Physical Environment and Transportation
6-01 - Accessible school facilities and programs
 

Ensure that school-sponsored programs both on-site and off-site (such as field trips, vocational education work experiences, extra-curricular activities, and sporting events) are accessible to all students and staff.

   
RATIONALE
 

The provision of access to all facilities for students and staff with disabilities is necessary to comply with the Americans with Disabilities Act (ADA) (24) and other federal laws, to enhance safety for those with disabilities, to prevent injury, and to promote an inclusive environment.

   
COMMENTARY
 

Accessibility to facilities for those with disabilities requires planning for new and renovated buildings and grounds and may require retrofitting of existing facilities. Children's height and other dimensions must be taken into account when designing or purchasing drinking fountains, toilet stalls, lavatories, sinks, and fixed or built-seats and tables. Include accessible routes for persons to reach buildings and other spaces. Ground surfaces along accessible routes, transportation (drop-off and pick-up sites), getting from one floor to another in multiple-story buildings, and parking spaces must be considered as part of facility planning. Apply these designs to both temporary and permanent facilities—any building that is used for the public.

Public school districts must comply with ADA in all programs, including those that are open to parents or the public. Therefore, aside from classes, events such as graduation exercises, school plays, sporting events, and board of education meetings must be accessible to persons with disabilities.

Technical requirements for accessibility to buildings, facilities, and routes are well defined in the Americans with Disabilities Act (ADA) of 1990 (24). The US Departments of Justice and of Transportation offer guidance and technical assistance for meeting these requirements.

   
 
6-02 - Communicating safety policies
 

Communicate all safety policies to staff, students, and families. Notify parents and staff in advance of physical plant projects and other changes that might affect the health, safety, and well-being of students and staff. Inform staff, students, and families about unplanned incidents such as a chemical and biological exposure or exposure to certain communicable diseases.

   
RATIONALE
 

Knowledge of safety policies, such as student drop-off and pick-up areas or prohibition of weapons in school, is essential to compliance. Warning parents, students, and staff about projects that affect the physical environment (e.g., painting, pesticide spraying) allows persons with unusual sensitivities to be protected from harm. Having a plan to deal with an unforeseen environmental exposure reduces unnecessary delay between exposure and treatment, thereby optimizing health outcomes.

   
COMMENTARY
 

Involve staff, students, and families in the development and revision of safety policies. Policies without clear parameters may be open to varying interpretation. Policies must be explicit, well-disseminated and explained to all those expected to abide by them. The existence of school health and safety teams with well-defined roles and clear reporting mechanisms can help clarify communication and improve the accuracy, approval, and acceptance of messages.

Projects that benefit from advanced notification include painting, renovation, pesticide application, and removal of mold or asbestos. Schools have a responsibility not only to minimize students' exposure but also to alert their families to the potential for exposure. Students with special health needs such as allergy or asthma who might be unusually susceptible can receive additional protection. When a school cannot predict an unusual environmental event, such as a chemical spill on a nearby highway, the school should consult with emergency personnel about the best ways to protect students (Guideline 4-11). School staff should notify students' families and health professionals of any such exposure and report the substance involved, signs and symptoms to watch for, and how to seek any necessary health care.

Adoption of a plan that addresses environmental concerns will assist the district in responding to them quickly and appropriately. Principles and goals of "risk communication" should be considered when designing a notification mechanism. This helps ensure that heath and safety messages are accurate and clearly understood by families, students, and staff. Parents with limited literacy or limited understanding of the English language must also be considered in this plan. The district should have knowledgeable personnel and/or consultants available to assist with investigations and to assist district personnel in developing the plan. The Agency for Toxic Substances and Disease Registry provides information on various toxic substances and on principles to use when communicating the risk of these substances to the public.

   
 
6-03 - Buildings: construction and renovation
 

Comply with local and state-level policies that address the design and specifications for new schools and that address construction and renovation projects. Use current professional engineering, public health, scientific, accessibility, and safety guidelines. Plan and implement projects so that workers' and occupants' exposure to environmental hazards is eliminated or minimized and comply with the US Environmental Protection Agency guidelines for air quality and school design.

   
RATIONALE
 

Designing and building schools as well as improving existing systems and buildings so that they provide a healthy and safe indoor and outdoor environment can prevent health and safety problems for occupants. Schools that are appropriately designed, constructed, and maintained can reduce operations and maintenance costs. Construction and renovation often disturb existing materials or introduce new materials thereby generating unsafe quantities of particulates, gases, and vapors, which result in poor indoor air quality.

   
COMMENTARY
 

Safety of a school environment must consider fire, earthquake and other safety codes (e.g., adequate stairways and exits, safety glass), thermal comfort controls, humidification and dehumidification systems, moisture protection measures, and building commissioning. Opt for energy efficiency and environmentally friendly materials and consider the energy absorbing properties of chosen materials. The design and construction of a healthy and safe school environment must also specifically consider school-site selection (based on transportation needs such as walking and biking paths), accessibility standards (i.e., accommodating disabilities), safe surfacing (e.g., playgrounds, hypoallergenic indoor flooring), and source control measures in areas such as science laboratories and vocational technical areas. Supplies of hot and cold water sources for sinks and toilets should be adequate and located strategically to promote hygiene (e.g., near food preparation areas, in rooms where students receive medical procedures, in toileting areas, in classrooms where chemical exposure may require flushing with water). Drinking fountain locations should promote water drinking but be protected from traffic to avoid oral injuries. Design classrooms, media centers, and libraries with good lighting and acoustics. Stairways, hallways, and restrooms should also be well-lit.

