Abstract
Little is known about the environmental health-related policies and practices of early care and education (ECE) programs that contribute to childhood asthma, particularly in Oklahoma where child asthma rates (9.8%) and rates of uncontrolled asthma among children with asthma (60.0%) surpass national rates (8.1% and 50.3%, respectively). We conducted a cross-sectional survey with directors of Oklahoma-licensed ECE programs to assess policies and practices related to asthma control and to evaluate potential differences between Centers and Family Childcare Homes (FCCHs). Surveyed ECEs (n = 476) included Centers (56.7%), FCCHs (40.6%), and other program types (2.7%). Almost half (47.2%) of directors reported never receiving any asthma training. More Center directors were asthma-trained than FCCH directors (61.0% versus 42.0%, p < 0.0001). Most ECEs used asthma triggers, including bleach (88.5%) and air fresheners (73.6%). Centers were more likely to use bleach daily than were FCCHs (75.6% versus 66.8%, p = 0.04). FCCHs used air fresheners more than did Centers (79.0% versus 61.0%, p < 0.0001). The majority of ECEs (74.8%) used pesticides indoors. Centers applied indoor pesticides more frequently (i.e., monthly or more often) than did FCCHs (86.0% versus 58.0%, p < 0.0001). Policy, educational, and technical assistance interventions are needed to reduce asthma triggers and improve asthma control in Oklahoma ECEs.
Highlights
Care and education (ECE) programs, known as childcare programs, are critical environments that shape children’s health
The purpose of the present study was to characterize environmental health-related policies and practices of licensed early care and education (ECE) programs in Oklahoma caring for preschool-aged children
Our study focused on policies and practices in three key areas: (1) asthma training, prevention, and control; (2) cleaners and air fresheners; and (3)
Summary
Care and education (ECE) programs, known as childcare programs, are critical environments that shape children’s health. 13 million (61%) children under the age of five in the United States (US) receive regular care in ECE programs [1], for as much as 50 h a week [2,3]. Young children attending ECE programs can be chronically exposed to environmental toxicants from commonly used products, such as cleaners, air 4.0/).
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