Environmental illness in children

Children are more vulnerable than adults to environmental illnesses for many reasons. They are growing and developing, and they have higher rates of cell production, less-developed metabolisms, and a higher relative level of exposure. Children in urban areas are most affected by environmental illnesses. The prevalence and number of deaths from asthma is highest among poor urban children. Because of their exposure to pollutants, allergens, cigarette smoke, pesticides, lead, and other toxins in our environment, research indicates that children may be increasingly affected by:^{1, 2}

• Asthma. In the past 15 years, the number of children with asthma has more than doubled. Now, more than 5 million children younger than 18 have this disease. Each year asthma accounts for 1 of every 6 pediatric visits to emergency departments nationwide and more than 10 million missed school days.
• Childhood cancer.Childhood cancer is increasing by 1% to 2% per year.
• Low birth weight and heart problems. The number of low-birth-weight babies has been rising steadily since the mid-1980s, and the rate of babies born with serious heart defects has more than doubled.
• Developmental disorders. About 17% of children in the United States have developmental disabilities.

Environmental factors affecting children's health include:

• Air pollution. In New York City, where coal is still a heating source in schools and there are more diesel buses than in any other city in the United States, the highest concentration of childhood asthma is in Harlem. Six of New York City's diesel bus terminals are in Harlem, and five of them are located next to schools. Because diesel engines are hard to start, the buses are left running in the garages, and the exhaust is vented to the outside.¹ Although other factors may also contribute to the high rate of asthma, exposure to diesel exhaust may contribute to high asthma rates in this area.
• Lead. The Centers for Disease Control and Prevention (CDC) estimates that 1 out of 20 children in the United States has elevated levels of lead in his or her blood, which can cause developmental problems. The most common sources of lead are lead-based paint, dust, toy jewelry, and some imported toys.^{3, 4} In 2007, the U.S. Consumer Product Safety Commission (CPSC) found high lead content in many children's toys and jewelry made in other countries. For a complete list of recalled products, see the CPSC Web site at www.cpsc.gov.
• Pesticides. About 4.5 billion pounds of pesticides are used in the United States each year. The U.S. Food and Drug Administration (FDA) estimates that between 33% and 39% of the food supply in any given year contains pesticide residues. Many school districts regularly use pesticides. For example, in California, 93% of 46 school districts use 73 different pesticides. Seventy percent of the school districts use pesticides that are known or suspected to cause cancer, and 54% of them use pesticides classified by the U.S. Environmental Protection Agency (EPA) as toxic to the nervous system. Pesticides can also be found in drinking water.

Evaluate your home and your child's school for toxins

Parents may be concerned that their children are being exposed to environmental toxins at home and in school. Consider the following questions and talk to your pediatrician if you are worried your child may be at risk for environmental illnesses:⁵

• What is the condition of your home? Is there peeling leaded paint or mold growth from water damage?
• Are you renovating your home? This could cause exposure to lead paint or other toxic substances.
• How do you heat your home? Are your heating sources properly maintained and vented? Do you use a fireplace or woodstove? Do you use a gas stove for cooking?
• Do you have carbon monoxide and smoke detectors?
• Do you use pesticides inside or around your home?
• Do you use glues or paints, solvents, or other chemicals for hobby activities or crafts?
• Do you possibly bring home toxic substances on your clothes or shoes from your workplace?
• Are there renovations in progress at your children's schools? Does your child have symptoms that get worse or better at school?
• Do you live near a chemical plant or hazardous waste site? Have there been any chemical leaks in your area lately?
• Do you smoke in your home, car, or elsewhere around your children? Do other family members smoke?

Citations

1. Crain EF (2000). Environmental threats to children's health: A challenge for pediatrics. 2000 Ambulatory Pediatric Association presidential address. Pediatrics, 106(4): 871-874.

2. Landrigan PJ, et al. (2002). Environmental pollutants and disease in American children: Estimates of morbidity, mortality, and costs for lead poisoning, asthma, cancer, and developmental disabilities. Environmental Health Perspectives, 110(7): 721-728.

3. American Academy of Pediatrics (2005). Lead poisoning from a toy necklace. Pediatrics, 116(4): 1050-1051.

4. American Academy of Pediatrics (2005). The need for vigilance: The persistence of lead poisoning in children. Pediatrics, 115(6): 1767-1768.

5. Balk SJ (2001). Resources for pediatricians: How do I answer questions from parents, patients, teachers, and others? Pediatric Clinics of North America, 48(5): 1099-1111.