In the design stage of a construction and renovation project, strategic plans should be implemented to minimize and eliminate potential exposures to various environmental hazards to workers and occupants. These strategies include but are not limited to: work site isolation, safety practices, indoor air quality-friendly products and materials selection, construction methods, activities scheduling, good housekeeping practices, and project updates and communications. Federal and state regulatory requirements apply to renovations that disturb certain highly regulated substances, such as asbestos-containing materials and lead paint. Renovations in occupied buildings should only be undertaken after the strategic plans have been agreed to by all parties including the school administration, contract administrators, contractors, parents, students, and other interested parties, and after obtaining necessary regulatory approval.

   
 
6-04 - Buildings and grounds: maintenance
 

Develop and implement comprehensive preventive maintenance procedures to ensure a healthy and safe environment within the building and on school grounds. Include staff training and have procedures that include playgrounds, sports areas, and bathroom facilities.

   
RATIONALE
 

A comprehensive preventive maintenance program can avert significant and premature deterioration of the building, its systems, and its playgrounds that could lead to compromised health and safety of students and staff.

   
COMMENTARY
 

An environmental safety review of buildings and grounds should be done at least annually. Proper attention to the maintenance of the heating, ventilating, and air-conditioning systems, building envelope (roofs, walls, windows, flooring, subflooring), and housekeeping will improve indoor air quality and energy efficiency and will reduce costs and level of custodial effort to keep the building clean. The maintenance plan should include consideration of weather related problems, such as water on floors in rainy/snowy weather. Maintenance should also include procedures for maintaining safety on school grounds, including playground surfaces and equipment. Have schedules to inspect equipment and repair items not in compliance with US Consumer Product Safety Commission guidelines.

Cover trash containers to keep out rainwater and remove waste on a regular schedule to prevent noxious odors and environmental reservoirs for disease. Open trash containers with decaying organic materials (scraps of food, for example) attract flies and other vermin that can carry bacteria and viruses to food sources and to humans directly. Cockroaches and rodents can also be vectors of disease.

Toilet facilities must be maintained to be both hygienic and safe. Areas of privacy must be provided (e.g., stall doors that are intact and operational). Adequate supplies of soap, toilet tissue, and paper towels must be maintained. Students should not be discouraged from utilizing toilet facilities for reasons of cleanliness or safety.

Require that an experienced maintenance supervisor develop inspection and maintenance procedures, including a detailed preventive maintenance schedule for all equipment, grounds, and facilities. School administrators must be aware of estimated labor-hours to complete all preventive maintenance activities and have a budget to meet those needs.

   
 
6-05 - Classroom safety: equipment, facilities, student conduct
 

Teach students safety practices, ensure safe conduct, and enforce use of applicable safety guards and protection devices in classrooms. Provide appropriate supervision, safe equipment, and safe facilities. Apply these principles to vocational education settings, to youth employment situations, and to all art, science, food preparation, industrial arts, and shop classes.

   
RATIONALE
 

Safety education, safe practices, and supervision, when enforced through school policy in science and shop classes, art courses, classes where there is food preparation, and vocational education classes, will prevent serious injuries to staff and students.

   
COMMENTARY
 

A coordinated effort to review safety needs as well as to revise and maintain safety protocols in these classes should be implemented through representatives from vocational education, science, and art. Class safety rules should be developed and taught to students. Students should sign a contract at the beginning of the term agreeing to follow the rules. Provide adequate supervision. Inspection checklists should be used in shop and vocational education classes.

Chemicals are of particular concern in classrooms. It is recommended that chemicals be stored by their chemical family rather than alphabetically to minimize dangerous interactions. Dispose of chemicals that are on the banned substance list, are out of date, or are in unlabeled containers. Material safety data sheets (MSDS) should be available to staff and students for each chemical stored and/or used in the school setting.

Certification programs, continuing education, and educational supplies that pertain to the prevention of injuries in these classes are available (84). A publication of the American Chemical Society (12) and an Internet site called "The Catalyst" (a resource for science teachers) provide detailed safety information pertaining to chemistry, biology, and physics in the school classroom. Guidelines on work space per student, eye protection, fire prevention, and protection from injuries in physics experiments that involve electricity, motion, energy, heat, and sound are available at this website. Inspections by the US Occupational Safety and Health Administration may be considered in order to verify compliance with meeting safety standards for staff.

Youth who are employed, particularly those who work as part of school-to-work programs or vocational training, require knowledge of safety practices (Guideline 2-06) and the skills to recognize and avoid unsafe work-site situations. Safety issues for students related to sport and physical activity are covered in Guideline 3-05 and Guideline 3-09.

   
 
6-06 - Safety on out-of-school trips
 

Develop and implement plans to address the safety of students on school-sponsored, out-of-school trips (field trips). Policy should address: supervision of students, transportation to sites, student-specific health information, equipment and expertise required to implement students' individualized health service plans (including administration of medication), and behavioral expectations of students and supervisors.

   
RATIONALE
 

Schools are responsible for students and their safety at any school-sponsored event, on or off school grounds.

   
COMMENTARY
 

Adequate supervision of students must be planned in advance of each trip and must take into consideration students' health, mental health, and safety needs. This includes having students accompanied by staff who are trained to administer medications, perform first-aid, and observe for health problems (for example, recognizing symptoms of asthma or observing that a student with diabetes has eaten lunch). Arrangements to transport health-related equipment must be made. A responsible adult on the trip should have a copy of each student's emergency information card. Information must include emergency contact information and key health information that will be needed in an emergency.

Encourage the use of school vehicles driven by appropriately trained and licensed school employees, not private vehicles, when the school district provides transportation to school-sponsored events. When private vehicles must be used, require operators to be licensed drivers of the type of vehicle driven, carry insurance for occupants of their vehicles, require occupants to wear safety belts, and follow state regulations for inspection and registration for the vehicle.

