Reducing Environmental Exposures in Child Care Facilities
Infants and young children consume more food and more water and breathe more air relative to their body weight than adults do. As a result, they are potentially exposed to relatively higher doses of environmental contaminants. Early childhood is an important time for immune system development. In addition, their developing systems are still learning to distinguish the difference between nutrients and toxins. It has been estimated that as much as 24% of all human diseases and disorders are attributable to environmental factors. Thus, much emphasis and regulation is placed on making the child care setting a safe and nourishing environment. The following is a review of the various environmental considerations for child care facilities.
The most common and stringently regulated contaminant in the day care setting is lead. Lead is particularly harmful to very young children because their developing brains and nervous systems are more sensitive to the damaging impacts, which include learning and behavior. Babies and young children are also at greater risk of exposure to lead in dust and soil because they often put their hands and other objects into their mouths. Direct ingestion of paint chips is no longer believed to be a significant exposure path.
All commercial and institutional child-occupied facilities require licensing and certification to demonstrate that the licensed spaces are "lead-safe." A child-occupied facility “means a building, or portion of a building, constructed prior to 1978, visited regularly by the same child, six (6) years of age or under, on at least two (2) different days within any week, provided that each day's visit lasts at least 3 hours and the combined weekly visit lasts at least 6 hours, and the combined annual visits last at least 60 hours. While restrooms would not meet these criteria, based on an EPA memorandum on interpretation, it is commonly believed that restrooms are also required to be tested. The focus of the testing is to identify lead contamination from deteriorated lead-based paint but sometimes other sources are identified such as plumbing repairs, lead-contaminated toys or atmospheric pollution. Learn about how Tri-Tech can help you certify your child care center as "lead-safe." Lead in drinking water can be a concern depending on the local water source and the individual plumbing features and fixtures. In the State of Michigan, testing of water supply systems for child care is optional. Significant governmental emphasis has been placed on improving municipal water quality. Since 1993, non-compliance with lead in water quality standards has decreased from 3% to less than 1% of all water systems. When lead is detected in water, it is normally attributable to one of two causes: lead somewhere within the on-site plumbing or fixture (such as solder ) or a surprise increase in lead in the municipal supply is related to some system change or nearby construction vibrations, which has dislodged the mineral scale lining of the leaded pipes. you can learn more about testing methodologies for lead in drinking water or the history of lead used in water supply systems. Radon is a colorless and odorless gas that causes cancer. It is formed from the natural radioactive decay processes of naturally-occurring uranium impurities found in bedrock below buildings. Michigan's Administrative Code 400.1901 requires that home-based child care facilities meet the following requirements:
- A licensee shall test the child care home for the concentration of radon gas before the initial license is issued and every four (4) years thereafter at the time of license renewal.
- The lowest level of the child care home must not have levels of radon gases that exceed 4 picocuries per liter (pCi/L) of air, except as provided in subrule (6) of this rule. Documentation of the results must be kept on file in the child care home.
- If the levels of radon gases exceed 4 picocuries per liter of air (the EPA recommended action level) in the lowest level of the child care home, the licensee shall notify the parents of children in their care and have a radon mitigation system installed. The licensee has up to 12 months from the date of the first measurement to meet the standard in subrule (5) of this rule.
It is commonly cited by the authorities that mitigation measures are inexpensive. However, claim this is arguable, particularly when additional yearly additional energy costs are considered. One study suggested an average increase of $500 per year in additional energy costs. The costs also depend on the levels measured and the existing building design. If testing results indicate an exceedance above 4 pCi/L, typically more rigorous testing is performed to determine if long-term levels might average below the Action Level and therefore not require investment in a mitigation system. At this time, the State of Michigan does not require radon testing for commercial or institutional buildings.
