Children today face an array of exposures to environmental hazards that significantly affect their health and wellness. Environmental toxins affect all children in that contaminants travel worldwide through air, water, soil, and food. Numerous children are disproportionately affected by environmental exposures because of poverty, lack of access to adequate health care, and the unique characteristics of the communities in which they live. Environmental toxins, such as lead, pesticides, mercury, air pollution, solvents, asbestos, and radon, are seeping into homes, schools, child care centers, and play areas, thereby putting children at increased risk for developing health problems related to such exposures. Children who are exposed to environmental toxins may be at risk for developing learning disabilities, behavioral disorders, chronic diseases such as asthma and cancer, and illnesses caused by damage to the central nervous system.
It is well recognized that infants and children experience unique differences in exposures, metabolism, and disease responses to environmental toxins. Toxic responses in infants and children can differ vastly from those in adults, both in severity and in the nature of the harmful effect. One of the most distinguishing characteristics of infants and children is that they are in a dynamic state of growth and development, which may make them much more vulnerable to environmental exposures. Infants and children also differ from adults because they consume more food, drink more water, and breathe more air per unit of body weight than adults do. In addition, the rate at which children absorb nutrients is different from that for adults, which can significantly impact their environmental exposures. For example, when children ingest lead, their bodies can absorb up to 50% of the lead in place of calcium, as compared to an adult, who can absorb only up to 10% of the lead.
Furthermore, developmental behaviors that are common in early childhood, such as crawling and hand-to-mouth activities, can introduce exposures to toxins in dust, soil, floors, carpets, and low-lying vapors. Children also tend to spend more time outdoors than adults and often participate in vigorous play. Because they breathe more air per pound of body weight than adults and because their respiratory systems are still developing, they may be more susceptible to adverse effects from outdoor air pollution.
In spite of these challenges, children's environmental health has advanced notably in the past 225 years. Since 1776 when a London physician noted scrotal cancer in young chimney sweeps, several important milestones have been reached in the effort to protect children from the harmful effects of environmental toxins. In this special issue of Family & Community Health, the Chronology of Children's Environmental Health (Children's Environmental Health Network) portrays a sketch of these milestones. In addition, each of the following articles investigates children's environmental health issues through a unique lens. A case study, literature review, and interview provide the reader a "flavor" of the diverse work occurring within the realm of children's environmental health.
Air pollution continues to be one of the primary environmental hazards in the world today. Common indoor air pollutants include carbon monoxide, radon, environmental tobacco smoke, asbestos, formaldehyde, and mercury. Common outdoor pollutants include ozone and particulate matter. Air pollution affects children more than adults because of children's narrow airways and rapid rate of respiration and because they inhale more air per pound of body weight. In her thorough literature review, Dixon explores the relationship between air pollution and children's health and presents an overview of diverse research methods used to better comprehend this relationship. Because strong leadership from health care and health promotion practitioners is essential in promoting children's environmental health, Dixon also calls for research-based advocacy to effect changes that will lead to healthier communities.
Mercury is an environmental toxin unfamiliar to many health promotion professionals. Although mercury poisoning in children is rare, it can produce extremely dire consequences when exposure is unrecognized. Cherry and her colleagues present an interesting case study in which a poison center, health department, physicians, and other professionals partnered to treat a family with long-term exposure to elemental mercury in the home. They also provide excellent resource information to support an environmental investigation and discuss some of the barriers that the family in the case study encountered. In addition, Cherry and her colleagues call attention to the fact that many cases of mercury poisoning could be prevented through proper education of physicians and other health professionals, responsiveness of the public health department to patients of diverse backgrounds and cultures, and establishment of sound regulatory measures.
Despite its rarity and the advances in treatment and supportive care, cancer is still the leading cause of death from disease in children under 15. Researchers continue to face numerous hurdles as they try to determine causative factors associated with childhood cancer. One of the most hotly contested issues in this area is the possible link between childhood cancer and environmental toxins. In an effort to delve into this contentious topic, Massey-Stokes and Lanning present an interview with three pediatric oncologists and an environmental research toxicologist. This article provides insight into the methodologic problems and unanswered questions that prevent researchers from drawing firm, scientifically based conclusions about the relationship between environmental exposures and childhood cancer.
Solutions to complex environmental health issues that affect children's health will require continual communication and diligent collaboration among professionals from a wide range of disciplines, including public and community health, medicine, nursing, epidemiology, economics, law, and political science. It is our responsibility as health professionals to help ensure that all children have the opportunity to grow up in safe, healthful environments. Furthermore, healthy children become healthy, productive adults; therefore, children's health promotion is a powerful investment in our natio's future and should be one of our top priorities. Everyone, including health professionals, policy makers, parents, and community members, must rise to the challenge and work tenaciously and collaboratively to address the pressing needs within the scope of children's environmental health. May we proudly meet that challenge!!