Children's
                                  Environmental
                                  Health   2005
                                 A Summary of EPA Activities
        The mission of the
        United States
        Environmental
  Protection Agency (EPA)
  is to protect human health
  and the environment. After the
  1993 publication of
  Pesticides in the Diets of
  Infants and Children by the
  National Research Council,
  EPA launched a major
  Federal effort to address the
  unique risks children face
  from a multitude of environ-
  mental agents.
&EPA
     United States
     Environmental Protection
     Agency
Children are different from adults
and may be more vulnerable to
environmental exposures.

Consider that:
• children's neurological, immuno-
 logical, digestive and other bodily
 systems are still developing and
 are more easily harmed;
• children eat more food, drink
 more fluids, and breathe more
 air than adults in proportion to
 their body mass—their food,
 fluids, and air therefore must be
 safe; and
• children's behavior patterns-
 such as crawling and placing
 objects in their mouths—often
 result in greater exposure to
 environmental contaminants.
Because of these characteristics,
children may not be sufficiently
protected by regulatory standards
that are set based on risks to
adults. EPA has forged partnerships
and taken increasingly more steps
to protect children's health from the
variety of contaminants and pollut-
ants that may affect them in the air
they breathe, the water they drink,
and the food they eat.

We direct our efforts toward ensur-
ing that their homes, schools, and
playgrounds provide the necessary
environmental conditions for nor-
mal growth and development. We
focus on preventing exposure as a
first-line defense against harmful
environmental pollutants and we
continue to work to improve envi-
ronmental protections and health
outcomes. This annual publication
highlights a variety of recent EPA
work.
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Children's Environmental
Health Awards
L
      aunched in 2005, the
      Children's Environmental
      Health Awards serve to
increase awareness, stimulate
activity, and recognize efforts that
protect children from environmental
health risks at the local,  regional,
national, and  international levels. In
addition to the Excellence Award
winners, EPA recognized 113
organizations for their  dedication
to protecting  children's health.
                2005
         Children's Environmental Health
         Excellence Award

• Agency for Toxic Substances and
 Disease Registry, Great Lakes Human
 Health Effects Research Program,
 Atlanta, Ga.

• The American Legacy Foundation,
 Truthฎ, Youth Advisory Panel,
 Youth Speakers Bureau, and Youth
 Empowerment Grants, Washington, D.C.

• American Lung Association
 of Washington, Master Home
 Environmentalist Program™,
 Seattle, Wash.

• The Association  of Occupational
 and Environmental Clinics,  Pediatric
 Environmental Health Specialty Unit
 Program (PEHSU), Washington, D.C.
  - The Rocky Mountain Region PEHSU,
    Denver, Colo.
  - The Southeast PEHSU, Atlanta, Ga
  - The Southwest PEHSU,  Tyler, Texas
• Childhood Lead Action Project,
 Providence, R.I.
• Columbia Center for Children's
 Environmental Health, IPM Interventions
 and Healthy Homes Healthy Child
 Community Education and Outreach
 Project, New York, N.Y.
• The Farmworker Justice Fund, Inc.,
 Project Clean Environment for Healthy
 Kids, Washington, D.C.
• Meghan Pasricha, The Anti-Tobacco
 Action Club,  Hockessin, Del.
• The National Nursing Centers
 Consortium,  Lead Safe  Babies,
 Philadelphia, Pa.
• Public Health Seattle and King County,
 The Healthy Homes Asthma Project,
 Seattle, Wash.
• Public Health Seattle and King County,
 The Tacoma  Smelter Plume Project,
 Seattle, Wash.
• The Real World Foundation, Asthma
 Free School Zone, New York, N.Y.
• City of St. Louis Department of Health,
 Department of Public Safety, Lead Safe
 St. Louis Task Force, St. Louis, Mo.
• West Harlem Environmental Action (WE
 ACT), Environmental Health Program,
 New York, N.Y.
• The Western North Carolina Regional
 Air Quality Agency, Western North
 Carolina School Bus Retrofit Project,
 Asheville, N.C.
                                       Visit www.epa.gov/children for 2006
                                       awards information.

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Helping Children
Breathe Easier

        Both indoor and outdoor air
        pollution can adversely
        affect children's health and
is a major threat to normal growth
and development. In the United
States, asthma is an epidemic,
affecting more than  6 million
children under 18 years
of age.

• Controlling Asthma: EPA raises aware-
  ness about managing environmental
  asthma triggers so that asthmatics can
  reduce the number and severity of
  episodes, emergency room visits, hospi-
  talizations, and missed school and work
  days. Asthma prevalence and negative
  health outcomes are more common
  among African Americans, some
  Hispanic children, and among families
  with limited education and lower income.
  EPA has developed Help Your Child Gain
  Control Over Asthma to provide targeted
  information to improve asthma out-
  comes. To receive a copy of the booklet,
  call 1 -800-438-4318 or visit
  www.epa.gov/asthma.

