lted States
                     protect!
  Office of Children's
  Health Protection
|  Washington, DC 20460
               The  ERAlChildren's
                          K , ental Health
               Yearboi
EPA 100-R-98-100
June 1998
www.epa.gov
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   Ensuring our children a
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     Vice President Al Gore

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                       UNfTED STATES ENVIRONMENTAL PROTECTION AGENCY
                                        WASHINGTON, DC. 20460
                                                                   THE ADWiMSTRATDR

                                               June 1998
Dear Reader,

       It gives us great pleasure to share with you "EPA's Children's Environmental Health Yearbook" representing
the United States Environmental Protection Agency's (EPA) current actions to protect children from environmental
hazards. It contains the latest information on the unique threats environmental hazards present to children and de-
scribes EPA's efforts to combat these hazards. It is our hope that this report will be a valuable resource for the public.

       The special susceptibility of children to certain environmental hazards as well as the changing nature of child-
hood illness have prompted the Clinton Administration to make children's health a high priority. In September 1996,
the EPA established a seven step National Agenda to Protect Children's Health from Environmental Threats. In April
1997, President Clinton issued an Executive Order requiring all federal agencies to make the protection of children a
high priority in implementing their statutory responsibilities and fulfilling their overall missions. The Office of Children's
Health Protection (OCHP) was created to coordinate children's health issues across EPA.

       The volume and breadth of this report demonstrate the hard work taking place in the Agency to focus signifi-
cant attention on protecting children's health. This work illustrates the commitment by EPA employees to safeguarding
children against environmental hazards. The Clinton Administration's focus on children will continue to grow, reflecting
an enduring effort to protecting the health of children.
                                                 Sincerely,
                                                 Uarol M. tsrowner

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                                         EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                        CONTENTS
Chapter 1 Introduction	1
   Our Children's World	1
   Special Vulnerabilities	1
   EPA Takes Action	1
   President Acts on Behalf of Children	2
   EPA Launches New Office	2
   Organization of this Report	4
   References	6

Chapter 2 Asthma and Other Respiratory Effects	7
   Definition	7
   Possible Environmental Factors	8
   Summary of EPA Activities	 11
   EPA Projects on Asthma and Other Respiratory Effects	12
      Indoor Air Quality IAQ Tools for Schools	12
      Environmental Tobacco Smoke (Secondhand Smoke)	17
      Indoor Air Outreach and Intervention	18
      Research on Indoor Air Quality and Asthma and Other Respiratory
      Illness Among Children	22
      Outdoor Air Quality	23
      Research on Outdoor Air Quality and Asthma and Other Respiratory
      Illness Among Children	25
   References	30

Chapter 3 Childhood Cancer	33
   Definition	33
   Possible Environmental Factors	34
   Summary of EPA Activities	36
   EPA Projects Related to Cancer	37
      Radon	37
      Asbestos	38

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      Ultraviolet Light	40
      Hazardous Waste	40
   References	43

Chapter 4 Developmental and Neurological Toxicity	45
   Definition	45
   Possible Environmental Factors	46
   Summary of EPA Activities	48
   EPA Projects on Developmental and Neurological Toxicity	51
      Lead	51
      Endocrine Disruptors	72
      PCBsandDioxin	74
      Mercury	76
   References	80

Chapter 5 Health Effects of Pesticides	83
   Definition	83
   Potential Health Effects from Pesticide Exposure	84
   Possible Environmental Factors	84
   Summary of EPA Activities	86
   EPA Projects on Health Effects of Pesticides	89
      Strengthened Standards and Better Public Information	89
      Support for Integrated Pest Management	91
      Expanded Enforcement Efforts	94
      Understanding Risks to  Children	96
   References	102

Chapter 6 Potential Risks from Contaminated Water	105
   Potential Waterborne Risks	105
   Summary of EPA Activities	107
                                                                              I

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                                                                EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                        Projects on Contaminants in Water and Fish	109
                           Contaminants in Water	109
                           Contaminants in Fish	 114
                        References	 117

                     Chapter 7 Predicting Health Risks to Children	119
                        EPA Assesses Risk to Protect Children and their Environment	 119
                        EPA Policy Initiatives and Research Targeting Children	120
                        EPA Projects to Improve Risk Assessment	122
                           Water	122
                           Hazardous Waste	123
                           Exposure	127
                           Cumulative Risk	128
                        References	130

                     Chapter 8 Protecting Children Worldwide	131
                        EPA's Role as International Leader in Environmental Protection	131
                        The Declaration of the Environmental Leaders of the Eight on Children's
                          Environmental Health	131
                        EPA's International Activities	132
                        EPA International Projects	134
                           Asthma and Other Respiratory Effects	134
                           Developmental and Neurological Toxicity	135
                           Health Effects of Pesticides	136
                           Potential Risks from Contaminated Water	137

                     Chapter 9 Environmental Education Related to Children's Health	139
                        Purposes of Environmental Education	139
                        How Environmental Education Addresses Children's Health Issues	139
                           Educating Children	139
iii

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      Educating Parents and Teachers	140
    Summary of EPA Activities	140
    EPA Environmental Education Projects	142

Chapter 10 Enhanced Community Right-to-Know	151
    Improving Public Access to Information Needed to Protect Children's Health	151
    EPA's Community Right-to-Know Activities	152
    EPA Community Right-to-Know Projects	154

Chapter 11 Children's Health Resources	159
    ContactingEPA	159
      EPA Headquarters	159
      EPARegions	159
    Obtaining EPA Publications	162
    EPA Materials, Tools, and Internet Resources Related to Children's Health	164
      Asthma and Other Respiratory Effects	164
      Childhood Cancer	171
      Developmental and Neurological Effects	177
      Health Effects of Pesticides	183
      Potential Risks from Contaminated Water	187
      Environmental Education	191
      Enhanced Community Right-to-Know	194
    Other Federal Agencies with Programs Related to Children's Environmental Health ... 195

Glossary	199
Acronyms and Abbreviations	205
Index  	209
    Environmental Justice Projects	209
    EPA Program Offices	210
    EPARegions[[[ 217

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                                             EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
OUR  Chi Id REN'S WoRld

Our children live in a world much different from the one in which we were raised. In
recent decades, about 50,000 synthetic chemicals have been produced in the United
States and many have dispersed into the environmental)
Now that many of the childhood diseases prevalent in the past can be prevented or
controlled with vaccines and antibiotics, there has been a shift to treating more chronic
conditions.  These conditions include, for example, asthma, learning disabilities, birth
defects, and childhood cancers. An estimated 4.8 million children under 1 8 years of age
have asthma.(2,3) About 1 50,000 children with asthma are hospitalized each year, and
600 die from the disease. (4) Asthma treatment was estimated to cost $6 .2 billion in 1990;
today this figure is expected to be substantially higher because of the increase in disease
incidence and medical costs.(5)
The overall frequency of childhood cancer has increased over the past two decades.(6,7)
The trends in some cancer rates suggest the need for a closer examination of the underly-
ing causes of cancer in children. This includes determining the role environmental con-
taminants may play in causing disease.
Children may have a special vulnerability to certain toxic substances, such as lead. Their
vulnerability exists for a variety of reasons. For instance, children may be more heavily
exposed to certain toxic substances in the environment than adults. Pound for pound of
body weight, children breathe more air, drink more water, and eat more food than adults.
In addition, their behavior patterns, such as play close to the ground and hand-to-mouth
activities, can increase their exposure to potential toxics in the environment. Furthermore,
the systems of a child's body are still developing making children less able to metabolize,
detoxify, and excrete some toxic substances than adults. However, it is not unusual for
children to be less sensitive or respond differently than adults to medicines and other
chemicals.(8,9) Our understanding of children's vulnerability to toxic substances is compli-
cated because the degree of vulnerability varies with age and developmental stage.
EPA
              AcrioN
In recognition of these factors, Administrator Carol Browner directed the Environmental
Protection Agency in the fall of 1 995 to explicitly and consistently take into account
environmental health risks to infants and children in all risk characterizations and public
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health standards set for the United States. In the fall of 1 996, the Administrator announced a
seven-step National Agenda to Protect Children s Health from Environmental Threats.

This NAiioNAl AqENcta INSTRUCTS T^E AqEixicy TO:
  •  Ensure that all standards set by EPA are protective of any heightened risks faced
    by children.
  •  Develop a scientific research strategy focused on the gaps in knowledge regarding
    child-specific susceptibility and exposure to environmental pollutants.
  •  Develop new, comprehensive policies to address cumulative and simultaneous
    exposures faced by children.
  •  Expand community right-to-know allowing families to make informed choices
    concerning environmental exposures to their children.
  •  Encourage parental responsibility for protecting their children from environmental
    health threats by providing them with basic information.
  •  Encourage and expand educational efforts with health  care providers and
    environmental professionals so they can identify, prevent, and reduce environmental
    health threats to children.
  •  Provide the necessary funding to address children's environmental health as a top
    priority among relative health risks.
ACTS  ON
                                 of
On April 21,1 997, President Clinton signed the Executive Order on the Protection of
Children from Environmental Health Risks and Safety Risks. This Executive Order
requires all federal agencies to assign a high priority to addressing health and safety risks to
children, coordinate research priorities on children's health, and ensure that their standards
take into account special risks to children. The Executive Order creates a Task Force on
Environmental Health Risks and Safety Risks to Children that will establish a coordinated
research agenda and enlist public input for these efforts.

EPA  LAUNCHES NEW  OfficE

In May 1 997, Administrator Browner established the Office of Children's Health Protec-
tion (OCHP) to support the Agency as it implements the President's Executive Order
as well as the National Agenda to Protect Children s Health from Environmental
Threats. The mission of OCHP is to make the protection of children's health a fundamental
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                                                                  EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                      goal of public health and environmental protection in the United States. OCHP will support
                      and facilitate Agency efforts to protect children's health from environmental threats. This
                      Children s Environmental Health Yearbook highlights EPA activities that protect children's
                      health from environmental hazards and is among the first projects of the new office.
          Office of Children's Health Protection Highlights

EPA Administrator, Carol Browner, convened the first federal conference addressing the preventable causes of
childhood cancer on September 15 and 16,1997. Recommendations for aresearch agenda included a call for a
National Childhood Cancer Registry and standardizing information, such as exposure history and family health data.
EPA and the Department of Health and Human Services (HHS) are establishing federally funded research centers
dedicated to the protection of children's health from environmental threats. The centers will focus on the
environmental causes of children's illnesses and disorders. They will seek an understanding of the mechanisms of
respiratory disease, such as asthma, and they will study the effects of environmental contaminants, such as lead,
mercury, and polychlorinated biphenyls (PCBs), on intellectual andphysical development. Also, they will institute new
community-based partnerships for prevention.
The Office of Children's Health Protection chairs an EPA Board on Children's Environmental Health that will ensure
the integration of Agency activities affecting children and serve as a catalyst for actions that will protect children.
Administrator Browner and Health and Human Services Secretary Donna Shalala co-chair the Task Force on
Environmental Health Risks and Safety Risks to Children. On October 9,1997, the Task Force met to implement
President Clinton's Executive Order. Work groups were established to coordinate federal data needs and research
and to facilitate children's environmental health programs across the federal agencies.
A Federal Advisory Committee on Children's Health Protection has been established. This broad-basedcommittee
will advise EPA on children's environmental health issues as it develops regulations, guidance, and policies;
communicates with the public; and conducts research.
                      EPA has already begun to fulfill the requirements of the National Agenda and Executive
                      Order. Some of the more visible examples include certain updated air quality standards,
                      implementation of the 1996 Safe Drinking Water Act (SDWA) Amendments, and the
                      1996 Food Quality Protection Act Amendments to the Food Drug and Cosmetic Act.
                        • The Clinton Administration's  1997 air standards for particulate matter and ozone
                          provide additional health protection to 35 million children and set standards for fine
                          particulate matter for the first time.(l 0) The strengthening of the ozone standard is
                          expected to result in one million fewer incidents of decreased lung function in children
                          eachyear.(ll)
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    The 1996 Food Quality Protection Act contains specific provisions to protect the
    health of infants and children in the absence of complete data on the harmful effects of
    pesticides. It also calls for the re-evaluation of nearly 10,000 existing pesticide
    tolerances within a ten-year period. Pesticide tolerances are the levels of pesticide
    residues that the government allows in food.
    The 1996 SD WA Amendments include a new focus on setting priorities based on risk.
    EPA will decide which waterborne contaminants to regulate under the SD WA based
    on data about the health risks the contaminant may pose, its likely occurrence in public
    water systems, and the projected benefit of reducing the risk. EPA will identify groups
    of sensitive people, called subpopulations, who are at greater risk than the general
    public from exposure to drinking water contaminants. These sensitive subpopulations
    include infants, children, pregnant women, the elderly, and people with weakened
    immune systems. The goal is to protect the people who are most sensitive to each
    contaminant and assure that the health of children is protected.
    The principles of environmental justice—that all people must have the opportunity to
    live in a healthy environment and that environmental laws apply without discrimination
    based on race, ethnicity, culture, or economic status—guide EPA's efforts to increase
    and improve access to education programs for the poor, immigrants, and ethnic and
    racial minorities. A great many EPA children's health projects target urban environ-
    mental problems and tribal health threats.

         izAiioN of ihis REPORT

The EPA Children s Environmental Health Yearbook is meant to be a resource guide of
EPA activities for the public and a tool for the Agency to use in protecting children's health
from environmental hazards. The Yearbook includes sections on asthma and other respi-
ratory effects; childhood cancer; developmental and neurological toxicity; health effects of
pesticides; and potential risk from contaminated surface water and ground water. Addi-
tional chapters describe improvements in predicting health risks to children, highlight
international activities to protect children, identify environmental education programs
addressing issues of children's health, and describe EPA's expansion of individual's and
families' right-to-know about environmental hazards.
Each chapter outlines EPA efforts to address potential environmental health threats. EPA
projects may relate to more than one health effect or risk. For instance, even though most
of the environmental tobacco smoke projects are summarized in the chapter on asthma
and respiratory effects, the same projects are also relevant to the childhood cancer chapter.
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                                             EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
The brief descriptions of EPA projects include contacts for more information. The final
section directs readers to additional EPA resources for more information.
The Yearbook identifies areas where research has established a link between a harmful
health effect and exposure to a contaminant.  Two examples are the effect of lead on the
brains of young children and of nitrates on the oxygenation of infants. The Yearbook also
includes a discussion of environmental contaminants where a link between exposure and
adverse health effects may only be suspected in children—not proven, especially at the
low levels of contamination generally found in the environment.  Harmful effects from
exposure to contaminants during childhood might not manifest themselves until later in life.
EPA is focusing significant attention on protecting children's health, as demonstrated in this
Yearbook. However, much basic and applied research remains to be done to establish or
refute links between exposure to environmental factors and specific health effects. EPA is
conducting research to better understand and prevent environmental health risks.
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REfERENCES

1.  SOCMA. Undated. Fact Sheet: The Batch Chemical Industry. Synthetic Organic
   Chemical Manufacturers Association, Washington, DC.
2.  CDC. 1995. Vital and Health Statistics, National Hospital Discharge Survey: Annual
   Summary, 1993 (U.S. Department of Health and Human Services, Public Health
   Service, National Center for Health Statistics). Department of Health and Human
   Services, Publication Number PHS 96-1782. August 1995. Centers for Disease
   Control and Prevention.
3.  CDC. 1995. Vital and Health Statistics, National Hospital Discharge Survey: Annual
   Summary, 1994 (U.S. Department of Health and Human Services, Public Health
   Service, National Center for Health Statistics). Department of Health and Human
   Services, Publication Number PHS 96-1521. December 1995. Centers for Disease
   Control and Prevention.
4.  CDC. 1996. Asthma Mortality and Hospitalization Among Children and Young
   Adults, 1980-1993. Morbidity and Mortality Weekly Report. Volume 45, Number
   17, Pages 350-353.  May 3.
5.  Weiss, K.B., P.J.  Gergen, and T.A. Hodgson.  1992. An Economic Evaluation of
   Asthma in the U.S. New England Journal of Medicine. Volume 326, Pages 862-866.
   March 26.
6.  NCI. 1997.  SEER Cancer Statistics Review, 1973-1994. U.S. Department of
   Health and Human Services.  National Cancer Institute. NIH Publication Number 97-
   2789, page 457.
7.  Devesa, S.S.,W.J. Blot,B.A. Miller, R.E. Tarove, and J.F. Fraumeni,Jr.  1995.
   Recent Cancer Trends in the United States. Journal: National Cancer Institute.
   Volume 87, Pages 175-182.
8.  NRC. 1993. Pesticides in the Diets of Infants and Children. National Research
   Council. Washington, DC: National Academy Press.
9.  ILSI. 1992. Similarities and Differences between Children and Adults: Implications
   for Risk Assessment.  International Life Sciences Institute, Washington, DC: ILSI Press.
10. FR.  1997. National Ambient Air Quality Standards for Particulate Matter, Final Rule.
   Federal Register 62(138), Pages 38651-38701, July 8.
11. FR.  1997. National Ambient Air Quality Standards for Ozone, Final Rule. Federal
   Register 62(138), Pages 38856-38896, July 8.
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                      HADTER  2
    ThE EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook

 ASTHMA  ANC]  OT^ER

RESpiRATORy  EFFECTS
               * ~
                       Asthma is a narrowing of the airways in the lung that produces difficulty in breathing.
                       Asthma attacks are commonly set off by "triggers" in children who have a genetic or
                       acquired predisposition to the disease. Several major triggers are household dust mites
                       (microscopic insects that live on dust), certain foods, lung and upper airway irritants (such
                       as cigarette smoke, smog, soot, and pollen), strong fumes, respiratory infections, cold or
                       windy weather conditions, and, occasionally, emotions or exercise that cause deep or
                       rapid breathing.( 1) The triggers may set off a chain of reactions leading to a narrowing of
                       the airways in the lung and inflammation of mucus membranes. These reactions, in turn,
                       cause coughing, wheezing, chest tightness, shortness of breath, and increased risk of
                       respiratory infections. Asthmatic episodes may last for hours or several days, and se-
                       verely restrict the ability of a child to live a normal life.
                             Childhood Asthma Facts

* An estimated 4.8 million children under 18 years of age have asthma and many more have hidden, or undiag-
 nosed, asthma.(2,3)
* Asthma is the leading chronic illness in children of the United States and the leading cause of school absenteeism
 due to chronic illness.(4)
* Six hundred children die each year from asthma, and 150,000 are hospitalized.(5)
* From 1980 to 1993, the death rate for childhood asthma in the United States increased by 78 percent.(5)
* Asthma treatment cost an estimated $6.2 billion in 1990.(6)
* Asthma-related hospitalizations have risen disproportionately for inner-city children, and in particular for minority
 populations.(7,8)
                       Childhood asthma is a disorder with genetic predispositions and a strong allergic compo-
                       nent. Approximately 75 to 80 percent of children with asthma have significant aller-
                       gies.(1) Allergens, such as household dust mites, tobacco, pet dander, insects, molds, and
                       pollen, are substances that may trigger allergic reactions and subsequent asthma attacks.
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            ENVIRONMENTAL FACTORS
Poor indoor and outdoor air quality have been linked with asthma symptoms as well as
with other respiratory problems, such as an increased frequency of respiratory infections,
bronchitis, and pneumonia in children. (8)
        AiR PolluTAINTS
People in industrialized nations spend 90 percent of their time indoors.(9) The home,
school, and daycare center where children spend most of their time are the locations of
highest concern for exposure to indoor air pollutants. A recent series of Government
Accounting Office (GAO) reports found that both new and old primary and secondary
school buildings need rehabilitation. Older buildings often contain materials with hazardous
substances, such as asbestos and lead. Newer buildings and furnishings may contain
formaldehyde and strong fumes. Several of the most common indoor air pollutants in
homes, schools, and daycare centers are described below.
Environmental Tobacco Smoke  (Secondhand Smoke)
The Centers for Disease Control and Prevention's (CDC) National Center for Environmental
Health reports that 43 percent of children, two months through 1 1 years of age, live in a home
with at least one smoker. (10) Children who live with smokers involuntarily inhale many pollut-
ants in smoke. Environmental tobacco smoke (ETS), also known as secondhand smoke, is a
complex mixture of more than 4,000 chemicals, including carbon monoxide, nicotine, tars,
formaldehyde, and hydrogen cyanide.(l 1) Several of these chemicals are known human
carcinogens or respiratory irritants.( 1 2)
Children exposed to ETS tend to have more bronchitis, pneumonia, respiratory infections, otitis
media (fluid in the middle ear), and asthma symptoms.( 1 3) The frequency of infection depends
directly on the amount of smoke in the home. Children who live with two smoking parents have
more respiratory infections than children who live with one smoking parent. The lowest rates of
respiratory infections and asthma are found in children of parents who do not smoke at all.
Maternal smoking during pregnancy is associated with an increased incidence of Sudden Infant
Death Syndrome.(13,14,15)
EPA estimates that between 150,000 and 300,000 cases of lung infections, such as bronchitis
and pneumonia, that occur annually in infants and young children up to 1 8 months of age may
be attributed to exposure to ETS. Of these, 7,500 to 15,000 will result inhospitalization.(13)
ETS exposure aggravates the condition of between 200,000 and 1 ,000,000 asthmatic chil-
dren. (14) EPA has found that ETS increases fluid in the middle ear, a sign of chronic middle ear
disease, the most common cause ofhospitalization for surgery in children.(l 3)
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                                             EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
The CDC estimates that children exposed to tobacco smoke in their homes have 18 million
more days of restricted activity, 10 million more days ofbed confinement, and miss 7 million
more school days annually than other children, primarily due to acute and chronic respiratory
conditions.(16)
Allergens
Allergens, especially those containing biological matter, such as house dust mites, cockroaches,
pet dander, pollen, molds, spores, bacteria, and viruses, are known to cause or aggravate
asthma.(l) Allergic reactions often combine with and seriously aggravate the symptoms of
asthma, the common cold, pneumonia, and other conditions. Allergens also may cause eye,
nose and throat irritation, shortness ofbreath, dizziness, lethargy, and fever.
Volatile Organic Compounds
Volatile organic compounds (VOCs) are chemicals that can volatilize (evaporate) from
substances, such as cleaning products, adhesives, paints, dry-cleaning fluids, and wood
preservatives.(17) VOCs can be emitted from these products into the air and may be
trapped indoors, especially in tightly sealed buildings. An EPA study of six communities in
various parts of the United States found that indoor levels of VOCs are up to ten times
higher than outdoor levels. Symptoms of VOC exposure may include eye, nose and lung
irritation, rash, headache, nausea, vomiting, and asthma. Exposure to some VOCs, such
as benzene and vinyl chloride, may cause cancer.
Formaldehyde, a common VOC, is a colorless, strong-smelling gas used in pressed wood
(particle board, fiberboard, and plywood), paints, coatings, cosmetics, fabrics, and insula-
tion materials.(l 8) Formaldehyde is released into the air from these products as well as
from burning wood, kerosene, or natural gas, and from automobiles and cigarettes. Formal-
dehyde causes cancer in laboratory animals and is considered by EPA to be a probable
human carcinogen. Although formaldehyde affects people differently, it may irritate the eyes,
nasal sinuses, throat, and lungs, and may trigger asthma. Children and adults have devel-
oped allergic reactions, including hives, from exposure to the gas.
Nitrogen Oxides
Nitrogen oxides are more often thought of as outdoor air pollutants emitted by motor
vehicles and fossil-fuel burning power plants, but they also are found indoors. Inadequately
vented gas ranges, gas pilot lights, gas or kerosene heaters, and welding activities, as well as
tobacco smoke, contribute to nitrogen oxides in indoor air. Because they are potent respira-
tory irritants, they may aggravate asthma and other respiratory diseases.(19)
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Carbon Monoxide
Carbon monoxide is a colorless, odorless gas produced from the incomplete burning of
virtually any combustible product. It may accumulate indoors as a result of tobacco smoking,
poorly ventilated appliances, and attached garages.
Carbon monoxide enters the blood from the lungs and combines with hemoglobin, blocking
the blood's ability to carry oxygen to body cells. Symptoms of carbon monoxide exposure
may mimic influenza and include fatigue, headache, dizziness, nausea and vomiting, mental
confusion, and rapid heart rate. Depending on the level of exposure, carbon monoxide can
be immediately fatal.  Long-term, low-level exposures to carbon monoxide by pregnant
women have the potential to injure the developing fetus.(20)

OuidoOR AiR PolluTAINTS

Urban air pollution appears to be a contributor to current increases in asthma incidence. In
1995, thirty-three percent of the U.S. population lived in counties that did not meet EPA air
quality standards for ozone (the principal component of smog), carbon monoxide, nitrogen
dioxide (one of the nitrogen oxides), sulfur dioxide, particulate matter (soot), andlead.(21)
Although any of the outdoor air pollutants may play a role in increased asthma attacks,
ozone is the pollutant consistently associated with aggravating the disease. High ozone
levels also are associated with a reduction in lung function in children without asthma.(22)
The American Lung Association determined that children with asthma are 40 percent more
likely to suffer asthma attacks on high-pollution days compared to days with average
pollution levels.
A recent study linked exposure to particulate matter with an increased risk of death to
newborns from respiratory problems and Sudden Infant Death Syndrome.(23)
Children are especially vulnerable to the effects of ozone and particulate matter.(24,25)
Except for the very young,  children typically spend more time outdoors than do adults,
especially in the summer when ozone and particulate levels are the highest. Children also
spend more time engaged in vigorous activity, which results in more outside air being taken
into their lungs. Their activity, combined with the higher breathing rate of children relative
to their body weight and lung surface area, results in a greater dose of pollutant delivered
to their lungs. Air pollution that would produce only slight breathing difficulties in an adult
may contribute to a more serious breathing problem in a young child because children have
smaller airways.
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                     SUMMARY of EPA AcrivmEs

                            iNq hdooR A!R QuAliiy (IAO)
                     EPA has joined with numerous nonprofit organizations, states, and educational systems to
                     develop indoor air quality programs that offer workshops, distribute educational materials,
                     and conduct media campaigns, home audits, and school inspections. EPA has developed
                     an easy-to-use guide called the Indoor Air Quality (IAQ) Tools for Schools Action Kit.
                     The kit empowers schools to carry out a practical plan of action to prevent and resolve
                     indoor air quality problems at little or no cost using simple activities and in-house staff.
                     Extensive efforts are underway by EPA regional offices to distribute thelAQ Tools for
                     Schools materials and assist schools in implementing an IAQ program.
                     Many national advocacy organizations are promoting the kit as an easy and effective
                     program for minimizing adverse health effects. With more than 20,000 kits distributed
                     nationwide since 1 996 to kindergarten through high schools, strong support for the
                     program has been voiced by state departments of education and health. Several state
                     legislatures are using the kit as a guide to develop indoor air quality standards in schools.
                     To determine whetherlAQ Tools for Schools is improving air quality, EPA is measuring
                     changes in symptoms, staff perceptions of the quality of indoor air, reductions in pollutant
                     levels, and improvements in ventilation system performance. Participating schools un-
                     dergo before-and-after testing over a one-year period.  Throughout the year, EPA
                     monitors the progress of specific activities, as well as their costs.
                     EPA also is working with the American Lung Association to implement the Open Airways
                     program among high-risk, inner-city minority children who have higher-than-average
                     asthma death rates. The Open Airways curriculum teaches children to manage their own
                     symptoms and has been completed by over 22,000 children. This year, Open Airways
                     training will be combined with thelAQ Tools for Schools program. Training will result in
                     an additional 25,000 children graduating from the Open Airways program and 1 ,500
                     schools implementing thelAQ Tools for Schools guidance.
                     EPA is collaborating with the U.S. Department of Health and Human Services to educate
                     the public about the dangers of ETS and has embarked on a national public education
                     campaign designed to reduce children's exposure to ETS. EPA has enlisted the help of
                     daycare operators and pediatricians in educating parents about the dangers of ETS in the
                     home. They also are teaching parents about techniques for avoiding exposure to sub-
                     stances that may trigger asthma and other respiratory illnesses.
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Although much is known about typical childhood activity patterns, less is known about the
physical characteristics of children's lungs that make them more susceptible to the effects
of airborne pollutants. EPA is conducting various studies to improve the understanding of
this relationship.

livipROviNq OuidooR A!R QuAliiy
EPA's efforts to control outdoor air pollution are focused on protecting everyone, including
children, from the harmful effects of ozone, particulate matter, and toxic substances. The
Agency develops standards that set safe limits for the most prevalent air pollutants, and
works with the states to implement those standards. In July 1997, the Clinton Administra-
tion strengthened the ozone standard from 120 parts per billion (ppb) averaged over one
hour to 80 ppb averaged over eight hours. This new limit was proposed to respond to
scientific evidence that previous standards, established 20 years ago, do not adequately
protect sensitive populations such as asthmatics and children, from the effects of ozone.
These new regulations also established standards for fine airborne particles for the first
time.  EPA estimates that the new standards will save at least 15,000 lives per year and
protect an additional 35 million children.
EPA's regional offices have begun various outreach efforts to emphasize the increased
susceptibility of children to certain air pollutants—particularly ground-level ozone. These
efforts include daily Internet postings on predicted air quality ratings, health effects fact sheets
(available in several languages), and media campaigns. The air in schools in industrial areas is
being monitored to further identify and measure air contaminants.
EPA is measuring the impact of outdoor air pollutants on the physical development of
children.  For example, the Agency is investigating the effects of inhaling ground-level
ozone, fine particulate matter, and other air pollutants over a long time. Other research
efforts include examining the effects of air emissions from fossil fuel combustion and
residential wood-burning, and identifying effects of air toxics on pregnancy.

EPA  PROJECTS  ON  ASTHMA ANC! OT^ER REspiRATORy EffEcrs

hdooR A!R QuAliiy (IAQ) Tools FOR Schools
Title:          Indoor Air Quality Tools for Schools
Description:    EPA has developed/^ £> Tools for Schools, an easy-to-use guidance
              intended to empower schools to prevent and resolve IAQ problems at little
              or no cost using simple activities and in-house staff. More than 20,OOOIAQ
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              Tools for Schools kits have been distributed nationwide since 1996. The
              program is directed from EPA headquarters through agreements with a
              number of associations, such as the National PTA, American Association
              of School Administrators, and National Education Association. EPA's
              regional offices have active implementation programs as well.
Partners:       National PTA, National Education Association, Association of School
              Business Officials, Council for American Private Education, American
              Federation of Teachers, and American Lung Association
Contact:       Office of Air and Radiation, John Guevin, 202-564-9055


Title:          American Association of School Administrators
Description:    EPA is working cooperatively with the American Association of School
              Administrators (AAS A) to enable schools to prevent and resolve IAQ
              problems using thelAQ Tools for Schools Action Kit. This proj ect
              includes training courses, IAQ sessions during workshops and conferences,
              and articles in newsletters to educate administrators about IAQ problems
              and solutions, as well as how to implement an IAQ program using in-house
              school staff. AAS A will conduct periodic surveys during the project to
              assess the administrators' understanding of IAQ and problem resolution.
Partners:       American Association of School Administrators
Contact:       Office of Air and Radiation, Susan Dolgin, 202-564-9048


Title:          National Education Association
Description:    The National Education Association Health Information Network (NBA
              HIN) and EPA are supporting NEA's 2.2 million members in improving
              the management of IAQ in schools and homes. Under NEA's training
              program, 51NEA members and 16 union liaisons were trained in school
              IAQ management. Trainees and workshop participants are currently
              working with 38 school districts and 32 schools to implement EPA's IAQ
              Tools for Schools.
Partners:       National Education Association
Contact:       Office of Air and Radiation, Matt Hiester, 202-564-9459
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TMe:          National Parent Teachers Association
Description:    The National Parent Teachers Association (NPTA) and EPA are working
              cooperatively to support the participation of over 6.5 million PTA mem-
              bers in the environmental management of homes, schools, communities,
              and ecosystems. Sixteen state PTA leaders were trained on school indoor
              air quality, air pollution, water pollution, drinking water quality, hazardous
              materials, emergency planning, radon exposure, pesticides, solid waste,
              and lead poisoning. These trainees have secured commitments from 71
              other PTA members to encourage their school district to implement EPA's
              IAQ Tools for Schools Action Kits in addition to other efforts. An
              additional 36 state PTA leaders received comprehensive environmental
              training in August 1997.
Partners:      National Parent Teachers Association
Contact:       Office of Air and Radiation, Tracy Washington-Enger, 202-564-9484
Title:          Regional IAQ Tools for Schools Programs
Region 1:      The Region has distributed//^ Tools for Schools to more than 1,000
              schools. Contact Mary Beth Smuts, 617-565-3232.
Region 2:      Working with the Environmental Sciences Training Center at Rutgers
              University, Region 2 is training school personnel, including nurses. Re-
              gional staff have developed a mentoring program for schools planning to
              implement the kit, and will accompany school personnel in building inspec-
              tions. Contact Rachel Chaput, 212-63 7-4001.
Region 3:      Region 3 is training maintenance workers in the Baltimore public schools.
              Participating schools will evaluate the effectiveness of the program. Con-
              tact Reggie Harris, 215-566-2988.
Region 4:      Together with the University of Tulsa, Region 4 presented five workshops
              attended by approximately 250 school officials, and distributed 1,400 kits.
              Contact Henry Slack, 404-562-9143.
Region 5:      A series of workshops have been held through grants to states and non-
              profit organizations, and regional staff developed a mentoring program for
              schools planning to implement the kit. Contact Phyllis Reed,
              312-886-6018.
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Region 6:     Approximately 300 school administrators, physical plant staff, school
             nurses, and public health officials from 103 school districts participated in
             seven one-day workshops.  Contact Joyce Stanton, 214-665-8377.
Region 7:     Workshops have been held throughout Region 7 to demonstrate the
             benefit of healthy indoor air in the school environment. Contact Tom
             Hogan, 913-551-7684.
Region 8:     The Region conducted a pilot program with North Dakota and S outh
             Dakota to provide workshops. In Montana, 357 schools are implement-
             ing the program. Contact Kathleen Craig, 303-312-6031.
Region 9:     Region 9 is providing outreach material and workshops, and is developing
             a pilot demonstration project in Alameda County, California, in coopera-
             tion with county health officials, school administrators, and health profes-
             sionals. Contact Barbara Spark, 415-744-1132.


Title:         Urban Schools Initiative
Description:   The Urban Schools Initiative demonstrates how significant IAQ problems
             in an urban school can be cleaned up to reduce health risks and improve
             the learning environment for children. Planned structural improvements at
             a school in Washington, DC, include removal and replacement of moldy
             walls and ceilings, ventilation system repairs and upgrades, abatement of
             lead-based paints, repair of steam system and plumbing leaks, and
             replacement of moisture-damaged windows. Changes resulting from IAQ
             improvements will be measured at the beginning and end of the project.
             Training of all DC school facilities managers on EPA?sIAQ Tools for
             Schools is an integral part of the initiative.
Partners:      Washington, DC public school system
Contact:      Office of Air and Radiation, Bob Thompson, 202-564-9056


Title:         School Intervention Study
Description:   The School Intervention Study will provide a measure of the effectiveness of
             EPAtsIAQ Tools for Schools guidance in improving the management of
             school buildings for better IAQ. Success measures include problem
             prevention activities, changes in staff symptoms and perceptions of indoor
             air quality, pollutantreduction, and ventilation systemimprovements.
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              Before-and-after testing is being conducted in several schools and costs will
              be monitored over a one-year period.
Contact:       Office of Air and Radiation, Brian Ligman, 202-564-9432


Title:          American Lung Association Open Airways
Description:    The American Lung Association is promoting EPA's IAQ Tools for
              Schools along with their Open Airways curriculum, which teaches asth-
              matic elementary school children to manage their own asthma. The
              program emphasizes inner-city children with higher than average death
              rates. The American Lung Association is developing an integrated training
              program in which 15 master trainers will train 250 other trainers who will
              then train 5,000 local volunteers. Project directors estimate that this
              combined program will result in 25,000 children graduating from Open
              Airways and 1,500 schools fully implementing the IAQ Tools for Schools
              guidance. The program has enhanced asthma management skills of
              children and their parents, reducing the frequency of asthma attacks.
              Several regions are translating Open Airways into Spanish. Additionally,
              local American Lung Associations purchased over 5,000 EPAIAQ Tools
              for Schools kits last year to promote in schools.
Partners:       American Lung Association, Zeta Phi Beta Sorority
Contact:       Office of Air and Radiation, Denise Settles, 202-564-9704; Office of
              Enforcement and Compliance Assurance, Marty Halper, 202-564-2601


Title:          Training School Nurses in Open Airways andlAQ Tools for Schools
Description:    EPA, along with the New York State American Lung Association
              (ALANYS), has taken advantage of the need for school nursing recertifica-
              tion by incorporating training in Open Airways andlAQ Tools for Schools
              into the recertification requirements. School nurses are trained and then
              encouraged to conduct training in these two programs within their own
              schools. Over 75 percent of the school nurses in New York State, outside
              of New York City (1,526), have been trained. Nearly 180 nurses requested
              the Open Airways kit and more than 70 school nurses have completed at
              least partial implementation of the program within their schools.
Partners:       New York State American Lung Association
Contact:       Region2, Rachel Chaput, 212-637-4001
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                      ElNViRONMEINTAl TobACCO SlVlokE (SECONdllANd
Title:         ETS Media Campaign
Description:   EPA, the Consumer Research Council, and the American Medical Associa-
             tion are working together to develop, disseminate, and promote a public
             communications campaign designed to reduce children's exposure to ETS.
Partners:      Consumer Research Council and the American Medical Association
Contact:      Office of Air and Radiation, Bill Long, 202-564-9733


Title:         Reducing Exposure to ETS through Child Care Outreach
Description:   EPA is implementing training developed by the Pennsylvania Chapter of
             the American Academy of Pediatrics (AAP-PA) in at least five state
             systems this year. The program trains daycare center operators on the
             risks to children from exposure to ETS at home. The AAP-PA has
             provided professional credits to 160 providers who passed an exam and
             implemented the program, resulting in an estimated 1,920 families who
             have reduced their children's risk from ETS.
Partners:      American Academy of Pediatrics Pennsylvania Chapter and National
             Resource Center for Health and Safety in Child Care
Contact:      Office of Air and Radiation, Bill Long, 202-564-9733


Title:         Community-Based Pediatrician Outreach
Description:   The American Academy of Pediatrics (AAP) is collaborating with EPA to
             develop and promote the use of public information materials on the risks
             of ETS and other indoor air pollutants. A speaker's kit for pediatricians
             to use in community-based risk reduction efforts is being developed. The
             kit is designed to communicate the health risks to children from involun-
             tary exposure to ETS. The program's goal is to have 150 pediatricians
             participate in community-based risk reduction projects using these
             materials.
Partners:      American Academy of Pediatrics
Contact:      Office of Air and Radiation, Bill Long, 202-564-9733
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TMe:
Region 1 :
Region 2 :
Region 4:
Region 7:
      Indoor Air Environment Program for Children
      With the American Lung Association and the Asthma and Allergy Founda-
      tion, Region 1 is developing home-audit checklists on asthma and carbon
      monoxide dangers and prevention. They also have developed and imple-
      mented the Program on Asthma and Clean Air for Day care Providers.
      Five workshops have been held, reaching 125 daycare operations. Con-
      tact Mary Beth Smuts, 6 1 7-565-3232.
      With the American Lung Association, Region 2 is implementing the Child
      Care Outreach project in New York State. The project reaches house-
      holds with children under six through daycare centers to reduce the
      number of households in which children are regularly exposed to tobacco
      smoke. Contact Larainne Koehler, 212-637- 4005.
      An outreach program for parents of young children and other care givers
      in Region 4 will reduce ETS exposure of 500,000 children in two states.
      Materials will be distributed to daycare centers, new parents, preschools,
      radio stations, and other forums.  Contact Henry Slack, 404-562-9 1 43 .
      In cooperation with the American Lung Association of Kansas and the
      Kansas Department of Health and Environment, the Region will implement
      the Child Care Outreach project and provide 10,400 child care centers
      with educational materials about the hazards of ETS . Contact Tom
      Hogan, 9 13-55 1-7684.
      In cooperation with the American Lung Association, Region 8 is imple-
      menting the Child Care Outreach project and has developed a required
      training program on indoor air quality and ETS for daycare center provid-
      ers applying for state certification. Contact Lon Hesla, 303-312-6024.
      Region 9 is working with the American Lung Association to promote use
      of the Child Care Outreach and Secondhand Smoke Education Projects
      by daycare providers . Contact Louise Hill, 415-744-1046.


