In a previous blog, The Latest Trend in Home Performance: Why You Should Be Concerned, I expressed some concerns about a recent trend in home performance of contractors focusing on the health benefits of retrofits as the primary selling point for an upgrade. My intent was to provide a bit of caution about the reality of dealing with clients who have health concerns. Meeting expectations when someone is sick can be a challenge. I suggested that as an industry we should be cautious about what we promise to deliver.

There were some folks who didn’t agree, and were even a bit upset that I was raining on their parade. That’s okay. My intent was just to make people think a bit first before jumping onto the home performance/health bandwagon.

I’ve worked in this industry for many years, and my cautions come from personal experience. The first home performance company I worked with played the health card pretty strong. On the back of our vans was a list of questions for people to ask themselves to see if their homes were making them sick. We used to get calls all the time from people who were stuck behind one of our vans in traffic. They said they wanted more information, but once we started down the path of selling an energy audit and really finding out what was going on in their house, many of these “curious” individuals went away. I think most were looking for an easy way to find out if their house was making them sick, but the idea of a comprehensive energy audit that actually cost money scared them off. In other words, the messaging created interest but didn’t exactly generate a flood of new work.

And as I said in my previous post, clients with health issues can be some of the most difficult to please.

All of that said, I do believe in promoting the connection between indoor air quality and health. Health improvements have a place in the home performance business, as long as contractors are cautious about what they’re promising.


There is no question that comprehensive upgrades improve the indoor air quality of homes, and better air quality equals better health. That’s a message I can stand behind. For example, I have been told firsthand by numerous clients how much less dusting they had to do after their retrofit was completed.

The effectiveness of air sealing and controlling where a home’s “fresh” air is coming from can’t be overstated. Seal up the attic and the crawlspace and the indoor air quality improves. Every home performance contractor should be selling jobs based on the benefits of air sealing for multiple reasons, up to and including the potential health benefits. Air sealing is unique to our industry, it's effective, and is difficult to cost shop with single measure contractors. I would go so far as to suggest that air sealing might be the single most important measure of a home performance upgrade.

Air sealing is effective and can be profitable as well. A couple of guys with a few cans of gun foam can make a huge difference for very little cost or preparation. On more than one occasion I’ve had homeowners tell me how much warmer their house was since we added the insulation, when in fact all we had done at that point was air sealing. The bottom line is: air sealing works, it’s relatively easy, it can be profitable. You can even make a case that by improving indoor air quality, air sealing makes homes healthier too.


I was once reviewing the results of an energy audit with a client that lived on the water in an upscale neighborhood.

Our retrofit proposal included replacing the heating system including the ductwork. The homeowner was pushing back on the cost of the duct system portion of our proposal, which he felt was not worth the price we were asking. We then explained that during our inspection of the crawlspace, we noticed the plenum from the air handler (furnace) was half buried in the dirt under the house, a code violation. This itself should have justified a duct replacement, but the customer still balked at the price.

Before we went any further, we asked if the family had experienced any health concerns during the heating season. The customer mentioned that his daughter had some respiratory issues that seemed to get worse in the winter.

We then showed him a photo of the furnace plenum up close, where the bottom had rusted away and there was evidence of fuzzy visitors making their home inside this warm, dry metal box. When we explained that this stuff was being circulated through the home when the furnace was running, he changed his tune and went all-in for our proposal including the duct replacement.

I’ve used photos of nasty crawlspaces and attics to close the deal on many jobs. You don’t need much of an imagination to realize that reducing air infiltration from attics covered with rodent debris or controlling infiltration from damp, moldy crawlspaces will improve the health of your home. Photos of these conditions illustrate real and serious health concerns—and can be a very effective tool for closing sales.


I can think of two examples where upgrades had unexpected health benefits.

