8 Safety and the Physical Environment © iStockphoto/Thinkstock After studying this chapter you will be able to: ▸▸ Describe the characteristics of safe indoor and outdoor places. ▸▸ Identify appropriate equipment, furniture, toys, and supplies for safe indoor places. ▸▸ Recognize the characteristics of safe outdoor equipment, surfaces, and toys. ▸▸ Discuss current safety regulations for early childhood education environments. ▸▸ Create strategies for staff to promote safety in early childhood programs. ▸▸ Explain how toxic pollutants affect early childhood settings. Creation of Safe Physical Spaces Chapter 8 8.1 Creation of Safe Physical Spaces The physical environment of an early care and education setting can influence a child’s physical and psychological comfort, which may influence the child’s behavior and ability to learn in that environment. A space for young children needs to be inviting to children, the child’s parents or guardians, and staff. The physical environment includes the overall appearance of the room, the arrangement of furniture, overhead lighting, organization of materials and decorations, use of windows, color of the walls, and the health and safety aspects of the room such as temperature, humidity, air quality, size of space, cleanliness, and noise level. The Whole Building Design Guide (WBDG) subcommittee of the National Institute of Building Sciences recommends that a child development facility be homelike, be child sized, encourage autonomy, invite self-expression, provide indoor and outdoor physical activities and spaces for nature, be structured but flexible, and be safe, secure, and healthy (WBDG Subcommittee, 2011). According to the World Health Organization (WHO), the international authority on world health, a healthy school is “one that constantly strengthens its capacity as a healthy setting for living, learning, and working” (WHO, n.d.a). The WHO provides a comprehensive listing of components of a healthy school environment (see Table 8.1). Table 8.1: Components of a Healthy School Environment ▲ The child care setting should be visually appealing and appropriate for young children. © Comstock/Thinkstock Provision of basic necessities • Shelter • Warmth • Water • Food • Light • Ventilation • Sanitary facilities • Emergency medical care Protection from biological threats • Molds • Unsafe or insufficient water • Unsafe food • Vector-borne diseases • Venomous animals • Rodents and hazardous insects • Animals (e.g., dogs) Protection from physical threats • Traffic and transport • Violence and crime • Injuries • Extreme heat and cold • Radiation Protection from chemical threats • Air pollution • Water pollution • Pesticides • Hazardous waste • Hazardous materials and finishes • Asbestos, paint • Cleaning agents This chapter will provide useful information on the most common elements of a healthy early childhood setting in the United States. Indoor Air Pollutants Chapter 8 8.2 Indoor Air Pollutants Studies have shown that Americans spend about 90% of their time indoors. Estimates show infants and urban residents spending even more than that indoors (Environmental Protection Agency [EPA], 2009). Lungs are the part of the human body that takes the major brunt of indoor pollutants. The result of such pollutants can be upper respiratory infections, nasal congestion, headaches, eye irritations, nausea, fatigue, and symptoms that often mimic the common cold or flu (American Lung Association, 2012). Sources of indoor air pollution in the typical early care and education environment can be classified into categories including volatile organic compounds (VOCs), human carcinogens, combustion sources, heavy metals, biological threats, and secondhand smoke. These sources release gasses or particles into the air. The danger these releases pose to humans depends on the concentration of the pollutant level and the nature of the release of particles. Some sources release pollutants continuously and some intermittently. Staff in these settings need to be informed of these groups of pollutants and be observant of symptoms of possible infection or other impacts on the children in their care, as well as aware of how to prevent exposure and reduce risk. ▲ Common indoor air pollutants include volatile organic compounds, which are found in subjects such as insecticides. © Jupiterimages/Thinkstock Volatile Organic Compounds: Formaldehyde, Pesticides, Solvents, Cleaning Agents VOCs at room temperature are released as gasses. They are in products used at home and school, including scents, hairsprays, glues, permanent markers, rug cleaners, carpet adhesives and padding, pesticides, sealants on cabinets, paneling, and other furnishings. They may cause eye and respiratory irritations, dizziness, rashes, nasal congestion, headache, nausea, and vomiting. Common VOCs include pesticides. Pesticides are products used to control insects, rodents, fungi, bacteria, and weeds. Pesticides come in a variety of forms, such as liquids, powders, and sprays. The Environmental Protection Agency (EPA), an agency of the U.S. federal government that is charged with protecting the American environment and guarding its impact on human health, recommends that rather than using pesticides that can pose a health problem, a safer way to control pests is to use Integrated Pest Management (IPM). This program uses strategies that limit or eliminate sources of food, water, and shelter for pests (American Academy of Pediatrics [AAP], American Public Health Association [APHA], & National Resource Center for Health and Safety in Child Care and Early Education [NRC], 2011). This includes a range of practices including pest exclusion, sanitation, and clutter control. Human Carcinogens Asbestos and radon are known human carcinogens (cancer-causing substances) with negative health effects that may appear decades after prolonged exposure. Asbestos is a fibrous Indoor Air Pollutants Chapter 8 H I G H L I G H T: Common Pollutants • Volatile organic compounds (VOC) • Heavy metals • Human carcinogens • Biological allergens • Combustion sources mineral that is heat resistant and was frequently used in materials for acoustics, insulation, fireproofing, and floor tiles. It is commonly found in older homes. Removal of asbestos can release fibers into the air, making the pollution much worse. Inhalation of asbestos fibers can cause lung cancer. Radon is a natural radioactive gas that is colorless, odorless, and tasteless, and is the second leading cause of lung cancer. Radon forms during the natural decay process of uranium or thorium, which is found in almost all soil types, and some water sources. The uranium releases radiation as it decays, which then becomes airborne. Radon is responsible for exposing individuals to ionizing radiation. Radon can accumulate in buildings, particularly confined spaces such as attics and basements. Children are thought to be more susceptible to radon effects, possibly due to their higher respiration rate (Air Chek, Inc., n.d.). Radon is considered a major contaminant to indoor air quality globally. It can be determined to be a problem in a particular environment by using low-cost radon test kits (EPA, 2010). Combustion Sources Combustion sources are indoor appliances that burn materials and produce gasses and particles that pollute the air, especially when the polluted air remains contained in an enclosed space such as a home or classroom. Seemingly innocuous indoor appliances that are used daily are sources of indoor pollutants, including stoves (gas or wood), water heaters, and clothes dryers. These appliances release carbon monoxide, which, when inhaled, interferes with the delivery of oxygen throughout the body, and nitrogen dioxide, which increases the risk of respiratory infection. Heavy Metals Another category of indoor air pollutants is heavy metals. The most common heavy metal pollutants are airborne lead and mercury vapor. Lead poisoning through ingestion has been publicized and described in chapter 1 of this book. Lead can harm virtually every bodily system, and it is widely known for its impact on young children in causing developmental delays. The Centers for Disease Control and Prevention (CDC) report that 225,000 children aged birth to 5 years have blood lead levels that exceed 10 micrograms of lead per deciliter of blood, the threshold at which the CDC recommends public health intervention (CDC, 2009a). The CDC provides data (found at http://www.cdc.gov/nceh/lead/ data/StateConfirmedByYear_1997_2009.pdf.) on the number of American children who have been tested and who tested positive for elevated blood lead levels. For example, in Indoor Air Pollutants Chapter 8 2009, approximately 3,750,000 children (birth to 72 months old) were tested, and less than 1% were confirmed to have elevated blood lead levels. These data show both the increase in children being screened and the reduction in elevated blood lead levels between 1997 and 2009. Even though lead-based paints have been restricted for decades, older buildings and furniture that are stripped or are flaking can give out lead dust and fumes that are airborne. Lead is also found in arts and craft materials such as soldering, stained glass, and glazes. New paint is a less-known source of another indoor air pollutant, mercury vapor. Mercury is found in water-based interior latex paint. In addition, early care and education staff should be aware that the sprinkling of mercury around the home is practiced by some ethnic and religious group and mercury is sold by some herbal medicine and botanical shops (Agocs et al., 1990). ▲ Lead is a toxic heavy metal that has been shown to cause developmental delays in young children. Older buildings or furniture with peeling or flaking lead paint can give off fumes and pose serious health risks. © iStockphoto/Thinkstock Secondhand Smoke Secondhand smoke is smoke that is released into the air from the burning end of a cigarette, pipe, or cigar, and from the exhalation of a person who is smoking. Secondhand smoke contains over 4,000 harmful substances that have been linked to lung cancer, heart disease, asthma, lower respiratory tract infections (such as bronchitis or pneumonia), and ear infections. Young children are especially vulnerable to the harmful effects of breathing secondhand smoke because they are not fully developed physically and they breathe more times per minute than adults. The EPA has numerous resources about the health risks of secondhand smoke and children available at http://www.epa.gov/smokefree/healtheffects. html (EPA, 2011a). Although an estimated 