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             organization, is reaching out to the community in several inner-city areas
             within New York City. Through an interactive dialog between the scien-
             tists and community, environmental issues of concern will be identified.
             Environmental testing and monitoring will be done where necessary to
             accumulate relevant exposure data.
Partners:      Columbia University School of Public Health and West Harlem
             Environmental Action Group
Contact:      Region 2, Rachel Chaput, 212-63 7-4001


Title:         "Breathe Easier" Support
Description:   Working with the Dimmock Community Health Center in Dorchester,
             MA, EPA has supported the establishment of an asthma educational
             outreach initiative, Breathe Easier. Conducted by community health
             activists and teen leaders, the project is directed toward children with
             asthma in four public housing units. Educational tools developed through
             this program include a video and an information packet on asthma. These
             materials address what to do during an asthma attack, how to properly
             take medication, and how to identify asthma triggers.
Partners:      Dimmock Community Health Center
Contact:      Region 1, Lois Adams, 617-565-3487


Title:         AmeriCorps Outreach on Asthma
Description:   EPA Region 1 is training AmeriCorps workers to provide asthma and
             carbon monoxide home inspections for inner-city families. Forty
             AmeriCorps volunteers will conduct the inspections for families with
             young children and provide them with "asthma control bedding" and
             carbon monoxide detectors as needed. AmeriCorps staff also provide
             environmental education to fourth- and fifth-grade classrooms and to
             after-school students.
Partners:      AmeriCorps and County Occupational Safety and Health Departments
Contact:      Region 1, Mary Beth Smuts, 617-565-3232
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TMe:          "Home Cleaning for Asthma Attack Control" Program
Description:    EPA Region 7 is working with the American Lung Association of Eastern
              Missouri (ALAEM) to implement the "Home Cleaning for Asthma Attack
              Control" program. ALAEM is developing a workbook showing
              step-by-step actions to remove the precursors, or triggers, that commonly
              cause asthma attacks. The workbook will be oriented to low-income
              apartment dwellers and home owners with school-age children. ALAEM
              also plans to develop a video that will follow the outline of the workbook,
              demonstrating and further explaining its recommendations.
Partners:       American Lung Association of Eastern Missouri
Contact:       Region?, TomHogan, 913-551-7684


Title:          Asthma Outreach and Education in the Bronx
Description:    The New York City Chapter of the American Lung Association
              (ALANY) is under a grant to provide asthma outreach and education at
              eight of the nine hospitals in the Bronx, NY This program includes the
              education of asthmatic children and their caretakers in this high-asthma
              area. ALANY has given several training sessions to child care providers,
              such as Head Start workers, and has distributed limited asthma manage-
              ment equipment within a public school.
Partners:       New York City Chapter of the American Lung Association
Contact:       Region2, Rachel Chaput, 212-637-4001


Title:          Cockroach Movement and Allergen Distribution in Inner-City Apartments
Description:    This research will provide information on where cockroaches are most
              often found in apartment buildings, what factors are related to their move-
              ment patterns, and how cockroach-related allergens (strongly associated
              with provoking asthma) are distributed throughout buildings based on
              movement of the insects. Patterns of cockroach movement have been
              investigated in some settings, but not in inner-city apartment buildings,
              where asthma prevalence in children is high.
Partners:       Columbia University
Contact:       Region2, Rachel Chaput, 212-637-4001
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Title:         Asthma Conference in New York City
Description:   EPA Region 2 is co-funding an asthma conference at the New York
             Academy of Medicine in New York City on May 4-5,1998, with the
             Centers for Disease Control and Prevention. The conference will address
             asthma issues in the inner-city and explore ways to improve communica-
             tions among the communities needing assistance and the scientific and
             health-care communities.
Partners:      Centers for Disease Control and Prevention, Center for Urban Epidemio-
             logical Studies at the New York Academy of Medicine
Contact:      Region 2, Rachel Chaput, 212-63 7-4001


Title:         Puerto Rico Department of Health Asthma Projects
Description:   Asthma is a serious issue in Puerto Rico, based on a series of epidemio-
             logical studies. Region 2 is supporting an Asthma Coordinator at the
             Puerto Rico Department of Health and will fund an environmental allergen
             study in Catano, Puerto Rico, in cooperation with the University of Ponce
             Medical School. Measurements of the standard environmental allergens
             (dust mite, cockroach, cat) will be made in the homes of asthmatic
             children along with measurements of heavy metals and other substances of
             interest, such as bacterial endotoxin thought to be a lung irritant.  The
             measurements will be conducted in 150 houses and will be complemented
             by an indoor air quality survey in the homes, and allergenic skin testing for
             the asthmatic children. This project will provide information on the levels
             of known allergens and irritants in homes in Catano and will possibly
             show associations with the asthmatic children's asthmatic profiles.
Partners:      Puerto Rico Department of Health, University of Ponce Medical School
Contact:      Region 2, Rachel Chaput, 212-63 7-4001


Title:         Environmental Interventions for Asthma
Description:   Many indoor environmental substances, particularly allergens, may
             prompt asthma attacks. The prevalence of asthma is particularly high in
             inner-city children. EPA and the Einstein College of Medicine will conduct
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              a study to examine ways to reduce dust mites, cockroaches, rodents,
              environmental tobacco smoke, molds, and pet dander in the inner city.
Partners:      Einstein College of Medicine
Contact:      Region 2, Rachel Chaput, 2 12-637-400 1
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Title:          Asthma Assessment
Description:    The National Academy of Science is collecting and analyzing available
              literature to determine the specific effects of indoor pollutants on asthma
              illnesses and death. The study will include both a general evaluation of
              asthma and indoor air quality and an analysis of the effects of individual
              indoor air pollutants on asthma, with special consideration for children.
              The project will determine the best methods to reduce exposures to indoor
              air pollutants that can cause or trigger asthma episodes. EPA will use the
              information to improve public outreach, including teaching children, par-
              ents, and school administrators about the benefits of reducing exposures to
              asthma triggers in homes and schools.
Contact:       Office of Air and Radiation, Tracey Mitchell, 202-564-9446


Title:          Allergens in the Development of Asthma in Children (Studied in
              Immature Rats)
Description:    Allergic asthma most often develops in young children. Children may
              become more easily sensitized to common allergens because of differences
              in their immune response compared to adults. Researchers will use an
              established model of pulmonary allergy to house dust mites in rats to
              examine whether newborn rats become more readily sensitized to antigens
              (leading to an allergic response) compared to juvenile and adult animals.
              Further studies will investigate whether pre-exposure to viruses, air pollut-
              ants, and pesticides influence susceptibility to allergic lung disease.
Contact:       Office of Research and Development, Hillel Koren, 9 1 9-966-6200
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                       Title:          Environmental Influences on Asthma in Children
                       Description:    A population of wheezing children was recruited from a pediatric practice
                                     in Raleigh, NC. The clinical and allergic status of these children was
                                     documented and compared with children without asthma symptoms.
                                     Concentrations of various allergens were measured in the children's
                                     homes. Analysis of the data is underway.
                       Contact:       Office of Research and Development, Hillel Koren, 919-966-6200
OuidooR A!R QuAliiy


Title:          New National Ambient Air Quality Standards for Ozone and Fine Particles
Description:    EPA's new ozone standards respond to scientific evidence that the previous
              standards were not adequate to protect the health of certain sensitive
              populations (such as asthmatics) and healthy individuals (including children)
              from the effects of ozone and fine particulates. Selected research reviewed
              for the proposed standard included studies of children in summer camps.
              The fine particles standard responds to evidence that particles 2.5 microns
              or less in size are a significant health threat to adults and children, with
              studies showing more frequent and serious attacks of asthma in children.
Contact:       Office of Air and Radiation, Sally Shaver, 919-541 -5551


Title:          Ozone Outreach Proj ect
Description:    EPA Region 1 undertook a comprehensive ground-level ozone outreach
              project, advising stakeholders and the public on air quality in the region.
              Activities stress the increased susceptibility of children to certain pollut-
              ants, particularly ground-level ozone. Outreach includes daily postings on
              the Internet of a color map detailing the predicted air quality rating for the
              following day for Region 1 areas (http://www.epa.gov.regionOl/eco/
              ozone), fact sheets and brochures on ozone and health effects, a confer-
              ence on Clean Air and Public Health in July, television and radio mes-
              sages, and press releases on days with unhealthy air.
Contact:       Region 1, David Conroy, 617-565-3255
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TMe:          Enforcement Program for Hazardous Air Pollutant Emissions
Description:    Facility inspection, compliance, and enforcement efforts are targeted at
              sources emitting hazardous air pollutants, particularly in populated areas.
              These facilities may contribute to increased incidences of childhood
              cancer. EPA is developing air toxics standards on which the associated
              regulations can be enforced, and that will provide for adequate monitor-
              ing, record keeping, and reporting requirements.
Contact:       Office of Enforcement and Compliance Assurance, Charlie Garlow,
              202-564-1088
Title:          Asthma Outreach Initiative
Description:    EPA Region 5 developed an Asthma Initiative to alert people with asthma,
              parents of children with asthma, and the elderly to the health hazards of
              ground-level ozone and its importance as an asthma trigger. The initiative
              also seeks to reduce asthma attacks during the ozone season.  EPA
              published and distributed 150,000 brochures (Ozone Action Days: A
              Special Alert for People with Asthma and Other Respiratory Problems) to
              schools, doctors, hospitals, libraries, and pharmacies. Approximately
              400,000 copies will be distributed in expanded areas. The Region also
              developed a Spanish-language brochure to be distributed in Hispanic
              communities and is developing an Arabic version.
Partners:      Local schools and public health community
Contact:       Region 5, Cheryl Newton, 312-353-6730
Title:          Air Sampling Project, Winton Hills, Ohio
Description:    Using a network of air monitors, EPA is conducting an air toxics study to
              identify and quantify ambient air contaminants in the Winton Place and
              Winton Hills communities of Cincinnati, Ohio. This study, which was
              developed with the assistance of community and industry representatives,
              will expand on the air toxics monitoring network currently maintained by
              the Hamilton County Department of Environmental Services. All of the
              monitoring sites will be in the Winton communities, which are close to
              heavy industry. Three sites involve Cincinnati public schools. Data
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              collected from the study will provide detailed air quality information for
              these communities and will be used to investigate reductions in community
              exposure, including enforcement if appropriate.
              Hamilton County, Ohio
              Region 5, Brian Barwick, 312-353-6730
                      Partners:
                      Contact:
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Title:          Total and Regional (Area) Deposition of Inhaled Particles in Children
Description:    EPA is determining whether children (ages 6-18) can accumulate more
              fine particles (soot) in their lungs than adults. The study also will deter-
              mine the extent to which age-related differences in lung size, function, and
              breathing patterns can influence the amount of soot that accumulates in the
              lungs of children and adults. Additional studies will include the accumula-
              tion of coarse particles in children (ages 5-18) as compared to adults.
Contact:       Office of Research and Development, Hillel Koren, 919-966-6200


Title:          Contributions of Oral versus Nasal Breathing to Fine Particle Deposition
              in Children
Description:    Studies will determine whether breathing through the mouth versus
              through the nose influences the amount of fine particles (soot) that accu-
              mulates in the lungs of children and adults. In conjunction with these
              measurements, an assessment of the relative contributions of mouth versus
              nasal breathing at rest and during exercise in children will be made for
              comparison with adults.
Contact:       Office of Research and Development, Hillel Koren, 919-966-6200


Title:          Deposition of Air Pollutants in the Developing Human Lung
Description:    EPA is developing a mathematical model to predict the amount of fine
              particulate matter (soot) that will accumulate in the developing human
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              lung. The model will account for humidity, temperature, age, and breathing
              rate as well as the relative distributions of particles in various lung areas.
Contact:       Office of Research and Development, Ted Martonen, 919-541 -7875


Title:          Childhood Susceptibility to Air Pollutants: Harvard-Mexico Studies
Description:   EPA is studying the effects of short-term exposures to particulate matter
              and ozone on disease and death in residents of Mexico City. Measure-
              ments include daily assessments of preschool and school-age children for
              symptoms of acute respiratory illness, and peak flow (a measure of lung
              capacity) in school age children. Records of emergency room use in acute
              care hospitals and daily death records are being collected. Acute respira-
              tory illness, peak flow, emergency room visits, and death are being exam-
              ined for any relationship with daily particulate matter or ozone exposure.
Partners:       Brigham Young University and Women's Hospital
Contact:       Office of Research and Development, Bill McDonnell, 919-966-6220


Title:          Lung Growth Study
Description:   EPA researchers are determining the effects of long-term exposure to
              ozone, fine particulate matter, and other pollutants on lung growth and the
              development of chronic respiratory illness in children in 12 southern
              California communities. Baseline lung function and symptom data will be
              compared with air monitoring information.
Partners:       University of Southern California
Contact:       Office of Research and Development, Bill McDonnell, 919-966-6220


Title:          Acute Respiratory Illness Study
Description:   The relationship between acute respiratory illness in school-age children and
              short-term exposure to particulate matter and ozone is being studied as part of
              the Lung Growth Study. School absences due to illness will be followed up
              with a telephone interview with parents, and the relationship between illnesses
              and short-term particulate matter and ozone exposure will be examined.
Partners:       University of Southern California
Contact:       Office of Research and Development, Bill McDonnell, 919-966-6220
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                      Title:
                      Description:
                      Contact:


                      Title:
                      Description:
DDQDD
QOQQD
                      Contact:
                      Title:
                      Description:


                      Contact:
Air Toxics and Pregnancy Outcome
This study will compare data from the Aerometric Information Retrieval
System (AIRS) database (which contains indices of ambient air pollution)
and vital statistics data, such as low birth weight, neonatal death, and fetal
death. EPA is currently examining data from the cities of Chicago, Denver,
and Los Angeles.
Office of Research and Development, Bill McDonnell, 919-966-6220


Childhood Susceptibility to Air Pollutants
A collaborative study is underway to determine whether children are more
susceptible than adults to nasal metaplasia (cancerous changes in cells),
and whether biochemical tests can detect the morphological (form and
structure) alterations caused by high ambient ozone and fine particulate
matter in Mexico City.
Office of Research and Development, Gary Hatch, 919-541-2658


Association between Ambient Ozone Concentration and Respiratory
Symptoms and Effects in German and Austrian School Children
This series of studies is designed to identify associations between levels of
ambient ozone and upper respiratory effects. Ambient concentrations of
ozone are monitored continuously from May to October. When a high or
low ozone episode is detected, nasal samples and respiratory symptoms
are measured in school children (ages 6 to 8). Preliminary results  suggest
a correlation between inflammation in the nasal cells and ambient levels of
ozone.
Office of Research and Development, Robert Devlin, 919-966-6255


Delivered Dose to Lungs in Infant versus Adult Rats
This study deals with a comparison of the amount of ozone delivered to
the lungs of infant versus adult rats as measured by radiolabeled isotopes
ofoxygen.
Office of Research and Development, Gary Hatch, 919-541-2658
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TMe:          Effects of Oxidants on Pulmonary Damage in the Very Young
Description:    This proj ect will confirm preliminary evidence that young rats are more
              sensitive to inhaled oxidant pollutants, such as ozone, than adult rats, as
              shown by increased lung injury and inflammation. The study also will
              examine the mechanisms underlying the increased sensitivity of young
              animals to ozone and other pollutants.
Contact:       Office of Research and Development, Robert Devlin, 919-966-6255


Title:          Characterization of Emissions from Home Wood Combustion
Description:    An obj ective of this study is to relate the possible health effects of wood
              combustion to sensitive subpopulations, such as children. This project will
              be completed through the use of field studies and laboratory measurements.
Contact:       Office of Research and Development, Robert McCrillis, 919-541 -2733


Title:          Link between Death Rates in Infants and Exposure to Particulate Air
              Pollution
Description:    EPA recently conducted a review to determine whether death in infants is
              linked with exposure to particulate matter (soot). Death records from the
              National Center for Health Statistics were combined with particulate
              matter levels from EPA's AIRS database. Among normal birth weight
              infants, high particulate matter exposure was associated with an increased
              incidence of death due to respiratory problems and Sudden Infant Death
              Syndrome (SIDS).
Contact:       Office of Policy, Tracey Woodruff, 202-260-6669


Title:          An X-Linked Genetic Susceptibility for SIDS and Respiratory Failures in
              Infancy
Description:    A World Health Organization/EPA epidemiological study has shown that
              there may be a genetic cause for SIDS and other respiratory failures in
              infancy. The presence of a dominant allele occurring with a frequency of
              one-third on the chromosome explains the 61.2 percent male and 38.8
              percent female sex distribution in these diseases and points to a defect in
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                     Contact:
anaerobic oxidation in the respiratory control centers of the brain stem as

the proximal cause of SIDS and infant respiratory death.

Office of Research and Development, David Mage, 919-541 -1327
ULUlU
uuuuu
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REfERENCES

1.   ALA. 1997. When You Can't Breathe, Nothing Else Matters. American Lung
    Association, Washington, DC.
2.   CDC. 1995. Vital and Health Statistics, National Hospital Discharge Survey: Annual
    Summary, 1993. U.S. Department of Health and Human Services, Publication
    Number PHS 96-1782. August 1995.  Centers for Disease Control and Prevention.
3.   CDC. 1995. Vital and Health Statistics, National Hospital Discharge Survey: Annual
    Summary, 1994. U.S.Department of Health and Human Services, Publication Number
    PHS 96-1521. December 1995. Centers for Disease Control and Prevention.
4.   Halfon,N. andP.W Newacheck. 1993. Childhood Asthma and Poverty: Differential
    Impacts and Utilization of Health Services. Pediatrics. Volume 91, Pages 56-61.
5.   CDC. 1996. Asthma Mortality and Hospitalization among Children and Young
    Adults, 1980-1993. Morbidity and Mortality Weekly Report. Volume 45, Number
    17, Pages 350-353. May 3.
6.   Weiss, K.B., P.J. Gergen, and T.A. Hodgson.  1992. An Economic Evaluation of
    Asthma in the U.S. New England Journal of Medicine. Volume 326, Pages 862-
    866. March 26.
7.   ALA. 1997. Asthma in Diverse Communities. American Lung Association,
    Washington, DC.
8.   Bates, D V. 1995. The Effects of Air Pollution on Children.  Environmental Health
    Perspectives. Volume 103 (Supplement B), Pages 49-53.
9.   USEPA.  1989. Report to Congress on Indoor Air Quality Volume II: Assessment
    and Control of Indoor Air Pollution. Publication Number EPA 400-1 -89-OOOC.
    U.S. Environmental Protection Agency. Pages 1:4-14.
10. CDC. 1996. Exposure to Second-Hand Smoke Widespread. Press Release.
    Centers for Disease Control  and Prevention. April.
11. USEPA. 1994. Indoor Air Pollution: An Introduction for Health Professionals. GPO
    Number 1994-523-217/81322. American Lung Association, U.S. Environmental
    Protection Agency, Consumer Product Safety Commission, and American Medical
    Association.
12. NIOSH. 1991. Current Intelligence Bulletin 54Environmental Tobacco Smoke in
    the Workplace. National Institute for Occupational Safety and Health.
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                                                             EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
  ULUiLj
  DDDDC
n
                    13.  USEPA. 1990. Respiratory Health Effects of Passive Smoking: Lung, Cancer, and
                        Other Disorders. Publication Number EPA 600-6-90-006F. U.S Environmental
                        Protection Agency, Office of Research and Development.
                    14.  Allard,P. Undated. Environmental Tobacco Smoke. Arizona Comparative Environ-
                        mental Risk Project. Arizona Department of Environmental Quality, Phoenix, AZ.
                    15.  MacDorman,M.F.,S. Cnattingius,H.J. Hoffman,M.S. Kramer,andB. Haglund.
                        1997. Sudden Infant Death Syndrome and Smoking in the United States and Swe-
                        den. American Journal of Epidemiology. Volume 146, Number 3, Pages 249-257.
                    16.  Mannino, D.M.,M. Siegel, C. Husten, D. Rose, andR. Etzel.  1996. Environ-
                        mental Tobacco Smoke Exposure and Health Effects in Children: Results from the
                        1991 National Health Interview Survey. Tobacco Control. VolumeS,Pages 13-18.
                    17.  USEPA. 1987. Project Summary: The Total Exposure Assessment Methodology
                        (TEAM) Study. Publication Number EPA 600-S6-87-002. U.S. Environmental
                        Protection Agency, Office of Acid Deposition, Environmental Monitoring and Quality
                        Assurance.
                    18.  USCPSC. 1990. An Update on Formaldehyde. U.S.  Consumer Product Safety
                        Commission.
                    19.  ALA. Undated.  Air Pollution In Your Home. American Lung Association,
                        Washington, DC.
                    20.  ALA. 1997. Fact Sheet: Carbon Monoxide. American Lung Association, New
                        York, New York. August.
                    21.  USHHS. 1997.  Progress Review: Environmental Health. U.S. Department of
                        Health and Human Services, Public Health Service. March 12.
                    22.  Thurston, G.D. etal. 1997.  Summertime Haze Air Pollution and Children with
                        Asthma. American Journal of Respiratory Critical Care Medicine.  Volume 155,
                        Pages 654-660.
                    23.  Woodruff, T.J.,J. Grillo, and K.C. Schoendorf. 1997. The Relationship between
                        Selected Causes of Postneonatal Infant Mortality and Particulate Air Pollution in the
                        United States. Environmental Health Perspectives. Volume 105, Pages 608-612.
                    24.  CDC. 1991. Children at Risk from Ozone Air Pollution in the United States.
                        Morbidity and Mortality Weekly Report.  Volume 44, Pages 309-312.
                    25.  U.S. EPA. 1997. Criteria Pollutants (Greenbook). National Ambient Air Quality
                        Standards. U.S.  Environmental Protection Agency, Office of Air and Radiation.
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                                                         Childhood  CANCER


                     Approximately 8,000 children under the age of15 are diagnosed with cancer each year in
                     the United States.(l) In 1992, cancer was the fourth leading cause of death for American
                     children under age 15, exceeded only by deaths from accidents, congenital anomalies
                     (birth defects), and diseases of infancy.(2,3) The most prevalent forms of the disease in
                     children are leukemia and brain cancer. (4)
                     The death rate from childhood cancer in the United States has declined dramatically in
                     recent years due to improved treatment.(5) However, the overall incidence rate of new
                     cancers in children has increased as shown in the table below.(6,7) The trends in some
                     cancer types suggest the need for a closer examination of the underlying factors leading to
                     disease in children. This includes determining whether environmental contaminants play a
                     role in causing the disease.
                                              Incidence of Childhood Cancer
                                   19/0
197S
1980
1935      199O
1995
                                                           Year
                          Incidence of cancer in children by calendar year of diagnosis, 1973-1994, United States, SEER
                          (data from Table 27-3).  The correlation coefficient, r, is 0.75
                     Cancer is characterized by the uncontrolled growth of cells. When a cell becomes
                     cancerous, it loses its ability to regulate its own growth, control cell division, and interpret
                     messages from other cells. Each tumor is believed to originate from a single cell gone
                     awry. The transformation of a normal cell into a cancerous one requires a series of
                     alterations often involving mutations in DNA, the genetic code. This stepwise series of
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changes usually takes many years to complete, although in young children, the sequence
may be accelerated. In addition to possibly causing childhood cancer, exposure to a
carcinogen as a child may lead to cancer as an adult. Carcinogens are substances that
trigger or accelerate the development of cancer. Cancer may be initiated or accelerated
by radiation and by some toxic chemicals.

PossiblE  ENVIRONMENTAL FACTORS

Exposures to certain carcinogens in the environment may be associated with some human
cancers.(8,9) People can be exposed to carcinogens through many routes, including air,
water, food, drugs, surface contact, and tobacco use. Examples of environmental factors
that may be associated with cancer are:(4,9, 1 0)
  • Environmental tobacco smoke (or secondhand smoke)
  • Radon
  • Asbestos
  • Ultraviolet light
  • Some hazardous waste
  • Some pesticides
Indoor air toxics are addressed more fully in Chapter 2 and pesticides in Chapter 5 of
this report.
ElNViRONMEINTAl TobACCO SlVlokE (SECONdllANd

Infants and children who live in households with smokers involuntarily inhale the toxic
substances in tobacco smoke. Environmental tobacco smoke (ETS) is a complex mixture
of more than 4,000 chemicals, such as nicotine, tars, formaldehyde, and hydrogen cya-
nide.(l 1) Some of these contaminants are known human carcinogens.(12) More informa-
tion on children's risks resulting from toxic substances in ETS is presented in Chapter 2
Asthma and Other Respiratory Effects.
Radon, a known human carcinogen, is a naturally occurring, radioactive gas that is color-
less, odorless, and tasteless. It comes from the natural decay of uranium, a radioactive
metal found in soil and rock in the earth's crust all over the United States. Radon travels
through soil and enters the indoor environments of buildings through cracks and other
openings in the foundation. Eventually, radon decays into radioactive particles that can be
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                      inhaled and then trapped in the lungs. As these particles decay, they release small bursts
                      of radiation that can damage lung tissue and lead to lung cancer later in life.( 13)
                      EPA estimates that radon may cause from 7,000 to 30,000 lung cancer deaths in the
                      United States each year. Radon is the second leading cause of lung cancer deaths in
                      adults, after smoking. An individual's risk of getting lung cancer from radon depends
                      mainly on three factors: the level of radon, duration of exposure, and smoking habits.
                      Risk increases in individuals exposed to high levels of radon over a long time. The risk of
                      dying from lung cancer caused by radon is much greater for smokers than for non-
                      smokers.

                      AsbESTOS
                      Asbestos is a fibrous mineral that was used widely in construction materials, such as
                      shingles for roofing and siding, pipe and boiler insulation, floor tiles, ceiling panels, coat-
                      ings, and gaskets. It is present in schools and other public buildings as well as in some
                      residential structures. Asbestos has caused lung cancer and malignant mesothelioma in the
                      children of asbestos workers. The children were exposed to asbestos-contaminated dust
                      brought home from work on their parents' shoes and clothing. EPA estimates that at least
                      1,000 premature deaths from cancer will occur in this country over the next 30 years among
                      children who are exposed today to asbestos in schools.(14) Asbestos is harmful only when
                      inhaled. If an asbestos-containing product, such as a floor covering, is not disturbed enough
                      to release microscopic particles into the air, no disease is expected to result.

                      UliRAviolET Liqhi
                      Overexposure to the sun's harmful ultraviolet (UV) light may damage children's skin.
                      Ultraviolet light is radiation from the sun that has a wavelength shorter than visible light
                      (toward the violet end of the visible spectrum) but longer than that of X-rays. This type of
                      radiation has increased on the earth's surface due to damage to the earth's ozone layer in
                      the outer atmosphere. Excessive sunburns experienced by children 10-15 years of age
                      increase by three fold the chance of developing malignant melanoma, the most deadly kind
                      of skin cancer, later in life.( 15,16)

                      HAZARdous WASTE
                      Exposure to hazardous wastes that have been released into the environment may present
                      serious health hazards to children. Hazardous wastes include substances that have cancer
                      or non-cancer health effects, are corrosive, or may present a danger due to fire or explo-
                      sion. They include a wide range of organic chemicals and heavy metals, as well as strong
                      acids and bases. Children may be exposed to such wastes when they play or live near
                      uncontrolled hazardous waste sites or spills. EPA estimates that 12 million people,
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including 4 million children, live within one mile of the nation's hazardous waste sites.
Many more children suffer from the toxic effects of heavy metals, such as lead, or are
poisoned accidentally from improper pesticide use in their homes.(l 7, 1 8)

SUMMARY of EPA AcrivmEs

ElNViRONMEINTAl TobACCO
EPA's activities relating to ETS are described in Chapter 2 Asthma and Other Respira-
tory Effects.
EPA oversees a program to detect and reduce elevated radon levels in buildings and to
inform the public about radon. Through partnerships with schools, non-profit organiza-
tions, and state agencies, EPA promotes: ( 1 ) radon awareness and testing programs for
schools and homes; (2) radon-resistant building practices; (3) methods to lower radon
levels; (4) training for school maintenance personnel on methods to lower radon levels; and
(5) technical assistance in inspecting school buildings. An important component of this
program is the National Radon Hotline (see Chapter 11).
EPA has participated in research to identify areas of the country with high levels of radon
in homes, schools, and workplaces, and to determine the national distribution of radon
levels and associated risks. EPA has supported the development of new technologies to
reduce radon concentrations in existing and new buildings.
AsbESTOS
EPA provides education and technical assistance to school districts that inspect school
buildings for asbestos-containing material and control asbestos contamination. This assis-
tance is required by EPA's Asbestos-in-Schools Rule (1987). EPA has a mandatory training
and accreditation program for professionals who work in schools and public and commercial
buildings to control asbestos.  EPA has approved 27 states to administer the Asbestos
Model Accreditation Plan (MAP) Rule and directly administers a federal program in the
remaining states. This program protects children and the general public by helping ensure
that buildings are inspected or cleaned up only by properly trained and accredited personnel.
EPA conducts some inspections to ensure compliance with the federal requirements for
managing asbestos indoors. EPA also ensures proper accreditation of workers. The
Agency takes enforcement actions to bring violators into compliance. EPA also provides
grants to several states and Native American Tribes for compliance monitoring activities.
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                     UliRAviolET Liqk
                     EPA offers educational programs for parents, students, and teachers about the health risks
                     resulting from exposure to UV light, and encourages them to reduce exposure. A new EPA
                     program calls for participating schools tomonitor the daily UV Index (a measure of expo-
                     sure based on weather), undertake one or more activities to reduce sun exposure, and
                     report their progress to EPA. EPA also has developed a World Wide Web site that encour-
                     ages teachers and students to learn about ozone depletion, UV radiation hazards, and steps
                     to reduce UV exposure.

                     HAZARdous WASTE
                     EPA is conducting research to determine the specific effects of hazardous substances on
                     children. For instance, a current EPA research project includes an approach for predict-
                     ing the cancer risk from vinyl chloride gas that takes into account a child's increased
                     sensitivity to this gas. This "state of the science approach" provides a better tool for
                     determining health risks to children. EPA also is conducting a study of potential exposures
                     of children to over 300 chemical compounds in a locality with an increased rate of child-
                     hood cancers over the past 21 years.  A related study addresses the health effects of
                     arsenic as a function of age. EPA enforcement efforts to remove or reduce children's
                     exposure to hazardous waste are included in Chapters 4 Developmental and Neurologi-
                     cal Toxicity and 5 Health Effects of Pesticides.
                      EPA PROJECTS  REkrEcl TO  CANCER
                     Title:
                     Description:
                     Partners:

                     Contact:
Radon Mitigation for School Maintenance Personnel
EPA Region 4 sponsored radon courses designed specifically to train
school maintenance personnel on how to fix their own schools. This
approach, which has served 15,000 clients in three states, is much more
cost effective than if the schools had to contract for the work. Discus-
sions are underway with Kentucky and North Carolina to offer the same
opportunity.
Alabama, Tennessee, and South Carolina Radon Programs, and Southern
Regional Radon Training Center
Region 4, Patricia Brooks, 404-562-9145
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litle:
Description:
Partners:
Contact:


Title:
Description:
Contact:


AsbESTOS


Title:
Description:
 School Visits in Counties with the Highest Radon Risk
 Region 4 has funded a project in which 25 schools in areas expected to be
 at risk for high radon levels will be visited. ThelndoorAir Quality Tools
for Schools guidance, which has a radon component, will be introduced
 and explained, and a courtesy walk-through inspection of each school will
 be conducted.  It is anticipated that this program will serve 10,000 clients.
 The Southern Regional Radon Training Center
 Region 4, Patricia Brooks, 404-562-9145


 Radon Outreach
 The Indoor Air program of Region 7 includes state and tribal radon
 programs and a variety of other indoor air quality topics such as ventila-
 tion, carpet, carbon monoxide, formaldehyde, and microbes. These
 programs focus on education, outreach, and technical assistance. The
 programs emphasize partnerships with schools, not-for-profit organiza-
 tions, and state and local governments to promote radon awareness,
 voluntary testing of homes and schools for radon, radon-resistant building
 codes and construction, and radon cleanup.
 Region 7, Tom Hogan, 913-551 -7684
Asbestos-in-Schools Rule
In response to the Asbestos Hazard Emergency Response Act, EPA
published the Asbestos-in-Schools Rule (1982, updated in 1987). The
rule requires public and private elementary and secondary schools to
inspect for friable (easily crumbled) and non-friable asbestos, develop
management plans to address hazards, and conduct responses to eliminate
the asbestos. The EPA rule also specifies training, examination, and other
requirements to accredit persons who do this work, and sets requirements
for warning signs and transportation and disposal of materials containing
asbestos. EPA continues to monitor the requirements of the Asbestos-in-
Schools Rule and to enforce standards that protect children against
 Childhood CANCER
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                                   asbestos hazards. The rule includes requirements for preschools and
                                   daycare centers to protect younger children. EPA provides Toxic Sub-
                                   stances Control Act funds to 26 states to carry out asbestos and other
                                   inspections. States refer violations to the appropriate EPA regional office
                                   for enforcement. Contact Jack Neylan, 202-564-5033 or Karen Taimi,
                                   202-564-5046. Examples of activities to promote the Asbestos-in-
                                   Schools Rule include:
                     Region 5:      The Region currently provides grants to three states for the purpose of
                                   inspecting schools to ensure adherence with the Rule. Contact Phyllis
                                   Reed, 312-886-6018.
                     Region 6:      Local education agencies are required to inspect for the presence of
                                   asbestos in schools.  If asbestos is present, it must be managed in good
                                   condition orremoved. Contact Neil Pflum, 214-655-2295.
                     Region 7:      The Region has inspected about half of the approximately 4,000 school
                                   districts in the Region. Schools have removed or immobilized large
                                   quantities of asbestos-containing materials in their buildings to protect the
                                   safety of children, teachers, staff, and other occupants. Contact Tom
                                   Hogan, 913-551-7684.
                     Region 9:      Region 9 conducts inspections and provides technical assistance to the
                                   regulated community to ensure requirements are met in schools and
                                   daycare centers. The Region also funds grants to states and tribes to
                                   develop their own asbestos programs. Contact Paula Bisson,
                                   415-744-1128.
                     Title:          Example of Asbestos Enforcement Case
                     Description:   A company responsible for the removal of asbestos from a Philadelphia
                                   facility abandoned 500 bags of asbestos materials in an unsecured facility.
                                   Children played with the materials and exposed themselves to hazards.
                                   The owner of the company was sentenced to six months incarceration and
                                   three years of probation, and was required to seek mental health counseling.
                     Partners:      EPA and the Philadelphia Environmental Crimes Task Force
                     Contact:      Office of Enforcement and Compliance Assurance, Martin Topper,
                                   202-564-2564
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LJliRAviolET Liqk
Title:          Ozone Depletion Art Project
Description:    The Ozone Depletion Art Proj ect uses the Internet to motivate students to
              learn about ozone depletion, UV radiation hazards, and ways to reduce
              sun exposure. Using an EPA web site (www.epa.gov/ozone/art), teachers
              and their students learn more about ozone depletion and UV exposure
              precautions. They submit drawings on the ozone layer (how it protects us
              from UV radiation); ozone depletion (how ozone-depleting substances
              harm the ozone layer); how UV radiation is measured; and how we can
              protect ourselves from the sun's UV rays. EPA has received more than
              200 drawings so far. EPA also responds to approximately 50 questions
              and comments per month from students and teachers.
Contact:       Office of Air and Radiation, Jeffrey Levy, 202-564-9727
Title:          Sunwise School Program
Description:    The Sunwise School Program is a school-based partnership that directly
              addresses health risks resulting from exposure to UV radiation. Member
              schools make a commitment to: report the UV Index daily, undertake
              activities to reduce sun exposure, and document their activities and report
              their progress to EPA. The program encourages schools to work with
              local meteorologists, physicians, and community groups in planning their
              individual Sunwise School Programs. EPA provides schools with guid-
              ance on setting their Sunwise School Program goals, and recognizes
              participating schools.
Contact:       Office of Air and Radiation, Kevin Rosseel, 202-564-9731


HAZARdous WASTE
Title:          Vinyl Chloride Risk Assessment Approach for Children
Description:    EPA Region 9 and the Office of Research and Development developed a
              risk assessment method that offers an innovative approach for protecting
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                                    children from exposure to the carcinogenic gas, vinyl chloride. This risk
                                    assessment method has been published in the scientific literature, pre-
                                    sented at national and international scientific meetings, nominated for an
                                    EPA scientific achievement award, and is being incorporated into the
                                    revised vinyl chloride file in IRIS (EPA's Integrated Risk Information
                                    System).  Newborn animal exposure studies have demonstrated that even
                                    a brief exposure in newborns to vinyl chloride could cause more cancers
                                    than if exposures had occurred later in life. The risk assessment method
                                    has been used in Region 9 to set indoor air action levels protective of
                                    children exposed in their homes to landfill gas containing vinyl chloride.
                      Contact:       Region 9, Gerald Hiatt, 415-744-2319 or Arnold Den, 415-744-1018


                      Title:          Site Assessment in Response to  Cancer in Children
                      Description:    McFarland is a small, mostly Hispanic, agricultural community in
                                    California's Central Valley. For the past 21 years, it has had an increased
                                    rate of childhood cancers documented by the California Department of
                                    Health Services. Due to the concern about children's health, EPA is
                                    sampling and analyzing the air, soil, and water for releases of hazardous
                                    substances associated with past industrial and agricultural practices, and is
                                    investigating health problems relating to children. Sampling is expected to
                                    be completed next year, and should allow EPA to determine the best
                                    approach to eliminating any causes that are identified through the site
                                    assessment.
                      Contact:       Region 9, Mark Calhoon, 415-744-2376 or Elizabeth Adams,
                                    415-744-2261
                      Title:          Multi-Pathway PAH Exposure Field Evaluation for Childrenin
                                    Low-Income Families
                      Description:    The purpose of this research is to understand the extent to which children
                                    in low-income families are being exposed to polycyclic aromatic hydro-
                                    carbons (PAHs). PAHs are a product of incomplete combustion of
                                    carbon substances (e.g., from automobile exhaust, smoke stacks, and
                                    cooking) and are fairly pervasive in the environment. A pilot study that
                                    included both inner-city and rural homes examined the exposures of
                                    children to PAHs in air, water, food, house dust, and soil. EPA is extend-
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              ing this research to include low-income children in daycare centers.
              Preliminary results indicate that exposure to PAHs through inhalation, skin
              contact, and dirt and dust ingestion is as important a source of contamina-
              tion as is dietary exposure for young children. Future research will com-
              pare low-income and middle-income family exposures.
Contact:       Office of Research and Development, N. Colleen Wilson, 913-551 -7272


