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Expert Views :: Children's Environmental Health and Well-Being Wendy Hessler Children are most at risk from environmental hazards, yet our understanding of how environmental contaminants affect growth and development is limited. That is changing, though, as more attention and research dollars in the United States are focused on children’s environmental health — or how environmental factors affect children’s health and well-being. Environmental pollution reaches everywhere and everyone, as recent reports show. The Arctic, without industry or large cities, is contaminated with air-borne chemicals from around the world (1). A recent Center for Disease Control report finds US citizens carry pesticide residues, industrial chemicals, metals, and a number of other toxins in their bodies (2). Children’s environmental dangers include indoor and outdoor air quality, water pollution, soil contamination, food contamination, and chemically-laden toys and personal care products. A number of diseases are linked to exposure to toxins. Most are implicated because of rising childhood rates during the last three decades, a time with higher use and exposure to modern chemicals and technologies than past generations (3). About 25 percent more children have brain cancer and 21 percent more children have leukemia today than in the 1960s, according to Philip Landrigan, director of the Center for Children's Health and Environment (CCHE) and leader of an awareness campaign to educate everyone about these issues (4). Other maladies associated with environmental exposures include asthma, birth defects, learning disabilities, diabetes, and some reproductive problems such as precocious puberty and reproductive cancers (3). Why are kids more at risk? Developing youngsters — from fetuses to late teens — face a higher risk for environmental exposures and consequent diseases than adults do. This is due to their small size; their exposure at a young age giving them more time to develop a disease; their higher exposure rates to toxins (from being closer to the ground, mouthing objects, inability to move from hazardous conditions, more outdoor play, and contaminated food and drink); their exposure during rapid growth and development periods; and their exposure when immune, nervous, respiratory, digestive, and reproductive systems are underdeveloped and quickly growing (5). The rising interest in understanding the relationship between contaminants and children's health has escalated during the last decade, spawned in part by increasing disease rates and the understanding that kids have a greater vulnerability to chemicals than adults. Conferences, newly formed organizations, and the burgeoning interest in endocrine disrupting chemicals have spurred professional and public debates of how environmental factors may be affecting children. In the 1990s, the US implemented policy changes that for the first time focused on protecting children from and understanding health impacts of indoor and outdoor environmental hazards. In 1995, the US Environmental Protection Agency (EPA) required all environmental risk assessments to take into account children’s unique vulnerabilities to environmental hazards. In 1996, the Food Quality and Protection Act was signed into law and required that pesticide standards must reflect children’s tolerances with a safe margin of error. Also that year, the EPA decided to re-evaluate existing standards and mandated that cumulative and simultaneous exposures be included when setting those chemical standards. Several other bills, executive orders, and offices devoted to children’s unique environmental health concerns were implemented during the next few years (6, 7). Other non-government efforts were underway as well. Professional associations stepped up efforts to train medical personal to recognize and properly treat environmental diseases. Non-profit organizations formed to promote children’s health through education, policy changes, and research (see Web sites below). The interest is worldwide. A recent report from Europe’s Environment Agency, Children's Health and Environment: A Review of Evidence, suggests that Europe should focus on children’s health, and summarizes the relationship between the physical environment and children's health; it also identifies research needs and policy priorities to protect children from environmental hazards. The environmental conditions affecting children in Asia and the Western Pacific was highlighted at the International Conference on the Environmental Threats to the Health of Children conference held in Bangkok, Thailand, in March (8). One way to better understand the risks of environmental hazards is through scientific research. Some recent initiatives include: • Several recent grants to be awarded by the US EPA’s Science to Achieve Results (STAR) Program called for proposals on children's vulnerability to toxic substances in the environment, biomarkers to assess exposure, and valuation of impacts. Through this research, the government hopes to improve understanding of when, how, and why children respond differently than adults to toxic agents, in order to develop effective approaches to reduce risks. • The National Institute of Environmental Health Sciences funded four research centers that will receive $5 million each over five years to study the link between environmental factors and childhood disease and behavior. • A large, 20-year research study that will follow 100,000 US children from before birth, through childhood and adolescence, and into adulthood is being planned by the National Institute of Child Health and Human Development (NICHD) along with many community, advocacy, and industry groups. The National Children's Study of Environmental Effects on Health and Safety will investigate chemical, physical, social, and behavioral influences on children to better understand the role of these factors on health and disease, especially neurodevelopment, immunology, and injury conditions. These recent reports, newly-funded research efforts, and awareness programs focusing on children’s environmental health all have a similar underlying message: Children are more at risk than adults from environmental factors and steps should be taken to protect them before birth and during childhood. Efforts to identify, understand, and mitigate the risks are focusing on outdoor air, water, and soil quality as well as indoor environments, such as the home, schools, and daycare facilities. With more concrete information, the true risks of environmental contaminants can be identified and protective measures implemented to ensure the safety and health of children everywhere. References
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