Grantee Research Project Results
2016 Progress Report: Assess school environmental effects on children's health and performance and strengthen state/community capacity to create a healthy and safe learning environment
EPA Grant Number: R835636Title: Assess school environmental effects on children's health and performance and strengthen state/community capacity to create a healthy and safe learning environment
Investigators: Lin, Shao
Current Investigators: Lin, Shao , Thurston, George D. , Hwang, Syni-An
Institution: The State University of New York
Current Institution: Health Research, Inc. / NYS Dept. of Health
EPA Project Officer: Hahn, Intaek
Project Period: December 18, 2014 through December 17, 2018 (Extended to July 31, 2020)
Project Period Covered by this Report: December 18, 2015 through December 17,2016
Project Amount: $1,000,000
RFA: Healthy Schools: Environmental Factors, Children’s Health and Performance, and Sustainable Building Practices (2013) RFA Text | Recipients Lists
Research Category: Children's Health , Human Health
Objective:
Aim 1: Assess if children’s exposure to contaminants in school environment is individually or jointly associated with adverse health outcomes and performance.
Aim 2: Examine if school environmental factors changed over time and their relationships to outcomes modified by SES, neighborhood and meteorological factors.
Aim 3: Identify potential factors mediating school environmental exposures on various outcomes and develop new methodologies to assess multiple exposures.
Aim 4: Identify sustainable building practices and evaluate interventions.
Progress Summary:
We have completed most tasks for Year 2, including IRB application for different components, finalizing data request/access, data cleaning and linkage, developing statistical methods, completing many components of statistical analyses, implementing surveys for private and public school leaders, developing protocols for personal monitoring, and beginning to recruit school participants. Even with the challenge of fund transferring delay, we completed some tasks ahead of schedule, such as geocoded all hospital admission and ED residences to street level for a new statewide master file from 2000-2016, developed innovative statistical methods for mediation analysis and state-of-the-art methods dealing with complex, highly-correlated variables, completed partial statistical analyses for most aims, assembled a strong, multi-disciplinary team with expertise in sampling, air pollutant and noise measurement, designed the diary questionnaire, and purchased equipment required. The goals of the project have not changed from the original application, and we have made good progresses toward achieving our project’s objective and main aims.
Specific Aim 1:
1) Private School Leader Survey/ Public School Leader Survey: In Years 1-2, we developed a survey designed for private school leaders in order to identify gaps in awareness of school environmental health issues in New York State private schools. We worked together with two leaders from the New York State Coalition for Independent and Religious Schools (NYSCIRS), who shared their input and the concerns of private school leaders in order to create a survey tailored to their needs. Questions include general information about the school, class size, building maintenance, student health services, health and safety committees, environmental issue identification, indoor air quality, construction and renovation, and radon presence and testing. Some questions examples are “How do you perceive the overall indoor air quality in your building?” and “How are environmental health issues identified at your school?” Furthermore, we distributed the private school survey with paper forms at the New York State Annual Conference for Administrators of Independent and Religious schools, where we had a table to collect responses and answer questions about the survey. By using a similar questionnaire as the Private School Leader Survey, we deployed another survey for public school administrators with help from NYSED. The public school leaders had a specific concern for lead in their water and asked us to include questions regarding this matter. The NYSED colleague helped distribute this questionnaire at their annual conference for facilities managers and building managers in October 2016. However, even with the support from the leaders of these agencies, we received unexpectedly low response rates (< 20%) for both surveys. To increase participation rate, we decided to redevelop both surveys into online formats to make them easy access. We are working with the leaders from both agencies and trying to redistribute the online survey through their email list-servs to reach a wider audience in spring 2017.
2) We conducted a multilevel case-control study to compare the ratios of various hazard indicators between the cases (ED visits and hospital admissions due to respiratory diseases) and controls (hospital admissions due to GI diseases and accidental falls), using NYS hospital and ED data (SPARCS). More specifically, we assessed the effects of some emerging exposures, including building practices and factors such as renovation, indoor/outdoor biomass burning, and school outdoor and home exposure factors such as proximity to industrial and waste sites, heavy traffic, airports, and wood burning facilities. We found that childhood respiratory ED visits were positively associated with attending schools located near industrial factories (toxic release inventory (TRI) sites), airports, or the schools where the air intake was not free of blockage. We observed stronger health effects for schools near TRI sites in rural areas and schools near airports in urban areas.
3) We continued developing an equipment purchase list, school recruitment, and visit plan for the sampling trips. We have brainstormed and fine-tuned the list in order to reach our project goals within budget. We will begin purchasing equipment in Q1 of Year 3. The equipment purchase list, made with the assistance of Dr. Thurston, Dr. Khwaja, and Dr. Anderson, includes both personal and stationary air monitoring equipment. We plan to recruit 10 schools, with the criteria that two schools be bio-mass burning schools, two suburban high-need schools, three urban high-need schools, and three low-need schools.
4) We also developed a comprehensive and well-tailored sampling plan and an 80-page quality assurance project plan (QAPP), which includes detailed QA/QC plans and standard operating procedures, and has been submitted to EPA.
Specific Aim 2:
1) In Years 1-2, we used the NYSED Building Condition Survey data to examine whether school building conditions change over time. We performed statistical analyses in order to compare the statewide prevalence of well-maintained systems (e.g., roof, windows, HVAC, etc.) questions and environmental health questions in the previous years’ (2005 versus 2010) building condition surveys.