Mold is only regulated in a handful of states and Michigan is not one of them. Mold is particularly difficult to regulate as it is a contaminant that doesn't behave like other contaminants. Susceptibility to mold varies widely between individuals, making health standards nearly impossible to establish. In addition, interpretation of mold data requires experience and professional judgment, something that is difficult to professionally certify. Strictly speaking, mold exposures to child care workers are potentially regulated by the Occupational Health and Safety Administration (OSHA) under the "general duty" provisions to provide a safe work environment.
Maintaining a building free of harmful levels of mold is important as mold is one the primary triggers of asthma or allergy attacks. Pediatric asthma has more than doubled over the past 20 years and is now the leading cause of child hospitalizations and school absenteeism.
Mold can generally be managed by maintaining a building in good condition and quickly addressing, leaks, spills, floods or other moisture-related problems. Mold and moisture investigations can be performed by various test methods to investigate possible concerns and make recommendations for corrective action. In the experience of Tri-Tech, mold spore testing of air can often find hidden problems not readily evident by visual inspection. Moisture testing can also be performed using moisture meters and humidity meters. Infra-red thermography can also potentially identify hidden problem areas.
Careful use of pesticides is required not only to control pests that are sources of allergens (e.g. cockroaches and rodents) but also to limit exposures of children to these toxic chemicals. The State of Michigan include requirements for child care facilities to have formal Integrated Pest Management (IPM) plans before pesticides are used at a child care center. A verifiable copy of the IPM program must be made available for use and review by facility staff, parents/guardians or State licensing officials as needed or requested. The best "pesticide" is vigorous cleaning that deprives pests of any food and minimizes the need for pesticide application.
Endocrine Disrupting Chemicals (EDCs)
Endocrine disruptors are complex family of chemicals that include heavy metals, pharmaceutical residues, organophosphate pesticides and other synthetic organic chemicals. We first learned of the problems with these contaminants in the 1990s resulting from the publicized discoveries of intersex or sexually ambiguous fish and invertebrates in contaminated waters. These chemical either mimic or react with our hormones, resulting in various health effects including nervous system damage, autoimmune problems, sexual ambiguity or dysphoria, diabetes, attention deficit disorders, autism and increases in cancer of organs involved in hormone regulation. There is some evidence that some of these effects can be genetically encoded and therefore passed on to future offspring.
In many cases the use of EDCs resulted from the laudable effort to replace a toxic chemical with a less toxic chemical. However, often these substitutes have hormonal impacts that eluded initial safety testing. This includes are wide range of consumer products, foam used in cushions and furniture, and certain substances used in toys. The applications include plasticizers, flame-retardants, non-stick coatings and various other purposes.
According to the World Health Organization, the most sensitive window of exposure to EDCs is during the critical periods of fetal development and puberty
rather than early childhood. Nevertheless, exposures affecting asthma and immune system development, learning behaviors, alterations to the schedule of puberty and dispositions to obesity are strongly linked to EDC exposures from ages zero to six.
It remains prudent to limit child exposures to EDCs as our understanding of them continues to unfold.
Child care facilities are thought of as notorious "germ factories" as children intermingle from multiple households where it is likely at any given time that someone is sick or carrying a subclinical infection. As a result, liberal use of hand sanitizers is thought of as the first line of defense. However, the CDC recommends washing hands with soap and water as the best way to practice good hygiene and reduce the number of microbes on skin. In most cases, in a child care setting, a bathroom or kitchen sink with soap and water is only a short distance. According to the agency, “[i]f soap and water are not available, an alcohol-based hand sanitizer can quickly reduce the number of microbes on hands in some situations, but sanitizers do not eliminate all types of germs,” and sanitizers are less effective when hands are visibly soiled or greasy. In addition, there are concerns pertaining to the side-effects of alcohol or other additives on the skin, including harms to the naturally-occurring beneficial bacteria found on skin. Sanitizers are great for disinfecting surfaces. For hands, not so much.
Several states have child care regulations establishing that hand sanitizers not be used as an alternative to regular hand washing, are prohibited for children of certain ages or require a parent's permission for use. Michigan does not have any such regulations. You can learn more about the case against hand sanitizers.