If you think you are being exposed to toxins, allergens, or other materials that are
affecting your health, consider the following questions about your home and
workplace. Write detailed answers to the questions, and discuss them with your
Do you come into contact with or handle any of the following at work or at home?
Metals, such as during soldering or welding
fibers, such as from textiles or building materials
Chemicals, such as from solvents, paint, glue, pigments, or dry cleaning fluids
Biological materials, such as bacteria, blood products, or human or animal tissues
Have you been exposed to any of the above in the past?
Are you exposed to loud noises or vibrations at work or at home?
Does anyone in your household come in contact with metals, dust,
fibers, chemicals, fumes, radiation, or biological materials?
Do you know what kinds of metals, fibers, chemicals, fumes,
or radiation you were exposed to? Did any of the materials get on your skin
Are your work clothes washed at home?
Can you smell any of the chemicals or materials you work with at your
job? Do you need to use protective equipment, such as gloves or masks?
Do you wash your hands with solvents?
Do you smoke or eat in your workplace?
Are any of your coworkers or family members experiencing unusual
Have any pets had a change in health or behavior?
Do your symptoms get better or worse at home, at work, on weekends,
or while on vacation?
Is your workplace poorly ventilated?
More questions about your home environment
Do you live near an industrial plant, dump,
commercial business, or nonresidential property?
Which of the
following do you have in your home?
Air conditioner, purifier, or
Fireplace or woodstove
Gas or oil
Gas or electric stove
Have you recently remodeled, installed new carpet,
or refinished furniture?
Can you see efflorescence on the walls?
Efflorescence-a white, powdery or crystalline substance that accumulates on the
surface of concrete, plaster, or masonry-can be a good first sign of the
presence of moisture that can lead to mold growth.
Do you use
pesticides or herbicides, such as bug and weed killers, flea and tick sprays,
collars, powders or shampoos, in your home or garden or on your
Do you work on your car or have a hobby or craft that you do
Do you get your drinking water from a private well, city
water supply, or grocery store?