Environmental Health Considerations

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This is part one of a four-part educational module, Planning for Early Care and Education, focused on the connection between early care and education, environmental health, and planning. Select the links at the bottom of the Story for links to other sections.

In this section, participants will learn about:

• Desirable and undesirable site attributes to consider when siting ECE programs
• Role of planners in siting ECE programs
• Equity considerations related to siting ECE programs

Careful siting of ECE programs is important to protect children from contaminants that could be harmful to their health. As discussed in  Section 1 , children are particularly susceptible to impacts based on environmental conditions because of their behaviors, smaller size, and the fact that they are actively growing. Planners can play a role in encouraging the ECE program to operate in places that are safe and promote health. This section describes site attributes and other aspects that planners should consider while siting ECE programs.

There is no single way to open an ECE program, but regardless of the approach, there are opportunities to incorporate environmental health considerations before starting its operation. In some cases, developers may already have a site, and based on market analysis, decide to open an ECE program on that site. In other cases, ECE operators may open the program in an existing building with either single or multiple uses in it (e.g., shopping center, church). There are also cases where an ECE provider may want to open an ECE program but has not selected a site. In those cases, they may compare multiple sites against a set of criteria to find the right fit.

In all the above circumstances, there are opportunities for planners to consider the contamination-related site characteristics. For instance, when constructing a new ECE facility or using an existing building that requires significant modification, municipalities may allow planners to request site information from developers or ECE operators as part of the permit approval process. During the approval process, local planners can compare site conditions with environmental health guidance to identify if a site is appropriate for an ECE program. Planners can also identify safer sites for ECE programs through site analysis processes. During a site analysis, planners can work with allied professionals to identify site assets and liabilities to determine whether environmental remediation is needed to reduce potential exposure to contaminants. Section 2.3 describes additional planning interventions to encourage safer siting of ECE programs.

Planners and elected officials can ask questions about how a site was used in the past as part of the permit approval process—and get the health department involved if needed (ATSDR n.d.)

Undesirable site attributes refer to conditions that negatively impact the perception of land. These attributes include negative environmental conditions, such as sites that have been exposed to contamination. In the case of ECE programs, these conditions can increase children’s exposure to contaminants. Sites may be contaminated due to previous site uses, migration of contaminants from nearby sites, or because of naturally occurring processes. Regardless of how a site becomes contaminated, it is important to proactively identify contaminants and other undesirable site attributes before beginning an ECE program. This section will discuss undesirable site attributes related to contamination.

2.1.1. Methods of Contamination

There are three ways in which a site can be contaminated: former uses, migrating contaminants, and naturally occurring contaminants. Contaminants can impact soil, air, and water. Manufacturing processes, waste disposal, and pesticide/fertilizer application are examples of human activities that can contaminate the soil. Air contamination can occur because of industrial or transportation activities. Water systems can become contaminated if water sources or water delivery systems introduce contaminants to drinking water. Public water systems may have routine testing; however, private well systems that are not regularly tested can introduce contaminants into drinking water. In collaboration with environmental health professionals and additional partners, planners should consider these methods of contamination when assessing the site’s suitability for ECE programs.

Former Uses

Human activity can have long-lasting impacts on the natural environment. Past uses can leave behind contaminants that can cause adverse health impacts on people, in some instances for an extended period. Thus, a community interested in encouraging infill development should investigate if the site was previously used for industrial or commercial land uses. Some sites are readily identifiable as brownfields—they may feature physical characteristics that indicate previous use. Other sites may appear clean and unused but may contain contaminants. In the case of redevelopments or changes in building use, a site assessment can help identify incompatible former uses and potential hazards. These are referred to as site liabilities and include conditions like soil contamination, groundwater contamination, and contamination due to hazardous building materials (ATSDR 2017; LaGro 2013).