Behavioral expectations may include, for example, making one's location known at all times; avoidance of tobacco, alcohol, and illicit drugs (see Guideline 6-11, Guideline 6-12); and housing males and females in separate sleeping quarters.

   
 
6-07 - Safe pedestrian and vehicle traffic areas
 

Establish and enforce a plan that is designed to provide safe movement of motorized vehicles, non-motorized vehicles, and pedestrian traffic on school property. Include all parking, pedestrian, and vehicle traffic areas, bicycle lanes, and student drop-off/pick-up areas. Apply the policy to staff and students driving on campus and to recreational and commercial service vehicles. The plan should encourage walking and/or bicycling to school and include the establishment of safe routes to school.

   
RATIONALE
 

Multiple modes of transportation at school as well as transportation to and from school and school-sponsored activities put students and staff at some risk for collision. Proper planning, development and enforcement of standards, and education can decrease risk of collision and injury.

   
COMMENTARY
 

Enforce all state and local vehicle regulations (even for school campuses considered to be private property), including occupant protection (safety belts) and helmets for all-terrain vehicles (ATVs) and motorized cycles. Non-motorized vehicle safety issues are addressed in Guideline 6-19. All motorized vehicles, including motorcycles, ATVs, and trucks, should be operated only by licensed drivers. Prohibit carrying of passengers on motorcycles, ATVs, and in the cargo beds of pickup trucks. Carefully restrict traffic in all loading and unloading zones during school hours.

Route vehicular traffic onto schools' driveways and parking lots to minimize danger to pedestrians. Protect pedestrian paths from bicyclists and students using skates, skate boards, and scooters (e.g., separate lanes). Protect users of these non-motorized recreational vehicles from motorized vehicle traffic. Playgrounds should be located away from traffic. Have clearly marked and separate drop-off and pickup areas for pedestrians, school bus riders, and private vehicle users. Situate them so as to reduce student and staff exposure to vehicle exhaust fumes. Pickup and drop-off points for students should be limited to the curb and preferably at an off-street location that is protected from traffic. Assure adequate supervision while students are boarding and exiting vehicles. Be certain that crossing guards and members of safety patrols are trained for these roles. Discourage the playing of car radios and public announcement systems in vehicles used to transport students. Communicate all policies to staff, students, and their families.

Conduct a school transportation safety assessment when considering where to build new schools. Assess whether areas have adequate road capacity to handle increased traffic, adequate sidewalks, bicycle lanes, places for school bus stops, and low crime rates that make walking safe. Efforts should be coordinated with appropriate jurisdictional authority to provide well-posted and enforced reduced-speed school zones around campuses. The National Highway Traffic Safety Administration and CDC's National Center for Chronic Disease Prevention (67) provide tools and checklists for "walkability" and "bikability" in communities, as well as suggestions on how to remove barriers that keep students from walking and bicycling to school.

   
 
6-08 - Playground safety
 

Use and monitor the use of the most updated US Consumer Product Safety Commission (CPSC) and ASTM International guidelines for playground safety. Use the guidelines to address playground surfacing, the use and maintenance of equipment, and supervision.

   
RATIONALE
 

Research has shown that many playgrounds fail to meet CPSC and other safety guidelines and standards. Following guidelines greatly reduces risks of injury to students and others who use the facilities.

   
COMMENTARY
 

Students must be taught to play safely. Falling from playground structures and colliding with equipment or other students can result in head, face, oral, and other musculoskeletal injuries. More than 200,000 playground injuries are reported each year in the United States. Approximately 75 percent of these injuries are attributable to falls, mostly from slides, jungle gyms, and other climbing equipment. Other causes of injury include running into equipment, various collisions, burns from hot surfaces or equipment, and strangulation. Student conduct related to playground safety must be also be addressed (Guideline 3-09).

Schools should follow CPSC and ASTM International safety guidelines to prevent these types of injuries to students. ASTM International was formerly known as American Society for Testing and Materials. Guidelines are fairly specific (e.g., do not wear bicycle helmets on play equipment, details on equipment hardware, inspections for sharp edges) and there are multiple ways to retrieve this information (e.g., videos, checklists, brochures, instruction books). Major focus areas include separation of playground areas for different age groups, installation and maintenance of safe and developmentally appropriate equipment, use of appropriate surface materials, appropriate fall zone areas, and adequate supervision at all times. Playground equipment and play surfaces should be inspected and maintained. Records should be kept of all playground injuries and reviewed. Injury data should be carefully analyzed and used to guide preventive, intervention, and education strategies. Inspections should take place on at least an annual basis (more often depending on life of equipment and surfaces, such as plastic equipment) and adjustments should be made on the basis of injury cause data, updated guidelines, and repair records.

   
 
6-09 - Exposure to toxic/poisonous substances in classrooms
 

Prohibit the use of toxic and poisonous substances as part of classroom or vocational education unless there is a clearly documented need that cannot be otherwise met and there are protocols and procedures in place to protect students and staff from toxin exposure. Communicate policies on acceptable and unacceptable substances to students, staff, and families.

   
RATIONALE
 

Ingestion, inhalation, or other misuse of potentially toxic substances, whether intentional or unintentional, can be prevented. By adopting policies that reduce access, schools and districts can avoid harmful consequences, such as poisoning and burns.

   
COMMENTARY
 

Art, theater, shop, vocational courses, science courses, and other courses that require the use of toxic substances, such as paints, solvents, wood dust, and other chemicals, require ventilation systems that are found within the American Conference of Governmental Industrial Hygienists (ACGIH) (14,15) guidelines. The ACGIH systems, which consider industrial workers' exposures at the "threshold limit value" (TLV), must be designed to meet the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) standard of 1/10 of the TLV or lower (20-22). Inspections should be performed at least annually for expired chemicals and/or damaged containers, which should be removed and disposed of properly.

