Agency for Toxic Substances and Disease Registry
Case Studies in Environmental Medicine (CSEM)
Pediatric Environmental Health
Appendix D: Environmental Health Concerns: Resources and Sources of Information
Agency for Toxic Substances and Disease Registry. 2002. Child health web page. Atlanta: US Department of Health and Human Services. Available from: URL: www.atsdr.cdc.gov/child/ochchildhlth.html.
Children's Environmental Health Network. 2000. The household detective primer: how to protect your children from toxins in the home. Princeton (NJ): Children's Environmental Health Network. Available from: URL: www.cehn.org. 
Needleman HL, Landrigan PJ. 1994. Raising children toxic free: how to keep your child safe from
lead, asbestos, pesticides, and other environmental hazards. New York: Farrar, Straus and Giroux.
Schoemaker JM, Vitale CY. 1991. Healthy homes, healthy kids-protecting your children from everyday environmental hazards. Washington (DC): Island Press.
Upton AC, Graber E. 1993. Staying healthy in a risky environment: the New York University Medical Center family guide. New York: Simon & Schuster.
Children's Environmental Health Network. 1997. Resource guide on children's environmental health. Washington (DC): Children's Environmental Health Network.
Goldman R, Shannon M, Woolf A. 1999. Pediatric environmental health history [on CD-ROM]. Boston: Pediatric Environmental Health Unit Cambridge Hospital and Children's Hospital.
Textbooks
Behrman RE, Kliegman RM, Arvin AM, Nelson WE, editors. Nelson textbook of pediatrics, 15th edition. Philadelphia: W.B. Saunders Company; 1996.
Burgess WA. Recognition of health hazards in industries: a review of materials and processes, 2nd edition. New York: John Wiley & Sons, Inc.; 1995. C ontains work-site analyses that facilitate recognition of health problems in design and operation of industrial processes. In addition to identifying health issues, provides information on control measures.
Encyclopedia of occupational health and safety, 3rd edition. International Labor Office/Boyd Printing; 1991. Extensive information on all aspects of occupational health and safety, including occupational diseases, hazards, prevention, institutions. Two-volume set of more than 3,600 pages. 4th edition, with a CD-ROM version, 1997.
Harris RL. Patty's Industrial Hygiene and Toxicology, 5th edition. New York: John Wiley & Sons Inc.; 2000. Guide to principles and practice of industrial hygiene, hazard evaluation and control, toxic exposures, and similar topics.
Hathaway GJ, Proctor NH, Hughes JP, Fischman ML. Proctor and Hughes' chemical hazards in the workplace, 4th edition. New York: John Wiley & Sons; 1996. This is the classic text on more than 500 chemicals that may result in workplace exposure. Provides definitive information on effects of exposure and on treatment approaches.
LaDou J, editor. Occupational and environmental medicine, 2nd edition. Stamford (CT): Appleton & Lange; 1997.
Manuele FA. On the practice of safety, 2nd edition. New York: John Wiley & Sons; 1997. Discussion of basic principles and aspects of safety as an evolving discipline.
Rogers B. Occupational health nursing-concepts and practice. Philadelphia: W.B. Saunders Co.; 1994. Primary reference for occupational health nursing principles and practice. Provides clinical nursing guidelines for common occupational health problems.
Rom WM, editor. Environmental and occupational medicine, 3rd edition. Philadelphia: Lippincott-Raven, 1998. Another helpful reference that considers environmental as well as occupational health problems.
Rosenstock L, Cullen MR, editors. Textbook of clinical occupational and environmental medicine. Philadelphia: Saunders, 1994. Useful reference for both environmental and occupational medicine concerns.
Vincoll J. Basic guide to accident investigation and loss control. New York: John Wiley & Sons; 1994. Provides information on safety principles and techniques, including preparation of safety system applications.
Wald P, Stave G. Physical and biological hazards in the workplace, 2nd edition. New York: John Wiley & Sons; 2001. Focuses on physical and biological hazard in the workplace and serves as a companion to Proctor and Hughes' Chemical Hazards in the Workplace. Available on CD-ROM.
Zenz C, Dickerson OB, Horvath EP, editors. Occupational medicine, 3rd edition. St. Louis (MO): Mosby, 1994. Information on occupational medicine principles and practice as well as on specific hazards and agents; 1,336 pages.
Abelsohn A, Sanborn M. Environmental health in family medicine. Available at URL: www.ijc.org/rel/boards/hptf/modules/content.html. Set of six full-text modules (lead, outdoor air quality, indoor air quality, pesticides, clusters of disease [water quality], and persistent organic pollutants). The modules are based on clinical cases that can be used for self-learning, or for teaching residents or practicing physicians. Also available on CD-ROM.