ECE programs may open in buildings that had previous uses, on a brownfield, in a building with other uses, or a site that has not had previous construction; it is important to consider how former uses may have impacted the environmental quality. Neglect of harmful environmental conditions can have adverse effects on ECE and its users. One ECE program in Indiana was located on a site that was previously used for manufacturing purposes and contained detectable levels of volatile organic chemicals (or VOCs). This program was relocated after air quality conditions raised concerns. Chapter 4 of the  Choose Safe Places for Early Care and Education Guidance Manual  has similar examples that show the effect of the previous land uses on ECE programs and health. Thus, when determining ECE program locations, the following factors should be given special attention to identify potential contamination:

• Prior activities at the site that could have contaminated the inside of the building
• Outdoor contamination, including soil, surface water, or groundwater
• Prior use, storage, or disposal of potentially hazardous substances on site, such as a dump site or underground storage tank
• Potentially hazardous substances on-site, including prior use, disposal, or storage
• Structures that may have contained harmful substances, such as underground storage tanks or a storage shed
• Physical hazards that could be evidence of contamination
• Potentially hazardous materials in structures on-site, such as asbestos insulation or lead-based paint
• Use of contaminated fill on the site
• Vapor intrusions of contaminant (ATSDR 2017)

Planners can work with environmental health professionals to compile environmental, social, and economic data from multiple sources to identify sites that are safe for ECE programs. See Section 3, Land Suitability Analysis, for more information about information sources and site analysis guidance.

Migrating Contaminants

Chemical contaminants may migrate to neighboring sites through groundwater, surface water, or air (ATSDR 2017). For this reason, it is important to consider neighboring land uses for potential sources of contamination. According to the American Academy of Pediatrics (AAP), American Public Health Association (APHA), National Resource Center for Health and Safety (NRC) (2019), ATSDR (2017), and Rhode Island Legal Services (2006), surrounding land uses that may pose a hazard include:

• Designated hazardous site, such as National Priorities List or Superfund sites, brownfield properties, and state-listed sites
• Sites that may release hazardous materials or contain potential contaminants, such as factories, gas stations, and auto repair businesses
• Sites that may release chemical contaminants to nearby sites in the form of runoff, flooding, wind erosion, or vapor intrusion
• Utility uses, such as drinking water reservoirs or storage tanks, electrical substations, high-voltage power transmission lines, pressurized gas transmission lines
• Proximity to explosive or flammable products, such as propane tanks
• Sites that use industrial pesticides 
• Toxics Release Inventory sites, which tracks some chemical releases and waste management in sites that generate chemical waste.
• Resource Conservation and Recovery Act Large Quantity Generators 
• Air Emitter Sites
• Leaking Underground Storage Tanks

Air and water quality can significantly impact children’s health. Three types of air pollutants (criteria pollutants, toxic chemicals, and greenhouse gasses) can contribute to adverse health impact in children and adults. Air quality can be impacted by surrounding land uses such as industrial land use, traffic pollution, regional pollution sources, and activities like fracking. Like clean air, access to a clean water supply should also be considered for ECE development. Contaminants present in one site can be transferred to the adjacent sites through the water. For instance, a clean site located next to a Superfund site is more likely to become contaminated through the transfer of contaminants through stormwater runoff. To limit such cross-contamination, planners can use green infrastructure techniques, such as using pervious materials to trap contaminants that may be present in stormwater runoff. Planners should consider the potential impacts of surrounding land uses on a site during the permit review process and, if possible while making plans and policies. The latter can help identify areas more suitable for growth, as well as areas requiring environmental remediation. Section 2.3, Planning Strategies to Site ECE Programs, provides safer siting recommendations to protect ECE programs from potential contaminants.

Naturally Occurring Contaminants

Many contaminants are naturally present in water, air, and soil. These contaminants are often contained and do not pose a threat to human health. While contaminants can present themselves naturally at any time, some activities, such as redevelopment, mining, and even geologic changes, can disturb naturally occurring contaminants and release them into the environment. ATSDR provides information about naturally occurring contamination including asbestos, lead, and radon, as well as information about  identifying sites  that are more likely to have naturally occurring contaminants (ATSDR 2017). Table 1 shows the list of naturally occurring contaminants that were listed in ATSDR’s Choose Safe Places for Early Care and Education Guidance Manual.

