Agency for Toxic Substances and Disease Registry Case Studies in Environmental Medicine (CSEM) Pediatric Environmental Health
Special Susceptibilities and Anticipatory Guidance about Opportunities for Hazardous Exposure by Developmental Stage
Dividing cells sensitive to transplacental carcinogens
Developing reproductive system can lead to transgenerational effects
Critical periods of organ development
Immature blood-brain barrier
Placenta as semipermeable membrane
Dietary advisories (mercury and PCBs)
Occupational, environmental, and avocational exposures
Take-home occupational exposures
Pharmaceuticals and herbal and alternative remedies
Substance abuse
Topical insect repellents
Baseline household environmental survey
Maternal exposures during preparation of nursery and other remodeling (lead and volatile organic compounds)
The information in this table is adapted from Bearer (1995).
Anticipatory guidance is the education provided to parents or caretakers during a routine prenatal or pediatric visit to prevent or reduce the risk that their fetuses or children will develop a particular health problem (CDC 1997).
Immature detoxification capacity of liver, kidney, and digestive system
Skin
Contaminants used or deposited on floor, especially household products, pesticides, and take-home occupational agents
Consider day care and home, indoor, and outdoor environments
Ingestion
Breast milk
Infant formula (tap or well-water contaminants)
Respiratory
Indoor air contaminants, especially those layering near the floor (e.g., mercury, pesticides, allergens,
radon,
asbestos, and take-home occupational agents).
Outdoor air pollutants, especially ozone and particulates
The information in this table is adapted from Bearer (1995).
Anticipatory guidance is the education provided to parents or caretakers during a routine prenatal or pediatric visit to prevent or reduce the risk that their fetuses or children will develop a particular health problem (CDC 1997).
Skin very permeable with large surface-to-volume ratio
Small intestine avidly absorbs lead if diet deficient in iron and calcium
Immature detoxification
capacity of liver, kidney, and digestive system
Consider day care and home, indoor, and outdoor environments
Ingestion
Pesticides on fruit and vegetables
Tap water contaminants
Contaminants on floor and within easy reach, especially medicines, household products, pesticides, lead, and take-home occupational agents
Pica
Respiratory
Indoor air contaminants, especially those layering near the floor (e.g., mercury, pesticides, allergens, radon,
asbestos, and take-home occupational agents)
Outdoor air pollutants, especially ozone and particulates
Skin
Contaminants on floor and within reach, especially household products, pesticides, and take-home occupational agents
Topical insect repellents
The information in this table is adapted from Bearer (1995).
Anticipatory guidance is the education provided to parents or caretakers during a routine prenatal or pediatric visit to prevent or reduce the risk that their fetuses or children will develop a particular health problem (CDC 1997).
Expanded environment, still includes significant time on floor
Increased independence
High intake of fruits and vegetables
Brain developing
Lungs: alveolar development and increasing volume
Small intestine avidly absorbs lead if diet deficient in iron or calcium
Immature detoxification capacity of liver, kidney, and gastrointestinal system
Consider home, day care, preschool, and playmates' indoor and outdoor environments
Ingestion
Pesticides on fruit and vegetables
Tap water contaminants
Contaminants on floor and within easy reach, specially medicines, household products, pesticides, lead, and take-home occupational agents
Pica
Respiratory
Indoor air contaminants, especially those layering near the floor (e.g., mercury, pesticides, allergens, radon, asbestos, and take-home occupational agents)
Outdoor air pollutants, especially ozone and particulates
Skin
Contaminants on floor and within reach, especially household products, pesticides, and take-home occupational agents
Topical insect repellents
The information in this table is adapted from Bearer (1995).
Anticipatory guidance is the education provided to parents or caretakers during a routine prenatal or pediatric visit to prevent or reduce the risk that their fetuses or children will develop a particular health problem (CDC 1997).
Increased number of environments and less supervised play: school, playground, friends' houses
Brain developing
Lungs: increasing volume
Consider home, school, friends, and afterschool programs' indoor and outdoor environments
Ingestion
Tap water
Food
Respiratory
Indoor and outdoor air quality
Hazards associated with hobbies and school crafts
Take-home occupational hazards
Skin
Hazards associated with hobbies and school crafts
Take-home occupational hazards
Topical insect repellents
The information in this table is adapted from Bearer (1995).
Anticipatory guidance is the education provided to parents or caretakers during a routine prenatal or pediatric visit to prevent or reduce the risk that their fetuses or children will develop a particular health problem (CDC 1997).
Independence and exposure to multiple environments
Possible employment, work in family business, or training in hazardous trades
Brain and lungs continue to develop
Muscles and bones grow rapidly
Gonad maturation
Breast development
Ova and sperm maturation
Consider home, school, friends, occupational, and trade school environments
Ingestion
Tap water
Food
Occupational hazards ingested because of poor poor hygiene
Substance abuse
Respiratory
Indoor and outdoor air quality
Occupational and trade school hazards
Take-home occupational exposures
Hazards associated with hobbies and school crafts
Substance abuse
Skin
Occupational and trade school hazards
Take-home occupational exposures
Hazards associated with hobbies and school crafts
Topical insect repellents
The information in this table is adapted from Bearer (1995).
Anticipatory guidance is the education provided to parents or caretakers during a routine prenatal or pediatric visit to prevent or reduce the risk that their fetuses or children will develop a particular health problem (CDC 1997).