• Simple Things: EPA and the Ad Council
  are sponsoring The Childhood Asthma
  Public Service Campaign to increase
  understanding about asthma, asthma
  triggers, and ways to limit exposure to
  environmental factors that can trigger
  asthma attacks. This year, the campaign
  messages focus on "simple things" that
  parents can do to manage their child's
  asthma. The materials are in
  English and Spanish for television, radio,
  and newspaper. As a result of this cam-
  paign, more than 1 million different view-
  ers have visited the Web site and 40,000
  hotline calls have been received since
  March 2001. Visit www.epa.gov/asthma.

• National Environmental Leadership
  Award in Asthma Management: EPA
  recognizes health plans and health care
  providers who have demonstrated lead-
  ership in managing environmental trig-
  gers as part  of a comprehensive asthma
  management program. The 2005 win-
  ners are: Optima Health (Virginia Beach,
  VA) and Children's Mercy Hospitals and
  Clinics (Kansas City, MO). In addition,
  the Neighborhood Health Plan of Rhode
  Island and the Connecticut  Children's
  Medical Center received honorable
  mentions. Application information for
  the 2006 Awards is available at
  www.epa.gov/asthma.

• Learning about Air Quality: Local air
  quality affects how we live and breathe.
  For children, whose lungs are still devel-
  oping, the local air quality may be poor
  enough to limit outdoor activities. The
  AIRNow Web site was developed in
  partnership with the National Weather
  Service, National Parks Service, and
  others to provide the public daily air
  quality forecasts and real-time air quality
  conditions for more than 3 million people
  in 300 U.S. cities. Visit www.airnow.gov.

• EnviroFlash: EnviroFlash provides free
  information on ozone and particle pollution
  forecasts through e-mail and mobile text
  messaging. To join more than 5,000 sub-
  scribers in 38 cities, visit www.airnow.gov
  and click on the EnviroFlash logo.
EnviroFlash
Your Environmental News Flash
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    • Diesel School Buses: The Clean School
      Bus USA initiative has created partner-
      ships with community, industry, and
      business leaders to improve the health
      of school children across the country by
      reducing diesel pollution on school buses.
      Buses are being retrofitted with emissions
      control technology, switched to cleaner
      fuels, or replaced with new, cleaner
      models. As of April 2005, the program
      included 150 school districts, reducing
      emissions on more than 20,000 school
      buses for two million children.
      Visit www.epa.gov/cleanschoolbus.


    Preventing Childhood
    Exposure to  Secondhand
    Smoke

A            recent EPA study
            states that approximately
            three million children ages
    six and under are exposed to
    environmental tobacco smoke,
    especially in low-income,
    low-education households.
    Environmental tobacco smoke
    increases the risks  of asthma
    episodes, middle ear and lower
    respiratory  tract infections, such
    as pneumonia and  bronchitis,
    recurring colds,  coughs, wheez-
    ing, and decreases lung function.

    • Take the Smoke-free Home Pledge:
      With more than 1,700 national, state, and
      local organizations promoting the
      Smoke-free Home Pledge Campaign,
  EPA is helping parents, caregivers,
  teachers, medical professionals, and oth-
  ers protect children from environmental
  tobacco smoke. The Campaign encour-
  ages everyone to choose not to smoke in
  the home, car, or anywhere children are
  present. The pledge can be taken online
  at www.epa.gov/smokefree.


Protecting Children from
too much  Sun

      Children must be protected
      from overexposure to the
      sun and its ultraviolet (UV)
rays. UV rays are classified as a
human carcinogen. Serious health
effects,  including skin cancer, eye
damage and cataracts, and
immune system suppression can
be caused by overexposure to the
sun. Skin  cancer is the  most com-
mon, yet preventable, type of
cancer in  the United States.

