Caring for Our Childen, 3rd Edition (CFOC3)

Chapter 5: Facilities, Supplies, Equipment, and Environmental Health

5.2 Quality of the Outdoor and Indoor Environment

5.2.1 Ventilation, Heating, Cooling, and Hot Water

5.2.1.1: Ensuring Access to Fresh Air Indoors

Content in the STANDARD was modified on 8/25/2016.

 


As much fresh outdoor air as possible should be provided in rooms occupied by children. Screened windows should be opened whenever weather and the outdoor air quality permits or when children are out of the room (1). When windows are not kept open, rooms should be ventilated, as specified in Standards 5.2.1.1-5.2.1.6. The specified rates at which outdoor air must be supplied to each room within the facility range from fifteen to sixty cubic feet per minute per person (cfm/p). The rate depends on the activities that normally occur in that room. Indoor air should be kept as free from unnecessary chemicals as possible, including those emitted from air fresheners and other fragrances, cleaning products containing chemicals, aerosol sprays, and some furnishings.


RATIONALE

The health and well-being of both the staff and the children can be greatly affected by indoor air quality. The air people breathe inside a building is contaminated with micorbes shared among occupants, chemicals emitted from common consumer products and furnishings, and migration of polluted outdoor air into the facility. Sometimes the indoor air is more polluted than the outdoor air.

 

Air quality significantly impacts people's health. The health impacts from exposure to air pollution (indoor and outdoor) can include: decreased lung function, asthma, bronchitis, emphysema, learning and behavioral disabilities, and even some types of cancer. Children are particularly vulnerable to air pollution because their organ systems (respiratory, central nervous system, etc.) are still developing and they also breathe in more air relative to their weight than adults do. Indoor air pollution is often greater than outdoor levels of air pollution due to a general lack of adequate air filtration and ventilation, and lingering and build up of air contaminants emitted from certain long-term furnishings (2). The presence of dirt, moisture, and warmth encourages the growth of mold and other contaminants, which can trigger allergic reactions and asthma (3). Children who spend long hours breathing contaminated or polluted indoor air are more likely to develop respiratory problems, allergies, and asthma (2,4,5). 

 

Although insultation of a building is important in reducing heating or cooling costs, it is unwise to try to seal the building completely. Air circulation is essential to clear infectious disease agents, odors, and toxic substances in the air. Levels of carbon dioxide are an indicator of the quality of ventilation. Air circulation can be adjusted by a properly installed and adjusted heating, ventilation, air conditioning, and cooling (HVAC) system as well as by using fans and open windows. 

COMMENTS
For further information on air quality and on ventilation standards related to type of room use, contact the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE), the U.S. Environmental Protection Agency (EPA) Public Information Center, the American Gas Association (AGA), the Edison Electric Institute (EEI), the American Lung Association (ALA), the U.S. Consumer Product Safety Commission (CPSC), and the Safe Building Alliance (SBA).

For child care, ANSI/ASHRAE 62.1-2007 calls for 10 cfm/person plus 0.18 cfm/sq.ft. of space. ANSI/ASHRAE 62-1989 or ASHRAE Standard 55-2007 is information on Thermal Environmental Conditions for Human Occupancy.

Qualified engineers can ensure heating, ventilation, air conditioning (HVAC) systems are functioning properly and that applicable standards are being met. The American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) Website (http://www.ashrae.org) includes the qualifications required of its members and the location of the local ASHRAE chapter. The contractor who services the child care HVAC system should provide evidence of successful completion of ASHRAE or comparable courses. Caregivers/teachers should understand enough about codes and standards to be sure the facility’s building is a healthful place to be.

Indoor air quality is important to all children and early care and education staff. A checklist from the National Heart, Lung and Blood Institute, How Asthma Friendly is your Child Care Setting? (available at http://www.nhlbi.nih.gov/health/public/lung/asthma/chc_chk.pdf), can help caregivers/teachers create a more asthma-friendly environment.

TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
3.1.3.2 Playing Outdoors
3.1.3.3 Protection from Air Pollution While Children Are Outside
5.2.1.2 Indoor Temperature and Humidity
5.2.1.3 Heating and Ventilation Equipment Inspection and Maintenance
5.2.1.4 Ventilation When Using Art Materials
5.2.1.5 Ventilation of Recently Carpeted or Paneled Areas
5.2.1.6 Ventilation to Control Odors
5.2.9.5 Carbon Monoxide Detectors
REFERENCES
  1. American Society of Heating, Refrigeration and Air-conditioning Engineers (ASHRAE), American Institute of Architects, Illuminating Engineering Society of North America, U.S. Green Building Council, U.S. Department of Energy. 2008. Advanced energy design guide for K-12 school buildings, 148. Atlanta, GA: ASHRAE.
  2. U.S. Environmental Protection Agency. IAQ tools for schools program. http://www.epa.gov/iaq/schools/.
  3. U.S. Environmental Protection Agency (EPA). 2008. Care for your air: A guide to indoor air quality. Washington, DC: EPA. http://www.epa.gov/iaq/pdfs/careforyourair.pdf.
  4. U.S. Environmental Protection Agency, Consumer Product Safety Commission. 2010. The inside story: A guide to indoor air quality. http://www.epa.gov/iaq/pubs/insidest.html.
  5. American Lung Association, American Lung Association, U.S. Consumer Product Safety Commission, U.S. Environmental Protection Agency (EPA). 1994. Indoor air pollution: An introduction for health professionals. Cincinnati: EPA National Service Center for Environmental Publications. http://www.epa.gov/iaq/pdfs/indoor_air_pollution.pdf.
  6. Daneault, S., M. Beusoleil, K. Messing. 1992. Air quality during the winter in Quebec day-care centers.Am J Public Health 82:432-34.
NOTES

Content in the STANDARD was modified on 8/25/2016.

 

5.2.1.2: Indoor Temperature and Humidity


A draft-free temperature of 68°F to 75°F should be maintained at thirty to fifty percent relative humidity during the winter months. A draft-free temperature of 74°F to 82°F should be maintained at thirty to fifty percent relative humidity during the summer months (1,2). All rooms that children use should be heated and cooled to maintain the required temperatures and humidity.
RATIONALE
These requirements are based on the standards of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE), which take both comfort and health into consideration (1,2). High humidity can promote growth of mold, mildew, and other biological agents that can cause eye, nose, and throat irritation and may trigger asthma episodes in people with asthma (3). These precautions are essential to the health and well-being of both the staff and the children. When planning construction of a facility, it is healthier to build windows that open. Some people need filtered air that helps control pollen and other airborne pollutants found in raw outdoor air.
COMMENTS
Simple and inexpensive devices that measure the ambient relative humidity indoors may be purchased in hardware stores or toy stores that specialize in science products. The ASHRAE Website (http://www.ashrae.org) has a list of membership chapters, and membership criteria that help to establish expertise on which caregivers/teachers could rely in selecting a contractor.
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
5.2.1.3 Heating and Ventilation Equipment Inspection and Maintenance
REFERENCES
  1. American Society of Heating, Refrigeration and Air-Conditioning Engineers, American Institute of Architects, Illuminating Engineering Society of North America, U.S. Green Building Council, U.S. Department of Energy. 2008. Advanced energy design guide for K-12 school buildings, 148. Atlanta, GA: ASHRAE.
  2. American Society of Heating, Refrigerating and Air-conditioning Engineers (ASHRAE). 2007. Standard 55-2007: Thermal conditions for human occupancy. Atlanta: ASHRAE.
  3. U.S. Environmental Protection Agency (EPA). 2008. Care for your air: A guide to indoor air quality. Washington, DC: EPA. http://www.epa.gov/iaq/pdfs/careforyourair.pdf.

