Feel free to copy and modify according to your own needs.
If there’s an interested and cooperative vendor or real estate agent who can speak with the vendor (or property manager, etc) to get the answers to as many of these questions as you need answered for your health, it’s easier to make better decisions about being able to function in a potential new home.
You can also use the list in other ways. Feel free to use as needed.
QUESTIONS regarding potential health issues for interested buyer /renter who suffers from severe allergies and chemical sensitivities.
We need and appreciate your complete honesty when answering these questions, realizing they may seem unusual. There are no right or wrong answers.
Your answers will help us to understand what substances and materials have been and may still be present in this environment, and if these are ones that are safe, or are present in safe amounts for the prospective buyer to be exposed to. Sometimes trace amounts are dangerous, so we need to know the history. What may be normal and cause no problems for most of us may cause symptoms ranging from mild and irritating, to severe neurological effects, or something similar to what you might expect from someone with a peanut allergy.
We realize that no place will be perfect. The goal is to find a home that is least likely to have an impact on the existing medical condition. We expect that some remediation or modification may need to be done before moving in to any home, and need to know to what extent this may or may not be possible here.
Thank you for your co-operation.
Phone Number: _____________________________ Daytime Number:______________________
Email: _____________________________________ Other _______________________________
Please answer the following to the best of your knowledge. If you are not sure of an answer, please indicate that you “don’t know”.
1) What is the approx. age of your home? _____ years
2) What direction does your house face? Circle two, if applicable: N E S W
3) What direction are your prevailing winds from? Circle two, if applicable: N E S W
4) Have you ever used Any plug-in type air fresheners ? Y ___ N ___
IF YES… thank you but we cannot proceed.
If yes to any of these, approximately how often, where, and how long ago did you use them last?
All these products tend to be absorbed into walls, cabinetry etc, and contain substances which cannot be easily removed.
Any other air fresheners? Y ___ N __ _________________________________________
Sprays like Lysol? Y __ N __ _________________________________________
Scented candles? Y __ N __ _________________________________________
Incense? Y __ N __ _________________________________________
5) Do you use fabric softeners for the laundry? Yes____ No_____
Do you recall ever having spilled fabric softener on the floor before? Y___ N ___
If yes, where, on what kind of a surface, and approximately how long ago did this happen?
6) Have you used WD40 or other lubricant in the home before? Y ___ N ___
If yes, please specify where and when used: _______________________________________
7) What products do you use to clean the following areas? When were they last used?
a) kitchen ___________________________________________________________________
b) bathroom ___________________________________________________________________
c) carpets/floors ___________________________________________________________________
d) permanent wood fixtures ___________________________________________________________________
e) wood floors ___________________________________________________________________
f) appliances ___________________________________________________________________
8) Is there anywhere else you use another cleaning product? If so, where, and what do you use?
9) Are any scents, cleaning or deodorizer products used in the closets/cabinets? Y___ N ____
If yes, please indicate where and what is used: _____________________________________
10) When was the most recent painting done and where? ________________________________
11) Have you conducted any recent (within 10 years) renovations on this property? Y ___ N ___
Of particular interest are any recent interior counters or cabinet installations (using particle board, MDF, or plywood), caulking or gluing, windows, flooring (vinyl, laminate, hardwood, tile…), carpet installation, roofing, plumbing or water damage repairs, or mould remediation work.
If so, please indicate what, where, and when these were done:
12) Have you ever used pesticides (for insects and rodents) in the home before? Y ___ N ___
If yes, please indicate what you used, where was it used, and when:
a) Store bought spray pesticides (such as Raid) _______________ (please name product used)
Used approx. _____ days/months/years ago in __________
b) Professional pest control spraying ___
Used approx. _____ days/months/years ago in ______________
c) Ant traps ___ d) Glue Paper ___
e) Other (please specify): ____________________________________
Used approx. _____ days/months/years ago where __________
13) What is your water source? __________________________________
If you have well water, how often is it checked? ___________________
Is anything required to make your well water safe to drink? __________
14) Does this home use a septic system? Y N
If yes, when was the system last fully maintenanced? _________________________________
When is the system due to be maintenanced again? __________________________________
15) Please indicate any odours, however small, that you may recall sensing either in your home or outside over the past year:
a) Neighbour’s BBQ ___ Detected inside ____ outside _____
b) Wood smoke from fireplaces ___ Detected inside ____ outside _____
c) Woodburning stoves ___ Detected inside ____ outside _____
d) Gas fumes (or propane, or oil) ___ Detected inside ____ outside _____
e) Neighbour’s laundry line or dryer exhaust ___ Detected inside ____ outside _____
f) Roofing tar or asphalt ___ Detected inside ____ outside _____
g) Garbage dump ___ Detected inside ____ outside _____
h) Burning garbage ___ Detected inside ____ outside _____
i) Diesel /propane exhaust fumes ___ Detected inside ____ outside _____
j) Industrial smells (if so, please specify if known): ____________________________________
16) Are there any go cart, ATV, or snowmobile trails nearby? Y N Don’t know ___
If yes, approximately how far away are these trails from your residence? __________________
17) Do you know of any planned roadwork near your home? Y N
18) When was your road last resurfaced? ___________________________ Don’t know ______
19) Do you often see or hear airplanes near your residence? Y N
20) Approximately how far away is the nearest airport from your home? ______________________
21) Are there any industries or factories operating close to where you live? Y N Don’t know___
If yes, approximately how far are they from your home? If you can, please also specify what is produced.