Title:          Evaluation of Urinary Metabolites of Arsenic for Exposure Biomarker
Description:    Information on urinary arsenic metabolic profiles (chemical indicators of
              the presence of arsenic in the body through urine tests) are being devel-
              oped for arsenic in drinking water and diet. This will enable EPA to
              compare differences as a function of age (adults and children under 16),
              sex, volume of water ingested, and individual differences.
Contact:       Office of Research and Development, Rebecca Calderon, 919-966-0617
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                     REFERENCES
                     i.
    Miller, B.A., L.A.G. Ries, F.R. Hankey, F.L. Kosary, A. Harras, S.S. Devesa,
    and B .K. Edwards (editors).  1993. SEER Cancer Statistics Review: 1973 -1990.
    NIH Publication Number 93-2789. National Cancer Institute, Bethesda, MD.
    USPHS.  1991. Vital Statistics of the United States, 1988, Volume II: Mortality.
    National Center for Health Statistics, U.S. Public Health Service, Washington, DC.
    Parker, S.L.,T. Tong, S. Bolden, and PA. Wingo. 1996. CA-A Cancer Journal
    for Clinicians. Volume 46, Pages 5-28.
    Zahm, S.H. and S.S. Devesa. 1995. Childhood Cancer: Overview of Incidence
    Trends and Environmental Carcinogens. Environmental Health Perspectives. Vol-
    ume 103 (Supplement 6), Pages 177-184.
    Bleyer, W. A. 1993. What Can be Learned about Childhood Cancer from Cancer
    Statistics Review 1973-1988. Cancer (supplement). Volume 71, Pages 3229-
    3236.
    NCI. 1997. SEER Cancer Statistics Review, 1973-1994. U.S. Department of
    Health and Human Services. National Cancer Institute. NIH Publication Number
    97-2789, page  457.
    Devesa, S.S.,W.J. Blot,B.A. Miller, R.E. Tarove, and J.F. Fraumeni,Jr.  1995.
    Recent Cancer Trends in the United States. Journal: National Cancer Institute.
    Volume 87, Pages 175-182.
    Doll, R.  1976.  The Contribution of Epidemiology to Knowledge of Cancer. Re-
    view of Epidemiology and Public Health (FR). Volume 24, Pages 107-121.
    Weinstein, I.B.  1988. The Origins of Human Cancer: Molecular Mechanism of
    Carcinogenesis and Their Treatment. Cancer Research. Volume 48, Pages 4135-
    4143.
10.  NRC. 1993.  Pesticides in the Diets of Infants and Children.  National Research
    Council. Washington, DC: National Academy Press.
11.  USEPA.  1994.  Indoor Air Pollution: An Introduction for Health Professionals.
    GPO Number 1994-523-217/81322. American Lung Association, U.S. Environ-
    mental Protection Agency, Consumer Product Safety Commission, and American
    Medical Association.
12.  NIOSH. 1991.  Current Intelligence Bulletin 54: Environmental Tobacco Smoke in
    the Workplace.  National Institute for Occupational Safety and Health.
                     2.
                     3.
                     4.
                     5.
                     6.
                     7.
                     8.
                     9.
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13.  USEPA. 1996. Radon: Risks and Realities. U.S. Environmental Protection
    Agency, Office of Radiation and Indoor Air. August 13.
14.  USEPA. 1980. Proposed Rule on Friable Asbestos Containing Materials in School
    Buildings: Health Effects and Magnitude of Exposure (Support Document). Publica-
    tion Number EPA 560-12-80-003. U.S. Environmental Protection Agency, Office
    of Prevention, Pesticides, and Toxic Substances.
15.  ACS. 1996. Skin Cancer Fact Sheet. American Cancer Society.
16.  AAD. 1997. Melanoma Risk Factors Fact Sheet. American Academy of Dermatology.
17.  ATSDR. 1996. 1996 ATSDR Report to Congress: 1993-1995. U.S. Department
    of Health and Human Services, Public Health Service, Agency for Toxic Substances
    and Disease Registry.
18.  USEPA. 1996. Pesticides and Child Safety. Publication Number EPA 735-F-93-
    050R. U.S. Environmental Protection Agency, Office of Pesticide Programs.
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                    HADTER  4
                                                                EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                    AN(J
NEURoloqicAl Toxiciiy
                     Neurotoxic substances are chemical compounds that, depending on the dose, may have
                     harmful effects on brain function and interfere with the workings of the nervous system.
                     Neurotoxics may affect intelligence, language ability, and attention. (1,2,3,4) They may
                     cause behavioral problems and affect mood and social adjustment. At very high doses,
                     neurotoxics may produce such effects as coma, convulsions, respiratory paralysis, and
                     death. (5) Lead, mercury, and poly chlorinated biphenyls (PCBs) are among the substances
                     suspected of having harmful and possibly permanent neurological effects on children.
                                                 The Mad Hatter
                        Lewis Carroll's Mad Hatter character in Alice s Adventures in Wonderland
                        probably is based on observations of the neurotoxic effects of inhaling vapors from
                        mercury that nineteenth century hat-makers used to prepare felt.
                     Abnormal development is a maj or concern in children because it may result in birth
                     defects and lasting changes in intelligence, behavior, and reproductive capability. A child's
                     nervous system, reproductive organs, and immune system grow and develop rapidly
                     during the first months and years of life. As organ structures develop, vital connections
                     between cells are established. These delicate developmental processes in children may be
                     easily and irreversibly disrupted by environmental toxic substances, such as lead.(6)
                     Neurotoxics that may have only a temporary ill effect on an adult brain can cause enduring
                     damage to a child's developing brain.(7,8) The immaturity of children's internal systems,
                     especially in the first few months of life, affects their ability to neutralize and rid their
                     bodies of certain toxics. If cells in the developing brain are destroyed by lead, mercury,
                     or other neurotoxic chemicals, or if vital connections between nerve cells fail to form, the
                     damage is likely to be permanent and irreversible. This may mean a loss of intelligence
                     and alteration of normal behavior.(9,10,11,12)
                     Lead is a neurotoxic metal that affects areas of the brain associated with regulating
                     behavior by altering the output of neurotransmitters and disrupting the development of
                     nerve cells. Lead poisoning in children may cause lowered intelligence, reading and
                     learning disabilities, impaired hearing, reduced attention span, hyperactivity, and antisocial
                     behavior. Pregnant women exposed to lead may transfer the metal to a developing fetus,
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resulting in developmental problems. While the fetus is developing, there are critical
periods for each organ system, including the nervous system. During these critical periods,
the cells of the body are especially sensitive to environmental toxics that may interfere with
the normal development of organ structure and function.
A growing body of evidence suggests a number of synthetic and naturally occurring
organic chemicals may disrupt the endocrine (hormonal) systems of humans and wildlife.
A variety of chemicals cause endocrine disruption in laboratory animals, and some scien-
tists have hypothesized that these effects also may occur in humans. Although further
research is needed before such effects can be either demonstrated or ruled out, theoreti-
cally children would be at particular risk from very low levels of endocrine disrupting
chemicals  because of the important role the endocrine system plays in development.
Concern exists about the potential for adverse developmental effects because chemicals
that block or "mimic" reproductive and thyroid hormones may determine the course of
prenatal development. (13,14)

PossiblE ENVIRONMENTAL FACTORS

l_EAd
Lead is a major environmental health hazard for young children.  In 1997, the Centers for
Disease Control and Prevention (CDC) reported that between 1991 and 1994, about
900,000 children in the United States under the age of six had elevated blood lead
levels.(15,16)
                       Childhood Lead Facts
     * 900,000 American children have elevated blood lead levels of concern.(l 5)
     * Lead paint in older housing is the principal source of lead exposure to-
       day.(15,16)
     * Drinking water can be a significant source of lead exposure in some homes and
       buildings.(15,20)
     * In the fetus and young children, elevated lead may damage the brain, resulting in
       persistent neurological dysfunction.(12)
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                     Approximately 75 percent of U. S . homes built prior to 1 978 contain some lead
                     paint.(l 7, 18,19) Children living in older homes are threatened by chipping or peeling lead
                     paint, and by excessive amounts of lead-contaminated dust resulting from efforts to
                     remove paint during remodeling. Children may be exposed to lead through drinking water
                     that has elevated concentrations from lead plumbing materials and corrosive water.  They
                     may breathe air contaminated from nearby smelters, battery plants, and industrial facilities
                     that process lead.  Exposure to lead from nearby hazardous waste sites also is a con-
                     cern.(15,20)

                     ENdocRiNE DisRupiORs
                     Increasing scientific and public attention has been focused on substances that have the
                     potential of disrupting the endocrine systems of wildlife, laboratory animals, and possibly
                     humans.(2 1 ) Disruption of the endocrine system may occur in various ways. Some
                     chemicals may mimic a natural hormone, in effect fooling the body into over-responding to
                     the hormone. Other chemicals may block the effects of a hormone in parts of the body
                     normally sensitive to it. Still others may indirectly stimulate or inhibit the endocrine system,
                     leading to overproduction or underproduction of hormones. Endocrine disrupters may
                     also play a role in reproductive cancers. (22)
                     Scientific questions remain, however, about which chemicals are involved in disruption of
                     the endocrine system and how children may be exposed to those chemicals. It is not yet
                     known whether health effects similar to those observed in laboratory animals are pro-
                     duced in humans, and what methods are best for testing for these effects. EPA is investing
                     significant resources to find answers to these questions.
                      PCBs ANd DioxiNs
                      PCBs and dioxins produce anumber of toxic effects in animals. (23 ,24) They have been
                      linked to such health concerns as decreased gestational age, lower birth weight, de-
                      pressed immune responses, impaired mental development, and growth retarda-
                      tion. (24, 25 ,26) Dioxin is considered by EPA to be a known human carcinogen and as
                      such may have adverse effects on children that do not become apparent until many years
                      after exposure occurs.(24,27) However, no direct causal relationship has been established
                      between PCB exposure and human health effects.
                      EPA banned PCBs over 20 years ago, and the Agency has taken steps to regulate over
                      95 percent of known sources of dioxin in the United States. Unfortunately, these chemi-
                      cals are highly persistent in the environment. Because PCBs accumulate in fish and in
                      humans, additional exposures to infants and young children may occur through ingesting
                      contaminated fish and breast muk.(22)
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MERCURY
Mercury is another neurotoxic substance that can produce a wide range of health effects
depending on the amount and timing of exposure. Mercury is a liquid at room temperature
but vaporizes readily; in vapor form it is readily absorbed through the lungs. Repeated
exposures to low levels of mercury vapor over long periods have been associated with
tremors, irritability, impulsiveness, drowsiness, impaired memory, and sleep distur-
bances.(28) These effects may occur at lower levels of exposure in children than adults.
When mercury attaches to an organic molecule, it may be absorbed into the body through
the digestive tract.  Methylmercury, which is produced naturally by certain bacteria, is such
a molecule. It can  cross the placenta and enter the brain, causing severe brain damage in
fetuses.  High mercury levels in fish consumed by pregnant women have been linked to
severe brain damage and cerebral palsy in newborns.(28,29)
Children are exposed to mercury primarily from eating contaminated fish. However,
children eating soil contaminated with mercury or accidental exposures to mercury, also
have been documented.

MANQANESE
Airborne manganese particles emitted from industrial and natural sources or from a fuel
additive (methylcyclopentadienyl manganese tricarbonyl or MMT) may be neurotoxic.
Although MMT was banned by EPA as a gasoline additive in 1994, a recent court ruling
allowed the additive to be used while being tested for health effects. Laboratory studies
show that manganese disturbs normal functioning of brain cells in rats. Manganese com-
pounds also cross the placenta and may retard growth in fetal rodents. Evidence of
developmental effects from chronic inhalation of manganese compounds in humans comes
from manganese miners, who have high rates of psychosis and frequently suffer from a
condition similar to Parkinson's disease.(30,31)
SUMMARY of EPA AcrivmEs
l_EAd
EPA's phase out of lead in gasoline, beginning in 1976, has resulted in a major reduction in
airborne lead levels. Between 1976 and 1995, ambient air lead concentrations in the
United States have declined on average by 97 percent.(32)
Several measures have substantially reduced lead exposure from drinking water. The Safe
Drinking Water Act prohibits use or sale of lead solder and the manufacture of water
coolers containing lead components. Plumbing manufacturers have phased down the
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                      amount of lead in faucets and other fixtures. Water suppliers are required by EPA regula-
                      tion to minimize the corrosiveness of their water and replace, where needed, lead service
                      connections. Lead in the diet has been reduced dramatically because crops are much less
                      likely to be contaminated by lead in the air and because of the phase out of lead solder in
                      food cans. The combination of all of these actions has helped reduce average blood lead
                      levels in children and adults by more than 80 percent since the 1970s, according to CDC
                      data, protecting millions of children from serious, permanent neurological effects.(16)
                      Because of the continuing threat of exposure from lead paint, EPA works with the De-
                      partments of Housing and Urban Development (HUD) and Health and Human Services
                      (HHS) to  ensure that the nation's housing is safe from lead contamination. HUD and EPA
                      are responsible for enforcement of the Residential Disclosure Rule that gives consumers
                      the right to know about lead-based paint hazards in pre-1978 homes that they may buy or
                      rent. This rule requires, among other things:
                        • Disclosure of all known lead-based paint hazards in pre-1978 housing and any
                         available reports on lead in the housing.
                        • Distribution of the EPA pamphlet "Protect Your Family from Lead in Your Home."
                        • Inclusion of warnings in sales or lease contracts.
                        • An opportunity to test the housing for lead.
                      EPA also  is working with the states to help ensure that abatement (control or removal) of
                      lead-based paint hazards is carried out safely. The Agency has established rules regulat-
                      ing the training of individuals conducting lead-based paint abatement, accreditation of
                      training programs, and certification of contractors.
                      A comprehensive assessment of residential lead risks to children is being developed by
                      the Agency. This assessment will include a process for identifying specific levels of lead
                      contamination in residential dust and soil as well as paint conditions that present hazards
                      to children.
                      EPA is taking legal action at nonferrous metal smelters that violate state or federal regula-
                      tions. Through increased enforcement, EPA is reducing lead emissions that may contami-
                      nate schools and lawns where children play. The Agency also is researching childhood
                      blood lead levels in communities surrounding former lead smelters and paying close
                      attention to ongoing studies in this area.
                      EPA, the Agency for Toxic Substances and Disease Registry (ATSDR), and HUD are
                      working together to examine blood lead levels in children and to develop ways to deal
                      with the effects of environmental lead on children in urban environments. This work
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includes examining the dietary intake of lead in young children and investigating the effects
of lead on adolescent development and maturation.
The Agency conducts a variety of public education programs aimed at the children most at
risk from lead poisoning, particularly disadvantaged children who live in houses contami-
nated with lead paint.  For example:
  • A number of EPA regions are training volunteers to educate residents in low-income
   areas about how to recognize and prevent childhood lead poisoning in their communities.
  • In Region 7, community outreach focuses on protecting children from lead poisoning in
   residential settings and in mining communities, where blood lead studies revealed
   unsafe lead levels in children.
  • Other regions offer programs to protect tribal groups and migrant workers from lead
   contamination in soils.
                  Scientists Study New Methods for Assessing

                           Lead Exposure  among Children
       EPA is expanding its efforts to evaluate the impact on children from lead-contaminated hazardous waste
       sites. A new Integrated Exposure and Uptake Biokinetics (IEUBK) model was designed to be used in
       predicting the risks to children posed by sites with lead contamination. This method allows researchers
       to evaluate the risk of lead poisoning to children between the ages of six months and six years for the
       first time. It predicts changes in blood lead levels based on exposure through soil ingestion and inhala-
       tion, allowing EPA to better evaluate the need for cleanup at the site.
           DisRupiORs

EPA has developed a substantial research program to understand the adverse effects of
endocrine disrupting chemicals that exist in the environment. Under the mandates of the
Safe Drinking Water Act and the Food Quality Protection Act, EPA established the
Endocrine Disruptor Screening and Testing Advisory Committee to advise the Agency
on a screening and testing strategy for potential endocrine disrupters. EPA has issued new
guidelines for evaluating reproductive toxicity and is updating guidelines for reproductive and
developmental toxicity testing. Region 5 sponsored a workshop to discuss science and
public policy issues related to endocrine disrupters in the Great Lakes Basin.
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                     EPA is devoting significant resources to implement a multi-year research strategy on endo-
                     crine disrupters. Agency personnel participate in a workgroup (convened by the President's
                     Office of Science and Technology Policy) charged with coordinating research on endocrine
                     disrupters throughout the federal government. The Agency is funding the National Research
                     Council 's detailed review of existing literature on endocrine disruption. EPA has prepared
                     its own review of the literature and has issued an interim policy statement while it awaits the
                     NRC report. (22) EPA also is sponsoring research on the reproductive effects of certain
                     pesticides, the relationship between human sperm count and fertility, and reproductive
                     problems among alligators and fish resulting from chemical contamination.

                     PCBs ANd DioxiNs
                     EPA is conducting research to better understand the potential neurological and develop-
                     mental effects of PCBs and dioxins. EPA is assessing the neurotoxic risks to children
                     exposed to PCBs, and is further examining the long-term effects of PCB exposure.

                     MERCURY
                     EPA has recently completed a Report to Congress on mercury that assesses the magni-
                     tude of U.S. mercury emissions, the health and environmental implications, and control
                     technologies. (33)
                     EPA is conducting studies that focus on specific risks to children from mercury, and is
                     monitoring the findings of human studies on methylmercury exposure and its impact on
                     nervous system development. The Agency will continue its work on setting standards for
                     allowable levels of exposure to mercury.  EPA also has begun a public education program
                     to increase awareness and prevent mercury poisoning in children exposed to mercury
                     vapors in homes.

                     EPA  PROJECTS ON  DEVELOPMENTAL Ai\d  NEURoloqicAl Toxiciiy

                     l_EAd
                     Title:          Lead-Based Paint Compliance Assurance Program—Compliance
                                   Assistance, Inspections, and Enforcement
                     Description:    EPA has issued guidance to help ensure compliance with rules designed to
                                   protect the public from lead-based paint hazards. Compliance assistance,
                                   inspections, and enforcement are all tools that will be used to help ensure
                                   that children are safe from lead-based paint hazards. EPA regions have
                                   provided compliance assistance to the real estate industry and others
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              subject to the Residential Disclosure Rule. EPA also is following up on
              complaints from the public about potential violations of this Rule. With
              regard to other lead-based paint requirements, a federal compliance and
              enforcement program addressing abatement, certification, and training will
              operate in those states without an authorized program.
Contact:      Office of Enforcement and Compliance Assurance, Claude Walker, 202-
              564-4042 or Fran Jonesi, 202-564-7043.
Title:          Examples of Regional Lead-Based Paint Activities:
Description:    As illustrated below, each EPA regional office conducts programs to
              reduce lead-based paint hazards:
Region 1:      Region 1 publicizes the new real estate notification rules that are designed
              to protect children from lead poisoning and lead paint, and to remove
              children from premises undergoing renovation. Contact Maureen
              McClelland, 617-565-3543.
Region 2:      The Region is conducting a study of high risk urban communities affected
              by the real estate disclosure regulations to ensure that realtors are inform-
              ing sellers and landlords of their responsibilities and properly informing
              buyers and lessees.  Outreach to community groups and compliance
              assistance to the regulated community also target these areas. Contact
              Louis Bevilacqua, 732-321-6671.
Region 5:      The Region has developed initiatives for public awareness and compliance
              with lead-based paint standards for daycare centers and other buildings
              frequented by children. Outreach to realtor groups raises awareness and
              helps prevent parents from buying or renting residential property that might
              expose children to unsafe lead-based paint conditions. Contact Phyllis
              Reed, 312-886-6018.
Region 6:      Region 6 is providing outreach to  assist the real estate industry in meeting
              the requirements of the lead-based paint regulations, and to inform parents
              about lead-based paint exposure and hazards. These actions will allow
              families to take the necessary steps to minimize risk to children. Contact
              AnnaTreinies, 214-665-8348.
Region 7:      Through a lead-based paint outreach program, the Region is testing blood
              lead levels, developing certification training classes for nonprofit organiza-
              tions, providing compliance assistance, conducting presentations and mass
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                                                                 EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                   mailings, and developing an Internet home page for children. The Region
                                   purchased X-ray fluorescence equipment to test the level of lead in tribal
                                   homes. Contact Tom Hogan, 913-551-7684.
                     Region 9:     Region 9 maintains an outreach program to implement the Residential
                                   Lead-Based Paint Hazards Reduction Act. State and tribal grants are
                                   awarded to establish programs for preventing or eliminating lead poison-
                                   ing in children and to help community-based organizations conduct public
                                   programs on the dangers of lead. The Region also provides technical
                                   assistance and training. Contact Paula Bisson, 415-744-1128.
                     Title:          Lead-Based Paint Compliance Monitoring and Enforcement Cooperative
                                   Agreement Funding for States
                     Description:   In fiscal year 1997, EPA provided $ 1 million to 13 states to enhance the
                                   state enforcement component of their lead-based paint programs.
                     Partners:      State agencies
                     Contact:      Office of Enforcement and Compliance Assurance, Jack Neylan, 202-
                                   564-5033 or Karen Taimi, 202-564-5046


                     Title:          Community/University Partnership for Lead Education
                     Description:   Through an EPA grant, Xavier University has developed a proj ect to
                                   identify, prevent, and intervene in instances of lead poisoning of at-risk
                                   children residing along the Mississippi River Chemical Corridor. The
                                   university is working with ten community-based organizations to develop
                                   and promote lead education and training for community members, health
                                   care providers, children, and elementary and secondary teachers. The
                                   program includes lead screening and lead testing in homes to reduce
                                   exposure in children.
                     Contact:      Office of Enforcement and Compliance Assurance, Daniel Gogal,
                                   202-564-2576
                     Title:          The Childhood Lead Action Project
                     Description:   EPA is assisting the Rhode Island Childhood Lead Action Project to
                                   prevent childhood lead poisoning through education, parent support, and
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              advocacy. The Childhood Lead Action Project has conducted lead
              education and outreach in high-risk, low-income Hispanic,
              African-American, and Asian communities.
Contact:       Region 1, Maureen McClelland, 617-565-3543 or Jim Bryson,
              617-565-3836
Title:          Urban Environmental Initiative
Description:    EPA Region 1 works with community leaders to address critical urban
              environmental issues, including lead poisoning. Efforts include the "Com-
              munities Saving Their Children's Future" series of workshops to train
              residents in the prevention of early childhood lead poisoning. Region 1
              also provides funds to its partners for outreach and educational campaigns
              directed toward parents and human service providers in the inner city.
Partners:      Boston University School of Public Health, Boston Department of Envi-
              ronmental Health, National Center of Lead-Safe Housing, The Medical
              Foundation of Boston, and Childhood Lead Action
Contact:       Region 1, Lois Adams, 617-565-3487


Title:          Lead Poisoning Prevention Curriculum
Description:    Through a cooperative agreement with the Education Development
              Center, EPA Region 1 has assisted in developing and distributing "Health
              Beginnings: Lead-Safe Families," an English-as-a-second-language
              curriculum on lead poisoning prevention. Almost 400 regional learning
              centers have received the curriculum and provided thousands of families
              with critical information on avoiding lead exposure.
Contact:       Region 1, Maureen McClelland, 617-565-3543 or Jim Bryson,
              617-565-3836
Title:          New England Lead Coordinating Committee
Description:    EPA and The New England Lead Coordinating Committee, through a
              cooperative agreement with Tufts University, facilitates coordination of
              lead poisoning prevention among the states, EPA, and other federal
              agencies. More than $130,000 has been granted to grassroots community
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                                                                 EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                   organizations working to prevent lead poisoning, many of which focus of
                                   children's health issues. For example, puppet shows have been devel-
                                   oped to teach children about lead safety.
                     Partners:      Tufts University
                     Contact:      Region 1, Maureen McClelland, 617-565-3 543 or Jim Bryson,
                                   617-565-3836


                     Title:          Daycare Provider Lead Awareness Course
                     Description:    The Daycare Provider Lead Awareness Course was developed by EPA
                                   Region 1 and distributed in all New England states.  State agencies and
                                   nonprofit organizations deliver the course to daycare providers.
                     Partners:      Connecticut Department of Public Health and University of Connecticut
                                   Cooperative Extension System in West Hartford, CT
                     Contact:      Region 1, Maureen McClelland, 617-565-3 543 or Jim Bryson,
                                   617-565-3836
                     Title:          Vermont Lead S afety Proj ect
                     Description:    The Vermont Lead Safety Project, through an EPA grant, has given
                                   hundreds of slide presentations and workshops. Children's puppet shows
                                   on lead have been performed for schools, community groups, daycare
                                   providers, hospitals, and other organizations.  The staff of the project
                                   also provide free phone consultations on lead to the public.
                     Contact:       Region 1, Maureen McClelland, 617-565-3543 or Jim Bryson,
                                   617-565-3836
                     Title:          AmeriCorps/EPA Neighborhood Improvement Project
                     Description:    With EPA funding, AmeriCorps members teach Newark, NJ, residents to
                                   recognize and prevent lead and carbon monoxide poisoning through
                                   public awareness presentations. More than 2,400 residents are more
                                   aware of lead and carbon monoxide poisoning risks and what they can do
                                   to keep themselves and their children healthy.
                     Contact:       Region 2, Louis Bevilacqua, 732-321 -6671
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TMe:          Environmental Justice Grants
Description:    EPA Region 2 has awarded over 45 grants totaling approximately
              $ 1,000,000 to nonprofit grassroots organizations for projects on children's
              health issues, primarily to prevent lead-paint poisoning. Grant programs
              include projects in the Bronx, NY; Syracuse, NY; and Patterson and
              Newark, NJ. One grant supports statewide outreach in New York to
              educate parents of school-aged children about environmental health and
              safety hazards in schools, such as pesticides, lead, asbestos, radon, and
              indoor air pollution.
Contact:       Region2, Melva Hayden, 212-637-5027
Title:          Superfund Risk Assessment for Children
Description:    Using the Integrated Exposure and Uptake Biokinetic (IEUBK) model,
              EPA Region 2 and other EPA regions have improved assessments of risks
              to children posed by Superfund sites. The IEUBK model allows re-
              searchers to evaluate risks to children of ages six months to six years
              through soil ingestion or inhalation. By predicting changes in blood lead
              levels in the population, EPA can evaluate the need for remediation.
              Potential risks to children trespassing onto abandoned hazardous waste
              sites also are evaluated.
Contact:       Region2, Marion Olsen, 212-637-4313
Title:          An Adult Lead Model at Hazardous Waste Sites
Description:    EPA's Region 2 Superfund program has started evaluating risks to women
              of childbearing age and their prospective children from lead exposure at
              commercial and industrial sites. This allows the potential for elevated
              blood lead levels in the developing fetus to be taken into consideration
              when determining whether to proceed with cleanup of lead contamination.
              The model is being used by other EPA regions, states, and contractors.
Contact:       Region 2, Mark Maddaloni, 212-63 7-4315
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                      Title:          Vega Baj a Solid Waste Disposal Site Assessment
                      Description:    EPA Region 2 conducted various tests to determine lead levels at the
                                    Vega Baja landfill site in a rural area of Rio Abajo Ward, Puerto Rico.
                                    Inspection of the site revealed that lead levels in soil samples collected
                                    from the residential area (200 dwellings on 11 acres) were higher than
                                    expected. Additional samples were collected to explore possible lead
                                    hazards in soil, tap water, and homegrown fruits and vegetables. Blood
                                    lead testing of 42 children, ages one to six, living on the Vega Baja site
                                    revealed no indication of health concerns at the present time, although
                                    isolated soil hot spots remain a potential health threat.
                      Partners:       ATSDR, Food and Drug Administration, and Puerto Rico Department of
                                    Health
                      Contact:       Region2, Jose Font, 212-637-6951
                      Title:          Roebling Playground Remediation
                      Description:    Lead paint contamination was removed from two playgrounds near the
                                    Roebling Steel Superfund site in New Jersey. Cleanup activities helped
                                    protect the health of children using the playgrounds. EPA Region 2
                                    continues to monitor the playgrounds in order to protect against recon-
                                    tamination from nearby structures.
                      Contact:       Region 2, Mark Maddaloni, 212-637-4315


                      Title:          Program-Specific Activities and Strategies
                      Description:    EPA Region 3 is working with the CDC and state agencies to promote
                                    community-based assistance projects to reduce and prevent childhood
                                    lead poisoning. Activities designed to protect children include: developing
                                    data on cumulative and simultaneous exposures from industrial chemical
                                    facilities; providing families with improved access to environmental and
                                    health information; developing data systems to facilitate better detection of
                                    children's unmet health needs; and measuring program improvements.
                      Partners:       Centers for Disease Control and Prevention
                      Contact:       Region 3, Aquanetta Dickens, 215-566-2080
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TMe:          Urban Environmental Initiatives
Description:    Region 3 is pursuing environmental and enforcement activities in urban
              areas that have high concentrations of industrial activity coincident with
              populations that are disadvantaged and largely minority. These areas are:
              Baltimore, Maryland; Chester and South/Southwest Philadelphia, Pennsyl-
              vania; and Anacostia, District of Columbia. The Childhood Lead Poison-
              ing Prevention Program provides outreach designed to inform parents of
              the health risks of lead dust and to train them to protect their children from
              these threats. Cleaning kits are distributed to families with at-risk children
              in order to reduce the levels of lead-bearing dust in these homes.
Contact:       Region 3, Reggie Harris, 215-566-2988
Title:          Superfund Evaluation of Lead-Contaminated Soil
Description:    Region 6 has taken response actions at three large lead sites (National
              Zinc, RSR, and Eagle-Picher) and is planning for another at Tar Creek.
              Concerted efforts are being made with state health departments to provide
              hygiene information to residents, schools, and daycare centers for minimiz-
              ing children's exposure to lead. For example, at the National Zinc site,
              EPA worked with Oklahoma's Department of Environmental Quality and
              Department of Health to develop educational programs for preventing
              children's exposure to lead. The agencies held seminars during a blood
              sampling campaign to discuss lead exposure prevention techniques with
              schools and daycare centers. Schools were provided material for children
              to take home to parents. At the RSR site, 1,500 families in seven neigh-
              borhoods received this type of information, and residential yard cleanup
              was conducted on four sites.
Contact:       Region 6, Ghassan Khoury, 214-665-8515 or Don Williams,
              214-665-2197
Title:          Industrial Chrome Plating Emergency Response
Description:    EPA Region 8 emergency response personnel are conducting response
              activities on the Industrial Chrome Plating Site in Denver, Colorado. A
              school is located near the plating facility, and local children used the property
              as a playground and its back alley as a school walkway. Industrial Chrome
              Plating is an abandoned electroplating facility that stored hazardous
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                                    materials, including acidic, caustic, oxidizing, and combustible materials
                                    associated with chrome, nickel, and lead plating. EPA has fenced the
                                    property and is removing hazardous materials and contamination from the
                                    site for disposal.
                      Contact:       Region 8, Due Nguyen, 3 03 -312-6509


                      Title:          Residential Cleanups of Lead-Contaminated Soil
                      Description:    A number of EPA Region 8 Superfund residential cleanups of
                                    lead-contaminated soil are being conducted to protect children under
                                    seven years of age from lead poisoning. These cleanups are intended
                                    primarily to reduce exposure occurring through ingestion of
                                    lead-contaminated soil. Sites being cleaned up are:
                                    • Smuggler Mountain, Colorado, 500 families
                                    • Leadville, Colorado, 1,700 families including 550 children
                                    • East Helena, Montana, 2,100 families including 800 children
                                    • Butte/Silver Bow Creek, Montana, 4,000 families
                                    • Herriman, Utah, 75 families
                                    • Bingham Creek, Utah, 1,100 families including 1,000 children
                                    • Sandy, Utah, 200 families including 250 children
                                    • Midvale, Utah, 600 families including 240 children
                                    • Murray Smelter, Utah, 100 families including 70 children.
                                    Blood lead levels were tested in 200 children of ages ten or less at the Butte/
                                    Silver Bow Creek site and in 45 children at the Smuggler Mountain site.
                      Contact:       Region 8, Susan Griffin, 303-312-6651


                      Title:          Environmental Epidemiological Survey of Lead Exposure of Children in
                                    Tijuana, Mexico
                      Description:    EPA and researchers from the University of California-Irvine are conduct-
                                    ing an epidemiological study of blood lead concentration. The research
                                    includes 1,600 Tijuana children of ages one to six years. Scientists are
                                    exploring sociological and demographic factors related to lead exposure.
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              The project will raise awareness of the problems associated with children's
              exposure to lead among Tijuana government officials, industries, and
              citizens. Work completed includes renovation of a nurses' coordination
              facility, development of a Spanish language survey instrument, training on
              blood lead analysis for Mexicans in San Diego, and agreements with the
              medical services in Tijuana to permit the collection of samples from children.
              Approximately 100 children have been screened over the past year.
Partners:      University of California-Irvine and Centers for Disease Control and Prevention
Contact:      Region 9, Winona Victery, 415-744-1021


Title:          Tribal Children Blood Lead Hazards
Description:   Region 10 is funding a region-wide information and education program
              designed to reduce exposure of tribal children to lead.  During 1996, EPA
              awarded $346,268 in grants to Washington, Alaska, and Idaho for lead
              information outreach to seven tribes and for blood lead level testing in
              tribal children.
Contact:      Region 10, Barbara Ross, 206-553-1985


Title:          Oregon Legal Services Corporation Grant
Description:   Region 10 provided funds to the Oregon Legal Services Corporation for
              outreach on lead poisoning to low-income rural and minority families in
              nine Oregon counties. The project will:
               • develop prevention methods,
               • identify children at risk,
               • direct at-risk children to medical staff for blood lead level testing,
               • obtain information about risk factors in rural housing, and
               • advocate statewide lead abatement programs to identify children at risk.
              Information about lead poisoning hazards will be provided to 8,000 people,
              including more than 80 percent of the area's families. The
              proj ect will identify specific rural concerns for use in state and local
              plans. Blood lead level testing of children between the ages of two and four is
              underway.
Contact:      Region 10, Susan Morales, 206-553-8580
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                      Title:          Migrant Worker Housing Facility Lead and Arsenic Survey
                      Description:    With EPA assistance, the Washington State Department of Health con-
                                    ducted an environmental lead and arsenic study at five migrant worker
                                    housing facilities in North Central Washington. Housing was located in or
                                    adj acent to orchards where soil was thought to be contaminated with lead
                                    arsenate used in the past to control the codling moth in apple and pear
                                    orchards. Data suggest that lead and arsenic remain at these facilities and a
                                    health risk may exist. As a result, efforts are being made to provide risk
                                    information to the residents. A strategy for preventing lead and arsenic
                                    exposure to young children will be implemented prior to the next harvest
                                    season.
                      Contact:       Region 10, Barbara Ross, 206-553-1985


                      Title:          Bunker Hill Superfund Site Childhood Blood Lead Study
                      Description:    EPA Region 10 is conducting a childhood blood lead study in the commu-
                                    nities surrounding the former lead smelter at the Bunker Hill Superfund
                                    Site near Kellogg, ID. Since 1974, every child nine years of age or
                                    younger has been screened annually. The study is used to direct the
                                    efforts of the local health intervention program and to target residential
                                    cleanup activities. Approximately 7,000 adults and 400 children in the
                                    community are affected. Project results show a 30-fold decrease in the
                                    percent of children whose blood lead concentrations exceed ten micro-
                                    grams per deciliter, a ten-fold drop in average blood lead concentrations,
                                    and a decrease in the percentage of children living on contaminated yards.
                      Partners:       Idaho Department of Environmental Quality
                      Contact:       Region 10, Nancy Wilson, 206-553-1237


                      Title:          Yakima Children Blood Lead Study
                      Description:    EPA awarded the Washington State Department of Health more than
                                    $2.5 million in grant funds for determining the extent of threats to children
                                    caused by lead paint and lead dust across the state. A study in the
                                    Yakima, WA, area found that 9 percent of about 170 children (six months
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              to three years old) had elevated blood lead levels. The Agency will rely
              on education and awareness about lead poisoning to reduce blood lead
              levels in children.
Contact:       Region 10, Barbara Ross, 206-553-1985
Title:          Monitoring Compliance with and Enforcing the Requirements of the
              National Drinking Water Regulations for Lead and Copper
Description:    EPA is currently evaluating compliance of public water systems with the
              national primary drinking water regulations for lead and copper. These
              regulations established monitoring and treatment requirements for public
              water systems. This project is designed to ensure compliance by all public
              water systems, thereby reducing the amount of lead children consume from
              drinking water. So far, several hundred enforcement actions have been
              taken by EPA and the states against systems that have failed to meet the
              initial monitoring requirements of the rule. Currently, EPA is evaluating
              data on whether systems have complied with the subsequent requirements
              in the rule (e.g., installation of corrosion control, beginning of lead service
              line replacement). EPA will be working with the states to take appropriate
              actions to return violators to compliance.
Partners:      State agencies
Contact:      Office of Enforcement and Compliance Assurance, Brian Maas,
              202-564-6019 or Betsy Devlin, 202-564-4054


Title:          Investigations and Enforcement at Nonferrous Metal Smelters
Description:    EPA is conducting investigations and enforcement activities at nonferrous
              (other than iron) metal smelters in an effort to reduce overall emissions at
              facilities that violate state or federal regulations. Those in violation may be
              emitting lead and other toxic metals into the air, which may contaminate
              schools and lawns where children play. Sources have been targeted for
              inspections to determine compliance with state and federal requirements.
Contact:      Office of Enforcement and Compliance Assurance, Gary Secrest,
              202-564-8661
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                      Title:           Rulemaking on Do-It-Yourself Debris from Removal of Lead-Based Paint
                      Description:    EPA will clarify the regulations concerning disposal of debris generated
                                    from renovations and remodeling that involves removal of lead-based
                                    paints from private households. This program is aimed at protecting
                                    children because they are most at-risk from lead-based paint in house-
                                    holds. The Agency will encourage homeowners and contractors to
                                    accelerate the removal of lead from children's home environments by
                                    addressing disposal costs for lead-contaminated debris.
                      Contact:       Office of Solid Waste and Emergency Response, Rajani Joglekar,
                                    703-308-8806
                      Title:           Targeting Criminal Violations that Threaten Health and Safety of Children
                      Description:    EPA is implementing strategies to expose potential criminal violations that
                                    threaten the health and safety of children. Criminal enforcement actions
                                    can have direct relevance to children's health. For example, 17 children
                                    showed high blood lead levels after lead mining waste from railroad cars
                                    was illegally disposed of in a rural creek bed near the children's homes.
                                    Criminal actions were pursued in this case and others.
                      Contact:       Office of Enforcement and Compliance Assurance, David Montoya,
                                    202-564-2548
                      Title:           Lead in Children's Products
                      Description:    EPA and the Consumer Product Safety Commission work together to
                                    monitor the use of lead in consumer products, especially those used by
                                    children in the United States. Examples of products that have posed
                                    exposure problems in the past include crayons imported from China, toys
                                    decorated with lead-based paint, and non-glossy vinyl mini-blinds. Both
                                    agencies currently are reviewing studies of lead in other children's vinyl
                                    products.
                      Partners:       Consumer Product Safety Commission
                      Contact:       Office of Prevention, Pesticides, and Toxic Substances, Tova Spector,
                                    202-260-3467
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litle:

Description:
Contact:



