1. Results Participation District personnel from 326 public school districts (44% of NYS public school districts, excluding NYC) completed and returned the survey (Figure 1). Custodians from 1434 elementary schools in 492 school districts (71% of NYS public school districts, excluding NYC) completed and returned the earlier survey. 770 custodian surveys were paired with their corresponding district surveys in 241 districts. School indoor air quality (IAQ) policies and practice: A survey of district facilities managers (DFMs) and school custodians in New York State (NYS) public schools Shao Lin a, Amanda Reddy a, Christine Kielb a, Carl Thurnau b, Syni-An Hwang a Contact Information: a Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, 547 River Street, Troy, NY 12180; Amanda Reddy: alr04@health.state.ny.us b Office of Facilities Planning, New York State Education Department, Albany, NY 12234 1. CDC. Asthma prevalence, health care use and mortality, 2002. Hyattsville, Maryland: US Department of Health and Human Services, CDC, National Center for Health Statistics, 2004.Asthma prevalence, health care use and mortality, 2002 2. Moglia, D., Smith, A., MacIntosh, D. L., Somers, J. L. 2006. Prevalence and Implementation of IAQ Programs in U.S. Schools. Environmental Health Perspectives, 114(1): 141-146. NumberPercent District-wide programs: Any formal IAQ program15447% At least one school in the district: Uses EPA’s Tools for Schools15648% Uses another formal IAQ program4514% Either of the above18858% Plans to implement an IAQ program4113% Background Asthma remains a leading cause of school absenteeism, prompting some school districts to adopt programs to manage asthma and reduce environmental triggers[1]. However, little is known about the presence or effectiveness of indoor air quality (IAQ) policies or programs instituted at the district level. This project examined IAQ policies in New York State (NYS) public school districts and individual school compliance with these policies. Methods Survey of District Facility Managers Surveys were mailed to District Facilities Managers (DFMs) in 744 NYS school districts and BOCES, excluding NYC. This survey was also distributed at the 2004 annual NYS School Building and Grounds Association meeting and posted on the NY State Education Department website. The survey asked about district-wide environmental policies and actions, with a particular emphasis on management of IAQ. The survey contained questions related to both broad IAQ policies/programs and specific IAQ management practices or actions. DFMs provided information about existing environmental policies as well as plans for future implementation of such policies. Survey of School Custodians In an earlier (2003) and separate survey, NYS elementary school custodians were questioned about school policies, the school environment and cleaning/maintenance practices. Custodian surveys were matched to DFM surveys by district number. Comparison of DFM and Custodian Responses Information provided by custodians was compared with corresponding DFM responses to estimate the level of individual school compliance with district-level policies. Recommendations Districts and schools should work together to formalize and expand upon existing IAQ policies. Further NYSDOH examination of district level IAQ policies and school compliance may highlight opportunities to close gaps between policy and implementation. Discussion Summary More than half of the school districts in NYS lack a comprehensive IAQ management policy and individual school adherence to district-level policies is variable. For instance, in districts reporting established policies, fewer than half of the corresponding schools reported having an IAQ program, IAQ management plan, anti-idling policies, policy to air out of new carpets, use of green-rated products or use of HEPA filters. However, in other areas of IAQ management, many schools in NYS have adopted strategies either in conjunction with district-level policies or independently. For example, more than half of schools in districts without policies governing IPM, construction after hours, precautions to protect students and staff during construction and airing out newly painted areas reported having such policies or practices in place. Opportunities may exist to assist schools and districts in implementing new policies and formalizing and complying with existing policies. Potential Limitations Despite the low response rate from DFMs, the responding districts were similar to all non-NYC, NYS school districts in terms of poverty, district type and race. The temporal difference and slight differences in wording of some questions prohibits a robust analysis of agreement between the custodian and DFM surveys. Data collected on different scales (school vs. district) is difficult to compare, since some district policies were compared to just one school in the district and others to many schools. Different levels of knowledge or interpretation of questions may affect the accuracy of the data. Schools that lack environmental policies do not necessarily have more environmental problems than schools that have established policies. Policies instituted by districts may not always be translated into practice at the school level, e.g. among districts reporting anti-idling policies and among districts reporting policies to use green-rated cleaning products, less than half of the corresponding schools reported equivalent practices (Table 3). Conversely, even in the reported absence of district-wide policies or programs, some schools have voluntarily adopted measures to assess or improve the school environment. However, in many cases policies are lacking at both the school and district levels (Figures 4-5). Figure 1. Participating districts shown in blue. DISTRICT-LEVEL USE OF SPECIFIC IAQ PROGRAM COMPONENTS OR ACTIONS DISTRICT-LEVEL ASSESSMENT OF SCHOOL IAQ AGREEMENT WITH RESPONSES FROM CUSTODIANS Checklist: All n=322 IAQ program n=184 No IAQ program n=138 ventilation 52%73%22% maintenance 45%67%16% renovation 40%59%14% classroom 16%27%1% Figure 3. Assessment of school IAQ Table 2. Use of IAQ/TfS Checklists Figure 2. Specific IAQ program components in NYS public school districts % of Schools Non-Adherent*Voluntary** IAQ program68%12% IAQ management plan60%24% IAQ coordinator32%62% Health & Safety committee35%37% Integrated Pest Management (IPM)26%54% Anti-idling policy56%0% Construction after hours39%70% Precautions during construction32%89% Air out new carpets65%35% Air out newly painted areas14%66% Use green-rated cleaning products58%23% Use HEPA filters51%31% Table 3. Reporting of policies/actions among schools in districts with and without corresponding policies Figure 4. IAQ Assessment in NYS public schools and school districts Figure 5. Specific IAQ policies/actions in NYS public schools and school districts Table 1. District-level use of IAQ management programs in NYS DISTRICT-LEVEL USE OF BROAD IAQ MANAGEMENT PROGRAMS Specific IAQ program components/ actions refers to steps that districts or schools can take to control specific sources of environmental exposures (e.g. use of integrated pest management (IPM) to minimize exposure to both pests and pesticides). All of these actions or policies were more commonly reported by districts with a broad IAQ management program than by districts without such a program (Figure 2). However, fewer than two- thirds of school districts with or without broad IAQ management programs reported anti-idling policies, use of green-rated cleaning products or policies regarding animals in the classroom. Assessment of school IAQ was more frequently reported among districts with an IAQ program (Table 2, Figure 3). While 92% of the districts with a formal IAQ program reported completion of at least one IAQ assessment activity (walk-through of school, use of any of the EPA’s TfS checklists, naming of an IAQ coordinator and development of an IAQ management plan), only 27% of districts without a formal IAQ program had completed one of these tasks. Broad IAQ management programs refer to a comprehensive set of policies or actions to assess, monitor and improve school indoor air quality. The EPA’s Tools for Schools (TfS) program is an example of a broad IAQ management program that entails many specific components or actions to address school IAQ. District-wide IAQ programs exist in 47% of the responding districts. An additional 13% reported future plans to implement an IAQ program and 58% of districts indicated that at least one school used such a program. *Non-adherent: The district reports having the policy, but the school doesn’t report having a similar policy (i.e. the school is not complying with or adhering to the district-wide policy). **Voluntary: The district doesn’t report having the policy, but the school reports having a similar policy (i.e. the school has voluntarily adopted the policy in the absence of a district-wide policy).