5.2.1.3: Heating and Ventilation Equipment Inspection and Maintenance


All heating and ventilating equipment, including heaters, stoves used for heating (or furnaces), stovepipes, boilers, and chimneys, should be inspected and cleaned before each cooling and heating season by a qualified heating/air conditioning contractor, who should verify in writing that the equipment is properly installed, cleaned, and maintained to operate efficiently and effectively. The system should be operated in accordance with operating instructions and be certified that it meets the local building code by a representative of the agency that administers the building code. Documentation of these inspections and certification of safety should be kept on file in the facility.
RATIONALE
Routinely scheduled inspections and proper operation ensure that equipment is working properly. Heating equipment is the second leading cause of ignition in fatal house fires (1). Heating equipment that is kept in good repair is less likely to cause fires.
COMMENTS
Qualified engineers can ensure heating, ventilation, air conditioning (HVAC) systems are functioning properly and that applicable standards are being met. The American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) Website (http://www.ashrae.org) includes the qualifications required of its members and the location of the local ASHRAE chapter. The contractor who services the child care HVAC system should provide evidence of successful completion of ASHRAE or comparable courses. Caregivers/teachers should understand enough about codes and standards to be sure the facility’s building is a healthful place to be.
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
5.2.1.1 Ensuring Access to Fresh Air Indoors
5.2.1.8 Maintenance of Air Filters
5.2.9.5 Carbon Monoxide Detectors
REFERENCES
  1. Chowdhury, R., M. Greene, D. Miller. 2008. 2003-2005 residential fire loss estimates. Washington, DC: U.S. Consumer Product Safety Commission. http://www.cpsc.gov/library/fire05.pdf.

5.2.1.4: Ventilation When Using Art Materials


Areas where arts and crafts activities are conducted should be well-ventilated. Materials that create toxic fumes or gases such as spray adhesives and paints should not be used when children are present.Safety Data Sheets (SDS) should be obtained and kept for all chemicals used.
RATIONALE
Some art and craft supplies contain toxic ingredients, including possible human carcinogens, creating a significant risk to the health and well-being of children. Art supplies containing toxic chemicals can also produce fumes that trigger asthma, allergies, headaches, and nausea (1). Art and craft materials should conform to all applicable ACMI safety standards. Materials should be labeled in accordance with the chronic hazard labeling standard, ASTM D4236-94(2005) (1). Children in grade six and lower should only use non-toxic art and craft materials (1,2). Labels are required on art supplies to identify any hazardous ingredients, risks associated with their use, precautions, first aid, and sources of further information.
COMMENTS
Staff should be educated to the possibility that some children may have special vulnerabilities to certain art materials (such as children with asthma or allergies). Not allowing food and drink near supplies prevents the possible cross contamination of materials and reduces potential injuries from poisoning. For more information on poisoning, contact the poison center at 1-800-222-1222 begin of the skype highlighting 1-800-222-1222 end of the skype highlighting.

See the How Asthma Friendly is Your Child Care Setting? checklist at http://www.nhlbi.nih.gov/health/public/lung/asthma/chc_chk.pdf to learn more about creating an asthma-friendly indoor environment.

TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
5.2.9.7 Proper Use of Art and Craft Materials
REFERENCES
  1. Art and Creative Materials Institute. 2010. Safety - what you need to know. http://www.acminet.org/Safety.htm.
  2. Art and Creative Materials Institute, Arts, Crafts, and Theater Safety, Inc., National Art Education Association, U.S. Consumer Product Safety Commission (CPSC). Art and craft safety guide. Bethesda, MD: CPSC. http://www.cpsc.gov/cpscpub/pubs/5015.pdf.

5.2.1.5: Ventilation of Recently Carpeted or Paneled Areas


Doors and windows should be opened in areas that have been recently carpeted or paneled using adhesives until the odors are no longer present. Window fans, room air conditioners, or other means to exhaust emission to the outdoors should be used.
RATIONALE
Adhesives that contain toxic materials can cause significant symptoms in occupants of buildings where these materials are used. Many carpets contain polybrominated diphenyl ethers (PBDEs) to retard flames. PBDEs are associated with several adverse health effects in animal studies including changes in memory and learning, interference with thyroid function, endocrine disruption, and cancer (2). One study found that toddlers and preschoolers typically had three times more of these compounds in their blood as their mothers (1).
COMMENTS
Facilities should choose carpeting or other flooring options that are PBDE-free. Low-odor, water-based, non-toxic products should be encouraged.