• SunWise: Currently, more than 12,000
  schools and informal  learning centers
  (up from 10,500 in 2004) are registered
  in the SunWise Program, which started
  in 2000 to teach children and their care-
  givers how to protect themselves from
  overexposure to the sun. SunWise
  education materials have been shown to
  be effective in children ages five to
  twelve by reducing sunburns by 11 per-
  cent and reducing the desire for a tan by
  10 percent. Materials and information
  are available in English and Spanish at
  www.epa.gov/sunwise.
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Protecting Children from
Lead Poisoning

      Lead is toxic and particularly
      harmful to young children, but
      lead poisoning is preventable.
EPA and other Federal agencies
have been working to protect chil-
dren from these effects and are
committed to eliminating childhood
lead poisoning by 2010.  The on-
going reduction  in the number of
children with elevated blood lead
levels, from  1.4 million in the early
1980's to 310,000 in 2002, demon-
strates the success of Federal, State
and local efforts. To further these
reductions, EPA is launching a pro-
gram to ensure the use of lead-safe
work practices by the renovation,
repair, and painting industries.
• Lead Education: Children in minority
  populations, children from low income
  families, and children who live in older
  homes tend to have higher exposures
  and higher blood-lead levels than the
  national average. EPA and Head Start
  educated teachers, parents, and chil-
  dren in 75 Head Start centers in New
  York, Philadelphia, Los Angeles,
  Chicago, and Houston, reaching about
  61,000 people about the dangers of
  lead poisoning by distributing informa-
  tional materials. Visit www.epa.gov/lead.
• Lead Grants: EPA has established a
  competitive grant program to reduce
  incidences of childhood lead poisoning
  in vulnerable populations,  such as those
  with higher-than-average blood-lead
  levels. In addition, EPA provides grants
  to Native American communities to
  assist in assessing the extent of child-
  hood lead poisoning and to implement
  effective education programs.
Protecting Children from
Mercury in Fish

       Some fish and shellfish contain
       higher levels of mercury that
       may harm an unborn baby
or young child's developing nervous
system. The risks from mercury in
fish and shellfish depend on the
amount eaten and the levels of mer-
cury present. Therefore,  the Food
and Drug Administration (FDA) and
EPA are advising women who are
pregnant or may become pregnant,
nursing mothers, and young chil-
dren to avoid some types of fish
and eat fish and shellfish that are
lower in mercury.

• Fish Consumption and Health: Last
  year, EPA and the Food and Drug
  Administration (FDA) began distributing
  the brochure titled What You Need to
  Know About Mercury in Fish and
  Shellfish, targeting women of childbear-
  ing age and physicians. Approximately
  five million copies of this brochure, in
  English and Spanish, have been distrib-
  uted to more than 200,000 members of
  United States medical and public health
  organizations. EPA and FDA promoted
  the fish advisory program at major medi-
  cal and environmental health confer-
  ences. EPA also continues to distribute
  the brochure, Should I Eat the Fish I
  Catch? (with versions in English,
  Spanish, Korean, Vietnamese, Hmong
  and Cambodian), that discusses ways to
  reduce health risks from eating fish
  containing chemical pollutants.
  Representatives from EPA distributed this
  brochure at the 2005 National Boy Scout
  Jamboree. Visit http://www.epa.gov/
  waterscience/fish/.

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     Keeping Pesticides Away
     from Children

           In regulating pesticides,
           EPA considers children's
           exposure to pesticides in
     their diets, their drinking water,
     and in their home and school.
     These considerations include
     examining a variety of adverse
     health effects, such as acute poi-
     soning, disruption of the hormone
     and immune systems, neurological
     damage, and cancer. EPA also has
     outreach and education materials
     aimed at teaching children and
     adults how to use pesticides safely
     to reduce children's exposure.

     • Poison Prevention: More than 70,000
      cases of children exposed to pesticides
      were reported to poison centers last
      year.  Many more cases go unreported.
      EPA and the American Association of
      Poison Control Centers are working to
      raise awareness of pesticide poisoning
      prevention.  For example, information
      from  these organizations recently
      appeared on Despierta America, a
      television program that reaches over one
      million Spanish-speaking households.

     • Outreach: Occupational exposure and
      language barriers place many Hispanics
      at high risk for pesticide exposure.
      Pesticide product labels, which contain
      important use and emergency care
      information, are written in English, and
      may not  be easily understood by the 28
      million Spanish speakers living in the
      United States. In an effort to reach this
  population, EPA participated in a series
  of media interviews with more than
  three million listeners.

  EPA and the National Head Start
  Association are raising awareness to
  prevent  pesticide poisonings in children
  with a room-by-room poison
  prevention checklist. Visit
  www.epa.gov/pesticides.


Training Health Care
Providers to  Address
Environmentally-Related
Illness

       EPA recognizes that health
       care providers can play a
       key role in helping to pre-
vent, diagnose, and manage chil-
dren's health risks  related to the
environment. Yet most health care
providers are not schooled in envi-
ronmental health. EPA is building a
cadre of children's environmental
health champions in North  America
and throughout the world.