Naturally occurring contaminants are less likely to be identified using historic site information. Some contaminants are more easily detected than others; for example, radon. The EPA recommends testing for radon when a property is sold or purchased (U.S. EPA 2018). If contaminant information is not readily available, a site review or postconstruction inspections can give more information about their occurrence.

Contaminants can be naturally present in water. Children consume more water by body weight than adults, and they can be exposed to contaminants in it through ingestion, skin contact, and inhalation (Council of Environmental Health and AAP 2019). Water sources should be tested periodically to detect contaminants that could cause adverse health impacts. Additionally, pipes and water infrastructure should be inspected as potential sources of contamination; these components can introduce contaminants, such as lead, copper, and other chemicals, into otherwise safe drinking water (ATSDR 2017).

Access to a public water system is desirable, as municipalities conduct regular testing to identify contaminants in public water systems. Hence, to promote health, planners should steer ECE development in areas that are serviced by public utilities. If the water is from private sources such as private wells then testing for pH level (corrosivity of drinking water) and other agents is even more vital for ECE programs. Local public health departments may have information about naturally occurring contaminants that affect private wells. Planners can thus coordinate with environmental health or public health professionals to make sure a site is tested for water quality before an ECE program is approved. Additionally, the U.S Geological Survey  provides information  about water quality risks present in aquifers across the country.

Planners can integrate these criteria into the development review process, as part of an infrastructure investment plan, or when working on plans that identify community areas suitable for growth.

2.1.2 Identification of Contaminants

While some former uses such as storage sheds or loading dock doors are easy to classify as an incompatible land use because they are visible, others may be less visible during a physical site assessment. Incompatible site uses, such as nail salons or funeral homes, may not leave visible clues about possible contamination. In such cases, questionnaires, licensing records, zoning maps, and tax files are reliable sources of data to identify potential contaminants (ATSDR 2017). Planners can ask for historic site information as part of the development review process. Section 3, Land Suitability Analysis, provides further guidance on collecting site-specific data.

Environmental site assessments (ESAs) can be used to identify site contamination. Some municipalities may require ESAs under certain conditions, such as in rezoning and permit approval processes. ESAs may be required by lenders to reduce liability for the new owner. Local and state entities can include requirements for development projects to conduct ESAs and present them as part of a development plan. For instance, some states require ESAs on projects that fall under specific parameters, such as those that are publicly funded. Phase I ESAs focus on identifying potential sources of contamination. If there is sufficient evidence that a site may be contaminated, potential buyers may conduct a Phase II ESA, which confirms the presence of contaminants by testing samples from the site (Wisconsin Department of Natural Resources 2014).

A variation of an ESA is an environmental audit. According to a report published by the AAP, APHA, and NRC, “[a]n environmental audit should be conducted before construction of a new building; renovation or occupation of an older building; or after a natural disaster, to properly evaluate and, where necessary, remediate or avoid sites where children’s health could be compromised” (AAP, APHA, and NRC 2019). Remediation may be necessary for circumstances when a site is contaminated.

Methods used to identify the contaminants may vary depending on the community type. Sites in rural areas exhibit different potential sources of contamination (chemicals applied to fields and runoff from animal pastures) than urban areas (Child Care Planning Associates 2010). Residents and stakeholders may be able to provide more information on chemical use in these communities. In urban areas, potential ECE program sites may have a long history of land-use change, a greater number of children who are impacted, and a greater exposure from various urban issues such as traffic congestion. It may be simpler to obtain historic site information about sites in urban areas because of their higher capacity to store and retrieve the records.

Siting ECE programs such that they are accessible to all community members, including those that are most in need, create inclusive communities that support growth for youngest residents and complement local economic processes by providing a necessary service to working families. In addition to being inclusive, integrating ECE programs into the fabric of a neighborhood maximizes health benefits for children and community members. Thus, the community planning principles (beyond siting) that encourage community well-being support such practice.