For more information on “safe” levels of home indoor air pollutants, contact the U.S. Environmental Protection Agency (EPA) or the U.S. Consumer Product Safety Commission (CPSC).

TYPE OF FACILITY
Center, Large Family Child Care Home
REFERENCES
  1. Lunder, S., A. Jacob. 2008. Fire retardants in toddlers and their mothers: Levels three times higher in toddlers than moms. Environmental Working Group. http://www.ewg.org/reports/pbdesintoddlers/.
  2. U.S. Environmental Protection Agency. Pollution prevention and toxics: Polybrominated diphenylethers (PBDEs). http://www
    .epa.gov/oppt/pbde/.

5.2.1.6: Ventilation to Control Odors

Content in the STANDARD was modified on 8/25/2016.

 


Odors in toilets, bathrooms, diaper changing areas, and other inhabited areas of the facility should be controlled by ventilation and appropriate cleaning and disinfecting. Toilets and bathrooms, janitorial closets, and rooms with utility sinks or where wet mops and chemicals are stored should be mechanically ventilated to the outdoors with local exhaust mechanical ventilation to control and remove odors in accordance with local building codes. Air fresheners or sanitizers (both manmade and natural) should not be used. Adequate ventilation should be maintained during any cleaning, sanitizing, or disinfecting procedure to prevent children and caregivers/teachers from inhaling potentially toxic fumes.
RATIONALE
Air fresheners or sanitizers (both manmade and natural) may cause nausea, an allergic or asthmatic (airway tightening) response in some children (1). Ventilation and sanitation help control and prevent the spread of disease and contamination. The Safety Data Sheet (SDS) for every chemical product that the facility uses should be checked and available to anyone who uses or who might be exposed to the chemical in the child care facility to be sure that the chemical does not pose a risk to children and adults.
COMMENTS
The SDS gives legally required information about the presence of Volatile Organic Compounds (VOCs) and the risk of exposure from all the chemicals in the product. The Occupational Safety and Health Administration (OSHA) requires the availability of the SDS to the workers who use chemicals (2). In addition these sheets should be available to anyone who might be exposed to the chemical in the child care facility.
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
3.3.0.1 Routine Cleaning, Sanitizing, and Disinfecting
4.8.0.7 Ventilation Over Cooking Surfaces
REFERENCES
  1. Elliott, L., M. P. Longnecker, G. E. Kissling, S. J. London. 2006. Volatile organic compounds and pulmonary function in the Third National Health and Nutrition Examination Survey, 1988-1994. Environmental Health Perspective 114:1210-14.
  2. U.S. Occupational Safety and Health Administration. 2009. Hazard communication: Foundation of workplace chemical safety programs. http://www.osha.gov/dsg/hazcom/index.html.
NOTES

Content in the STANDARD was modified on 8/25/2016.

 

5.2.1.7: Electric Fans


Electric fans, if used, should bear the safety certification mark of a nationally recognized testing laboratory and be inaccessible to children (1). The cords to fans should also be inaccessible to children.
RATIONALE
Children having access to electric fans might insert their fingers or objects and otherwise interfere with the safe operation of the fan. Access to the cords of electric fans could result in a child pulling the fan onto him/herself.
COMMENTS
The Occupational Safety and Health Administration (OSHA) has a program that recognizes Nationally Recognized Testing Laboratories. Private sector organizations are listed at http://www.osha.gov/dts/otpca/nrtl/index.html#nrtls.
TYPE OF FACILITY
Center, Large Family Child Care Home
REFERENCES
  1. U.S. Occupational Safety and Health Administration. 2010. Certification of workplace products by nationally recognized testing laboratories. http://www.osha.gov/dts/shib/shib021610.html.