Ceramic kilns can be used if they are vented sufficiently and only a teacher or other trained adult is potentially exposed to the heat, kiln wash, etc. Ceramic glazes, either leaded or lead-free, and processes or chemicals requiring ventilation should not be used in elementary schools. For older students in classes such as Chemistry, substances should be properly stored and used with supervision. In areas in which students through age eight may have access, potentially toxic substances should be stored in a locked cabinet.

Poison Control and emergency assistance numbers should be clearly posted by all telephones. Poison control and emergency assistance numbers are 800-222-1222 and 911, respectively. Staff and students should be trained in proper response to poisonings and toxic exposures.

   
 
6-10 - Live animals in school environment
 

Limit exposure to live animals in order to protect the health and safety of students and staff.

   
RATIONALE
 

Students in schools should not have access to live animals that may pose a threat to safety and health.

   
COMMENTARY
 

Exposure to live animals places students at risk for animal bites, allergic reactions, and infection from animal vectors. Furred and feathered animals are common triggers for students with allergies and asthma. Reptiles are frequent carriers of infectious diseases. Access to all animals on school property should be limited, so that no animal roams freely.

Animals should be eliminated from regular classrooms. Animals necessary for certain curricula, such as biology or animal husbandry/vocational-agricultural programs, should be carefully confined in suitable, sanitary, self-contained enclosures appropriate to the size of the animal. Staff must be responsible for ensuring that enclosures are kept in a sanitary condition. Prior to introducing any animals into the classroom, school staff must verify that students and school personnel have no known allergy to that animal and that animals are free from any diseases or parasites. Animals must present no physical danger to students and contact should be limited to instructional purposes. Students must be fully supervised during all points of animal contact.

   
 
6-11 - Tobacco use policy
 

Develop and enforce policies that prohibit tobacco use on school property by all students, school staff, families, and visitors. This policy should include school vehicles and any school-sponsored indoor or outdoor event.

   
RATIONALE
 

Environmental tobacco smoke exposure is a well-recognized health hazard for children and adolescents. Tobacco smoke is associated with serious adverse health effects, including bronchitis, emphysema, exacerbation of asthma, lung cancer, heart disease, and many other illnesses.

   
COMMENTARY
 

States and/or school districts typically ban smoking inside schools as well as on school grounds for teachers, staff, and students to minimize students' opportunities to smoke and their exposure to environmental smoke. Studies show that restrictions on smoking may help young persons refrain from starting to smoke. Pipes, cigars, chewing tobacco, and any tobacco product should be included in this policy. Tobacco cessation programs should be offered to all who use tobacco.

   
 
6-12 - Drug/alcohol-free school policy
 

Develop and enforce alcohol-free and drug-free policies for all school staff, families, students, and visitors at indoor and outdoor school-sponsored events.

   
RATIONALE
 

Substances that can impair function and compromise the safety of students and staff must not be allowed on school property or at school-sponsored events. It is illegal for students to purchase, possess, and utilize such substances.

   
COMMENTARY
 

An alcohol and drug-free policy still permits staff and students to use prescribed medications during the school day in order to maintain their health. Illicit use of drugs, including tobacco and alcoholic beverages, cannot be tolerated on school property. Failure to comply with these policies should result in disciplinary action and referral to appropriate treatment programs. While expulsion from school may seem to be appropriate, it may aggravate the student's problem rather than help move towards a solution.

Alternate education and therapeutic intervention programs can provide a more acceptable solution and ensure that students receive necessary treatment.

A policy addressing staff using alcohol or other drugs while driving vehicles used to transport students must be in place to ensure the safety of all (Guideline 6-21). Employees found to be using alcohol and illicit drugs must be immediately removed from such duty and appropriate referrals for evaluation and treatment should be made.

   
 
6-13 - Indoor/outdoor allergens, irritants, air quality
 

Develop and enforce policies that minimize exposure to indoor and outdoor allergens and irritants for students and staff.

   
RATIONALE
 

Reducing exposure to allergic triggers is a school's responsibility. Enforcing policies helps to prevent life threatening events and to keep students and staff with sensitivities free of symptoms and better able to carry out their academic functions.

   
COMMENTARY
 

Allergies to foods, insect stings, medications and latex puts approximately 3% of students at risk for severe allergic reactions. Dust mites, pollen, cockroach droppings, molds, animal saliva, urine, and dander are common allergic triggers that cause less severe reactions. Asthma can be exacerbated by these allergens, by tobacco smoke, and by strong odors. Include specific environmental precautions in allergic students' individualized health services plans. On days with high pollen counts and/or pollution levels (e.g., smog, ozone), physical activities for sensitive individuals may need to be conducted in a controlled indoor environment (Appendix E). Retrofit buses and reduce idling to minimize students' exposure to vehicle emissions. Use vinyl or nitrile gloves, rather than latex, in handling food, in laboratories, and in caring for special-needs children.

To decrease fungal and pollen exposure in mechanically ventilated buildings, keep windows closed and use efficient filters. Periodically disinfect locker rooms because fungi often grow in moist environments. Regulate the relative humidity of the air (e.g., via insulation, dehumidification, source control, temperature control). Unless carpeting is necessary and unless its composition and schedule of maintenance minimize dust, mold, and chemical irritants, consider hard surfaces instead of carpets. Avoid unnecessary accumulation of materials in classrooms and hallways that collect dust and harbor molds.

Limit exposure to animal allergens by minimizing animal presence in classrooms (Guideline 6-10). Weigh risk of allergen exposure against risk of pesticide exposure. Implement pest control strategies (e.g., rats, mice, cockroaches, flies mosquitoes) by controlling food sources and moisture and by using specific pesticides or other "integrated pest management" methods. Recognize that many staff and students are in contact with animals and carry allergens on their clothing to school. Do not require students with certain animal allergies to take field trips to zoos or farms or to be exposed to animals (e.g., science projects). Because school renovations that produce dust can aggravate asthma, schedule renovations when students are not present.

