Children and infants are especially vulnerable to pollution and other environmental factors that may cause serious health problems. There are several reasons why children are at higher risk:

• Pound for pound, children eat, drink, and breathe more than adults relative to their size.
• Children frequently put objects in their mouths, explore more, and play on the floor and ground.
• Protective bodily systems, such as those that filter pollutants from inhaled air and process chemicals in the body, are not yet fully functional in children.
• During periods of rapid growth and development in childhood, normal biological processes may be disrupted by environmental chemicals.

Doctors and scientist do not always know what causes a disease or a disorder. Some health conditions are genetic and can be passed from grandparents to parents to children. Some health problems may be caused by injury from things in our environment. Most scientists agree that diseases are probably caused by both, which is called the gene-environment interaction. Since we cannot do much to change our genes, researchers believe that identifying and managing environmental hazards offers the best hope for prevention.

By protecting children, we may also improve their health as adults. According to NIEHS research, when pregnant women improved their nutrition and reduced exposure to environmental chemicals, they were more likely to have healthy babies, and their babies were better able to cope with environment stressors later in life.

Children are often more likely to be at risk from environmental hazards than adults because of:

• Unique activity patterns and behavior.
• Physiological differences.
• Windows of susceptibility during early lifestages including fetal development and puberty.

Children are also dependent upon adults to ensure that their environment is safe.

Unique Activity Patterns + Behavior

• Children crawl and play close to the ground making them more likely to come into contact with dirt and dust, which can include toxicants.
• Children often put their hands, toys, and other items into their mouths

Physiology

• Children eat, breathe, and drink more relative to their body mass than adults do.
• Children’s natural defenses are less developed.
  • More permeable blood-brain barrier.
  • Less effective filtration in nasal passages.
  • Highly permeable skin.
  • Lower levels of circulation of plasma proteins.
  • Digestive system, metabolic pathways, renal clearances, and vital organs are still developing.

Windows of Susceptibility

• The timing of exposure to chemicals or other insults is critical in determining the consequences to children’s health.
• Because of the differing windows of susceptibility, the same dose of a chemical during different periods of development can have very different consequences.
• For example, fetal loss or birth defects are most likely to occur as a result of exposures to chemicals during the embryonic period, when organs are beginning to differentiate.
• Even after the basic structure of an organ has been established, disruption of processes such as growth and cell migration can have lifelong consequences on the function of key organ systems.
• Due to the complexity and speed of development during the prenatal period, organ system development is particularly susceptible to adverse effects resulting from environmental exposures (See image below).

Keep pesticides and other toxic chemicals away from children

• Store food and trash in closed containers to keep pests from coming into your home.
• Use baits and traps when you can; place baits and traps where kids can't get them.
• Read product labels and follow directions.
• Store pesticides and toxic chemicals where kids can't reach them - never put them in other containers that kids can mistake for food or drink.
• Keep children, toys, and pets away when pesticides are applied; don't let them play in fields, orchards, and gardens after pesticides have been used for at least the time recommended on the pesticide label.
• Wash fruits and vegetables under running water before eating - peel them before eating, when possible.

Protect children from chemical poisoning

If a child has swallowed or inhaled a toxic product such as a household cleaner or pesticide, or gotten it in their eye or on their skin

• Call 911 if the child is unconscious, having trouble breathing, or having convulsions.
• Check the label for directions on how to give first aid.
• Call the Poison Control Center at 1-800-222-1222 for help with first aid information.

Help children breathe easier

• Don't smoke and don't let others smoke in your home or car.
• Keep your home as clean as possible. Dust, mold, certain household pests, secondhand smoke, and pet dander can trigger asthma attacks and allergies.
• Limit outdoor activity on ozone alert days when air pollution is especially harmful.
• Walk, use bicycles, join or form carpools, and take public transportation.
• Limit motor vehicle idling.
• Avoid open burning.
• Limit outdoor activity on poor air quality days.
• Check your air quality at AirNow.

