All children deserve a healthy learning environment.
Children are inherently more vulnerable to
environmental hazards because their bodies are still
developing. Substandard environmental conditions in
schools, such as insufficient cleaning or inadequate
ventilation, can cause serious health problems for
children. Evidence continues to mount demonstrating
that indoor air quality (IAQ) directly impacts student
academic performance and health.1-2  IAQ refers to
those characteristics of the air in indoor environments
that impact the occupants' health, comfort and ability
to perform. Taking steps to improve the IAQ of schools
is critical to bettering student health and academic
performance.
The Evidence Exists: Scientific evidence has long
demonstrated an association between poor IAQ and
respiratory health effects, including asthma. Maintenance
issues in schools, such as insufficient cleaning or
excessive use of cleaning chemicals, have been shown to
trigger asthma and allergies. According to the Centers for
Disease Control and Prevention (CDC), asthma is one
of the leading causes of school absenteeism.3 Multiple
studies have found that children's overall performance
decreases with illnesses or absences from school.4'5'6'7'8

The Evidence is Mounting: Evidence demonstrating
the  relationship between IAQ and human performance
and productivity has become more robust.  Studies
demonstrate that improved IAQ increases productivity
and improves the performance of mental tasks, such as
improved concentration and recall in both adults
and children.9
                              (Continued on next page)
       •'•'••  •  •  • •   '•    '    • '  '  A structured
maintenance program is a cornerstone of academic
performance and IAQ. With tight operating budgets,
school boards and administrators often consider the
maintenance budget as "soft money," an expense that
they can cut without affecting core academic program
needs. However, the literature demonstrates otherwise,
with several studies finding that health, attendance
and academic performance improves with increased
maintenance.
Furthermore, schools with
better physical conditions show7 improved academic
performance while schools with fewer janitorial staff
personnel and higher maintenance backlogs show-
poorer academic performance. H
In most schools, ventilation rates are below
recommended levels.15 Growing evidence suggests
that improving outdoor air ventilation rates can
improve student and teacher performance, increase
test scores, and reduce airborne transmission of
infection.16-17'1*-19-20-21 Students in classrooms with high
outdoor air ventilation rates score 14 to 15 percent
higher on standardized test scores than children in
classrooms with low outdoor air ventilation.22
       •':...   ': ••   ' •    Studies show that dampness
and mold in homes, offices and schools causes a
significant increase in several respirator}-' and asthma-
related health outcomes.23-24 Symptoms identified
in students exposed to dampness or mold include:
coughing, throat irritation, tiredness, headache and
increased wheezing.

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Coordinate  an IAQ Program with  Other School
              to  Improve Health and Attendance
Many effective school IAQ management programs are
implemented in conjunction with other health programs
(e.g., physical education, nutrition, and counseling
services). IAQ implementation strategies such as moisture
management, integrated pest management, and adequate
ventilation help control environmental triggers and
interface well with asthma and other health program
initiatives. Literature reflecting field experience with
health programs suggests that integrating related health
programs into a coordinated or comprehensive program
can achieve improved results for learning and health, and
be more resource efficient. ZS;26
 Follow a Structured Process
 EPA developed the IAQ  Tools for Schools (TJS)
 Framework to provide a comprehensive resource
 to help maintain healthy school environments. The
 Framework provides schools with the strategies to
 establish and sustain a successful IAQ management plan.
 The Framework  is also a highly flexible and adaptable
 structure that allows any school  regardless  of location,
 size, budget, or condition, to launch, reinvigorate, and
 sustain an effective  IAQ management program.
 The  IAQ Tools  for            Program provides a  variety
 of products, materials, and tools  at no cost to help schools
 implement an indoor air quality management program. In
 addition to the IAQ  TfS Action Kit, specialized fact sheets,
 brochures, and software programs are available to provide
 in-depth information on environmental topics.
  1 Stolz, A,D,, A. Kmckelbem, and 5, Cobum, 200>5, "Linking coordinated school health to student
  success," Presentation at ike Annual Conference of the National Association of School Nurms,
  Albuquerque, TSIM,