• Pediatric Environmental Health
  Specialty Units (PEHSUs): PEHSUs
  provide consultation, information, train-
  ing, and referrals to health care profes-
  sionals,  agencies,  and the public on
  pediatric environmental health issues.
  There is a network of 13 Units in North
  America and several are being created
  in other parts of the world. This  year, the
  World Health Organization, the
  International Pediatric Association, and
  the delegates to the Health and
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  Environment Ministers of the Americas
  met and endorsed the adaptation and
  expansion of a PEHSU model for other
  nations. PEHSUs are supported by the
  Agency for Toxic Substances and
  Disease Registry, and EPA and are
  administered by the Association of
  Occupational and Environmental Clinics.
  They were awarded one of fifteen
  Children's Environmental Health
  Excellence Awards in 2005. For more
  information, visit www.aoec.org and
  www.atsdr.cdc.gov/child/ochchildhlth.html.

• Training Materials for Developing
  Countries: EPA supports the World
  Health Organization effort to develop
  comprehensive training materials for
  health care providers internationally.
  Materials are being tested in training
  sessions in several countries and will
  cover a plethora of children's environ-
  mental health issues for formally and
  informally trained providers and in sev-
  eral different formats, including a book,
  available electronically, and in pam-
  phlets.  Visit www.who.int/ceh.

• Air Pollution Educational Materials:
  EPA has created several resources for
  health professionals to use when educat-
  ing patients about the health effects of air
  pollution. Visit www.airnow.gov and click
  on "Health Providers" to download asth-
  ma fact sheets  and medical posters.

• Ozone and Health: During the summer
  months, millions of people in the United
  States are exposed to ground-level
  ozone (smog) at levels that can cause
  uncomfortable and damaging respiratory
  symptoms. Ozone and Your Patients'
  Health is an online training course for
  medical professionals that describes the
  physiological mechanisms responsible
  for the symptoms such as lung function
  changes associated with exposure to
  ground-level ozone. It also gives advice
  to patients about exposure to ozone and
  provides practical tools to help them
  understand what triggers asthma symp-
  toms and how to alleviate them. Visit
  www.epa.gov/air/oaqps/eog/ozonehealth.

• Mold and Health: Guidance for
  Clinicians on the Recognition and
  Management of Health Effects Related
  to Mold Exposure and Moisture Indoors
  was published last fall by the Center for
  Indoor Environments and Health at the
  University of Connecticut Health Center
  with support from EPA. This free publi-
  cation is available at
  http://oehc.uchc.edu/clinser/indoor.htm.

• Drinking Water: Tap into Prevention is a
  continuing education video/DVD that
  explains potential health risks from
  exposure to microbial and chemical
  contaminants in drinking water and
  demonstrates actions health care
  providers can take in their practices.
  Visit www.epa.gov/safewater/
  healthcare/index, htm I.

• Pediatric Asthma Initiative: With EPA's
  support, the National Environmental
  Education Teaching Foundation and
  the National Institute of Environmental
  Health Sciences defined competencies
  and developed environmental history
  forms for environmental triggers of asth-
  ma. These tools are built upon the best
  current practices and existing resources.
  Visit www.neetf.org/health/
  asthma.htm.
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     Studying Environmental
     Exposures and Children's
     Health
     • National Children's Study: This effort
      will examine the effects of environmen-
      tal influences on the health and devel-
      opment of more than 100,000 children
      across the United States, following them
      from before birth until age 21. The goal
      of the study is to improve the health and
      well-being of children. The study defines
      "environment" broadly  and will take a
      number of issues into account including:

       - Natural and man-made
         environmental factors
       - Biological and chemical factors
       - Physical surroundings
       - Social factors
       - Behavioral influences and outcomes
  - Genetics
  - Cultural and family influences and
    differences
  - Geographic locations
Researchers will analyze how these ele-
ments interact with each other and what
helpful and/or harmful effects they might
have on children's health. By studying
children through the different phases of
growth and development, researchers will
be better able to understand the role of
these factors on health and disease. The
study has designated more than 100 loca-
tions across the United States where it
will seek to recruit and enroll eligible fami-
lies for participation. The locations were
selected to ensure that children across
the nation are fairly represented.

The National Children's Study will be one
of the richest information  resources avail-
able for answering questions related to
      National Children's Study Locations
                                                          '•'
                                                            Ste     
       Tut NATIONAL!
      CHILDPxEN'S
               STUOT
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children's health and development and
will form the basis of child health guid-
ance, interventions,  and policy for genera-
tions to come. It is anticipated that the
preliminary results from the first years of
the study will be available in 2008-2009.
The study is authorized by the Child
Health Act of 2000 and awaits assured
funding. The study sponsors are the
National Institutes of Health and the
Centers for Disease Control and
Prevention (both part of the U.S.
Department of Health and Human
Services) and the EPA. Visit www.
nationalchildrensstudy.gov and join the
study listserv at ncs@mail.nih.gov.