The first job was a deep energy retrofit that included several home performance measures, including air sealing, insulation improvements, a new combined hydronic heating solution, new ductwork and a crawlspace treatment. One of the findings during our audit had to do with the shower in the master bedroom. It seems someone installed the shower and forgot to attach the “P” trap under the house. This meant that for quite some time—years--the shower had been draining into the crawl space. The good thing was that the dirt was pretty porous, so the water eventually drained away. Even so, before we fixed it, the crawlspace was probably damp most of the time.

Several months after the retrofit I ran into the homeowner at the grocery store. She raved about how comfortable her house was and how much her heating bills had been reduced. She then told me how much better her teenaged daughter was feeling. In fact, her daughter no longer needed to use her asthma medications when she was inside the home! This was a huge and unexpected win for us, and I suspect some of it had to do with that damp crawlspace. It’s amazing what happens when you keep the nasty air out of a home.

Another story is about a home we converted for a stay-at-home quadriplegic. Unfortunately, an auto accident had left this young woman in a condition where she would be bedridden for the remainder of her life. We were called in to make several improvements on a home she had purchased so she could be comfortable and safe. Part of her care involved the use of oxygen in the home, which meant all combustion appliances had to be removed.

We demolished the fireplace and removed the furnace from its location in the hallway closet. A hydronic air handler was located in the attic with all new duct work and insulation. A sealed combustion water heater was installed in the garage and was used for domestic hot water and space heating. Last but not least, we air sealed the home and installed a vapor barrier in the crawlspace. We included two large filter grill returns in the system with 2” pleated media filters. In addition, we removed all of the carpeting and installed hardwood floors. As a side note, if I did this job today, I would probably use a heat pump and include a heat recovery ventilator.

Once our work was complete, the young woman moved in and was very comfortable in her newly upgraded home. The real test began when winter set in. Her care nurse told us she was so comfortable that she often asked to be moved outside to get some fresh air, not realizing that it was in the 40s outdoors.

The most amazing part was how her battles with infection changed. Because of her compromised immune system, before the upgrade she regularly caught serious infections that often led to pneumonia. It wasn’t uncommon for her to have four or five of these per winter, each of which was potentially life threatening due to her condition.

After the winter season was over, we got feedback from her mother and were blown away to hear that the young woman made it through the winter without a single serious infection. This was a huge improvement in her health and quality of life, to a degree we never anticipated. In effect, her retrofitted home was better for her health than a hospital room.


The potential for beneficial partnerships is significant when your business is focused on health improvements. In some states, doctors can now prescribe a healthy home inspection (energy audit) to find out what is going on in a patient’s home. This means that the cost of the evaluation, and potentially the upgrade, could be covered by insurance.

At a recent trade conference, I learned about a contractor who was working with an asthma clinic as a means of getting new leads. After building a positive relationship with the clinic, the contractor has been allowed to leave his promotional materials in their lobby. His offer promotes a “healthy home inspection” as an introductory service. This inspection is basically an energy audit with a few more tests. Another example is a home performance contractor who has created a separate business to market to folks with health concerns. The business has its own health related name and website. At this point neither one of these approaches has proven to be a huge success, but as time goes on these efforts might become viable ways to generate new leads.

One of the best partnerships you can foster is a good relationship with an industrial hygienist. There are a couple of reasons to find one in your area before you start down the path of healthy home improvements. The first is that industrial hygienists have the ability to measure and quantify indoor air quality. Using high tech tools, they can sample air from a variety of sources and then send them to a lab. This means a hygienist can actually quantify which particulates are in the home.

This has huge value if you ever have a problem client. Perhaps your client is convinced that the insulation you put in the attic is making their symptoms worse. You really have no way to verify or refute this claim unless you sample and test the actual air in the home, and indoor air sampling and testing doesn’t come cheap. Most of the services I am aware of start out at about $2,000. There are some kits that allow you to install a small device yourself and then send it off to a lab for testing, but honestly if you’ve reached that point on a job I would call in the pro and pay the price.

