Healthy Schools

School Drinking Water Testing and Reporting

Infants and young children are particularly vulnerable to the effects of lead exposure. Drinking water can be a source of lead, especially in buildings with older plumbing systems. Lead may enter the water supply through pipes, fixtures, or solder that contain lead. Testing water in schools and child care facilities is essential, as children spend a substantial amount of time in these settings and are likely to consume water while there.

Free Testing for Lead in School Drinking Water

The Lead Testing in Schools and Child Care Centers (LTSCC) Program is a free, voluntary program offered by the Tennessee Department of Environment and Conservation (TDEC) to help reduce childhood lead exposure. Eligible facilities include Tennessee Department of Human Services (TDHS)-licensed child care centers, Head Start and Early Head Start programs, Tennessee Department of Education (TDOE) public schools, and TDOE-certified school-administered child care programs.

Frequently-Asked Questions about Lead Testing and the LTSCC Program

Why is it important to test water for lead?
Lead is a toxic metal that is especially harmful to children. Testing for lead in drinking water helps evaluate plumbing systems and materials so that targeted remediation efforts can be taken. It is a key step in understanding the problem, if there is one, designing an appropriate response, and reducing children’s exposure to lead.

What are the sources of lead in school drinking water?
Lead can enter your school's drinking water as it travels through lead connecting service lines and your school's internal plumbing and fixtures, especially those that were installed prior to 1988 (the effective date of the “lead free” act). Faucets that provide water used for consumption including drinking, cooking lunch, and preparing juice may contain lead.

What does Tennessee law require?
The Tennessee General Assembly passed T.C.A. § 49-2-133 in 2018 requiring each local board of education to implement policies to test for lead in water sources for schools constructed prior to Jan. 1, 1998. If school's testing results show the presence of lead, equal to or greater than 20 parts per billion (ppb). in its drinking water the school shall: remove the drinking water source form service until retesting confirms results of less than 20 ppb;  notify parents and  guardians, and State and Local health and education officials, within 5 business days of the test result; and, retest the lead level of the drinking water within 90 days of taking corrective action. 

Click and complete this form for additional information on Tennessee's lead reporting requirements and to submit your LEA's testing results to TDH, or click the LTSCC Participant Portal link above.

How can I participate in the LTSCC Program?
The first step is to enroll in the program using the link “Enroll Now in the LTSCC Program” button below. Once your enrollment is confirmed, the program team will contact you and guide you through the free lead in drinking water sampling process. All necessary materials are provided at no cost, including sample bottles, laboratory analysis, and pre-paid shipping labels. 

Does this testing count towards the Office of Head Start Federal Memorandum?
Yes, testing completed through this program meets the testing requirements outlined by the Office of Head Start Federal Memorandum.

Does this testing count towards Public Charter 977?
Yes, testing completed through the LTSCC program meets the testing requirements outlined by Public Charter 977. 

Contact

Email: info@tnleadtesting.org
Phone:  (865) 213-3284
Hours: Monday to Friday, 8 a.m. to 4 p.m., Central

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What Is Green Chemistry?

Green chemistry, also called sustainable chemistry, focuses on designing and using chemicals and processes that reduce or eliminate pollution and hazardous substances. It aims to make chemistry safer, cleaner, and more efficient by improving how chemicals are made, used, and disposed of.

Why It Matters in Schools

Chemicals are important tools for science education—but when not managed properly, they can pose risks to students, staff, and the environment. By applying green chemistry principles in classrooms and labs, schools can:

• Reduce the use and storage of toxic and outdated chemicals
• Prevent chemical spills, fires, and exposure risks
• Save money by minimizing hazardous waste disposal
• Improve indoor air quality and reduce student and teacher absences

Children are especially vulnerable to chemical exposures. Using safer materials in science experiments protects health, supports learning, and creates a safer school environment.

Educating the Next Generation

Teaching green chemistry helps students understand how science can balance environmental, social, and economic factors. By integrating these concepts into the curriculum, schools: 

• Prepare students for modern science and technology careers
• Encourage innovation in sustainability
• Build awareness of how chemical choices affect human and environmental health

Green chemistry is shaping the future of science, and introducing it at the high school level equips students to think critically about safety, sustainability, and responsible innovation.