90% of children who are exposed to secondhand smoke are exposed in their homes, child care centers should do their part to encourage safe and healthy environments for the children for whom they care. Centers should forbid employees, parents, or anyone else Infants and toddlers are very vulner from smoking on the premises. Additionally, cenable to the health risks caused by ter staff can provide parents and guardians who breathing secondhand smoke. It is smoke information on the health risks for children not enough for caregivers who exposed to secondhand smoke. However, center staff will have to be tactful when raising this issue smoke to open a window or move with individuals who smoke. Individuals may resent to another room. Adults should the implication that they are putting their child at never smoke indoors or in vehicles. risk by smoking, or perhaps they have tried unsuccessfully to quit smoking in the past or are currently struggling with addiction to smoking. Working with Head Start, the EPA has created several resources for child care staff, parents and guardians, and teachers regarding secondhand smoke. These can be found at http://www.epa.gov/iaq/headstart/index.html. Indoor Air Pollutants Chapter 8 Thirdhand smoke, a relatively new area of study, comes from nicotine residue left by smoking that accumulates over time on surfaces such as carpets, clothing, furniture, bedding, or car seats. This residue is difficult to clean and can remain on a surface long after smoking has taken place. Thirdhand smoke may be harmful to children and adults who touch surfaces covered in nicotine residue. Because the residue remains in the environment for a long time, the only way to fully protect against exposure is to create a smoke-free environment (Mayo Clinic, 2012). ▲ Caregivers should never smoke inside a room or car when a child is present. © iStockphoto/Thinkstock Improving Indoor Air Quality To prevent the spread of disease and to maintain a healthy and safe early childhood environment, child care centers should conduct routine cleaning and maintenance. Every room should be aired out, and surfaces such as activity tables, countertops, and doorknobs should be cleaned and sanitized daily, with particular attention given to the cleanliness of bathrooms and kitchens, as they are frequently used spaces and are exposed to many germs and bacteria (Aronson & Spahr, 2002). Source Control The most effective protection from indoor air pollutants is source control. This means the sources of pollution are eliminated or adjusted to decrease the amount of pollutants that are released. For example, lead paint is removed, standing water is eliminated, and radon is vented up and away from the center. Improved Ventilation Improved ventilation is the process of increasing the amount of outdoor air coming indoors. This can be done simply by opening windows and doors or by using exhaust fans. Good ventilation and outdoor air exchange have been proven to improve indoor air quality. On the other hand, the ventilation system can be a source of irritants if it is poorly designed, maintained, or operated. For example, filters must be changed or cleaned regularly or they will not filter irritants properly. H I G H L I G H T: Improving Indoor Air Quality According to the EPA (2011a), there are three basic strategies for improving indoor air quality: • Source control • Improved ventilation • Air cleaners Water Pollution Chapter 8 Air Cleaners Air cleaners have mixed effectiveness in removing indoor pollutants. Some can remove particles but few remove gasses. The effectiveness is dependent on how much air is pulled through the filtering element of the air cleaner. An air cleaner can be a small device that can sit on top of a table or it can be a whole-house system. They are not recommended for use to reduce levels of radon. The use of plants as a natural air cleaner is not well established, even though they do remove carbon dioxide from the air. Plants can actually present problems by becoming sources of indoor mold if they are watered too much. H E A LT H I N A C T I O N : Fundamental Ways to Protect the Early Childhood Environment from Indoor Pollutants • Do not allow smoking inside or near the premises. • Dust and clean the surfaces often. • Clean up mold. • Fix water leaks. • Seal up cracks and other openings in walls and on floors. • Do not leave food or uncovered trash out. • Test the environment with a radon kit. • Follow directions on common cleaning products. • Open windows and use fans. • Never smoke indoors or in a vehicle when children are present. • Know the local threats to the water supply and have drinking water tested annually. 8.3 Water Pollution Child care centers must consider the quality of the water children consume and any hazards that could be present in water in which children play or wash. Water that is provided by a public agency has to pass certain quality standards and is likely tested regularly for hazards to public health. The EPA has set national standards for over 90 contaminants of drinking water. However, water that comes from private wells is typically only regulated by the state at a minimum and the well owner bears the responsibility to ensure the water is safe. This is an important issue in rural areas that depend on well water (EPA, 2011c). The AAP and The National Institute of Environmental Health Sciences recommend well water be tested annually, if there is any reason to think the structure of the well has been Outdoor Air Pollutants ▲ Children are especially vulnerable to pollutants in water such as nitrates and lead. © iStockphoto/Thinkstock Chapter 8 compromised, or when a new child is brought into a home or child care center. Children are especially vulnerable to some pollutants that are found in well water, such as nitrates. Nitrates can enter a water supply through sewage or fertilizer, which is the most common contaminant of wells. Infants under 1 year of age should not drink water that may contain nitrates, so if the water quality is unknown or questionable, infant formula should be mixed with bottled water. A child care center should contact the local health department to learn what pollutants and potentially harmful substances are present in the local water supply (National Institute of Environmental Health Sciences–National Institutes of Health, 2009). Lead is another potential water contaminant that can be very harmful to children. In 1991 The Lead and Copper Rule was established to regulate the presence and treatment of lead in public water supplies, however, the EPA recommends that facilities serving children have their water tested for lead. This is because these water supplies are often regulated by local or state agencies that may not test for lead. The EPA has created a quick reference guide for schools and child care centers on the Lead and Copper Rule, which is available at http:// water.epa.gov/infrastructure/drinkingwater/schools/upload/2006_1_11_schools_lead_qrg_ lcr_schools.pdf. 8.4 Outdoor Air Pollutants Young children are very susceptible to outdoor pollutants because they are short and breathe closer to the ground, they have increased air intake, their lungs and other organs are still growing, and their immunities are not developed fully. The most common outdoor pollutants that affect children come from industry, cars, and fires. Specifically, these release nitrogen oxides, carbon monoxide, and sulfur dioxide, all being extremely dangerous when inhaled frequently (WHO, n.d.b). In addition to these common outdoor pollutants, children are exposed to biological outdoor air pollutants such as molds and pollen. Children who are sensitive to these biological pollutants should avoid outside play on high mold and pollen days. The Air Quality Index is a mechanism for reporting daily how clean or polluted the air is. According to the AAP (2004), ambient (outdoor) air pollution is associated with respiratory symptoms, asthma hospitalizations, infant mortality, and poor lung growth. Nitrogen Oxides Nitrogen oxides are a group of very reactive gasses known as “NOx.” This group includes nitrogen dioxide, nitrous acid, and nitric acid. Nitrogen dioxide or NO2 is the most well-known pollutant in this group. It is a product of automobile emissions, power plants, and large equipment. Nitrogen dioxide contributes to ozone formation at the ground level and fine particle pollution in the air, and has been linked to several harmful effects on the respiratory system. Short-term exposure (30 minutes to one day) to NO2 can cause air passage inflammation in any individual, but is especially problematic for people with asthma. Exposure to nitrogen dioxide has been linked to increased use of the emergency room and hospital stays for respiratory Outdoor Air Pollutants Chapter 8 problems. NO2 concentrations are 30–100% higher within 50 meters of roads. Therefore, playgrounds and other spaces where children play outdoors should be located more than this distance from a roadway or area with heavy traffic. In the United States, approximately 16% of households, or about 48 million people, are located within 300 feet of a major highway, railroad, or airport. Exposure to NO2 is especially dangerous for children, the elderly, and those with respiratory problems such as asthma (EPA, 2012b). Carbon Monoxide ▲ The most common outdoor pollutants that impact children come from industry, cars, and fires. Carbon monoxide is a toxic gas that is difficult to © Hemera/Thinkstock be aware of because it is colorless, odorless, and impossible to see. Moderate exposure to carbon monoxide can cause flu-like symptoms such as disorientation, headaches, nausea, and fatigue. Symptom severity varies among people depending on age, health, and length and concentration of exposure. Carbon monoxide can be an outdoor or indoor hazard, but is most often harmful when it builds up indoors and is breathed over time. Carbon monoxide comes from kerosene heaters, leaking chimneys or furnaces, wood stoves, generators or other gasoline-powered equipment, and automobile exhaust. The Consumer Product Safety Commission recommends that every home (or homebased child care center) have carbon monoxide alarms on each level and an annual professional inspection of all fuel-burning appliances (EPA, 2012a). Sulfur Dioxide Sulfur dioxide is a highly reactive gas that is produced from fossil fuel combustion at power plants and industrial facilities, industrial processes such as extracting metal from ore, and burning of fuels that contain sulfur, such as those used by trains, large ships, and large