1. Sensible Steps to Healthier School Environments Maryann Suero, PhD US Environmental Protection Agency suero.maryann@epa.gov 312-886-9077 Part 1: Issues in School Environmental Health

2. Sensible Steps to Healthier School Environments Objectives: To Understand impacts of environmental exposures on productivity, learning Understand major environmental exposures in schools 2

3. Sensible Steps to Healthier School Environments What’s the difference? Toxicity Exposure How bad? How much? RISK TIMING Lifestage 3

4. Sensible Steps to Healthier School Environments Health Gains from Improved IAQ 4 Increased Outside Air Source Control Moisture Control

5. Sensible Steps to Healthier School Environments Proactive Maintenance in Schools Schools without a major maintenance backlog - Higher average daily attendance, 4 - 5 per 1,000 - Lower annual dropout rate, 10 - 13 per 1,000 5

6. Sensible Steps to Healthier School Environments Major Issues in Schools Asbestos Asthma triggers Bus / Vehicle Idling Carbon Monoxide Chemical Management Drinking Water Energy Efficiency Indoor Air Quality / Ventilation Lead Mercury Mold / Moisture Control PCBs in Caulk & Light Ballasts Pesticides & Pest Management Radon UV Radiation Waste Reduction 6

7. Sensible Steps to Healthier School Environments Lead Poisoning 7

8. Sensible Steps to Healthier School Environments ( Data from Illinois - 2010) Percentage of Children with Elevated Blood Lead Levels (over 10 ug/dL) by Race Represents about 3,500 children Another 38,000 children above 5 ug/dL! African American AsianWhiteHispanic 8

9. Sensible Steps to Healthier School Environments Lifelong Health Effects of Lead Damage to the brain and nervous system Behavior and learning problems (such as) – Hyperactivity – Poor impulse control – Violence – Lower IQ Delayed growth Other problems – Hearing – Headaches 9

10. Sensible Steps to Healthier School Environments Renovate Right! WHO: Contractors performing activities that disturb lead-based paint WHAT: Renovation, Repair, Painting projects WHERE: Child-occupied facilities (e.g. homes, child care facilities, and schools) built before 1978 HOW: Must be certified and must Notify and Follow Specific Work Practices to prevent lead contamination including – Contain the work area – Minimize dust – Clean up thoroughly http://www.epa.gov/oppt/lead/pubs/renovaterightbrochure.pdf 10

11. Sensible Steps to Healthier School Environments Asthma 11

12. Sensible Steps to Healthier School Environments Childhood Asthma in the US 12

13. Sensible Steps to Healthier School Environments We really don’t know yet Lots of theories Some genetic component ETS exposure in very small children What Causes Asthma? What Causes Asthma Attacks?  Poor medical control  Poor environmental control 13

14. Sensible Steps to Healthier School Environments Common Asthma Triggers Allergic –Dust mites –Molds –Pollen –Animal dander –Pests Non-Allergic –Tobacco smoke –Pesticides –Wood /coal smoke –Ozone –Particulate matter 14

15. Sensible Steps to Healthier School Environments Important to Control Asthma Triggers Room by Room Individual by individual Not everyone has the same environmental asthma triggers Control the most common asthma triggers in your school 15

16. Sensible Steps to Healthier School Environments Reduce Asthma Triggers Vent sources of particles and humidity (kept ideally between 30-50%) Use finishes / furnishings – Easy to clean – Don’t harbor pests Use IPM (more to come!) 16

17. Sensible Steps to Healthier School Environments Key to Mold Control is Moisture Control Mold can’t be eliminated from indoors…will always be spores Don’t need to test for mold – If you see it – If you smell it – You’ve got it – You need to get rid of it Not just a nuisance – Health effects – Structural damage – $$$$$$$$ Dry up moisture within 48 hours 17

18. Sensible Steps to Healthier School Environments Pests / Pesticides 18

19. Sensible Steps to Healthier School Environments Pests / Pesticides Can Trigger Asthma Attacks or Cause Other Health Effects Pests –Dust mites –Cockroach allergen –Rodent urine Pesticides –Carriers –Fragrances –Active ingredients 19