How to Implement a Green Chemistry Program

Start with Chemical Management:

• Conduct a full inventory of chemicals used in school labs.
• Remove outdated or high-risk substances.
• Seek assistance from the Tennessee Department of Environment and Conservation (TDEC) for chemical management support, 1-888-891-TDEC (8332).

Build a Supportive Framework:

• Train teachers and staff in green chemistry practices and lab safety.
• Develop policies for chemical purchasing, storage, and disposal.
• Budget for ongoing inventory tracking and chemical removal.
• Encourage collaboration among teachers, maintenance staff, administrators, and nurses.

Engage the School Community:

• School nurses can educate staff and students about chemical exposure risks.
• Maintenance teams can ensure compliance with state and local disposal rules.
• Teachers can use smaller quantities of safer materials and model sustainability principles in experiments.

Key Benefits

• Safer classrooms and labs
• Reduced liability and waste disposal costs
• Healthier indoor environments
• Students prepared for sustainable science careers

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Head Lice and Pest Management in Schools

Head lice are a common nuisance but do not spread disease. According to the CDC, students diagnosed with live head lice do not need to be sent home early. They may return to class once treatment has started.

Key Points

• Hygiene is not a factor. Getting head lice is not related to cleanliness.
• “No-nit” policies should be discontinued. The American Academy of Pediatrics (AAP) and the National Association of School Nurses (NASN) discourage requiring students to be nit-free before returning to school.
• Nits (lice eggs) found more than ¼ inch from the scalp are usually empty or non-viable.
• Misdiagnosis is common; many particles in hair can resemble nits.
• The impact of unnecessary absenteeism outweighs the risk of lice transmission.

Recognizing Head Lice

• Found mostly on the scalp, behind the ears, and near the neckline
• Spread only by direct head-to-head contact (cannot jump or fly)
• Pets do not spread lice
• Symptoms may include itching, tickling sensations, and irritation, especially at night

Diagnosing and Treating

• Diagnosis is confirmed by finding live lice (not just nits).
• Use a fine-tooth comb to inspect the scalp and hair shafts, especially near the ears and neck.
• Only treat active infestations. If only distant nits are found (>¼ inch from scalp), treatment is not necessary.
• Follow all medication instructions carefully; some treatments require retreatment 7–10 days later.
• Wash or heat-dry bedding, hats, and towels used in the two days before treatment. Items that can’t be washed should be sealed in a plastic bag for two weeks.
• Avoid sharing combs, hats, and personal items.

Head lice are not a public health hazard, but good communication and sensible school policies prevent stigma and lost learning time.

Integrated Pest Management (IPM) in Schools

Schools may encounter pests such as insects or rodents—and the pesticides used to control them. Because children are more sensitive to chemical exposure, careful pest control practices protect both health and learning environments.

Children are more vulnerable because:

• Their bodies are still developing, making them more sensitive to toxins.
• They breathe, eat, and drink more relative to body weight than adults.
• Their behaviors (playing on floors, hand-to-mouth contact) increase exposure risk.

What Is IPM?

Integrated Pest Management (IPM) is an environmentally responsible approach that emphasizes prevention and the least-toxic solutions. Rather than relying solely on pesticides, IPM focuses on eliminating the conditions that attract pests.

Core IPM Practices

• Clean food surfaces, utensils, and dishes daily.
• Empty and clean garbage cans and dumpsters regularly.
• Collect litter at least weekly.
• Identify the pest before taking action.
• Seal cracks, gaps, and crevices where pests enter.
• Clean lockers and desks at least twice per year.
• Keep vegetation and mulch at least one foot away from buildings.
• Apply fertilizers and pesticides in small, targeted amounts only when needed.
• Use spot treatments instead of large-area spraying.

Benefits of IPM

• Reduces pesticide exposure and health risks
• Creates cleaner, safer school environments
• Prevents recurring pest problems
• Supports compliance with state health and safety guidelines

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Air Quality and Student Health

Clean air is essential to a healthy learning environment. Poor air quality—indoors or outdoors—can make it harder for students to breathe, focus, and learn. Children, teens, and staff with asthma or other respiratory conditions are especially sensitive to polluted air and temperature extremes. Air pollution is linked to asthma attacks, allergies, respiratory illness, and even mental health issues such as anxiety and depression.