Opening new ECE programs on sites that have certain desirable attributes (such as access to transit, open spaces, and libraries) can not only reduce exposure to contaminants but may also positively influence other social determinants of health.  Health in the Development Review Process , a guide created by APA, provides health considerations that can be applied to new developments. Based on that guide and other resources, planners should consider the following desirable attributes during site analysis, including for ECE programs:

• Absence of unacceptable environmental or public health risks
• Access to public water and sewer systems
• Access to infrastructure such as telecommunication systems
• Convenient location in the community, near facilities like schools, libraries, and parks, but away from land uses like highway, industrial areas, and high aircraft noise areas.
• Safe and secured
• Compliant with zoning code
• Provide opportunities to incorporate universal design principles
• Promote accessibility and congruency with surrounding developments. (Environmental Protection Agency 2015; City of Richmond 2019).
• Multimodal connectivity

In addition to the site characteristics listed above, if an ECE program can collaborate with another nearby existing program, that can also be considered a desirable attribute. For instance, a retirement community in Ithaca, New York shares their facility with a Head Start program, resulting in shared programming and benefited the youngest and eldest community members (Ghazaleh et al. 2011). While the role of planners is minimal in these cases, creatively approaching multigenerational planning can help improve children’s physical and mental health.

It is important to consider how ECE programs connect to surrounding systems, services, and populations. According to the EPA (2015), ECE programs with these desirable site attributes can have positive impacts on the following community goals: 

• improving public health
• supporting revitalization effort
• strengthening fiscal responsibility
• increasing transportation choices
• providing opportunities to live, work, play, and attend school in convenient locations
• limiting emissions of greenhouse gases, and toxic air pollutants

This approach ensures that developments are serving community health interests. While these desirable attributes are many times considered for schools, they are not considered as often for ECE programs. Considering that the children going to the ECE programs are more vulnerable to the impacts of chemical contaminants, it is imperative that planners and ECE operators consider these desirable factors while making ECE siting decisions. 

Planners have opportunities to positively influence environmental health. In the briefing paper titled “Child Care and Sustainable Community Development,” Anderson and Dektar (2010) identify key points for planning ECE facilities, including meeting the needs of parents and children, supporting community development, aligning smart growth goals with childcare services, and developing funding mechanisms to reduce the cost of childcare. In another study, Randolph (2012) explains the variety of roles that planners play in influencing environmental health (see Table 2), many of which can be transferred to planning for ECE programs.

As seen in Table 2, planners can work with communities, developers, and ECE operators to identify sites and integrate environmental health consideration into development processes. Childcare facility considerations that prioritize environmental health can be applied through planning interventions, including through comprehensive planning processes, zoning, and developer agreements. Below are five strategic points of intervention for planners (Klein 2011), as they apply to ECE siting.

Long-range community visioning and goal setting: Planners can help communities identify values and goals for how members would like to see their communities grow. Education is usually a priority among the residents of many communities and planners can make sure to include ECEs in those discussions.

• Visioning activities are opportunities for community engagement. These activities can result in a set of values, which can include quality and healthy ECE programs, that inform other interventions, such as plan making and public investments.

Plan making: Planners can guide community members to create plans or incorporate safe ECE program siting policies into comprehensive plans. Depending on the needs of the community, planners are also involved in creating functional plans or subarea plans that address environmental health. They can include ECE and the ECE siting process as component of those plans.

• Comprehensive plans can guide development to grow in a way that supports a community vision.
• Functional or subarea plans can also address safe ECE program siting. These plans can focus on narrower topics than comprehensive plans (such as a transportation plan) or smaller geographies (such as a neighborhood plan).

Standards, policies, and incentives: Planners can identify areas that are better suited for ECE programs (Klein 2011; LaGro 2013). Drafting a policy can help communities outline next steps for implementation, including providing standards for ECE operators and creating incentives for adopting environmental health considerations.