Title:
Description:
Contact:
Title:
Description:
Contact:
Lead-Based Paint Activities in Residences and Daycare Centers—State
and Tribal Program Development
Safe removal of lead-based paint requires a professional who knows how
to evaluate and remove the hazard without worsening the problem. To
ensure that homeowners and others who need these services can locate
trained professionals, EPA issued rules on the training and certification of
lead-based paint inspectors and abatement professionals. The rule also
includes procedures for states and tribes to apply to EPA for authorization
to set up their own programs. States and tribes have been given two years
to apply. After August 31,1998, EPA will administer the program in any
remaining states and tribal areas.
Office of Prevention, Pesticides, and Toxic Substances, Mark Henshall,
202-260-5089
Lead-Based Paint Activities in Buildings and Other Structures
In September 1977, EPA took comments on a series of questions EPA
had formulated to better understand the industrial painting sector prior to
developing new regulations for lead-based paint activities in buildings and
other structures. EPA will develop regulations similar to those for lead-
based paint activities in residences and daycare centers. Over the next
year, EPA will gather information on the industry. The proposed rule will
be issued for public comment in 199 8.
Office of Prevention, Pesticides, and Toxic Substances, Ellie Clark, 202-
260-3402
Disposal of Lead-Based Paint Debris
EPA is exploring regulatory alternatives to lower the cost of disposal
of lead-based paint waste while continuing to protect human health and
the environment. These regulations will make abatement less expensive
so that more families will be able to remove lead-based paint from
their homes.
Office of Prevention, Pesticides, and Toxic Substances, Tim Torma,
202-260-4595
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                      Title:          Evaluating the Risks of Lead Hazards from Renovation and Remodeling
                      Description:    The 1992 Lead Hazard Reduction Act required EPA to assess the risk of
                                    exposure to lead resulting from renovation and remodeling of housing,
                                    commercial buildings, and public buildings constructed before 1978. EPA
                                    is currently completing studies of renovation and remodeling activities.
                                    EPA will use the results and consult with stakeholders to determine if
                                    revisions to the training and certification rules for lead-based paint inspec-
                                    tors and abatement professionals are needed.
                      Contact:       Office of Prevention, Pesticides, and Toxic Substances, Dana M.
                                    Screws, 202-260-1562


                      Title:          Lead-Based Paint Hazard Standards
                      Description:    EPA is developing standards that specify the condition and location of
                                    lead-based paint in pre-1978 housing and child-occupied facilities that
                                    can result in exposure to dangerous levels of lead. The regulation also will
                                    specify when lead in household dust and residential soil are at dangerous
                                    levels, and provide objective criteria for identifying hazards in housing.
                      Contact:       Office of Prevention, Pesticides, and Toxic Substances, Jonathan
                                    Jacobson, 202-260-3779


                      Title:          Lead-Based Paint in Housing Disclosure Requirements and Implementation
                      Description:    In March 1996, EPA and HUD issued final regulations implementing the
                                    disclosure requirements mandated under Section 1018 of the Residential
                                    Lead-Based Paint Hazard Reduction Act of 1992. The regulations
                                    impose obligations on sellers and lessors. These provisions will ensure
                                    that families receive lead hazard information before they buy or rent
                                    housing built before 1978. The new rule recognizes the public's right to
                                    know about potential hazards in the home and options for reducing those
                                    hazards. The Agency is working with national and local media, child and
                                    housing advocates, the real estate community, and local community
                                    leaders to highlight awareness of the issue and the law, and to ensure the
                                    smooth implementation of the rule.
                      Partners:       U.S. Department of Housing and Urban Development and Alliance to
                                    End Childhood Lead Poisoning
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Contact:       Office of Prevention, Pesticides, and Toxic Substances, Dayton Eckerson,
              202-260-1561 or Megan Carroll, 202-260-7269
Title:          Redefining Childhood Blood Lead Level Reduction Goals and Lead
              Strategic Plan
Description:    EPA is revising the Environmental Lead Goals for 2005 based on new
              data from the Third National Health and Nutrition Examination Survey
              (NHANES III) Phase II report published in 1997.  EPA and the CDC will
              evaluate all applicable data.
Partners:      Centers for Disease Control and Prevention
Contact:       Office of Prevention, Pesticides, and Toxic Substances, Dana M. Screws,
              202-260-1562
Title:          Environmental Indicators Bulletin
Description:    As part of a series of environmental indicator bulletins, EPA is developing
              the Lead in the Environment bulletin. This public outreach document
              provides information on the sources of lead in the environment, the state of
              human health related lead exposure, and responses taken to reduce lead
              exposures.
Contact:       Office of Policy, Planning, and Evaluation, Susan Auby, 202-260-4901


Title:          National Lead Information Clearinghouse
Description:    The National Safety Council, under a cooperative agreement with EPA,
              operates the National Lead Information Clearinghouse—a valuable
              resource for the public on lead hazards. Parents, homeowners, state and
              local officials, and anyone else can speak to a trained lead specialist and
              receive answers over the phone, request written materials, or obtain
              references to other resources. The Clearinghouse operates in both English
              and Spanish and maintains a web site and fax service to better serve the
              needs of the public (see Chapter 11).
Partners:       U. S. Department of Housing and Urban Development and Centers for
              Disease Control and Prevention
Contact:       Office of Prevention, Pesticides, and Toxic Substances, Georgene
              Cooper, 202-260-3904
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                      Title:           Lead Poisoning Prevention and Lead Hazard Awareness Public Educa-
                                    tion and Outreach Grant Program
                      Description:    In 1997, EPA announced a new lead poisoning prevention and lead
                                    hazard awareness public education and outreach grant program. The
                                    purpose of the program is to increase lead-based paint hazard awareness
                                    and promote lead-poisoning prevention to high-risk target audiences.
                                    EPA is particularly interested in supporting projects conducted by smaller
                                    organizations, such as local governments, community groups, and other
                                    specialized non-governmental organizations operating on the local level.
                      Contact:       Office of Prevention, Pesticides, and Toxic Substances, Megan Carroll,
                                    202-260-7269
                      Title:           Lead-Based Paint Maintenance Training Program
                      Description:    EPA and the HUD have developed a lead-safe training program for
                                    building maintenance staff. The training is designed to educate workers
                                    and their supervisors at multi-unit rental properties on techniques to use
                                    during routine maintenance to prevent lead hazards in the buildings they
                                    maintain.
                      Contact:       Office of Prevention, Pesticides, and Toxic Substances, Jack Primack,
                                    202-260-3407
                      Title:           Renovation and Remodeling Study Phases 1 and 2
                      Description:    EPA is conducting a renovation and remodeling study to characterize the
                                    lead levels associated with selected renovation and remodeling activities
                                    and the blood lead levels from a survey of workers who typically engage
                                    in renovation and remodeling.
                      Contact:       Office of Prevention, Pesticides, and Toxic Substances, Darlene Watford,
                                    202-260-3989


                      Title:           Laboratory Study of Lead Cleaning Products
                      Description:    EPA conducted a laboratory study of cleaning products. In the past, EPA
                                    has recommended the use of trisodium phosphate or powdered dish-
                                    washer detergent with a high phosphate content for cleaning dust.  Based
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              on the study, EPA now recommends cleaning with an all-purpose cleaner
              or cleaner made specifically for lead. This recommendation is for cleaning
              after a lead-based paint abatement and for regular household cleaning.
              One conclusion was that the amount of effort involved in cleaning probably
              is more important than the choice of cleaning product.
Contact:      Office of Prevention, Pesticides, and Toxic Substances, Ben Lim, 202-
              260-1509


Title:          Renovation and Remodeling Study Phase 3
Description:   EPA is working with the University of Wisconsin to study the relationship
              between the incidence of renovation and remodeling activities and
              children's blood lead levels. Data has been collected from approximately
              3,600 households.  Participants were administered an extensive question-
              naire by telephone. The primary goal is to determine if there is an associa-
              tion between elevated blood lead levels in children and renovation and
              remodeling activities in the home. A secondary goal is to examine the
              relationship between behavioral characteristics and blood lead levels.
Partners:      University of Wisconsin
Contact:      Office of Prevention, Pesticides, and Toxic Substances, Dan Reinhart,
              202-260-1585
Title:          Guidance for Testing Lead Products
Description:   The goal of this project is to develop guidelines and performance characteris-
              tics for the testing of lead hazard identification and lead hazard control prod-
              ucts by third party organizations. A number of meetings with affected stake-
              holders are planned to gather information on how a third party testing program
              would work. In the past, EPA has tested lead-related productsby itself.
Contact:      Office of Prevention, Pesticides, and Toxic Substances, Darlene Watford,
              202-260-3989
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                     Title:           Repair and Maintenance Study
                     Description:    This study examined the effect of different levels of lead-based paint
                                    interventions on dust and children's blood lead levels. The study includes
                                    three intervention groups, a control group of homes built after 1978, and a
                                    group of homes previously abated. The three intervention groups applied
                                    a series of control measures that cost about $ 1,500 per home for the least
                                    intensive intervention, about $3,000 per home for the next level of inter-
                                    vention, and $6,000-7,000 per home for the most expensive intervention.
                                    Reports on the outcome will be published in 1998.
                     Partners:       Kennedy Krieger Research Institute
                     Contact:       Office of Prevention, Pesticides, and Toxic Substances, Ben Lim, 202-
                                    260-1509
                     Title:           Milwaukee Low-Cost Intervention Studies
                     Description:    In cooperation with the Milwaukee Health Department, EPA is assessing
                                    the effectiveness of in-home visits by trained representatives of the Health
                                    Department and of low-cost abatement methods. The in-home visits
                                    cover hygiene, nutrition, cleaning, and reducing lead exposure, and they
                                    cost approximately $ 100 per visit. The abatement methods include paint
                                    stabilization and window treatments.
                     Partners:       City of Milwaukee Health Department and University of Wisconsin
                     Contact:       Office of Prevention, Pesticides, and Toxic Substances, Brad Schultz,
                                    202-260-3896
                     Title:          National Lead Laboratory Accreditation Program (NLLAP)
                     Description:   The NLLAP provides a list of laboratories recognized by EPA as being
                                   proficient for analysis of lead in paint, dust, and soil. Two additions to the
                                   NLLAP are planned. First, the proficiency testing part of NLLAP will be
                                   changed to a double-blind system that more closely represents typical
                                   laboratory performance.  Second, the NLLAP will be expanded to
                                   include field-portable technologies commonly used to test for lead in
                                   paint, dust, and soil.
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Partners:      National Institute for Occupational Safety and Health, Centers for
              Disease Control and Prevention, and U.S. Department of Housing and
              Urban Development
Contact:      Office of Prevention, Pesticides, and Toxic Substances, John Scalera,
              202-260-6709


Title:          Assessment of the Effectiveness of Risk Assessments
Description:    Risk assessments are conducted to identify and control lead hazards. The
              purpose of this project is to determine if risk assessments are effective in
              identifying hazards that would cause a child to have an elevated blood lead
              level.
Contact:      Office of Prevention, Pesticides, and Toxic Substances, Susan Dillman,
              202-260-5375


Title:          CD-ROM Release of Technical Reports
Description:    The purpose of this project is to produce and release a CD-ROM copy
              of technical lead reports dealing with lead in paint and soil, and some of
              the larger data sets associated with those reports. The release of the CD-
              ROM will make these reports and data available to a wider audience than
              in the past.
Contact:      Office of Prevention, Pesticides, and Toxic Substances, Sam Brown,
              202-260-2282


Title:          Dissemination of Technical Information
Description:    EPA has published a substantial number of documents in recent years
              on a variety of lead issues. Staff continuously update EPA's lead home
              page with current information, publicize available reports, and speak at
              professional meetings in order to make the public aware of the available
              information.
Contact:      Office of Prevention, Pesticides, and Toxic Substances, Ron Morony,
              202-260-0282 or John Schwemberger, 202-260-7195
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                      Title:          Evaluating Food Contamination Scenarios in Dietary Exposure
                                    Studies—Child Dietary Lead Study
                      Description:    EPA is conducting a study to examine dietary lead exposure using experi-
                                    mental techniques for determining actual lead intake of children two to
                                    three years of age. The subjects live in New Jersey homes with high
                                    levels of environmental lead. Dietary exposure is being evaluated by
                                    collecting food samples representative of the foods young children eat in
                                    their homes. EPA also is collecting samples of drinking water, dust on
                                    floors, and data on skin exposure, as well as measuring blood lead levels
                                    to evaluate the potential for food to be contaminated during handling and
                                    eating by the child.
                      Contact:       Office of Research and Development, Maurice Berry, 513-569-7284


                      Title:          Effects of Lead on Adolescent Development
                      Description:    This study will examine the relationship between blood lead levels and
                                    adolescent development and maturation. Both human and laboratory
                                    studies suggest that relatively low levels of lead exposure may affect the
                                    growth and sexual maturation of the child.
                      Partners:       Indo-U.S. Collaborative Program in Science and Technology
                      Contact:       Office of Research and Development, Gary Kimmel, 202-260-5978


                      Title:          Long-Term Potentiation as a Model System for Cognitive Function
                      Description:    This study utilizes lead as a model compound for establishing methods of
                                    identifying chemicals that can disrupt brain function over the long term by
                                    affecting nerve cell development. Using a biologically-based
                                    dose-response (BBDR) approach, the research will try to establish a
                                    direct link between the many alterations in cell function that accompany
                                    lead exposure and the observed effects of lead on intellectual function in
                                    children.
                      Contact:       Office of Research and Development, Elaine Francis, 202-564-6789


                      Title:          The Integrated Exposure Uptake Biokinetic (IEUBK) Model
                      Description:    This project will broaden the usefulness of the IEUBK Model for assess-
                                    ing lead in children. The improved model will provide better estimates of
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              lead in blood, bone, and other tissues for children in the first six months of
              infancy. The current model does not estimate concentrations in these
              tissues until after six months due to a lack of information on the maternal
              contribution to fetal lead burdens.  The project will incorporate data on the
              mobilization of bone-lead during pregnancy and the uptake and distribution
              of this lead into fetal tissues.
Contact:       Office of Research and Development, Robert Elias, 919-541-4167
            DisRupiORs
Title:          Test Guidelines for Developmental Neurotoxicity
Description:    EPA is working with the Organization of Economic Cooperation and
              Development to produce an international testing guideline that will evaluate
              the effects of prenatal and early post natal exposure to chemicals on the
              developing nervous system of laboratory animals.
Contact:       Office of Prevention, Pesticides, and Toxic Substances, Susan Makris,
              703-305-5222
Title:          Test Methodologies for Endocrine Disrupters
Description:    The Food Quality Protection Act of 1996 mandates that EPA develop
              screening and testing methods for certain kinds of endocrine disrupters.
              Supported by the work of the Endocrine Disrupter Screening and Testing
              Advisory Committee, EPA is developing screens and tests for the evalua-
              tion of potential effects mediated by estrogens, androgens, and thyroid
              hormones.
Contact:       Office of Prevention, Pesticides, and Toxic Substances, Gary Timm,
              202-260-1859
Title:          Pollutant-Specific Risk Assessments
Description:    EPA is studying pollutant-specific assessments that address risks to
              children. Risks under evaluation include exposure to PCBs, environmen-
              tal tobacco smoke, and mercury.  Researchers also are conducting a
              reassessment of dioxin risks to children.
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                      Contact:       Office of Research and Development, Jim Cogliano, 202-260-3814;
                                    Jennifer Jinot, 202-260-8913; Gary Kimmel, 202-260-5978; Sherry
                                    Selevan, 202-260-2604; or Kate Mahaffey, 513-569-7957
                      Title:           The Effects of Pesticides on Reproductive Toxicity
                      Description:    Research on the effects that perinatal exposures to pesticides have on the
                                    function of the reproductive system are being examined. The prolonged
                                    gestation period of rabbits closely approximates the infancy-adolescence
                                    phase in humans. Male rabbits are being evaluated for alterations in
                                    endocrine markers (such as hormone levels), semen (sperm number,
                                    motility and morphology), fertility, and reproductive organ changes.
                      Contact:       Office of Research and Development, Gary Klinefelter, 919-541 -5779


                      Title:           Effects of Endocrine Disrupters on Disposition of Testosterone in Adult
                                    and Developing Rats
                      Description:    This proj ect will measure changes in testosterone in rats administered
                                    anti-androgenic chemicals (one form of an endocrine disrupter). Project
                                    results will aid understanding of how anti-androgens affect adolescent and
                                    adult rats.
                      Contact:       Office of Research and Development, Teresa Leavens, 919-541 -4431
                      Title:           Mechanisms of Abnormal Reproductive Development Produced by
                                    Endocrine Disrupting Chemicals Administered during Critical Develop-
                                    mental Periods
                      Description:    The purpose of this research is to identify mechanisms of toxicity and to
                                    develop biological models.  These models will help to assess the severity
                                    of the risk of endocrine disrupters to human health. Several endocrine
                                    disrupting chemicals that primarily target the reproductive system of
                                    developing and adult animals are under investigation.
                      Contact:       Office of Research and Development, Earl Gray, 919-541 -7750 or
                                    WilliamKelce, 919-541-1580
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TMe:
Description:
Contact:


Title:
Description:
Contact:
              Effects of Environmental Toxicants on the Steroid Hormone Pathway
              This research will characterize the toxic effects of environmental sub-
              stances (4-tert-octylphenol, nonylphenol, bisphenol A, phytoestrogens)
              on steroid receptors; address differences in age, gender, and target tissue
              sensitivities; identify pathways through which toxics alter steroid receptor
              function; and demonstrate how such changes relate to altered fertility.
              Office of Research and Development, Susan Laws, 9 1 9-54 1-0173


              Endocrine Disrupters
              EPA Region 5 has initiated several forums to increase the understanding of
              endocrine disrupters. Activities include hosting a symposium with national
              experts to discuss endocrine disrupters and policy implications for the Great
              Lakes Basin; providing presentations about recent research on endocrine
              disrupters for tribal representatives, the public, and other regional staff;
              including endocrine disrupters as contaminants of concern at Superfund
              sites; and funding grants for research on endocrine disrupters.
              Region 5, Amy Pelka, 3 12-886-9858 or Lara Pullen, 3 12-886-0138
PCBs ANd DioxiN
Title:          Polychlorinated Biphenyls (PCBs) and Polychlorinated Benzodifuran
              (PCDF) Biomarkers of Risk Assessment in Adolescent Children and
              Mothers
Description:    This is a comparison study of endocrine and cytochrome biomarkers for
              risk assessment of developmental toxicities in humans induced by PCBs
              and PCDF. The study will examine effects in mother rats and their sexu-
              ally mature adolescents that have been exposed to high levels of PCB/
              PCDF since conception. Biomarkers (induction of cytochrome enzymes
              and serum levels of endocrine hormones) will be measured in the subjects.
              Adverse health impacts on sexual maturation, menstrual cycles, neuro-
              behavioral development, and growth will be examined.
Partners:      Mississippi State University
Contact:      Office of Research and Development, David Reese, 202-564-6919
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                      Title:          Neurotoxicity of PCBs
                      Description:    This project examines the long-term consequences of developmental PCB
                                    exposure in rats. PCB-induced changes in calcium homeostasis in the
                                    brain are being examined as a basis for long-term behavioral effects.
                      Contact:       Office of Research and Development, Prasada Kodavanti,
                                    919-541-7584
                      Title:          Developmental Toxiciry of PCBs
                      Description:    This proj ect focuses on examining whether perinatal exposure to PCBs
                                    alters the development of learning and memory behavior in rats. Re-
                                    searchers are studying whether these alterations are associated with
                                    changes in neurotransmitters (chemicals that transmit signals in the brain)
                                    in the central nervous system. The physiology of chemical-induced
                                    thyroid dysfunction also is being investigated.
                      Contact:       Office of Research and Development, Christopher Lau, 919-541 -5097


                      Title:          The Ototoxicity of Developmental Exposure to PCBs
                      Description:    This project tests the hypothesis that developmental exposure of rats to
                                    PCBs results in abnormal development of the hearing system. Research-
                                    ers also are studying whether this toxic effect is related to alterations in
                                    thyroid hormone levels.
                      Contact:       Office of Research and Development, Kevin Crofton, 919-541 -2672


                      Title:          Toxicokinetics in Pregnant and Lactating Rats
                      Description:    The amount of TCDD, a dioxin, transferred from mothers to fetal tissues
                                    is being assessed in rats in order to understand the effects of dioxin
                                    concentrations on development. Researchers are determining tissue
                                    concentrations following single or continuous exposures, and examining
                                    the possibility of transferring dioxin from mothers to nursing infants
                                    through breast milk.
                      Contact:       Office of Research and Development, Linda Birnbaum, 919-541 -2655 or
                                    Christine Hurst, 541-754-4739
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litle:
Description:
Partners:
Contact:
MERCURY


Title:
Description:
Contact:


Title:
Description:
Contact:


Title:
Description:
PCB Compliance Monitoring Cooperative Agreement Funding for States
EPA provides funds to 14 states to carry out PCB compliance monitoring
activities. States make referrals to EPA on potential violations of federal
requirements that require clear identification and marking of PCBs and
proper use and disposal.
State agencies
Office of Enforcement and Compliance Assurance, JackNeylan, 202-
564-5033 or Karen Taimi, 202-564-5046
Great Lakes Binational Toxics Strategy
This Canada-U.S. strategy seeks to eliminate persistent toxic substances,
such as mercury, PCBs, lead, and dioxins/furans from the Great Lakes
Basin. The strategy sets specific percentage reduction targets for many of
these substances. For example, the strategy calls for a 50 percent reduc-
tion in the use and release of mercury.
Region 5, Elizabeth LaPlante, 312-353-2694


Promulgation of Standards for Municipal Waste Combustion (MWC)
Municipal waste combustors (MWCs) located primarily in urban areas
emit mercury, dioxin, lead, and other pollutants related to developmental
problems and birth defects. EPA's MWC rules of 1995 were struck
down by the courts in December 1996 because of a challenge by a
municipality.  However, EPA has filed a petition to vacate a portion of the
rules that were under dispute, allowing the remainder to go into effect.
EPA's action will allow standards applicable to MWC units, representing
87 percent of the capacity in the United States, to remain in effect.
Office of Air and Radiation, Bruce Jordan, 919-541 -5572


Emergency Response
EPA Region 8 has responded to several emergency situations at sites
where children were found playing with mercury. Approximately seven
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                                    children were affected through this type of mercury exposure at two
                                    mobile homes and an apartment during 1993. In each case, Region 8 's
                                    Emergency Response Team helped local officials identify and clean up
                                    areas of contamination. EPA personnel collected air samples, tested
                                    children who had touched or played with the mercury, and disposed of
                                    contaminated materials, personal items, and soils.
                      Contact:       Region 8, Due Nguyen, 3 03 -312-6509


                      Title:           Mercury Neurotoxicity in Children
                      Description:    EPA Region 8 is conducting an outreach proj ect aimed at increasing the
                                    awareness of emergency cleanup personnel, parents, and others about the
                                    risk of mercury exposure. A collaborative effort with the states in Region
                                    8 focuses on identifying and preventing mercury neurotoxicity in children
                                    exposed to mercury vapors in homes.  EPA has set standards and coordi-
                                    nated with emergency response personnel in Colorado and Wyoming to
                                    identify children who are overexposed to mercury in homes and are at
                                    risk for mental injury.
                      Contact:       Region 8, Chris Weiss, 3 03 -312-6671


                      Title:           Grand Street Relocation
                      Description:    EPA provided immediate temporary relocation of the residents of a
                                    converted loft building in Hoboken, NJ, when resident families were
                                    exposed to high levels of mercury. The building's former use as a mercury
                                    vapor lamp factory was discovered when mercury began oozing from the
                                    walls and ceilings during residential renovation. Six children were among
                                    the residents; all had elevated mercury levels in their urine. Mercury levels
                                    in all residents, including children, have decreased since relocation.
                      Contact:       Region 2, Marian Olsen, 212-637-4313
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TMe:          Pollutants and Neurobehavioral Function in the Czech Republic
Description:    This study focuses on determining the relationship between behavioral test
              performance in school children and their exposure to pollutants, particu-
              larly mercury and arsenic. Elevated mercury levels in the urine of children
              have been associated with behavioral problems. Poorer test perfor-
              mances were found in children residing in heavily polluted mining areas.
Contact:       Office of Research and Development, David Otto, 919-541 -0479


Title:          Developmental Biologically-Based Dose-Response (BBDR) Model for
              Mercury Vapor
Description:   This proj ect focuses on developing a biologically-based dose-response
              model for the effects of mercury vapor in rats following developmental
              exposure. Biologically-based models describe and quantify the key steps
              in cellular, tissue, and organism responses to environmental toxicants.
              Changes in prenatal  and neonatal nervous systems of rats were found to
              be associated with mercury exposure over time. Information gained from
              this study will be used to determine nervous system changes in children
              exposed to mercury vapor and associated risks.
Partners:       National Institute of Environmental Health Sciences
Contact:       Office of Research and Development, Stanley Barone, Jr., 919-541-3916


Title:          Prenatal Developmental Research
Description:    EPA is conducting prenatal developmental research to determine age-
              related sensitivities and reduce risks to fetuses and children.  This research
              identifies and quantifies effects to provide data that will be used by the
              Agency to assess potential hazards to humans resulting from exposure to
              various environmental pollutants. EPA also is evaluating methods for using
              data collected in animal studies to predict health outcomes in humans.
Contact:       Office of Research and Development, Robert!.  Kavlock,
              919-541-2771
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                      Title:          Perinatal Exposure of Rats to Toxic Chemicals and the Effects on Immune
                                    Function Development
                      Description:    Immune systems in rats are being evaluated at various ages following
                                    perinatal exposure to pesticides or toxic chemicals. Researchers will
                                    determine if developmental exposure to pesticides or toxic chemicals
                                    results in persistent alterations in immune system response.
                      Contact:       Office of Research and Development, Ralph Smialowicz, 919-541 -5776


                      Title:          Molecular Mechanisms Common to Toxicant-Induced Neural Injury
                      Description:    This proj ect utilizes nerve cell proteins as indicators of neural damage to
                                    the developing and adult nervous system. Tests have been developed for
                                    localizing nerve cell proteins that are used to assess critical toxic effects on
                                    normal nervous system maturation, such as the growth and development
                                    of new nerve cells, dendrites, and synapses (e.g., neurogenesis, myelino-
                                    genesis, and synaptogenesis).
                      Contact:       Office of Research and Development, Elaine Francis, 202-564-6789


                      Title:          Individual Variability for Neurotoxic Effects
                      Description:    EPA is evaluating how neurotoxic effects vary among individuals within a
                                    sensitive subpopulation, such as children. The results will be used to more
                                    accurately predict risks in children from neurotoxics.
                      Contact:       Office of Research and Development, Kenneth Hudnell, 919-541-7866


                      Title:          Environmental Exposures and Human Neurological Function
                      Description:    This project involves the development and testing of neurobehavioral and
                                    electrophysiological tests for evaluating the effects of neurotoxic chemicals
                                    in humans and animals.
                      Contact:       Office of Research and Development, Kenneth Hudnell, 919-541-7866
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REfERENCES

1.   Bellinger, D., A. Leviton, and C. Waternaux. 1987. Longitudinal Analyses of
    Prenatal and Postnatal Lead Exposure and Early Cognitive Development. New
    England Journal of Medicine. Volume 316, Pages 1037-1043.
2.   Needleman,H.L.,A. Schell,andD. Bellinger. 1990. The Long-Term Effects of
    Exposure to Low Doses of Lead in Childhood: 11-Year Follow-Up Report. New
    England Journal of Medicine. Volume 322, Pages 83-88.
3.   McLaughlin, J.F., R.W. Telzrow, and C.M.  Scott. 1980. Neonatal Mercury Vapor
    Exposure in an Infant Incubator. Pediatrics. Volume 66, Number 6, Pages 988-990.
4.   Maker, E.L.,T.J. Smith, and PL. Landrigan. 1985. The Neurotoxicity of Industrial
    Solvents: A Review of the Literature. American Journal of Industrial Medicine.
    Volume 8, Pages 207-217.
5.   Morgan, D.P. 1989. Recognition and Management of Pesticide Poisonings (4th
    Edition). Publication Number EPA 540-9-88-001. U.S. Environmental Protection
    Agency.
6.   Schardein, J.L. andK.A.  Keller. 1989. Potential Human Developmental Toxicants
    and the Role of Animal Testing in their Identification and Characterization.  CRC
    Review and Toxicology. Volume 19, Pages 251-339.
7.   NRC. 1993. Pesticides in the Diets of Infants and Children. National Research
    Council. Washington, DC: National Academy Press.
8.   Needleman, H.L. andC.A. Gatsonis. 1990. Low-Level Lead Exposure and the
    IQ of Children: A Meta-Analysis of Modern Studies. Journal of American Medical
    Association. Volume263, Pages 673-678.
9.   ATSDR. 1993. Toxicological Profile for Arsenic. U.S. Department of Health and
    Human Services, Public Health Service. Agency for Toxic Substances and Disease
    Registry.
10. ATSDR. 1993. Toxicological Profile for Lead. U.S. Department of Health and
    Human Services, Public Health Service. Agency for Toxic Substances and Disease
    Registry.
11. Gilbert, S.G. andK.S. Grant-Webster. 1995. Neurobehavioral Effects of Devel-
    opmental Methylmercury Exposure. Environmental Health Perspectives. Volume
    103(Suppl. 6), Pages 135-142.
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                     12.  ATSDR. 1993. Case Studies in Environmental Medicine: Lead Toxicity. U.S.
                         Department of Health and Human Services, Public Health Service. Agency for
                         Toxic Substances and Disease Registry.
                     13.  ATSDR. 1989. Toxicological Profile for PCBs. U. S.  Department of Health and
                         Human Services, Public Health Service. Agency for Toxic Substances and Disease
                         Registry.
                     14.  ATSDR. 1994. Toxicological Profile for 4,4'-DDT,4,4'-DDE,4,4'-DDD (Up-
                         date). U.S. Department of Health and Human Services, Public Health Service.
                         Agency for Toxic Substances and Disease Registry.
                     15.  ATSDR. 1997. Healthy Children—Toxic Environments.  Report of the Child Health
                         Workgroup. U.S. Department of Health and Human Services, Public Health
                         Service. Agency for Toxic Substances and Disease Registry.
                     16.  CDC. 1997.  Update: Blood Lead Levels—United States, 1991-1994. Morbidity
                         and Mortality Weekly Report. Volume 46, Number 7, Pages 141 -145.
                     17.  Sargent, J.D., M.J. Brown, J.L.  Freeman, A. Bailey, etal. 1995. Childhood Lead
                         Poisoning in Massachusetts Communities: Its Association with Sociodemographic
                         and Housing Characteristics. American Journal of Public Health. Volume 85, Pages
                         528-534.
                     18.  Gemmel, D.  1994. Association of Housing Age and Condition with Blood Lead
                         Levels. In: Proceedings of the 25th Public Health Conference on Record and
                         Statistics.
                     19.  USEPA. 1996. Lead Hazard Prevention in Homes: Fact Sheet. Publication
                         Number EPA 747-F-96-003 .U.S. Environmental Protection Agency, Office of
                         Prevention, Pesticides, and Toxic Substances.
                     20.  ATSDR. 1995. A Case-Control Study to Determine Risk Factors for Elevated
                         Blood Levels in Children. U.S. Department of Health and Human Services, Public
                         Health Service, Agency for Toxic Substances and Disease Registry.
                     21.  Kavlock, R.J. andG.T. Ankley. 1996. A Perspective on the Risk Assessment
                         Process for Endocrine-Disruptive Effects on Wildlife and Human Health. Risk
                         Analysis. Volume 16, Pages 731-739.
                     22.  USEPA. 1997. Special Report on Endocrine Disruption: An Effects Assessment
                         and Analysis. Publication Number EPA 630-R-96-012. U.S. Environmental
                         Protection Agency, Office of Research and Development.
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23. Kimbrough, R.D. 1995. Polychlorinated Biphenyls (PCBs) and Human Health: An
    Update. Critical Reviews of Toxicology. Volume 25, Pages 133-163.
24. ATSDR. 1992. Congressional Testimony: Public Health Implications of Dioxins.
    Department of Health and Human Services, Public Health Service, Agency for Toxic
    Substances and Disease Registry.
25. Schantz, S.L.  1996. Developmental Neurotoxicity of PCBs in Humans: What Do
    We Know and Where Do We Go from Here? Neurotoxicology and Teratology.
    Volume 18, Pages 217-227.
26. Silbergeld, E.K. 1993. Evaluating the Success of Environmental Health Programs in
    Protecting the Public's Health. In: Hazardous Waste Conference 1993. Agency for
    Toxic Substances and Disease Registry.
27. ATSDR. 1989. Public Health Statement: PCBs. U.S. Department of Health and
    Human Services, Public Health Service, Agency for Toxic Substances and Disease
    Registry.
28. Amler, R.W., D.A. Rice, and B.L.  Johnson. 1996. Assessment of Mercury Neu-
    rotoxicity through Psychometric and Neurobehavioral Testing. Neurotoxicology.
    Volume 17, Pages 237-240.
29. Koos, B.J. andL.D.  Longo. 1976. Mercury Toxicity in Pregnant Women, Fetuses,
    and Newborn Infants. Obstetrics and Gynecology. Volume 126, Pages 390-409.
30. Mena, L.,O. Meurin, S. Feunzobda, and G.C. Cotzias. 1969.  Chronic Manga-
    nese Poisoning—Clinical Picture and Manganese Turnover. Neurology. Volume 17,
    Pages 128-136.
31. Mena, L.,H. Kazuko, K. Burke, and G.C. Cotzias. 1969. Chronic Manganese
    Poisoning—Individual Susceptibility and Absorption of Iron. Neurology.  Volume 19,
    Pages 1000-1006.
32. USEPA. 1996. National Air Quality and Emissions Trends Report, 1995. Publica-
    tion Number EPA 454-R-96-005. U.S. Environmental Protection Agency, Office of
    Air and Radiation.
33. USEPA. 1997. Report to  Congress on Mercury. U.S. Environmental Protection
    Agency, Office of Air and Radiation.
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                     LlApTER  5
                                                                EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                   EFFECTS
of
                     A pesticide is any substance intended to destroy, prevent, or repel pests, such as insects,
                     weeds, fungi, and rodents. The term pesticide includes numerous types of substances
                     designed for different purposes. For instance, herbicides kill unwanted plants, fungicides
                     kill fungi, rodenticides kill rodents, and disinfectants kill microorganisms. Although many
                     pesticides are synthesized from petroleum, some are derived from natural origins.
                               Childhood Pesticide Facts
               * Children develop leukemia three to nine times more often when pesticides are
                 used around their homes.(l ,2)
               * Brain tumors and other cancers in children have been linked with exposures to
                 insecticides.(3,4,5)
               * EPA estimated that as much as 75 percent of household pesticide use is inside
                 the home and 22 percent is in yards and gardens.(6)
                     Pesticides are used widely in the United States, but not without some risk. Depending on
                     the dose, pesticides may cause a range of harmful health effects and may accumulate in
                     ecosystems. Among the health effects reported are cancer, acute and chronic injury to the
                     nervous system, lung damage, reproductive dysfunction, and possibly dysfunction of the
                     endocrine (hormone) and immune systems.(7,8)
                     Children are at greater risk of pesticide exposure than most adults. Pound for pound of
                     body weight, children not only breathe more, eat more, and have a more rapid metabo-
                     lism than adults, but also they play on the floor and lawn where pesticides are commonly
                     applied. Children have more frequent hand-to-mouth contact as well.
                     Children may be exposed to pesticides in their diets, drinking water, and during activities
                     at home, play, and school. Children may be exposed more heavily to certain pesticides
                     because they consume a diet different than adults. For instance, children typically con-
                     sume larger quantities of milk, applesauce, and orange juice per pound of body weight.
                     This means their exposure to any pesticide residues in these foods may be higher than that
                     of adults. Children generally are more susceptible than adults to environmental toxics
                     because they are growing and developing.  Also, their enzymatic, metabolic, and immune
                     systems are immature, allowing in some cases for less natural protection than that of
                     adults.(9,10)
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Several hundred active ingredients, representing thousands of pesticide products, are
registered with the EPA.( 1 0) Some may cause massive acute poisoning if used improperly.
Others have no obvious immediate effects, but may lead to cancer, nervous system injury,
or immune system damage years or decades after exposure. (10)
                      EffEds FROM PEsiicidE  EXPOSURE
The organophosphate and carbamate insecticides are commonly-used pesticides and are,
therefore, a concern for children. Organophosphate insecticides work by disrupting the ner-
vous system of insects . Unfortunately, they have a similar effect on people, pets, and wildlife.
Exposure to organophosphates inhibits an important enzyme (acetylcholinesterase) found at
many nerve endings. Inhibiting this cholinesterase enzyme can cause excessive nerve stimula-
tion. Pinpoint pupils, nausea, vomiting, abdominal pain, diarrhea, profuse sweating, and muscle
twitching are common symptoms after exposures to high doses of organophosphate pesti-
cides . Respiratory paralysis and death may occur in severe cases. Repeated exposures may
damage the nervous system.
Carbamate insecticides are very similar to the organophosphates, but the acute effects are
usually reversible.(8,l 1) For this reason, carbamate insecticides often are used instead of
organophosphates.  Delayed adverse effects to the nervous system have not been docu-
mented with the newer carbamate chemicals.
In recent years, scientists have become concerned that certain chemicals, including a few
pesticides, might be disrupting the endocrine systems of humans and wildlife. Scientists
also have proposed that endocrine disruption might result in cancer and harm to the
reproductive system and thyroid glands. (8, 12) EPA activities related to endocrine disrup-
ters are described in Chapter 4 Developmental and Neurological Effects .
Pesticides may present a threat to the health of children because of their wide-spread use, high
toxicity and possible misuse by uninformed, inexperienced homeowners and professionals.
Some active ingredients in pesticides have been shown to cause birth defects, cancer, and
thyroid disease in rats and mice .  Supposedly inert ingredients in any pesticide product may
include solvents, diesel fuel, or other petroleum products that also may be toxic to exposed
children.(9,10,ll)

PossiblE ENVIRONMENTAL FACTORS

DiETARy EXPOSURES
Infants and children may be exposed to trace amounts of pesticides in food and in breast
milk. EPA regulates trace amounts of pesticides, termed "residues," in food through a
        EffEcrs of
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                      system of standards called "food tolerances." A tolerance is a legal limit on the amount of
                      pesticide in a particular food. In the past, the amount of pesticide predicted to be consumed
                      was based on the behavior and diet of an average adult American rather than on the special
                      susceptibility, diet, and behavior of children.( 10,11) For over a decade, however, assess-
                      ments of pesticide residues in the diet has included other age groups, including children under
                      one year of age and one to six years of age. Also in the past, EPA considered the effects of
                      each pesticide in isolation rather than recognizing that people, and especially children, often
                      are exposed to many pesticide residues at the same time. This practice has changed in light
                      of the requirements of the 1996 Food Quality Protection Act.
                      Certain agricultural chemicals, particularly herbicides, have been detected in ground water
                      in some areas of the country. (13,14) As aresult, children and others maybe exposed to
                      pesticides through their drinking water. Although insecticide use in the United States has
                      decreased in recent years, herbicide use has increased dramatically. Certain herbicides
                      have been associated with cancer, particularly soft tissue sarcoma and non-Hodgkin's
                      lymphoma in animal studies. Fungicides also may be toxic, and some have been linked to
                      cancer.( 15) They are used extensively on fruits and vegetables, many of which are eaten in
                      larger quantities by children than adults.
                      Each year children accidentally ingest pesticides as a result of careless storage or handling.
                      EPA receives an average of 24,000 pesticide hotline calls each year, two-thirds of which
                      are from parents concerned about pesticide risks to their children.