22) Are any of the following businesses located within 1 mile of your home:
a) Laundromats? Y ___ N ___ Don’t know ___ If yes, approx. distance from home: __________ Direction ___________
b) Dry cleaners? Y ___ N ___ Don’t know ___ If yes, approx. distance from home: __________ Direction____________
c) Hair salons? Y ___ N ___ Don’t know ___ If yes, approx. distance from home: __________ Direction___________
d) Other (please provide details): _______________________________________________________________________
23) Do you know of any cell phone towers located within 2 miles of your home?
Y ___ N ___ Don’t know ___
24) Do you know of any future plans to erect cell phone towers nearby?
Y ___ N ___ Don’t know ___
25) Are there any high transmission power lines located within 2 miles of your home?
Y ___ N ___ Don’t know ___
26) Is there a golf course located nearby? Y N
If yes, approximately how far and in which direction? ____________direction_____________
27) How close are the nearest rail lines to your home? __________________________________
28) Is there a farm located nearby? Y ____ N ______ Several ________
If yes, approximately how far is it/are they from your home? ____________ directions _______
If you can, please specify what is farmed and in what direction :
29) Do you know of any outdoor pesticide or fertilizer use by you or your neighbours or township?
Y ___ N ___ Don’t know ___
If yes, please specify where used: and products used
This residence ___
DIY ___ Hired company ___ Frequency of use: __________ Products_______________________
By neighbours ___
DIY ___ Hired company ___ Frequency of use: __________ Products ______________________
Township ___ Utilities ____ How often and where _______________________________________
30) How would you describe the traffic on your road? Rare ___ Regular ___ Busy ____
Approximately __________ cars/hour at peak times
31) Is your driveway currently plowed by a service? Y ___ N ___ Reccomend? ___________
How long is the driveway? __________ How far is the house from the road? ______________
32) Do you have outdoor laundry lines? Y ___ N ___ If no, can lines be installed? Y ___ N___
33) Is there a Vegetable garden here? Y ___ N ___ Flower garden? Y ___ N ___
34) What kinds of flowering trees are located on the property?
a) None ___ d) Jasmine ___
b) Catalpa ___ Other ______________________________
c) Lilac ___ Other ______________________________
35) Please indicate, to the best of your knowledge, your closest neighbours and their approximate distance from your property. Where there are no neighbours, please indicate the type of land in the specified direction (e.g. conservation land, swamp, horse farm, etc.)
a) North: _________________________________Approx. distance from property: __________
b) East: __________________________________Approx. distance from property: __________
c) South: _________________________________Approx. distance from property: __________
d) West:__________________________________Approx. distance from property: __________
36) What type of heating system does your home have? __________________________________
37) Do you have forced air vents? Yes ___ No _____
If yes, are they lined? Yes ___ No _____
Have they been recently cleaned? Yes ___ No _____
If yes, by whom? ____________________________ When? __________
Were sprays/anti-bacterials used in the cleaning process? Yes ___ No ___ Don’t Know ___
38) Please indicate if your home contains any of the following:
a) Air exchange unit? _____________ Last serviced: __________
b) HRV _____ with VOC filters? _____ Last serviced: __________
c) Attached Humidifier? ___ Last serviced: __________
d) Central Vac? ___ Last serviced: __________
e) Water filter or conditioner? ___ Last serviced: __________
39) If known, please indicate the material used in your plumbing pipes: ___________________
40) Do you know of any lead in your plumbing? Yes ___ No ___ Don’t Know ___
41) Is the laundry room/area enclosed? Yes___ No___ Type of door_________________ What materials are the floors made of?________ Walls?________
42) What material are the kitchen cabinets? _______________Bathroom cabinets ____________
43) Is high speed internet available here? Y ___ N ___ Don’t know ___
44) Is the mail delivered to the door? Y ___ N ___
If no, how far away do you have to travel to pick up your mail? __________________________
45) Is there a garage? Yes___ No____ Is it Heated? ___________________________________
Other out buildings? ___________________________________________________________
Gazebo or covered porch or deck? _______________________________________________
46) Is the area quiet? Yes ____ No____ Can you hear any neighbours? ____________________
What kind of sounds are regularily heard here, and are they seasonal or regular?
