State Health Lawmakers' Digest: Children's Environmental Health (Vol. 2, No. 1), Cover Story

INTRODUCTION

Children's Environmental Health

Children are not small adults. Their bodies function differently than adults' bodies-they breathe more air, drink more fluids and eat more food in relation to their body weight. As a result, children receive higher doses of everything they are exposed to, including chemicals and pollutants.

In the world of standard setting, one standard is applied to everyone. When standards are set for chemicals, they usually are based on the reactions of a 180-pound adult male, not a child. Chemicals, pollutants, food additives and even drug dosages are based on the effect they have on adults. For children, doses are higher because they eat more fruits and drink more juices, play in sand and soils and put more things in their mouths. In many instances, exposures considered safe for adults have been shown to adversely affect children. For most chemicals, data are not available on whether the current exposure standards are safe for children.

Unique Susceptibilities of Children

Children's brains and nervous, immune and hormonal systems continue to mature throughout childhood into adolescence, making them more susceptible to contaminants found in the environment. A chemical that is harmless for an adult can be devastating to a child. Children's internal organs are also still developing, which means that their liver and kidneys may not remove toxic substances as efficiently as an adult's, their gastrointestinal tract may absorb more of a pollutant and their maturing skin can more easily absorb chemicals.

Because children breathe, eat and drink more than adults relative to their body mass, they ingest more pollutants per pound of body weight, which translates to a higher dose. Children's diets often include larger amounts of raw fruits and vegetables, water and other foods, which can increase pesticide exposure. Finally, children have increased exposure to chemicals because they tend to play on the ground, where they inhale ground-level contaminants and put contaminated objects or their own dirty hands and fingers in their mouths. These behaviors dramatically increase exposure to lead and pesticides. Combined, these factors increase a child's risk of receiving harmful doses chemicals and pollutants, yet standards designed to protect the health of all people may not be protecting the most vulnerable population-children.

Setting Standards for Children

State and federal regulators are beginning to revise their standard-setting protocol to address the unique nature of children. The Food Quality Protection Act (FQPA) fundamentally changed the way EPA regulates pesticides, requiring the agency to address risks to infants and children. The act also provides for an additional safety factor, which means the maximum allowable dose is divided by 10 to account for children's special sensitivities, unless reliable data show that a smaller safety factor will be acceptable. The safety factor is designed to ensure that tolerances are safe for infants and children. The Safe Drinking Water Act Amendment (SDWA) also requires special consideration for children.

Still, fewer than 25 percent of the 3,500 chemicals produced in amounts greater than 1 million pounds per year have been tested for their toxic effects on children. Less than half of them have been tested at all, and no data exists on whether these chemicals harm children.

Some states are acting on children's environmental health issues where the federal government is not. In California, for example, the Children's Environmental Health Act, passed in 1999, requires the state to assess air quality and toxics to ensure that standards protect infants and children, not only adults. Maryland House Bill 313, enacted in 2000, creates a children's environmental health panel to review statutes, regulations and proposed regulations to determine whether they adequately address children's needs. The panel makes recommendations to the regulatory agencies to ensure that state laws address children's vulnerabilities.

Many other states regulate specific chemicals or diseases. Almost every state has laws to protect children from lead poisoning (children are five times more likely to have lead poisoning than adults). Legislation seeking to regulate or ban uses of mercury appeared in 17 states in 2001 and passed in four-Indiana, Maine, Maryland and Minnesota. Asthma, a disease that is on the rise, was addressed in a number of states, most notably Virginia. There the Department of Health will develop a statewide comprehensive asthma management strategy.

Environmental Health Tracking

The foremost problem facing scientists and policymakers who work on children's environmental health issues is the lack of data on the effects chemicals in the environment have on children. To help fill the gap, the Centers for Disease Control and Prevention released the National Chemical Exposure Report, which documents national levels of 27 chemicals in the population. The report found that levels of lead and nicotine-which include second-hand smoke-dropped significantly in the past 10 to 20 years. The report indicated that levels of mercury and pthalates (a chemical softener used in plastics), however, may pose a risk to certain portions of the population, including children.

Beyond the federal effort, states have introduced legislation to identify and track the links between environmental hazards and illnesses. An Indiana bill seeks to establish a state registry of health problems and environmental conditions. California legislation looked at tracking chronic illness, offering information on these illnesses as they relate to the environment. Maryland, Nevada and Montana also introduced legislation to track links between the environment and health.

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