                      DERMA! ANd AinboRNE EXPOSURES
                      Pesticides are used extensively in homes, apartments, schools, daycare centers, and
                      public buildings to control cockroaches and other pests. In the home, flea bombs,
                      insecticide sprays, and foggers are the primary sources of exposure to children. The
                      pesticide chlordane, banned by the EPA for termite control because of its cancer-causing
                      potential, was used for many years in basements and around foundations of homes and
                      other buildings. Because it persists in the environment for decades, children may remain
                      at risk in areas where this pesticide was used.( 16,17) Lawn-care pesticides also are a
                      major source of childhood exposure. Children not only contact these pesticides while
                      playing outside, but also track them inside.
                      Children living on or near farms or pesticide manufacturing facilities may be exposed to
                      pesticides in the air. Children also may be exposed to pesticides through contaminated
                      shoes and clothing if their parents work in agriculture or with pesticides. Occupational
                      and household pesticide exposures of parents have been associated with increased risks
                      for acute nonlymphoblastic leukemia in their children.(l)
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Finally, children may come into contact with pesticide residues from pest treatment of
school buildings and classrooms. Because of health concerns and costs, schools are trying
to reduce pesticide use through new pest-control methods. The use of integrated pest
management strategies, encouraged by EPA, offer alternatives to and reduction in chemical
pesticide use.
SUMMARY of EPA AcrivmEs
A 1993 National Academy of Sciences report Pesticides in the Diets of Infants and
Children concluded that the scientific and regulatory approaches in effect at that time did
not adequately protect infants and children from pesticide residues in food. (9) The Acad-
emy called on EPA to make significant changes: to identify pesticide exposures, analyze the
potential for harmful health effects, and use these data to determine actual risks. The
Academy report provided a major challenge to EPA to improve the safety of the food
supply and provide greater assurance that children are protected.
EPA Administrator Carol Browner responded to the Academy report with the announce-
ment of a national policy to consistently and explicitly take into account health risks to
children and infants from environmental hazards when assessing environmental risks. In
1996, Congress passed the Food Quality Protection Act (FQPA) to provide further
protection to children (See box on following page).
EPA is committed to ensuring the safety of the foods children eat by: (1) reducing the use
of high-risk pesticides, (2) increasing the research and testing needed to learn more about
children's exposure to pesticides in food, (3) working with the states to assure compliance
with existing pesticide laws and regulations, and (4) establishing new standards to protect
children and infants from dietary exposures to pesticides. EPA also is expanding its study
of the effects of pesticides on the neurological, endocrine, and immune systems of children.
SlRENqi^ENEd  SlANdARcJs AN
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                               FQPA Reforms on Pesticides
          * Strengthen health-based standards to limit risks of pesticide exposure to children.
          * Require an additional safety factor in setting standards to protect the health of unborns
            andnewborns.
          * Require consideration of all sources of pesticide exposure, such as diet and drinking water, and
            the cumulative effects of pesticide residues when determining health risks to children.
          * Expand consumers' right-to-know about pesticide risks to children.
                     To reduce the use of the most dangerous pesticides, EPA is working with other govern-
                     ment agencies on integrated pest management techniques. The purpose of this program is
                     to ensure the availability of cost-effective alternatives for agricultural growers, utilities, and
                     other groups. Toward this end, EPA is hastening the movement of safer pesticides onto
                     the market.
                     EPA assesses the dietary risk to infants and children when registering and re-registering
                     uses of pesticides on foods. The Agency is developing better methods to assess pesticide
                     exposures. EPA also is working with the Department of Health and Human Services
                     (HHS) and the Department of Agriculture (USDA) to design new surveys to improve
                     knowledge of what infants and children eat. The USDA, in partnership with several state
                     laboratories, conducts an annual survey of residues of pesticides in foods (the Pesticide
                     Data Program, or POP). The foods that are sampled are those most often eaten by chil-
                     dren. The sampled pesticides are those commonly used on the foods eaten by children.
                     EPA, USDA, and the Food and Drug Administration (FDA) are working with the Na-
                     tional Food Processors Association and other private sector groups to develop a National
                     Pesticide Residue Database. This database will contain PDP and other residue data EPA
                     will use to develop more accurate estimates of pesticide residues in food. EPA is devel-
                     oping methods for estimating pesticide exposures and risks from multiple sources, such as
                     food, drinking water, and household pesticides. The Agency also has developed a new
                     method for assessing acute exposures to pesticides.
                     A new Consumer Labeling Initiative will expand the amount of hazard and health informa-
                     tion on pesticide labels, similar to the new food nutrition labels. EPA is working with the
                     Consumer Product Safety Commission, FDA, key industry groups, parents, and health
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professionals to implement this program. EPA also provides numerous publications and public-
service announcements to increase public awareness of the dangers to children from careless
handling and other misuses of pesticides.

SuppORT FOR llNTEqRATEd  PEST MANAqEMENT
Pesticides are useful to society because of their ability to kill disease-causing organisms
and control insects, weeds, and other pests. However, they need to be managed to
protect people and the environment. EPA, which has the lead responsibility for regulating
pesticides in the United States, supports an integrated pest management (IPM) approach.
The overall goals of IPM are to minimize pesticide use, choose those pesticides that are
least toxic to people and the environment, and increase the use of non-chemical ap-
proaches, such as good housekeeping and preventive maintenance. IPM has been suc-
cessfully adopted by many school districts across the country.

ExpANckd  ENFORCEMENT  EffoRTs
EPA and state pesticide agencies cooperate to ensure that pesticide users, manufacturers,
producers, dealers, and the rest of the regulated community follow the pesticide laws and
regulations. This cooperation includes issuing enforcement actions in response to viola-
tions, some of which may endanger children.  For instance, EPA and several state agencies
are responding to a series of incidents in urban and other residential communities involving
illegal application of methyl parathion.  Methyl parathion is approved only for use outdoors
as an agricultural pesticide, but was used illegally in homes and businesses mainly to
control cockroaches.
The Urban and Residential Pesticide Control and Enforcement Program provides guidance
to state agencies to help identify, halt, and prevent the illegal use of pesticides indoors. The
program also attempts to facilitate cooperation between state enforcement agencies, public
health officials, and other local organizations.

                Risks TO  ChildREN's
EPA will require pesticide and chemical manufacturers to conduct new tests to assess
potential toxic effects of pesticides on reproduction and development and on the immune
and nervous systems. EPA has proposed updated guidelines for assessing the risks of
cancer causing substances. It also recently issued guidelines for assessing potential neuro-
toxic effects in humans, including children.
EPA is expanding its research program on pesticides in children. Scientists are surveying
children's exposures to pesticides through air, water, food, and house dust in schools,
daycare facilities, and other places children may encounter pesticides.  Researchers are
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                      studying children's activity patterns and examining how the health effects of pesticides
                      differ for children and adults. They are especially interested in how pesticide effects differ
                      at critical periods of neurological and immunological development.
                      Title:
                      Description:
                      Contact:
EPA  PROJECTS ON  HEAlih  EffECis of

              STANdARds ANd BETTER Public


              Pesticide Re-Registration Program
              Through the re-registration program, EPA is reviewing human health and
              environmental effects data and making re-registration eligibility decisions
              on all active pesticide ingredients registered before November 1,1984.
              All registered pesticides must meet the new safety standards of the 1996
              Food Quality Protection Act. Under this law, EPA must conclude with
              "reasonable certainty" that "no harm" will come to infants and children or
              any other individuals exposed to pesticides. Pesticide exposure from
              food, drinking water, home, garden, and all other sources must be consid-
              ered in determining allowable levels of pesticides in food. As a result of
              this law, all pesticide tolerances are being reassessed as part of the
              re-registration program.
              Office of Prevention, Pesticides, and Toxic Substances, Carol Stangel,
              703-308-8007
                      Title:          Pesticides: Food Safety
                      Description:    EPA Region 5 frequently provides information to the public regarding
                                    pesticide residues in food. This includes general information on why
                                    pesticides are needed, ways to reduce the residue remaining on fresh
                                    fruits and vegetables, pesticide-specific data, and specific food tolerances.
                                    Region 5 provides bulletins to help educate the public on food safety
                                    particularly the FQPA provisions for infants and children.
                      Contact:       Region 5, John Ward, 312-886-5220
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TMe:           Great Lakes Binational Toxics Strategy: Virtual Elimination of Persistent
               Toxic Substances
Description:    The Great Lakes Binational Toxics Strategy targets certain persistent, toxic
               substances, including six banned pesticides, for elimination from the Great
               Lakes Basin. Although these pesticides are no longer used in the United
               States, they are still being released into the global environment where they
               may cause harm.  The strategy seeks to find the remaining sources and
               releases affecting the basin and virtually eliminate them. The targeted
               pesticides are DDT, chlordane, mirex, toxaphene, and aldrin/dieldrin.
Contact:        Region 5, Elizabeth LaPlante, 312-353-2694


Title:           Pesticide Safety for Agricultural Workers and Their Families
Description:    Under EPA's Worker Protection Standard, farm workers must receive
               pesticide safety training prior to working in the fields. Workers learn about
               the potential dangers of field-applied pesticides. Since the standard was
               published in 1992, EPA Region 5 has performed extensive outreach on
               agricultural safety and has assisted in the development and approval of
               education tools for states and safety trainers to relay pesticide safety
               messages to farm workers. Region 5 also has performed general pesticide
               safety outreach and offered training to rural primary health care providers.
Partners:       States and local health care organizations
Contact:        Region 5, Don Baumgartner, 312-886-7835


Title:           National Pesticide Telecommunications Network (NPTN)
Description:    NPTN is a national toll-free telephone information service that provides
               poisoning prevention and technical information on pesticide active ingredi-
               ents and product registrations in the United States. Callers receive infor-
               mation, such as:
               • Emergency human and animal treatment
               • First aid and safety tips
               • State health and agricultural contacts
               • Poison Control Centers
               • Product labeling
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                                    • Toxicology
                                    • Cleanup and disposal
                                    • Regulation of pesticides
                                    • Referrals for pesticide incident investigations and laboratory analyses
                                    • Training in the recognition and management of pesticide poisonings
                     Partners:       Oregon State University
                     Contact:       Office of Prevention, Pesticides, and Toxic Substances, Frank Davido,
                                    703-305-7576


                     Title:           Poison Prevention
                     Description:    Accidental poisoning from pesticide chemicals in and around the home
                                    remains a serious threat to children. EPA is an active member of the
                                    Poison Prevention Council and annually distributes thousands of fact
                                    sheets on pesticides and child safety to medical establishments and the
                                    general public. As a result of the Poison Prevention Week outreach in
                                    1995, EPA sent a poison prevention message to 3.5 million television
                                    viewers.
                     Contact:       Office of Prevention, Pesticides, and Toxic Substances, Carol Stangel,
                                    703-308-8007

                     SuppORT FOR llNTEqRATEd  PEST MANAqEMEINT


                     Title:           Oklahoma Ag in the Classroom Program
                     Description:    With EPA support, the Oklahoma Department of Agriculture and Okla-
                                    homa State University have developed a curriculum for grades K-4 on
                                    pesticide management in the classroom. The program, which has been
                                    distributed to all elementary schools in Oklahoma City, emphasizes
                                    Integrated Pest Management (IPM), safe pesticide use, and food safety.
                     Partners:       Oklahoma Department of Agriculture and Oklahoma State University
                                    Division of Agricultural Sciences and Natural Resources
                     Contact:       Region 6, Jerry Oglesby, 214-665-7563
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TMe:          Texas Structural Pest Control Board IPM in Schools Program
Description:   The Texas Structural Pest Control Board (TSPCB) developed a pilot
              program to assist school districts in developing IPM policies. The TSPCB
              representatives visit the districts to explain regulations, provide resource
              materials, and review existing policies and practices. The pilot involves 16
              school districts of various sizes. The goal of the program is to provide
              economical and effective pest control while reducing the risks posed to
              children's health. Utilization of IPM practices is a state legislative mandate.
Partners:      Texas Structural Pest Control Board
Contact:      Region 6, Jerry Oglesby, 214-665-7563


Title:          Integrated Pest Management in Schools Proj ect
Description:    Through a cooperative agreement, EPA is funding the IPM Project for
              schools in the Monroe County Community School Corporation
              (MCCSC). Most MCCSC schools spray for common pests on a
              monthly schedule. MCCSC eliminated 90 percent of applications in three
              elementary schools. The cooperative agreement funds will be used to
              expand this program in all 18 MCCSC  schools.
Partners:      National Foundation for Integrated Pest Management
Contact:      Office of Prevention, Pesticides, and Toxic Substances, Anne Leslie,
              703-308-8727
Title:          Sustainable Reduction of Cockroaches and Rodents in Inner-City Dwellings
              Using IPM Techniques
Description:    This project seeks to demonstrate the effectiveness of IPM techniques to
              reduce or eliminate pesticide use and cockroach and rodent infestations in
              inner-city apartments. Simple IPM techniques that may be learned and
              used effectively by residents are sustainable and create a healthy indoor
              environment for children.
Contact:       Region 2, Rachel Chaput, 212-637-4001
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                      Title:          Educational Photo Literature for Integrated Pest Management in a
                                    Low-Income Setting
                      Description:    IPM techniques to reduce cockroach and rodent infestations in inner-city
                                    housing (currently being demonstrated in EPA Region 2) will be outlined
                                    in community-based educational literature. Each community will learn
                                    about pest infestations and their association with asthma, methods for
                                    teaching people about IPM, methods for conducting IPM, and the
                                    production of photo literature. This program is being implemented in the
                                    Hunts Point community of South Bronx, NY.
                      Contact:       Region 2, Rachel Chaput, 212-63 7-4001


                      Title:          English/Spanish Video on Integrated Pest Management Techniques to
                                    Reduce Cockroaches and Rodents in Inner-City Dwellings
                      Description:    EPA provided funding to Rutgers University to produce English and Spanish
                                    language versions of a video on integrated pest management in the home. A
                                    disproportionately high cockroach infestation is often found in low-income,
                                    minority communities, and especially in inner-city buildings. Asthma inci-
                                    dence and pesticide exposure are linked with cockroach infestations.
                      Partners:       Environmental Sciences Training Center at Rutgers University
                      Contact:       Region 2, Rachel Chaput, 212-63 7-4001


                      Title:          New Jersey S chools and Pesticides
                      Description:    The New Jersey Department of Environmental Protection Pesticide
                                    Control Program (NJDEP/PCP) mailed a letter and survey to all schools
                                    (over 2,000) in New Jersey to promote the use of IPM practices instead
                                    of routine chemical applications. The survey will be used to develop an
                                    IPM strategy.
                      Contact:       Region 2, Adrian Enache, 732-321 -4424


                      Title:          Cornell University Non-Ag Sector IPM Program
                      Description:    Cornell University started a program approximately three years ago to
                                    promote IPM in the non-agricultural sector. The program, which started
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Contact:
with schools, examines both interior and exterior pesticide uses. Pilot
projects demonstrate IPM concepts. Outreach material is distributed to
all area school districts.
Region 2, Audrey Moore, 732-906-6809
ExpANckd ENFORCEMENT EffoRis
Title:          Urban and Residential Pesticide Control and Enforcement Program—A
              National Initiative
Description:   This national program addresses the illegal use of highly toxic agricultural
              pesticides indoors in residential dwellings and commercial businesses, such
              as daycare centers. Comprehensive guidanceis provided to state agencies
              for identifying, halting, and preventing the illegal diversion of agricultural
              pesticides into residential areas.  States that receive EPA funds are asked to
              identify communities at risk, conduct inspections of commercial establish-
              ments with a high probability of agricultural pesticide misuse, and investigate
              applicators who may be misusing these pesticides. The program encourages
              outreach activities to educate residents concerning proper pest control and
              potential dangers of using bootleg pesticides. The states and EPA pursue
              enforcement actions when needed. EPA provides regulatory oversight as
              well as technical assistance to the states for investigation and enforcement
              actions. The national program was developed by the Office of Enforcement
              and Compliance Assurance in cooperation with Regions 4 and 5.
Partners:      State agencies
Contact:      Office of Enforcement and Compliance Assurance, Mary McDonnell,
              202-564-4173 or Carl Eichenwald, 202-564-4036; Region 4, Carter
              Williamson, 404-562-9003; Region 5, Phyllis Reed, 312-886-6018
Title:          Methyl Parathion Outreach Proj ect
Description:   Misuse of methyl parathion indoors has been reported in numerous states.
              EPA issued a nationwide alert to consumers through the Agency for Toxic
              Substances and Disease Registry (ATSDR). EPA is working with the
              pesticide supplier to recall all methyl parathion products, add a stenching
              agent to give the products an offensive odor, package all products in
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                                     containers that may be tracked by retailers, and inform the public about
                                     the dangers of misusing pesticides indoors.
                      Partners:       ATSDR and state agencies
                      Contact:       Office of Prevention, Pesticides, and Toxic Substances, Claire Gesalman,
                                     703-308-3260


                      Title:           Methyl Parathion Investigation
                      Description:    EPA Region 5 is working with a number of state and local health and
                                     environmental agencies to determine the extent of the illegal use of the
                                     highly toxic insecticide methyl parathion in the Chicago area. The Agency
                                     is conducting community outreach and testing. Homes illegally sprayed
                                     with this pesticide are being cleaned up under a multi-agency health and
                                     safety procedure.
                      Partners:       City of Chicago and State of Illinois
                      Contact:       Region 5, Don de Blasio,  312-886-4360


                      Title:           Example of Illegal Pesticide Use Case
                      Description:    A Mississippi pesticide applicator was sentenced to six and one-half
                                     years in prison on a 45-count conviction for knowingly spraying methyl
                                     parathion without a license and distributing the substance in violation of
                                     the Federal Insecticide, Fungicide, and Rodenticide Act. This is the
                                     longest consecutive imprisonment ever handed down in a case involving a
                                     strictly environmental violation. A codefendant received a similar sen-
                                     tence. The defendants applied the agricultural pesticide to residences and
                                     a variety of commercial facilities, including daycare centers.
                      Partners:       Federal Bureau of Investigation and State of Mississippi
                      Contact:       Office of Enforcement and Compliance Assurance, Martin Topper,
                                     202-564-2564
                      Title:           Tropical Fruits Enforcement Case
                      Description:    Operators of an agricultural facility in Guayanilla, Puerto Rico, regularly
                                     applied pesticides, such as Malathion, Supracide-2E, Captan 50, and
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              Dithane F-45, to agricultural crops. These pesticides drifted or migrated
              into an adjacent housing complex for low-income families. Children have
              shown symptoms consistent with pesticide exposure, although a causal link
              has not been established. EPA ordered the operators of the facility to
              cease all pesticide applications and develop a comprehensive plan for any
              future application, which EPA would oversee.
Contact:       Region 2, Jose Font, 212-637-6951


Title:          Example of Enforcement Case in Antimicrobials Program
Description:    Under federal law, public health claims of products containing pesticides
              cannot be made for any products distributed or sold unless the products
              have been approved and registered by EPA or have been granted an
              exemption. EPA reached an enforcement agreement with Hasbro, Inc.
              that prevents the manufacturer of Playskool toys from claiming that toys
              treated with an antibacterial pesticide protect children from infectious
              diseases caused by bacteria. Labels and ads for the toy suggested that the
              treatment protects kids from health risks, when in fact it protects only the
              plastic in the toy.
Contact:       Office of Enforcement and Compliance Assurance, Mark Garvey, 202-
              564-4 1 68 or Brenda Mosley, 202-564-4 1 74
                Risks TO ChildREixi's
\Title:         Dietary Exposure Models and Related Databases to Estimate Exposure to
              Chemical Residues
Description:    The Dietary Exposure Potential Model (DEPM) provides estimates of
              pesticide exposure in the diet by linking food consumption with residue
              information. The model incorporates available information from nationwide
              surveys of food consumption, food intake surveys on individuals in specific
              demographic subgroups, and national food chemical residue measurements.
              EPA is modifying the model to improve its usefulness for infants and children.
Contact:       Office of Research and Development, Maurice Berry, 513-569-7284
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                      Title:          National Health and Nutrition Examination Survey (NHANES)
                      Description:   NHANES, conducted by the National Center for Health Statistics
                                   (NCHS), is designed to assess the health and nutritional status of a
                                   statistically representative sample of the U.S. population. It includes
                                   information on active and passive smoking; respiratory function tests;
                                   blood, urine, and hair sample tests for the presence of various toxic
                                   substances; and house dust tests for lead. The survey utilizes extensive
                                   questionnaires and standardized physical examinations. NCHS and EPA
                                   will collect data for the NHANES-4 version that details health, medical,
                                   and nutritional information on children.
                                   National Center for Health Statistics
                                   Office of Research and Development, Sue Perlin, 202-260-5877
Partners:
Contact:


Title:
Description:
                                    Exposure of Children to Pesticides in Yuma County Arizona
                                    EPA will survey pesticide use by families of 300 children in low-income
                                    Hispanic communities. One hundred families will be selected and various
                                    samples taken to determine the level of pyrethroids and organophos-
                                    phates in their homes. Samples will be taken from air, dust,  surfaces, and
                                    children's hands to provide a comprehensive assessment of multiple
                                    pesticide exposures.
                                    Office of Research and Development, Chris Saint, 202-260-1093
                                    Measuring and Apportioning Children's Exposure to Pesticides in Urban,
                                    Suburban, and Rural Communities
                                    The purpose of this study is to compare pesticide exposure data on
                                    children based on where they live. Researchers will measure total expo-
                                    sure (including all important exposure pathways to selected pesticides) for
                                    a sample of children living in inner-city, suburban, and rural neighborhoods
                                    of Minnesota and determine the relative contributions of important pesti-
                                    cide sources. The data will be obtained from questionnaires; skin contact
                                    measurements; and monitoring of air, water, food, house dust, outside soil,
                                    urine, and blood.
                      Partners:       Minnesota Department of Health
                      Contact:       Office of Research and Development, Chris Saint, 202-260-1093
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TMe:          Pesticide Exposure of Young Children in Minnesota
Description:   In collaboration with the Minnesota Department of Health, children and
              their households will be screened for pesticide use. The purpose is to
              identify children highly exposed to pesticides in an urban setting, and
              determine the routes and sources of exposure. The study includes a
              survey of residential pesticide use, information on indoor exposure (air,
              skin, diet), environmental concentrations (air, surfaces), biomarkers
              (urine), and activity patterns (questionnaire, diary, observation).
Partners:      Minnesota Department of Health
Contact:      Office of Research and Development, James Quackenboss,
              702-798-2442
Title:          Total Organophosphorus Pesticide Exposure among Children in Urban
              and Rural Environments
Description:   This one-year study in Washington State will characterize the variability in
              total organophosphate pesticide exposure in children based on location,
              time, age, and gender. The goal is to determine the relative contributions
              of different environmental sources of organophosphate pesticides to the
              amount of pesticide in children's bodies. The study will account for all
              exposure pathways (diet, air, skin, house dust).
Contact:       Office of Research and Development, Chris Saint, 202-260-1093


Title:          Children's Exposure to Pesticides in the Agriculture Health Study (AHS)
Description:   This is a study of the relationship between pesticide exposure and the rates
              of cancer and non-cancer diseases in 250 licensed pesticide applicators,
              50 spouses, and 50 children in Iowa and North Carolina.  Pesticide
              applicators and their families will be selected randomly within each group
              of interest. Pesticide exposure will be monitored using personal monitoring
              procedures. The results of the study will be used in characterizing pesti-
              cide exposures to families, defining cancer and non-cancer exposure-
              response relationships, and identifying methods to reduce the risks of
              pesticide poisoning.
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                      Partners:       National Cancer Institute and National Institute of Environmental Health
                                    Sciences
                      Contact:       Office of Research and Development, David Mage, 919-541 -1327
                      Title:          Pesticides in Young Children Study in Border States
                      Description:    Research will be conducted in Arizona, California, New Mexico, and
                                    Texas as part of the Environmental Health on the US-Mexico Border
                                    program. The study includes a review of existing environmental pesticide
                                    exposure and health data. Researchers will identify exposure indicators
                                    or biomarkers in body fluids, and screen infants and children under five
                                    years old for evidence of pesticide exposure. Children classified as
                                    subject to "high exposures" will receive more extensive monitoring.
                      Partners:      States of Arizona, California, New Mexico, and Texas
                      Contact:       Office of Research and Development, Brian Schumacher, 702-798-2242


                      Title:          The Effects of Pesticides on the Immune System and Allergic Response
                      Description:    Researchers are examining the impact of exposure to pesticides on the
                                    development of allergies to house dust mites in adult and young animals.
                                    The hypotheses being tested are that pesticide exposure promotes
                                    development of allergic sensitization, and that this effect is greater in young
                                    than in mature rodents. Measures of allergic sensitization include immune
                                    parameters, lung inflammation, and pulmonary hyper-reactivity.
                      Contact:       Office of Research and Development, Mary Jane Selgrade,
                                    919-541-2657


                      Title:          The Biochemical Effects of Pesticides on the Central Nervous System
                      Description:    This research will determine if the adverse effects of exposure to pesticides,
                                    such as organophosphates and carbamates, in young rats during develop-
                                    ment of the central nervous system (CNS) are different from the adverse
                                    effects of exposure in adults. In the body, these pesticides block an impor-
                                    tant enzyme, acetylcholinesterase (AChE), found at many nerve endings.
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              Blocking the activity of this enzyme may cause excessive nerve excitement.
              Age-related changes in this enzyme's activity in blood and tissues and CNS
              development in young and adult animals will be examined.
Contact:       Office of Research and Development, Stanley Barone, Jr., 919-541-3916


Title:          The Effects of Pesticides on Learning and Memory
Description:    This project will determine if perinatal exposure to pesticides, such as the
              organophosphates and carbamates, produces persistent effects on learning
              and memory in young animals and whether these effects are different from
              those produced by comparable exposure in adult animals. Also the
              project will study possible mechanisms for these effects, including changes
              in neurotransmitter levels.
Contact:       Office of Research and Development, Robert MacPhail, 919-541-7833
Title:          Neurochemical Changes and Behavioral Effects Induced by Pesticides
Description:   Cognitive and neurotransmitter effects of pesticides on memory and learning
              will be compared in young and adult rodents. Immediate and long-term
              effects will be assessed and changes in behavioral measures will be
              evaluated.
Contact:       Office of Research and Development, Mark Stanton, 919-541 -7783


Title:          Neurotoxicity of Cholinesterase-Inhibiting Pesticides
Description:   The objective of this research is to determine the effects of pesticides that
              block acetylcholinesterase (AChE) in animals of different ages and gen-
              ders. Chemical-specific effects on blood AChE levels, and toxic effects
              elicited by anti-AChE pesticides as a function of age and gender, are being
              examined in rodents.
Contact:       Office of Research and Development, Stephanie Padilla, 919-541 -3 956


Title:          Neurobehavioral Characterization of Susceptible Populations and Pesti-
              cide Neurotoxicity
Description:   Researchers are comparing the behavioral and biochemical effects of
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                                     cholinesterase-inhibiting pesticides on male and female rats at ages
                                     representing those of human toddlers, preadolescents, and young adults.
                                     Researchers also will try to determine the mechanisms responsible for the
                                     observed effects and track any changes that persist or develop later in life.
                      Contact:       Office of Research and Development, Ginger Moser, 919-541 -5075


                      Title:           Age-Related Sensitivity to Cholinesterase-inhibiting Pesticides
                      Description:    Specific biological factors that may be responsible for differences in the
                                     sensitivity of young versus adult animals to cholinesterase-inhibiting
                                     pesticides will be identified. Once identified, factors contributing to the
                                     different age sensitivities will be applied to predict human toxic responses.
                      Contact:       Office of Research and Development, Stephanie Padilla, 919-541-3956


                      Title:           Organophosphate Insecticide Exposure from Pets Treated with Flea
                                     Control Insecticides
                      Description:    This study will assess the amount of residues of organophosphate insecti-
                                     cides available for transfer to children from dogs treated for fleas with
                                     either a dip or a collar.  The study will determine the potential exposure of
                                     children who play with, touch, and spend large amounts of time with pets.
                      Contact:       Office of Research and Development, Chris Saint, 202-260-1093
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REfERENCES

1.   Buckley, J.D., L.L. Robison, R. Swotinsky, D.H. Garabrant, M. LeBeau, P.
    Manchester, M.E. Nesbit, L. Odom, J.M. Peters, W.G. Woods, and G.D.
    Hammond. 1989. Occupational Exposures of Parents of Children with Acute
    Nonlymphocytic Leukemia: A Report from the Children's Cancer Study Group.
    Cancer Research. Volume 49, Pages 4030-4037.
2.   Lowengart, R.A., J.M. Peters, C. Cicioni,J. Buckley, L. Bernstein, S. Preston-
    Martin, and E. Rappaport.  1987. Childhood Leukemia and Parents' Occupation and
    Home Exposures. Journal ofNational Cancer Institute. Volume 79, Pages 39-46.
3.   David, J.R., R.C. Browonson,R. Garcia, B.J. Bentz,andA. Turner. 1993.
    Family Pesticide Use and Childhood Brain Cancer. Archive of Environmental Con-
    tamination and Toxicology. Volume 24, Pages 87-92.
4.   Gold, E., L. Gordis, J. Tonascia, and M. Szklo. 1979. Risk Factors for Brain
    Tumors in Children. American Journal of Epidemiology. Volume 109, Pages 309-319.
5.   Olshan, A.F.,N.E. Breslow, J.M. Falletta, S. Grufferman, T. Pendergrass, L.L.
    Waskerwitz, W.G. Woods, T.J. Vietti,andG.D. Hammond. 1993. Risk Factors
    for Wilm's Tumor: Report from the National Wilm's Tumor Study. Cancer. Volume
    72, Pages 938-944.
6.   Whitmore, R.W., J.E. Kelly, and PL. Reading. 1992. Executive Summary, Results,
    and Recommendations. In: The National Home and Garden Pesticide Survey, Volume
    1. Publication Number RTI/5100/17-0 IF. U.S. Environmental Protection Agency.
7.   Zahm, S.H. andS.S. Devesa. 1995.  Childhood Cancer: Overview of Incidence
    Trends and Environmental Carcinogens. Environmental Health Perspectives. Volume
    103 (Supplement 6), Pages 177-184.
8.   Goldman, L.R. 1995. Children—Unique and Vulnerable: Environmental Risks
    Facing Children and Recommendations for Response. Environmental Health Per-
    spectives. Volume 103 (Supplement 6), Pages 13-18.
9.   NRC. 1993. Pesticides in the Diets of Infants and Children. National Research
    Council. Washington, DC: National Academy Press.
10. USEPA.  1996. Office of Pesticide Programs Annual Report for 1996. Publication
    Number, EPA 73 5-R-96-001.  U. S. Environmental Protection Agency.
11. Longnecker, M.P., WJ. Rogan,andG. Lucier. 1997. The Human Health Effects of
    DDT (Dichlorodiphenyltrichloroethane) and PCBs (Polychlorinated biphenyls) and an
        EffEcrs of
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                                                                EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                         Overview of Organochlorines in Public Health. Annual Review of Public Health.
                         Volume 18, Pages 211-244.
                     12.  Kavlock, R.J. andG.T. Ankley.  1996. A Perspective on the Risk Assessment
                         Process for Endocrine-Disruptive Effects on Wildlife and Human Health. Risk
                         Analysis. Volume 16, Pages 731-739.
                     13.  USEPA. Undated. Drinking Water and Health Fact Sheet on Atrazine. U.S.
                         Environmental Protection Agency, Office of Water.
                     14.  EXTOXNET. 1993. Atrazine. Extension Toxicology Network. National Agricul-
                         tural Pesticide Impact Assessment Program. Cooperative Extension Offices of
                         Cornell University Michigan State University, Oregon State University, and Univer-
                         sity of California at Davis.
                     15.  Zahm, S.H. and A. Blair. 1993. Carcinogenic Risks from Pesticides. In: 1992
                         Accomplishments in Cancer Research (Fortner, J.G. and I.E. Rhoads, Editors).
                         General Motors Cancer Research Foundation. Philadelphia: Lippincott. Pages
                         266-279.
                     16.  ATSDR. 1994. Toxicological Profile for Chlordane (Update). U.S. Department
                         of Health and Human Services, Agency for Toxic Substances and Disease Registry.
                     17.  EXTOXNET. 1993. Chlordane.  Extension Toxicology Network. National
                         Agricultural Pesticide Impact Assessment Program. Cooperative Extension Offices
                         of Cornell University, Michigan State University, Oregon State University and
                         University of California at Davis.
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                     Risks  FROM
CoiNTAMiNATEd  WATER
                             iAl WATERb>ORNE  Risks
                     Children's exposure to waterborne contaminants can occur when eating contaminated
                     fish, consuming contaminated drinking water, or swimming in contaminated oceans, lakes,
                     or streams. Disease-causing organisms in sewage-contaminated water can result in
                     hepatitis, dysentery, gastrointestinal illness, fever, ear infections, and other health prob-
                     lems. Also bodies of water and their sediments can be contaminated with toxic sub-
                     stances, such as polychlorinatedbiphenyls (PCBs) and metals like arsenic, mercury, lead,
                     and chromium. These contaminants are thought to contribute to serious health problems,
                     such as cancer, birth defects, nervous system damage, respiratory system disease, burns,
                     and skin irritations.(l ,2,3,4,5)
                     Hundreds of beaches are closed each summer because of contamination from untreated
                     sewage and other sources. In 1995, more than 3,500 beaches in the United States
                     posted warning signs or closed for at least one day due to bacteriological or other types
                     of contamination. The most frequent sources of harmful microbes are fecal contamination
                     from sewer overflows, water treatment plant malfunctions, and storm water runoff.
                     Surface waters and their sediments also can be contaminated by toxic chemicals, such as
                     PCBs and heavy metals.(6)
                     Children and women of childbearing age may be at increased risk compared to other
                     subpopulations. Compared to adults, children are at increased risk to bacterial and viral
                     infections because they play in the water for longer periods, tend to have more cuts and
                     scrapes, and may accidentally swallow more water than adults. Women exposed to high
                     levels of PCBs or mercury during pregnancy may give birth to children with delayed
                     development and learning disabilities. Fish are an important part of a healthy diet. How-
                     ever, some fish caught for sport or subsistence may contain chemicals that could pose
                     health risks if eaten too often.
                     Pollutants, such as PCBs and mercury that accumulate (or bioaccumulate) in increasing
                     amounts in the tissues offish, birds, animals, and humans, are of great concern because of
                     the potential for high exposures. Eating fish containing certain chemical pollutants may
                     cause birth defects, liver damage, cancer, and other serious health problems. These
                     pollutants may pose special risks to a developing fetus, nursing infant, and young child
                     when they or their mothers eat contaminated fish.(7)
                     Tap water that meets federal and state standards generally is safe to drink.  However,
                     some contaminants of potential concern are not currently regulated. Threats to drinking
                     water quality and quantity are increasing. These emerging problems need attention and
                     are the object of extensive federal, state, and local efforts.
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All drinking water contains some naturally occurring chemical contaminants, which are
usually not harmful at low levels. Actual events of serious drinking water contamination are
infrequent, and typically are not at levels posing acute health concerns. In 1994, only eight
percent of community drinking water systems reported a violation of the total coliform
(bacteria) standard in drinking water.(8) Generally, these standards are established based
on a lifetime of exposure, therefore, one violation poses a limited health risk.
When microbiological and chemical contaminants enter water supplies, their potential
effects include gastrointestinal illness, skin irritations, cancer, reproductive and develop-
mental problems, and other health effects. Microbiological contaminants are of greater
concern because they may cause immediate health threats, such as gastrointestinal ill-
ness.(9,10) Frequently occurring microbial contaminants include the Norwalk virus,
Cryptosporidium, and Giardia. The effects of contaminated drinking water are illustrated
by localized outbreaks of waterborne disease.  Most of these outbreaks have been linked
to contamination by bacteria, protozoa, or viruses, probably from human or animal waste.
For example, in 1993 and 1994, there were 30 reported disease outbreaks associated
with drinking water: 23 associated with public drinking water supplies; and seven with
private wells.(9,10) In 1993, the water treatment plant in Milwaukee became ineffective
during a period of heavy rainfall and storm water runoff, and hundreds of thousands of
Milwaukee residents  became ill from drinking water contaminated by the microbe
Cryptosporidium. Over 4,000 persons were hospitalized, and over 50 died (some
counts put deaths as high as 100). (11)
Children may be more vulnerable to certain waterborne contaminants. Because children,
especially infants, drink more fluids per pound  of body weight than adults, they could be
more exposed to contaminants present in drinking water. Since the immune systems of
very young children are not as well developed  as those of adults, they may be less able
than healthy adults to  fight microbes in drinking water, and children have more severe
effects from gastrointestinal infections.  While growing, children may be susceptible to
contaminants that affect the critical stages of development.
Nitrates, which are occasionally found in drinking water at concentrations above the
national standard, can pose a serious threat to very young children, especially newborns.
Commonly used in fertilizer and as curing agents in foods, nitrates can be converted to
nitrites in the intestines of children. After entering the blood stream, nitrites block the
oxygen carrying capacity of the blood, resulting in anemia or blue-baby disease. While
rare, this condition can be particularly severe in infants who consume nitrate-rich water in
their milk formula. An enzyme that reverses the effect of nitrites in older children and
adults is not fully functional in infants.(12)
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SUMMARY of EPA AcrivmEs

EPA is protecting children from risks associated with water pollution in drinking water,
surface water, and fish. EPA issues national standards and health advisories; oversees the
monitoring of drinking water supplies; and supports state programs that help ensure safe
beaches, clean surface water, and uncontaminated fish. EPA takes enforcement actions
where there are violations of drinking water standards or wastewater discharge permits,
or where a discharge is not permitted.
CONTAMINANTS IN DmNkiNq WATER
EPA is engaged in a number of activities to characterize better the occurrence, exposure,
and health impacts of drinking water contaminants on a number of particularly vulnerable
populations (sensitive subpopulations), including infants and young children. These
activities result in better health assessments, regulations, and enforcement with respect to
drinking water protections. Examples of these activities include general improvements in
risk assessments that cut across all areas of the drinking water program:
  • Health assessment methods: Maximum Contaminant Levels (MCLs) for drinking
   water are written with the goal of protecting the most sensitive subpopulations from
   contaminant exposure.  Therefore, regardless of whether children are found to be the
   most sensitive subpopulation to exposure to a particular contaminant, their health is
   protected.
  • General health research: The Safe Drinking Water Act of 1996 calls for better science
   and analysis of health effects to sensitive subpopulations, including children, to support
   the development of drinking water regulations. Extensive research to better charac-
   terize risk is underway and focuses on the health effects of chemical and microbial
   contaminants.
  • Risk-based contaminant selection: New tools are being developed to help ensure that
   contaminants posing the greatest threat to public health are the first to be considered
   for regulation. (Determinations of greater public health risk are based on the most
   sensitive subpopulation.) For example, a National Contaminant Occurrence database
   is being developed that will store information on occurrence of drinking water con-
   taminants and potential contaminants. This database will be used to support EPA's
   decisions on which contaminants to regulate in the future.
In the past, EPA has focused its drinking water regulatory activities in three areas: gas-
trointestinal diseases resulting from exposure to waterborne microbes, cancer, and lower
intelligence quotients (IQ) in children exposed to lead in drinking water.  The Surface
Water Treatment Rule and the Total Coliform Rule help prevent gastrointestinal diseases
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by controlling microbial pathogens in drinking water. Future regulations will target high
priority chemical contaminants. Also, EPA is examining the health risk trade-off between
controlling microbial pathogens, including Cryptosporidium, and increased risk of cancer
resulting from potentially cancer causing byproducts that are formed when water disinfec-
tants come in contact with organic matter present in water.
The Safe Drinking Water Act controls children's exposure to lead via drinking water by
requiring regulated public water supplies to treat their water to reduce the water's capacity
to corrode lead materials in plumbing and distribution systems.( 13) Also, there are national
standards for lead in various plumbing materials, houses, and the connections between the
public water main and buildings where people receive their water. Lead service lines can
no longer be installed, and those still in place must be tested and replaced if tap water
exceeds the drinking water action level. Other lead materials, particularly lead solder, have
been banned from use in water systems. Faucets must undergo performance testing to
demonstrate that they do not contribute excessive concentrations of lead to the drinking
water. The requirements of the Lead and Copper Rule have resulted in a significant
reduction in the exposure of children to excessive lead in drinking water.(8)

CONTAMINANTS IN SURFACE WATER
EPA's efforts to protect people from surface water contamination center around the Clean
Water Act. Under the Act, any point-source discharge to a water of the United States is
prohibited unless authorized by a permit. Through the permit process, EPA and the states
control chemical and other discharges to surface waters. Facilities must operate, monitor,
and report in compliance with their permits. EPA or delegated states enforce the  provi-
sions of the permit when violations of the limits occur.
The Beach Health Protection Program works with local officials and groups to inform the
public about contamination at beaches and thus reduce children's exposure. EPA has begun
to collect beach monitoring and closure information and make it available to the public. This
information will be compiled in a database and included on a World Wide Web site on beach
health. EPA takes legal action against municipal wastewater systems by requiring that they
upgrade to eliminate or reduce overflows and malfunctions, which are major contributors to
beach contamination. The Agency also is working with other federal agencies and the states
to protect infants from exposure to toxic molds resulting from floods.
CONTAMiNATEd Fish
EPA and state and tribal health departments are improving the effectiveness offish con-
sumption advisories and thus are reducing health risks to children who eat fish and to the
fetuses of pregnant women who eat fish. EPA is developing new ways to determine health
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risks and to assess how much fish children and women of childbearing age eat. In con-
junction with the Agency for Toxic Substances and Disease Registry (ATSDR), EPA is
developing materials that explain the health risks developing fetuses and children may
encounter when their mothers consume contaminated fish. These materials are intended
for pediatricians; state, tribal, and local health agencies; and the public. Through its
regional initiatives program, EPA is working with a number of states, tribes, and Canada
to reduce contamination and eliminate future pollution in the Great Lakes.