Protect children from lead poisoning

• Get kids tested for lead by their doctor or health care provider.
• Test your home for lead paint hazards if it was built before 1978.
• Wash children's hands before they eat; wash bottles, pacifiers, and toys often.
• Wash floors and window sills to protect kids from dust and peeling paint contaminated with lead - especially in older homes.
• Run cold water until it becomes as cold as it can get. Use only cold water for drinking, cooking, and making baby formula.

Protect children from carbon monoxide (CO) poisoning

• Have fuel-burning appliances, furnace flues, and chimneys checked once a year.
• Never use gas ovens or burners for heat; never use barbecues or grills indoors or in the garage.
• Never sleep in rooms with unvented gas or kerosene space heaters.
• Don't run cars or lawnmowers in the garage.
• Install in sleeping areas a CO alarm that meets UL, IAS, or Canadian standards.
• Read about CO's impact on indoor air quality.

Protect children from contaminated fish and polluted water

• Be alert for local fish advisories and beach closings. Contact your local health department.
• Take used motor oil to a recycling center; properly dispose of toxic household chemicals.
• Learn what's in your drinking water - call your local public water supplier for annual drinking water quality reports; for private drinking water wells, have them tested annually by a certified laboratory. Call 1-800-426-4791 for help.

Safeguard children from high levels of radon

• Test your home for radon with a home test kit.
• Fix your home if your radon level is 4 pCi/L or higher. For help, call your state radon office or 1-800-SOS-RADON.

Protect children from too much sun

• Wear hats, sunglasses, and protective clothing.
• Use sunscreen with SPF 15+ on kids over six months; keep infants out of direct sunlight.
• Limit time in the mid-day sun - the sun is most intense between 10 AM and 4 PM.
• Read more about sun safety.

Keep children and mercury apart

• Eat a balanced diet but avoid fish with high levels of mercury.
• Replace mercury thermometers with digital thermometers.
• Don't let kids handle or play with mercury.
• Never heat or burn mercury.
• Contact your state or local health or environment department if mercury is spilled - never vacuum a spill.

Promote healthier communities

• Walk, use bicycles, join or form carpools, and take public transportation to reduce air pollution, including greenhouse gases

• Spearhead a clean school bus campaign in your community. Clean School Bus USA emphasizes three ways to reduce public school bus emissions:
  1. Anti-idling strategies: Unnecessary idling pollutes the air, wastes fuel, and causes excess engine wear. It also wastes money and results in the wear and tear of the vehicle's engine.
  2. Engine retrofit and clean fuels: Retrofitted engines run cleaner because they have been fitted with devices designed to reduce pollution and/or use cleaner fuel.
  3. Bus replacement: Older buses are not equipped with today's pollution control or safety features. Pre-1990 buses have been estimated to emit as much as six times more pollution as new buses that were built starting in 2004 and as much as 60 times more pollution as buses that meet the 2007 standards.

• Develop safe routes so that children can walk to and from school, limiting vehicle use and increasing physical activity. Conduct walkability audits in your community to understand where you can and cannot walk. Children can help for a fun and educational activity.

• Promote green building. Green building considerations include:
  • Careful site selection to minimize impacts on the surrounding environment and increase alternative transportation options.
  • Energy and water conservation to help ensure efficient use of natural resources and lower utility bills.
  • Responsible stormwater management to help limit disruption of natural watershed functions and reduce the environmental impacts of stormwater runoff.
  • Improved indoor air quality through the use of low volatile organic compound products and careful ventilation practices during construction and renovation.

• Use Indoor Air Quality Design Tools to create healthy school environments. Indoor air quality (IAQ) is a critically important aspect of creating and maintaining school facilities. IAQ Design Tools for Schools provides detailed guidance and links to other resources to help design new schools and repair, renovate and maintain existing facilities. IAQ Design Tools for Schools is Web-based guidance to assist school districts, architects, and facility planners design and construct the next generation of schools.

• Support local smart growth activities. Smart growth is development that serves the economy, the community, and the environment. EPA helps states and communities realize the economic, community, and environmental benefits of smart growth by: Learn more about smart growth.
  • Providing information, model programs, and analytical tools to inform communities about growth and development.
  • Working to remove federal barriers that may hinder smarter community growth.
  • Creating new resources and incentives for states and communities pursuing smart growth.