5.2.1.8: Maintenance of Air Filters


Filters in forced-air heating and cooling system equipment should be checked and cleaned or replaced according to the manufacturer’s instructions on a regular basis, at least every three months (and more often if necessary) (1).
RATIONALE
Clogged filters will impede proper air circulation required for heating and ventilation. Poor air flow causes pressure imbalances in the system and can result in the premature failure of equipment. Low air flow can reduce heating and cooling performance of the system and cause cooling coils to freeze up.
TYPE OF FACILITY
Center, Large Family Child Care Home
REFERENCES
  1. U.S. Environmental Protection Agency. 2009. Indoor air quality for schools program: Update. http://www.epa.gov/iaq/schools/pdfs/publications/iaqtfs_update17.pdf.

5.2.1.9: Type and Placement of Room Thermometers


Thermometers that will not easily break and that do not contain mercury should be placed on interior walls in every indoor activity area at children’s height.
RATIONALE
The temperature of the room can vary between the floor and the ceiling. Because heat rises, the temperature at the level where children are playing can be much cooler than at the usual level of placement of interior thermometers (the standing, eye level of adults). Mercury, glass, or similar materials in thermometers can cause injury and poisoning of children and adults. Mercury is a potent neurotoxin that can damage the brain and nervous system (1). Placing a safe digital thermometer at the children’s height allows proper monitoring of temperature where the children are in the room. A thermometer should not break easily if a child or adult bumps into it.
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
5.2.1.2 Indoor Temperature and Humidity
REFERENCES
  1. U.S. Environmental Protection Agency. 2010. Mercury: Health effects. http://www.epa.gov/mercury/effects.htm.

5.2.1.10: Gas, Oil, or Kerosene Heaters, Generators, Portable Gas Stoves, and Charcoal and Gas Grills


Unvented gas or oil heaters and portable open-flame kerosene space heaters should be prohibited. Gas cooking appliances, including portable gas stoves, should not be used for heating purposes. Charcoal grills should not be used for space heating or any other indoor purposes.

Heat in units that involve flame should be vented properly to the outside and should be supplied with a source of combustion air that meets the manufacturer’s installation requirements.

RATIONALE
Due to improper ventilation, worn or faulty parts, or malfunctioning equipment, dangerous gases can accumulate and cause a fire or carbon monoxide poisoning. Carbon monoxide is a colorless, odorless, gas that is formed when carbon-containing fuel is not burned completely and can cause illness or death. See Standard 5.2.9.5 on installation of carbon monoxide detectors.

Many burns have been caused by contact with space heaters and other hot surfaces such as charcoal and gas grills (1). If charcoal grills are used outside, adequate staff ratios must be maintained and the person operating the grill should not be counted in the ratio.

COMMENTS
For more information on carbon monoxide poisoning and poison prevention, contact your local poison center by calling 1-800-222-1222 begin_of_the_skype_highlighting 1-800-222-1222 end_of_the_skype_highlighting.
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
5.2.1.13 Barriers/Guards for Heating Equipment and Units
5.2.9.5 Carbon Monoxide Detectors
REFERENCES
  1. Palmieri, T. L., D. G. Greenhalgh. 2002. Increased incidence of heater-related burn injury during a power crisis. Arch Surg 137:1106-8.

5.2.1.11: Portable Electric Space Heaters


Portable electric space heaters should:

  1. Be attended while in use and be off when unattended;
  2. Be inaccessible to children;
  3. Have protective covering to keep hands and objects away from the electric heating element;
  4. Bear the safety certification mark of a nationally recognized testing laboratory;
  5. Be placed on the floor only and at least three feet from curtains, papers, furniture, and any flammable object;
  6. Be properly vented, as required for proper functioning;
  7. Be used in accordance with the manufacturer’s instructions;
  8. Not be used with an extension cord.

The heater cord should be inaccessible to children as well.

RATIONALE
Portable electric space heaters are a common cause of fires and burns resulting from very hot heating elements being too close to flammable objects and people (1).
COMMENTS
To prevent burns and potential fires, space heaters must not be accessible to children. Children can start fires by inserting flammable material near electric heating elements. Curtains, papers, and furniture must be kept away from electric space heaters to avoid potential fires. Some electric space heaters function by heating oil contained in a heat-radiating portion of the appliance. Even though the electrical heating element is inaccessible in this type of heater, the hot surfaces of the appliance can cause burns. Cords to electric space heaters should be inaccessible to the children. Heaters should not be placed on a table or desk. Children and adults can pull an active unit off or trip on the cord.