offroad equipment. Short-term exposures (several minutes to 1 day) to sulfur dioxide have been linked to respiratory problems such as constriction of the breathing passages and asthma symptoms. The effects are seen particularly when individuals have increased breathing rates, such as children at play. Sulfur dioxide can react with other airborne compounds to form tiny particles that penetrate deep into the lungs and complicate existing breathing problems (EPA, 2012c). Urban and industrial communities are at elevated risk for health problems due to sulfur dioxide exposure. Early childhood centers in these communities should be mindful of the air quality and the risk posed to young children when playing outdoors, as well as the risk of poor air entering the classroom through open windows. Unfortunately, there is a tradeoff between the importance of outdoor play for a young child, and increasing the child’s exposure to air pollution. Early childhood professionals should be aware of the air quality issues in their local area and make informed decisions about how to provide outdoor time to young children while protecting their health. Biological Threats Some biological agents can cause poor health, especially if a person is sensitive to the agent due to an allergy, or if a person is exposed to a large quality of the agent. A biological threat Outdoor Air Pollutants Chapter 8 is a biological agent—a bacterium, virus, prion, or fungus—that can cause poor health or be used purposefully as a biological weapon in bioterrorism or biological warfare. Biological agents have the ability to adversely affect human health in a variety of ways, ranging from relatively mild allergic reactions to serious medical conditions, including death. Many of these organisms are ubiquitous in the natural environment where they are found in water, soil, plants, or animals. Biological threats include allergens such as mold and pollen. Mold can be found indoors or outdoors but pollen is more commonly airborne outdoors. Mold Mold is a fungus that is a health hazard in any damp place, including indoors. Minimizing moisture in the environment is important to preventing the growth of mold because mold does not grow well in clean, dry environments (Florida Department of Health, n.d.). People experience irritations or allergic reactions to mold ranging from mild to severe. Individuals who are very sensitive to mold can experience respiratory problems such as stuffy nose, wheezing, coughing, or eye and skin irritations. Severe reactions to mold may cause difficulty breathing or fever. Mold can also trigger asthma attacks in asthmatics. For individuals with chronic lung conditions, such as obstructive lung disease, it is even possible to develop mold infections inside the lungs (CDC, 2009b). The toxicity of some mold exposures is a source of debate, but some research has shown a connection to long-term health effects (Florida Department of Health, n.d.). For instance, the Institute of Medicine has linked indoor exposure to mold with upper respiratory tract problems and asthma symptoms. The WHO has published articles on these effects (WHO, 2009). With mold, prevention is the key. Water is the key to mold growth, so centers should be kept dry and clean. Keep humidity levels below 60% by using a dehumidifier or air conditioner. Rooms used for showering and cooking should be vented to the outdoors. Naturally damp spaces such as basements and bathrooms should not contain carpeting that can accumulate moisture and standing water should always be cleaned up as soon as possible but certainly within 24 hours (Florida Department of Health, n.d.). If a center or classroom has mold, it can be removed using soapy water while wearing gloves and goggles. Allow the area to dry completely. Discard the sponge or cloth used to clean up. If the mold reappears in the same location, check for a water leak. The EPA has published a guide on “Mold Remediation in Schools and Commercial Buildings,” available at http://www.epa.gov/mold/ mold_remediation.html. This is merely a guide to Symptoms of sensitivity to mold  regular cleaning practices. Centers should sanitize include difficulty breathing, fever, more frequently if there is an outbreak of illness respiratory problems such as stuffy at the center, a contamination has been reported, nose, wheezing, coughing, or eye bodily fluids are visible in the environment, or a health official has recommended disease control and skin irritations. measures (Aronson & Shope, 2009). Pollen Pollen is one type of biological threat that can adversely impact a child’s health, and must be taken into consideration while the child is in the early care and education setting. Pollen, or a fine, powdery substance that is released into the air from plants, causes allergic reactions in many children. An allergic reaction occurs when the body’s immune system overreacts to a Play Spaces and Environments Chapter 8 H I G H L I G H T: Signs and Symptoms of Allergic Reactions Mild Symptoms: Severe Reactions: • Itchy or watery eyes • Swollen tongue or mouth • Sneezing or stuffy nose • Difficulty swallowing or speaking • Itchy skin, hives, or other skin irritation • Difficulty breathing • Slight swelling • Dizziness or fainting (KidsHealth.org, 2012) • Abdominal pain, diarrhea, or vomiting substance that is typically harmless to most individuals. When a person has an allergy to pollen, for example, the body reacts to the pollen as if it is a threat. The body produces antibodies and releases chemicals, including histamine, into the blood to protect the body against the pollen. The common signs of an allergic reaction, such as watery eyes, runny nose, sneezing, and more, are the products of those chemicals the body creates in defense. A person will have the same allergic reactions to substances if the person is exposed again; however, some medications help to prevent allergic reactions. In the early education setting, staff must ask parents and guardians about each child’s allergies to limit the likelihood of exposing the child to something harmful, such as exposure to pollen while engaging in outdoor play. The best way to prevent an allergic reaction is to avoid the trigger. Mold, pollen, dust mites, and animals are all common sources of airborne allergens that may be present in an early education environment (KidsHealth.org, n.d.a). 8.5 Play Spaces and Environments Caregivers should become familiar with the Caring for Our Children: National Health and Safety Performance Standards published jointly by the APHA and the AAP. These standards are the result of a five-year national project funded by the U.S. government to produce a set of health and safety standards as guidelines for out-of-home child care programs around the country. The following sections in this chapter on indoor and outdoor play environments rely heavily on information provided in the third edition of this report, which is available at http:// nrckids.org/CFOC3/ (AAP, APHA, & NRC, 2011). H I G H L I G H T: What Are Learning Centers? Learning centers are areas of an early childhood environment designed with opportunities for children to explore different kinds of activities such as a “reading center,” a “natural science center,” a “kitchen center,” and others. Play Spaces and Environments Chapter 8 Indoor Play Spaces To be effective, an early childhood physical environment must be designed with learning objectives in mind. It must be developmentally appropriate for the age group that will be using it and varied in materials, toys, furnishings, space, and creative opportunities to keep the children interested. Dividing an environment into sections or learning centers is the most frequently used method to accomplish this, however, the centers should not be viewed as static but rather should be changed during the year, matched to the children’s interests and skill level as the children evolve and mature. ▲ Creating learning centers allows children to engage in different kinds of small group or individual activities. © Sean Justice/Getty Images To comply with safety and learning objectives, learning centers should be divided by low shelves or anchored dividers. Centers can be grouped by noise level so that quiet rest or reading areas are farther away from the gross motor activity center than the messy sensory materials area is. Each section should be labeled at eye level and with identifying symbols for nonreaders if necessary. In general, each learning center should be relatively small to limit too many children crowding in but big enough to encourage interaction between at least two children. To encourage independence, space for children should have shelves and materials at a level reachable by the children when this is age appropriate. This will also encourage creativity. How many “activity centers” are enough? There is no definitive answer to this, but according to Swim (n.d.), the basic formula to follow is to multiply the number of children to be using the space at one time by 1/3 (20 children times 1/3 equals 6–7 centers). Location of these centers is also important. Walking through one center to get to another center is distracting to the children walking through and to those using the center being walked through. Making pathways outside of the centers is more effective. In addition to learning centers, a healthy and safe early childhood environment should accommodate the basic daily needs of the children, such as napping, eating, and toileting. These sections are best kept separate so that each need can be accomplished effectively. It is also recommended that a separate space be designated to care for children who are ill or have an injury. This area can be within another room but should be separated from the other children and supervised. Early learning environments also need areas that provide space for arrivals and departures without interrupting the care or play of children in the setting. Therefore, individual lockers or dressing space should be near the entrance. It should also be large enough for parents and children to move about if they arrive or depart at the same time. Other space may include office or private meeting space. Again, this should be away from the pathways of children playing. Activities unrelated to the work of the early childhood environment should not be conducted in these areas while the program is in session and children are present. Finally, all early learning facilities need storage space. This space should be inaccessible to children and should be kept clean, neat, and orderly to minimize time spent searching