• International Interest and the National
  Children's Study: The National Children's
  Study has sparked interest in many
  other countries about improving
  research on children's environmental
  health. The study has therefore teamed
  with the World Health Organization to
  promote research  in developing and
  developed countries. This research can
  be integrated with the research ques-
  tions of the study for everyone's benefit.

International cooperation on children's
environmental health research  extends the
reach and scope of the study and pres-
ents opportunities for different approaches
in study design. Common measures in all
longitudinal cohort studies of the environ-
ment and children's  health strengthen all
the studies and builds the global pediatric
environmental health infrastructures.
Around the world, researchers are better
able to study rare but important childhood
diseases, such as cancer and birth defects.

• Asthma Research Results  Highlights
  Report: Asthma research by EPA and
  collaborators on the causes, triggers
  and best practices for management is
  providing critical scientific information to
  address this growing public health
  threat. EPA's Asthma Research Results
  Highlights Report summarizes accom-
  plishments in asthma research over the
  last five years and outlines future direc-
  tions in asthma research. For more
  information on this report, visit
  www.epa.gov/ord/asthma.
• Children's Health Research Centers:
  Many chronic childhood diseases, such
  as asthma, autism and learning defi-
  ciencies have consistently been linked
  to environmental factors. In 1998 EPA
  and the National Institute of
  Environmental Health Science (NIEHS)
  initiated a unique program to fund
  Children's Environmental Health
  Research Centers to investigate the role
  of environmental exposures in burden-
  some childhood disorders.  Each center
  is a university-community partnership
  conducting basic science, exposure,
  epidemiological, and/or intervention
  research.

A mini-monograph, including an overview
and six "Lessons Learned" papers by the
centers, is available at:
www.ehp.niehs.nih.gov
  University of California, Berkeley
  Agricultural pesticide exposures and
  effects on pregnant women and children
  www.cham acos. org
  University of Southern California
  The effects of traffic-related air pollution
  on asthma in an urban population
  Johns Hopkins University
  Urban air pollutants and allergens
  effects on the development of asthma
  Columbia University
  Cumulative impact of household pes-
  ticides, air pollutants, environmental
  tobacco smoke and heavy metal expo-
  sures on growth, asthma and cancer risk
  www.ccceh.org
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 Mt. Sinai Medical School
 The effects of pesticides, RGBs,
 endocrine disrupting chemicals and the
 built environment on growth and
 development
 University of Washington
 Exposure pathways and health effects
 of agricultural pesticides
 http://depts.washington.edu/chc/
 University of California Davis
 Environmental factors in childhood
 autism
 www.vetmed.ucdavis.edu/cceh/
 Children's Hospital Cincinnati
 Lead and tobacco effects on
 neurodevelopment
 www.cincinnatichildrens.org/research/
 project/enviro/default.htm
 University of Med/Dentistry New Jersey
 Environmental chemicals and autism
 development
 www.eohsi.rutgers.edu/childhood/
 index.shtml
 University of Illinois at Urbana-
 Champaign
 The effects of mixtures of RGBs and
 mercury on neurodevelopment and
 hearing loss
 www.cvm.uiuc.ed u/vb/friends_center/
 Harvard University
 Metal mixtures in mining wastes and
 children's growth and neurodevelopment
 www.hsph.harvard.edu/niehs/children/
 index.html
Protecting Children
Beyond  Our Borders
       Children's environmental
       health issues span  the
       globe. EPA works with
international organizations,
nongovernmental organizations,
and other countries to highlight
issues, share tools,  and build the
political will needed to
protect children everywhere.

• Global Indicators: Protecting children
  from exposure to environmental hazards
  requires that we better understand the
  relationship between environmental con-
  ditions and health outcomes. With EPA's
  support, the World Health Organization is
  leading the partnership effort that started
  at the World Summit on Sustainable
  Development to create global children's
  environmental health indicators. In 2005,
  the Commission on Environmental
  Cooperation will publish children envi-
  ronmental health indicators for North
  America. For more information, visit
  www.who.int/ceh/indicators/en/.

• International Law: EPA supported a
  new publication from the Physicians for
  Social Responsibility and the Center for
  International Environmental Law that
  provides individuals, institutions,  and
  countries with a logical way to address
  environmental health threats. To read
  Using International Law and Institutions
           mul Institutions
        to Protect Children's
      Eiivirouuieiit.nl Health

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  to Protect Children's Environmental
  Health, visit www.envirohealthaction.org/
  children/articles.cfm?article_ID=219.