Another benefit of working with an industrial hygiene company is that they can provide potential leads for jobs. As a contractor, I received more than one lead from a hygienist who recognized the value of mechanical ventilation but had trouble finding contractors who knew how to correctly install one. We sold a couple of heat recovery ventilator systems (HRVs) based on leads from our hygienist.


In the past couple of years, several low-cost particulate monitors have come to market. Now homeowners can have some idea of their indoor air quality for under $300. Awareness is the first step, so a home owner who is measuring their indoor air quality is a great lead. I have even heard of a contractor who provides a low-cost particulate monitor as part of their evaluation. At a bulk price of about $150, this contractor is able to absorb the cost as part of his assessment.


Addressing health concerns can certainly play a role in the home performance industry. The concept is getting traction and technology is making people more aware of the air they breathe in their homes. I will however, refer you back to my original blog and suggest you walk with caution when pursuing this approach. On more than one occasion I have been told by contractors that health-concerned clients were some of the most difficult they have dealt with.

So be smart, be careful what you promise, and make sure you have a relationship with a professional that can measure the results, just in case your customer is not completely satisfied.

Charles Cormany
Executive Director
Efficiency First California

Image by iStock

Originally posted on

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Tags: Advocacy, Air, Charles, Cormany, Healthy, Homes, Indoor, Quality


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Comment by KRicket Smith-Gary on January 15, 2018 at 10:26am

While discussing health benefits for various retrofits and new construction, please also keep in mind that building materials themselves can cause allergies.  Of course, everyone is different in this regard and what is safe for one might be dangerous to another.  Chinese sheetrock scares aside, IAQ and building material allergies should be considered in all construction.  

Comment by Luke Langhals on January 8, 2018 at 1:52pm

I received a call from a recent ERV installation stating that she painted a bedroom in her house. She said the house smelled terribly of paint fumes (naturally...) and she had hoped her ERV would help alleviate the issue. Upon some over-the-phone trouble shooting; we discovered the ERV had been left off when she changed the filters several days before. She called me back the next day stating that the home now smells fantastic again! Sometimes it is hard to see the benefits of balanced ventilation...until an obvious issue makes them extremely apparent.

Comment by Chris Dorsi on January 8, 2018 at 10:55am

I have to agree with most of Charles' assumptions, especially his experience with health benefits becoming apparent AFTER the job. Many years ago, we had good luck selling many retrofit packages that included air-sealing, source control, and balanced HRV systems. Most clients came to us after the job -- even the same day we finished the job -- and reported that they loved the feel of their "new" house. Many came back in the ensuing months bragging about how much happier and healthier their families were. You can't buy advertising like that.

We'll be brokering a discussion on this very topic at the 2018 Habitat X Conference, and will focus on developing honest-to-god contracting models. There is a lot of activity right now at the nexus of health and home performance, and though it's not easy to fold this stuff into a standard contracting model, we'd like to at least assure that everybody is on the same page.

Comment by tedkidd on January 4, 2018 at 2:02pm
Hi Stephen! The most difficult change is shifting to a "charge for your time" model - no more free visits or estimates. No free consulting.

Even our voicemail drives people to our website. Not "selling" the value of our initial visit was hard.

If you look at our Google reviews even people who only have the initial visit feel the experience is well worth it. That is the key.

Provide a worthwhile experience at every step.
Comment by Stephen Standley on January 4, 2018 at 12:36pm

Hi tedkidd,

I'm trying to figure out how to move from a energy audit first approach too. Can you explain your smaller steps medical model?

Comment by tedkidd on January 4, 2018 at 12:03pm
The "selling energy audit" out of the gate model is out if order. Surgeons don't sell surgery, or even super complex diagnostics over the phone.

Like surgery, energy audits are NOT something everyone needs.

More importantly, energy audits are NOT something everyone wants.

We developed a path. It's much gentler. It has about 80% closing ratio, average project of $27,600, and follows the smaller steps medical model.

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