[ELI], 2007), New York state issued an executive order mandating the use of envi

ronmentally preferred cleaning products (Executive Order 134), and the New York
state legislature passed supporting legislation for all K–12 public and private sc
hools (ELI, 2007). Illinois passed similar legislation in 2007, and a movement g
rew in New England to follow suit (ELI, 2007). As of spring 2009, 17 states had
adopted green cleaning procurement policies (Ba- lek, 2009). In addition, nation
wide, many school districts have begun to embrace, or have already adopted, gree
n cleaning regimens, even in the absence of state mandates. An effective and com
prehensive green clean- ing program focuses not only on reducing the use of toxi
c chemical cleaners but calls for the use of more efficient equipment and the im
plementation of proper training protocols for the cleaning staff. Third-party–cert
ified cleaning chemicals, both for everyday use and for specialty cleaning uses
(e.g., floor sealers and finishes), are required. A product must meet strict, an
d continually updated, human and environmental health criteria throughout its li
fecycle to achieve certification. In a green cleaning program, the majority of e
veryday clean- ing can be accomplished with just one third-party– certified, all-p
urpose concentrate, greatly reducing the number of different chemicals in use. E
nviron- mentally preferable disinfectants, graffiti removers, mineral build-up r
emovers, and white board cleaners and markers are also available to replace thei
r conventional equivalent. Investment in equipment such as HEPA-filter vacuum cl
eaners, high-filtration floor care equipment, microfiber cloths and mops, and mu
ltilevel, scraper walk-off mats, greatly improves indoor air quality. Green clea
ning custodial training programs ideally include instruction on best practices,
proper equipment operation, and the use of the new certified cleaning products,
as well as information on bloodborne pathogens and chemical right-to-know; these
programs would be provided in a multilingual format where necessary. Reducing t
he use of antimicrobials is another important goal of green cleaning programs. T
he overuse of antibacterial soaps, wipes, and washes may be creating antibiotic-
resistant strains of bacteria (McDonnell & Russell, 1999). Conven- tional hand s
oaps can be replaced with third-party– certified and nonanti-bacterial soaps. Staf
f should be trained to clean prior to disinfecting and to use disinfectants in h
igh-risk areas only, such as those areas required by regulations and those where
body fluids may be present. Detergent and water can remove most microbes, and s
anitizers may be appropriate for certain touch points, rather than disinfectants
. Schools planning to implement a green cleaning program need only invite their
favored vendor to present a free demonstration of certified green cleaning produ
cts on real dirt to custodial staff and then initiate a pilot project by selecti
ng products and practices to phase in, based on the unique needs of the site. Fo
r schools that want to assess the benefits of adopting a green cleaning program,
an evaluation of the current products, equipment, and methods used on site shou
ld be conducted, and baseline measurements, such as the number of student visits
to the nurse’s office, should be obtained. Schools may also elect to establish an
environmental health and safety committee to educate staff other than custodian
s and to monitor and reward success. Ideally, schools would adopt policy that wo
uld endure staff and administrative turnover. However, it is most important that
schools understand how easy it is to begin a green cleaning program immediately
. Pest Management The school environment presents an agreeable habitat for a num
ber of various pests. Meals and snacks are served and eaten within school facili
ties, and moisture and nesting areas abound. Pests may also find suitable nutrie
nts and habitat among books and other educational materials present within schoo
ls (Healthy Schools Network, 2006). Hazards associated with pests include the sp
read of diseases from flies, cockroaches, mice, and rats; allergies and asthma a
ttacks triggered by cock- roaches and mice; and allergic reactions to some insec
t bites or stings (EPA, 2009a). Structural damage from termite and mice activity
may also present physical hazards to schoolbuilding occu- pants (EPA, 2009a). H
owever, conventional pest control methods may introduce serious hazards of their
own. Routine pesticide application is often the primary means of pest preventio
n and control in U.S. schools, and herbicides are used on school grounds to cont
rol weeds. Herbicides and fungicides are formulated to kill certain plants and f
ungi, and insecticides and rodenticides are often neurotoxins designed to kill c
ertain animal species via enzyme INTELLECTUAL AND DEVELOPMENTAL DISABILITIES VOL
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lities
system disruption or cell membrane damage (EPA, 2009b). These lethal compounds a
re potentially toxic to children, and adults. Indeed, pesticides registered with
the EPA are not guaranteed to be safe for human health (Landrigan, Needleman, &
Land- rigan, 2002). Levels of the enzyme critical in detoxifying organophosphor
ous (OP) pesticides, in particular, and in protecting against oxidative stress r
emain low in children through at least Age 7 (Huen et al., 2009). Thus, this win
dow of vulnerability to OPs includes school-aged children as well as infants, ne