for supplies. Play Spaces and Environments Chapter 8 Noise Levels Young children should spend their time in indoor environments that are calming and motivate learning. High noise levels are not conducive to learning. Children must be able to hear others and be heard by others. This should all take place in a normal conversational tone without shouting to be heard. Loud sounds, whether sudden or constant, can damage hearing and even produce a physiological effect like elevated blood pressure. A high level of ambient noise can interfere with hearing enough that a child’s language development is at risk (Maxwell & Evans, n.d.). ▲ A healthy and safe childhood environment should accommodate daily needs of young children such as napping, eating, and toileting. Methods that will reduce indoor noise levels include using partitions, acoustical tile ceilings, and soft sur- © Ingram Publishing/Thinkstock faces on walls (i.e., cork boards), on floors (i.e., rugs), and on windows (i.e., draperies or curtains) (AAP, APHA, & NRC, 2011). Carpets are good noise absorbers but they also are breeding grounds for microorganisms, so washable area rugs with nonslip undersides are recommended. Lighting Appropriate levels of illumination are needed for safety and comfort. Too much glare or too little light is believed to be associated with symptoms of illnesses, such as headaches. Rest areas and other quiet areas can have less lighting than work and play areas. It is extremely important to provide well-lit areas used for entrances or stairways. Natural lighting should be used as often as possible and is best provided by windows at the children’s eye level. If artificial lighting is used, dimmers may be more efficient so that if a learning center is changed from one activity to another one in the future, lights can be adjusted (i.e., riding toy area changed to nap area). Space Requirements There are very specific recommendations regarding space requirements in indoor areas designated for early childhood activities. However, complicating the matter are recent research findings. Research studies have found that crowding of children in early childhood facilities is associated with increased air pollutants, difficult child behavior (Aronson, & Spahr, 2002), and injuries. Studies have also found that the quality of physical space in these programs is related to children’s development in several domains such as the cognitive, language, and emotional areas. What has been agreed upon by the experts is that between 42 and 54 square feet per child of usable floor space is needed. However, certain areas cannot be used in the tally of footage. These areas include space used for administrators, bathrooms, kitchen areas, and areas used to walk around learning centers. Staff–child ratios are another consideration in this calculation because the more adults there are in an area, the less usable space there is. Other considerations include furniture: infant cribs, storage units, bookcases, and other needed furniture take up space that cannot be part of the per-child calculation. Play Spaces and Environments Chapter 8 Although experts recommend a minimum of 42 feet per child indoors, each state has its own regulations specifying minimum space requirements. It is important for early care and education program directors to read the licensing requirements of the state in which they work and recommendations provided by the national performance standards. These standards address other safety issues such as providing exits and labeling them, the location of posts and handrails, placement of landings on stairways, emergency shelters, and other important safety details. Check your state’s licensing ­regulations for minimum space requirements. Supplies and Toy Selection The purpose of toys is to help a child have fun and learn. To fulfill this purpose the toys with which children play should be developmentally appropriate for their ages, interests, and abilities. The challenge of finding the best toys is that they should meet children at a level of comfort but take them up a notch so they are intrigued. Toys should also match the learning objectives of the learning centers within the program. Quiet rest areas could have soft toys and soothing musical players, reading centers could have a variety of books that can be paged independently by the children or read by an adult to the children. Learning centers that facilitate adaptive daily life skills could have lacing toys, household items such as brushes and combs, baby dolls to dress, and play cooking units. Imagination, art, or other creative learning centers could have a variety of materials depending on the skills and ages of the children. These can include crayons, easels and paints, clay, and child scissors. When selecting toys, the caregiver should consider the child’s temperament, interests, and maturity. However, do not assume a child can play safely with toys meant for older children. The Consumer Protection Safety Commission (CPSC), a federal agency that monitors the safety of consumer products, labels toys according to age-specific safety factors, not the intelligence of the child (KidsHealth.org, n.d.b). For example, choking is possible at any age but young children, regardless of intelligence, often put toys in their mouths for exploration, thereby increasing the risk of choking. Therefore, toys with small parts are dangerous to even the smartest of babies. ▲ Choking is possible at any age, but young children often put toys in their mouths for exploration, thereby increasing the risk of choking. © iStockphoto/Thinkstock Toys for children less than 3 years old should meet the federal small parts standards for toys. In addition to restricting toys with small or removable parts, these standards are very specific in restricting toys with sharp points or edges, balloons, coins, and foam and Styrofoam objects. These are all considered choking hazards either due to size or the type of material from which the toy is made. For children using cribs in early learning settings, the national standards prohibit any toys or items hung from the ceiling over the crib or attached to the crib. This includes toys in the crib such as stuffed animals that can cause suffocation. The Caring for Our Children: National Health and Safety Performance Standards (AAP, APHA, & NRC, 2011) recommend the following readings for play materials for young children: “Which Toy for Which Child: A Consumer’s Guide for Play Spaces and Environments Chapter 8 Selecting Suitable Toys” from the CPSC and “The Right Stuff for Children Birth to 8: Selecting Play Materials to Support Development” from the National Association for the Education of Young Children (NAEYC). Furniture Selection Furniture selected for early childhood environments must be sturdy, in good repair, and meet recommendations of the CPSC. These recommendations address many safety hazards of furnishings and equipment, including the size of openings, spacing between equipment, loose, small, and rusty parts, nails and other sharp objects, flaking paint, and many other potential problems. Staff should also check monthly for recalls of products they may have in the setting (AAP, APHA, & NRC, 2011). The size of furniture is also very important. Furniture that is mismatched in size with its users or not adapted to be used by children can tip, pinch skin, ▲ Appropriately sized furniture facilitates a child's or even crush parts of a child. To check the match development of fine motor and adaptive skills of furniture to a child, observe whether the child’s because the child can use materials independently. feet are firmly on the ground and whether tables © Hemera/Thinkstock are a height between the average child’s waist and mid-chest (for the age group served) (AAP, APHA, & NRC, 2011). For instance, tables no higher than 20 inches and shelves no higher than 24–30 inches are recommended for preschool and kindergarten classrooms (Diller, 2008). Appropriate-sized furnishings facilitate fine motor and adaptive skills development because children can easily reach and use materials independently. Because it is important to maintain a sanitized environment in early care and education environments, the surfaces of furniture and other furnishings used should not be organic or porous. Rather, they should be smooth and washable or disposable. Furnishings that can trap dirt and other microorganism carriers, such as large carpets, should not be used in play areas, bathrooms, diaper changing areas, or where food is prepared. H I G H L I G H T: Features of Quality Furniture Selection and Placement in Early Childhood Settings • Sturdy and in good repair • Size matched with users • Nonorganic or porous surfaces • Safe placement in room • Placement in room that matches goals of learning centers Play Spaces and Environments Chapter 8 In addition to the size and surfaces of furniture, furnishings, and equipment, placement of furniture is important to designing and maintaining a safe and healthy environment. Furniture and equipment should be placed in a way that makes the setting inviting, promotes movement by children, and prevents injuries. Placement should also match the goals of the area. If the space is to be used for large motor activities such as running or riding, then placement of furniture should be around the perimeter to allow for as large a space as possible in the middle to avoid collisions. Furniture should also be arranged in such a way that staff can see the children at all times and monitor their activities. Furniture should not be arranged so that children can climb on it and cause injury to themselves or others. This can occur if furniture is near windows that children can climb out of or near heavy or large units (i.e., TVs, storage cabinets, tall bookcases) that children can tip or pull down on themselves. Furniture typically used for young children also has specific safety specifications. For instance, high chairs are required to have wide bases, securely locking trays, safety straps, and a crotch guard. Placement of this piece of furniture is also a safety issue. If placed too close to a table, counter, or other surface while in use, the child can reach with feet or hands and push off and topple the chair, or reach potentially dangerous items. Children’s time should be limited when using any furniture or equipment that restricts movement. Safety specifications for children’s furniture can be found through the Consumer Product and Safety Commission at http://www. cpsc.gov/cpscpub/pubs/chld_frn.html. Cribs are very important pieces of furniture in many early childhood environments, and safety standards must be followed explicitly. Beginning December 28, 2012, child care providers will be required to have cribs that meet new federal safety standards. These standards went into effect for manufacturers in July 2011 and address potentially fatal hazards in older cribs that are caused by drop-side railings, hardware malfunctions, and a lower standard of testing for crib safety. See http://www.cpsc.gov/cpscpub/pubs/5023.pdf for more information on replacing cribs in child care centers. Crib safety standards and updated information on crib recalls can be found from The Consumer Product Safety Commission at http://www.cpsc.gov/info/ cribs/index.html. H I G H L I G H T: Crib Safety Tips • Do not use pillows or thick blankets inside a crib. • Ensure the gaps in crib sides and mattresses are smaller than two fingers wide. • Follow the manufacturers’ instructions for crib assembly and make sure that every part is installed correctly. • Do not use cribs older than 10 years or broken cribs. • Do not position a crib near window blinds or curtains with cords or strings, on which a baby can strangle. (U.S. Consumer Product Safety Commission, Crib Information Center [n.d.]) Play Spaces and Environments Chapter 8 H E A LT H I N A C T I O N : Setting Up the Environment Those eight considerations for quality infant and toddler environments are adapted from PITC’s Infant/Toddler Caregiving: A guide to setting up environments (www.pitc.org). 