2) We also assessed change in the percentage of school buildings with multiple problems for important IAQ areas such as mold/moisture, ventilation, and cleanliness.
3) Additionally, we assessed the percentage of school buildings who either “stayed bad,” “got better,” “got worse,” or “stayed good” during 2005-2010 for each environmental health question asked and for select well-maintained system questions. We found that 25.3% of overall building conditions and 7.2% intakes by bus areas got worse in 2010 while comparing to the 2005 survey. We also found that ventilation problems increased in recent years, including inadequate outside air (20.1% in 2010 vs. 8.7% in 2005) and malfunctioning dampers (13.2% in 2010 vs. 10% in 2005).
Specific Aim 3: After performing a comprehensive literature review on comparison between two mediation analysis methods that are currently available in Year 1, we decided to use the counterfactual mediation approach. This approach is chosen for several advantages. Compared to the traditional “Baron and Kelly” approach, this approach allows binary or discrete outcome variables, interaction between exposure and mediator, and can assess multiple mediators in one model. This approach also provides a detailed breakdown of total effect to natural direct effect and natural indirect effect. We are currently under the stage of choosing appropriate statistical methods in selecting our indicators of exposure among multiple environmental factors and highly correlated factors. We chose to use sure independence screening combined with smoothly clipped absolute deviation penalty (ISIS-SCAD) to select important indicators of the exposures. We will use directed acyclic graphs (DAGs) to identify potential confounders on exposure-mediator, exposure-outcome, and mediator-outcome pathways to fulfill the assumptions required for the counterfactual approach.
Specific Aim 4: In Years 1-2, we started to evaluate if schools using environmental guidelines or programs had better health outcomes. Guidelines and programs studied include the EPA Tools for Schools, LEED, and CHPS. We have employed a longitudinal study to temporally compare the school conditions and children’s outcomes before and after LEED and CHPS programs, using GAM models. We used statistical methods such as linear regression to spatially compare schools with the LEED and CHPS programs to schools without the programs.
Future Activities:
Planned activity for next reporting period: 1) During the next reporting period, we will conduct and complete the online follow-up of the private and public school surveys; 2) We will continue to analyze the building condition survey data, specifically examining how total environment, including school building conditions, school outdoor and home outdoor environment, and socio-demographics affect children’s health, test scores, and attendance; 3) In Year 3, we will continue school recruitment and try to start the project component of classroom sampling and personal monitoring; 4) We will also examine the modifying effects of socio-demographics/neighborhood factors on school environment-children’s outcomes by conducting stratified analysis in Year 3; 5) We will move forward with the mediation analysis methods newly developed to study the interrelationships among student performance, health outcomes, and student absenteeism; 6) We will also use innovative statistical methods to deal with highly correlated factors; and 7) In Year 3, we will prepare a manuscript to summarize our findings regarding environmental policy implementation on children’s health.
Journal Articles on this Report : 5 Displayed | Download in RIS Format
Other project views: | All 24 publications | 11 publications in selected types | All 11 journal articles |
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Kielb C, Lin S, Muscatiello N, Hord W, Rogers-Harrington J, Healy J. Building-related health symptoms and classroom indoor air quality: a survey of school teachers in New York State. Indoor Air 2015;25(4):371-380. |
R835636 (2016) R835636 (2017) R834787 (2013) R834787 (2014) R834787 (2015) R834787 (Final) |
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Lin S, Lawrence WR, Lin Z, Francois M, Neamtiu IA, Lin Q, Csobod E, Gurzau ES. Teacher respiratory health symptoms in relation to school and home environment. International Archives of Occupational and Environmental Health 2017;90(8):725-739. |
R835636 (2016) R835636 (2017) |
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Lu Y, Lin S, Lawrence WR, Lin Z, Gurzau E, Csobod E, Neamtiu IA. Evidence from SINPHONIE project: impact of home environmental exposures on respiratory health among school-age children in Romania. Science of the Total Environment 2018;621:75-84. |
R835636 (2016) R835636 (2017) R835636 (2018) |
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Muscatiello N, McCarthy A, Kielb C, Hsu W-H, Hwang S-A, Lin S. Classroom conditions and CO2 concentrations and teacher health symptom reporting in 10 New York State schools. Indoor Air 2015;25(2):157-167. |
R835636 (2016) R835636 (2017) R834787 (2013) R834787 (2014) R834787 (2015) R834787 (Final) |
Exit Exit Exit |
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Palumbo JR, Lin S, Lin Z, Neamtiu IA, Zhang W, Csobod E, Gurzau ES. Assessing associations between indoor environment and health symptoms in Romanian school children: an analysis of data from the SINPHONIE project. Environmental Science and Pollution Research International 2018;25(9):9186-9193. |
R835636 (2016) R835636 (2017) R835636 (2018) |
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Supplemental Keywords:
school environment, LEED, CHPS, environmental healthProgress and Final Reports:
Original AbstractThe perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.
Project Research Results
- Final Report
- 2019 Progress Report
- 2018 Progress Report
- 2017 Progress Report
- 2015 Progress Report
- Original Abstract
11 journal articles for this project