November 2012
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Student Health and Academic Performance
Quick Reference Guide
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 that indoor air
quality (IAQ) directly impacts health and student academic
performance continues to mount.12
IAQ refers to those characteristics of the air in indoor
environments, such as levels of pollutants, humidity,
temperature, etc., 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.
Building the Case with Evidence
Scientific evidence has long demonstrated an association
between poor IAQ and respiratory health effects, including
asthma. Maintenance issues in schools, such as mold and
moisture 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
The Scientific Evidence is Mounting
Qualitative and quantitative 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 concentration and recall
in both adults and children.6 This strengthens the case for
schools to develop IAQ management plans, which include
critical maintenance tasks, as a key part of an education
development strategy.
"Each year since our LAO management program began, we have j
i been able to boost both reading and math test scores and have	i
1 created exceptional learning environments that promote student	1
[ success. " - Dave Hill, Blue Valley School District, Kansas
Evidence from Scientific Literature
Scientific evidence shows that there are key areas in which
schools can take action to improve IAQ in order to advance
the health and performance of students and school staff. In
fact, a structured maintenance program is a cornerstone of
academic performance and IAQ.
Managing Your School Environment Despite Tight
Operating Budgets
School boards and administrators often consider the
maintenance budget as soft money that they can cut without
affecting core academic program needs; however, scientific
literature demonstrates otherwise:
•	Health, attendance and academic performance can improve
with increased maintenance.7 8
•	Schools with better physical conditions show improved
academic performance, while schools with fewer janitorial
staff and higher maintenance backlogs show poorer
academic performance.9
The Effects of Air Ventilation on Health
and Performance
Most schools' ventilation rates are below recommended
levels.10 However, ensuring adequate air ventilation rates in
all classrooms can:
•	Reduce absences and the transmission of infectious
diseases.11
•	Improve the overall health and productivity of teachers.
•	Improve test scores and student performance in completing
mental tasks. 12>13' 14> 15>16'17
In one study, students in classrooms with higher outdoor
air ventilation rates scored 14 to 15 percent higher on
standardized test scores than children in classrooms with
lower outdoor air ventilation rates.18
In addition, ensuring that heating, ventilation and air
conditioning (HVAC) drainpans and other components are
clean reduces the chance of occupant illnesses.
Indoor Air Quality (IAQ)

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November 2012
Control Mold and Moisture to Reduce Asthma Symptoms
Dampness and mold in homes, offices and schools cause a
significant increase in several respiratory and asthma-related
health outcomes.19'20
•	Asthma is the leading cause of absenteeism in schools,
which hinders classrom achievement.21
•	Symptoms identified in building occupants exposed to
dampness or mold include: coughing, throat irritation,
tiredness, headache and increased wheezing.
"Our district implemented an IAO management plan that led to
unprecedented academic success for our students. Since 2005,
we have seen an increase of 17.3 percent on test scores and an
increase in the average daily attendance rate to 97percent,
allowing students to have more classroom time. "
- Frank DiNella, Keller Independent School District, Texas
Establish an IAQ Management Program
Many effective school IAQ management programs are implemented in conjunction with other health programs, such as
physical education, nutrition and counseling services. Implementing IAQ management strategies, including moisture
management, integrated pest management and adequate ventilation, help control environmental triggers and are linked
with asthma and other health initiatives.
Literature suggests that integrating health programs into a coordinated or comprehensive program can achieve improved
results for learning and health, while allowing schools to be more resource efficient.12
For more information on school IAQ management programs, visit http://www.epa.gov/iaq/schools/.
References
1	Stolz, A.D., A. Knickelbein, and S. Coburn. 2008. "Linking coordinated school
health to student success." Presentation at the .Annual Conference of the National
Association of School Nurses, Albuquerque, NM.
2	Vinciullo, F. 2008. 'The relationship between multi-component school health
programs and school achievement." Presentation at the Annual Conference of the
National Association of School Nurses, Albuquerque, NM.
