Environmental contaminants in early learning environments

It's known that children are more susceptible to various environmental health risks due to their unique physiology, unique behaviours, and their general curiousity. While parents go out of their way to ensure their homes are safe for the newest members of their family, many children spend a large portion of their days in child care. In B.C., requirements for licensed child care facilities are generally outcome based: they speak to ensuring the health and safety of the children in care, but don't really talk about the potential environmental hazards that might be found in the facility, and how they should be mitigated.

An American study looked at the current scope of legislation around environmental hazards in "early learning environments" (i.e. child care facilities), and how these environments contributed to "environmental exposures". In the USA, "children of working parents ... spend on average 40 hours a week in child care". This isn't really a surprising number: unless there are close friends or family members in the immediate vicinity, working parents have no option but to find child care for their children. One would assume that the numbers are similar in Canada.
Table 2 from Hudson, Miller, & Seikel

Just like in Canada, the U.S.A. has no federal legislation surrounding environmental health in child care facilities. Licensing standards are set at a state level, and state officials are responsible for their application. The study pointed out that the standards varied greatly between states, with some requiring such controls as environmental testing (for asbestos, lead, etc.), and others not licensing family child care facilities at all. It also speaks to the fact that most states have a requirement for environmental health inspections of the facilities, but their frequencies vary "from zero to four inspections annually". One consistency found in the study was that nearly every state required some sort of protection for the children from environmental tobacco smoke (though again, there were differences in how severe these restrictions were).

The study goes through a long list of potential environmental hazards for children in care, and looked at which states had controls in place for each of them. While nearly all, as mentioned above, had restrictions on ETS, only 12 states required environmental health inspections for "small" family child care facilities, and only 13 states required some sort of environmental testing. Further, the authors pointed out that "even in states where environmental testing requirements are in place, compliance ... is low".

The report concluded that "current regulatory and licensing standards ... address only the most basic environmental health protections", and Table 2 above seems to graphically describe that quite well. While it's easy to see the difficulties in a federally-mandated legislative process for environmental health in care facilities, some consistency (both in the U.S.A. and in Canada) would be helpful to ensure infants and children are protected from some of the more egregious risks.

Personally, I'm a fan of the idea of testing for various environmental hazardous to provide concrete data on the need for remediation or mitigation. As an example, Interior Health has sent out radon test kits to all child care facilities (letter from Senior Medical Health Officer here). A friend of mine did some research a few years back on the efficacy of surface lead test swabs (such as these ones) and found that they did a decent job. Legislation in B.C. requires that a number of child care facilities (depending on size, etc.) test their drinking water quality to ensure compliance with provincial drinking water legislation. Once we (as a society) have the knowledge that these types of exposures are a risk, why not take advantage of testing mechanisms to determine whether further action is required?

Source: Hudson, G., Miller, G.G., & Seikel, K. (2014). Regulations, policies, and guidelines addressing environmental exposures in early learning environments: a review. Journal of Environmental Health, 76(7), 24-34.

No comments: