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Published in Spring 2003
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Is it really the flu, or an environmental illness?
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By Martha Shimkin
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A child with carbon monoxide poisoning shows up
at the doctor’s office and her mom is told she has the
flu, a common virus, and the best thing to do is to
‘wait it out’.
Scenarios like these play out everyday as children face an increasing number of diseases associated with environmental health causes. The problem is that while advances in medicine and hygiene have done
well to fight traditional infectious diseases, the
same cannot be said for the training of health
professionals who often don’t know how to assess
environmental exposures.
“Symptoms of environmental diseases may mimic those of many other childhood illnesses,” explains
Dr. Ruth Etzel, a pediatrician and editor of the American Academy of Pediatrics Handbook of Pediatric Environmental Health. “If a familiar childhood disease could explain the child’s symptoms, a clinician lacking training in environmental health may fail to ask key questions to uncover possible environmental causes.”
According to several experts from Canada,
Mexico and the United States at a recent meeting of
the Expert Advisory Board on Children’s Health and
the Environment of the Commission for Environmental Cooperation (CEC), medical schools have not kept
pace with the expanding field of pediatric environmental health.
And since health professionals—including doctors, nurses, midwives, medical technicians and public health officials—have face-to-face contact with patients, their families and communities, they
are the first line of defense against environmental
health threats. “People want to know about children’s environmental health and they trust healthcare providers to be the source of information,” asserts
the United States-based Children’s Environmental
Health Network in its online training manual for
health workers. Interest in the effects of environmental contamination on children’s health is beginning to grow.
A National Fellowship Program in Pediatric Environmental Health was recently established in the United States, and several nongovernmental organizations and governmental agencies have planned and supported projects aimed at building capabilities
in the health professional arena. At their meeting, the CEC Expert Advisory Board discussed ways to support this interest, ranging from things as simple as sending a few people to already planned conferences on the topic, to discussions of long-term strategies to increase attention paid to environmental health in North American medical education systems.
“As a North American forum, the CEC is in a
unique position to bring people from all three countries together on this issue, and to foster sharing of approaches,” says Erica Phipps, program manager of the CEC’s Children’s Health and the Environment initiative.
Projects are underway to interest medical students in the field, and information is actively shared through publications, journals and web sites. The CEC has also developed a list of web sites on the topic as part of their background paper on health professional training in children’s environmental health.
“We need to maintain a high profile on this and facilitate information and communication,” says Dr. Irena Buka, chair of the Expert Advisory Board.
“We also need to ensure that our three countries grow capabilities simultaneously.”
Buka says there is still a long way to go before children with symptoms of possible environmental genesis will have the benefit of comprehensive, up-to-date knowledge when they see a healthcare professional.
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