Protecting children's health: Comparison of child care policies and regulations in New England

Introduction: Air pollutants are associated with many health risks. Children in the day care environment are uniquely susceptible to lung damage, infection, systemic illness and pollutant-triggered hypersensitivity reactions from these pollutants. This is exacerbated in a state whose asthma rate is among the highest in the United States. Objective: To assess the adequacy of Vermont's child care center regulations in protecting children from exposure to specific environmental pollutants linked to health risks. To compare Vermont's existing requirements to those in six surrounding states in order to make recommendations for possible improvement. Methods: We reviewed the potential risks posed to children by the following EPA-identified pollutants: carbon monoxide (CO), pesticides, radon, biological contaminants, asbestos, smoking, ventilation and volatile organic compounds (VOCs). We examined, using qualitative and quantitative methods, state child care center regulations in Connecticut, New Hampshire, Maine, Massachusetts, New York, and Rhode Island and compared them to Vermont's regulations, then posing recommendations to the American Lung Association (ALA) for improvements within Vermont. Results: With regard to asbestos, smoking, VOCs, and ventilation, Vermont has the most protective regulations in the northeast. Other states surveyed afforded children additional protection from CO, radon, pesticides, pet dander, and lead. Conclusions: There is considerable heterogeneity in scope and specificity of laws and regulations in New England. Overall, Vermont has the most comprehensive regulations. Areas for additional improvement in Vermont include: the addition of mandatory radon testing, more comprehensive CO monitoring, parental notification of pesticide use and the presence of animals to child care regulations, as well as addition of more extensive lead testing requirements. Similar methods could be used in other states to assess the strength of laws and policies protecting children's environmental health in day care centers.