Caring for Our Children (CFOC)

Chapter 5: Facilities, Supplies, Equipment, and Environmental Health

5.3 General Furnishings and Equipment

5.3.1 General Furnishings and Equipment Requirements Facility Arrangements to Minimize Back Injuries

The child care setting should be organized to reduce the risk of back injuries for adults provided that such measures do not pose hazards for children or affect the implementation of developmentally appropriate practice. Furnishings and equipment should enable caregivers/teachers to hold and comfort children and enable their activities while minimizing the need for bending and for lifting and carrying heavy children and objects. Caregivers/teachers should not routinely be required to use child-sized chairs, tables, or desks.
Back strain can arise from adult use of child-sized furniture. Analysis of worker compensation claims shows that employees in the service industries, including child care, have an injury rate as great as or greater than that of workers employed in factories. Back injuries are the leading type of injury (1). Appropriate design of work activities and training of workers can prevent most back injuries. The principles to support these recommendations (see Comments) are standard principles of ergonomics, in which jobs and workplaces are designed to eliminate biomechanical hazards.

In a statewide (Wisconsin) survey of health status, behaviors, and concerns, 446 randomly selected early childhood professionals, directors, center teachers, and family providers, reported dramatic changes in frequency of backache and fatigue symptoms since working in child care (2).

Some approaches to reduce risk are:
  1. Adult-height changing tables;
  2. Small, stable stepladders, stairs, and similar equipment to enable children to climb to the changing table or other places to which they would otherwise be lifted, without creating a fall hazard;
  3. Convenient equipment for moving children, reducing the necessity of carrying them;
  4. Adult furniture that eliminates awkward sitting or working positions in all areas where adults work.

This standard is not intended to interfere with child-adult interactions or to create hazards for children. Modifications can be made in the environment to minimize hazards and injuries for both children and adults. Adult furniture has to be available at least for break times, staff meetings, etc.

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS Pre-Employment and Ongoing Adult Health Appraisals, Including Immunization Daily Staff Health Check Staff Health Guidelines for Return to Work On-Site Occupational Hazards Stress Management for Staff
  1. Brown, M. Z., S. G. Gerberich. 1993. Disabling injuries to childcare workers in Minnesota, 1985 to 1990: An analysis of potential risk factors. J Occup Med 1993 35:1236-43.
  2. Grantz, R. R., A. Claffey. 1996. Adult health in child care: Health status, behaviors, and concerns of teachers, directors, and family child care providers. Early Child Res Q. 11:243-67.