PROJECTS ON CONTAMINANTS ii\ WATER ANC!  Fish

CONTAMINANTS IN WATER
Title:          Microbial Disinfectant/Disinfection Byproducts (M-DBP) Rules:
Description:    A new set of rules currently is being developed to address the risk trade-
              off between controlling microbial pathogens, including Cryptosporidium,
              and potentially cancer causing byproducts formed when disinfectants
              come into contact with organic matter present in water. These rules are
              collectively known as the Microbial-Disinfectant/Disinfection Byproducts
              (M-DBP) Rules. The first of these, the Interim Enhanced Surface Water
              Treatment Rule and the Stage 1 Disinfectant/Disinfection Byproducts Rule
              (D/DBPR), are due to be completed in November 1998.  Other rules in
              the M-DBP cluster are the Information Collection Rule, the Final En-
              hanced Surface Water Treatment Rule, and the Stage 2 D/DBPR.  These
              standards will be set based on the most sensitive subpopulations affected
              by the contaminants. Children are among those sensitive subpopulations
              considered, and therefore will be protected by these regulations.
Contact:       Office of Water, Elizabeth Corr, 202-260-8907
                        Title:          Information Collection: Sensitive Subpopulations
                        Description:    The 1996 amendments to the Safe Drinking Water Act charge EPA to
                                      identify subpopulations (e.g., infants, children, pregnant women) at greater
                                      risk than the general public to adverse health effects from exposure to
                                      contaminants in drinking water. The contaminants of interest for the
                                      Interim Enhanced Surface Water Treatment Rule are microorganisms
                                      (specifically Cryptosporidium, Giardia, and intestinal viruses) that are a
                                      potential hazard to human health.  In addition, EPA has begun to collect
                                      data on individuals whose immune systems are potentially suppressed
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              (e.g., individuals with diabetes, osteoporosis, renal disorders, AIDS,
              cancer, organ transplants). One project seeks to compile information on
              daycare facilities where children are in close physical contact with each
              other. In the event of a waterborne disease outbreak, infection may
              spread rapidly in daycare centers, especially if hand washing and diaper
              changing practices are inadequate.
Contact:       Office of Water, Joyce M. Donohue, 202-260-1318


Title:          Microbial Diseases: Effects of Age and Sex on Morbidity and Mortality
Description:    In the regulation of disinfectants and their byproducts, there is a delicate
              balance between the risk associated with chemical exposure and the risk
              associated with exposure to waterborne pathogens. The relative risks are
              affected by a number of factors, including the impact of age and sex on
              sensitivity to microbial diseases. EPA proposes to use CDC data on
              morbidity and mortality from outbreaks of microbial foodborne and
              waterborne diseases, to evaluate the influence of age and sex on suscepti-
              bility to microbial diseases and disease mortality Differences in apparent
              response for different microorganisms will be evaluated where possible.
              The CDC data will be supplemented by published accounts of the disease
              outbreaks. This study will allow EPA to document the susceptibility of
              children to microbial diseases and make better risk-management decisions
              based on improved data.
Contact:       Office of Water, Joyce M. Donohue, 202-260-1318


Title:          Water Consumption Estimates for Subpopulations, Including Children
Description:    This study will examine whether and to what extent infants, children,
              pregnant women, the elderly, individuals with a history of serious illness, or
              other subpopulations may experience elevated health risks from contami-
              nants in drinking water. Current drinking water intake rates for primary
              sources of water are based on data now 20 years old, and there is reason
              to believe that water consumption patterns have changed since that time.
              To characterize current exposure to contaminants in drinking water, EPA
              will generate estimates of tap and bottled water intake based on the U.S.
              Department of Agriculture's  1994,1995, and 1996 Continuing Survey of
              Food Intake by Individuals (CSFII). Estimates will be generated based
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                                      on population demographics, such as age, gender, and geographical region.
                                      Consumption estimates for plain water consumed as a beverage and water
                                      added to foods and beverages during preparation will be determined.
                        Contact:       Office of Water, Helen Jacobs, 202-260-5412 or Julie Du, 202-260-7583
Title:          Monitoring Compliance with and Enforcing the Requirements of the
              National Drinking Water Regulations on Lead and Copper
Description:    EPA currently is evaluating compliance of public water systems with the
              national primary drinking water regulations for lead and copper. These
              regulations established monitoring and treatment requirements for public
              water systems.  This project is designed to ensure compliance by all
              public water systems, thereby reducing the amount of lead children
              consume from drinking water. So far, several hundred enforcement
              actions have been taken by EPA and the states against systems that have
              failed to meet the initial monitoring requirements of the rule. Currently,
              EPA is evaluating data on whether systems have complied with the
              subsequent requirements in the rule (e.g., installation of corrosion control,
              beginning of lead service replacement). EPA will be working with the
              states to take appropriate actions to return violators to compliance.
Partners:      State agencies
Contact:      Office of Enforcement and Compliance Assurance, Brian Maas, 202-
              564-6019 or Betsy Devlin, 202-564-4054


Title:          Ongoing Nitrate/Nitrite Compliance Monitoring
Description:    Primary responsibility for compliance with the national nitrate/nitrite
              regulations in drinking water has been delegated to most states. The
              regions work cooperatively with the states. EPA performs inspections
              and takes enforcement actions on selected systems in all regions.
Contact:      Office of Enforcement and Compliance Assurance, Betsy Devlin,
              202-564-4054
                        Title:          Community Enteric (Intestinal) Disease Study
                        Description:    This project will characterize the nature and magnitude of common
                                      waterborne disease in approximately 300 families with children between
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              the ages of two and ten. Gastrointestinal symptoms will be recorded on a
              daily basis. Questionnaires and reports obtained from hospital admissions
              and clinical laboratories will be used to assess the health status of families.
              Efforts will be made to identify the microbes or other contaminants that
              cause diseases, using laboratory analysis of fecal and body fluid speci-
              mens, and a survey of blood characteristics. The research will allow EPA
              to document the susceptibility of children to microbial disease and respond
              appropriately.
Contact:       Office of Research and Development, Rebecca Calderon, 919-966-0617


Title:          Determination of Human Infective Dose and Antibody Levels for
              Cryptosporidium Parvum
Description:    This proj ect will help determine water treatment goals and drinking water
              standards for Cryptosporidium by estimating the Infective Dose 50 (the
              dose at which 50 percent of people can be expected to show symptoms).
              This value has been determined in human volunteers for one strain. Other
              strains are being examined.
Contact:       Office of Research and Development, Walter Jakubowski, 513-569-73 85


Title:          Feasibility of a Cultural Method for Detecting Viable Cryptosporidium
              Parvum Oocysts in Environmental Samples
Description:    This study is attempting to develop a more effective and efficient method
              for detecting Cryptosporidium, a type of microorganism that causes
              waterborne disease.
Contact:       Office of Research and Development, Walter Jakubowski, 513-569-7385


Title:          Source Water Protection Activities
Description:    EPA regions are working with states using various tools to institute source
              water protection measures as an important part of the initiative to protect
              children from contaminated drinking water. Among other efforts, regions
              are identifying systems and sources with significant nitrate levels, which is
              of particular concern for infants. Regions also are piloting an education
              and outreach program involving small communities and tribes for whom
              source water protection may be the only means to protect the community
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                                        from drinking water contamination. All of EPA's regions continue to
                                        provide technical assistance and conduct enforcement activities related to
                                        municipal and industrial wastewater treatment works.
                          Contact:      Office of Water, Beth Hall, 202-260-5553
Title:          Enforcement of Drinking Water Regulations Governing Microbial Quality
              of Drinking Water
Description:    Enforcement oflhedrinkingwaterregulations dealing with themicrobiological
              quality of drinking water, specifically the Surface Water Treatment Rule and
              Total Coliform Rule, is a high priority. Two of the most common violations in
              the drinking water program are violations of the total coliform monitoring/
              reporting requirements and violations of the total coliform Maximum Contami-
              nant Level. While compliance with this rule has improved somewhat over the
              years, efforts to increase the rate of compliance must continue.
Contact:       Office of Enforcement and Compliance Assurance, Brian Maas, 202-
              564-6019 or Betsy Devlin, 202-564-4054


Title:          Flood-Related Disease in Children
Description:    EPA Region 8 is working with interagency groups to identify infectious
              agents and mold toxins that selectively injure children. The proj ect includes
              the initiative to identify mycotoxins produced by stachybottrous molds that
              have been linked to potentially fatal lung damage in infants. Recent studies
              have been conducted in Grand Forks and Fargo, North Dakota.
Partners:      National Institute of Occupational Safety and Health, Centers for Disease
              Control and Prevention, and states
Contact:       Region 8, Chris Weiss, 303-312-6671


Title:          Children's Health Protection
Description:    Because children are very vulnerable to beach contamination when they
              spend a lot of time playing near water, EPA strives to protect them and
              others from the risks of beach contamination. The primary contaminants
              of beaches are microbial organisms from fecal material in sewer over-
              flows, storm water runoff, and water treatment malfunctions. The pur-
              pose of EPA's beach health program is to improve methods of assessing
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Contact:
the problems, monitoring conditions, and informing the public who may be
at risk. EPA has begun to collect beach monitoring and closure informa-
tion and make it available to the public. This information will be compiled
in a database and included on an Internet beach health home page.
Office of Water, William F. (Rick) Hoffmann, 202-260-0642
CONTAMINANTS IN Fish
Title:          Fish Consumption/Toxics in the Harbor Program
Description:    EPA Region 3 is collecting data on fish consumption patterns in a minority
              community to estimate the risks to children and their families from eating
              the fish. The program will provide effective communication to Baltimore
              residents about the fish consumption advisories in the harbor, best methods
              for preparing and cooking fish to reduce exposure to contaminated fish
              tissue, and the risks from eating fish caught in the harbor.
Contact:       Region 3, Reggie Harris, 215-566-2988


Title:          Fish Advisories in Region 2
Description:    EPA has been involved in public communication offish advisories in the states
              ofNew York and New Jersey.  The health advisories are targeted to particular
              populations at risk, including anglers who eat their catch, pregnant and nursing
              women, and children. Communication takes the form of flyers (some trans-
              lated into other languages); public service announcements; and working with
              local health care providers, particularly pre-and neonatal clinics. The bodies of
              water most involved are the Hudson River, New York/New Jersey Harbor,
              Passaic River, Niagara River, and the Great Lakes.
Partners:       States of New York and New Jersey
Contact:       Region 2, Rachel Chaput, 212-637-4001


Title:          EPA Region 4, U.S. Department of Energy (DOE), and State of South
              Carolina Contaminated Fish Public Involvement Campaign
Description:    EPA Region 4 is working closely with DOE and South Carolina to publi-
              cize health issues associated with eating contaminated fish downstream
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                                        from the Savannah River facility. Recent research has shown that young
                                        children have been eating fish taken from waters where fish historically
                                        have been shown to have unhealthy levels of Cesium 137 and Strontium
                                        90. The public involvement campaign provides information to local health
                                        centers and produces fact sheets and public announcements for radio and
                                        TV stations.
                          Contact:       Region 4, Camilla Warren, 404-562-8519
Title:          Columbia River Intertribal Fish Commission (CRITFC) Study
Description:    EPA is in the second phase of a two-phase study to examine the role of
              fish consumption as an exposure route for waterborne contaminants
              among individuals of four Columbia River tribes, including their children.
              The first phase, which was completed by the Columbia River Intertribal
              Fish Commission, documented the types and amounts offish eaten by
              tribal members. It showed that tribal children ate an average of 19.6
              grams offish per day, three times the national average of 6.5 grams. This
              finding is important since several studies have shown that plants and
              animals in the Columbia River Basin have elevated levels of harmful
              contaminants. Phase II of the study consists of sampling and analysis of
              fish species that are eaten by tribal members. Information from both
              phases will be used to assess the potential health impacts to children from
              consuming contaminants in the river.
Partners:       Columbia River Intertribal Fish Commission
Contact:       Region 10, Marcia Lagerloff, 206-553-0176
                          Title:          Reduction/Elimination of Persistent Toxic Substances in Great Lakes
                          Description:    EPA's Great Lakes National Program Office and Region 5 have been
                                        working with several partners to eliminate the releases of specified
                                        persistent toxic substances to the Great Lakes Basin. The strategy targets
                                        PCBs, DDT, mercury, dioxins, and certain canceled pesticides for per-
                                        centage reductions within a ten-year timeframe on the path to virtual
                                        elimination of these substances.
                          Partners:       Environment Canada, Great Lakes states, industries, tribes, environmental
                                        groups, and non-government organizations
                          Contact:       Region 5, Elizabeth LaPlante, 312-353-2694
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Title:          Technical Assistance on Risk from Consumption of Contaminated Fish
Description:    EPA's Fish Contamination Program (FCP) provides technical assistance to
              states and tribes in characterizing health risk associated with exposure to
              chemical contaminants in noncommercial fish and wildlife. In cooperation
              with the states, tribes, and other federal agencies, the FCP has developed
              a four-volume set of guidance documents entitled Guidance for Assessing
              Chemical Contaminant Data for Use in Fish Advisories. This guidance
              includes recommended methods for protecting children and women of
              childbearing age from consuming fish with harmful levels of contaminants.
              The guidance has been distributed nationally and is used by the majority of
              states for issuing fish advisories, and is periodically updated to reflect new
              information.
Contact:       Office of Water, Jeffrey Bigler, 202-260-1305
Title:          Guidance on Risk from Consumption of Contaminated Fish
Description:    EPA's Fish Contamination Program (FCP) is currently undertaking several
              projects that will include recommendations for protecting children from
              harmful levels of contaminants. These projects include:
              • The Comparative Dietary Risk Project, which will compare health risks
                in people who eat chemically contaminated fish to health risks in people
                who do not eat fish.
              • Guidance for Conducting Fish Consumption Rate Surveys.
              • New toxicity values for five chemicals (DDT, DDE, chlorpyrifos,
                chlordane, and toxaphene) found in fish tissue and included in the FCP
                national guidance.
              • A collaborative outreach effort with the Public Health Service.
              • Guidance directed at women of childbearing age on how to reduce risks
                associated with the consumption of PCB-contaminated fish.
Partners:      States and Tribes, Agency For Toxic Substances and Disease Registry
Contact:       Office of Water, Jeffrey Bigler, 202-260-1305
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REFERENCES

1.   ATSDR. 1989. Toxicological Profile for PCBs. U.S. Department of Health and
    Human Services, Public Health Service. Agency for Toxic Substances and Disease
    Registry.
2.   ATSDR. 1993. Toxicological Profile for Arsenic. U.S. Department of Health and
    Human Services, Public Health Service. Agency for Toxic Substances and Disease
    Registry.
3.   ATSDR. 1995. Toxicological Profile for Mercury. U.S. Department of Health and
    Human Services, Public Health Service. Agency for Toxic Substances and Disease
    Registry.
4.   ATSDR. 1993. Toxicological Profile for Lead. U.S. Department of Health and
    Human Services, Public Health Service. Agency for Toxic Substances and Disease
    Registry.
5.   ATSDR. 1995. Toxicological Profile for Chromium. U. S. Department of Health
    and Human Services, Public Health Service. Agency for Toxic Substances and
    Disease Registry.
6.   USEPA. 1997. Before You Go to the Beach. Publication Number EPA 820-K-
    97-001. U.S. Environmental Protection Agency.
7.   USEPA. 1997. Should I Eat the Fish I Catch? Publication Number EPA 823-B-
    97-009. U.S. Environmental Protection Agency.
8.   USEPA. 1994. Indicator I: Population Served by Community Drinking Water
    Systems Violating Health-Based Requirements. Safe Drinking Water Information
    System. U.S. Environmental Protection Agency.
9.   USEPA. 1997. Public Water System Inventory and Compliance Statistics
    FY1991-FY1995. Publication Number EPA 816-R-97-006. U.S. Environmental
    Protection Agency.
10. Kramer, M.H., B.L. Herwaldt, G.F. Craun, R.L. Calderon, andD.D. Juranek.
    1996. Waterborne Disease: 1993-1994. Journal AWWA. Volume 88, Pages
    66-80. March.
11. Solo-Gabriele, H. andS. Neumeister. 1996. U.S. Outbreaks of
    Cryptosporidiosis.  Journal AWWA. Volume 88, Pages 81-82. September.
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12.  USEPA. 1994. National Primary Drinking Water Standards, February 1994.
    Nitrate/Nitrite Health Advisory.  Series 7 Inorganics, 1987. Publication Number
    EPA 810-F-94-001 A. U.S. Environmental Protection Agency, Water Resource
    Center.
13.  USEPA. 1991. Preamble to National Primary Drinking Water Regulations for Lead
    and Copper. June 7,1991. Federal Register. Volume 56, Page 26460.
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        Stepl:


        Step 2:

        Step 3:


        Step 4:
                     EPA ASSESSES  Risk TO  PROTECT ChildREN ANC]
                            ENVIRONMENT
                     To protect human health and the environment, EPA estimates the severity of environmental
                     risks that could influence human populations and the environment. Risk assessment is the
                     process of identifying and estimating the level of risk. Risk assessment is a complex,
                     analytical process involving expertise in various disciplines, such as chemistry, biology,
                     ecology, statistics, and medicine.  EPA's risk assessment process has evolved over the
                     years and is described in anumber of reports. (1 ,2,3,4,5)
                     People often have different perceptions of risk based on their personal experiences and
                     knowledge. Risk assessments are important because they provide a systematic, consis-
                     tent way of estimating risk.
                     Risk assessments are used along with other factors in deciding what to do about environ-
                     mental hazards. Decisions to prevent or control risk involve the participation and expertise
                     of many different people in government, industry, and the community who have a broad
                     understanding of the risks, laws, community, business, and feasibility of pollution control or
                     prevention methods. Thus, risk assessments help interested parties decide how to reduce or
                     prevent health risks by offering a common means of analyzing a complex situation.
                     Most EPA human health or ecological risk assessments address specific substances, such
                     as toxic chemicals, or sites, such as a lake, river, city, industrial facility, or uncontrolled
            Risk Assessment Process

Hazard Identification:
Determines whether exposure to a substance can cause cancer, birth defects, or other
adverse health effects.
Dose-Response Assessment:
Determines the possible severity of adverse health effects at different levels of exposure.
Exposure Assessment:
Estimates the amount of contact individuals within a population—including potentially
sensitive groups, such as children—could have with the substance.
Risk Characterization:
Combines the information in the first three steps to determine the level of potential risk
to humans andthe environment.
1 19
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hazardous waste areas. Typically, a human health risk assessment entails a four-phase process
(see box on previous page) to identify the type of adverse health effects, estimate the severity
of effects, determine exposure levels, and characterize the overall risk.
Some substances, such as lead, mercury, and nitrates, have prompted EPA to conduct more
research and develop better risk assessment methods to protect children from exposure to such
substances. In addition, EPA has begun developing new methods to account for combined
exposures to a variety of substances and sources of exposure. For instance, an individual may
be exposed to lead from many sources, such as contaminated drinking water, lead-based paint,
and airborne lead in industrial or densely populated areas. The exposures from all of these
sources could be combined into one measure for an assessment of combined risk to children.

EPA Policy liNimAiivEs Ai\d RESEARC^ TARqEiiiNq ChildREN

WATER
EPA historically has developed national standards to protect children and adults against
potential exposures to contaminants in drinking water. However, EPA is broadening the
protection of children by ensuring that the developmental studies used to determine national
drinking water standards are designed to evaluate lifetime effects of exposures of infants and
children during their formative years. EPA also is evaluating whether children are more
susceptible than adults to water contaminants. The 1996 Safe Drinking Water Act and the
Food Quality Protection Act provide for additional measures to protect susceptible segments
of the population, including children, from contaminants in water.

HAZARdous WASTE
EPA's Superfund program analyzes possible risks to children from exposure to hazardous
waste sites. The analysis of risks to children between six months and six years of age ac-
counts for exposures from soil ingestion and inhalation as well as potential risks from tres-
passing on abandoned hazardous waste sites. In determining risk to children, the Superfund
Program modifies several factors in their calculations. Among them are body weight, inhala-
tion rates, and ingestion rates to account for age-specific activities, such as playing in soil.
EPA and the states track the treatment, storage, and disposal of hazardous waste under
the  Resource Conservation and Recovery Act (RCRA). Risk assessments guide the
RCRA program in correcting past pollution problems at hazardous waste facilities, as well
as in setting standards for operating the facilities. The RCRA program requires an assess-
ment of the potential risks to a child at any hazardous waste facility on which housing may
someday be built. EPA also addresses potential ways that children might become exposed
when evaluating chemicals being considered as hazardous waste.
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                      In assessing potential risks to children from lead exposure, the Superfund and RCRA
                      Programs use methods specifically developed for children to predict changes in blood
                      lead levels. The Integrated Exposure and Uptake Biokinetic model (IEUBK) uses
                      exposure values based on the behavior and physiology of children six years of age and
                      under to predict future lead levels in children.
                      In a project to develop better tools for risk assessment, the Superfund Program in EPA's
                      Region 9 incorporated the unique characteristics of children's activities into screening
                      values called preliminary remediation goals (PRGs). The PRGs allow for rapid identifica-
                      tion of potential cancer and non-cancer health risks (especially to children) from contami-
                      nation at hazardous waste sites. Since they were developed, PRGs have gained wide-
                      spread acceptance. They are used for screening of hazardous waste contamination and
                      for setting cleanup priorities at Superfund sites and hazardous waste facilities.

                      EXPOSURE
                      In response to the Food Quality Protection Act, the Agency has been developing analyti-
                      cal methods to better estimate children's exposures to pesticides in the diet and from other
                      sources. EPA's risk assessments will address the differences in exposure levels and
                      susceptibilities between children and adults wherever adequate data are available. EPA
                      already has made significant progress in protecting children from lead poisoning and
                      exposure to polychlorinated biphenyls (PCBs).
                      Several projects are underway to improve exposure estimates in infants and children. For
                      instance, EPA is studying the structural differences in the airways of children and adults.
                      The Exposure Factors Handbook, recently revised and reviewed by EPA's Science
                      Advisory Board, includes exposure information by age group and provides information on
                      childhood exposure factors.  These factors include age-based exposures (such as soil
                      ingestion), physical characteristics (such as body size), and activity patterns (such as time
                      spent outdoors).

                      CuMulAiivE  Risk
                      The Cumulative Exposure Project is a comprehensive effort to develop estimates of pollut-
                      ant exposures to children. This new initiative considers a wide range of environmental
                      hazards, such as the combined exposure to contaminants in food, drinking water, and
                      outdoor air. The Cumulative Exposure Proj ect will identify pollutants that have the greatest
                      impact on children and identify their sources. This project is consistent with EPA's 1997
                      Guidance on Cumulative Risk Assessment.(6)
                      Through collaboration with the World Resources Institute and the School of Public Health at
                      the University of California, Berkeley, EPA is developing a children's environmental "health
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index" as part of an overall Children's Environmental Health Indicators project. The index
will be a combination of environmental health conditions for children and will evaluate both
exposures and effects. The goal is to provide information for developing policies to improve
environmental health conditions for children and to generate useful information for the public.
EPA is preparing a "vulnerability index" for children that will be used in the Agency's Chemi-
cal Indexing System. The Chemical Indexing System describes the relative hazard of chemi-
cal releases rather than simply ranking facilities, industries, or chemicals by the number of
pounds of chemicals released into the environment each year.  The vulnerability index pro-
vides a description of socioeconomic characteristics that may make children and other
groups more susceptible to specific chemicals than the general population.

EPA  PROJECTS  TO  IMPROVE  Risk  ASSESSMENT
WATER


Title:

Description:
Partners:

Contact:
Children Health Protection-Improvement in Risk Assessment Methods for
Drinking Water
To protect children from drinking water contaminants, EPA evaluates the
potential adverse effects of contaminants on reproduction and development.
The available data, usually from animal studies, are reviewed extensively to
determine the potential risk from short-term and long-term exposure to
contaminants on the developing fetus and children. These efforts include:
• Improvements in risk assessment to evaluate the effects of children's
  exposure to water contaminants.
• Application of new risk assessment methods to characterize the risk
  associated with these exposures and how they disrupt children's normal
  development into healthy adults.
• Evaluation of the mechanisms underlying children's susceptibility to
  water contaminants.
• Education and communication to prevent maj or outbreaks from water
  contamination.
State and local health departments, Centers for Disease Control and
Prevention, and Food and Drug Administration
Office of Water, Amal M. Mahfouz, 202-260-9568 or Alan Rubin,
202-260-7589
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                      Title:          Children's Health Protection-Biosolids
                      Description:    Biosolids, commonly known as sewage sludge, are the remains of domes-
                                    tic and wastewater treatment. They may be processed and used as
                                    fertilizer or fill. In developing standards (Part 503 Regulation for the Use
                                    or Disposal of Biosolids), EPA applied a risk assessment method that
                                    offers extraordinary protection to young children, toddlers, newborns, and
                                    fetuses from potential human health impacts of arsenic, cadmium, lead,
                                    mercury, selenium, and other pollutants inbiosolids. The standards for
                                    these pollutants protect not only the young and very young, but also the
                                    rest of the population.
                      Contact:       Office of Water, Alan Rubin, 202-260-7589
                      HAZARdous WASTE
                      Title:          Determining Potential Exposure of Children Near Superfund Sites
                      Description:    Potential cancer risks and other hazards to children from exposure to
                                    chemicals in air, water, and soil at National Priorities List sites are ana-
                                    lyzed as a routine part of the Superfund program. These evaluations
                                    include assessing risks to children aged six months to six years who may
                                    ingest soil, evaluating risks to children through inhalation, and evaluating
                                    potential risks to children and teenagers trespassing onto abandoned
                                    hazardous waste sites (primarily 10-18 year olds). In addressing risk to
                                    children, appropriate adjustments are made to body weight, inhalation
                                    rates, and ingestion rates to account for age-specific activities. The
                                    analysis predicts changes in blood lead levels in the population.  This
                                    information is used to evaluate the potential need for site cleanup.
                      Contact:       Region2, Marian Olsen, 212-637-4313, Mark Maddaloni, 212-637-
                                    4315, Audrey Galizia, 212-637-4352, or Gina Ferreira, 212-637-4431


                      Title:          Superfund Site Evaluation
                      Description:    The mathematical model used to evaluate Superfund sites for possible
                                    response actions explicitly considers children as a segment of the
                                    population. Children are counted twice when exposure to contamination
                                    can occur in their schoolyards  and homes. Response actions have been
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              taken at three large lead sites in Region 6 to address children's health.
              Risks to children from exposure to Superfund site contaminants are
              estimated using a special set of assumptions for children six years of age
              and younger. Baseline risk assessments have been conducted at every
              National Priorities List site in the Region.
Contact:       Region 6, Don Williams, 214-665-2197 or John Rauscher,
              214-665-8513
Title:          Human Health Risk Assessments/Risk Assessment Work Plans
Description:    All human health risk assessments reviewed by Region 6 for hazardous
              waste programs address sensitive populations, including infants and young
              children. The potential pathways for a child's exposure to hazardous
              wastes include eating, breathing, and skin contact. Risk assessments also
              address the potential for accumulation of hazardous constituents through
              the food chain, such as the breast milk pathway. The Region also ad-
              dresses potential pathways for children's exposure when evaluating
              substances petitioned for delisting as a hazardous waste. Ten risk assess-
              ments were completed in FY1997.
Contact:       Region 6, William Gallagher, 214-665-6775
Title:          Cleanup Actions
Description:    Once a site is placed on the National Priorities List, the risk assessment
              performed for the site may take into account exposure to children as a
              special group that needs protection. This determination is made on a
              site-by-site basis depending on the potential population that may be exposed
              to contaminants at the site. If children are currently present at the site or are
              expected in the future, the risk assessment will address them specifically.
              Actual or potential exposure to children is a factor considered in determining
              the levels of risk and the appropriateness of a removal action.
Contact:       Region 5, Pat Van Leeuwen, 312-886-4904


Title:          Hazardous Waste
Description:    An important component of the Hazardous Waste Program (RCRA
              Corrective Action) process is an assessment of risks to human health and
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                                    the environment at potentially contaminated properties. These assess-
                                    ments require inclusion of children as a distinct exposure population. For
                                    example, a quantitative risk assessment that explicitly includes children's
                                    risk is required for any facility that may contain homes in the future, even
                                    though no one currently lives on or near the property.  EPA requires that
                                    assessments of children's risk include the use of Agency methods for
                                    assessing risk specifically to children (e.g.,Guidance Manual for the
                                    Integrated Exposure Uptake Biokinetic Model for Children).
                      Contact:       Region 8, Tala Henry, 303-312-6648


                      Title:          Risk Assessment in Region 9
                      Description:    Region 9 hazardous waste management programs incorporate protection
                                    of children's health into virtually all risk assessment activities. These
                                    include assessments for specific contaminants to which children are
                                    susceptible.  For example, children may be very susceptible to vinyl
                                    chloride. Region 9 and EPA's Office of Research and Development have
                                    developed a new vinyl chloride risk assessment method. In its first use at
                                    the Operating Industries, Inc. Superfund site, the method helped deter-
                                    mine safe levels of exposure to landfill gas containing vinyl chloride for
                                    children in nearby homes. Indoor air was sampled in more than 200
                                    homes, seven of which were found to be unsafe for children because of
                                    the high vinyl chloride cancer risk. This new method is being used in four
                                    other  environmental cleanup projects.
                      Contact:       Region 9, Gerald Hiatt, 415-744-2319 or Arnold Den, 415-744-1018
                      Title:          Preliminary Remediation Goals to Protect Children
                      Description:    In a project to develop better tools for risk assessment, toxicologists from
                                    Region 9 incorporated the particular characteristics of children's activities
                                    into risk-based screening values called preliminary remediation goals
                                    (PRGs). The PRGs allow for rapid identification of potential health risks
                                    (especially to children) from contamination at hazardous waste sites.
                                    Since their development, Region 9 PRGs have gained widespread
                                    acceptance regionally, nationally, and internationally. They are used for
                                    risk-based screening of hazardous waste contamination and for setting
                                    priorities at hazardous waste sites. PRGs have been developed to
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              address both contaminants that cause cancer and those responsible for
              non-cancer toxicity. The non-cancer PRGs are based entirely on a
              childhood exposure scenario, and the PRGs for carcinogens are devel-
              oped from a child-to-adult exposure scenario.
Contact:       Region 9, Gerald Hiatt, 415-744-2319, Stanford Smucker,
              415-744-2311, or Daniel Stralka, 415-744-2310


Title:          ATSDR Implementation
Description:    EPA has been involved in the Agency for Toxic Substances and Disease
              Registry (ATSDR) Child Health Initiative. EPA ATSDR's Board of
              Science Counselors in efforts to protect children at Superfund sites. EPA
              also is currently working with the Rush Medical Center in Cleveland in
              writing a chapter for the American Academy of Pediatrics Green Book on
              Environmental Diseases in Children. EPA and ATSDR are planning
              new projects that go beyond studying risk of specific substances to
              studying cumulative risks to children at Superfund sites.
Partners:      ATSDR and American Academy of Pediatrics
Contact:       Office of Solid Waste and Emergency Response, Gershon Bergeisen,
              703-603-8816
Title:          Office of Solid Waste Risk Assessments
Description:    EPA continues to include children when considering risks posed by contami-
              nants . A new multi-pathway risk assessment (MPRA) model evaluates
              human and ecological risks from the disposal of more than 100 waste
              constituents (50 evaluated for ecological risk). The MPRA evaluates the
              movement of contaminants through the air, surface water, groundwater, and
              soil, and chemical changes that occur during this movement.  Because of
              their small bodyweight and lifestyle, children may be more likely to encounter
              higher exposures per unit bodyweight than adults. In addition, children are
              more sensitive to certain toxics, such as lead and mercury.
Contact:       Office of Solid Waste and Emergency Response, Charlotte Bertrand,
              703-308-9053
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                          Title:
                          Description:
                          Contact:



                          EXPOSURE


                          Title:
                          Description:
                          Contact:


                          Title:
                          Description:
                          Contact:
Combustion Rulemaking
EPA currently is developing regulations that will significantly reduce
emissions of dioxins, furans, and mercury from hazardous waste combus-
tion. These chemicals pose significant risk to children.  When exposed,
children may suffer from brain and central nervous system damage or
harmful developmental effects, such as delayed walking and talking.
Mercury exposure in mothers may cause developmental effects in their
children. EPA is examining alternative technologies for the treatment and
disposal of mercury-bearing wastes.
Office of Solid Waste and Emergency Response, Fred Chanania,
703-308-8420
Airway Anatomical Structure
This is a study of anatomical differences between children and adults. The
research uses complete airway measurements for ten generations of
children ranging from infants to young adults to improve the previous
estimates of airway dimensions in children. The analyses will provide
estimates of changes in children's airways. This work will contribute to
estimates of quantitative human health risk assessments in children.
Office of Research and Development, Elaine Francis, 202-564-6789


Exposure Factors Handbook
The Handbook contains exposure information by age group, including
children. It provides information on childhood exposure factors, including
age-based exposure route data, physical characteristics, and daily activity
patterns. Information is presented for factors, such as dietary intake,
drinking water intake, and activity patterns.
Office of Research and Development, Jacqueline Moya, 202-260-2385
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Title:          The Chester Environmental Justice Initiative
Description:   This is an assessment of the exposure pathways and sources of environ-
              mental threats faced by children in Chester, Pennsylvania. Region 3 will
              estimate the relative risk posed by each exposure pathway and develop
              measures to help ensure that children are not exposed to unacceptable
              health threats. Chester has a high concentration of industrial facilities (oil
              refineries, an incinerator, and a medical waste processing facility) that are
              located close to residential neighborhoods. The city has the highest infant
              death rate, the lowest birth rate, and the highest death rate from malignant
              tumors of any city in Pennsylvania.
Contact:       Region 3, Janet Viniski, 215-566-2999
        ivE Risk
Title:          Cumulative Exposure Proj ect
Description:   The Cumulative Exposure Project is a broad-based examination of expo-
              sure that considers cumulative exposures to pollutants through air, food,
              and drinking water. The methods rely on existing data to estimate occur-
              rence of exposures across communities and for different segments of the
              populations. Data from the Cumulative Exposure Project will focus on
              identifying pollutants and sources with the greatest impacts on children.
              Initial analyses will focus on exposures through air and food. Levels of
              toxic pollutants in air, food, and drinking water will be examined to identify
              exposures of greatest concern.
Contact:       Office of Policy, Tracy Woodruff, 202-260-6669


Title:          Chicago Cumulative Risk Initiative (CCRI) Proj ect
Description:   This project is designed to advance EPA's science of cumulative risk,
              possibly leading to a better understanding of urban industrial areas and the
              complexities of permitting and locating numerous incinerators and other
              sources in a relatively confined geographic area around Southeast Chicago
              and Northwest Indiana.  The first phase is the development of a profile of
              the pollution exposures experienced by these communities based on
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                                         existing studies and data. In a second phase, Argonne National Laboratory
                                         will conduct a project to calculate cumulative risk impacts on children.
                                         The profile of pollution exposures and the resulting data will be available
                                         for use by the Agency and other interested parties to determine what
                                         activities are needed to reduce risk (e.g., inspections, education and
                                         training, and pollution prevention).
                           Partners:      States of Illinois and Indiana and local agencies
                           Contact:       Region 5, Cheryl Newton, 312-353-6730


                           Title:          Sixteenth Street Community Health Center
                           Description:    The Sixteenth Street Community Health Center in Milwaukee, Wisconsin,
                                         was funded in part by EPA's Office of Environmental Justice to raise
                                         awareness of environmental hazards. Children of low-income Hispanic,
                                         Southeast Asian, and other ethnic groups living in the vicinity of the
                                         inner-city health center are of particular concern. A 1995 survey found
                                         that most residents in this area were poorly informed about health risks
                                         associated with exposure to environmental hazards. Children in these
                                         communities had elevated levels of lead in their blood but were not being
                                         routinely tested.  They also had extremely high asthma rates. The project
                                         translated educational materials into the Hmong and Laotian languages
                                         and provided in-home education and health treatment, monitoring, and
                                         cleanup.
                           Partners:      Sixteenth Street Community Health Center in Milwaukee, Wisconsin
                           Contact:       Region 5, Linda Smith, 312-564-2602
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REfERENCES

1.   Cohrssen, J.J., andV.T. Covello. 1989. Risk Analysis: A Guide to Principles and
    Methods for Analyzing Health and Environmental Risks. Council on Environmental
    Quality. National Technical Information Service (NTIS) Publication Number PB 89-
    137772.
2.   NRC. 1983.  Risk Assessment in the Federal Government: Managing the Process.
    Committee on the Institutional Means for Assessment of Risks to Public Health,
    Commission on Life Sciences. National Research Council. Washington, DC: Na-
    tional Academy Press.
3.   NRC. 1993.  Issues in Risk Assessment. Committee on Risk Assessment Method-
    ology, Commission on Life Sciences. National Research Council. Washington, DC:
    National Academy Press.
4.   NRC. 1994.  Science and Judgment in Risk Assessment.  Committee on Risk
    Assessment of Hazardous Air Pollutants, Commission on Life Sciences. National
    Research Council.  Washington, DC: National Academy Press.
5.   USEPA. 1994. Report on the Workshop on Cancer Risk Assessment Guidelines
    Issues. EPA 630-R-94-005a. U.S. Environmental Protection Agency, Office of
    Research and Development, Risk Assessment Forum.
6.   USEPA. 1997. Guidance on Cumulative Risk Assessment. U.S. Environmental
    Protection Agency, Science Policy Council.
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                                                      PROTECT! Nq  Chi Id REN
                     EPA's RO!E AS INTERNATIONAL LEAdER ii\ ENVIRONMENTAL
                     PROTECTION

                     The United States plays a role in promoting children's environmental health in interna-
                     tional organizations and other nations. The United States' goal is to foster
                     multi-national efforts to reduce risks to children's health from global environmental
                     hazards. EPA's leadership in building international cooperation and technical capability
                     is an essential part of the U.S. role.
                          DECLARATION  of T^E ENVIRONMENTAL LEAC!ERS of T^E  Eiqkr
                     ON ChildREN's ENVIRONMENTAL
                     The 1 997 Declaration of the Environment Leaders of the Eight on Children's Environmen-
                     tal Health has given worldwide attention to environmental hazards that threaten children
                     and to the need for international cooperation to improve protection of children. The
                     Declaration was adopted unanimously by environmental leaders of the G7 countries plus
                     Russia, known as "the Eight," at a summit hosted by Administrator Carol Browner in May
                     1 997 . Its adoption signifies the willingness of the eight most economically influential
                     countries to collaborate on children's environmental health issues.
                     The Declaration, and its list of implementation actions, provides guidelines for domestic
                     and international efforts to improve the protection of children's health. The guidelines
                     specify concrete actions that the Eight will undertake in considering infants and children in
                     environmental studies, risk assessments, and protection programs. Seven specific areas
                     for international collaboration are identified:
                       • Improving environmental science and risk assessments by using more explicit scientific
                        knowledge of children's characteristics.
                       • Reducing blood lead levels in children to below ten micrograms per deciliter and
                        reducing child, infant, and maternal exposure to lead.
                       • Improving access worldwide to microbiologically-safe drinking water.
                       • Reducing air pollution.
                       • Reducing children's exposure to environmental tobacco smoke.
                       • Increasing and coordinating scientific research on endocrine (hormone) disrupting
                        chemicals.
                       • Taking decisive international action to confront the problem of global warming.
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EPA will coordinate U.S. efforts to put into action the steps called for in the Declaration and
will work with other countries of the Eight. EPA also will work with the United Nations
Environment Programme, United Nations Children's Fund (UNICEF), the World Health
Organization, and other international organizations to further the goals of the Declaration.

