couple carrying cardboard boxes in living room
Photo by Karolina Grabowska on

Each year, housing conditions in the U.S. are implicated in thousands of deaths and hundreds of thousands of illnesses and injuries requiring medical attention, according to the Centers for Disease Control and Prevention (CDC). Negative health outcomes have been linked to the hazardous conditions in homes across the nation in studies since the 1980s. Americans spent up to 50 percent of their time within their homes, before the pandemic, making the overall safety of the home a critical component to good health.

Home hazards have been linked to a variety of negative health outcomes. Mold and volatile organic compounds have been linked to respiratory tract infections, asthma, and asthma morbidity. Radon has been linked to cancer and death. Extreme weather has also led to the exacerbation of existing respiratory and heart ailments as well as to death. Each of these illnesses can manifest from neglected or abused household appliances, HVAC (heating, ventilation, and air conditioning) systems, and from within older homes where unregulated materials were used in their construction.

The Housing Health and Safety Rating System (HHSRS) provides a method of grading the severity of threats to health and safety in homes. The inspection process considers the effect on occupant health of any hazards in the property. Hazards are rated according to how serious they are and the effect they are having, or could have, on the occupants, that is, “the effect of the defect.”

The U.S. Department of Housing and Urban Development’s (HUD) Office of Lead Hazard Control and Healthy Homes (OLHCHH) began training its Healthy Homes program grantees to use the Healthy Housing Health and Safety Rating System (HHSRS), a tool designed in the United Kingdom, to justify intervention decisions to correct identified residential health and safety hazards. Both the British and U.S. versions assess 29 housing hazards that pose risks to health or safety — grouped into four categories determined by their characteristics: physiological, psychological, infection, and accidental hazards. Each of the 29 hazards are assessed separately and weighted according to likelihood of occurrence and the possible outcomes should the hazard result in harm.

The assessment process not only spots defects, but also takes a risk assessment of outcomes and effects. For instance, if old windows in poor condition are assessed as a hazard, it can contribute to excessive cold as well as damp and mold., and be a contributor to excessive noise pollution, entry by intruders, or falls between levels. A single deficiency, then, can produce more than one hazard and impact the score.

The likelihood and severity of a hazard causing harm is tabulated using the rubric: Extreme (Scoring of 10,000) in which the hazard can cause death, lung cancer, mesothelioma, paralysis, 80 percent burn injuries; Severe (Scoring of 1000) in which cardio respiratory disease, Legionnaires, fractures, burns, or loss of consciousness can occur; Serious (Scoring 300) in which eye disorders, hypertension, parasitic dermatitis, vomiting, strain or sprain injuries can occur; and Moderate (Scoring of 10) in which severe discomfort, slight confusion, moderate cuts, bruising, regular serious coughs and colds, occur.

“The U.S. system is designed to monitor the impact of insidious conditions within a home on the overall health of the residents. In addition to checking for the existence of mold and dampness, HHRS checks for hazards that could cause serious injury or death from caustic agents like carbon monoxide and asbestos,” real estate agent Priscilla Whelan told The Informer. “As a property owner the cost can be great to make repairs; however, the cheap comes out expensive when hazards are not remedied. The goal is also to ensure that homes are not ‘sick buildings’ that cause serious health problems.”

Studies conducted by the Home Safety Council have associated toxins such as lead paint in the home to lead poisoning and lower IQs, learning disorders, criminal activity, and hormonal deficiencies. Similarly, other toxins like carbon monoxide have led to neurotoxicity, coma, and death.

“Our homes are supposed to be places of great comfort and joy, but when those spaces hide hazards, the dream home can turn quickly into a nightmare,” Whelan noted. “There will always be some level of hazard in any indoor space, but the rating system helps minimize the potential of injury and death from those hazards.”

Join the Conversation

1 Comment

  1. Great article , funny thing is HHSRS is based on the 1938 APHA system , so USA knew about this way back then.
    It took the UK until April 2006 to catch up……….

Leave a comment

Your email address will not be published. Required fields are marked *