National Library of Medicine's Medline. Available via NLM's Health Information Web site at URL: www.nlm.nih.gov/hinfo.html. Medline is the National Library of Medicine's premier bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, and the preclinical sciences.
TOMES Plus. Available from Micromedix, Inc. 6200 South Syracuse Way, Suite 300, Englewood, CO 80111-4740 (USA and Canada phone: 1-800-525-9083 or 303-486-6400; International Department phone: +1 303 486-6444); Web page: www.micromedex.com/products/tomesplus. The TOMES System provides rapid, easy access to medical and hazard information needed for managing chemicals safely in the workplace, evaluating exposures, quick response to emergency situations, and regulatory compliance. The system includes MEDITEXT, medical managements; HAZARDTEXT, hazard managements with initial response information; and INFOTEXT, Documents with regulatory listings and other general information.
Specific information, such as reports by the Hazard Evaluation and Technical Assistance Branch of the National Institute for Occupational Safety and Health, is available through the National Technical Information Service (NTIS) database at www.ntis.gov.
Professional journals provide information on research, clinical practice, prevention techniques, new hazards, and similar topics. A few examples include the following:
- American Industrial Hygiene Journal, published by the American Industrial Hygiene Association.
- American Journal of Industrial Medicine, published by John Wiley & Sons, Inc.
- Annals of Occupational Hygiene, published by Elsevier Science Publishers.
- Archives of Environmental Health, published by Heldref Publications.
- Environmental Epidemiology and Toxicology, published by Stockton Press.
- Environmental Health Perspectives, published by the National Institute of Environmental Health Sciences.
- International Archives of Occupational and Environmental Health, published by Springer-Verlag.
- Journal of Occupational and Environmental Medicine, published by Williams & Wilkins.
- Journal of Toxicology-Clinical Toxicology, published by Marcel Dekker.
- Occupational and Environmental Medicine (formerly British Journal of Industrial Medicine), published by BMJ Publishing Group.
- Scandinavian Journal of Work, Environment and Health, published by the Finnish Institute of Occupational Health.
Web sites for a few professional organizations include the following:
Essentially every national agency with health and safety information or activities has an Internet Web site. These sites can be found by direct search using the agency's name or initials. A few examples include
- Agency for Toxic Substances and Disease Registry: emergency response line 404-498-0120; 1-888-42-ATSDR (1-888-422-8737).
- Centers for Disease Control and Prevention Hotlines:
National AIDS Hotline 1-800-342-2437.
National HIV/AIDS Hotline (Spanish) 1-800-344-7432.
National Immunization Hotline (English) 1-800-232-2522.
National Immunization Hotline (Spanish) 1-800-232-0233.
National STD Hotline 1-800-227-8922.
Traveler's Health 1-877-394-8747.
- National Institute of Environmental Health Sciences: 919-541-3345.
- National Institute for Occupational Safety and Health: 1-800-35-NIOSH (1-800-356-4674).
- U.S. Environmental Protection Agency (National Response Center for environmental emergencies): 1-800-424-8802.
- U.S. Food and Drug Administration: 1-888-INFO-FDA (1-888-463-6332).
- U.S. Occupational Safety and Health Administration (OSHA): 1-800-321-OSHA (1-800-321-6742) TTY 1-877-889-5627.
The Association of Occupational and Environmental Clinics (AOEC) is a network of more than 60 clinics and more than 250 individuals committed to improving the practice of occupational and environmental medicine through information sharing and collaborative research.
The primary goal of AOEC is to facilitate the prevention and treatment of occupational and environmental illnesses and injuries through collaborative reporting and investigation of health problems. AOEC members develop curriculum materials in occupational and environmental health and provide Education Activities (EA) programs for primary care practitioners and others.
For more information and a listing of AOEC clinics in your area, contact the AOEC office:
1010 Vermont Avenue, NW #513
Washington, DC 20005
Telephone: 202-347-4976
Fax: 202-347-4950
Web site: www.aoec.org.
The Pediatric Environmental Health Specialty Units (PEHSUs) are a resource for pediatricians, other health care providers, parents, teachers, the general public, and U.S. Environmental Protection Agency (EPA) and ATSDR staff members nationwide. PEHSUs provide medical education and training, consultation, and clinical specialty referrals. Health care providers can use this resource when responding to suspected clinical presentations, known exposures, and in community settings.
Ten PESHUs are now in operation across the United States; contact information for each unit is listed below. Check AOEC's Web site (www.aoec.org/PEHSU/) for the most up-to-date information on the units.
Massachusetts
Pediatric Environmental Health Center
Children's Hospital, Boston
Telephone: 1-888-Child14
Web site: www.childrenshospital.org/pehc
Washington State
Pediatric Environmental Health Specialty Unit
Harborview Medical Center, Seattle
Telephone: 1-887-KID-CHEM (1-877-543-2436; toll-free west of the Mississippi River) or 206-526-2121
Web site: depts.washington.edu/pehsu/
New York
Mt. Sinai Pediatric Environmental Health Unit
Mt. Sinai-Irving J. Selikoff Center for Occupational and Environmental Medicine, New York
Telephone: 212-241-6173
Web site: www.mssm.edu/cpm/peds_environ.shtml
Illinois
Great Lakes Center for Children's Environmental Health
Cook County Hospital, Chicago
Telephone: 1-800-672-3113 (toll-free) or 312-633-5310
Web site: www.uic.edu/sph/glakes/kids
Georgia
The Southeast Pediatric Environmental Health Specialty Unit
Emory University, Atlanta
Telephone: 1-877-337-3478 (1-877-33PEHSU)
Web site: www.sph.emory.edu/PEHSU
California
Pediatric Environmental Health Specialty Unit
University of California-San Francisco (UCSF)/University of California-Irvine (UCI)
Telephone: 1-415-206-4320 (for both sites)
Web site: www.ucsf.edu/ucpehsu
Texas
Southwest Center for Pediatric Environmental Health
University of Texas Health Center at Tyler, Tyler, Texas
Telephone: 1-888-901-5665 (toll-free)
Web site: www.swcpeh.org
Washington, District of Columbia
Mid-Atlantic Center for Children's Health and the Environment (MACCHE)
George Washington University, Washington, District of Columbia
Telephone: 1-866-MACCHE1 (1-866-622-2431)
Web site: www.health-e-kids.org
Colorado
Rocky Mountain Regional Pediatric Environmental Health Specialty Unit
National Jewish Medical and Research Center, Denver
Telephone: 1-877-800-5554 (toll-free)
Web site: rmrpehsu.org
Kansas
Mid-America Pediatric Environmental Health Specialty Unit (MAPEHSU)
The University of Kansas Medical Center
Regional Toll-Free Telephone: 800-421-9916; National Number: 913-588-6638
Web site: www2.kumc.edu/mapehsu/
The National Institute for Occupational Safety and Health (NIOSH) has established centers throughout the United States for learning about occupational safety and health. The Education and Research Centers (ERCs) are in 33 universities in 14 states. The ERCs conduct training courses on occupational and environmental medicine topics (continuing medical education credits available).
Telephone: 1-800-35-NIOSH (1-800-356-4674)
Web site: www.cdc.gov/niosh/oep/centers.html.
Poison control centers were established in 1953 to help physicians and other clinicians deal with poisonings of adults and children in the United States. In 1983, the American Association of Poison Control Centers was established as the professional organization for poison control centers. The regional poison control centers can act as valuable resources in providing information about the toxicity and health effects of hazardous exposures involved in poisonings.
The local poison control center can specify the ingredients of common household products when labels do not provide adequate information.
Each certified poison control center is required to publicize its location and methods of contact. Typically, the contact telephone number can be found on the inside front cover of telephone books, where other emergency numbers are usually located.
The main emergency number across the country is 1-800-222-1222, although some states have other contact numbers as well as a number for the hearing impaired. For more information, contact the American Association of Poison Control Centers:
American Association of Poison Control Centers
3201 New Mexico Avenue, Suite 310
Washington, DC 20016
Telephone: (202) 362-7217
E-mail: aapcc@poison.org
Web site: www.aapcc.org
For poisoning emergencies, call 1-800-222-1222. APCC does not manage poison exposure cases.
Both state and local health departments frequently have departments and staff with environmental health expertise. In some instances, a separate government agency addresses environmental concerns. In addition to providing assistance in evaluating individual patients, these organizations establish mandatory reporting requirements for selected environmental exposures or diseases related to environmental exposures. If necessary, department members can also help in obtaining assistance from federal agencies, such as the Agency for Toxic Substances and Disease Registry (ATSDR), Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), and Occupational Safety and Health Administration (OSHA). State health departments or the federal ATSDR both maintain inventory lists of chemicals at hazardous waste sites.
EPA and state health departments maintain the Toxic Release Inventory (TRI), which lists the amount of hazardous chemicals released by industry into the atmosphere at levels above the allowable threshold amount. These organizations can also help elucidate the history of former industrial or agricultural properties converted to residential use.
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