EPA  INTERNATIONAL AcrivmEs

EPA already supports several international initiatives that promote the goals of the 1997
Declaration. The project to promote microbiologically safe drinking water includes a
water reference laboratory in the Americas and an international exchange of water moni-
toring data. EPA also plans to fund a scientific conference on environmental tobacco
smoke and participate in international meetings on endocrine disrupters, environmental
science, and risk assessments.
EPA is committed to reducing the risks to children's health from toxic chemicals in the
environment on a global scale. The Agency will continue to cooperate with other federal
agencies and international organizations to:
  • Promote worldwide use of environmentally safe technologies and services.
  • Coordinate environmental policies and implement cooperative research programs.
  • Provide international technical assistance, training, and information exchange.
EPA will continue working to ensure that today's children and future generations receive
the protection they deserve.

ASTHMA ANd  OT^ER RESpiRATORy EffECis
The Declaration on Children's Environmental Health highlighted the need to reduce air
pollution in order to "alleviate both domestic and transboundary impacts of air quality and,
particularly, children's health." Of particular concern are the effects of poor air quality on
children and infants. Childhood asthma and other pediatric respiratory ailments are
increasing dramatically around the world. These ailments can be exacerbated by environ-
mental pollutants in the air, including emissions from fossil fuel combustion.
Studies in locations where air pollution is very concentrated, such as an EPA-sponsored study
of children in China, provide information that will benefit children around the globe.
Achieving our national environmental goals requires cooperation with neighboring countries
to reduce pollution that crosses international borders. EPA and Environment Canada
provide joint leadership in efforts to better protect children from the negative effects of air
pollution.  The U.S.-Canada Air Quality Agreement is intended to reduce smog pollution
in the Midwest and Eastern regions of the two countries. As highlighted in Chapter 2
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                      Asthma and Other Respiratory Effects, the United States has established new national
                      ambient air quality standards for ozone and fine participate matter.

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promote the protection of safe drinking water sources through watershed protection activi-
ties, good wastewater management practices, and improved community sanitation.
Under the Great Lakes Water Quality Agreement, EPA and Environment Canada review
and report on discharges of toxic substances and their effects in the Great Lakes Basin.
The agreement sets goals to better protect children, pregnant women, and women of
childbearing age from persistent pollutants found in fish and marine mammals.

EPA  INTERNATIONAL PROJECTS

ASTHMA ANd OT^ER RespiRATORy EffECis


Title:          Children's Lung Function Study in China
Description:    This U.S.-China cooperative study in four Chinese cities will determine
              long-term effects on children's lung function caused by several air pollut-
              ants, including: 1) ambient acid aerosols, particulates, and sulfur oxides;
              and 2) indoor air pollution (coal smoke, environmental tobacco smoke).
              The study also examines the effects of changes in ambient pollution levels
              on children's lung function. Pilot study results have shown a clear associa-
              tion between particulate matter exposure and long-term reduction in
              elementary school children's lung function.
Partners:      China National Environmental Protection Agency (NEPA) and Robert
              Wood Johnson Medical School, New Jersey, USA
Contact:       Office of International Affairs, Jentai Yang, 202-564-6429


Title:          U. S .-Canada Air Quality Agreement
Description:    This agreement on reducing smog pollution of the Midwest-Eastern
              regional airshed involves federal, provincial, and state governmental
              cooperation and significant public and private stakeholder involvement.
              EPA and Environment Canada also review, assess, and report on
              ground-level ozone and its effects through joint biennial progress reports.
Partners:       Environment Canada
Contact:       Office of International Affairs, Pete Christich, 202-564-6404
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TMe:          Mobile Source Training/Lead Phase-Out Training
Description:   Working with international organizations, EPA has developed a training
              program designed to encourage the phase-out of leaded gasoline and
              reduce motor vehicle pollution. The course has been delivered in two
              Latin American countries, two Chinese cities, and the English-speaking
              Caribbean countries. It has been partially credited with China's subse-
              quent commitment to phase lead out of gasoline by 2000.
Partners:      World Health Organization, Pan American Health Organization, and
              World Bank
Contact:      Office of International Affairs, Sylvia Correa, 202-564-6443
Title:          Mobile Source Program in India
Description:   During the next three years, EPA will assist the City of Delhi, India, to
              implement a program to phase out lead in gasoline and reduce motor
              vehicle emissions. EPA experts will provide training, technical assistance,
              and tools to national and municipal governments.  Specific time frames are
              set for elimination or reduction of targeted pollutants, including lead,
              particulate matter, ozone, and hydrocarbons. One key benchmark will be
              the successful elimination of lead from gasoline in India by 2000.
Partners:      U.S. India Fund
Contact:      Office of International Affairs, Jane Metcalfe, 202-564-645 1
        EffECTS Of
Title:          Pesticides Management Proj ect in Central America
Description:   This program assists governments of Central American countries to
              regulate, monitor, and ensure safe use of pesticides. The national program
              focuses on building capacity to develop regulations for pesticide handling,
              storage, and use. The community-level program targets agricultural workers
              and public health and safety issues related to pesticide use. It focuses on
              using protective equipment, safe pesticide handling and application, container
              disposal, and avoiding pesticide contamination of drinking water.
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                      Partners:      U.S. Agency for International Development
                      Contact:       Office of International Affairs, Paul Almeida, 202-564-6453


                             iAl Risks  FROM CONTAIN! NATEC! WATER
                      Title:          U.S.-Canada Great Lakes Water Quality Agreement (GLWQA)
                      Description:    Under this agreement, EPA and Environment Canada review, assess, and
                                    report biennially on discharges of toxic substances and their effects in the
                                    Great Lakes basin. A GLWQA Binational Strategy signed in April 1997
                                    lists targeted persistent toxics and sets ambitious discharge reduction
                                    goals to better protect women of childbearing age, pregnant women, and
                                    children. These provisions are particularly targeted to minority cultures
                                    dependent upon family subsistence fishing and other people who depend
                                    on fish from the Great Lakes for food.
                      Partners:       Environment Canada
                      Contact:       Office of International Affairs, Pete Christich, 202-564-6404


                      Title:          Microbiologically Safe-Drinking Water Laboratory Capacity in Latin
                                    America
                      Description:    EPA will provide technical assistance from its national laboratories to help
                                    convert the Pan-American Health Organization's training laboratory in
                                    Lima, Peru, to a microbiological drinking water reference laboratory
                                    serving all of Latin America. Technical expertise, technology transfer,
                                    and training will be provided to assist with monitoring programs and
                                    certifying compliance with World Health Organization drinking water
                                    quality guidelines.
                      Partners:       World Health Organization and Pan-American Health Organization
                      Contact:       Office of International Affairs, Martha Shimkin, 202-564-6453


                      Title:          Municipal Water Management in Latin America
                      Description:    This proj ect seeks to improve human health and child survival in Latin
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              American and Caribbean countries through better access to microbiologi-
              cally-safe drinking water. Activities include training Peace Corps volun-
              teers on ways to improve drinking water supplies, protect watersheds, and
              improve community sanitation and wastewater treatment practices.
Partners:      U.S. Peace Corps
Contact:      Office of International Affairs, Martha Shimkin, 202-564-6453
Title:          The Central American Small Community Wastewater Treatment Project
Description:   This project focuses on the use of appropriate wastewater treatment tech-
              nologies to reduce microbiological contamination of water used for house-
              hold purposes and to ensure safer water for communities downstream.
Partners:      U.S. Agency for International Development
Contact:       Office of International Affairs, Paul Almeida, 202-564-6402


Title:          Semen Quality in 18 Year Olds and Air Pollution in Czech Republic
Description:   This project is evaluating semen quality in 18 year olds and air pollution
              levels in two districts of the Czech Republic: (1) Teplice, with high levels of
              air pollution, and (2) Prachatice, with low levels. The air pollution levels
              during the winter months in Teplice may reach extremely high levels. Data
              were collected on men who took physical examinations prior to joining the
              military. Sampling was conducted in early spring after three months of high
              exposure, or in the fall after the relatively cleaner summer months. Each
              man was interviewed, given a physical examination, and asked to provide
              a semen sample. The results from the first phase of the study revealed
              significant air pollution effects on sperm, including changes in cell structure
              and mobility. A second phase has begun to study these relationships in
              more depth.
Partners:      Brno Veterinary Research Institute; Institute of Hygiene, Brno; South
              Dakota State University; and University of North Carolina
Contact:       Office of Research and Development, Sally Perreault Darney, 919-541 -
              3826 or Sherry G. Selevan, 202-260-2604
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                                           ElNViRONMENTAl  EduCAliON

                                                                   TO  Chi Id REN'S
                     PURPOSES  of ENVIRONMENTAL EducAiioN

                     As part of the National Agenda to Protect Children's Health from Environmental Threats,
                     EPA is working with health and environmental professionals to identify, prevent, and
                     reduce environmental health threats to children. Environmental education increases public
                     awareness and knowledge about environmental issues, and provides children, parents,
                     and communities with skills they need to make informed decisions. With education and
                     improved access to information, parents and community leaders can better understand
                     complex issues and find creative ways to improve the protection of children's health.
                     Congress recognized the importance of working with educators, parents, and children
                     when it passed the National Environmental Education Act in 1 990. This Act authorizes
                     grants to non-profit organizations and institutions. EPA awards $3 million annually to
                     support approximately 250 grants for environmental education projects.  The majority of
                     grants are for small, local-level projects costing $5,000 or less. Current funding priorities
                     include projects that educate the public about human health problems caused by environ-
                     mental pollution, programs that educate young people, and teacher training.
                     A number of EPA's public information activities are described throughout previous chap-
                     ters, and additional resources, publications, and Internet sites are listed in Chapter 1 1 .
                     This section focuses on environmental education projects supported by EPA that help
                     teach children, parents, and educators about the environment. The projects encourage
                     students to become involved in community pollution prevention activities, and they often
                     lead to removal of environmental hazards in homes, schools, and communities.

                     How  ENVIRONMENTAL  EducAiioN ACTRESSES

                              ISSUES
                    EPA environmental education programs seek to empower Americans to make better
                    environmental decisions and participate in setting local and national priorities. The Agency
                    is working to inspire a sense of personal responsibility for the care of the environment
                    through relationships with environmental educators, students, media, non-profit institu-
                    tions, the private sector, and state and local governments.

                    EducAiiNq Chi Id REN
                    EPA believes that an environmentally-educated population starts with children. Environ-
                    mental education programs teach children about environmental health issues of interest to
                    them and their families, schools, and communities. Children learn about the effects of air
                    and water pollution. They learn about the importance of conserving resources for the
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future through pollution prevention, waste reduction, and recycling. Young people who
learn about environmental issues may want to participate in community environmental
programs and may influence their elders.

EducAiiNq PARENTS ANd TEACHERS

Environmental education programs provide knowledge that parents, educators, and
community leaders can use in simple, everyday ways to protect children from environmen-
tal hazards at home, at school, and at play.  EPA has worked to educate parents and
teachers about potential environmental risks and how to avoid them. For instance, a
number of consumer information kits have been produced to help prevent exposures to
pesticides, lead, radon, environmental tobacco smoke, and other indoor air contaminants.
The Agency provides a focus on environmental justice issues through a special program of
grants for ethnically diverse and disadvantaged populations.
         Sample EPA Education Programs Targeted to
              Poor and Disadvantaged Communities
   * The New Orleans Environmental Justice Education Teacher Training Program addresses
     environmental health threats in the New Orleans area, especially those affecting children. The
     Teacher Training Program focuses on environmental justice issues related to lead, air pollution,
     asthma, pesticides, landfills, and abandoned urban industrial sites.
   * The Youth Star environmental justice project in Revere, Massachusetts, provides hands-on
     learning and encourages students to take an active role in environmental issues in their
     community. The project trains students in disadvantaged and ethnically-diverse communities on
     environmental health and community conservation work.
SUMMARY of EPA AcrivmEs

EPA supports quality environmental education programs by awarding grants to schools,
states, and non-profit organizations to help them improve educational programs. Special
emphasis is placed on developing interdisciplinary programs and training teachers and
other education professionals.
Human health, and especially children's health, is one of seven priorities for this year's
Environmental Education Grant Program. The program awards grants for environmental
education proj ects that enhance the public's ability to make responsible decisions affecting
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                     the quality of our environment. Colleges and universities, local and tribal education agencies,
                     state education and environmental agencies, non-profit organizations, and noncommercial
                     educational broadcasting stations may apply for funds under the program. These environ-
                     mental education projects reach teachers and students as well as the general public.
                     EPA encourages partnerships between the public and private sectors as a way to make
                     the most of scarce funds and help the environmental education community ensure quality
                     programs. The Global Rivers Environmental Education Network (GREEN) Leadership
                     Initiative, for example, is sponsored by an array of partners including major corporations,
                     government agencies, and environmental groups that support local efforts to address
                     water quality problems.
                     Under a cooperative agreement with the National Parent Teachers Association (NPTA), a
                     partnership has been formed to support the participation of local PTAs in the environmen-
                     tal management of homes, schools, communities, and ecosystems. PTA officials have
                     been trained as environmental leaders on topics such as air pollution, environmental
                     tobacco smoke, hazardous materials, emergency planning, indoor air quality, lead poison-
                     ing, pesticides, radon, solid waste, water pollution, and drinking water quality. NPTA has
                     developed an environmental mini-grant program to support the involvement of state PTAs
                     in environmental projects and programs. See Chapter 2 for more information on the
                     NPTA's activities.
                     EPA also is building stronger partnerships with other governmental organizations and the
                     private sector to improve public understanding of the role of science in environmental
                     decision making. Through the National Enforcement Training Institute (NETI), EPA
                     delivers courses on methods of preventing, investigating, and resolving violations of
                     environmental laws.
                     EPA is committed to supporting the development of quality education opportunities for all
                     citizens. The Agency expects to reach six million people—one-third of them under the
                     age of 18—with a series of segments on the Public Broadcasting Service's popular
                     Newton s Apple television show. The impact of the series will be heightened through an
                     outreach effort, including lessons in the Newton s Apple Teacher s Guide and a special
                     feature on the Newton's Apple World Wide Web site.
                     The principles of Environmental Justice—that all people must have the opportunity to live
                     in a healthy environment and that environmental laws apply without discrimination based
                     on race, ethnicity, culture, or economic status—guide EPA's efforts to promote increased
                     and improved access to education programs for the poor, immigrants, and ethnic and
                     racial minorities.
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EPA  ENVIRONMENTAL EdlJCATiON PROJECTS

Title:          Newton's Apple "Environmental Impacts on Children's Health"
Description:    "Environmental Impacts on Children's Health" will be a series of three
              short video segments on the Public Broadcasting System's Newton s
              Apple television show, the most frequently viewed science program in
              middle school classrooms. It is broadcast on approximately 300 stations
              across the nation. The video segments educate viewers about environ-
              mental health threats and strategies for minimizing children's exposure.
              The project includes lessons in theNewton s Apple Teacher s Guide and
              a special feature on the Newton's Apple World Wide Web site.
Partners:      Twin Cities Public Television, Inc., KTCA-TV
Contact:       Office of Communications, Education, and Media Relations, Diane Berger,
              202-260-8747
Title:          The GREEN Leadership Initiative
Description:    The Global Rivers Environmental Education Network (GREEN) uses an
              interdisciplinary education course that addresses water quality and its
              effect on human health. A diverse audience of more than 100 educators,
              10,000 students, and 100 community leaders in ten communities will be
              targeted for training sessions to improve environmental education skills and
              learn about watershed and health issues within their own communities.
Partners:       General Motors Corporation, Owens Corning Corporation, George Gund
              Foundation, National Fish and Wildlife Federation, National Science
              Foundation, Budd/Deschutes Project GREEN (Washington State),
              Friends of the Rouge (Michigan), Rivers Project of Lee County Schools
              (Florida), Project del Rio (Texas and New Mexico), Project WET,
              Susquehanna River Basin Project (New York), and World Resources
              Institute
Contact:       Office of Communications, Education, Medis Relations, Diane Berger,
              202-260-8747
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                     Title:          New Orleans Environmental Justice Education Teacher Training Program
                     Description:   The Environmental Justice Education Teacher Training Program provides
                                   an integrated curriculum with modules on issues affecting children's
                                   environmental health in New Orleans. Topics include lead, air pollution
                                   and asthma, pesticides, landfills, and brownfields. The project will
                                   implement a curriculum that emphasizes environmental justice concerns,
                                   train K-6 teachers on its use, and disseminate environmental justice
                                   education materials to schools in the New Orleans area.
                     Partners:      The Deep South Center for Environmental Justice, New Orleans Public
                                   Schools, and National Lead Information Center
                     Contact:      Office of Communications, Education, and Media Relations,
                                   \Diane Berger, 202-260-8747


                     Title:          Pollution Prevention Education Toolbox
                     Description:   The Pollution Prevention Education Toolbox contains lesson plans and
                                   educational activities related to water pollution prevention and conser-
                                   vation, energy conservation, general pollution prevention, waste reduc-
                                   tion, pesticide reduction, and household hazardous waste reduction.
                                   Lessons include changing what you use, changing what you do, improv-
                                   ing housekeeping, and educating yourself and others.  Workshops for
                                   middle school teachers from the Chicago Public Schools were con-
                                   ducted in summer 1997.
                     Partners:      Chicago Public Schools
                     Contact:      RegionS, Dolly Tong, 312-886-1019


                     Title:          Environmental Education Grants
                     Description:   Grants awarded by EPA's Region 2 related to children's environmental
                                   health include a childhood lead poisoning prevention program for
                                   Patterson, New Jersey, and an indoor air pollution project for the St.
                                   Regis Mohawk Tribe. EPA has awarded grants worth approximately $ 11
                                   million to educational organizations in all 50 states and the District of
                                   Columbia. Most grants are for $5,000 or less.
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Partners:       Nearly 1,000 grantees including schools and universities; state, local, and
               tribal government agencies; and non-profit organizations
Contact:       Region 2, Terry Ippolito, 212-637-3671


Title:           Give Water a Hand
Description:    This camp educates high school students about water and the environment.
               The goal of this grant is to improve citizen involvement and partnerships to
               promote clean water.
Contact:       Region 6, Karen Bick, 214-665-7539


Title:           River Revitalization Program
Description:    EPA will support the development of river revitalization proj ects that
               directly involve Boston's youth in community environmental issues.
Partners:       Boston Urban Resource Partnership and Massachusetts Riverways Program
Contact:       Region 1, Angela Bonarrito, 617-565-2501


Title:           Youth Star Program
Description:    EPA is assisting the Youth Star environmental justice project through a
               grant to train students in environmental education, environmental health
               issues, and community conservation work in Revere, Massachusetts.
Partners:       Youth Star Program
Contact:       Region 1, Angela Bonarrito, 617-565-2501


Title:           Teacher Training Program
Description:    This project provides hands-on training and curriculum materials to 20
               elementary school teachers to cultivate a natural vegetable and herb garden
               with students on their school grounds. Children in participating schools will
               learn about pollution prevention concepts and techniques related to water,
               soils, and non-polluting alternatives to pesticides and herbicides.
Partners:       University of Rhode Island Cooperative Extension Education Center
Contact:       Region 1, Angela Bonarrito, 617-565-2501
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                     Title:          Teacher Training Workshops
                     Description:   EPA's regional office in New England periodically co-sponsors teacher
                                   training workshops on indoor pollutants, air quality, wetlands, and other
                                   environmental topics.
                     Contact:      Region 1, Maria Pirie, 617-565-9447


                     Title:          Youth and the Environment
                     Description:   Students in the New England states work at summer j obs at a wastewater
                                   treatment plant or a zoo and participate in weekly field trips and seminars
                                   on topics ranging from wastewater management to restoration ecology.
                                   During the summer of 1996,70 inner-city students were introduced to
                                   environmental careers. Sixty disadvantaged students participated in the
                                   program during 1997.
                     Contact:      Region 1, Charles Conway, 617-565-3517


                     Title:          That Magnificent Groundwater Connection
                     Description:   This is a resource package for teachers with stories, experiments, and
                                   songs to teach children about water. Children learn about water's cyclical
                                   movement through the environment; the connections between water and
                                   the streams, lakes, estuaries, and wetlands near their homes; where
                                   drinking water comes from; and how to be better environmental stewards.
                                   The K-6 curriculum has been distributed to teacher organizations in New
                                   England.
                     Contact:      Region 1, Mary Jo Fuerbach, 617-565-4721


                     Title:          A World in Our Backyard/Adopt-a-Wetland Program
                     Description:   This two-part, hands-on project for middle school and high school
                                   students includes an educational curriculum with videos and a teacher's
                                   guide with activities. The "Adopt a Wetland" program teaches children
                                   about wetland ecology by helping them protect an area in their own
                                   community through stewardship activities conducted with their classes.
                     Contact:      Region 1, Stafford Madison, 617-565-4868
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Title:          Junior Environmental Training (JET) Program
Description:    Groups of EPA staff volunteers perform skits on hazardous waste and
              recycling at schools, daycare centers, and environmental events in New
              England. Hundreds of students in grades K-8 have attended and partici-
              pated in these skits.
Contact:       Region 1, Maria Pirie, 617-565-9447


Title:          Save the Sound
Description:    One hundred upper-elementary school teachers from communities within the
              Long Island Sound watershed will be trained on preservation and restoration
              of the Sound. They also will incorporate information on the Sound into their
              curricula. Teachers at five locations within the watershed will receive
              hands-on training about the Sound, its watershed, and water quality.
Partners:      Save the Sound, Inc. and University of Connecticut
Contact:       Region 1, Maria Pirie, 617-565-9447


Title:          Appalachian Mountain Club
Description:    This community-based conservation project teaches outreach and advo-
              cacy skills through the process of planning, promoting, and implementing a
              neighborhood environmental service project in the disadvantaged and
              culturally diverse community of Chelsea, Massachusetts. The project
              provides training to enable youth to pursue employment in the environmen-
              tal and recreational fields and also helps young people create a community
              base for maintaining local parks and green spaces.
Partners:      City of Chelsea, Massachusetts
Contact:       Region 1, Maria Pirie, 617-565-9447


Title:          Harvard Human Health and the Environment Project
Description:    This hands-on educational program brings high quality instruction about
              human health and the environment to inner-city school children. By sharing
              technical expertise with teachers and students, the project will increase
              awareness of the environment and its effects on health among fifth grade
              public school students.
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                           Partners:      Harvard University School of Public Health
                           Contact:       Region 1, Maria Pirie, 617-565-9447


                           Title:          E.N. Rogers Environmental School
                           Description:    This project educates teachers, students, and the public about human
                                         health problems caused by pollution. The E.N. Rogers Environmental
                                         School will use an environmental curriculum that will allow students to: (1)
                                         correlate the effects of water quality on an urban river; (2) collaborate via
                                         the Internet with students from Great Britain on historical comparative
                                         research; and (3) develop critical thinking, problem solving, decision
                                         making, and laboratory skills.
                           Partners:      Lowell Public Schools, in collaboration with several partners
                           Contact:       Region 1, Maria Pirie, 617-565-9447


                           Title:          The Connections Project
                           Description:    This project will complete the "Taunton River Watershed Connections
                                         Curriculum" and teacher resource kit for grades 6-12. The project will
                                         provide a model for watershed pollution prevention to schools and local
                                         communities.  The Connections Project team of scientists and educators
                                         will finalize the curriculum. Workshops will provide training on the
                                         curriculum for teachers throughout the Taunton River watershed.
                           Partners:      University of Massachusetts Extension Service
                           Contact:       Region 1, Maria Pirie, 617-565-9447


                           Title:          Teacher Training on Integrated Pest Management and Pesticides
                           Description:    New Hampshire's state association of Future Farmers of America will
                                         educate high school teachers about integrated pestmanagement (IPM) and
                                         pesticides in the environment. An initial workshop for 30 teachers will show
                                         them how to integrate instructional materials on pesticides and IPM into
                                         existing curricula. Teachers will receive further assistance through follow-up
                                         visits that will gauge additional teacher and student needs.
                           Partners:      Granite State Association of Future Farmers of America
                           Contact:       Region 1, Maria Pirie, 617-565-9447
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Title:          Active Watershed Education (AWEsome!) Program
Description:    The Active Watershed Education (AWEsome!) curriculum provides future
              stewards of the Narrow River and Saugatucket River watersheds with the
              skills needed to make informed decisions about local environmental issues.
              The program will revise existing watershed-specific curriculum guides and
              train 20 upper-elementary and middle school teachers to use the curricu-
              lum. The project assists teachers and their students in assessing local
              environmental issues and conducting student-driven community action
              projects related to these issues.
Partners:      Southern Rhode Island Conservation District
Contact:       Region 1, Maria Pirie, 617-565-9447


Title:          Water Quality Information Sharing Program
Description:    Teachers and students from Rhode Island and Columbia, South America,
              learn about water quality, perform water quality monitoring, and share
              information. Seven teachers and 240 6th to  1 Oth grade students from
              Rhode Island and three teachers with 120 students from Columbia partici-
              pated in the 1996-97 school-year program by monitoring and working to
              preserve a river near their respective schools.
Partners:      Rhode Island Zoological Society Roger Williams Park Zoo
Contact:       Region 1, Maria Pirie, 617-565-9447


Title:          Aquatic Education Exhibit
Description:    Region 6 awarded a grant to the Jasmine Moran Children's Museum in
              Seminole, Oklahoma, to refurbish an aquatic education exhibit that will use
              hands-on scientific methods to teach about water pollution problems.
              Large tanks filled with water, fish, and plants show the effect of a polluted
              environment and how "bad water" can be turned into "good water." Forty
              thousand students are expected to visit annually.
Partners:      Jasmine Moran Children's Museum
Contact:       Region 6, Joe Taylor, 214-665-2200
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                      Title:          Environmental Awareness and Testing Program
                      Description:   Region 6 awarded a grant to the Zachary Historical Association for an
                                    "Environmental Awareness and Testing" program that will involve ap-
                                    proximately 1,000 students, including children with disabilities. The
                                    students will learn environmental research and monitoring techniques
                                    through hands-on experiences at this unique facility.
                      Partners:      Zachary Historical Association
                      Contact:      Region 6, Joe Taylor, 214-665-2200


                      Title:          Philadelphia Public Environmental Education Center
                      Description:   A Public Environmental Education Center in downtown Philadelphia
                                    educates the public about dangers to health posed by various environ-
                                    mental hazards. The center regularly hosts groups of school children,
                                    distributes publications, and operates a toll-free customer service hotline.
                      Contact:      Region 3, Rene Henry, 215-566-5560
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                                                                          CoMMUINlhy
1 51
Public ACCESS TO I N FORMATION
                                                                                   TO  PROTECT
                     Chi Id REN'S
                     EPA is rapidly expanding the public's right-to-know about environmental pollutants in
                     their community. Families and communities need the information to make informed
                     decisions about how to protect children from the potential health risks posed by pollutants
                     released in their neighborhood. In keeping with community right-to-know principles in the
                     Emergency Planning and Community Right-to-Know Act (EPCRA), EPA has expanded
                     public access to Agency information on pollution, particularly through the Internet. Par-
                     ents can use this information to help prevent pollution in their neighborhoods and protect
                     the health of the community's children. EPA initiatives that improve public access to
                     information on pollution include:
                       • In 1 993 , EPA nearly doubled the chemicals on which industry must provide
                        information about toxic releases. Over 600 chemicals are now included in EPA's
                        Toxic Release Inventory (TRI).
                       • In 1 996, EPA expanded the categories of industrial facilities required to disclose
                        information about toxic releases by 30 percent, bringing the total to more than 3 1 ,000
                        facilities that must report their toxic emissions to the public.
                       • The 1 996 Amendments to the Safe Drinking Water Act require water suppliers to
                        provide consumer confidence reports to their customers, including information on
                        local water quality, sources of drinking water, drinking water contaminants, and health
                        risks posed by local water (see chapter 6).
                       • The 1 996 Food Quality Protection Act includes special right-to-know provisions
                        that provide more public information about risks from pesticides on foods (see Chapter 5).
                       • To protect children from lead-based paint poisoning, EPA and the Department of
                        Housing and Urban Development recently required sellers and landlords of pre- 1 978
                        housing to disclose any known lead-based paint to home buyers, allowing potential
                        buyers the option of conducting a lead hazard assessment (see Chapter 4).
                       • EPA and other federal agencies, in cooperation with medical organizations,
                        meteorologists,  and educators, have created anew federal Ultraviolet (UV) Index
                        program to provide information needed to protect children from overexposure to
                        harmful ultraviolet light (see Chapter 3).
                       • EPA has developed a national listing of Fish Consumption Advisories that makes
                        information about state-issued fish consumption advisories more accessible to the
                        public (see Chapter 11).
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  • In 1997, EPA began collecting beach monitoring and closure information and making
   it available to the public. Eventually, the information will be compiled in a database
   and included with other information on a World Wide Web site on beach health (see
   Chapter 6).
  • EPA has produced a number of consumer information kits on preventing exposures to
   lead, radon, other indoor air contaminants, and pesticides in neighborhood homes and
   schools (see Chapter 2).
  • EPA recently began a Consumer Labeling Initiative to expand the amount of hazard
   and health information on household consumer and pesticide product labels (see
   Chapters).

EPA  COMMUNITY Riqhi'TO'KNOW AcrivmEs

EPA is responsible for implementing the provisions of EPCRA. The legislation mandates
the improvement of the Toxic Release Inventory. The TRI is a national database that
provides the public with annual information on the environmental release of over 600 toxic
chemicals commonly used by industry. More than 31,000 industrial facilities across the
country are required to provide EPA with reports on the types and amounts of chemicals
they release to the air, land, and water. The reports are presented in an easy to follow
format and are made available to the public through on-line services, such as the National
Library of Medicine (NLM) and the Right-to-Know Network (RTK-NET), public
libraries, and EPA.
EPA has adopted a broad focus for TRI to meet the needs of communities, local govern-
ments, academia, industry, and public policy groups. Because of TRI's reporting require-
ments, hazardous emissions have been reduced by 61 percent since 1987. EPA will use
the TRI program to ensure that parents, teachers, and health care providers are aware of
all sources of contamination that may affect children's health.
President Clinton is directing federal agencies to build on the success of the right-to-know
laws and develop proposals to provide families with better information about the risks they
face from toxics and other hazards. This initiative will include common-sense and cost-
effective ways to assist parents in avoiding environmental health risks to children from
products and chemicals. The initiative also provides information on environmental health
risks, such as cancer, developmental, hormonal, and reproductive risks. This information
encourages informed consumer choices.
The President directed EPA to work with other federal, state, and local agencies to
establish a nationwide network for observing key environmental health indicators in the air,
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                   land, and water. Families willhaveaccesstothe timely health-related data generated
                   from these observations. They may then use the information to make informed choices
                   that directly affect themselves. For instance, timely information on air quality can mean the
                   difference between hospitalization and a healthy day for an asthmatic child.
                  New  Orleans Children  Aged 6 and Under
1 5 5
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Environmental health indicators are being developed for use in detecting trends in public
health impacts of environmental contaminants. This includes developing an aggregated index
of environmental health conditions for children. EPA Region 3 has produced a vulnerability
index based on information contained in the TRI. The vulnerability index provides a descrip-
tion of socioeconomic and demographic characteristics that may render a subpopulation
(e.g., children) more susceptible than the general population. A similar geographic informa-
tion system (GIS) maintained by Region 6 can evaluate the potential occurrence of respira-
tory diseases, lead exposures, and waterborne diseases in local communities, and can be
used to warn communities of potential health problems for their children. A sample of the
demographic information available through the GIS is shown in the graph above.
EPA also monitors regulatory compliance. EPA enforcement personnel conduct routine
monitoring and oversight of the data submitted by facilities for the TRI to detect facilities
that fail to report as required, to identify waste streams that should have been reported and
were not, and to evaluate the integrity of the data submitted to EPA.

EPA COMMUNITY  Riqhi'TO'KNOW PROJECTS

Title:          Toxic Release Inventory
Description:    The Toxic Release Inventory is a national database that provides the public
              with annual release information on over 600 toxic chemicals commonly
              used by U.S. industry. This inventory requires that each of 31,000
              industrial facilities across the nation provide EPA with chemical-specific
              reports on the amount of chemicals they release to the air, land, and water.
              The reports are made available to the public in a variety of means, includ-
              ing on-line services, public libraries, and by request, from EPA. As part of
              ongoing efforts to enhance family right-to-know, EPA is developing TRI
              chemical fact sheets for parents and a Sector Facility Indexing project that
              will provide profiles of the environmental performance of five major
              industries.
Contact:       Office of Prevention, Pesticides, and Toxic Substances, Darlene Dinkins,
              703-305-5214
Title:          Enforcement Activities to Help Ensure Compliance with the Emergency
              Planning and Community Right-to-Know Act (EPCRA)
Description:    Over the past several years, EPA has initiated a focused enforcement effort
              aimed at improving the regulated community's rate of compliance with both
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                                    the emergency planning requirements and the community right-to-know
                                    components of EPCRA. For example, each of the ten EPA regional offices
                                    reviews databases to detect TRI non-reporters, responds to tips and
                                    complaints of potential violations, evaluates the quality of data submitted by
                                    the regulated community, and issues enforcement actions for violations.
                                    These actions are designed to improve the overall completeness and
                                    accuracy of the public inventory of toxic emissions in communities.
                      Contact:       Office of Enforcement and Compliance Assurance, Dean Ziegel, 202-
                                    564-4038
                      Title:          Potential Exposure to Environmentally Released Chemicals and Child-
                                    hood Cancer
                      Description:    This project is an analysis of chemical releases, as documented in the
                                    Toxic Release Inventory (TRI) database, and childhood cancer mortality
                                    rates for children between the ages of one and 19 in the United States.
                      Contact:       Office of Research and Development, Denise Lewis, 919-966-63 85


                      Title:          Children's Environmental Health Index for the United States
                      Description:    EPA is developing environmental indicators to detect trends in public
                                    health impacts of environmental contaminants and assess whether environ-
                                    mental programs are protecting the health of the public and our children.
                                    The results will be used to develop an index of health impacts on children.
                                    The indicators will help identify the environmental chemicals that can
                                    contribute to adverse health effects. An air index will be developed to
                                    provide an aggregate estimate of exposure to all six criteria air pollutants.
                                    Respiratory diseases in children will be included. Future work will
                                    consider other children's health outcomes, such as cancer and develop-
                                    mental effects.
                      Partners:       World Resources Institute and School of Public Health at the University
                                    of California, Berkeley
                      Contact:       Office of Policy, Tracy Woodruff, 202-260-6669
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Title:          Chemical Indexing System for Toxic Release Inventory, Part It:
              Vulnerability Index
Description:    The vulnerability index provides a description of socioeconomic character-
              istics that may render a subpopulation more susceptible to toxic releases
              than the general population. It includes income and minority status as well
              as methods for considering other factors, including number of persons age
              14 or under, that may influence the vulnerability of subpopulations. The
              index will be used in conjunction with Part I of the Chemical Indexing
              System to estimate the relative hazard of chemical releases.
Contact:       Region 3, Debra Forman, 215-566-2073
Title:          Use of a Geographic Information System (GIS) to Gather and Analyze
              Information for Regional Programs
Description:    A GIS system maintained by EPA Region 6 includes community-level data
              associated with economic status, minority representation, proximity to
              known pollution sources, cumulative impact concerns, enforcement
              activities, and other environmental parameters. The analytical capabilities
              of the system can improve awareness of children's issues. Maps indicate
              areas of concern for environmental problems and children's health. The
              system can evaluate the potential for respiratory diseases, lead exposures,
              and waterborne diseases and relate them to areas where many families
              with children are likely to reside. Vulnerability factors, such as low eco-
              nomic status, also can be considered. The system can access state health
              monitoring and epidemiology information that can be used to show rela-
              tionships among environmental exposures, population characteristics, and
              children's diseases.
Contact:       Region 6, Gerald Carney, 214-665-6523
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                     Title:           Consumer Labeling Initiative
                     Description:    In 1995, EPA began its Consumer Labeling Initiative to develop labeling
                                    for products that is easy to understand and allows parents to make more
                                    informed choices.  EPA has initiated a pilot proj ect focused on indoor
                                    insecticides, outdoor pesticides, and household antimicrobial products—
                                    all products that are present in children's environments.
                     Contact:       Office of Prevention, Pesticides, and Toxic Substances, Darlene Dinkins,
                                    703-305-5214
                     Title:           Poison Prevention
                     Description:    Accidental poisoning from pesticide chemicals around the household
                                    remains a serious concern for children. EPA is an active member of the
                                    Poison Prevention Council, and annually distributes thousands of fact
                                    sheets on pesticides and child safety to medical establishments and the
                                    general public. As a result of the Poison Prevention Week outreach in
                                    1995, EPA sent a poison prevention message to 3.5 million television
                                    viewers.
                     Contact:       Office of Prevention, Pesticides, and Toxic Substances, Darlene Dinkins,
                                    703-305-5214
                     Title:           Consumer Pesticide Right-to-Know Brochure
                     Description:    The FQPA requires that EPA develop an annual brochure that discusses
                                    the risks and benefits of pesticides. The brochure will be distributed
                                    through large retail grocers and will provide information for consumers on
                                    how they can reduce their exposure to pesticide residues on food. This
                                    program will allow parents to make more informed choices for their
                                    families.
                     Contact:       Office of Prevention, Pesticides, and Toxic Substances, Darlene Dinkins,
                                    703-305-5214
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                                                           Chi Id REN'S
                                                                           RESOURCES
                     This chapter contains sources of additional information, lists of EPA publications related to
                     children's health topics, and references for hotlines and Internet resources. Most of the
                     resources listed below focus specifically on children or issues of primary importance during
                     the developmental years. Others address EPA efforts to protect the environment where
                     children live, learn, and play. The listing is not intended to be exhaustive, but to allow
                     readers to better understand how to protect children's health.