Some districts prohibit all students from bringing a food item to school (e.g., nuts) when a fellow student is allergic. Although this is one management strategy and proves useful on celebratory occasions when food is brought from homes, it is difficult to enforce, often provides a false sense of security, and is not recommended by the Food Allergy and Anaphylaxis Network. Setting aside a meal table for selected food allergic students is more restrictive but generally safer than relying on all students' parents to read food labels for hidden allergic ingredients. In addition to the allergic child, educate all students, lunch monitors, and other staff on ingredient avoidance. Prohibit sharing of foods and eating on buses. Keep potential allergic foods, such as those with nuts as an ingredient, off of school food service menus and out of vending machines.

   
 
6-14 - Reservoirs of infectious agents in physical environment
 

Control the indoor and outdoor school environment to prevent potential reservoirs for infectious agents from becoming a source of disease (e.g., standing water and animal droppings).

   
RATIONALE
 

Diseases caused by environmental source infectious agents can be life threatening. Preventive maintenance and control of the environment are relatively straightforward, effective and essential.

   
COMMENTARY
 

Infectious agents (e.g., bacteria, fungi) are always present in the air, on environmental surfaces, and as part of contact with other persons. Bioaerosols are microscopic organisms in the air we breathe, are always present in the environment, and pose no problems when kept within reasonable limits. Although bacteria cause many odors in indoor environments (e.g., human body odor, locker room odors, sour milk), exposure to such bacteria is rarely harmful.

Rarely, specific infectious agents can become so populous that they pose a particular health risk. When excessively concentrated bioaerosols are inhaled, they can cause disease. The most serious risks are to immunologically compromised individuals. There are many examples: humidifiers may harbor bacteria and cause pneumonia, rhinitis (i.e., runny nose), and other respiratory infections; accumulation of bird droppings (feces) can carry infectious fungi (e.g., Histoplasmosis, Cryptococcosis); human contact with rodent droppings can lead to hantavirus infection; human contact with parasites and bacteria in feces of cats, dogs, fowl, and reptiles can cause diseases such as toxoplasmosis and salmonella. Untreated water reservoirs can release bioaerosols or attract disease-transmitting insects (e.g., mosquitoes), which may increase the risk for West Nile virus, Legionella disease, and malaria.

Birds, mice, rats and bats should not be allowed to colonize in attics, air intakes, or other areas near schools where people are likely to be exposed to fecal aerosols. Utilize methods to discourage migrating birds from congregating on school grounds. Any accumulated bird or rodent droppings should be treated to kill disease-causing organisms and then removed when the building is unoccupied.

Regularly clean ventilation systems and carpets. Prevent build-up of dirt and moisture. Immediately attend to unusual situations that could result in bioaerosol problems (e.g., wet carpets). Stagnant water should not be allowed to collect in ventilation system drain pans. Aerosol humidifiers should not be used in schools unless specific cleaning protocols are followed for preventing growth of infectious agents. Keep trash cans tightly covered and keep rain gutters clear of obstruction to prevent accumulation of standing water, a breeding ground for mosquitoes.

The National Center for Infectious Diseases (68) has resources that are disease-specific (e.g., salmonella, West Nile virus, etc.) and provides tips on disease prevention through management of the physical environment, such as preventing accumulation of standing water and taking caution with animal feces. The American Conference of Governmental Industrial Hygienists (14) has resources targeted to building managers such as school custodians.

   
 
6-15 - Universal precautions; blood-borne pathogens
 

Provide school staff with education on the safe handling of blood, vomit, urine, other body fluids, and fecal material. Provide ample and convenient supplies of gloves, containers for proper disposal of needles and other sharp objects, disinfectants (including bleach), and other equipment in identified, predetermined locations, including classrooms.

   
RATIONALE
 

Staff trained in procedures to handle potential exposure to blood-borne pathogens and other infectious agents minimizes risk to students and other staff and alleviates unnecessary anxiety. Hepatitis B, hepatitis C, human immunodeficiency virus (HIV), cytomegalovirus, and other viral infections are readily preventable through the use of basic protocols. A blood-borne pathogen exposure control plan for schools is mandated by the Occupational Safety and Health Administration.

   
COMMENTARY
 

Sport and playground injuries, severe bites, used needles, and many other occurrences in school can expose students and staff to blood-borne pathogens. "Universal precautions" refers to a set of protocols for handling body fluids properly (i.e., blood, saliva, urine, vomit). Body Substance Isolation (BSI) is an acceptable and alternative set of procedures to universal precautions and differs primarily in that this includes handling of all body fluids and substances.

Universal precautions include: hand washing, avoiding punctures, utilizing gloves when handling body fluids, using containers with plastic liners to dispose of contaminated tissues, having special containers for disposing of contaminated sharp objects, promptly washing blood and other human fluids from skin, and cleaning hard surfaces with a disinfectant (e.g., diluted household bleach).

Gloves, disinfectants, and containers to dispose of contaminated materials should be made available throughout the school for easy access. Vinyl and nitril (or nitrile) gloves have less risk than latex for allergic reaction. Nitril gloves have been shown to provide comparable pathogen protection to latex gloves. Masks are required for procedures where splattering to the face is a risk. Good hand washing technique is essential for preventing the spread of disease and should be taught to all staff and students. Adequate facilities for hand washing that should be available throughout all school facilities include warm water, soap or detergent, towels, waste receptacles and posted signs to instruct on hand washing technique.