• Zoning regulations play an important role in identifying permitted uses and in identifying circumstances that require discretionary review. Proposed ECE programs can be assessed for both desired and undesired characteristics when ensuring that the use is appropriate for an area.
• Ordinances or standards can protect environmental health and reduce exposure to contaminants by outlining precautions to avoid contamination.

Development work: Planners can work with developers to review and make recommendations on private plans. This ensures that proposed projects are in line with community needs and goals.

• Planners can guide a development review process to encourage ECE operators or developers to select safer sites.
• During the development review period, planners can identify if additional information is required to determine if a site is safe for children.

Public investments: Planners can play a role in shaping public investments that encourage future development in spaces that are safer for ECE programs. Desirable characteristics such as access to community services and multimodal transportation options are impacted by decisions about community investments.

• Communities can also develop programs that provide financial support for ECE programs who are looking to select a safe site.

Planners can use these interventions to support environmental health considerations at a broader scale beyond just during development process. Planners can integrate health considerations in community planning processes such as making corrective/selective amendments to comprehensive planning documents and revising implementation tools like zoning ordinances and design standards (University of Minnesota 2007). Some of these interventions can benefit from cross-disciplinary collaboration and support.

2.3.1 Cross-Sector Collaboration

Creating an environment that promotes healthy ECE program development requires cross-sector collaboration. In Creating Healthy Neighborhoods, Forsyth, Salomon, and Smead (2017) mention that “not all environmental toxins are related to issues that are controllable by the planning and environmental design fields at the local scale.” Planners are equipped to bring siting considerations to the table and to support collaboration among a wide range of specialists who share an interest in the built environment. With a unified approach from stakeholders, including health professionals, childcare inspectors, and community members, planners can help communities identify sites that support healthy ECE programs and address environmental health challenges.

Planners can collaborate with experts in the following ways:

• Environmental health officials — Identify environmental health measures that fit community context; propose/support ordinances that support health, safety, and welfare of community; and assist with interpreting identified environmental health concerns.
• Childcare inspectors — Collaborate to establish uniform standards for health and safety facility assessments related to permitting and licensing requirements.
• Fire marshals — Support developing building and fire code inspection processes that address site conditions and environmental health.
• Community councils or task forces related to ECE — Identify opportunities to integrate land use and environmental health considerations in local groups focused on ECE programs.
• Community members — Work with community members to identify priorities for future developments and collect information about where ECE services are needed.
• Developers — Provide recommendations to avoid hazards on permit applications and promote environmental health by identifying the data and data sources needed to perform the site selection process.
• Architects — Encourage review of information and additional considerations outside of a site-specific analysis. 

Planners and affiliated professionals can use a variety of resources to identify sources of contamination in an existing site. During the site review process, planners can identify activities that could have disturbed naturally occurring harmful substances, such as mining or groundwater spills. Also, depending on project funding and developer protocols, environmental professionals may be brought on to conduct environmental site assessments. Environmental site assessments can identify possible environmental contamination and incorporate remediation strategies (Russ 2009). It may be challenging to identify all former uses, but planners can work with other professionals to collect publicly available information (such as previous zoning and land-use maps, building and permit department records), conduct resident interviews, and do site visits to identify if a site previously contained any incompatible land use and more specifically, potential sources of contamination.

Additionally, planners can use tools like health impact assessments (HIAs) and environmental impact assessments to understand how community changes can impact the health of those around a proposed development site. Since HIAs are not limited to a specific discipline, but rather benefits from cross-sector collaboration, planners should work with public health departments to conduct these assessments, especially those related to environmental health. (National Research Council 2011). The Planning and Community Health program at APA has developed  resources to help planners understand, conduct, and collaborate on HIAS .

