pest control involves the routine 

application of pesticides. In contrast, IPM focuses 

on pest prevention and uses pesticides only as 

needed. This provides a long-term, cost-effective 

and environmentally sensitive pest control. More 

information on IPM and safe pest control is 

available at https://www.epa.gov/safepestcontrol/

do-you-really-need-use-pesticide. Stop Pests in 

Housing (www.StopPests.org) provides resources 

on ways to deal with pests that avoid or reduce 
www.hud.gov/healthyhomes 33

A Guide to Healthy Homes

for Housing Professionals 

exposure to pesticides. EPA’s Citizen’s Guide to Pest 

Control and Pesticide Safety is available at https://

www.epa.gov/safepestcontrol/citizens-guide-pestcontrol-and-pesticide-safety. 

Home Safety:

➤ Poison Control Centers, (800) 222-1222

➤ National SAFE KIDS Campaign, https://

www.safekids.org/, (202) 662-0600

➤ National Safety Council, https://www.nsc.

org/, (800) 621-7615

Temperature Control:

➤ U.S. Department of Energy, https://www.

energy.gov/energysaver/energy-saver

➤ Energy Information Administration,

https://www.eia.gov/

➤ U.S. Environmental Protection Agency 

Indoor Air Plus, https://www.epa.gov/

indoorairplus

➤ Mercury cleanup and disposal, https://

www.epa.gov/cfl/cleaning-broken-cfl

➤ Energy Star, https://www.energystar.gov/

➤ Residential Energy Services Network, http://

www.resnet.us/

Cigarette Smoking:

➤ Centers for Disease Control and Prevention 

smoking cessation, 1-800 QUIT-NOW

➤ American Lung Association, https://www.

lung.org/, (800) LUNGUSA

➤ E-Cigarettes: 

Using e-cigarettes can harm your health and 

can expose children and others to harmful 

secondhand and thirdhand smoke. More 

information about e-cigarettes is available at 

the links below.

➤ U.S. Surgeon General, https://e-cigarettes.

surgeongeneral.gov/

➤ Centers for Disease Control and Prevention 

(CDC), https://www.cdc.gov/tobacco/basic_

information/e-cigarettes/index.htm

➤ California Department of Public 

Health, https://www.cdph.ca.gov/

Programs/CCDPHP/DCDIC/CTCB/Pages/

CaliforniaTobaccoControlBranch.aspx
U.S. Department of Housing and Urban Development

Funding for this guide is provided through an interagency agreement between the U.S. Department of Agriculture – 

National Institute of Food and Agriculture (NIFA) and the U.S. Department of Housing and Urban Development – Office 

of Lead Hazard Control and Healthy Homes (OLHCHH). 

Project Coordination provided by Michael Goldschmidt, 

University of Missouri and National Director – Healthy Homes Partnership

April 2020

National Tribal Air Association (NTAA) Indoor Air 

Quality Work Group:

• NTAA Chairman Wilfred J. Nabahe, Chairman, and 

All Members of the Indoor Air Quality Work Group

• Ernie Grooms, Group Lead and All Members of the 

NTAA Indoor Air Quality Work Group

• Andy Bessler, Project Director, NTAA, Institute 

for Tribal Health Professionals, Northern Arizona 

University, Flagstaff, Arizona

Project Team:

U.S. Environmental Protection Agency

• Lou Witt, Program Analyst, Indoor Environments 

Division, Washington, DC

• Erin McTigue, Alaska Tribal Air Program and Tribal 

Indoor Air Program Coordinator, Region 10 

• Priyanka Pathak, Air Toxics, Radiation, and Indoor Air 

Office, Region 9

U.S. Department of Housing and Urban Development

• Dr. Peter Ashley, PhD, Director of Policy and Standards 

Division, HUD OLHCHH

• Iris Friday, Native American Program Specialist, HUD Northwest Office of Native American Programs, Seattle, WA

• Dr. Warren Friedman, PhD, CIH, Senior Advisor to the 

Director, HUD OLHCHH

• Karen Griego, Healthy Homes Representative, HUD 

OLHCHH

• Aaron J. Salkoski, HUD OLHCHH

Additional Contributors:

• Kristin Hill, Tribal Public and Environmental Health 

Think Tank

• Gillian Mittelstaedt, MPA, Executive Director, Tribal 

Healthy Homes Network, Issaquah, Washington

• Arthur Nash Jr., Energy Faculty and State Radon 

Outreach Coordinator, University of Alaska, Fairbanks

• Mansel A. Nelson, Senior Program Coordinator, 

Tribal Environmental Education, Institute for Tribal 

Environmental Professionals, Northern Arizona 

University, Flagstaff, AZ

• CAPT Stephen R. Piontkowski, MSEH, REHS, Senior 

Environmental Health Officer, Indian Health Service, 

U.S. Department of Health and Human Services

Acknowledgements

The U.S. Department of Housing and Urban Development, Office of Lead Hazard Control and Healthy Homes, thanks the 

following individuals for their many valued comments and information used in the preparation of this publication: