Agency for Toxic Substances and Disease Registry Case Studies in Environmental Medicine (CSEM)
Pediatric Environmental Health
Exposure-Disease Model
![Figure 1](https://webarchive.library.unt.edu/eot2008/20080916225614im_/http://www.atsdr.cdc.gov/csem/pediatric/images/figure1.jpg)
*Contamination of environmental medium: air, water, soil, or food. Assessment tools: exposure history and environmental monitoring.
†Primary routes of exposure: respiratory, oral, and dermal. Secondary routes of exposure: breast milk, transplacental, nonplacental/intrauterine, and parenteral. Assessment tools: exposure history and biologic monitoring.
‡Assessment tools: biologic monitoring.
§Assessment tools: history, physical, biologic monitoring (to include advanced diagnostic testing of target organ), and specialty referral (if necessary).
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