1. Safety: An environment where a child can move about freely and interact with other children is important to the safety and social development of young children. Some characteristics of a safe environment include the following: • developmentally appropriate equipment made of nontoxic materials • nonslip floors • stable shelves and furniture with rounded corners • low (24”) steps for toddlers to use for reaching 2. Health: Environments that promote good health need separate eating, diapering, and toileting areas; must be clean and have easy to clean surfaces; have adequate plumbing to wash hands regularly; must have good heating and cooling systems along with good lighting, acoustics, and proper ventilation. Smell is important to a quality environment for children so it must have an efficient air exchange system with screened windows that can be opened. 3. Comfort: Calm, stress-free environments with little to no clutter are relaxing to young children. Soft, natural colors for walls and furnishings, as well as natural lighting, fresh air, acoustical tiles and rugs, and soft cushions and pillows, contribute to a comfortable environment. 4. Convenience: Environments that foster easy-to-access materials that are easy to see and find and have storage and shelves that are adequate in size and space are important to an efficiently managed child care setting. Also, feeding, washing, and toileting areas should be clean, bright, and easy to locate. Cheerful and welcoming entrances and parent areas make the environment predictable for young children. 5. Child-size space: Environments designed to fit the children so they can climb and explore should include small, low tables and chairs and 24”–30” shelves so they can see and reach. 6. Flexibility: Flexible learning environments have easy-to-move, lightweight furniture, adjustable equipment, and a variety of toys and materials. In addition, to make areas efficient and flexible, activity areas should be grouped so that similar activities are together (e.g., messy activities versus quiet activities). All centers need an open area so children can see what is available and where to find the caregiver. This allows the child to be more independent. 7. Movement: Good early childhood environments must include areas that encourage movement so children can learn through sensory exploration. This may include open pathways for crawling, low steps to climb, surfaces with textures, tunnels, slides, balance beams, easy but safe access to outdoors, and multiple levels so crawlers and walkers can get around and see. 8. Choice: An environment that allows children to make choices has areas with a variety of activities and equipment. Also it is important to have private areas, quiet play areas, and rest and sleeping areas because young children should be able to rest or sleep when tired. Play Spaces and Environments Chapter 8 Outdoor Play Spaces Children need outdoor play spaces because of the opportunities these spaces provide for them to use their larger muscles in ways that are not possible indoors. In these spaces children can practice the freedom of movement that is important in developing those muscles. Outdoor play also offers fresh air and exercise. Therefore, the National Health and Safety Performance Standards recommend that every child care center and small or large family child care home have an outdoor play area that is no farther than an eighth of a mile from the indoor setting or, even better, adjoining it. In addition to where the play space is located, the amount of outdoor play space is important. There should be a minimum of 75 feet for each child using the play space at one time, less for infants and toddlers (AAP, APHA, & NRC, 2011). The amount of space is important because according to Ruth (2008), as cited in Caring for Our Children, the more space, the fewer number of injuries occur with gross motor toys such as riding toys, slides, swings, balls, and others. If enough nearby outdoor space is either unavailable due to bad weather, inner-city restrictions, or just not accessible, a large indoor activity room that meets these requirements can be used if it is well ventilated and there are shock-absorbing surfaces. The same requirements exist for rooftops and elevated areas such as ramps and platforms that are used as play areas, but these need fencing or effective railings in accordance with local ordinances to prevent children from climbing or falling off the surface. Fencing is also needed to surround outdoor play areas that do not have natural barriers. There are safety standards for the construction of fences and entry gates that are essential. These include the size of openings, type of latches, height of the fence and size of chain linking in the fence, and type of wood, if wood is used. Effective fences prevent entrapment and discourage climbing. The posts must be on the external side of the area so children do not run into them. Wooden fences and other structures made of wood must be sealed every year if chromatid copper arsenate (CCA) is contained in the wood. CCA is made up of arsenic, a known carcinogen. ▲ Outdoor equipment should be age-appropriate, well anchored to the ground, and inspected regularly for loose parts, sharp edges, and other possible sources of injury. © Hemera/Thinkstock For safety reasons, all outdoor and large indoor play spaces should be separated according to the age of the children using them. Signs that clearly label each area by age should be used to prevent confusion (KidsHealth.org, n.d.b). Play areas should be supervised at all times and all areas of the playground should be visible to the staff. If the area is relatively large, cell phones should be considered for communication among staff. Outdoor Equipment Each state sets safety standards for playgrounds and equipment. The full listing of state regulations is available from the National Program for Playground Safety at http://www. playgroundsafety.org/standards/regulations. Outdoor equipment should be appropriate for the children using it. As in indoor toy selection, outdoor equipment should be based on the Play Spaces and Environments Chapter 8 developmental abilities, interests, and other needs of the children who will be using it. This includes matching the size of the outdoor equipment to the children using it to promote safety and reduce frustration. The way to do this is to be sure the equipment is appropriate for the youngest child using it. In addition to size, quantity of equipment and materials plays into outdoor play safety. There should be enough equipment and materials so there is no unnecessary competition and so that waiting is avoided (AAP, APHA, & NRC, 2011). Other requirements of play equipment safety include installation, maintenance, and monitoring. The CPSC standards and the manufacturers’ guidelines must be followed for construction and anchoring of all play equipment. This will help safeguard toys and equipment so that they do not tip, capsize, or otherwise cause injury to anyone. Outdoor equipment must be monitored for any loose parts such as bolts and screws, and checked for protruding parts and sharp edges. Once again, placement and arrangement of play equipment, whether mobile or fixed, is an important safety practice. The use of zones is a standard practice in early learning settings. Zones are the amount of clearance from structures that are not part of the activity and use zones are the distance needed to safely clear equipment while in use, such as swings. Play equipment should be arranged so that children can run between all pieces, and moving play equipment such as swings should be placed at the edge or corner of the play area. Surfaces of all play areas should be shock-absorbing to lessen the likelihood of severe injury during falls. Sandboxes, Water Tables, and Sensory Materials Sand boxes, water tables, and other sensory stations contain organic materials and are often polluted by undesirable germs and toxins. To minimize this kind of contamination, sand boxes should contain only sand labeled for play, be kept covered when not in use, replaced often, and kept free from animal excrement. Water tables should have fresh water with every new group of children and the water should never be placed in a dirty basin. Sensory materials should not be used by children less than 18 months old. Once again, no small round objects should be allowed for children less than 3 years old because they are potential choking hazards. For all of these activities, good hand washing should be encouraged before and after use, children should be supervised at all times, materials should be kept sanitized between uses, and children with obvious infections or cuts and sores should be discouraged from using the materials or given their own individual materials. Early childhood sensory materials are often made from food products, clay, and other porous materials. In all cases, they should be dated and stored in airtight packages, and made fresh at least once per week. Children and staff need to wash hands before and after using