Nurses who work in school settings and nurses who are parents to children in school settings can play a significant role in affecting the environmental quality of schools. Because there is no single person who can "make" a school environmentally healthy and safe, a good place to start is with a committee of people who may each play a role in improving the school's environment. In many workplaces, health and safety committees provide the structure through which to address conditions that may pose risks to health. Because schools are both workplaces for adults and learning places for children, creating a health and safety committee can provide a forum in which a multidisciplinary team can learn about health and safety issues; develop and exercise assessment capabilities; prioritize concerns and issues; develop an intervention plan; and provide a feedback loop regarding the success of the remediation and other intervention activities. A health and safety committee can also propose policies. Some of the people who could be considered for a school health and safety committee would be teachers, principals, parents, custodial staff, facilities managers, a school board representative, and even a student.

The Environmental Protection Agency has created an action kit entitled Indoor Air Quality Tools for Schools that provides a complete program that schools can implement to assess and address indoor air quality concerns. To obtain a kit at no cost, call the EPA clearing house at (800) 438-4318.

Some of the issues that should be addressed when considering the development of a health and safety committee in a school include: Who will chair the meetings? Will the group elect a chair? Will it be a member of the school's management? Should it be shared by a parent, employee, and principal (or other manager)? Should facilitation of the meetings be rotated? Who will take notes and how will they be distributed? How often will the committee meet, for how long, and where? Will you include facilities "walk-through" as part of your meeting? Every meeting? Once a problem is identified and an intervention suggested, who is responsible for its implementation? What is the recourse of the committee if the intervention is not implemented? What is the appropriate mechanism for communicating to the whole school and parent community when a problem has been identified or any other finding or decisions of the committee, including recommendations for actions?

A Healthy and Safe Nurse's Office What a nurse can do in his or her immediate domain: Eliminate the mercury thermometers and mercury blood pressure cuffs. Replace them with non-mercury ones. (Make sure that the mercury containing ones are disposed of properly because they are considered hazardous waste.) See www.noharm.org Eliminate latex-containing products, particularly latex gloves. Many children and adults are allergic to latex. See ANA's latex web site. Request that the health suite NOT be routinely sprayed with pesticides, especially if your school has a regularly scheduled pesticide application. Employ IPM techniques if pests are noted. See: www.childproofing.org/poisonedschoolsmain.html Check the ventilation in the health suite. Are the vents free from obstruction? Do you know where the "fresh air" intake is located? Check to make sure that the intake is in a location that is as healthy as possible. See: www.epa.gov/iaq/schools/tfs/guide5.html. If there are any signs of moisture problems, request that maintenance repair the problem. Check to see if there is lead-based paint in your suite. Since sick students and staff frequent the health office, it is important to take steps that can help prevent transmission of airborne diseases. Ensure that the ventilation system is properly operating. See that air filters are clean and properly installed. Question whether air removed from the health suite circulates through the ventilation system into other occupied areas. If so, request that this situation be addressed. Obtain Material Safety Data Sheets (MSDS) for any chemicals used in building from the chemical manufacturer.