• Protect children's environmental health. Children may be more vulnerable to environmental exposures than adults because:
  • Their bodily systems are still developing
  • They eat more, drink more, and breathe more in proportion to their body size
  • Their behavior can expose them more to chemicals and organisms

• For questions about children's health and environmental conditions, visit www.pehsu.net.
• Contact your local health department and ask about cooling centers, disaster preparedness, and other issues of concern to you.
• Sign up for weather, air quality, water quality and pollen count alert systems through your local government.
• Plant trees, walk instead of driving, teach your children to ride bikes, support neighborhood gardens, recycle paper, compost kitchen waste, and conserve water -- taking simple steps to improve the environment really does help!

Storms and floods

• Have a battery powered weather radio and a basic emergency supply kit.
• Make an evacuation and communication plan in place for the family during floods and storms.
• If children are exposed to flood waters, watch for diarrhea.
• Check for local drinking water advisories.
• Drink bottled water or boil tap water to disinfect it.
• Check local advisories about recreational activities, such as beach closures.
• After a major storm, check your child's mental health, school performance, sleeping and eating patterns for signs of change and seek treatment if needed.
• Read about preparing for natural disasters.

Too much heat

• If you are pregnant try to stay cool, stretch your legs and sip water more often than usual to prevent dehydration.
• Infants and young children overheat quickly and are less able to adapt to extreme heat. Offer sips of water often.
• Dress infants and children is loose, lightweight, light color clothing.
• Children may not ask for water and may not be aware that they need to cool down.
• Never leave infants in a parked car.
• Help children find places to cool off when they are overheated.
• Ensure that children drink plenty of water before and after athletic events.
• Monitor children, and even teenagers, for signs of heat-related illness, provide water, and have a plan to combat heat illness.
• Communities can work together to create cooling centers for children, to issue heat warnings and alerts, and to air condition schools.
• Seek medical care right away if your child has signs of heat-related illness.

Avoiding ticks

• Keep the ticks away from your child to prevent Lyme disease.
• Have children wear protective clothing, such as socks, shoes and long pants if possible.
• Reduce tick habitats by keeping grass short and removing brush from play areas.
• Parents should apply insect repellent rated for ticks on children. Always follow label instructions and avoid applying on hands or near eyes and mouth.
• Check children for ticks after they have been outdoors, especially in wooded areas and meadows and especially from April to October.
• Teach children how to check themselves for ticks, and what to do if they find one.
• Have children bathe or shower after playing in woods or grassy fields.
• Remove ticks promptly.
• Call your child's health professional if you suspect Lyme disease -- some early signs can include a red expanding "bulls-eye" rash around the spot a tick attached, fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes (particularly of note when other children or members of the family aren't sick).

Stopping mosquito bites

• Use insect repellents when your children play outdoors. Always follow the label directions.
• Wear long sleeves and pants from dusk through dawn when mosquitoes are most active.
• Install or repair screens on windows and doors. If you can, use your air conditioning.
• Help reduce the number of mosquitoes around your home by emptying standing water from containers, flowerpots, gutters, buckets, pool covers, pet dishes, tires, and birdbaths.
• Read more about preventing mosquito bites.

Asthma Facts

• Asthma is a common chronic disease among children in the United States.
• In 2006, 9.9 million children under 18 years of age were reported to have ever been diagnosed with asthma; 6.8 million children had an asthmatic episode in the last 12 months.
• The hospitalization rate for asthma remained at 27 per 10,000 children from 2002-2004.
• Asthma is the third ranking cause of non-injury related hospitalization among children less than 15 years of age.
• Although asthma deaths among children are rare, 195 children under 18 years of age died from asthma in 2003.