• Mercury Partnership: The United
  Nations Environment Programme
  (UNEP) agreed to develop and imple-
  ment partnerships as one approach to
  reduce the risks to human health and
  the environment from mercury. EPA is
  working with other Federal agencies,
  UNEP, countries, states, industry, envi-
  ronmental groups, and intergovernmental
  organizations to develop global
  partnerships in the sectors that repre-
  sent the majority of all global atmo-
  spheric mercury emissions: artisanal and
  small-scale gold mining; chlor-alkali
  manufacturing; coal combustion; and
  products containing mercury; and to
  research mercury fate and transport.
  These partnerships are expected to help
  countries characterize and reduce mer-
  cury uses, releases, and exposure. For
  additional information, reports, and dis-
  cussion papers visit www.chem.unep.ch/
  mercury/partnerships/.

• Indoor Cooking Smoke: Solid fuels
  used for indoor cooking threaten the
  health of children in more than 75 per-
  cent of homes in many parts of Africa
  and Asia. Throughout the world, 1.6 mil-
  lion people, mainly women and children,
  die each year from breathing the dense
  smoke from traditional indoor cooking
  and heating fires. Indoor smoke also
  makes children under five highly sus-
  ceptible to respiratory infections in the
  homes of almost three billion people
  worldwide where firewood, coal, crop
  residues, and dung are burned. More
  than 100 public and private organiza-
  tions are working together through the
  EPA-sponsored Partnership for Clean
  Indoor Air to reduce exposure to indoor
  air pollution from household energy use
  for five million people by 2010. To learn
  more, visit www.PCIAonline.org.

• Partnership for Clean Fuels and
  Vehicles: Motor vehicles account for a
  significant portion of urban air pollution
  around the world. EPA is a key partner
  in the Partnership for Clean Fuels and
  Vehicles, with the goal to eliminate lead
  in gasoline and reduce sulfur in diesel
  fuels while adopting cleaner vehicle
  technologies. For more information, visit
  www.unep.org/PCFV.


Using Guidance  and
Regulations  to
Protect Children

       EPA's  1995 policy ensures
       that we  "consistently and
       explicitly evaluate environ-
mental health risks of infants and
children in all risk assessment, risk
characterizations and environmen-
tal and public health standards
that we set for the nation." (EPA,
October 20,  1995)
• Cancer Guidelines: Guidelines for
  Carcinogen Risk and Supplemental
  Guidance for Assessing Susceptibility
  from Early-Life Exposure to Carcinogens
  were issued  in March 2005 to assist
  EPA in assessing the cancer risks result-
  ing from exposure to chemicals or other
  agents in the environment. The
  Supplemental Guidance describes pos-
  sible approaches that EPA could use in
  assessing cancer risks of exposures to
  children from 0 to 16 years of age, and
  includes a review of existing scientific
  literature on chemical effects in animals
  and humans. Documents and additional
  information are available at
  www.epa.gov/cancerguidelines.


                                                                            
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  x
.
• Clean Air Interstate Rule: This rule is
  designed to reduce air pollution that
  moves across state boundaries in 28
  eastern states. EPA estimates that by
  2015 this rule will provide health and
  environmental benefits valued at over
  25 times the cost of compliance. When
  fully implemented, it will reduce 862
  emissions by over 70 percent and NOX
  emissions by over 60 percent from
  2003 levels in the affected areas, preventing
  millions of lost work and school days.

• Lead in Drinking Water: EPA is initiat-
  ing the Drinking Water Lead Reduction
  Plan to  strengthen, update, and clarify
  existing requirements for water utilities
  and states to test for and reduce lead in
  drinking water. This action, which follows
  extensive analysis and assessment of
  current  implementation of these regula-
  tions, will tighten requirements related to
  monitoring, treatment, lead service line
  management, and customer awareness.
  The plan also addresses lead in tap
  water in schools and child care centers.

• Coke Oven Residual Risk Rule: EPA
  issued the first in a series of emission
  reductions requirements known as resid-
  ual risk  standards, requiring further
  reductions in emissions of toxic air pol-
  lutants from coke ovens. With this
  action, EPA amended the maximum
  achievable control technology (MACT)
  standards to include more stringent
  requirements to address health  risks
  remaining after implementing EPA's
  October 1993 air toxic emission stan-
  dards. The risk assessment conducted
  for this  rule is the first to apply the new
  Cancer Guidelines and Supplemental
  Guidance on Early Life Exposures.
Making  Schools Healthier

          More than 53 million chil-
          dren and almost 3 million
          adults spend a significant
portion of their days in approxi-
mately 112,000 public and private
school buildings; many of these
buildings have environmental
conditions that may inhibit learning
and pose  substantial risks to the
health of children and staff.

