Air Quality

Air quality significantly impacts children’s health. Children are particularly vulnerable to air pollution because their lungs are still developing and they breathe more air per pound of body weight than adults, giving them increased risk of exposure. The health impacts associated with poor indoor and outdoor air include:

Indoor Air Pollution

Indoor pollution levels are often 2-5 times greater than outdoor levels as a result of indoor contaminants, inadequate air filtration, and inadequate ventilation. Common indoor air contaminants are:

• flame retardants
• fragrance chemicals such as phthalates
• pet dander, sweat, and urine.
• dust mites and cockroaches

Poor indoor air quality (IAQ) can harm academic performance and learning and increase child and staff absenteeism. You can make changes to improve indoor air quality by reducing chemicals and particles and keeping your facility dry and clean.

Outdoor Air Pollution

Comes from a variety of sources, including: cars, buses, trucks, ships, trains, wildfires, industry, and activities such as smoking or campfires. Traffic pollutants include possible harmful chemicals in gasoline and diesel exhaust and fine particulate matter. Child care facilities may be exposed to harmful levels of pollutants if they are located less than 500 feet from major roadways or close to heavy bus traffic.Children have higher exposures to air pollution because they spend, on average, more time outdoors than adults. Fortunately, there are many ways to reduce or eliminate sources of air contaminants and improve air quality in child care settings.

Improving Ventilation

Ventilation means bringing in fresh outdoor air into the building to dilute indoor air that contains contaminants. Buildings can be ventilated naturally by opening doors and screened windows or mechanically, by using heating, ventilation and air conditioning (HVAC) systems that bring in outdoor air and distribute it through ducts.

Natural Ventilation: open screened windows and doors. Avoid these actions when outdoor air pollution is high or when it makes your home or facility too cold, hot, or humid. To improve natural ventilation you can open more than one window or door at a time. Opening windows or doors at opposite sides of a home while keeping internal doors open will increase cross-ventilation which will further improve your air quality.

Maintain HVAC Systems:

1. Service annually by a professional company;
   
2. Change filters according to the manual and keep a log;
3. Look to see if HVAC dampers open and close; 
4. Check to see if dampers are clear or clogged with debris.

Consider using portable air cleaners. These can be used to supplement natural and mechanical ventilation systems. Choose air cleaners that have a high efficiency particle air filter (HEPA).

Keeping Facility Dry

Prevent mold growth by controlling moisture--keep the relative humidity below 60%. Buy a hygrometer to help monitor indoor humidity. If you notice damp or earthy odors in your facility, consider using the National Institutes of Occupational Safety and Health guide “Mold and Dampness Assessment Tool” to determine if you need remediation for mold.

For major water leaks hire a professional company to ensure drying within 24-48 hours. Avoid wall to wall carpeting. If carpeting gets wet, and remains wet for longer than 48 hours, consider removing carpet completely.

Reducing Indoor Air Pollution Exposures

Do not use fragrance products. These include scented/unscented candles, artificial air fresheners or other products with fragrances. These products contain multiple harmful chemicals including phthalates and solvents. Choose “fragrance-free” instead of “unscented” as the “unscented” label indicates that other chemicals were added to mask smells. Even naturally derived essential oils and incense can be harmful to human health and the environment.

Ensure all solvents, adhesives, paints, and art supplies are stored in a well-ventilated area. Products should be sealed tightly and stored in their original containers, out of the reach of children. Dispose of anything that is not being used by taking it to a hazardous waste facility.

Remove classroom pets. Pets’ sweat, urine, dander, fur and feathers can trigger allergic and asthmatic reactions. While reptiles and amphibians may not trigger these reactions, they carry bacteria called salmonella which can cause serious illness in children. If a pet cannot be removed from the facility, regular cleaning of the cage, thorough wet-dusting, mopping, and vacuuming with a HEPA filtered vacuum is essential.

When it comes time to paint, make sure to use "no-VOC" or "low-VOC" paints. Allow 24 hours of ventilation before re-entering the area after painting. Make sure painting happens when children are not present.