   
 
6-16 - Hand washing
 

Encourage frequent hand washing with warm water and soap for students and staff in order to prevent or reduce the spread of communicable diseases.

   
RATIONALE
 

Thorough hand washing with warm water and soap is the most effective way to prevent and avoid communicable disease.

   
COMMENTARY
 

Students and staff should be encouraged to wash their hands with soap and warm water before consuming any food and after the use of the toilet or assisting others with toilet needs. To help prevent disease transmission, health services staff should educate students and staff on the importance of hand washing after nose-wiping, before preparing foods, before eating, and after using the toilet.

Schools should be equipped with adequate facilities and supplies. Adequate facilities for hand washing include warm water, soap, waste receptacles, and posted signs to instruct on hand washing technique. Schools with automatic shutoff water faucets should ensure that water runs for at least 30 seconds to provide adequate time for effective hand washing. Soap dispensers and towel dispensers should be checked daily or more often to be certain they are replenished and functioning.

Waterless hand cleaner should be used when running water is not available, but not to replace soap and water when running water is available.

   
 
6-17 - A plan for safe school bus transportation
 

Develop and implement a plan that promotes safety for bus transportation. Include driver qualifications, student and bus driver transportation equipment, emergency provisions and plans, loading/unloading procedures, staff-child ratios, vehicle maintenance schedules and provisions for special events, special routes, and for children with special needs. Follow legal guidelines as well as local and state regulations and laws.

   
RATIONALE
 

A transportation plan provides a process for schools to determine needs of students and drivers. Adherence to a transportation plan that is designed to optimize safety will protect staff and students from harm, prevent injuries and help to avoid delays.

   
COMMENTARY
 

Federal, state, and local regulations and policies must be implemented, enforced, and augmented by best practices to ensure optimal safety. For loading and unloading, have students do the following: stand at least 10 feet from the edge of the road, wait for driver's permission to load, take caution against catching clothing and drawstrings on bus handrails when exiting, and cross in front of bus where they can be seen by the driver.

Drivers need communication devices so they can communicate to a central dispatcher in the event of an emergency or atypical situation. Provide equipment for students with special health care needs. Safety seats and restraints, wheelchairs, and wheelchair tie down systems must meet the specific safety needs of students of various heights, weights and positional needs. Inspect these regularly and make needed repairs.

Ensure that transportation needs specified in students' individualized plans are met. Train personnel and familiarize them with procedures necessary to evacuate students in wheelchairs and child restraints as well as students with a range of behavioral and communication problems. School districts should involve police, fire, and emergency medical services personnel in evacuation training exercises. Bus routing schedules should minimize transportation time as excessive hours on a school bus can compromise sleep, study hours, and extra-curricular activities. Students picked up first in the morning could be dropped off first in the afternoon.

Use only well-maintained vehicles that have passed regular and consistent inspection and comply with "National School Transportation Specifications and Procedures" (75). Train transportation staff to address child passenger safety precautions, including use of safety restraints, handling of emergency situations, defensive driving, child supervision responsibilities, and education of students.

Take drivers' age and experience into account when hiring. Laws, rules, regulations, policies and procedures on driver qualifications, including a health and mental health assessment, are determined by each state and addressed by the National Highway Traffic Safety Administration (NHTSA). NHTSA offers a training and certification program for child passenger safety (called "NHTSA Standardized Child Passenger Safety Technician Training and Certification Program"), which includes a module for school bus safety. NHTSA also addresses: behavior management on the bus; various passenger disabilities and health conditions; securing wheeled mobility devices; transporting infants, toddlers, and preschoolers; emergency evacuation procedures; and routing and scheduling.

   
 
6-18 - Health information for transportation
 

Provide the transportation department and drivers with access to all health and safety information about students with special health care needs that is relevant to safe transportation, without compromising students' confidentiality.

   
RATIONALE
 

Bus drivers spend large amounts of time with and have great responsibility for students with special health care needs, and they must be adequately prepared to meet these needs. Understanding what students with special health care needs may require, including information about their health care and equipment, can reduce staff anxiety and produce a safer environment for the student.

   
COMMENTARY
 

Personnel on school buses should be trained in first aid and cardiopulmonary resuscitation (CPR). Health and safety information should be conveyed to the driver by the school nurse who has developed the health services plan for the student with input from the student's family

School personnel who transport students with special health care needs must also know if certain seating and placement choices within the bus pose a health or safety risk. For example, some students will require a specific type of seat or should not be near an air conditioning vent. Staff requires access to information on management of students' particular behavioral problems (Guideline 6-20).

School personnel who transport students must have the ability to communicate with them in a manner that is comfortable, familiar, and appropriate to the student. Guidelines for staff must be specific to students' language, speech, and hearing-related communication needs so that student and transportation staff can convey relevant health and safety information to each other.

   
 
6-19 - Bicycles, skateboards, skates, scooters on campus
 

Establish and enforce policies for the safe use of all non-motorized wheeled recreational devices on school property, including appropriate use of protective gear.

   
RATIONALE
 

Safety precautions prevent and reduce injury. Head injuries are the most serious type of injury sustained by cyclists of all ages. Approved helmets, when worn properly, save lives and prevent traumatic brain injuries.

   
COMMENTARY
 

Many families and schools encourage students to bicycle to school because of the benefits of regular exercise. Non-motorized wheeled devices that students (and staff) use for transportation or recreation include bicycles, tricycles, skateboards, skates, and scooters. Safety policies need to be communicated to families, staff, and students (Guideline 6-02). Policies must include the required use of properly fitted, approved helmets and prohibitions on the carrying of passengers. In addition to helmets, require the use of other personal protection equipment such as wrist guards and knee and elbow pads. Helmets and other protective gear must be worn properly to prevent injuries.