cessitating the implementation of safer pest management practices in schools. Re
gulatory authorities use a retroactive, ‘‘proof-of- harm’’ approach to pesticide regulat
ion rather than taking a more precautionary tactic. Many older pesticides have n
ot been thoroughly tested by today’s standards and are still commonly used, despit
e the complete testing of each compound taking at least 10 years (Purdue Univers
ity Cooperative Extension Service [PUCES], 2001). Furthermore, most pesticides i
n use today have not been tested specifically for their health effects on childr
en (Landrigan, Needleman, & Landrigan, 2002). Recent toxicological studies found
that many pesticides harm the developing brain and nervous system. Some pestici
des act as hormone disruptors, resulting in impaired development and functioning
, and many herbicides are known, probable, or suspected carcinogens (Landrigan,
Needleman, & Landrigan, 2002). Acute human health problems associated with pesti
cide exposure include eye and skin irritations, nausea, dizziness, breathing dif
fi- culties, upper respiratory infections, systemic man- ifestations, and even s
eizures and pulmonary edema in high-severity cases (Alarcon et al., 2005; Califo
rnians for Pesticide Reform, 2003; EPA, 1999). Long-term exposure to some pestic
ides has also been associated with chronic health problems, such as childhood ca
ncers; respiratory diseases, such as asthma; abnormal brain development; and dev
elopmental and behavioral delays and disorders (Guillette, Meza, Aquilar, Soto,
& Garcia, 1998; Lizardi, O’Rourke, & Morris, 2008; Rudant et al., 2007; Salam, Li,
Langholz, & Gilliland, 2004; Weiss, Amler, & Amler, 2004). Although no federal
regulations exist for pesticide use in schools, the EPA recommends that schools
use integrated pest management (IPM) practices to reduce the risk of pesticide e
xposure to children. IPM is a safer and usually less costly option for effective
pest management within schools, although it does not eliminate use of pesticide
s altogether. A school IPM program takes advantage of all pest management strate
gies, including the judicious and careful use of pesticides when necessary. Howe
ver, a properly implemented program focuses on implementing preventative measure
s and least toxic solutions, such as strategies to reduce sources of food, water
, and shelter for pests within school buildings and grounds. Proper school IPM p
ractices include the follow- ing: vegetation, shrubs, and wood mulch are kept at
least 1 foot away from structures; cracks and crevices in walls, floors, and pa
vement are either sealed or eliminated; lockers and desks are emptied and thorou
ghly cleaned at least twice a year; all food- contaminated dishes, utensils, and
surfaces are cleaned by the end of each day; garbage cans and dumpsters are cle
aned regularly; litter is collected and disposed of properly at least once a wee
k; fertilizers are applied several times throughout the year rather than one hea
vy application; the problem or pest is identified prior to taking action; and sp
ot treatments, rather than area-wide applications, of pesticides are used when p
esticides are needed (EPA, 2009a). Pesticides can travel long distances and have
been found as far as 50 miles away from the point of application (Californians
for Pesticide Reform, 2003). Thus, reduction of pesticide drift, particularly fo
r schools near agricultural fields, is also critical, and pesticide-spray buffer
zones should be estab- lished around school buildings. Last, schools should str
ive to educate their school communities about pesticides and IPM practices and n
otify and provide re-entry recommendations when pesticides are used (NIOSH, 2007
). Conclusion School facilities in the United States are densely occupied, under
staffed, underfunded, and often designed and built by low bidders, without any,
or minimal, oversight. Maintenance budgets are often the first to be reduced whe
n budgets shrink. In addition to poor availability of school sites and the lack
of research and policy regulation, these realities pose considerable unaddressed
health hazards to schoolchildren across the country. Siting committees need to
establish environ- mentally sound protocol for selecting new school INTELLECTUAL
AND DEVELOPMENTAL DISABILITIES VOLUME48, NUMBER2: 135–144| APRIL2010 Perspective:
children’s Environmental Health K. Trousdale et al. ’American Association on Intell
ectual and Developmental Disabilities 141
sites, and new schools need help to improve the design and construction of the f
acility. Existing schools should establish an environmental health committee to
report on facility conditions and recommend improvements; to provide advance not
ice to parents, staff, and the community of school construction projects and the
public plan to protect occupants; to physically separate construc- tion from oc
cupants and air out new areas prior to reoccupancy; to practice nontoxic pest co
ntrol, such as IPM practices; to adopt green cleaning practices; and to inventor
y and clean out ‘‘legacy’’ stored chemicals. Research, such as the National Children’s Stu
dy, funded and led primarily by the Eunice Kennedy Shriver National Institute of
Child Health and Human Development, should capture exposures in daycare setting
s and schools. Health providers, advised by the EPA, should develop a common way
to assess these exposures. Advocates should insist that congress supports and f
ederal agencies create a coordinated strategy for children’s health at school. Ref
erences Akinbami, L. J. (2006).The state of chil