47) Does the house have an enclosed entryway / foyer? Yes _____ No _____
With an enclosed closet? Yes _____ No_____
48) When was the roof last replaced? _________________________________________________
Is there anything else we may have missed, good or bad, that you want to add?
These, and other questions could be added to the questionnaire also:
What materials are the bathroom cabinets/sink/counter made of?____________
Is the tub and surround plastic/acrylic or enamel and tiles________________
What materials are the floors made of – list
Is there any wood paneling?
What is the finish on it? (paint, shellac, urethane,…)
What walls are the utility meters against? (bedroom, kitchen, etc)
Is there a smart meter, and if so, against which wall/room of the house?
Those are all our questions for now. Thank you
Here’s a useful, but older document download of things to be aware of when house-hunting, from MCS-CanadianSources (copied in 2008, not updated). Please ignore the links at the top, they no longer exist.
MCS and pre-existing dwellings
2023 update 1 – mcs-and-dwellings
(word document with a link to the original PDF in the document)
Here’s another helpful checklist: http://reshelter.org/safer-housing/househunters-checklist/
Hi, I just found out about your website today. It has some great information on it! I am a little chemically sensitive but nothing to the extent of some of the people on here. My background is in real estate development and it has always scared me how many chemicals go into the average home, both in building and in maintenance. Just wondering, how is everyone with concrete homes? I always wondered if this could be a solution.
The concrete here had to be done without the usual chemical additives, which cause problems for people.
The storage areas where the concrete bricks were not painted are still problematic, and in a couple of places I “wallpapered” them with sheets of mylar using double sided painters tape.
Hempcrete is a newer material that some people are having success with. I haven’t been able to sample any myself, so don’t know how I’d do with it.
Has anyone actually presented this list to a real estate agent and had a vendor return it?
Back in about 2008, I think it was, and when vendors balked, it became clear that it was because they had something to hide. They had major liability fears. I was able to discover a few details from other agents that confirmed there were undisclosed problems (like why there might have been a plug-in in the basement or elsewhere = mold).
I did learn to avoid any place that didn’t want to answer questions!
If you know anyone who could put together a more agent/vendor-friendly version that would be well received, let me know please!
Did you find a good place to live since then and do you have any pointers? I am thinking I will end up in an apartment and have terror thoughts of bug spraying. It has been 20 years since my last apt then we could not say no. Do you know if that has changed.
Housing accessibility is still hugely problematic.
I am in safe(r) housing on the inside, but outside is not, and air is air.
Plus, the way things are set up here, and the lack of supports, makes it impossible to “get ahead” in some ways.
CERA has some really good guidance documents available here:
Real Estate: Why scents may not make cents
If you are seriously in the market to sell your home, increase your odds of getting top dollar and more offers by discontinuing the use of fragranced products.
April 07,2014/Free-Press-Release.com/ — Salem NY
For many home sellers and real estate agents who believe the TV commercials that claim chemical sprays “sanitize” the air, plug-ins “freshen” the air and Fragrance emitting devices actually clean the air, well…this may not be music to your ears.
The savvy, health conscious home buyer has added chemical fragrances to their list of what they don’t want to smell when they are looking to buy a home. These chemical fragrances are now listed right next to mold, cigarette smoke odor and animal urine by many home buyers.
Home buyers today are more educated than ever. Even inexperienced first time home buyers understand that chemical fragrances do not clean the air, they contaminate it with toxic chemicals and more often than not these chemical fragrances make people very sick.
Home buyers have kids with asthma and allergies. They, themselves, might suffer from migraines, respiratory illness, cancer or fragrance sensitivity. Home buyers know that clean should not have a smell, not of disinfectant or chemical emitted fragrances .
So, while the location, square footage and price of your home might be perfect for your would be buyer, the smell of your home just might be the deciding factor on why an offer was not written up.
What does your house smell like?
Once plug in style fragrance emitting devices are used in a home, the oil / fragrance permeates the wallboard as well as flooring. Similar goes for the fragranced dryer sheets in the laundry room. These chemical odors then circulate in the air vent heating and cooling system and will never come out, no matter what you do.
With the growing population of people suffering with fragrance sensitivity, Asthma, respiratory conditions, various cancers and allergies, house hunting can often prove to be quite a challenge.
If you are seriously in the market to sell your home, increase your odds of getting top dollar and more offers by discontinuing the use of fragranced products. Open your windows and let the fresh air in. Clean with non-fragranced products. Your house will then be marketable to all potential buyers… even those with health issues.