such materials. Staff should always sanitize the surfaces they put them on. Materials used by a child who has cuts, rashes, open sores, or obvious infection signs such as coughing, sneezing, or runny nose must be discarded or sealed separately from materials of other children. ▲ Outdoor toys and equipment should be appropriate for the development abilities, interests, and safety requirements of the children who will use it. © iStockphoto/Thinkstock Safety and Security Chapter 8 Outdoor Toy Selection Outdoor toy selection follows the same basic guidelines as indoor toy selection. Toys and equipment should match the interests and skill levels of the users. Riding toys for each skill level (e.g., tricycles, scooters, and bikes) should be capable of being steered, be the appropriate size for the user, in good condition, nonmotorized, have a low center of gravity, and not have any spokes. All riders should wear properly fitting helmets, and knee and elbow pads. Balls, hoops, jump ropes, and other gross motor toys should be available in enough quantity to avoid crowding and long waits for a turn. These outdoor toys should be in good condition and provide variety. To avoid careless behavior and injury all children should be within sight of caregivers and under constant supervision. For safety reasons, trampolines should be prohibited in early care environments. Although a popular toy among children, they are listed by the American Academy of Orthopedic Surgeons as the third leading cause of sport-related injuries among children. The most common injuries from trampolines are broken bones, concussions, neck injuries, sprains, and bruises or cuts. There were almost 100,000 trampoline related injuries treated in emergency rooms in 2011. Most of these injuries occurred on home trampolines and among children 5 through 14 years old. A child care center or school should avoid the potential for injury by not providing a trampoline to children. If one is available, children using it should be monitored by an adult at all times (Childcare.net, 2012). 8.6 Safety and Security Safety issues for young children cared for in early childhood settings are varied and extensive and change only partly with age. For instance, an infant or young toddler should be kept from objects and situations that could cause choking, falls, strangulation, drowning, and burns. Generally the caregiver has control of what toys and items the child has access to in the crib, high chair, or playpen. But as they get a little older and can get around, the previous hazards still remain and even more come into play because the child can explore independently and find hidden hazards that were not obvious before. Children who are mobile can pull down heavy objects onto themselves, get tangled in wires, and experiment with poisons, even common household objects that can be poisonous. They often continue to put things in their mouths at this age. ▲ Safety in early childhood settings includes appropriate furniture such as high chairs with safety straps and sturdy bases. © Exactostock/SuperStock Playground and water safety are added areas of needed precautions for the mobile child. Providing children with simple and understandable rules and guidelines make caregivers’ jobs easier, but constant vigilance is still necessary. Children at this age are both pedestrians and automobile passengers strapped into appropriate car seats. Therefore, practicing rules of pedestrian behaviors can be fun for the children and helpful to caregivers. Preschool-aged and older children may also become hearty outdoor enthusiasts, playing harder in team sports or motor activities that take a lot of energy. This adds the concern of dehydration. Water should be provided before and after outdoor play. This stage of play Safety and Security Chapter 8 Additional Resources The state of Indiana has created a daily checklist of health and safety in child care settings, available at http://www.in.gov/fssa/files/HealthSafetyDailyChecklist.pdf. sea rch . . . also introduces new equipment and learning of new skills to go along with it. Remembering to use appropriate gear such as helmets and elbow and knee guards and wearing them correctly are important precautions to take. Poisons and Other Environmental Toxins Children under the age of 6 account for more than one million poisonings every year. The poisons that they are harmed by most often are cosmetics and personal care products, cleaning products, plants, and medications (Bronstein et al., 2008). However, in today’s world scientists are finding more and more toxicity in the environment that many are unaware of. Caregivers of young children are responsible for knowing these toxins and avoiding them completely or minimizing the possibility of contact with them. Some early care and education environments do not permit the use of cleaning products that are stronger than soap and water. Some use products that are considered safe enough for this environment, such as Simple Green. Toxic or poisonous substances that are needed on-site, such as some cleaning products, must be carefully stored. They should always be kept in the original container, labeled, and locked and out of reach of children. If used to clean surfaces children use, the surfaces must be thoroughly rinsed and dried (i.e., tables, toys, high chairs, changing tables). Each classroom or center will have a policy on appropriate cleaning agents and procedures. The following sections give insight into the most frequently found toxins that may be common in early care and education settings. Plastic Containers and Toys Some toxic chemicals are in plastics commonly used in children’s toys, eating utensils, clothing, and other daily use items. The most dangerous plastic is polyvinyl chloride, or PVC, also known as vinyl. PVC is found in many products, including toys, food containers and packaging, and building materials. Plastic food containers with PVC are especially harmful when heated because heat causes the chemical vapors to be released. Many household or classroom items containing PVC are not labeled, making it challenging for people to know the health risks or the extent of their exposure to PVC. More information on PVC can be found at http:// healthychild.org/blog/comments/pvc_the_most_toxic_plastic/. Many plastics are made of toxic chemicals and metals such as lead, cadmium, and phthalates. Although scientists have not fully studied the effects of these chemicals on children, there is enough evidence from animal studies to believe that they can ▲ Many plastic toys are made of toxic chemicals or metals such as lead, cadmium, and phthalates. Scientists have found evidence from animal studies that indicates these chemicals can cause a range of health problems in children. © iStockphoto/Thinkstock Safety and Security Chapter 8 cause a range of health problems from altering development to cancer (AAP, 2007). The only completely safe way to avoid the health effects of harmful plastics is to avoid contact with them. The suspected problem with these plastics is their release of poisonous chemicals contained in them into food or drink, especially when heated. Other items made from these plastics release toxic chemicals into the surroundings. That means even baby bottles, toys, plastic wrap, plastic raincoats, soap, and plastic food storage containers can release chemicals through ingestion, inhalation, and contact with the skin. As much as possible, caregivers in early care and education environments should not use plastics that contain PVC, commonly known as vinyl, Biphenyl A (BPA), or phthalates. They should substitute glass, paper, and stainless steel when possible. Plants Although plants have value to the aesthetics of early care settings and to the environmental education of the children, early care environments are prohibited from having plants anywhere accessible to children (AAP, APHA, & NRC, 2011). The reason is that plants are about the most common household substance eaten by young children and some plants are poisonous when ingested or touched. Knowing the toxicity of each plant is very difficult, so they are simply forbidden (AAP, 2011). Shoes Another source of toxicity is shoes in indoor infant and toddler play areas. Outdoor shoes can track in dirt from surrounding areas and that dirt may contain lead and other poisons. Even indoor shoes that are worn in toileting areas, other play areas for older children, or common areas such as lobbies and reception rooms are potential carriers of toxins and germs. Very young children who are allowed to explore on the floor of their play areas frequently put their hands in their mouths and consequently would ingest those poisons and microorganisms. Centers should institute policies that staff and visitors either wear shoes or slippers designated for indoors in infant areas only, or cover footwear with disposable shoe covers. ▲ Shoes are a common method of transmitting dirt, toxins, and germs. © iStockphoto/Thinkstock Security Good security measures at the child care facility are essential to keep children safe, put parents’ minds at ease, and maintain the credibility of the facility. Access to the center is one place where security is crucial. The entrance should be situated so that a staff person inside can see who is at the door, and the door should be constantly monitored. If more security is needed, doors can be equipped with motion sensors that sound upon entry or exit, or doors can be locked from the inside and a doorbell provided. All visitors should be required to sign in and out. Strangers should not be allowed into the facility without permission and a reason to enter. Additionally, the center should have a record of who is authorized to pick up each child, check the identification of anyone requesting to take a child out of the center, and Safety and Security Chapter 8 Additional Resources Each state sets safety standards for playgrounds and equipment. The full listing of state regulations is available from the National Program for Playground Safety at http://www.playgroundsafety.org/standards/regulations. sea rch . . . never allow an unauthorized person to take a child. Adults should be present in all areas of the center, including outdoor spaces (North Carolina Division of Child Development, 2011). It may also be necessary to monitor the grounds during the day or overnight with video cameras or security personnel. Finally, every center should develop a written plan for emergencies that instructs staff what to do to keep the children safe. Children should be taught about emergency situations