How Poor Indoor Air Affects Health

When indoor air quality is poor, students may experience:

• Asthma attacks or wheezing
• Coughing and shortness of breath
• Headaches and eye irritation
• Fatigue or difficulty concentrating
• Increased risk of infections

Maintaining good indoor air quality helps reduce absenteeism and supports student success.

Improving Indoor Air Quality

Schools can protect students and staff by:

• Properly maintaining HVAC systems to provide clean, filtered air
• Controlling moisture to prevent mold growth
• Managing pests using Integrated Pest Management (IPM) instead of chemicals
• Testing for radon and using carbon monoxide detectors near boilers, stoves, or water heaters
• Avoiding harsh cleaning chemicals and unnecessary pesticide use

The EPA’s Indoor Air Quality Tools for Schools Action Kit and Indoor Air Quality in Schools webpage offer step-by-step resources to help schools identify and correct air quality issues.

Asthma-Friendly Schools

Asthma is one of the leading causes of school absences. Common triggers include dust, mold, pollen, strong odors, and poor ventilation. Schools can reduce asthma episodes by:

• Keeping classrooms clean and dry
• Using fragrance-free cleaning supplies
• Reducing use of aerosols or sprays
• Ensuring proper air circulation

Parents should share their child’s Asthma Action Plan with teachers and the school nurse. Resources are available from the National Heart, Lung, and Blood Institute and CDC Tools for Asthma Control.

Why Outdoor Air Quality Matters

Outdoor air pollution can come from cars, trucks, power plants, wildfires, and even natural sources like pollen or mold. Exposure to outdoor pollutants can worsen asthma, trigger coughing or wheezing, and reduce overall lung function—especially during physical activity or sports. The EPA’s Air Quality Flag Program for Schools helps schools make informed decisions about outdoor activities when pollution levels are high.

Common Outdoor Air Pollutants

Ground-Level Ozone: Forms when sunlight reacts with vehicle or industrial emissions. Causes coughing, throat irritation, and breathing difficulty, especially during hot weather.

Particulate Matter (PM): Tiny particles from smoke, dust, or exhaust that can reach deep into the lungs. PM2.5 (fine particles) can increase the risk of asthma attacks, heart problems, and low birth weight in infants.

Using the Air Quality Index (AQI)

The Air Quality Index (AQI) reports daily air pollution levels using a color-coded system:

Green: Good

Yellow: Moderate

Orange: Unhealthy for sensitive groups

Red: Unhealthy

Purple/Maroon: Very unhealthy or hazardous

Schools can use AQI forecasts to plan outdoor activities safely.

High Temperatures

Many school buildings struggle to manage heat due to aging infrastructure or limited air conditioning. High temperatures can:

• Trigger asthma or breathing problems
• Cause fatigue, headaches, and dehydration
• Lower concentration, memory, and test performance

Access to cooling systems and good ventilation significantly reduces these risks and helps maintain academic performance during heat waves.

Low Temperatures

Cold weather can also harm student health, especially for young children or those with respiratory issues. Prolonged exposure to freezing temperatures increases the risk of frostbite and hypothermia.

Safety tips for cold weather:

• Dress in layers with hats, scarves, gloves, and warm, waterproof clothing.
• Limit outdoor exposure during extreme cold or high wind chill.
• Ensure staff can recognize symptoms of cold-related illness.

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School Nursing in Tennessee

The National Association of School Nurses (NASN) defines school nursing as:

“A specialized practice of nursing that protects and promotes student health, enables optimal development, and advances academic success. School nurses, grounded in ethical and evidence-based practice, bridge health care and education, coordinate care, advocate for quality student-centered care, and design systems that help individuals and communities reach their full potential.”

School nurses promote student health and safety, respond to health problems, provide case management, and help families and students build skills to manage health needs effectively.

Coordinated School Health in Tennessee

Coordinated School Health (CSH) is an evidence-based model from the Centers for Disease Control and Prevention (CDC) that helps schools create environments where students are healthy, safe, and ready to learn.

CSH addresses eight components of school health:

• Health education
• Physical education and activity
• Health services
• Counseling, psychological, and social services
• Nutrition services
• Healthy school environment
• Staff wellness
• Student, family, and community involvement

Before CSH, Tennessee’s schools had inconsistent health policies and programs. Statewide adoption of CSH streamlined school health efforts, ensuring consistent support for students across the state.