Allow the use of wheeled non-motorized devices on specific areas of campus and on crosswalks leading to and from the facility. Avoid use in loading and unloading zones during school hours. Wheeled non-motorized devices should be walked, not ridden, in areas of heavy pedestrian traffic. School staff should help establish the safest routes for staff and students on bicycles (and other such vehicles) to get to school. Secure storage space should be provided for these non-motorized wheeled devices and for helmets.

   
 
6-20 - Safe student conduct during transportation
 

Establish and implement comprehensive training programs for staff and for students so that students demonstrate acceptable behavior during transportation and during drop-off and pickup.

   
RATIONALE
 

Training transportation staff to manage student behavior can prevent serious injuries that originate with or are exacerbated by poor student conduct. Behavior management techniques, interaction with students' families and collaboration with students' regular school programs can enhance transportation safety.

   
COMMENTARY
 

Managing student behavior and having appropriate discipline are unusually challenging when students are being transported. Poor conduct can lead to vandalism, injury, and death. Transportation staff must address behavior management issues of all students who share the same vehicle, including those with special needs. Students and families must understand the rules and expectations. Safety should be the focus of student conduct, which includes: keeping passengers seated, using safety belts when available, and keeping arms and heads inside windows. Excessive noise and unsafe student behavior can distract or harm the driver, increasing the risk of a crash.

One way to enforce safe student conduct on school buses is to have additional staffing on the bus. Teach school transportation staff basic behavior management techniques (e.g., how to give positive reinforcement for good behavior and discourage bad behavior). Transportation staff should have rules that are simple, realistic, and enforced fairly. Transportation staff should monitor student behavior, be consistent with their responses, and take a positive attitude and approach with students. Strong and consistent enforcement of discipline in accordance with district policy must be maintained.

Students with special health, mental health, and educational needs (including but not limited to students with primarily mental and emotional disabilities) can have individualized transportation behavior protocols written into their Individualized Education Program. Arrange this if behavior problems are anticipated when the student's Individualized Education Program is developed or as they arise. Individualized behavioral protocols designed to promote acceptable conduct during transportation should be developed together with students' families and with the multidisciplinary teams that are involved with students' on-site education and support. School personnel who transport students with special health care needs and behavior management problems must follow all federal regulations and school district policies related to students with special needs.

   
 
6-21 - Bus drivers and alcohol/drug use
 

Adopt and enforce a zero tolerance, alcohol-free, and other drug-free policy for school bus drivers.

   
RATIONALE
 

High rates of motor vehicle crashes are associated with alcohol and other drug impairment. School bus drivers must not be impaired by alcohol or other drugs that can affect their driving abilities and compromise the safety of students.

   
COMMENTARY
 

More than fifty percent of all motor vehicle crashes involve alcohol. School bus drivers should be regularly tested for drugs and alcohol, and if they are found to be under the influence of alcohol or other drugs, they should immediately be fired.

Specific regulations regarding the operation of a school bus when taking medications (e.g., anti-depressant agents, anti-hypertensive agents, antihistamines) are determined at the state level. At the very least, bus drivers should be instructed not to operate school buses if initiating any medication, any new dose of a medication, or initiating any new combination of medications which may result in drowsiness, lightheadedness, or other adverse reaction that could impair ability to safely operate a school bus. If any previous experience with a medication or combination of medications has resulted in such an adverse reaction, it must not be taken within 24 hours of operating a school bus. A bus driver on a medication (over-the-counter and prescribed) should report this immediately to his/her supervisor.

   
 
6-22 - Emergency supplies and equipment
 

Provide and maintain emergency supplies (such as first aid equipment, posted signs, and communication equipment) in identified, predetermined locations, including in all buildings and buses. Emergency supplies should also be available at all indoor and outdoor school-sponsored events.

   
RATIONALE
 

Emergencies can occur at any time or at any place, and supplies need to be available to treat less severe injuries and to stabilize more severe injuries until appropriate help arrives.

   
COMMENTARY
 

The Ohio Chapter of the American Academy of Pediatrics together with Emergency Medical Services for Children (EMS-C) have created Emergency Guidelines for Schools that include recommended first aid supplies (80). Ensure that supplies are accessible and inspected at least monthly and re-supplied after each use. Written guidelines should identify members of the staff responsible for inspecting and maintaining emergency equipment as well as those who are trained in first aid and cardiopulmonary resuscitation (CPR). Epinephrine injector pens, gloves, and other supplies should be included. Automated External Defribrillators (AEDs) have electric paddles to resuscitate a person with cardiac arrest. Because of the low mean age of students and staff, these devices are required on fewer occasions per capita in schools as compared to many other settings. But when AEDs have been available in schools, they have successfully saved lives and so they may also be considered as desired emergency equipment for the school environment.

Special emergency equipment required for any student with a special health care need must also be accessible and in ample supply (e.g., glucagon for students with diabetes). Schools need to be prepared for emergencies on campus and at all school-sponsored events (e.g., field trips, sporting events, and outdoor education). Therefore, equipment should include some means of communicating rapidly if emergency medical services are needed (e.g., walkie-talkies, telephones). Emergency assistance numbers should be posted in strategic places (e.g., near telephones). Poison control and emergency assistance numbers are 800-222-1222 and 911, respectively.

   
 
6-23 - Facility preparation for evacuation, lockdown, disasters
 

Establish physical environment and ground security measures that will prepare each school to respond to fire, natural disasters, attacks, and other crises.

   
RATIONALE
 

By preparing the school environment and personnel for crises well in advance, lives can be saved, injuries reduced, and school property preserved.