To prevent burns or potential fires, consideration must be given to the ages and activity levels of children in care and the amount of space in a room. Alternative methods of heating may be safer for children. Baseboard electric heaters are cooler than radiant portable heaters, but still hot enough to burn a child if touched.

If portable electric space heaters are used, electrical circuits must not be overloaded. Portable electric space heaters are usually plugged into a regular 120-volt electric outlet connected to a fifteen-ampere circuit breaker. A circuit breaker is an overload switch that prevents the current in a given electric circuit from exceeding the capacity of a line. Fuses perform the same function in older systems. If too many appliances are plugged into a circuit, calling for more power than the capacity of the circuit, the breaker reacts by switching off the circuit. Constantly overloaded electrical circuits can cause electrical fires. If a circuit breaker is continuously switching the electric power off, reduce the load to the circuit before manually resetting the circuit breaker (more than one outlet may be connected to a single circuit breaker). If the problem persists, stop using the circuit and consult an electrical inspector or electrical contractor.

The Occupational Safety and Health Administration (OSHA) has a program that recognizes Nationally Recognized Testing Laboratories. Private sector organizations are listed on their Website at http://www.osha.gov/dts/otpca/nrtl/index
.html#nrtls.

Manufacturer’s instructions should be kept on file.

TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
5.2.1.13 Barriers/Guards for Heating Equipment and Units
REFERENCES
  1. U.S. Consumer Product Safety Commission (CPSC). 2001. What you should know about space heaters. Washington, DC: CPSC. http://www.nnins.com/documents/WHATYOUSHOULDKNOWABOUTSPACEHEATERS.pdf.

5.2.1.12: Fireplaces, Fireplace Inserts, and Wood/Corn Pellet Stoves


Fireplaces, fireplace inserts, and wood/corn pellet stoves should be inaccessible to children. Fireplaces, fireplace inserts, and wood/corn pellet stoves should be certified to recognized national performance standards such as Underwriters Laboratories (UL) or the American National Standards Institute (ANSI) and Environmental Protection Agency (EPA) standards for air emissions. The front opening should be equipped with a secure and stable protective safety screen. Fireplaces, fireplace inserts, and wood/corn pellet stoves should be installed in accordance with the local or regional building code and the manufacturer’s installation instructions. The facility should clean the chimney as necessary to prevent excessive build-up of burn residues or smoke products in the chimney.
RATIONALE
Fireplaces provide access to surfaces hot enough to cause burns. Children should be kept away from fire because their clothing can easily ignite. Children should be kept away from a hot surface because they can be burned simply by touching it. Improperly maintained fireplaces, fireplace inserts, wood/corn pellet stoves, and chimneys can lead to fire and accumulation of toxic fumes.

A protective safety screen over the front opening of a fireplace will contain sparks and reduce a child’s accessibility to an open flame.

Heating equipment is the second leading cause of ignition of fatal house fires (1). This equipment can become very hot when in use, potentially causing significant burns.

TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
5.2.1.10 Gas, Oil, or Kerosene Heaters, Generators, Portable Gas Stoves, and Charcoal and Gas Grills
5.2.1.13 Barriers/Guards for Heating Equipment and Units
5.2.9.5 Carbon Monoxide Detectors
REFERENCES
  1. Chowdhury, R., M. Greene, D. Miller. 2008. 2003-2005 residential fire loss estimates. Washington, DC: U.S. Consumer Product Safety Commission. http://www.cpsc.gov/library/fire05.pdf.