  1 Vinciidlo, R 2008, "The relationship between multi-component school health programs and
  school achievement," Presentation at the Anm&l Conference of the National Association of
  School N&rse$-> Albuquerque, MM,
  3 Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and
  Health Promotion, Healthy Youlhl Retrieved My 14 2009, from CDC's Asthma Health Topics
  Web site; http;/'.%7\¥^¥,cdc,goY/HealthyYouti;i/'Asthma/'
  5 Weitzman, M., LA'. Klerman, et al. 1982. "'School absence; A problem for fie pediatrician,"
  Pediatrics 69(6);739-746, (22)
  7 Silverstein, M.D,, J,E. Mair, et al, 2001. "School attendance and school performance: A
  population-based study of children with asthma," J&uma!. ofPeeliatfieg 139(2;:278-283, {24)

  8 Mooiijg, 5,, IX A, Sterling, etal, 2QOS, "The relationship between school absence, academic
  performance, and asthma status," J&umczl of School Health ?8; 140-148.

  9 For a ^uminary of the impact of mdoor environmental quality* on work and school performance,
  as well as other IAQ research findings, see the IAQ Scientific Findings Resource Bank (SFRB)
  established as a cooperative venture between EPA and the Lawrence Berkeley National
  Laboratory; Accessible athttp;//w^rwj,aqsoiejiccJH,gov/'pcrfoni{anoe-s5imiTi,ar);,htail
  m Schneider, M, 2002, "Public school facilities and teaching; Washington, DC and Chicago," 21st
  Century School Fund, Washington, IXC,

  11 Cash, C.S, 1S93, ""Building condition and student achievement and behavior," Bkeksbmg. ¥A:
  Unpublished doctoral dissertation, Virginia Polytechnic Institute and State University,

  13 Eartnraaxi, (J ,L, C,S, Cash, and D, Van JSerkum, 1995, 'vStuclent aohisvement and behavior and
  school building condition," Journal of SchoolBttsiness Management., 8(3;,

  13 Hines, H W, 1996, v'Buildiog condition end student achievement and behavior," Blacksburg, VA:
  Unpublished doctoral dissertation, Virginia Polytechnic Institute and State University,
14 Branham, D. 2004. "The wise man builds his house upon the rock: The effects of inadequate
school building infrastructure on student attendance," Social St'ienc-s Quarterly {&5)5.

15 California Energy ConiraissiGii. 1995. Air exchange rates in Tton-res'id&ntwl buildings in
California. California Energy Commission. (39;

16 Myhrvold, A.N,, E, Olsen, and O, Laurid^en 1996, "Indoor sEtvironnisiit m schoote—Pupils
heaMi and performance in regard to CO2 concentrations," Proceedings, Indoor Air '96:- TM ?th
International Conference on Indoor Air Qualify arsd Climate Nagoya, Japan, 4:369-371. (26)

IT Sunclell, J, 1994, v'Onthe assocMtion between building ventilation characteristics, some indoor
environmental exposures, some allergic manifestations and subjective  symptom reports," Indoor
Air Supplement 2:94, (33)

18 Sundell, I,, T, Lindvall, andB. Shenberg, 1991, 'Influence of tj^pe of ventilation and outdoor
airflow rate on the prevalence of SBS symptoms," Proceeding^ IAQ '91, Healthy BuiMings.
Conference o/'the American Soffiefy1 offfe&ting, Refrigerating, &ndAw~ConditioningEngwieersf
jnzf Washington, DC, 785-89, (32)
^MendelL M, 1993, ""Non-specific symptoms in office workers; A review and summary of the
epidemiologic literature,"' Indoor Air 3{4'):227-23&, (34)
® Seppanen, O,, W, J, Fisk, et al, 1999, "Association of ventilation rates and CO2 concentrations
with health and other responses in commercial and institutional buildings," Indoor Air 9(4); 226-
252. (35)
  Shaughnes&y., R,J,, et al, 20Q6, Aprelinainary study on the association between ventilation
nates HI cla^rooms and student performance. Indoor Air 16(5); 465-468,
M Mudanij D, and W. J. Fisk, 2007 . "'Public health and economic impact of dampness and
mold" Indoor, 4ir 17 (3); 226-23 5,
35 Stolz, A,D.; A, Knickelbein, and S, Cobum 2008, "Linking coordinated school health to
student success," Presentation at the Annual Conference of the National Association of School
N&rses, Albuquerque, NM,
                            For more information on this research, visit EPA's IAQ,  Health and Academic Performance Web site at www.epa.go¥/xxxxxx.

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