   
COMMENTARY
 

Schools must have a system for which evacuation, lockdown, and other responses to situations are decided. Establish the safest areas on or near campus to evacuate students and staff for various types of disasters (e.g., hurricanes, flood, earthquake, fire, loss of electricity). Have a plan to safely transport students in cases where hazardous chemical or biological exposure requires evacuation that is distant from the school site. In addition to regular assessments of school buildings and grounds (e.g., for fire hazards), provide opportunities for students and staff to practice evacuations (e.g., fire drills).

Plans need to define how each school will be closed to outsiders and how to secure the campus perimeter and protect the building against vandalism. Methods for effective enforcement must be considered, including the presence of law enforcement on campus. Some schools must also prepare to accept people who are evacuated for disasters that occur elsewhere.

Educate staff and students on disaster plans, make the information known and accessible, and pre-assign tasks to members of the staff. This includes training staff how to use fire extinguishers, use communication equipment, and implement other aspects of disaster plans. Develop a system to report violent incidents; to deal with the media; to reach staff, students and families; and to respond to the aftermath (both physical and emotional). Partnerships with various community agencies (e.g., public utilities, fire, law enforcement, emergency medical services, health, mental health, and social service agencies) and parents are necessary to develop these plans.

Guidelines for schools regarding crisis preparedness have been developed by the US Department of Education (37). The National Education Association provides a useful tool-kit (69) designed to prepare schools for such crises.

   
 
   
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CHAPTER RELATED LINKS
 

Access Board
Federal agency committed to accessible design.

Agency for Toxic Substances and Disease Registry
This agency of the US Department of Health And Human Services provide health information to prevent harmful exposures and disease related to toxic substances.

American Association of Poison Control Centers

American Conference of Governmental Industrial Hygienists (ACGIH)
Information for school custodians on air sampling, bioaerosols, infectious agents and industrial ventilation.

American Heart Association

American Institute of Architects

American Lung Association
Ozone and the Air Quality Index: A Program Resource Guide

American Red Cross

American Society of Heating, Refrigeration, and Air-Conditioning Engineers

ASTM International (formerly known as American Society for Testing and Materials)
Provides consensus standards and related technical information in order to promote public health and safety as well as contribute to the reliability of materials, products, systems and services. This includes anything from art materials and sports equipment to construction supplies and playground equipment/surfaces.

Children's Environmental Health Network
Provides a resource guide for children's environmental health.

Children's Safety Network
Resources on child safety in school and on employed youth.

Construction Specifications Institute

Consumer Product Safety Commission
Safe playground equipment and other products.

Council of Educational Facility Planners
Professional association of those involved in planning, designing, building, and equipping schools; resources on advocacy, education on the efficacy of school design and student outcomes; training and professional development, research.

Emergency Medical Services for Children (EMS-C)
Resources available through their clearinghouse, including: Basic Emergency Lifesaving Skills (BELS): A Framework for Teaching Emergency Lifesaving Skills to Children and Adolescents.

Environmental Protection Agency

Environmental Protection Agency
For information on daily air quality across the United States.

Environmental Protection Agency - "Keeping Kids Safe from Sun and Smog"
Includes a color-coded air quality index that relate to ozone levels and a UV index that relates to harmful effects of sun.

Environmental Protection Agency - "Tools for Schools" including renovations

Environmental Protection Agency - Additional School-Specific Matters and Resources

Environmental Protection Agency - Exhaust Fumes

Environmental Protection Agency - School Buses

Federal Emergency Management Agency

Food Allergy and Anaphylaxis Network
Information on managing food allergies in schools.

Governors Highway Safety Association
Promotes occupant protection; addresses impaired driving; speed enforcement; and school bus, pedestrian, and bicycle safety.

Injury Free Coalition for Kids
Safety tips and resources.

Inline Skating Association
Safety tips on equipment.

Keep Schools Safe
Information on violence and unintentional injury prevention in schools.

Maternal and Child Health Bureau; Health Resources and Services Administration
Includes programs, data and resources on health and safety issues for school children.

Mycological Aspects of Indoor Environmental Quality

National Association of School Psychologists

National Center for Infectious Diseases (CDC)
Access to division of Vector-Borne Infectious Diseases and of Bacterial and Mycotic Diseases. Brochures and resources for the public and professionals include tips on disease prevention through management of the physical environment, such as preventing accumulation of standing water and taking caution with animal feces.

National Coalition for Food Safe Schools
Represents a number of national organizations, associations, and government agencies. Resources for reducing food borne illness by improving food safety in schools.

National Highway Traffic Safety Administration (US Department of Transportation)
Information on child safety restraint systems, training for child passenger safety technicians, and on laws and regulations governing transporting children. The "Child Passenger Safety" pages include information on transporting children with disabilities, and school bus safety.

National Institute for Occupational Safety and Health (NIOSH) Sharps Disposal Containers
Information on selecting, evaluating and using sharps disposal containers.

National Institute of Standards and Technology

National Program for Playground Safety

National Resource Center for Safe Schools

North American Guidelines for Children's Agricultural Tasks
For an example of defining developmentally appropriate, which has defined developmental readiness for children to be able to engage in a variety of specific agricultural chores.

Occupational Safety and Health Administration

Pedestrian and Bicycle Information Center

Safe USA
Resources for safety on playgrounds and in sports, and for violence prevention.

School Indoor Air Quality Questions and Answers Web site

The Catalyst
A site developed for secondary school teachers as a resource for finding relevant information for teaching chemistry. Includes safety measures to be taken in biology, chemistry, and physics classes.

Tobacco Information and Prevention Source (TIPS), National Center for Chronic Disease Prevention and Health Promotion

US Department of Education - Emergency Planning
This resource from the Office of Safe and Drug-Free Schools provides school leaders with information to plan for many emergencies.

US Department of Justice, Americans with Disabilities Act
Information and technical assistance on compliance with the Americans with Disabilities Act.