and practice the appropriate response, such as evacuating during a fire drill. Injuries and Emergencies Staff of child care facilities should know common causes of hazards to children, how to prevent injuries, and be well trained in how to respond to emergencies so that they can react appropriately and quickly. One key to prevention is ensuring at least one staff person is present at all times who is trained in pediatric first aid. For example, if a child is choking, every second counts. To prevent choking, meals and snacks should consist of foods that are appropriate for the age of the child, and the size and shape of the food should not be conducive to becoming stuck in the throat. Children should always be monitored by adults when eating. Safety is the responsibility of every adult in the child care center. All adults, whether staff, parents, or volunteers, should model safe behavior and monitor the environment for safety hazards. For more detailed information on safety promotion, see the resources provided by the Child Safety Network at http://www.childrenssafetynetwork.org/pubs_topic. Unintentional Injury Risk Factor Recognition and Identification Injury is the leading cause of death and disability among children in all industrialized countries, so it is extremely important that child care centers anticipate and plan to prevent unintentional injuries. Most injuries in child care occur on playgrounds. Other common causes of injury for children are due to other children (i.e., pushing, hitting), furniture, toys, bicycles and sleds, and the physical environment (e.g., glass doors, gates, radiators) (Child Safety Network, n.d.). Transportation Transportation of young children is a common activity conducted by early childhood programs. According to Aronson & Spahr (2002), transportation-­related injuries are the leading cause of death for young children. So, in addition to safety checks on the vehicle ▲ Safety equipment such as helmets, kneepads, and appropriate car or bicycle seats will protect children when they participate in physical ­activities. © iStockphoto/Thinkstock Safety and Security Chapter 8 each time it is used, all child care safety rules should be followed. A very basic but extremely important practice in transportation safety is to have all children fastened correctly in a safety seat or seat belt depending on the laws of the state in which the facility is located. As in any part of the program, staff–child ratios must be observed and children should never be left alone. Drivers are responsible for safe driving and nothing else during trips. They should be prepared with maps or a Global Positioning System (GPS) and have reviewed the routes that will be taken. Drivers should not read maps or use cell phones while driving. They should not be considered part of the staff to child ratio. Every early care program should have written policies on transportation rules and regulations and on what to do in case of transportation emergencies, and all adult monitors, including volunteers, and other staff should receive training on transportation safety precautions. One such safety precaution for any transportation event is to have updated information on each of the children in the vehicle. This information must be easily accessible to accompanying staff and should include contact information for parents, special health information on the children, and telephone numbers for the local police, hospital, and ambulance service. At least one of the accompanying adults should have first aid training. A first aid kit should also be kept in the vehicle as well as drinkable water and a fire extinguisher. Early childhood facilities should have explicit policies and enforced rules on child dropoff and pickup. Written instructions and demonstrations for parents and staff are a good way to convey the procedures and the importance of following these procedures. Dropoff and pickup should occur only on the curb side of vehicles. This area should be supervised by an appropriate number of adults who can see that the children are clear of vehicles before the vehicles are in motion. Furthermore, traffic flow patterns should be modified during busiest dropoff and pickup times to provide the best clearance for children. The Healthy Child Care America program of the AAP at www.childcare@aap.org has details on how to maintain a safe transportation system. Evacuation Drills Every child care facility should have written plans for emergencies such as fires, severe weather, or chemical spills. All staff should be trained in safety procedures and policies. Centers may have several types of emergency plans that require different levels of response, ranging from evacuation to locking down the facility. Fire drills are a common safety precaution in child care centers and schools. Children should be taught to recognize the signs of a fire such as smoke, be instructed how to respond, and shown where to go. Centers should identify and create written plans for multiple escape routes that are accessible to children. Staff must also be prepared to assist young children, especially infants who must be carried. It is important to make children aware of the dangers of fire without frightening them. Fire drills should be conducted monthly and a log kept, such as the one found at http://health. utah.gov/licensing/forms/All/FireAndDisasterDrillLog4Family.pdf. If the center offers overnight care, practice drills must also be conducted during sleeping hours. Staff should bring necessary records for the children with them during drills and unplanned evacuations. This will help ensure all children are accounted for, families’ contact information is readily available, any necessary medical information is on hand, and the children are delivered safely back to the correct parent or guardian (South Carolina Child Care Services, 2011). Implications for Educators Chapter 8 H E A LT H I N A C T I O N : Supplies to Bring with You for an Evacuation • Contact information for children’s families • Tissues or wet wipes • Emergency medications and supplies • Water • Cell phone • Nonperishable foods, including baby formula • First aid kit • Diapers • Flashlight and batteries • Blankets • Hand sanitizer or disinfectant • Vehicle keys 8.7 Implications for Educators A key to safety in early care learning environments is to teach children how to be safe and act responsibly. For instance, swing safety includes the child’s own appropriate behavior. A child should never stand or kneel on a swing, should hold on tightly with both hands, and stop the swing before getting off. There are comparable rules for slide safety, climbing equipment safety, and seesaw safety (KidsHealth.org, n.d.b.). Children can be taught to tell a trusted adult if they notice safety hazards or unsafe playing. Also, teaching children transportation safety rules for pedestrians and passengers can reduce the number of injuries to children. Even everyday age-appropriate practices in health and safety measures can be emphasized so that young children begin caring for themselves and practicing independence. Such a behavior would be to get out of the sun of an extremely sunny playground and requesting sun protection when going outside to a sunny playground. If a child does not know these rules or does not act responsibly in following rules, safety is compromised. Licensing Standards Each state has its own licensing regulations for child care providers, which can be accessed via the NRC website, at http://nrckids.org/STATES/states.htm. For example, Pennsylvania has three policy documents that describe health and safety regulations. The regulations are subdivided into the categories of child day care centers, group child day care homes, and family child day care homes. Each document outlines requirements for each of the child care settings such as staff–child ratio, physical site, staff qualifications, activities, admissions procedure, health, transportation, and many others. Collaborating with Families and Communities Child care centers should share their emergency plans with parents and encourage parents to reinforce emergency preparedness in the home. Centers should also make arrangements with nearby centers, schools, libraries, or other facilities in the event of an emergency, so that children who have to be evacuated can be easily transported to a safe location. The center should Summary Chapter 8 also post the relocation information where parents are readily able to see where their child has been relocated. The South Carolina Child Care Services has comprehensive emergency planning guidelines for child care facilities, which can be seen at http://childcare.sc.gov/main/ docs/EmergencyPlanGuidelines.pdf. Summary • According to the WHO, the international authority on world health, the following are components of a healthy school environment: –– Provision of basic necessities –– Protection from biological threats –– Protection from physical threats –– Protection from chemical threats • Indoor air pollutants include VOCs, human carcinogens, combustion sources, heavy metals, and biological allergens. –– VOCs include formaldehyde, pesticides, solvents, and cleaning agents. –– Asbestos and radon are human carcinogens. –– Combustion sources are stoves, water heaters, and dryers. –– Heavy metals that are common air pollutants are lead and mercury vapor. –– Biological allergens include mold and pollen • The EPA is the Environmental Protection Agency, an agency of the U.S. federal government charged with protecting the environment and guarding its impact on human health. –– Three strategies of the EPA for improving indoor air quality are source control, improved ventilation, and air cleaners. –– Secondhand smoke is harmful to anyone, but especially harmful to children. Secondhand smoke can cause respiratory infections, asthma, heart disease, and cancer. It is never safe for a caregiver to smoke around a child. –– Children are particularly vulnerable to pollutants in drinking water, such as lead or nitrates. Child care facilities and families should know the local contaminants to look for in the water supply and have drinking water tested annually. If the water is in question, use bottled water. • Young children are susceptible to pollutants because they are short, have increased air intake, their organs are still growing, and their immunities are not completely developed. • Outdoor air pollutants come from industry, automobiles, and fires. • Classroom design is intentional and dynamic, must be developmentally appropriate, and be matched to the children’s