3	Centers for Disease Control and Prevention. National Center for Chronic Disease
Prevention and Health Promotion. Healthy Youth! Retrieved July 14, 2009,
from CDC's Asthma Health Topics Web site: http://www.cdc.gov/HealthyYouth/
Asthma/ Also see Akinbami, L.J. 2006. The State of Childhood Asthma. United
States, 1980-2005. Advance Data from Vital and Health Statistics: no 381, Revised
December 29, 2006. Hyattsville, MD: National Center for Health Statistics.
4	Silverstein, M.D., J.E. Mair, et al. 2001. "School attendance and school
performance: A population-based study of children with asthma." Journal of
Pediatrics 139(2):278-283.
5	Moonie, S., D.A. Sterling, et al. 2008. "The relationship between school absence,
academic performance, and asthma status." Journal of School Health 78:140-148.
6	For a summary of the impact of indoor 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 at http://www.
iaqscience.lbl.gov/performance-summary.html
7	Schneider, M. 2002. "Public school facilities and teaching: Washington, DC and
Chicago." 21st Century School Fund, Washington, D.C.
8	Earthman, G.I., C.S. Cash, and D. Van Berkum. 1995. "Student achievement and
behavior and school building condition." Journal of School Business Management,
8(3).
9	Branham, D. 2004. "The wise man builds his house upon the rock: The effects of
inadequate school building infrastructure on student attendance." Social Science
Quarterly (85)5.
10	California Energy Commission. 1995. Air exchange rates in non-residential
buildings in California. California Energy Commission.
11	Nazaroff, W. 2011. "Norovirus, gastroenteritis, and indoor environmental quality.
Editorial." Indoor A ir 21: 352-356.
12	Myhrvold, A.N., E. Olsen, and O. Lauridsen 1996. "Indoor environment in
schools—Pupils health and performance in regard to C02 concentrations."
Proceedings, Indoor Air '96: The 7th International Conference on Indoor Air
Quality and Climate. Nagoya, Japan. 4:369-371.
13	Mendell, M. 1993. "Non-specific symptoms in office workers: A review and
summary of the epidemiologic literature." Indoor Air 3(4):227-236.
14	Seppanen, O., W.J. Fisk, et al. 1999. "Association of ventilation rates and C02
concentrations with health and other responses in commercial and institutional
buildings." Indoor Air 9(4):226-252.
15	Apte, M., W. Fisk, and J. Daisey. 2000. "Associations between indoor C02
concentrations and sick building syndrome symptoms in U.S. Office buildings: An
analysis of the 1994-1996 BASE study data." Indoor Air 10(4):246-257.
16	Shendell, D. G., R. Prill, et al. 2004. "Associations between classroom C02
concentrations and student attendance in Washington and Idaho." Indoor Air 14(5):
331-41.
17	Sundell, J., H. Levin, et al. 2011. "Ventilation rates and health: multidisciplinary
review of the scientific literature." Indoor Air 21: 191-204. http://onlinelibrary.
wiley.eom/doi/10.llll/j.1600-0668.2010.00703.x/pdf
18	Shaughnessy, R.J., et al. 2006. A preliminary study on the association between
ventilation rates in classrooms and student performance. Indoor Air 16(6): 465-468.
19	Fisk, W. J., Q. Lei-Gomez, and M. J. Mendell. 2007. "Meta-analyses of the
associations of respiratory health effects with dampness and mold in homes."
Indoor Air 17(4):284-295.
20	Mudarri, D. and W. J. Fisk, 2007. "Public health and economic impact of
dampness and mold." Indoor Air 17(3):226-235.
21	Haverin-Shaughnessy U., M. Turunen, et al. 2012. "Sixth grade pupils' health and
performance and indoor environmental quality in Finnish school buildings." British
Journal of Education Research 2(1) 42-58.
Indoor Air Quality (IAQ)

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