people; are in contact with staff, students, families, and community members; and
have credibility and access that enables them to provide scientifically sound informa-
tion about environmental issues and exposures.^38
Of specific importance to school nurses is the impact of environmental exposure for
the growing child. Schools have programs serving young infants, toddlers, and pre-
schoolers, as well as traditional school-age children and youth. The child’s metabolism,
developing body systems, and environmental components can interact in ways similar to
and different from those of adults. Also, some exposures, while not apparently harmful
to adults in similar doses, can result in adverse health effects for children. Childhood
exposures may result in health problems years later. Children differ from adults in the
exposure dose levels, routes, response potentials, and response effects.^39
The school nurse is concerned with child toxin exposures that have occurred prior
to school attendance and have impaired a child’s health or learning potential (such as
lead exposure causing neurological and learning deficits). Additionally, the nurse is
concerned with preventing adverse health reactions in children exposed to physical,
chemical, and biological toxins occurring in the school environment.^40
The Occupational Health and Safety Administration (OSHA) has many regula-
tions that impact the safety of school workers, especially those relating to occupa-
tional exposure to environmental toxins. Safe practices for employees translate into
safer practices and environments for children. The school nurse can assist in imple-
menting safety standards and in making the standards understandable and applicable
to the school setting.^41
However, the nurse’s role does not stop with treating or evaluating existing health
hazards to children. She must also take a proactive role to anticipate health hazards
and act to reduce or prevent adverse health effects on the school population. For
example, the nurse may note that pesticides are routinely sprayed during the morning
hours every three months. Some who have been exposed may seek her help. Her pro-
active role here would be to work with the school administration and the pesticide
applicator to spray on Friday afternoons after school, so that when students return on
Monday morning, there are much lower amounts of pesticide residues in the school
and thus much less of a potential health impact.
Parents’ Pesticide Awareness
While parents of school-age children may be deeply concerned about adverse
health effects in the school environment, their awareness of the threat posed by pesti-
cides may be inadequate.
The fact of the matter is that most parents do not often think about pests or the
use of pesticides in their children’s schools, but when these issues are raised, they
strike a deep emotional chord. That is one of the findings from focus group discus-
sions with parents.
When asked which environmental quality issues in their children’s schools con-
cerned them most, parents mentioned air quality, asbestos, and lead and mold/fungus
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