In Child Care Settings

Press Release for 2013 Update Report 

Feburary 6, 2013, San Francisco:

The San Francisco Asthma Task Force report issued today, “2013 Update: Bleach-free Disinfection and Sanitizing for Child Care,” provides child care operators comprehensive information on how to meet infection control regulations with bleach-free products approved for that use.

Many child care operators are moving away from bleach as their primary disinfectant and sanitizer because it has been recognized as an asthmagen, meaning a substance that can cause new asthma. Asthma is a chronic disease that has been progressively affecting a greater proportion of the US population over the past two decades without a single source of causation.

The 2013 Update is a how-to guide for converting a single site to a bleach-free environment, replicating this intervention on a larger scale, and assuring that a child care site is prepared for communicable disease outbreaks.  You may also access this report and associated program implementation resources from the website of RAMP, Regional Asthma Management and Prevention

In a 2008 pilot project to study this issue, the San Francisco Asthma Task Force found that in a single day, one child care worker could potentially spray bleach up to almost 100 times if cleaning is her/his designated duty for the day. Child care workers have reported that spraying bleach frequently throughout the day has caused respiratory distress, allergic reactions, and burns to skin/ clothing.

Funding was provided by Human Services Agency of San Francisco, San Francisco Department of Children, Youth & Their Families, First 5 San Francisco Children & Families Commission, San Francisco Department of Public Health, Regional Asthma Management and Prevention, San Francisco Public Health Foundation, San Francisco Department of the Environment, Neil Gendel, Director of Healthy Children Organizing Project, and the San Francisco Foundation. 


2013 Update Report: Bleach-free Disinfection and Sanitizing for Child Care


Program implementation resources

Bleach-free Toolkit, Trilingual, July 2013 (pdf)

Bleach-free Training, Triligual, July 2013 (pdf)

Bleach-free Training, English July 2013 (Powerpoint)

Bleach-free Training, Chinese July 2013 (Powerpoint)

Bleach-free Training, Spanish July 2013 (Powerpoint)

Referral for Service (SF Only), English (pdf)

CA CCL Regulations for Sanitizing and Disinfecting,Trilingual table (pdf)



Background materials

Child Care Licensing Quarterly Update Winter 2020/2021 (pdf)

Evaluation of acetic acid and hydrogen peroxide exposures during sanitizing and disinfecting practices at a child care center (pdf)


For more current information, please contact:

Western States Pediatric Environmental Health Specialty Unit:  

           Environmental Health in Early Care and Education Project


Other Resources for Asthma-Safe Healthy Child Care