After all, you do want your home to take a buyers breath away… but not literally.
(contact info for MCS America no longer accurate or available)
The comment section for this article is insightful (via the internet archive way back machine)
(note that ‘artificial’ scents are mentioned. This was before the advent of essential oils and other so-called natural scents became a thing.
EOs and natural scents are NOT benign, or a good alternative. They are causing increasing levels of harm (including life threatening reactions) in a growing segment of society. Clean has no smell. Please do not add fragrances of any kind)
(1) International prevalence of chemical sensitivity and fragrance sensitivity.
Across four countries (United States, Australia, United Kingdom, Sweden), 19.9% of the general population report chemical sensitivity, 7.4% report medically diagnosed MCS, and 32.2% report fragrance sensitivity (i.e., health problems from fragranced consumer products). For individuals with asthma or with autism, the prevalences are several times higher.
“Prevalence of diagnosed MCS has increased over 300%, and self-reported chemical sensitivity over 200%, in the past decade. Reducing exposure to fragranced products could help reduce adverse health and societal effects.
Fragranced consumer products: exposures and effects from emissions.
Fragranced consumer products, such as cleaning supplies, air fresheners, and personal care products, are a primary source of indoor air pollutants and personal exposure.
Previous research indicates that fragranced products can trigger adverse health effects, with implications for workplaces and public places. This is the first study to examine the multiple dimensions of exposures related to fragranced products and effects in the US population.
The study investigated the prevalence and types of fragranced product exposures, associated health effects, awareness of product emissions, and preferences for fragrance-free policies and environments. Data were collected using an online survey with a nationally representative population (n = 1136) of adults in the USA.
Overall, 34.7 % of the population reported health problems, such as migraine headaches and respiratory difficulties, when exposed to fragranced products.
18.6 % respiratory problems;
16.2 % mucosal symptoms;
15.7 % migraine headaches;
10.6 % skin problems;
8.0 % asthma attacks;
7.2 % neurological problems;
5.8 % cognitive problems;
5.5 % gastrointestinal problems;
4.4 % cardiovascular problems;
4.0 % immune system problems;
3.8 % musculoskeletal problems; and
1.7 % other.”
Further, 15.1 % have lost workdays or a job due to fragranced product exposure in the workplace.
Also, 20.2 % would enter a business but then leave as quickly as possible if they smell air fresheners or some fragranced product.
Over 50 % of the population would prefer that workplaces, health care facilities and professionals, hotels, and airplanes were fragrance-free.
While prior research found that common fragranced products, even those called green and organic, emitted hazardous air pollutants, more than two thirds of the population were not aware of this, and over 60 % would not continue to use a fragranced product if they knew it emitted such pollutants.
Results from this study provide strong evidence that fragranced products can trigger adverse health effects in the general population.
The study also indicates that reducing exposure to fragranced products, such as through fragrance-free policies, can provide cost-effective and relatively simple ways to reduce risks and improve air quality and health.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093181/ (full text)
“Beyond their immediate effects, VOCs react with other molecules in the air, such as oxygen and nitrogen oxides, to generate ozone as well as fine particulate matter. (Those nitrogen oxides come, in large part, from vehicle exhaust.) High levels of fine particulate matter make it hard to breathe and contribute to chronic lung problems (SN: 9/30/17, p. 18). And while ozone high in the atmosphere helps shield Earth from the sun’s ultraviolet radiation, at ground level, it mixes with fine particulates to form breath-choking smog.”
~ Household products make surprisingly large contributions to air pollution
Household products make surprisingly large contributions to air pollution
“In urban areas, emissions from consumer goods such as paint, cleaning supplies and personal care products now contribute as much to ozone and fine particulate matter in the atmosphere as do emissions from burning gasoline or diesel fuel.”
Everyday products like these emit a bouquet of volatile organic compounds that contribute to air pollution.
Canadian Human Rights Commission Policy on Environmental Sensitivities
Click to access policy_sensitivity_0.pdf
Ontario Policy on ableism and discrimination based on disability
“inconvenience, morale, and preferences are not valid considerations in assessing whether an accommodation would cause undue hardship”.
The Code protects people from discrimination and harassment because of past, present and perceived disabilities. “Disability” covers a broad range and degree of conditions, some visible and some not visible. A disability may have been present from birth, caused by an accident, or developed over time.
There are physical, mental and learning disabilities, mental disorders, hearing or vision disabilities, epilepsy, mental health disabilities and addictions, environmental sensitivities, and other conditions.
Air fresheners and indoor built environments: why air fresheners impair rather than improve indoor air quality, and pose health risks
The “MCS and pre-existing dwellings” document was updated in January 2023.