These tips were originally the fifth in a series of twelve emails for child care providers in New York State that Clean and Healthy New York trained on EcoHealthy Child Care® and toxic chemical reduction and elimination strategies. We hope you find them helpful and they inspire you to take further steps to reduce the hidden toxic chemicals in your setting.

Caring for our Children:
Updates to National Health & Safety Performance Standards

The American Academy of Pediatrics and American Public Health Association's National Resource Center for Health and Safety in Child Care and Early Education (NRC) has revised 18 environmental health standards in their 3rd edition of Caring for our Children: National Health and Safety Performance Standards: Guidelines for Early Care and Education Programs. They now include best practices suggestions from EcoHealthy Child Care®'s 30 item checklist. 

What do the new standards ask you to do?
Make sure your facility and the nearby environment are safe and healthy
  • Conduct an environmental audit before new building construction, renovation or occupying old buildings, and after a natural disaster. Remediate or avoid sites where children's health could be compromised based on previous uses of site or nearby sites; air, soil, water contamination on site and play spaces, toxic building materials, and noise hazards. 

  • Buildings should be inspected by a public inspector to ensure they are up to all relevant codes after construction, renovation, remodeling or alteration. (Standards and

Outdoor play is important, and needs to be provided in a healthy way
  • Make sure you have a written policy for at least one to two hours of outdoor physical activity and removal of barriers to a child participating (such as inadequate or inappropriate clothing). Have a plan to ensure similar activity indoors during extreme weather or pollution conditions. (Standard

  • Before going out, check the Air Quality Index daily for pollutant levels to determine if it is safe for children to play outdoors. (Standard

  • Protect kids from arsenic exposure by applying two coats of waterproof stain or sealant on all chromated copper arsenate (CCA) treated outdoor wood surfaces, such as play equipment, benches, decks, and picnic tables - once a year if sealant is oil-based, twice a year if water-based. (Standard


Ensure their indoor environment is healthy
  • Monitor children to prevent them from consuming "non-nutritive" substances, or things that are not food to reduce exposure to chemicals of concern in dust, dirt, and household objects. This is of particular concern for very young children as their bodies absorb more than adults do (3-5x as much lead is absorbed when swallowed). (Standard

  • Increase fresh air indoors by opening windows or ensuring frequent enough air exchange via your HVAC system to flush out pathogens and chemicals, and to control odors. 

  • Don't use air fresheners (manmade and natural, including essential oils), incense, moth balls/crystals, or toilet/urinal deodorizer blocks as they can contain chemicals of concern, and trigger asthma and other respiratory problems. Remember: "The smell of clean is nothing."(Standards, and


Clean, sanitize, and disinfect to protect from pathogens and chemicals
  • Update diaper and underwear changing procedures to include increased signage and other steps to reduce possible injury and spread of germs. It includes reference to bleach-free sanitizing and disinfecting agents. (Standards and

  • Require more frequent hand washing, using plain soap and water (hand sanitizer can be used away from facility if hands are not also soiled). These steps have been shown to reduce incidence of diarrhea by 50% in centers that implemented them. (Standard

  • Change cleaning, sanitizing, and disinfecting procedures to reduce the presence of germs on objects. The standard acknowledges EPA-approved bleach-free sanitizing and disinfecting solutions and the change in bleach concentrations now for sale. (Standard and Appendix J)


Meal times matter
  • When feeding infants, avoid bottles and cups made with bisphenol A (BPA) and phthalates (found in #3 plastic), and instead use glass (wrapped in silicone) and plastics #2, #4, and #5. See additional recommendations on storage and disposal of human milk and formula, and heating methods to avoid bacterial growth. (Standards, and

  • Hold common meals seated together at tables to prevent food aspiration and choking, increase social skills, and avoid obesity. (Standard


Use Integrated Pest Management to treat lice 
  • Follow a more deliberate approach to managing children with lice (which carry no disease and are not signs of poor hygiene). End any "no nit" policies and follow prescribed Integrated Pest Management strategies to contain the infestation.  (Standard

Learn more

Mt. Sinai School of Medicine operates the Children's Environmental Health Center of Excellence, conducting research into environmental causes of childhood disease. They also provide free consultation for parents who have questions about pediatric environmental exposures. To contact the Mount Sinai Pediatric Environmental Health Specialty Unit (PEHSU), please call 1-866-265-6201 or e-mail


(1) Caring for Our Children: National Health and Safety Performance Standards - Guidelines for Early Care and Education Programs, 3rd Edition

NYSP2I is dedicated to helping NYS residents and businesses find implementable and cost-effective sustainability solutions.

Funding provided by the NYS Pollution Prevention Institute through a grant from the NYS Department of Environmental Conservation. Any opinions, findings, conclusions or recommendations expressed are those of the author(s) and do not necessarily reflect the views of NYS Pollution Prevention Institute or Department of Environmental Conservation.

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