Sentinel Indicators of Unhealthy Homes

Cherry, Debra; Vasselli, John; Huff, Sharon; Saito, Rena
March 2014
Texas Public Health Journal;Spring2014, Vol. 66 Issue 2, p19
Academic Journal
Objective: Home observation reveals factors that are highly relevant to children's health and development, but no standardized tool currently exists that is both brief enough for widespread application and detailed enough to capture a broad spectrum of environmental concerns. The purpose of this study was to begin developing a brief, easily administered home observation tool that could identify sentinel indicators of unhealthy homes with minimum burden to study participants. Methods: Investigators developed a new dwelling unit observation (DUO) tool based on review of existing home assessment tools and subjective selection of items that were easy to administer, highly in- formative, and possibly indicative of more extensive environmental concerns. The new DUO was pilot tested in a sample of 18 homes that varied widely in value and location within a Texas county. Results: The most outstanding sentinel observations indicating potentially unhealthy conditions, all of which occurred with a frequency of one in 18 dwellings, included a roach infestation, structural disrepair, extremely unclean indoor surfaces, poor access to services (18 miles from the nearest grocery store), and close proximity to an agricultural field. Sentinel air quality measurements obtained with 15-minute readings on handheld sensors included elevated carbon monoxide (CO) and carbon dioxide (C02) in a home with poor ventilation and elevated particulates (PM 2.5) in a home with indoor tobacco smoking. Conclusions: Using the DUO, data collectors without any specialized training were able to record the most important environmental factors related to health and simple air quality measurements in a matter of minutes. Sentinel indicators of unhealthy conditions can trigger more detailed evaluations, limiting such evaluations to homes that are most likely to have a problem.


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