• Healthy School Environments
  Assessment Tool: EPA has developed
  a comprehensive software tool that will
  help school districts manage self-
  assessment programs for all of their
  school facility environmental, health,
  and safety issues. The Healthy School
  Environments Assessment Tool
  (HealthySEAT) can be customized to
  reflect state and local requirements,
  policies, and priorities, and includes a
  built-in checklist that reflects the critical
  elements of every EPA regulatory and
  voluntary program affecting schools.
  Using HealthySEAT, school districts will
  be able to track the status of a virtually
  unlimited number of school facility condi-
  tions, generate a wide range of reports
  on those conditions, and better manage
  their resources. For more information
  visit www.epa.gov/schools.

• Chemical Cleanout and Prevention
  Program: In 2004, EPA launched the
  Schools Chemical Cleanout Campaign
  to promote removal of existing stocks of
  dangerous chemicals from schools and
  encourage safe chemical management.
  Ten pilot projects removed over 75,000

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 pounds of dangerous chemicals and
 created a safer learning environment for
 over 400,000 students. In Tennessee,
 more than 14,000 pounds of dangerous
 chemicals from 46 schools were
 removed. Visit www.epa.gov/osw/
 conserve/clusters/schools.htm.

' PEHSU Schools Manual: The Pediatric
 Environmental Health Specialty Unit
 (PEHSU) in Region 4 just released Safe
 and Healthy School Environments, a
 resource book that applies the methods
 and perspectives of environmental
 health to school settings. Visit
 www.sph.emory.edu/PEHSU/.

' School Siting: EPA worked with the
 Council of Education Facility Planners
 International to develop Schools for
 Successful Communities: An Element of
 Smart Growth to explain why and how
 communities should use smart growth
 principles to build schools. This publica-
 tion helps communities invest in schools
 that will give children the best possible
 learning environment, use taxpayer dol-
 lars wisely, and express the values and
 vision of the community. For more
 information, visit www.cefpi.org.

' Improving the Air in Schools: Twenty-
 two percent of our nation's schools have
 addressed indoor air issues using guid-
 ance consistent with the Indoor Air
 Quality Tools for Schools (IAQ TfS) pro-
 gram. This program has been supporting
 schools for nearly a decade to reduce
 exposures to indoor environmental
 contaminants. The core of the program
 is the IAQ TfS Kit which provides best
 practices, industry guidelines, and prac-
 tical management actions in a format
 designed to help school personnel iden-
 tify, solve, and prevent indoor air quality
 problems. For more information, visit
 www.epa.gov/iaq/schools.
• Indoor Air Quality Tools for Schools
 Mentor Network: The IAQ TfS Mentor
 Network started in 2003 to provide a
 collaborative forum for school profes-
 sionals and advocates for healthy indoor
 school environments to exchange ideas
 and discuss indoor air quality issues.
 The Network is a resource for school
 districts beginning new indoor air man-
 agement programs. To join the over 50
 current members, email
 guarneiri.michele@epa.gov.

• Indoor Air Quality Tools for Schools
 Awards: The IAQ TfS Awards program
 provides incentives and public recogni-
 tion to schools and school districts that
 consistently implement effective IAQ
 management practices. More than 250
 school districts and school-affiliated
 organizations have been recognized for
 outstanding achievement and  leader-
 ship in improving indoor air quality. Visit
 www.epa.gov/iaq/schools/awardsfor
 information and applications.

• Asbestos: The Asbestos Hazard
 Emergency Response Act (AHERA)
 requires schools to inspect for asbestos
 and submit publicly-available manage-
 ment plans to  states. EPA has begun to
 re-educate local education authorities
 on the Federal requirements for
 asbestos in schools and AHERA by
 partnering with the National Parent
 Teacher Association, the National
 Education Association, the American
 Association of School Administrators,
 and the Department of Education. The
 Agency is distributing updated outreach
 materials on asbestos in schools and
 AHERA compliance and working with
 other Federal agencies, such as the
 Bureau of Indian Affairs to distribute
 information to tribes.

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Smart Growth and
Children's Health

        Urban development that
        incorporates smart growth
        principles can provide clear
health benefits to children, includ-
ing improved air and water quality,
walkable cities, and preservation of
green spaces.

• Smart Growth Grants: EPA funded five
 programs to protect children's health
 from environmental risks by implement-
 ing smart growth principles. These grants
 included a walkability audit, a safe-
 routes-to-school program, smart growth
 and children's health curriculum devel-
 opment, creation of a multi-use path
 connecting schools and an initiative to
 eradicate lead hazards from homes. The
 grants emphasize projects that feature
 innovative and replicable ideas on smart
 growth and children's environmental
 health. Visit www.epa.gov/
 smartgrowth/grants.