interests and skill level. –– The environment should be divided into learning centers. –– Napping, eating, and toileting should be separate areas. –– Ill children should have a designated place away from other children. –– Noise levels should be kept low so that normal conversational tones can be used. Chapter Review Chapter 8 –– Lighting should be at appropriate levels for safety and comfort, and natural light should be used as much as possible. –– Space requirements are regulated by each state but experts agree that a minimum of 42 square feet per child is needed. • The Consumer Protection Safety Commission (CPSC) is a federal agency that monitors the safety of consumer products including toys, furniture, and equipment for children. • Size, condition, quality, and placement of furniture is important to a healthy and safe early childhood environment. • Poisons can be found in common products such as cosmetics, plastic containers and plastic toys, plants, cleaning products, and debris carried indoors on shoes. • Outdoor play space and equipment and toys follow guidelines and recommendations similar to those for indoor play. –– Base selection on the developmental abilities and interests of the children. –– Match size to the children. –– Quantity of equipment and materials should be enough so that there are no long waiting periods. –– Follow all requirements of installation, maintenance, and monitoring of equipment. –– Use zones for placement and arrangement of play equipment and sections for games. –– Surfaces should be shock absorbing. –– Sensory materials should not be used by children less than 18 months old or by children who have symptoms of infection. –– Good hand washing should be practiced before and after use of toys and equipment. –– Children must be in view of caregivers and supervised at all times. Facilities must develop and practice plans for emergencies, such as fires. Staff should teach children how to respond to a fire through drills that should be practiced monthly. In an evacuation, staff must take emergency supplies and important records for each child. Parents must be informed of emergency plans, including where to retrieve their child if the center is evacuated. Chapter Review 1. Describe the meaning of each of the key terms. 2. Design an indoor early learning environment. 3. List materials and equipment needed for a safe and challenging outdoor play space for children 3 and 4 years old. 4. Explain the measures that should be taken to reduce indoor air pollution in an early care and education setting. 5. Name three national agencies that provide guidelines and recommendations that would be helpful in creating a safe and healthy learning environment and why. Concept Check Chapter 8 Case Study Chris and Donna are experienced child care workers with approximately 20 years of child care experience between them. They have decided to open their own child care center. They purchased an urban home built in 1920 that has approximately 2,000 square feet of space that can be turned into various activity centers and about a half acre yard out back that can be turned into an outside play area. They have received a line of credit in order to purchase the necessary indoor and outdoor equipment they will need for the children, and were pleased to learn that all of the appliances will stay with the house, saving them money on the purchase of that equipment. 1. What other information should Chris and Donna find out about the home before they decide if it could be a safe environment to care for young children? 2. What are some of the potential indoor environmental issues that they may have to consider? 3. What are some of the potential outdoor environmental issues that they will have to consider? 4. What sorts of safety issues will the center have to deal with? 5. Approximately how many children will the center be able to accommodate? Activity At home, or in an early education setting, have the children help the caregivers to designate which bottles, containers, receptacles in the classroom are permissible to touch, and which are poisonous. The caregiver can receive a free sheet of Mr. Yuk™ stickers from the Pittsburgh Poison Center, UPMC, 200 Lothrop Street, BIR 010701, Pittsburgh, PA 15213. Or a center can purchase a package of 250 sheets (10 stickers per sheet) at the cost of $30.50. The caregiver can gather the children together and show them different bottles, telling the children which are cleaners, beverages, medicines, etc. Then the caregiver can ask the group of children whether or not the container should be labeled with a Mr. Yuk™ sticker. If there are disagreements, the caregiver should lead a discussion among the children as to why the container should, or should not, be labeled with a Mr. Yuk™ sticker. This activity can be reinforced each time a new cleaning product or other container is brought into the classroom. Additionally, other Mr. Yuk™ products and teaching resources are available at http://www.upmc.com/Search/Pages/Results.aspx?k=Mr.Yuk%20and%20teaching%20 resources&s=All%20Sites. Concept Check 1. The WHO provides a listing of physical threats from which children should be protected. The following is NOT considered a physical threat: a. traffic b. unsafe food c. crime d. extreme heat Key Terms 2. Mercury vapor is considered an indoor pollutant. It is a Chapter 8 . a. human carcinogen b. VOC c. combustion source d. heavy metal 3. A resource for caregivers that provides important recommendations for out-of-home child care programs was published jointly by the APHA and the AAP. It is named . a. Environments for Learning b. Caring for Our Children: National Safety Performance Standards c. State Licensing Requirements: State by State d. The Right Stuff for Children Birth to 8: Selecting Play Materials for Out of Home Care Programs 4. How is the size of outdoor equipment determined? a. Match the size to the largest child enrolled b. Match the size to the average height of children in the age group using it c. Match the size to the youngest child using it d. Match the size to the oldest child using it 5. A safe transportation system at an early childhood facility has the following: a. a staff–child ratio that includes the driver b. a training program for all staff and parents c. rules for dropoff and pickup posted in the vehicle d. written policies on transportation rules and regulations on what to do in emergencies Answers: 1. b; 2. d; 3. b; 4. c; 5. d Key Terms air cleaner A small device that can take many forms and is used to remove particles from the air. asbestos A carcinogenic, fibrous mineral that is heat resistant and was frequently used in materials for acoustics, insulation, fireproofing, and floor tiles. biological threats A biological agent—a bacterium, virus, prion, or fungus—that can be used purposefully as a biological weapon in bioterrorism or biological warfare. carbon monoxide A toxic gas that is difficult to be aware of because it is colorless, odorless, and impossible to see. Moderate exposure to this gas can cause flu-like symptoms such as disorientation, headaches, nausea, and fatigue. chromatid copper arsenate (CCA) A chemical wood preservative which contains arsenic, a known carcinogen. Key Terms Chapter 8 combustion sources Indoor appliances that burn materials and produce gasses and particles that pollute the air. Common sources in homes and classrooms are stoves, water heaters, and dryers, all of which contribute to indoor air pollution. Consumer Protection Safety Commission (CPSC) A federal agency that monitors the safety of consumer products, and labels toys according to age-specific safety factors. Environmental Protection Agency (EPA) An agency of the federal government charged with protecting the U.S. environment and guarding its impact on human health. heavy metals A type of indoor air pollutant that is most commonly encountered as airborne lead or mercury vapor. human carcinogens Cancer-causing agents in humans, such as asbestos and radon. improved ventilation The process of increasing the amount of outdoor air coming indoors, such as by opening windows or using an exhaust fan. learning centers Spaces inside a larger environment such as a child care center, which are divided into sections for specific learning tasks, activities, and goals. The centers should be designed to meet the children’s interests and skill level as the children evolve and mature. mold A fungus that poses a health hazard in any damp place, including indoors. This fungus can cause irritations or allergic reactions that can range from mild to severe. nitrogen oxides A group of gasses that are products of automobile emissions, power plants, and large equipment, and have been linked to several harmful effects on the respiratory system. pesticides A common type of volatile organic compound that is used to control insects, rodents, fungi, bacteria, and weeds. pollen One type of allergen that is most commonly found in airborne particles outdoors. radon A natural radioactive gas that is colorless, odorless, and tasteless and formed through the natural decay of uranium found in most soil, and once formed, travels through the air. secondhand smoke The smoke that is released into the air from the burning end of a cigarette, pipe, or cigar, and from the exhalations of a person who is smoking. source control The most effective protection from indoor air pollutants. Here, the sources of pollution are eliminated or adjusted to decrease the amount of pollutants that are released. sulfur dioxide A gas that is produced from fossil fuel combustion at power plants and industrial facilities, industrial processes, and the burning of fuels that contain sulfur, such as those used by trains, large ships, and large off-road equipment. Exposure is linked to respiratory problems. thirdhand smoke Nicotine residue left by smoking that accumulates over time on surfaces such as carpets, clothing, furniture, bedding, or car seats, and is harmful to health. Key Terms Chapter 8 use zones A concept employed in early learning settings to designate safe distances in the placement and arrangement of play equipment. These zones refer to the distance needed to safely clear equipment while in use, such as swings. volatile organic compounds (VOCs) One category of common indoor air pollutant that includes formaldehyde, pesticides, solvents, and cleaning agents. zones This refers to the amount of clearance from any structure that is not part of an activity so that young children may move freely between all pieces of equipment.
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