Executive Summary

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The original Basic Housing Inspection manual was published in 1976 by the Center for Disease Control (now known as the Centers for Disease Control and Prevention). Its Foreword stated:

“The growing numbers of new families and the increasing population in the United States have created a pressing demand for additional housing that is conducive to healthful living. These demands are increased by the continuing loss of existing housing through deterioration resulting from age and poor maintenance. Large numbers of communities in the past few years have adopted housing codes and initiated code enforcement programs to prevent further deterioration of existing housing units. This growth in housing activities has caused a serious problem for communities in obtaining qualified personnel to provide the array of housing service needed, such as information, counseling, technical advice, inspections, and enforcement. As a result many agencies throughout the country are conducting comprehensive housing inspection training courses. This publication has been designed to be an integral part of these training sessions.”

The original Basic Housing Inspection manual has been successfully used for several decades by public health and housing personnel across the United States. Although much has changed in the field of housing construction and maintenance, and health and safety issues have expanded, the manual continues to have value, especially as it relates to older housing.

Many housing deficiencies impact on health and safety. For example, lead-based paint and dust may contribute to lead poisoning in children; water leakage and mold may contribute to asthma episodes; improper use and storage of pesticides may result in unintentional poisoning; and lack of working smoke, ionization, and carbon monoxide alarms may cause serious injury and death.

Government agencies have been very responsive to “healthy homes” issues. The U.S. Department of Housing and Urban Development (HUD) created an office with an exclusive focus on healthy homes. In 2003, CDC joined HUD in the effort to improve housing conditions through the training of environmental health practitioners, public health nurses, housing specialists, and others who have interest and responsibility for creating healthy homes.

The revised Basic Housing Inspection manual, renamed the Healthy Housing Reference Manual, responds to the enormous changes that have occurred in housing construction methods and materials and to new knowledge related to the impact of housing on health and safety. New chapters have been added, making the manual more comprehensive. For example, an entire chapter is devoted to rural water supplies and on-site wastewater treatment. A new chapter was added that discusses issues related to residential swimming pools and spas. At over 200 pages, the comprehensive revised manual is designed primarily as a reference document for public health and housing professionals who work in government and industry.

The Healthy Housing Reference Manual contains 14 chapters, each with a specific focus. All chapters contain annotated references and a listing of sources for additional topic information. A summary of the content of each chapter follows:

Chapter One, Housing History and Purpose, describes the history of dwellings and urbanization and housing trends during the last century.

Chapter Two, Basic Principles of Healthy Housing, describes the basic principles of healthy housing and safety—physiologic needs, psychologic needs, protection against injury and disease—and lays the groundwork for following chapters.

Chapter Three, Housing Regulations, reviews the history of housing regulations, followed by a discussion of zoning, housing, and building codes.

Chapter Four, Disease Vectors and Pests, provides a detailed analysis of disease vectors that have an impact on residences. It includes information on the management of mice, rats, cockroaches, fleas, flies, termites, and fire ants.

Chapter Five, Indoor Air Pollution and Toxic Materials, provides information on indoor air pollution, both biologic and chemical, and to toxic materials in the home, including methods for controlling these hazards. The impact of cockroaches, dust mites, pets, and mold are discussed. Also included is information about the impact of carbon monoxide, ozone, tobacco smoke, volatile organic compounds, radon, and pesticides.

Chapter Six, Housing Structure, contains information about “older” housing construction and new construction materials and methods. The chapter also introduces new terminologies and includes information about foundations, vapor barriers, house framing, roof framing, exterior walls, and roofs.

Chapter Seven, Environmental Barriers, provides information on roofing, insulation, and siding materials.

Chapter Eight, Rural Water Supplies and Water-quality Issues, covers issues related to the drilling and proper maintenance of wells. Research information is provided that indicates that many wells are not properly sealed, allowing for the leakage of contaminated water into wells during hurricanes and periods of significant flooding.

Chapter Nine, Plumbing, provides information on plumbing standards and how they can be accessed, followed by a review of the elements of a residential water delivery system, the types of available hot-water heaters, drainage systems, and methods for water conservation. It also includes a visual synthesis of water system components during new residential construction.

Chapter Ten, On-site Wastewater Treatment, complements chapter seven by providing information on proper on-site methods for the treatment of human waste.

Chapter Eleven, Electricity, expands on information contained in the original manual covering such topics as breaker systems and polarized plugs and connectors. It also provides a format for the inspection of residential electrical systems.

Chapter Twelve, Heating, Air Conditioning, and Ventilation, provides information about types of residential fuels and heating systems, including solar heating and minor sources of heating (e.g., coal-fired, oil-fired, gas-fired, and electrical space heaters). Chimney and fireplace safety and the variety of cooling systems are also discussed.

Chapter Thirteen, Energy Efficiency, discusses energy efficiency, including “R” values and their interpretation, roof ventilation, wall and floor insulation, and door and window energy efficiency systems. It also discusses active and passive solar systems and provides a methodology for conducting a residential energy audit.

Chapter Fourteen, Residential Swimming Pools and Spas, provides information about child safety, pool and spa hazards, and diseases. It also provides information on methods for testing and ensuring a safe water system and on methods for spa and pool disinfection. Further, it covers concerns related to unregulated individual residential pools and spas.

The quality of housing plays a decisive role in the health status of its occupants. Substandard housing conditions have been linked to adverse health effects such as childhood lead poisoning, asthma and other respiratory conditions, and unintentional injuries. This new and revised Healthy Housing Reference Manual is an important reference for anyone with responsibility and interest in creating and maintaining healthy housing.

The housing design and construction industry has made great progress in recent years through the development of new innovative techniques, materials technologies, and products. The HUD Rehab Guide series was developed to inform the design and construction industry about state-of-the-art materials and innovative practices in housing rehabilitation. The series focuses on building technologies, materials, components, and techniques rather than on projects such as adding a new room. The nine volumes each cover a distinct element of housing rehabilitation and feature breakthrough materials, labor-saving tools, and cost-cutting practices. The nine volumes address foundations; exterior walls; roofs; windows and doors; partitions, ceilings, floors, and stairs; kitchen and baths; electrical/electronics; heating, air conditioning, and ventilation; plumbing; and site work.

Additional information about the series can be found at http://www.huduser.org/publications/destech/rehabgui.html and http://www.pathnet.org/sp.asp?id=997. This series is an excellent adjunct to the Healthy Housing Reference Manual.