Disparities of Asthma

• Asthma disproportionately affects children from lower-income families and children from various racial and ethnic groups.
• African-American children have a 500% higher mortality rate from asthma as compared with Caucasian children.
• In 2005, 13% of African-American children were reported to have asthma as compared with 9% of Hispanic children and 8% of non-Hispanic white children.
• Larger disparities exist within the Hispanic population such that 20% of Puerto Rican children were reported to have asthma as compared with 7% of Mexican children.
• While national level surveys suggest Asian and Pacific Islander children do not have high rates of asthma, small scale surveys however show a high prevalence of asthma among subgroups of Asian and Pacific Islander children.
  • Filipino children have an asthma prevalence of 23.8%
  • Pacific Islander children have an asthma prevalence of 21%

Economic Impact of Asthma

• In 2002, children 5-17 years old missed 14.7 million school days due to asthma.
• The direct and indirect costs of asthma to the U.S. economy were $19.7 billion in 2007.
  • Approximately $14.7 billion dollars are directly associated with the medical care costs of asthma
  • Approximately $5 billion are associated with lost productivity
• Asthmatic patients and their families pay a higher portion of their medical care costs than patients with other diseases due to heavy reliance on prescription medication combined with lower insurance coverage for prescription drugs.

Childhood Cancer Facts

• In 2007, an estimated 10,400 new cancer cases were expected to occur among children aged 0-14 years old. An estimated 1,545 deaths from cancer were expected to occur among children in 2007.
• Leukemia is the most common cancer in children under 15, accounting for 30 percent of all childhood cancers, followed by brain and other nervous system cancers.
• Cancer is the second leading cause of death among children ages 1-14 years of age, with unintentional injuries being the leading cause.
• The causes of childhood cancer are poorly understood, though different forms of cancer have different causes. A number of studies suggest that environmental contaminants, including radiation, secondhand smoke, pesticides and solvents, may play a role in the development of childhood cancers.

Disparities in Childhood Cancer

• Hispanic children were reported to have a higher incidence of acute lymphocytic Leukemia (ALL) than non-Hispanic white children.
• Although national studies indicate that Asian Pacific Islander American (APIA) children overall do not have higher rates of Cancer compared to non- Hispanic whites, a smaller scale study conducted in California showed APIA children are at increased risk of developing acute non lymphocytic Leukemia (ANLL) compared with non-Hispanic white infants.

Economic Impact of Childhood Cancer

• The total cost per case of childhood cancer was estimated to be about $623,000.

Developmental Disabilities Facts

• In 2001-2004, about 7 children out of every 1,000 children were reported to be diagnosed with mental retardation.
• Between 3-8 percent of the babies born each year will be affected by developmental disorders such as attention-deficit/hyperactivity disorder or mental retardation. In 2003-2004, an estimated 300,000 U.S. children aged 4-17 years were reported to have Autism.

Disparities in Developmental Disabilities

• Mental retardation is more common for children from lower income families and for certain racial and ethnic groups.

Economic Impact of Developmental Disabilities

• During the 2001-2002 school year, an estimated 6.5 million children were enrolled in special education programs. This is almost 75% increase from 1976-1977.
• The economic costs associated with autism are approximately $35 billion dollars per year.
• Expenditures can range from 1.6 times (for students with specific learning disabilities) to 3.1 times (for students with multiple disabilities) higher than expenditures for a regular education student.

Lead Exposure Facts

• Currently, no level of lead in blood has been identified as safe for children. The U.S. Centers for Disease Control and Prevention (CDC) recommend public health actions be initiated for children with a reference level of 5 micrograms of lead per deciliter of blood.
• Today, elevated blood lead levels in children are due mostly to ingestion of contaminated dust, paint and soil.
• Other sources of lead exposure include ceramics, drinking water pipes and plumbing fixtures, consumer products, batteries, gasoline, solder, ammunition, imported toys, and cosmetics.
• In 2010, an estimated 535,000 children had a blood lead level of 5 µg/dL. The number of children affected by lead poisoning has decreased significantly from 4.7 million in 1978.
• The decline in blood lead levels is due to the phasing out of lead in gasoline between 1973 and 1995 and the reduction in the number of homes with lead-based paint from 64 million in 1990 to 38 million in 2000. About 24 million homes still have significant lead-based paint hazards.
• Lead exposure in young children can result in lowered intelligence, reading and learning disabilities, impaired hearing, reduced attention span, hyperactivity, delayed puberty, and reduced postnatal growth.