Prevent Carbon Monoxide (CO) exposure. Purchase and install a carbon monoxide detector. Gas stoves (stove top and ovens) can be a significant source of carbon monoxide. Ensure adequate ventilation when using gas stoves. Be sure your stove hood vents to the outdoors.

Never smoke, including e-cigarettes and/ or “vaping”, on child care premises, in your car or near or within sight of children. If you do smoke, wear an outer garment that you remove upon entering the building. Wash hands immediately. Consider implementing a no smoking policy.

Reducing Outdoor Air Pollution Exposure

• Do not allow vehicle idling near child care facilities.
  • Consider adopting an anti-idling policy. Car exhaust releases pollutants that are harmful to health (especially to children) and the environment. Pollution from idling vehicles can quickly enter a child care facility.
• Maintain a working HVAC system.
• Close windows during heavy traffic.
• Identify your outside air intakes and ensure they are working properly.
• Distance play areas from traffic.
• Check the local air quality index daily.

Check the daily air quality index (AQI). On Code Orange days (unhealthy for sensitive populations such as children), minimize strenuous outdoor activities or keep children indoors. On days where the air quality index is worse than Code Orange, it is best to keep children inside. In some areas, you can sign up for electronic updates; visit www.enviroflash.info to find out more.

Climate Change and Children's Health

Climate change is adversely impacting children’s health. Low-income children and children of color are disproportionately impacted by climate change. Impacts include increases in:

• Risk for heat related illness.
• Certain diseases such as Lyme disease and West
  Nile, other mosquito-borne illnesses.
• Frequency of natural disasters leading to children losing their lives and homes from wildfires, hurricanes or flooding.
• Asthma and allergies.
  

Wildfire Smoke

Smoke can be present in the outdoor air from a fire, even if it is very far away. When smoke occurs, it is important to reduce children’s exposure. Wildfire smoke is a mix of air pollutants including fine particulate matter (PM2.5). Exposure to PM2.5 can cause short-term health effects such as eye, nose, throat, and lung irritation, and shortness of breath. Long-term exposure may be associated with increased rates of chronic bronchitis, reduced lung function, and increased death from lung cancer and heart disease.To help prevent health effects from wildfire smoke-when smoke levels are lower, measures like closing windows and doors and ensuring your HVAC system is working properly can be sufficient. As smoke levels increase, more significant measures like canceling outdoor activities or moving to an indoor environment with cleaner air may be necessary.

To help make decisions during wildfires, consult the air quality index

Extreme Heat

Extreme heat events in the U.S. are already occurring and will become more common and more severe, as the climate changes. Extreme heat is linked to more deaths than any other weather-related hazard.

Extreme heat events can cause heat-related illnesses such as heatstroke and dehydration. Signs of heat illness include changes in behavior, dizziness, nausea, headache, fast breathing, extreme thirst and decreased urination.

Reducing Health Risks Before and After Extreme Heat:

• Train staff to recognize the signs of heat illness and know when it is an emergency.
• Find out about local heat alert systems and subscribe to them.
• Regularly check the latest weather forecasts.
• Make sure air conditioning systems work properly and replace old ones as they are inefficient.
• Use electric fans to provide comfort when the temperature is above 95°F. (when air conditioning is not present).
• Ensure that children have a way to stay cool and drink plenty of water.
• Limit outdoor activities, especially during the middle of the day when the sun is hottest.
• Locate nearby places to visit where children can cool off during extreme heat events.

EPA Indoor Air Quality Pages:

Check the Air Quality Index for your community:
www.airnow.gov or www.enviroflash.info

American Lung Association:

Eco-Healthy FAQs on Fragrances and Pet Allergens:

American Academy of Pediatrics, Climate Change and Children's Health

Eco-Healthy Child Care ® ‘s COVID-19: Healthy Indoor Air Quality in Child Care Facilities

Western States Pediatric Environmental Health Specialty Unit: Story of Health, Sofia’s story: Health Effects of Wildfires