Pediatric Environmental Health Response — at Schools and Childcare Centers

The best time for frontline schools and childcare centers to prepare for environmental disasters is before it happens

When environmental disasters occur such as emissions, discharges, explosions, fires, and other industrial accidents from factories, trains and other point sources, schools and childcare centers often become frontline responders. These institutions may care for children under unusual circumstances with disrupted operations or for extended periods, especially when families are displaced or emergency services are overwhelmed.

Children are particularly vulnerable to environmental hazards due to their developing bodies, higher respiratory rates, and behavioral patterns which may cause small or brief exposures to have serious or longstanding impacts. Elevated industrial emissions have been linked to increased rates of asthma, autoimmune disorders, headaches, sleep disturbances, learning difficulties and exaggeration of pre-existing conditions among children in nearby communities.

Environmental health responses that include environmental monitoring, risk reduction, health monitoring, effective communication and other proactive measures are essential to prevent these adverse effects and build trust. Improve outcomes by designating a lead person with supports. Including children in these strategies that benefit them offers the mots impactful experiential learning. Note that however, their participation is often overlooked due to societal norms and institutional barriers.

Immediate Measures for Schools & Childcare Centers

1. Air Quality Monitoring & Alerts

   The EPA's AirNow.gov, the Weather Channel and public health sites offer updated data on environmental exposures and level of risk. Local and national environmental organizations raise awareness, add significant insight and have access to air quality experts and other collaborators. Schools and childcare centers can enroll in text and email alerts to follow air quality announcements. Obtain a portable air quality monitor to allow for self-tracking. Establish a protocol for "sensitive groups" and identify them early.

   
   

2. Indoor Air Protection

   Use air purifiers with HEPA filters in classrooms and health offices, ensuring the Clean Air Delivery Rate (CADR) matches the room size. Control humidity with a dehumidifier or humidifier to maintain levels between 30-50%. High humidity can trap certain pollutants at the ground level increasing their exposure and low humidity can suspend certain pollutants in the air for longer periods. Seal HVAC systems and keep windows and doors closed when outdoor air quality is poor. Regularly inspect and maintain HVAC filters (MERV 13 preferred) and save them if a forensic investigation is ever needed.

   
   

3. Indoor Water Protection

   Filter/run water if infiltration of industrial runoff is possible; test water quality in nearby wells or supply lines. Test tap water using a certified environmental testing company and test water quality at the faucet with a Total Dissolved Solids (TDS) meter. The closer to zero the number the better. Know the status of any lead testing of water. Install carbon-based filters on all water fountains to improve the quality of drinking water. Encourage adequate hydration in children.

   
   

4. Symptom Tracking and Health Management

   Instruct school nurses to record increases in symptoms such as cough, wheezing, headache, nosebleed, nasal congestion, dizziness, inhaler usage, behavior and mental health problems, absenteeism, or similar complaints among multiple students. Prioritize children who are at higher risk due to a pre-existing condition, disability or other vulnerability. Practice good handwashing and maintain other hygiene practices. Use logs, and diaries to track symptoms, including frequency and severity. Know when to seek medical attention, for more severe or persistent symptoms. Recognize patterns and clusters. Share your observations and findings. Refer to your state and/or local health department accordingly.

   
   

5. Nutrition (Cafeteria) Support

   Enhance children’s immunity and biological protection by providing and encouraging consumption of whole foods rich in antioxidants such as fruits, vegetables and leafy greens, berries and beans. Organic foods are recommended and remember to wash them well even though they are pesticide-free. Seek out Farm-to-Table programs.

   
   

6. Temporary Activity Modifications

   Hold recess and physical education classes indoors on days with high pollution levels, and restrict intense outdoor activities for children with asthma and other high risk conditions. Utilize air monitoring data to modify physical activity recommendations.

   
   

7. Mental Health Support

   Address eco-anxiety in children caused by the heightened alerts, community panic, loud noises, evacuations, or persistent concerns by offering culturally-sensitive school-based counseling and implementing calming practices in classrooms. Minimize digital overload. Be honest, give age-appropriate explanations and validate their feelings. Focus on solutions and the work of the clean up crew and first responders (police officers, firefighters, EMTs, and paramedics), providing continuous reassurance. Reward children for good behavior, emotional resilience and their participation in any activities. Involve a school psychologist.

   
   

8. Dealing with the loss of a loved one

   Environmental disasters often result in fatalities, presenting significant challenges due to the sudden, shocking nature of the loss and its extensive media coverage. Create a safe and calm environment. Maintain a predictable routine to maintain stability. Children pick up emotional cues from trusted adults. Communicate openly and recognize that each child reacts differently. Honor their loved one by looking at photos. Plant a seed or make a memory box. Seek trauma-focused health support as early as possible.

