HHA Safety Hazards: Cockroaches and Clutter Top The List

Home Health Care Patients and Safety Hazards in the Home

Home health care is the fastest growing sector in the health care industry, with an anticipated growth of 66 percent over the next 10 years and with over 7 million patients served each year.

With the increasing acuteness of care provided in the home and the increasing number of frail elderly that make up this patient population, it is important to identify risk factors that affect patient health and safety in this setting.

A sample of ~ 1,500 home health aides, attendants, and personal care workers completed a risk assessment survey.

Items addressed personal, patient, and home characteristics and health hazards.

Results: Ninety-five percent of home health care workers (HHCWs) were female with an average of 8 years experience. The majority of clients were elderly, with a smaller percentage of adult (26%) and pediatric (7%) cases.

HHCWs reported the following exposures at their clients’ homes: cockroaches (33%), cigarette smoke (30%), vermin (23%), irritating chemicals (17%), and peeling paint (15%).

top hha home hazards

The following conditions were also described: clutter (17%), temperature extremes (9%), unsanitary (12%) and unsafe (6%) conditions in the home, neighborhood violence/crime (11%), and aggressive pets (6%). Two percent of respondents reported the presence of guns in the home. Additionally, 12% of HHCWs reported signs of abuse of their clients.

Both HHCWs and home care patients appear to be at potential risk due to a variety of health hazards/exposures in the clients’ homes.


Gershon RRM, Pogorzelska M, Qureshi KA, et al. Home Health Care Patients and Safety Hazards in the Home: Preliminary Findings. In: Henriksen K, Battles JB, Keyes MA, et al., editors. Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 1: Assessment). Rockville (MD): Agency for Healthcare Research and Quality; 2008 Aug. Available from: https://www.ncbi.nlm.nih.gov/books/NBK43619/