State and Community
Actions to Protect
Children

       EPA works with states in many
       creative  and innovative ways
       to  bolster environmental
protections for children's health.

• In EPA Region 10, the Northwest
 Pediatric Environmental Health Specialty
 Unit (PEHSU) brought together over 150
 health care professionals for an accredited
 course on Controversies and Advances
 in Pediatric Environmental Health. In
 2006, the focus will be on children and
 pesticides. See the Region 10 PEHSU
 site at http://depts.washington.edu/
 pehsu/index.html.
• EPA Region 8, the Rocky Mountain
  PEHSU, states, universities, medical
  centers, and local agencies conducted
  three children's environmental health
  summits, resulting in many actions. For
  example, Montana has created a chil-
  dren's environmental health network;
  Montana and Utah have developed
  excellent informational web pages; the
  Utah governor declared October 2004
  Children's Health Month; and Colorado,
  Utah and Wyoming public health and
  environmental health associations have
  included children's environmental health
  issues in their annual conferences. Visit
  the Rocky Mountain PEHSU site at
  http://rmrpehsu.org/ and www.epa.gov/
  regionS/humanhealth/children.

• EPA Region 4, and the U.S. Department
  of Agriculture Cooperative State
  Research, Education, and Extension
  Service, and the 1890 Traditional Black
  Land Grant Colleges and Universities
  increased awareness of children's envi-
  ronmental health hazards,  reaching over
  80 percent of the  counties in the
  Southeast Region and over 17 million
  people via conferences, health fairs, and
  media programming. A children's health
  working group has been established in
  each of the Region 4 states.

• The  Environmental Council of the
  States and the Association of State and
  Territorial Health Officials, with support
  from EPA and the  Centers for Disease
  Control and Prevention, are implement-
  ing a national action agenda to reduce
  environmental triggers of childhood
  asthma. See Catching Your Breath:
  Strategies to Reduce Environmental
  Factors that Contribute to Asthma in
  Children at www.astho.org/pubs/
  CatchingYourBreathReport. pdf.

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Teaching Children

       Children are eager to learn
       about their environment
       and their bodies. EPA has
materials and programs in place
to educate kids about children's
environmental health.

• Resource Booklet for Youth: Live,
  Learn, Play, Tune-In to Your Environment
  is a new resource booklet for children
  from ages 10 to 16. It contains informa-
  tion, illustrations, activities, and music
  on children's environmental health
  issues. The booklet is available free at
  www.epa.gov/ncepihom/ordering.htm

• Reaching Youth Groups: EPA Region 4
  and the Northwest Georgia Girl Scout
  Council hosted the Environmental
  Awareness Day for the last 3 years.
  More that 50 EPA volunteers developed
  and ran activities to help more than 700
  scouts earn  their Eco-Action and
  Environmental Health Badges. Region  4
  has also developed a toolkit to enable
  others to replicate these activities. EPA's
  Region 8 and their local Girl Scout
  Council also sponsor a children's envi-
  ronmental health badge day for girls
  from 3^ grade to high school.

• Air Quality Information: EPA's Air
  Quality Kits-To-Go educate children
  about air pollution topics. The kits were
  originally created for agency employees
  to provide air pollution lessons to local
  school districts; their popularity drove
  EPA to develop a national program. Visit
  www.epa.gov/apti.
• "In The Air": EPA and the Missouri
  Botanical Garden's Earth Ways Center
  developed materials to help K-12 stu-
  dents understand how individual and
  collective behaviors result in airborne
  toxics and how these pollutants affect
  their health.  In The Air received EPA's
  2005 Children's Environmental Health
  recognition award. To download free
  materials, visit www.intheair.org.

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   Protect  Children,
   Protect  Our  Future
   Protecting the environments where children live, grow, and learn enables them to thrive and
   develop into healthy and productive adults. Environmental illnesses are largely preventable,
   expensive to treat, and often irreversible in their health effects. Children are different from
   adults, their bodies are developing, they interact with the environment differently and they play
   closer to many harmful pollutants.

   The health of children depends on the quality of their environment. All their environments need to
   be safe: from the womb to the crib, from home to school, from local communities to global villages.

   For more information, visit EPA's Office of Children's Health Protection Web site:
   www.epa.gov/children.
&EFK
United States
Environmental Protection
Agency

Office of Children's
Health Protection

October 2005

EPA100-F-05-041
                                                    Recycled/Recyclable
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