Of Tennessee’s 1,714 public schools surveyed, 58% (994 schools) employ a full-time nurse serving both general and special education students.

The Role of the School Nurse

After the home, school is the most influential environment in a child’s life. Health and learning are closely connected—students are more likely to succeed academically when school nurses are present and accessible.

Modern school nurses address a broad range of physical, emotional, and social challenges, including chronic illness, family crises, and mental health concerns.

According to NASN, school nurses fulfill seven core roles to support student health and academic success:

• Provide direct care to students.
• Lead delivery of health services within schools.
• Screen and refer students for health conditions.
• Promote a healthy school environment.
• Educate and promote health across the school community.
• Lead development of health policies and programs.
• Act as a liaison between students, families, health providers, and the community.

School nurses rely on collaboration with teachers, administrators, families, and the wider school community to be effective.

Guidance for Parents and Caregivers

Healthy students learn better. School nurses, working with families, doctors, and educators, help students stay healthy, manage chronic conditions, and succeed in school. Nurses provide:

• Illness and injury assessment and intervention
• Emergency and medication management
• Health counseling and education
• Daily care for students with chronic health needs

When to Keep Your Child Home

Do not send your child to school if they:

• Have a fever, nausea, vomiting, or diarrhea
• Are lethargic, in pain, or appear obviously sick
• Have an unexplained rash or contagious illness

Helping the School Nurse

Parents can support their child’s care by:

• Providing all required medications and medical supplies (e.g., EpiPens, insulin, asthma inhalers)
• Submitting updated physician orders for daily or emergency procedures
• Teaching children good hygiene, such as handwashing, coughing into their elbow, and using tissues properly

More Than Health Care

The nurse’s office can be a safe, supportive space for students who need comfort, a listening ear, or a quiet moment during a difficult day. School nurses also support school staff, offering blood pressure checks, health counseling, and emergency response.

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Nutrition and Healthy Eating in Schools

According to the Centers for Disease Control and Prevention (CDC), children may eat up to half of their daily calories while at school. Offering healthy meals and snacks supports classroom learning and helps children develop lifelong healthy eating habits. Healthy eating improves:

• Concentration and memory
• Energy and classroom participation
• Growth, development, and long-term wellness

How Schools Can Support Healthy Eating

Schools play an important role in shaping children’s eating behaviors. Healthy students are better learners, and schools can promote both health and academic success by:

• Providing nutritious meals and snacks that meet dietary guidelines
• Teaching nutrition education through classroom lessons and hands-on activities
• Creating environments that make healthy choices easy and appealing

School Gardens: Growing Healthier Kids

A school garden gives students hands-on learning opportunities and helps them understand where food comes from. Gardening encourages children to:

• Eat a wider variety of fruits and vegetables
• Be more physically active
• Connect with nature and their community

Gardens can also be designed as sensory gardens, engaging all five senses to support learning and wellness.

Tips for Successful School Garden Programs

• Educate and Plan Together – Teach students about healthy diets and involve them in planning the garden layout and choosing plants.
• Make It Fun – Create a garden that is inviting and enjoyable. Add colorful signage and learning stations.
• Share the Experience – Place the garden in a visible area and share updates in newsletters or class announcements.
• Celebrate the Harvest – Use the produce in the cafeteria or let students take food home to share.
• Seek Partnerships and Funding – Look for grants or local sponsors to support garden materials and education.

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Physical Activity and Healthy Schools

According to the U.S. Department of Health and Human Services, regular physical activity helps children and adolescents:

• Build strong bones and muscles
• Improve strength and endurance
• Control weight
• Reduce anxiety and stress
• Boost self-esteem and confidence
• Support healthy blood pressure and cholesterol levels

The U.S. Surgeon General recommends that children get at least 60 minutes of physical activity each day.

Regular movement also supports learning and classroom success:

• Brain Function – Increases concentration and attentiveness
• Wellness – Reduces feelings of depression and anxiety, promoting overall well-being
• Healthy Weight – Burns calories and supports a balanced lifestyle
• Social Skills – Encourages teamwork, cooperation, and communication

Importance of Physical Education (PE)

Physical education (PE) provides structured, standards-based instruction in movement, health, and fitness. PE classes help students develop the knowledge and skills needed for lifelong physical activity.

