New Study Assesses Implementation of Children’s Environmental Health Best Practices Among Child Care Providers

Share Article

University of Maryland School of Nursing and the Children’s Environmental Health Network evaluate level of environmental stewardship in child care facilities via responses to the Eco-Healthy Child Care® program’s self-auditing checklist.

Each week there are approximately 11 million children under age five in child care settings in the United States (US), and average weekly attendance for children of working mothers is 35 hours. Due to the sheer number of children attending child care, and the significant number of hours many of them spend at child care facilities, it is important to ensure that child care settings are free from environmental health hazards. Prior research studies out of the University of California at Berkeley discovered the presence of lead, pesticides, and polychlorinated biphenyls (PCBs) within child care settings, all of which may have serious short and long-term health implications for children. Hester Paul, the National Director of the Eco-Healthy Child Care® (EHCC) Program, states, "It is imperative that we protect young children from exposure to common environmental health hazards found within child care facilities. As their bodies are growing and developing at a rapid rate, they are especially vulnerable to the effects of toxicants.”

EHCC, a program of the Children’s Environmental Health Network (CEHN), is the only national program that provides technical assistance and training on environmental health best practices for child care professionals and an endorsement for child care providers who meet a minimum number of eco-healthy criteria on a self-auditing checklist. Since 2010, over 2400 child care facilities throughout the US as well as a few in Australia, Canada, India, and the United Kingdom, and have been EHCC endorsed, reaching more than 105,900 children. The endorsement checklist consists of 30 items describing environmentally safe practices for center-based and family child care facilities; topics include: lead, mercury, pesticide use, treated playground equipment, art supplies, plastics, radon, and more.

CEHN teamed up with a research team led by Dr. Robyn Gilden from the University of Maryland School of Nursing, using response data from 396 completed EHCC endorsement checklists to formulate an evaluation of environmental stewardship in those child care facilities. Forty states plus one US territory, three Canadian territories, and two locations in Australia were represented in the data.

Findings were published in the March issue of the Journal of Environmental Health, and included some positive discoveries. For example, approximately 70% of the facilities rated an 80% compliance rate or higher, making them eligible for endorsement as “eco-healthy”. In fact, all but ten of the checklist items were implemented by 90% of the facilities, and three checklist items were implemented by 100% of the facilities. Those three practices adopted by all the facilities were: safe pest management, with a focus on not using pesticides; no smoking on the premises; and the maintenance and use of furniture in good condition (to reduce exposure to flame retardants and formaldehyde).

There were also a few unsafe practices uncovered. Notable among them were: 30% of facilities had wall-to-wall carpeting (a respiratory hazard for young children); over 25% of facilities had not been properly tested for radon; and almost 10% of facilities did not use BPA-free baby bottles.

This important study has helped to identify potential areas for further education aimed at child care facilities. According to Paul, “The Eco-Healthy Child Care® program and related resources, including the EHCC checklist, are effective at educating and supporting child care professionals, though there is still much work to be done." The authors also encourage further research to find out whether facilities that adopt the best practices listed on the EHCC checklist show actual reductions in hazardous exposures, and whether parents and guardians are aware of and/or seek out EHCC endorsed facilities.

The full research article can be read here:

For more information on the Eco-Healthy Child Care® (EHCC) program, visit:

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Hester Paul
Children's Environmental Health Network
Like >