Planners can coordinate with health departments and environmental professionals to collect information about potential sources of contamination. Multiple entities can provide and help interpret environmental data about a site. These include local environmental health departments, pediatric environmental health specialty units, and resources from ATSDR. ATSDR collects and publishes information related to toxic substances and exposure. One measure used to understand the relationship to hazardous materials and health are minimal risk levels (MRLs). This measure identifies condition that could lead to adverse health effects. For more information about MRLs, including lists of contaminants, frequently asked questions, and toxicological profiles, visit  ATSDR's site .

2.3.2 Equity Consideration

Healthy ECE programs can provide opportunities for all children to thrive by providing educational experiences in spaces that are safe and free of contaminants. Residents of communities that face social inequities and poor environmental quality can experience health challenges that negatively impact their quality of life and life expectancy (Council of Environmental Health and AAP 2019). Underserved communities are also often located closer to activities that are hazardous to health and have a greater propensity to release contaminants into the soil, air, and water (Maantay 2001). Ensuring that children have access to safe and healthy places is one way in which ECE programs and communities can work towards reducing health disparities. 

Access to high-quality ECEs is one factor that can contribute to improved opportunities and enhance child development (Barnett and Lamy 2013). There are, however, gaps in quality preschool program access. In 2013, 90 percent of children from high-income families attended a center-based preschool program, compared to only 65 percent of children from low-income families (cited in Barnett & Lamy 2013). These conditions contribute to an achievement gap that begins before students are enrolled in kindergarten.

Children who do have access to ECE programs can still experience an achievement gap depending on their exposure to contaminants. Studies have shown that after controlling for programmatic quality, environmental conditions were found to be the contributing factor behind the achievement gap. For example, a 2009 study found that lower scores on a test among students of lower socioeconomic status were associated with their exposure to lead (Miranda et al. 2009). Exposure to contaminants, in combination with social determinants of health and other factors, can lead to decreased quality of life —contaminants can contribute to chronic health issues that impact a child well beyond their time in ECE program.

While many of the recommendations related to ECE programs can focus broadly on issues related to access and equity, connecting recommendations to specific geographies can encourage changes in the built environment that support all members of the community. Planners can play a role in helping communities plan for goals similar to those identified by the  Human Impact Project , where the connection between planning interventions, ECE permitting processes, and environmental health considerations shaped the opportunities students had to access quality ECE programs.

Disparities in exposure to environmental contaminants have led to environmental justice initiatives to support healthier home environments (Council of Environmental Health and AAP 2019). The disproportional impact of historic siting decisions can have significant health impacts on children in some communities. While many of the environmental health impacts can be attributed to housing conditions, it is important to emphasize that without adequate siting regulations, ECE programs can expose children to contaminants as well. Children spend a significant portion of their time in ECE facilities—exposure to contaminants in this setting can have just as much of an impact on health as exposure to contaminants at home.

Planners have a responsibility to address equity considerations as part of their practice, including considerations related to environmental justice, health, and education (Ross et al. 2019). Approaching planning processes with an equity and environmental health lens enables planners to help communities identify opportunities to reduce exposure to contaminants within ECE programs.

In 2016, Human Impact Partners released a report that provides recommendations for how to improve preschools throughout Cincinnati. Report recommendations include strategies for increasing access to high-quality preschool programs for all children in Cincinnati (Avey et al. 2016).

In Summary

Environmental health conditions should influence where communities place ECE programs. When a new ECE program is proposed, making informed decisions about site selection can encourage safer site selection. Undesirable site attributes, including the presence of contaminants, can have a negative health impact and are potential deterrents for development. Desirable site attributes benefit an ECE program and a community by supporting community goals like connectivity to services, density, and reduced exposure to contaminants. Planners, in collaboration with environmental health professionals and community stakeholders, have a variety of tools at their disposal to encourage safer site selection. By following inclusive processes, it is possible to develop communities with access to quality ECE programs for all.

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•  Part 1: Planning and Environmental Health With A Focus on Early Care and Education 
•  Part 2: Environmental Health Considerations for Siting ECE Programs 
•  Part 3: Land Suitability Analysis 
•  Part 4: Safe Siting in Hurricane-Affected Areas