According to the Centers for Disease Control and Prevention (CDC), high-quality PE classes can:

• Increase students’ overall physical activity levels
• Improve grades and standardized test scores
• Help students stay focused and on-task in the classroom

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Why Recycling Matters in Schools

Schools generate large amounts of waste each year — from paper and packaging to electronics and food scraps. According to Recycle Now, the average secondary school student produces about 48 pounds of waste annually. A strong recycling program not only reduces waste but also engages students and staff, builds school pride, and encourages families and communities to adopt sustainable habits. Successful recycling programs often have a dedicated champion — a teacher, student, or administrator who leads the effort and helps create a positive culture of environmental stewardship.

The Four Rules for Waste Reduction

Every school recycling program should be built around these core principles:

1. Reduce – Be mindful of packaging, consume less, and throw away less.
2. Reuse – Repair, donate, or sell items instead of discarding them.
3. Recycle – Keep recyclable materials out of the trash and give them new life.
4. Buy Recycled – Support a circular economy by purchasing products made from recycled materials.

Tips for Starting or Strengthening a Recycling Program

• Educate and Train – Conduct a waste audit to understand recycling needs. Teach students and staff what materials can be recycled and how to sort them properly.
• Make It Fun – Form recycling teams or after-school clubs. Encourage friendly competitions or themed events to increase participation.
• Promote and Share Results – Highlight your recycling efforts in newsletters or school announcements. Report how much waste has been diverted to show progress and build motivation.
• Use Clear Bins and Signage – Place recycling bins next to trash cans and label them clearly. Make sure they’re visible and easy to use to prevent contamination.
• Partner with Custodial Staff – Collaborate with janitorial teams to track progress and ensure materials are properly collected and processed.
• Seek Grants or Donations – Look for recycling grants or community partnerships to fund bins, signage, and educational materials.

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What Is School Siting?

School siting is the process of deciding where to locate or renovate a school. Thoughtful siting helps ensure schools are safe, healthy, and accessible for students, staff, and families. School siting decisions should be made before:

• Choosing to renovate or build a new school,
• Acquiring or leasing property, or
• Reusing or redeveloping existing buildings.

Where a school is placed affects student health, transportation options, community development, and long-term maintenance costs.

School Siting Guidelines

The U.S. Environmental Protection Agency (EPA) provides guidelines to help schools evaluate environmental and public health risks and benefits when selecting sites. Environmental risks can include:

• Onsite contamination such as chemicals in soil or groundwater,
• Nearby industrial or traffic-related pollution, or
• Past use of the land for hazardous purposes.

Environmental benefits include:

• Locations close to where students live, allowing safe walking or biking,
• Opportunities to share facilities like parks or community centers, and
• Reduced long-term costs for transportation and cleanup.

EPA recommends avoiding sites with known contamination or close proximity to pollution sources—especially former industrial, landfill, or hazardous waste properties.

Using the Guidance

This guidance is a resource for school systems, communities, tribes, and state agencies to help provide healthy learning environments. They outline steps for evaluating potential sites, assessing environmental concerns, and involving the public in decision-making.

Children are particularly sensitive to environmental exposures because of their size and development. Careful review of environmental risks helps protect them from long-term health effects.

Key Questions When Evaluating Locations

• Which sites have the lowest risk of exposure to pollutants?
• Which sites allow for shared or joint use of facilities, such as parks, gyms, or clinics?
• Which sites align with local or regional development plans?
• Which sites encourage active transportation, such as walking or biking to school?
• Which sites have the least potential for environmental harm?

Public Involvement in School Siting

Meaningful community engagement is essential throughout the school siting process. Stakeholders—parents, teachers, staff, local officials, and residents—should have opportunities to share input and receive updates. Effective strategies include:

• Developing a clear communication plan,
• Holding public meetings and sharing written reports,
• Providing accessible materials for individuals with disabilities or limited English proficiency, and
• Forming a school siting committee with representatives from the school system, local government, and community organizations.

Walk, Bike, or Ride

The distance between where students live and their school affects how they get to class. In 1969, about half of elementary students lived within two miles of their school. By 2001, that number dropped to one-third. Encouraging students to walk or bike to school supports physical activity and community connection. States such as South Carolina, Rhode Island, and Maine have reduced or eliminated minimum acreage requirements to allow schools to be located closer to neighborhoods. Other states now promote shared use of facilities and stronger coordination between school districts and local planners.

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