UCSF

Background: Research designed to understand and improve the environmental health and safety of early care and education (ECE) programs is important given the potential impact of environmental exposures on young children’s health and development.

Objectives: The main aims of this dissertation are to (1) synthesize the current evidence of the association between early child care attendance and the risk of childhood asthma and wheezing, (2) assess the demographic characteristic that are associated with in the prevalence of pesticide use and IPM knowledge among different regions of California, and (3) describe the frequency of key national health and safety standards in family child care homes (FCCHs) using the Health and Safety Checklist for Early Care and Education Programs (HSC).

Methods: This dissertation consists of three independent studies: (1) a meta-analysis of 32 studies to measure the association between early care and education program attendance and childhood asthma or wheeze, (2) a cross- sectional analysis of the pest management practices and knowledge of integrated pest management (IPM) of 45 child care centers by their geographic region of California, and (3) a cross-sectional pilot study assessing national standards for health and safety using a standardized HSC in 21 FCCHs in California.

Results: The main findings from this dissertation include (1) Early child care attendance is not significantly associated with the risk of asthma or wheeze in children 6 years of age or older, (2) pest management practices in child care center facilities differs by geographic region, and (3) the HSC is a feasible tool to measure health and safety in FCCHs.

Conclusion: Although early attendance in ECE programs doesn’t increase the risk of asthma or wheezing older children, young children in ECE programs continue to be exposed to pesticide application in ECE facilities and poor hygiene practices that can increase their potential exposure to infectious diseases. The findings from these three studies have important implications for parents, ECE providers, pediatric nurses and medical providers. Interventions to address the health and safety quality of ECE programs are needed to improve the overall environmental health of children in ECE settings.