20. Sensible Steps to Healthier School Environments Potential health effects of pesticides depend on the type of pesticide Some may affect the nervous system Others may irritate the skin or eyes Some pesticides may be carcinogens Others may affect the hormone or endocrine system in the body 20

21. Sensible Steps to Healthier School Environments To Reduce Pests and Pesticide Use Integrated Pest Management Look for them Dry them out Starve them out Keep them out Least amount of least toxic pesticides, when needed 21 In Illinois, the key component of IPM people remember is notification IPM is MORE than notification It’s about behaviors and actions that prevent pests

22. Sensible Steps to Healthier School Environments Carbon Monoxide (CO) – A Silent Killer Product of Incomplete Combustion From appliances that use fuels e.g. – Stoves – Furnaces – Gas heaters – Cars Health Effects – Flu-like symptoms, headaches, nausea… – Claims several hundred lives each year in the US Good ventilation and appliance condition key to preventing hazardous levels of carbon monoxide Impossible to see or smell, CO detector or alarm is the only way to determine exposure 22

23. Sensible Steps to Healthier School Environments Overview of Radon Naturally occurring radioactive gas Ubiquitous in nature Undetectable with 5 senses Can have high concentrations indoors 23

24. Sensible Steps to Healthier School Environments Why we Care about Radon #1 Cause of Lung Cancer for Non-Smokers #2 Cause of Lung Cancer in the US 21,000 Lung Cancer Deaths/Year in US Cause of more than half US Radiation Exposure Radon risk ~8X greater for smokers 24

25. Sensible Steps to Healthier School Environments EPA Action Levels Action Level (4 pCi/L) Consider Action (2-4 pCi/L) Greatest exposure especially in rooms below grade 25

26. Sensible Steps to Healthier School Environments Zone 1 Highest Potential (greater than 4 pCi/L) Zone 2 Moderate Potential (from 2 to 4 pCi/L) Zone 3 Low Potential (less than 2 pCi/L) Illinois Radon Potential

27. Sensible Steps to Healthier School Environments New IL Law Requires Radon Testing in Day Care Centers Must test as part of the initial application or license renewal process More at http://www.radon.illinois.gov/ 27

28. Sensible Steps to Healthier School Environments School Radon Screening Program Illinois School Code allows school district employees to complete an online training course approved by IEMA in order to perform screening measurements in their district school buildings After successfully completing the Radon Measurement course, employee receives certification 28

29. Sensible Steps to Healthier School Environments Household products contain mercury Replace with non-mercury alternatives when feasible, especially THERMOMETERS If you have mercury-containing products, know how to clean up spill properly – No vacuum – No broom – No drains – Get help if larger amount than what’s in 1 fever thermometer Mercury 29

30. Sensible Steps to Healthier School Environments Sensible Steps to Improving Chemical Management in Schools 30

31. Sensible Steps to Healthier School Environments Case 1 HS custodian found students mixing chemicals in a bottle Bottle exploded, releasing gas Custodian became ill, vomited 12 students / 3 school staff treated for respiratory problems 1,640 persons evacuated for 5 hours while hazardous materials team cleaned and ventilated the school 31

32. Sensible Steps to Healthier School Environments Case 2 Custodian entered a MS science storage area, became unconscious Someone had spilled a solution of 37% formaldehyde in room and failed to tell anyone Fortunately the custodian was rescued 32

33. Sensible Steps to Healthier School Environments Case 3 Student took ~ ½ cup mercury from HS science lab, sold some to friends Contaminated classrooms, gymnasium, cafeteria Contamination went beyond school HS was closed for 35 days Cleanup costs were about $1,500,000 33

34. Sensible Steps to Healthier School Environments Where Do You Find Chemicals? Maintenance Areas Custodial Storage Lawn care sheds Vocational Shops Science Laboratories Art Classrooms Offices Health unit 34

35. Sensible Steps to Healthier School Environments Coming Up Approaches, Solutions and Resources for School Environmental Health 35