5.2.1.13: Barriers/Guards for Heating Equipment and Units


Heating equipment and units, including hot water heating pipes and baseboard heaters with a surface temperature hotter than 120°F, should be made inaccessible to children by barriers such as guards, protective screens, or other devices.
RATIONALE
A mechanical barrier separating the child from the source of heat can reduce the likelihood of burns (1,2).
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
5.2.1.3 Heating and Ventilation Equipment Inspection and Maintenance
5.2.1.11 Portable Electric Space Heaters
5.2.1.12 Fireplaces, Fireplace Inserts, and Wood/Corn Pellet Stoves
REFERENCES
  1. Ytterstad, B., G. S. Smith, C. A. Coggan. 1998. Harstad injury prevention study: Prevention of burns in young children by community based interventions. Inj Prev 4:176-80.
  2. McLoughlin, E., C. J. Vince, A. M. Lee, et al. 1982. Project burn prevention: Outcomes and implications. Am J Public Health 72:
    241-47.

5.2.1.14: Water Heating Devices and Temperatures Allowed


Facilities should have water heating devices connected to the water supply system as required by the regulatory authority. These facilities should be capable of heating water to at least 120°F. Hot water temperature at sinks used for handwashing, or where the hot water will be in direct contact with children, should be at a temperature of at least 60°F and not exceeding 120°F. Scald-prevention devices, such as special faucets or thermostatically controlled valves, should be permanently installed, if necessary, to provide this temperature of water at the faucet. Where a dishwasher is used, it should have the capacity to heat water to at least 140°F for the dishwasher (with scald preventing devices that prohibit the opening of the dishwasher during operation cycle).
RATIONALE
Hot water is needed to clean and sanitize dishes and food utensils adequately and sanitize laundry. Tap water burns are a common source of scald injuries in young children (1). Children under six years of age are the most frequent victims of non-fatal burns (1). Water heated to temperatures greater than 120°F takes less than thirty seconds to burn the skin (1). If the water is heated to 120°F it takes two minutes to burn the skin (2). That extra two minutes could provide enough time to remove the child from the hot water source and avoid a burn.
COMMENTS
Anti-scald aerators designed to fit on the end of a modern bathroom and kitchen faucets, and anti-scald bathtub spouts, are also available. Only devices approved by the American National Standards Institute (ANSI) or the Canadian Standards Association (CSA) should be considered. A number of other scald-prevention devices are available on the market. Consult a plumbing contractor for details.
TYPE OF FACILITY
Center, Large Family Child Care Home
REFERENCES
  1. D’Souza, A. L., N. G. Nelson, L. B. McKenzie. 2009. Pediatric burn injuries treated in US emergency departments between 1990 and 2006. Pediatrics 124:1424-30.
  2. Erdmann, T. C., K. W. Feldman, F. P. Rivara, D. M. Heimbach, H. A. Wall. 1991. Tap water burn prevention: The effect of legislation. Pediatrics 88:572-77.

5.2.1.15: Maintenance of Humidifiers and Dehumidifiers


If humidifiers or dehumidifiers are used to maintain humidity, as specified in Standard 5.2.1.2, the facility should follow the manufacturer’s cleaning, drainage, and maintenance instructions to avoid growth of bacteria and mold and subsequent discharge into the air.
RATIONALE
Bacteria and mold often grow in the tanks and drainage hoses of portable and console room humidifiers and can be released in the mist. Breathing dirty mist may cause lung problems ranging from flu-like symptoms to serious infection, and is of special concern to children and staff with allergy or asthma (1). Humidifiers or dehumidifiers may be required to meet American National Standards Institute (ANSI) and Association of Home Appliance Manufacturers (AHAM) humidifier standards and must not introduce additional hazards.
COMMENTS
Improperly maintained humidifiers may become incubators of biological organisms and increase the risk of disease. Film or scum appearing on the water surface, on the sides or bottom of the tank, or on exposed motor parts may indicate that the humidifier tank contains bacteria or mold. Also, increased humidity enhances the survival of dust mites, and many children are allergic to dust mites.
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
5.2.1.2 Indoor Temperature and Humidity
REFERENCES
  1. U.S. Consumer Product Safety Commission (CPSC). CPSC issues alert about care of room humidifiers: Safety alert–dirty humidifiers may cause health problems. Document #5046. Washington, DC: CPSC. http://www.cpsc.gov/cpscpub/pubs/
    5046.html.