Disparities in Lead Exposure

• Blood lead levels are higher for children ages 1-5 years old from lower-income families and for certain racial and ethnic groups.
• The median blood lead level in Black non-Hispanic children ages 1-5 years old is higher than the level in White non-Hispanic children, Mexican-American children, and children of “All Other Races/Ethnicities.”
• The median blood lead level for children living in families with incomes below poverty level is higher than for children living in families at or above poverty level.

Economic Impact of Lead Exposure

• The cost of reduced cognitive ability is measured by IQ scores and valued in terms of forgone earnings and is estimated to be about $9,600 per IQ point lost.
• The cost of not eliminating lead exposure to children between 2000-2010 is expected to be about $22 billion in forgone earnings.

FDA research shows that many nutritious foods may contain contaminants from the environment where they are grown or raised. Read on to learn about environmental contaminants in foods, what FDA is doing, and what you can do to help protect your child.

Environmental Contaminants in Foods

Environmental contaminants refer to chemicals that may be in foods because they are in the environment where foods are grown, raised, or processed. Contaminants can be taken up by plants and animals from the soil, water, and air and can be harmful to human health.

Arsenic, lead, cadmium, and mercury are environmental contaminants. Amounts in the environment can vary depending on many factors, including the presence of current or past pollution.

Contaminants in the soil, water, and air may be present naturally and from current or past pollution. Because certain contaminants come from the earth’s crust, there has always been some level in foods. However, it is only with recent scientific advances that we can now measure different types of environmental contaminants in foods at very low levels and are learning more about exposure from the diet.

The FDA’s Closer to Zero program is focused on driving down levels of arsenic, lead, cadmium, and mercury (often referred to as heavy metals) in food commonly eaten by babies and young children. Our priority is protecting the very young because they are more vulnerable to harmful health effects from exposure to these contaminants. While we, our federal partners, and the food companies work to lower levels in foods, there are things you can do to help ensure your child has good nutrition—this not only supports their health and development but can also help to protect them from the effects of contaminants. Read on to learn strategies to support good nutrition from the Centers for Disease Control and Prevention and the United States Department of Agriculture.

Focus on variety

Feeding a variety of age-appropriate healthy foods helps your child get essential nutrients for development and can make it less likely for your child to be exposed to the same contaminant from the same food many times.

• Work toward a diverse diet. Around age 6 months, as you start feeding single solid foods to your baby, build on those experiences by offering many different foods from across and within the food groups -- vegetables, fruits, grains, protein foods, and dairy.
• Change it up. When your baby first experiences solid food, they may eat the same food for several feedings in a row. Once your child has experienced a food several times, add a different new food, and then alternate foods to create variety in mealtime.
• Keep track. A journal can help you recall which foods are in your baby’s diet and plan for your child’s next new food.
• “Picky eating” is normal as they explore new foods. If your child doesn’t like a new food right away, don’t give up! It can take up to 10 tries for children to get used to a new food. Giving your child a variety of foods now can help them enjoy a greater variety of foods as they get older.
• Wait on these foods. Wait until your baby is at least 1 year of age to give them cow’s milk, fortified soy beverages, or fruit juice.

Many nutrients help protect from the effects of contaminants that foods can absorb from the environment.

Include foods rich in iron and zinc.

Iron and zinc are essential nutrients for child development. They also can help prevent the harmful effects of arsenic, lead, cadmium, and mercury.

• Include iron- and zinc-fortified infant cereals. Infant cereal is a common staple. It’s easy to prepare and can be combined with solid foods to create more diversity in your baby’s diet.
  • Choose whole grains like whole wheat or barley infant cereal. They provide B vitamins that help protect against the effects of arsenic.
  • Know your grains. Feed your baby iron-fortified cereals to help them get enough iron. Rice cereal shouldn’t be the only source and does not need to be the first source. Other fortified infant cereals include wheat, oat, barley, and multigrain. Read the label to see which grains are ingredients.
• Include meat, poultry, seafood, and/or beans as key sources of iron, zinc, and other nutrients.
  • Seafood has nutrients that support child brain and immune system development. Choices particularly low in mercury include salmon, catfish, shrimp, and pollock (common in fish sticks).