   
   

9. Effective Communication with Families

   Distribute concise, empathetic updates detailing school actions. Distribute parent/teacher tip sheets on recognizing early symptoms (persistent cough, wheezing, headaches, fatigue) that merit medical evaluation. Urge sensitive children to stay indoors. Obtain information from credible, multidisciplinary sources and school board resources. Use multiple channels such as email, texts, flyers, social media and school apps to maintain open lines of communication. Promptly respond to questions and feedback.

   
   

10. Community Health

    Participate in community meetings, rallies, legislative hearings, online forums. Advocate for stronger health protections- to stop the exposure, fully disclose relevant health and environmental information, monitor community health and employ early interventions. Spread word of mouth and network. Expect public health messaging of "no health concerns" and avoid emotionally charged responses.

Reporting a Disease Cluster

Reporting disease clusters is the most important environmental health response that you can take following an environmental disaster. Document symptoms, dates, ages, and locations. Also note clusters of absenteeism. Report the cluster to the school district health coordinator and the local state or county health department. Seek collaborations with pediatricians and medical associations, epidemiologists, public health agencies, environmental nonprofits, community groups, universities and environmental health leaders to conduct community-based participatory research.

Long-Term Community Initiatives

1. Incorporate environmental health modules into health curricula (e.g. how pollution affects breathing, lifestyle mitigation strategies).

   
   

2. Form a local Environmental Health Action Team consisting of school, childcare, environmental, health and government officials. Add scientists, engineers, attorneys and community advocates to coordinate information-sharing, environmental monitoring, screenings, health strategies and advocacy efforts.

   
   

3. Advocate for school districts, public health agencies and city planning to conduct environmental health impact assessments.

   
   

4. Demand transparency on turbine operation logs, emissions data, permit compliance, and corrective action plans. Obtain MSDS data sheets and other relevant data and reports from companies and regulators. Use geospatial tools (mapping health complaints vs proximity to turbines) to support legal and public health action.

   
   

5. Advocate for mobile health screenings (spirometry, peak flow tests, symptom surveys) and environmental sampling (air, soil, water) near schools and wells.

   
   

6. Promote protective school policies, including funding for improved indoor air filtration and establishing no-idling zones. Plant trees around schools and create buffer zones (trees, vegetation barriers) between industrial and residential/school areas. Advocate for regular ambient monitoring in neighborhoods and school zones (NOₓ, particulate matter, formaldehyde).

   
   

7. Identify hazardous sites and facilities in your community, where you live, work and where children attend school or childcare. The EPA has three main databases to find this information: Toxic Release Inventory in the Classroom, Envirofacts and MyEnvironment. Unfortunately, their EJ Mapping Tool--a great resource--was discontinued.

   
   

8. Push local agencies to designate this area as nonattainment or pollution burden zone, triggering stricter air quality controls.

   
   

9. Support appeals and legal actions (e.g. Clean Air Act enforcement) led by community groups (e.g. NAACP, Southern Environmental Law Center SELC). Study the experiences of other environmental justice communities.

Resources and References

1. CERT Training- FEMA (Federal Emergency Management Agency) offers free Community Emergency Response Team training to volunteers on environmental and other community disaster preparedness and response, usually through local fire departments. Training is typically over 2 days and comes with a large binder, bookbag filled with a helmet, flashlight and other emergency supplies.

   
   

2. American Red Cross- While technically not a first responder, they offer immediate aid to affected communities such as shelter, clean water, hot meals, supplies and financial assistance. They train trainers, healthcare professionals and communities on emergency and disaster response and preparedness.

   
   

3. Healthy Schools Network- Involved in research, education, coalition-building, and advocacy to promote environmental public health services, child-safe school design and maintenance, and policies that reduce exposure to air pollutants and other environmental hazards in schools.

   
   

4. EPA Indoor Air Quality Tools for Schools- Helps schools identify, resolve, and prevent indoor air quality problems using low-cost, practical strategies including an Action Kit with checklists, best practices, and a management framework to reduce exposure to pollutants, improve student and staff health, and enhance academic performance.

   
   

5. School-Based Interventions to Support Healthy Indoor and Outdoor Environments for Children: A Systematic Review- This research review found that increasing classroom ventilation improved short-term air quality, greening schoolyards enhanced cognitive function and physical activity, and infrastructure changes promoted active travel.

   
   

6. Toxic Docs- Online archive of previously secret internal documents from chemical and manufacturing industries, made public through toxic tort litigation that reveal suppression of health risks.

   
   

7. FencelineData.org- Public data platform that consolidates environmental information from multiple EPA programs into a single, user-friendly interface. Relevant for communities, researchers, and advocates seeking to identify and monitor pollution sources, environmental violations, and chemical emissions from industrial facilities.

Schedule an environmental health consultation for risk screening, assessments and recommendations for individuals, schools and child care centers. Schools and childcare centers have the right to know and access support that is available. Remember, early intervention leads to the most favorable outcomes.

Dr. Yolanda Whyte, MD