Search | Index | Home | Glossary | Contact Us | |
| |
Children's ExposuresChildren are at higher risk
than adults of being exposed to hazardous substances and of suffering
adverse health effects as a result of their exposure. Children’s activities
put them at higher risk of exposure to hazardous substances that might
be in water or soil. Their height puts them at a level where they are
more likely to breathe dust and vapors close to the ground. Small children
often put their hands in their mouths, which can allow contaminants
into their bodies. Children’s smaller body
size and developing systems also place them at greater health risk than
adults. Because they are smaller, children receive higher doses of toxicants
per pound of body weight. Pound for pound, children drink more water,
eat more food, and breathe more air than adults do. Many organ systems
in young children, such as the nervous system and the lungs, undergo
rapid growth and development in the first years of life. During these
periods of development, children’s organ systems are especially vulnerable
to injury. Of special concern is exposure of the fetus, whose organ
and body systems are still developing. Environmental toxicants are a growing cause of preventable illness in children. Exposure to the following toxicants can cause a variety of health and learning disorders.
In addition, environmental triggers of asthma are also a concern. Environmental pollutants are major contributors to asthma, the most common admission diagnosis in many children’s hospitals. Some of these environmental toxicants are addressed in this issue; others will be discussed in the Children’s Environmental Health section in future issues.
ATSDR's
Special Emphasis
|
Pediatric
Environmental Health Specialty Units:
|
|
|
Activity |
Number
|
|
|
Number of children evaluated |
907
|
Number of calls received |
30,581
|
Number of health professionals who received education or training |
>
16,275
|
The ATSDR Child Health Workgroup is a multidisciplinary panel of experts appointed by ATSDR’s Board of Scientific Counselors. The workgroup makes recommendations to the agency regarding research and policy directions for pediatric environmental health practice.
The most recent Child Health Workgroup meeting in April 2002 addressed
ATSDR's Child Health Program (www.atsdr.cdc.gov/child) emphasizes ongoing focus on relevant child health issues in all of the agency's activities. |
ATSDR is developing a community action plan to help communities deal proactively with children’s exposure to toxic substances. The action plan will create safe environments for children in communities at risk. The program will
A key component of the project
will be the development of a database of information about educational,
policy, and programmatic resources available for community use. This
database will include products from government, medical, and educational
organizations. The plan will include the roles of and suggested activities
for segments of the community that have an impact on environmental health
and children, including health care and public health, government, education,
media, and business and industry. This plan will be developed with experts
in the field and state and community representatives.
ATSDR recognizes that children
today face an array of exposures to potentially toxic environmental
hazards. These exposures can have a significant impact on their health
and well-being. Children are at risk for learning disabilities, chronic
and acute respiratory diseases, cancers, and illnesses caused by damage
to the nervous system from hazardous substances. The incidences of chronic
childhood diseases are increasing. It is essential that every effort
be made to better understand children’s unique susceptibilities to environmental
hazards.
Children’s Environmental
Health: Interagency Collaboration To Promote Children’s Health
was held in January 2002 in Research Triangle Park, North
Carolina. Attendees included staff from the 11 PEHSUs in
the United States, 12 Centers for Children’s
Environmental Health and Disease Prevention Research, ATSDR,
National Institute of Environmental Health Sciences (NIEHS), EPA,
and PEHSUs in Canada and Mexico. The meeting focused on opportunities
for collaboration among and between the centers and the PEHSUs.
|
Dr. Robert Amler is an epidemiologist and emergency room physician. He has worked in public health for 25 years and at ATSDR for 15 years. He administers the Child Health Program and heads the Office of Children’s Health (OCH), created in 1998. The office coordinates ATSDR’s program activities in children’s health. He says he chose public health because “I believe that public service is the highest calling, and the most important mission in medicine is to protect the health of all people, especially those with the least access to health care.”
OCH works closely with the divisions to focus on children’s issues. In the future, OCH plans to examine ways to expand the effectiveness of the PEHSUs, increase the distribution of toxicological reference materials, and work with professional organizations and other federal agencies to develop professional training and practice standards for children’s environmental health.
Dr. Amler also
practices emergency medicine at Children’s Health Care of Atlanta because
“I enjoy helping people during emergencies,” he says, “and because it
keeps me current in the latest techniques and methods in handling medical
and surgical emergencies.”
[Table of Contents]
Three children were referred by their pediatrician to the Region 1 Pediatric Environmental Health Specialty Unit (PEHSU) for evaluation and management of moderate lead poisoning. All three children (2, 3, and 4 years old) had lead levels of 21–26 micrograms per deciliter (µg/dL) with corresponding elevations in blood concentration of zinc protoporphyrin. (Elevated blood lead levels are defined as greater than or equal to 10 µg/dL.)
The children’s mother reported that her home had been completely renovated, and she believed it was lead free. (The state childhood lead poisoning prevention program inspected the home and found no accessible lead hazards.) When asked about other potential environmental sources of lead, the mother said that the children often played outside in the home’s unfinished driveway. An environmental inspection of the driveway found that the soil lead concentration was greater than 25,000 parts per million (ppm), far above the 400 ppm considered acceptable by the U.S. Environmental Protection Agency. The mother was later told that the driveway had been used by previous residents for car repair that included sanding, painting, and soldering.
Despite the availability of state funds for residential lead abatement, funds were not available to clean up soil. However, with the PEHSU serving in an advocacy role, funds were secured and the driveway soil was completely cleaned up. In less than 6 months, the children's blood lead levels dropped to less than 20 µg/dL as a result of the combination of abatement, close monitoring, and a brief course of chelation therapy.
"This unusual case showed us that outdoor lead sources are occasionally significant. We also learned that resources for the abatement of out-of-home lead hazards are insufficient. Additional infrastructure and support are needed to help families such as this one," said Dr. Michael W. Shannon, MD, MPH, Co-Director of the Pediatric Environmental Health Center.
The Pediatric Environmental Health Center at Children's Hospital Boston is Region 1's PEHSU. The center offers multidisciplinary consultation, evaluation, and management of children with known or suspected exposure to environmental toxicants. The center provides medical management for illnesses or intoxications resulting from exposures to heavy metals, indoor air pollutants, outdoor pollutants, and adolescent occupational hazards. The center coordinates the care of children and adolescents exposed to a wide range of poisons. In addition to providing clinical services, the staff and affiliated staff are doing research to answer important questions in pediatric environmental health, including
|
[Table of Contents]
PEHSUs:
Where We Are
Stars indicate PEHSU locations on map.
Region 1, Massachusetts (featured in Spotlight on Region 1 PEHSU): Pediatric Environmental Health Center, Children’s Hospital Boston |
|
Region 2, New York: Mt. Sinai Pediatric Environmental Health Unit/Mt. Sinai-Irving J. Selikoff Center for Occupational and Environmental Medicine, New York |
|
Region 3, Washington, DC: Mid-Atlantic Center for Children’s Health and the Environment (MACCHE), George Washington University Medical Center, Washington, DC |
|
Region 4, Georgia: The Southeast Pediatric Environmental Health Specialty Unit at Emory University, Atlanta |
|
Region 5, Illinois: Great Lakes Center for Children’s Environmental Health, Cook County Hospital, Chicago |
|
Region 6, Texas: Southwest Center for Pediatric Environmental Health, University of Texas Health Center at Tyler, Tyler, Texas |
|
Region 7, Iowa: Midwest Regional Pediatric Environmental Health Center, University of Iowa, Iowa City, Iowa |
|
Region 8, Colorado: Rocky Mountain Regional Pediatric Environmental Health Specialty Unit, National Jewish Medical and Research Center, Denver |
|
Region 9, California: University of California-San Francisco (UCSF)/University of California-Irvine (UCI) Pediatric Environmental Health Specialty Unit |
|
Region 10, Washington State: Pediatric Environmental Health Specialty Unit, Harborview Medical Center, Seattle |
|
|
In 1998, the National Institute of Environmental Health Sciences (NIEHS), the U.S. Environmental Protection Agency (EPA), and the Centers for Disease Control and Prevention (CDC) developed the Centers for Children's Environmental Health and Disease Prevention Research program. The program promotes both basic research and the translation of research findings into applied intervention and prevention methods. The following 12 centers in the program address a range of environmental health-related issues, diverse populations, and a variety of settings:
|
Table
of Contents | PHE Newsletter Home Page
| ATSDR Home Page
This page last updated on
October 24, 2003
Contact Name: Wilma López/ WLópez@cdc.gov
ATSDR Home | Search | Index | Glossary | Contact Us
About ATSDR | News Archive | ToxFAQs | Public Health Assessments
Privacy Policy |
External Links Disclaimer
| Accessibility
U.S.
Department of Health and Human Services