SUPPLEMENT ARTICLE |
Environmental Pediatrics and Its Impact on Government Health Policy
* Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
Agency for Toxic Substances and Disease Registry and National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
Mt Sinai School of Medicine, New York, New York
|| Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
¶ Medical University of South Carolina, Charleston, South Carolina
# George Washington University School of Public Health and Health Services, Washington, DC
Recent public recognition that children are different from adults in their exposures and susceptibilities to environmental contaminants has its roots in work that began >46 years ago, when the American Academy of Pediatrics (APA) established a standing committee to focus on children’s radiation exposures. We summarize the history of that important committee, now the AAP Committee on Environmental Health, including its statements and the 1999 publication of the AAP Handbook of Pediatric Environmental Health, and describe the recent emergence of federal and state legislative and executive actions to evaluate explicitly environmental health risks to children. As a result in large part of these efforts, numerous knowledge gaps about children’s health and the environment are currently being addressed. Government efforts began in the 1970s to reduce childhood lead poisoning and to monitor birth defects and cancer. In the 1990s, federal efforts accelerated with the Food Quality Protection Act, an executive order on children’s environmental health, the Agency for Toxic Substances and Disease Registry/Environmental Protection Agency Pediatric Environmental Health Specialty Units, and National Institute of Environmental Health Sciences/Environmental Protection Agency Centers of Excellence in Research in Children’s Environmental Health. In this decade, the Children’s Environmental Health Act authorized the National Children’s Study, which has the potential to address a number of critical questions about children’s exposure and health. The federal government has expanded efforts in control and prevention of childhood asthma and in tracking of asthma, birth defects, and other diseases that are linked to the environment. Efforts continue on familiar problems such as the eradication of lead poisoning, but new issues, such as prevention of childhood exposure to carcinogens and neurotoxins other than lead, and emerging issues, such as endocrine disruptors and pediatric drug evaluations, are in the forefront. More recently, these issues have been taken up by states and in the international arena.
Key Words: child • child welfare • environmental exposure • environmental health • environmental pollutants • human risk assessment • public policy
Abbreviations: AAP, American Academy of Pediatrics • COEH, Committee on Environmental Hazards/Health • NICHD, National Institute of Child Health and Development • NIEHS, National Institute of Environmental Health Sciences • EPA, Environmental Protection Agency • CDC, Centers for Disease Control/Centers for Disease Control and Prevention • ATSDR, Agency for Toxic Substances and Disease Registry • NRC, National Research Council • FDA, Food and Drug Administration • PCB, polychlorinated biphenyl • HPV, high-production volume • HUD, Department of Housing and Urban Development • FQPA, Food Quality Protection Act • NCSL, National Conference of State Legislatures • CEC, Commission for Environmental Cooperation • WHO, World Health Organization • UNEP, United Nations Environment Program
Received for publication Oct 7, 2003; Accepted Oct 20, 2003.
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