                     CONTACT! Nq  EPA

                     For additional information on the EPA children's environmental health projects inventoried in
                     this document, you may call the individuals listed as contacts for each project. To contact
                     other individuals and offices within the U. S. Environmental Protection Agency, address all
                     correspondence using the following addresses and telephone numbers:


                     EPA HEAdQUARTERS
                     Environmental Protection Agency
                     401 M Street, S.W.
                     Washington, DC 20460
                     Administrator's Hotline: 202-260-1000
                     Toll Free Number: 888-372-8255
                     Internet: http://www.epa.gov
                     Children's Health Web page: http://www.epa.gov/children


                     EPA ReqioNs
                     Region 1 (Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut)
                     Environmental Protection Agency
                     One Congress Street
                     JohnF.  Kennedy Building
                     Boston, MA 02203-0001
                     Phone:617-565-3420
                     Fax:617-565-3660
                     Internet: http://www.epa.gov/regionl
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Region 2 (New York, New Jersey, Puerto Rico, Virgin Islands)
Environmental Protection Agency
290 Broadway
New York, NY 10007-1866
Phone:212-637-3000
Fax:212-637-3526
Communications Division: 212-637-3660
Internet: http://www.epa.gov/region2
Region 3 (Pennsylvania, Delaware, District of Columbia, Maryland, Virginia,
West Virginia)
Environmental Protection Agency
841 Chestnut Building
Philadelphia, PA 19107
Phone:215-566-5000
Fax:215-566-5103
Customer Service Center: 800-438-2474
Internet: http://www.epa.gov/region3
Region 4 (Kentucky, Tennessee, North Carolina, South Carolina, Mississippi,
Alabama, Georgia, Florida)
Environmental Protection Agency
6IForsyth Street, S.W.
Atlanta, GA 30303
Phone: 404-562-9900
Fax:404-562-8174
Public Affairs and Information: 404-562-8327
Internet: http://www.epa.gov/region4
Region 5 (Minnesota, Wisconsin, Illinois, Michigan, Indiana, Ohio)
Environmental Protection Agency
77 West Jackson Boulevard
Chicago, IL 60604-3507
Phone:312-353-2000
Fax:312-353-4135
Toll Free Number: 800-621 -8431
Internet: http://www.epa.gov/region5
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                                                               EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                    Region 6 (New Mexico, Texas, Oklahoma, Arkansas, Louisiana)
                    Environmental Protection Agency
                    Fountain Place 12th Floor, Suite 1200
                    1445 Ross Avenue
                    Dallas, TX 75202-2733
                    Phone: 214-665-6444
                    Fax:214-665-7113
                    General Information: 214-665-2200
                    Internet: http://www.epa.gov/earthlr6/index.htm
                    Region 7 (Nebraska, Kansas, Iowa, Missouri)
                    Environmental Protection Agency
                    726 Minnesota Avenue
                    Kansas City, KS 66101
                    Phone:913-551-7000
                    Fax:913-551-7467
                    Toll Free Number: 800-223-0425
                    Internet: http://www.epa.gov/region7
                    Region 8 (Montana, North Dakota, Wyoming, South Dakota, Utah, Colorado)
                    Environmental Protection Agency
                    999 18th Street, Suite 500
                    Denver, CO 80202-2466
                    Phone:303-312-6312
                    Fax:303-312-6339
                    Environmental Information Service Center: 800-227-8917
                    Internet: http://www.epa.gov/region8
                    Region 9 (California, Nevada, Arizona, Hawaii)
                    Environmental Protection Agency
                    75 Hawthorne Street
                    San Francisco, CA 94105
                    Phone:415-744-1305
                    Fax:415-744-2499
                    General Public Inquiries: 415-744-1500
                    Internet: http://www.epa.gov/region9
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Region 10 (Washington, Oregon, Idaho, Alaska)
Environmental Protection Agency
1200 Sixth Avenue
Seattle, WA 98101
Phone: 206-553-1200
Fax:206-553-0149
Toll Free Number: 800-424-9372
Internet: http://www.epa.gov/regionlO
EPA also operates a number of hotlines and clearinghouses. Those that offer publications
and information relevant to topics covered in this report are listed in the appropriate
sections below. For information on other EPA offices, locations, public information
centers, hotlines, and clearinghouses, check the EPA home page or call the regional office
nearest you.

              EPA PublicAiioNs

EPA is making important progress to provide the public with information to protect
children's health.  The following tables list Web addresses for obtaining EPA information
and direct links to other resources available on the Internet. It is also possible to call or
write EPA to request copies of documents. General sources of EPA documents include:
  •  The National Center for Environmental Publications and Information (NCEPI) is a
    central repository for all EPA documents, with over 5,500 titles in paper and electronic
    format available for distribution (usually at no cost to the public). Individuals can
    browse and search EPA's National Publications Catalog, and order EPA Publications
    online or by telephone at 800-490-9198. The EPA publication number (e.g., EPA
    999-F-99-999) is used to identify the resource.
                NCEPI
                National Center for Environmental Publications and Information
                P.O. Box 42419
                Cincinnati, OH 45242-2419
                Phone: 800-490-9198
                Fax:513-489-8695
                Internet: http://www.epa.gov/ncepihom
Some documents not available free of charge through NCEPI can be obtained for a
charge through the Government Printing Office (GPO) or the National Technical Informa-
tion Service (NTIS).
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                                                                 EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                       • NTIS is a central resource for government-sponsored U.S. and international scientific,
                         technical, engineering, and business-related information. As a self-supporting agency
                         of the U.S. Department of Commerce, NTIS covers its business and operating
                         expenses with the sale of its products and services. For EPA publications, NTIS
                         indexes publications by their EPA publication number, complete title, and by an NTIS
                         product number. NTIS accepts VISA and MasterCard.
                                     NTIS
                                     National Technical Information Center
                                     5285 Port Royal Road
                                     Springfield, VA 22151
                                     Phone to Order: 800-553-6847 or 703-605-6000
                                     Fax:703-321-8547
                                     E-Mail Online Ordering: orders@ntis.fedworld.gov
                                     Internet: http://www.ntis.gov
                       • Documents available from the Government Printing Office can be obtained for a fee
                         by calling or writing to the address below. GPO also accepts VISA and MasterCard.
                         Place orders by title or appropriate order number.
                                     U.S. Government Printing Office
                                     Superintendent of Documents
                                     PO Box 371954
                                     Pittsburgh, PA 15250-7954
                                     Phone:202-512-1800
                                     Fax:202-512-2250
                                     Internet: http ://www.access .gpo .gov/su_docs/sale/prf/prf.html
                     Additional publications and interlibrary loans of EPA documents are available through the
                     EPA library system. The EPA Headquarters Information Resources Center provides
                     access to EPA information for U. S. and international requests, and has a range of infor-
                     mation services consisting of environmental and related subjects, including online searching
                     of commercial databases. The focus  of the EPA collection is on environmental regula-
                     tions, policy, planning, and administration. The library also maintains a large collection of
                     EPA documents on microfiche and in hard copy. Libraries are located in EPA regional
                     offices and laboratories across the country. For information contact:
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                Headquarters Information Resources Center
                Environmental Protection Agency
                40 1M Street, S.W.
                Washington, DC 20460
                Phone:202-260-5921
                Fax:202-260-5153
                E-mail: library-hq@epamail.epa.gov
                Internet: http://www.epa.gov/natlibra

EPA  MATERiAls, Tools, AN(J  INTERNET  RESOURCES  RElATE(J  TO

Chi Id REN'S
This section contains information resources specific to the health effects and environmental
contaminants addressed in the Children s Environmental Health Yearbook. Under each
topic, general resources — such as hotlines and clearinghouses — are listed first, followed by
an alphabetical listing of relevant EPA publications. For each document, one or more
sources for obtaining the information is indicated in the right hand column. Sources may be
one of the major document distribution centers or EPA offices listed above, an Internet site
address, or one of the topic-specific clearinghouses or hotlines. A specific individual
contact and telephone number are provided where needed.

ASTHMA ANd OT^ER RESpiRATORy EffECis

iNfoRMATJON RESOURCES foR lN(JoOR AJR
Indoor Air Quality Information Clearinghouse (IAQINFO)
P.O. Box 37 133
Washington, DC 20013-7133
Phone: 800-438-4318; 202-484-1307
Fax:202-484-1510
E-mail: iaqinfo@aol.com
Internet: http://www.epa.gov/iaq/iaq-pubs.html
The IAQ Information Clearinghouse provides information pertaining to indoor air pollut-
ants, their sources, health effects, and methods for testing, measuring, and controlling
indoor air pollution. Information about maintaining homes, schools, and other buildings to
minimize indoor air quality problems is available.
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                                     Indoor Air Quality Publications and Sources
                    Publication
                    A Special Alert for People with Asthma in the
                    Northeast Ohio Area (EPA 905-K-OO1, May 1997)

                    A Special Alert for People with Asthma in the
                    Greater Cincinnati, Northern Kentucky
                    Metropolitan Area (EPA 905-K-002, May 1997)

                    A Special Alert for People with Asthma in the
                    Greater St. Louis Metropolitan Area
                    (EPA 905-K-003, May 1997)

                    A Special Alert for People with Asthma in the
                    Chicago Metropolitan Area and Northwest
                    Indiana (EPA 905-K-004, May 1997)

                    A Special Alert for People with Asthma in
                    Southeast Wisconsin (EPA 905-K-005, May 1997)

                    Asthma, Air Quality, and Environmental Justice:
                    EPA's Role in Asthma Education and Prevention
                    (EPA 402-F-95-001, July 1995, IAQ-0084)

                    Carpet and Indoor Air Quality Fact Sheet
                    (EPA 402-F-94-011, October 1992, IAQ-0040)

                    Cual es el problema con el aire?
                    (EPA 905-K-97-004S, July 1997)

                    Flood Cleanup: Avoiding Indoor Air Quality
                    Problems Fact Sheet (EPA 402-F-93-005,
                    August 1993, IAQ-0061)
Source
Region 5, Indoor Air
Coordinator, 312-353-2205

Region 5, Indoor Air
Coordinator, 312-353-2205
Region 5, Indoor Air
Coordinator, 312-353-2205
Region 5, Indoor Air
Coordinator, 312-353-2205
Region 5, Indoor Air
Coordinator, 312-353-2205

IAQINFO
IAQINFO
Region 5, Indoor Air
Coordinator, 312-353-2205

IAQINFO
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                   RESOURCES

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  EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                       .-..v-
Publication
How Healthy Is the Air in Your Home? A
Room-by-Room Checklist for Your Home's
Indoor Air Quality (EPA 402-F-97-001)

IAQ Tools for Schools Action Kit
IAQ Tools for Schools-Ventilation Basics (video)

Indoor Air Pollution: An Introduction for Health
Professionals. (GPO 1994-523-217/81322)

Indoor Air Quality Basics for Schools Fact Sheet
(EPA 402-F-96-004, October 1996, IAQ-0095)

Protect Your Family and Yourself from Carbon
Monoxide Poisoning (EPA 402-F-96-005,
October 1996) in Spanish
(EPA 402-F-97-004, July 1997)

Residential Air Cleaners Fact Sheet
(EPA 20A-4001, February 1990, IAQ-0007)


Sick Building Syndrome Fact Sheet
(EPA 402-F-94-004, April 1991, IAQ-0004)
Source
IAQINFO
All except the problem
solving wheel and
video available at
http://www.envirovillage.com/
tools/NDefaulthtm.
GPO sells the complete kit
and extra wheels.

IAQINFO

IAQINFO
IAQINFO
IAQINFO
(This fact sheet also is
available in Vietnamese,
Chinese, and Korean.)

IAQINFO
IAQINFO
             RESOURCES
                                                166

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                                                             EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                    Publication
                    Targeting Indoor Air Pollution: EPA's Approach
                    and Progress (EPA 400-R-92-012, March 1993)

                    The Inside Story: A Guide to Indoor Air Quality
                    (EPA 402-K-93-007, April 1995, IAQ-0009)

                    Use and Care of Home Humidifiers Fact Sheet
                    (EPA 402-F-94-010, February 1991, IAQ-0008)

                    Ventilation and Air Quality in Offices Fact Sheet
                    (EPA 402-F-94-003, July 1990, IAQ-0003)

                    What You Should Know about Combustion
                    Appliances and Indoor Air Pollution
                    (EPA 400-F-91-100)
Source
IAQINFO
IAQINFO
IAQINFO
IAQINFO
IAQINFO
                              RESOURCES FOR OurdooR AJR PollimoN
                    Office of Air and Radiation
                    Office of Mobile Sources
                    2565 Plymouth Road
                    Ann Arbor, MI 48105-2498
                    Phone:313-668-4207
                    Internet: http://www.epa.gov/OMSWWW/consumer.htm

                    National Vehicle and Fuel Emissions Laboratory (NVFEL)
                    2565 Plymouth Road
                    Ann Arbor, MI 48105-2498
                    Phone:313-668-4311
                    Fax:313-668-4368
167
                  RESOURCES

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   EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                        .-..v-
                Outdoor Air Pollution Publications and Sources
Publication
Air Toxics from Motor Vehicles
(EPA 400-F-92-004, Fact Sheet OMS-2,
August 1994)

Automobile Emissions: An Overview
(EPA 400-F-92-007, Fact Sheet OMS-5,
August 1994)

Automobiles and Carbon Monoxide
(EPA 400-F-92-005, Fact Sheet OMS-3,
January 1993)

Be a Grower Not a Mower Fact Sheet
(EPA420-F-96-018)

Boating Pollution Prevention Tips Fact Sheet
(EPA 420-F-96-003)

Car Owners: Protect the Environment and Your
Health, Don't Tamper With Emissions Controls!
(EPA 420-F-93-004)

Commute Alternative Brochure (EPA 420-F-95-011)

Commute Alternative Poster (EPA 420-H-95-002)
Control of Emissions fromNonroad Engines Fact
Sheet (EPA 420-F-96-009)
Source
NVFEL or http://www.epa.gov/
OMSWWW/ consumerhtm
NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm
NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm
NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm

NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm

NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm
NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm
NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm

NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm
              RESOURCES
                                                 1 68

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                                                              EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                    Publication
                    Health and Environmental Effects of Participate
                    Matter, July 1997

                    Nonroad Engines and Air Pollution: An Overview
                    (EPA 420-F-94-003)

                    Tips For Reducing Fuel Spillage Fact Sheet
                    (EPA 420-F-96-002)

                    Tips to Save Gas and Improve Mileage
                    (EPA 420-F-94-004)

                    What You Can Do to Reduce Air Pollution: A
                    Citizens Guide to What Individuals and
                    Communities Can Do to Help Meet the Goals of
                    the Clean Air Act Amendments of 1990
                    (EPA 450-K-92-002)

                    Your Car or Truck and the Environment: An
                    Environmental Guide for Owners and Drivers of
                    Cars, Trucks, and Other Motor Vehicles
                    (EPA 420-K-93-001)

                    Your Car and Clean Air:  What YOU Can Do to
                    Reduce Pollution (EPA 400-F-93-002, Fact Sheet
                    OMS-18, August 1994)

                    Your Yard and Clean Air
                    (EPA 420-F-94-002, September 1996)
Source
http://ttnwww.rtpnc.epa.gov/
naaqsfin/pmhealth.htm

NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm
NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm

NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm
NCEPI
NCEPI
NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm
NVFEL or http://www.epa.gov/
OMSWWW/consumer.htm
169
                   RESOURCES

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                                                                                              .-..v-
iNfoRMATJON RESOURCES foR GROUNcI'LEVEl OZONE
Office of Air and Radiation
Office of Air Quality Planning and Standards
Research Triangle Park, NC 27711
Phone:919-541-5616
Ground-Level Ozone home page: http://www.epa.gov/airprogm/oar/oaqps/ozone.html
AIRLinks: http://www.epa.gov/oar/oaqps/airlink
Region 1
New England's Air Quality Hotline: 800-821 -1237
Anne Arnold, Air Quality Planning Unit, Office of Ecosystem Protection, 617-565-3166
Ground-Level Ozone Information Web Page: http://www.epa.gov/regionO 1/eco/ozone/
index.html
Ground-Level Ozone Publications and Sources
Publication
Automobiles and Ozone (EPA 400-F-92-006, Fact
Sheet OMS-4, January 1993)
Ground-Level Ozone Air Quality Guide
Health and Environmental Effects of Ground-Level
Ozone Fact Sheet, July 1997
Ozone Action Days (EPA 905-K-96-001)
Ozone Action Days: A Special Alert for People with
Asthma and Other Respiratory Problems
(EPA 905-F-95-001, May 1995)
Source
http://www.epa.gov/
OMSWWW/consumer.htm
Region 1 , Anne Arnold, Air
Quality Planning Unit, Office of
Ecosystem Protection,
617-565-3166
http://ttnwww.rtpnc.epa.gov/
naaqsfin/o3health.htm
Region 5, http://www.epa.gov/
region05/air/naaqs/ozoneday.htm
RegionS, http://www.epa.gov/
region05/air/naaqs/ozoneday.htm






               RESOURCES
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                                                                 EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                     Publication
                     Ozone Action Days: A Special Alert for Asthmatics
                     and Persons with Respiratory Illness: Lake Erie
                     Pamphlet

                     Ozone Action Days: A Special Alert for Asthmatics
                     and Persons with Respiratory Illness: Lake
                     Michigan Pamphlet

                     Ozone Action! For Better Health in Southeast
                     Michigan (EPA 905-K-007, May 1997)


                     Safety Tips for Protecting Your Children (Ozone)
Source
RegionS, http://www.epa.gov/
region05/air/naaqs/ozonedayhtm
RegionS, http://www.epa.gov/
region05/air/naaqs/ozoneday.htm
Region 5, http://www.epa.gov/
region05/air/naaqs/ozoneday.htm


RegionS, http://www.epa.gov/
region05/air/naaqs/ozoneday.htm
                     Childhood CANCER
                                RESOURCES FOR RAC!ON
                     Indoor Air Quality Information Clearinghouse (IAQ Information)
                     Radon Information Clearinghouse
                     Phone: 800-55-RADON
                     IAQ Radon Publications Web Site: http://www.epa.gov/iaq/radon/pubs/index.html
171

Radon Publications and Sources
Publication
A Radon Guide for Tenants
All About Radon (coloring book; English and
Spanish)
Source
IAQ Radon Pubs Web Site
Radon Information Clearinghouse
Region 7, http://www.epa.gov/
region07/kids/aar.htm

ChildREN's HEAlrh RESOURCES

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   EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                       .-..v-
Publication
Baby Radon Public Service Announcement, 1995

Basic Information on Radon Resistant New
Construction (pamphlet)

Citizen's Guide to Radon: The Guide to Protecting
Yourself and Your Family from Radon, Second
Edition, (EPA402-K-92-001, September 1994)
(in Spanish: EPA402-K-93-005, September 1993)

Consumer Federation of America Radon Public
Service Announcement (video)

Consumer's Guide to Radon Reduction: How to
Reduce Radon Levels in Your Home
(EPA 402-K92-003, August 1992, GPO Order
Number ISBN: 0-16-036255-5)

Dust Particles—Radon Public Service
Announcement, 1996 (in English and Spanish)

Home Buyer's and Seller's Guide to Radon
(EPA 402-R-93-003, March 1993)
Lung Radon Poster
My Radon Coloring Book
Source
IAQINFO

http ://www.epa.gov/
iaq/construc.html

IAQ Radon Pubs Web Site
Radon Information
Clearinghouse
NCEPI

IAQINFO
IAQ Radon Pubs Web Site
Radon Information
Clearinghouse
GPO

IAQINFO
IAQ Radon Pubs Web Site
Radon Information
Clearinghouse
GPO

IAQINFO

Region 7 http://www.epa.gov/
regionOV/kids/mrcb 1 .htm
              RESOURCES
                                                1 72

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                                                             EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                    Publication
                    Radon Measurement in Schools: Revised Edition
                    Booklet (EPA 402-R-92-014, July 1993)
                    Radon Measurement in Schools, Self-Paced
                    Training Workbook (EPA 402-B-94-001)

                    Radon in Schools Brochure, Second Edition
                    (EPA 402-F-94-009, October 1994)
                    Radon Resistant New Construction in
                    Homes (brochure)
                    Radon: Risks and Realities (August 13,1996)

                    Radon Video (also available in Spanish)

                    Reducing Radon Risks (EPA 520-1-89-027,
                    September 1992)
                    Reducing Radon in Schools: A Team Approach
                    (EPA 402-R-94-008, April 1994)
                    The Radon Student Activity Book
Source
IAQ Radon Pubs Web Site
Radon Information
Clearinghouse

NCEPI
IAQ Radon Pubs Web Site
Radon Information
Clearinghouse

IAQ Radon Pubs Web Site
Radon Information
Clearinghouse

IAQINFO

IAQINFO

IAQ Radon Pubs Web Site
Radon Information
Clearinghouse

IAQ Radon Pubs Web Site
Radon Information
Clearinghouse

IAQINFO
175
                   RESOURCES

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   EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                       .-..v-
iNfoRMATJON RESOURCES foR AsbESTOS

Toxic Substances Control Act (TSCA) Hotline
Phone: 202-554-1404
Fax: 202-554-5603
                     Asbestos Publications and Sources
Publication
Asbestos Hazard Emergency Response Act
Q & A (EPA 745-K-93-023)

Asbestos in the Home: A Homeowner's Guide
(EPA 910-K-92-001, August 1992)

Asbestos in Your Home (brochure,
EPA 745-F-93-006)

Asbestos Fact Book (EPA 745-K-93-016)

Asbestos in Schools: Evaluation of Asbestos Hazard
Emergency Response Act (fact sheet,
EPA 745-F-91-100)

Asbestos in Schools: Evaluation of Asbestos Hazard
Emergency Response Act (summary report,
EPA 745-K-91-101)

Advisory to the Public on Asbestos in Buildings
(EPA  745-K-93-014)

The ABCs of Asbestos in School (information
packet, EPA 745-K-93-017)
Source
TSCA Hotline
TSCA Hotline
TSCA Hotline
TSCA Hotline
TSCA Hotline
TSCA Hotline
TSCA Hotline
TSCA Hotline
              RESOURCES
                                                1 74

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                                                                EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                     Publication
                     Proposed Rule on Friable Asbestos Containing
                     Materials in School Buildings: Health Effects and
                     Magnitude of Exposure (support document,
                     EPA 560-12-80-003)
Source
TSCA Hotline
                               RESOURCES FOR UliRAviolET Liqkr(SuN PROTECTJON)
                     Stratospheric Ozone Hotline: 800-296-1996
                     Ozone Depletion Resource Center
                     Internet: http://www.epa.gov/docs/ozone/resource/public.html
                               Ultraviolet Light (Sun Protection) Publications and Sources
                     Publication
                     Action Steps for Sun Protection (fact sheet,
                     EPA 430-F-95-002)
                     Be Cool, Cover Up Poster

                     Be Sun Smart—Tips For You and Your Children
                     (fact sheet)

                     Health Effects of Overexposure to the Sun
                     (fact sheet, EPA 430-F-95-003)
                     How Will a Decreasing Stratospheric Ozone Affect
                     Our Environment? (fact sheet)
Source
Stratospheric Ozone Hotline
Ozone Depletion Resource
Center

Region 5, 800-621-8431

Region 3, Betty Ringkamp,
215-566-5663

Stratospheric Ozone Hotline
Ozone Depletion Resource
Center

Region 3, Betty Ringkamp,
215-566-5663
175
                   RESOURCES

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   EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                         .-..v-
Publication
Moving Out of CFCs, Benefits of the CFC
Phaseout (fact sheet, EPA 430-F-96-020)
Ozone Science Fact Sheet
Ozone Layer Educator's Guide (guidance
packet, EPA 430-E-95-003)


Ozone Depletion (fact sheet, EPA 430-F-95-001)

Practice Safe Sun (pamphlet)

Protecting the Ozone Layer: Safe Disposal of Home
Appliances Containing Ozone-Depleting
Substances (EPA 430-K-93-001)

Protection of the Ozone Layer
(EPA 230-N-95-002)

Radiation: Risks and Realities
(EPA 402-K-92-004)

Safe Sun Poster (EPA 905-H-93-002,1994)


Safety Tips for Protecting Your Children (fact sheet)
Stratospheric Ozone Facts (fact sheet)
Source
Stratospheric Ozone Hotline
Ozone Depletion Resource
Center

Region 3, Betty Ringkamp,
215-566-5663

NCEPI
NCEPI
Region 5, 800-621-8431
NCEPI
NCEPI
NCEPI
Region 5, 800-621-8431
Region 3, Betty Ringkamp,
215-566-5663

Region 3, Betty Ringkamp,
215-566-5663
               RESOURCES
                                            PAqE 1 76

-------
                                                               EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                     Publication
                     Sun Protection for Children (fact sheet,
                     EPA 430-F-95-004)
                     The Sun, UV and You: A Guide to the UV Index
                     and Sun-Safe Behavior (booklet,
                     EPA 430-K-95-005)

                     The Ultraviolet Index: What You Need to Know
                     (pamphlet, EPA 430-F-94-016)
                     UV Radiation (fact sheet, EPA 430-F-95-006)

                     What are the CFC Impacts on Stratospheric
                     Ozone? (fact sheet)

                     What Can You Do to Help Prevent Ozone
                     Depletion? (fact sheet)

                     What is the Ultraviolet (UV) Index (fact sheet,
                     EPA 430-H-94-003)
Source
Stratospheric Ozone Hotline
Ozone Depletion Resource
Center

NCEPI
Stratospheric Ozone Hotline
Ozone Depletion Resource
Center

NCEPI

Region 3, Betty Ringkamp,
215-566-5663

Region 3, Betty Ringkamp,
215-566-5663

Stratospheric Ozone Hotline
Ozone Depletion Resource
Center
                                   AN
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   EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                               .-..v-
The Hotline is available 24 hours a day, 7 days a week, in English and Spanish. The
Hotline distributes a basic information packet on lead that includes the EPA brochure
"Lead Poisoning and Your Children," three fact sheets, and a list of state and local
contacts for additional information. Callers who have more specific questions are re-
ferred to the clearinghouse (800-424-LEAD) and can speak directly with an information
specialist. Information specialists provide on-phone technical assistance.
Office of Prevention, Pesticides, and Toxic Substances
U.S. Environmental Protection Agency
401 M Street, S.W. (E637)
Washington, DC 20460
Phone: 202-260-2902
Lead home page: http://www.epa.gov/opptintr/lead/index.html
Lead Publications and Sources
Publication
A New England Guide: Community Resources for
Lead Poisoning Prevention Directory (1996)


Avoiding Dangers in the Dirt (children's workbook)



Be Safe With Lead-Man (poster)


Children and Lead: What You Can Do? A Guide for
Parents and Day Care Providers From Physicians
for Social Responsibility
Source
Region 1 , Maureen McClelland,
617-565-3232
http://www.epa.gov/region01/
eco/lead/lppform.html
Region 1 , Maureen McClelland,
617-565-3232
http://www.epa.gov/region01/
eco/lead/lppform.html
Region 4, Lead Coordinator,
Rose Anne Rudd,
404-562-8998
Region 3, Betty Ringkamp,
215-566-5663

















                RESOURCES
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                                                                 EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                     Publication
                     Controlling Lead In Soils Packet (1995)
                     Controlling Lead in Soils Report
                     Fact Sheet: Disclosure of Lead-Based Paint Hazards
                     in Housing (EPA 747-F-96-002, March 1996)
                     Finding the Right Home (children's workbook)
                     Finding a Qualified Lead Professional for Your
                     Home (EPA 747-F-96-006)
                     Going to the Doctor (children's workbook)
                     Healthy Yard: Is Your Yard Lead Proof? (poster)
Source
Region 1, Maureen McClelland,
617-565-3232
http://www.epa.gov/regionO I/
eco/lead/lppform.html

Region 1, Maureen McClelland,
617-565-3232
http://www.epa.gov/regionO I/
eco/lead/lppform.html

National Lead Information
Center
http://www.epa.gov/opptintr/lead/
leadbase.htm

Region 1, Maureen McClelland
617-565-3232
http://www.epa.gov/regionO I/
eco/lead/lppform.html

National Lead Information
Center
http://www.epa.gov/opptintr/lead/
leadbase.htm

Region 1, Maureen McClelland,
617-565-3232
http://www.epa.gov/regionO I/
eco/lead/lppform.html

Region 1, Maureen McClelland,
617-565-3232
http://www.epa.gov/regionO I/
eco/lead/lppform.html
1 79
                    RESOURCES

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   EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                         .-..v-
Publication
Healthy Beginnings: Lead Safe Families, an English-
as-a-Second-Language Curriculum on Lead Poisoning
Prevention (EPA 208-B-93-001,1996)

Home Repairs and Innovations: What You Should
Know About Lead-Based Paints

Identifying Symptoms of Illness (children's workbook)
Identifying Lead Hazards in Your Home (fact sheet,
EPA 747-F-96-007)

Lead in American Schools: What School Districts
Should & Should Not Do

Lead in Your Drinking Water (EPA 810-F-93-001)
Lead Prevention Videos: Lead Poisoning—
A Parent's Guide to Prevention, Sesame Street Lead
Away!, and Living With Lead

Lead Poisoning and Your Children (pamphlet,
EPA 800-B-92-002); El Envenenamiento por el
Plomo y Sus Ninos (EPA 747-K-95-001)

Lead Poisoning Prevention Wheel
Source
Region 1,617-565-4592
http://www.epa.gov/
regionO 1/eco/lead/lppform.html

Region 7, 800-223-0425
Region 1, Maureen McClelland,
617-565-3232
http://www.epa.gov/region01/
eco/lead/lppform.html

NCEPI
Region 3, Betty Ringkamp,
215-566-5663

NCEPI
Water Resource Center

National Lead Information
Center
Region 4, Lead Coordinator,
Rose Anne Rudd,
404-562-8998

Region 7, 800-223-0425
               RESOURCES
                                                 1 80

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                                                              EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                    Publication
                    Lead in Drinking Water Coolers (fact sheet,
                    EPA 810-F-90-021)

                    LEAD: A Cross Program Strategy (1993)
                    Lead-Free Kids, Lead-Free Homes (pamphlet)
                    Lead—Is Your Child At Risk? (pamphlet)
                    Let's Get the Lead Out 1997 Teaching Materials

                    Making Your Kids & Your Home Safe from Lead
                    Poisoning (pamphlet)

                    Our Mid-Atlantic Environment-25 Years of Progress
                    (EPA 903-R-017, December 1995)

                    Preparing and Storing Food (children's workbook)
                    Protect Your Family from Lead in Your Home
                    (pamphlet, EPA 747-DK-94-001, May 1995);
                    Poteja a Su Familia del Plomo en Su Casa
                    (EPA 747-K-94-001S)
Source
NCEPI
Water Resource Center

Region 1, Maureen McClelland,
617-565-3232
http://www.epa.gov/regionO I/
eco/lead/lppform.html

Region 3, Betty Ringkamp,
215-566-5663

Region 3, Betty Ringkamp,
215-566-5663

Region 5, 800-621-8431

Region 3, Betty Ringkamp,
215-566-5663

Region 3, Betty Ringkamp,
215-566-5663

Region 1, Maureen McClelland,
617-565-3232
http://www.epa.gov/regionO I/
eco/lead/lppform.html

National Lead Information
Center
181
                   RESOURCES

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   EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                          .-..v-
Publication
Protecting Your Child from Lead Poisoning
(pamphlet, 1993)
Protecting Your Family from Lead Poisoning: Como
Proteger a Sus Hijos y Su Hogar contra el
Envenenamiento por Plomo (pamphlet)

Questions & Answers on the EPA/HUD Disclosure
Rule (EPA 747-F-96-001, March 1996)
Questions Parents Ask About Lead Poisoning

Reducing Lead Hazards When Remodeling Your
Home (EPA 747-R-94-002, April 1994); Como
Reducir Los Peligros del Plomo al Remodelar Su
Casa (EPA 747-R-94-002S)

Testing Your Home for Lead
Source
Region 1, Maureen McClelland,
617-565-3232
http://www.epa.gov/region01/
eco/lead/lppform.html

Region 3, Betty Ringkamp,
215-566-5663
National Lead Information
Center
http://www.epa.gov/opptintr/
lead/leadbase.htm

Region 7, 800-223-0425

National Lead Information
Center
Region 7, 800-223-0425
iNfoRMATJON RESOURCES foR ENdoCRJNE DJSRUpTORS ANd Ol^ER NEUROTOXJCS

Office of Research and Development
National Health and Environmental Effects Research Laboratory
Research Triangle Park, NC 27711
Phone:919-541-2281
Endocrine Disrupters Research Initiative home page: http://www.epa.gov/endocrine
               RESOURCES
                                                  1 82

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                                                                EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                          Endocrine Disrupters and Other Neurotoxics Publications and Sources
                     Publication
                     Endocrine Disrupter Research Initiative: Relevant
                     Research Publications
                     Public Health Implications of PCB Exposures
                     (ATSDR/EPA Report, December 1996)

                     Special Report on Environmental Endocrine
                     Disruption: An Effects Assessment and Analysis
                     (EPA630-R-96-012)

                     Workshop Report on Developmental Neurotoxic
                     Effects Associated with Exposure to PCB's
                     (EPA 630-R-92-004)

                     Report to Congress on Mercury (Office of Air and
                     Radiation, December 1997)
Source
http://www.epa.gov/endocrine/
pubs.html

RegionS
http://www.epa.gov/endocrine/
pubs.html
http://www.epa.gov/endocrine/
pubs.html
http://www.epa.gov/oar/
mercuryhtml
                            EffECTS Of
                     INFORMATION RESOURCES FOR
                     Office of Pesticide Programs (OPP)
                     Communication Branch
                     U.S. Environmental Protection Agency
                     401M Street, S.W.  (7506C)
                     Washington, DC 20460
                     Phone:703-305-5017

                     National Pesticide Telecommunications Network (NPTN) Hotline
                     Toll Free Number: 800-858-7378
                     Internet: http://ace.orst.edu/info/nptn/
                     E-Mail: nptn@ace.orst.edu
185
                   RESOURCES

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   EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                            .-..v-
A national toll-free telephone information service provides callers (mainly parents,
consumers, medical community, and federal, state and local governments) with poisoning
prevention and technical information on pesticide active ingredients and product registra-
tions in the United States.
                      Pesticides Publications and Sources
Publication
Child-Resistant Packages for Pesticides
Citizen's Guide to Pest Control and Pesticide
Safety (EPA 730-K-95-001, September 1995)

Diagnostico y Tratamiento de Los Envenenamientos
por Plaguicidas, Cuarta Edicion (Spanish,
EPA 540-R-95-024)

Do You Really Need a Pesticide?
(EPA 910-F-94-004)

Emergency Action Guide for Pesticide
Incidents (1992)

For Your Information: Protecting the Public from
Pesticide Residues in Food (fact sheet,
EPA 735-F-96-001)

Growing Food Crops on City Lots (fact sheet,
June 1994)

Integrated Pest Management (poster,
EPA 735-H-92-001)
Source
Region 4, Wilson Harvard,
404-562-9002

NCEPI
NCEPI
 Region 10, 800-424-9372
Region 5, Pesticides Program
Section, 312-353-2192

NCEPI
Region 5, Pesticides Program
 Section, 312-353-2192

NCEPI
               RESOURCES
                                                   1 84

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                                                               EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                     Publication
                     Methyl Parathion in the Chicago Area (1997)

                     Office of Pesticide Programs Annual Report for
                     1996 (EPA 735-R-96-001)

                     Pest Control in the School Environment: Adopting
                     Integrated Pest Management (brochure,
                     EPA 735-F-93-012)

                     Pesticide Poisoning Action Guide for Agricultural
                     Pesticides in the Midwest: Resource Directory for
                     Medical Personnel (EPA 905-B-94-001, May 1994)

                     Pesticides and Child Safety (EPA 735-F-93-050R)

                     Protect Yourself from Pesticides: A Guide for
                     Pesticide Handlers (EPA 735-B-93-003)

                     Protect Yourself from Pesticides: A Guide for
                     Agricultural Workers/ Protejase de Los Pesticidas:
                     Guia para Los Trabajadores Agricolas
                     (EPA 735-B-93-002)

                     Protect Yourself from Pesticides (poster,
                     EPA735-H-93-001)

                     Protejase de Los Pesticidas: Guia Para Los Que
                     Manejan Pesticidas ( EPA 735-B-94-001)

                     Recognition and Management of Pesticide
                     Poisonings (Fourth Edition, EPA 540-R-98-001)
Source
Region 5, 312-353-2000
NCEPI
NCEPI
Region 5, 312-353-2000
NCEPI
NCEPI
NCEPI
NCEPI
NCEPI
NCEPI
185
                   RESOURCES

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   EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                         .-..v-
Publication
Status of Pesticides in Re-Registration and Special
Review (Rainbow Report, EPA 738-R-94-008)

Steps to Protect Yourself from Pesticides
(English/Laotian: EPA 735-F-95-006)
(English/Cambodian: EPA 735-F-95-005)
(English/Vietnamese: EPA 735-F-95-004)
(English/Haitian Creole: EPA 735-F-95-003)
(English/Spanish: EPA 735-F-95-002)

10 Tips to Protect Children from Pesticide and Lead
Poisonings around the Home (English/Spanish,
EPA 735-F-97-001)

The Federal Insecticide, Fungicide, and Rodenticide
Act (FIFRA) and Federal Food, Drug, and Cosmetic
Act ( FFDCA) as amended by the Food Quality
Protection Act (FQPA) of August 3,1996
(EPA730-L-97-001)

To Spray or Not To Spray (pamphlet,
EPA 905-F-95-003)

What You Need to Know About Methyl Parathion
and Your Health (fact sheet, 1997)

Wood Preservatives for Applicators (booklet, 1987)
Source
NCEPI
NCEPI
NCEPI
NCEPI
Region 5, 312-353-2000
Region 5, 312-353-2000
Region 5,312-353-2000
               RESOURCES
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                                                                       EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                 iAl Risks FROM CONTAIN! NATEC! WATER
                                     RESOURCES foR CONTAMJNANTS JN DRJNkJNq WATER, SURFACE WATER, ANd Fish
                          Safe Drinking Water Hotline
                          Phone: 800-426-4791
                          E-Mail: hotline-sdwa@epamail.epa.gov
                          The Safe Drinking Water Hotline is available to help the public, drinking water stakehold-
                          ers, and state and local officials understand the regulations and programs developed in
                          response to the Safe Drinking Water Act (as amended in 1 986 and 1 996).  This includes
                          information about drinking water regulations and publications, source water protection
                          programs, and public education materials. The Hotline can be reached Monday through
                          Friday (except federal holidays) from 9 a.m. to 5:30 p.m. (Eastern Standard Time).

                          EPA's Office of Water Resource Center
                          Water Resource Center (RC4 1 00)
                          Room 26 15 Mall
                          40 1M Street, S.W
                          Washington, DC 20460
                          Phone: 202-260-7786
                          Fax: 202-260-0386
                          E-mail: waterpubs@epamail.epa.gov
                          EPA's Office of Water Resource Center is a one-stop location for information and materi-
                          als produced by the Office of Ground Water and Drinking Water, the Office of Science
                          and Technology, and the Office of Wastewater Management, within EPA's Office of
                          Water. Materials available include: fact sheets, guidance manuals, technical reports,
                          models, educational kits, training materials, brochures, videotapes, and posters. The
                          Office of Water Resource Center is open from 8:30 a.m. to 5:00 p.m. EST.

                          Office of Water Web Site
                          Internet: http://www.epa.gov/ow
                          EPA's Office of Water web site contains current information about a variety ofoffice of water
                          responsibilities. The Office of Ground Water and Drinking Water site contains information
                          about the public water system program and standards established for contaminants. The
                          Office of Science and Technology site contains information about beaches and fish, as well as
                          contaminant health advisories. The Office of Wetlands, Oceans, and Watersheds site includes
                          information about watershed protection. The Office of Wastewater Management site includes
                          materials on control and prevention of water pollution from industrial discharge and sludge.
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Great Lakes National Program Office
U.S. Environmental Protection Agency
Region 5
77 West Jackson Boulevard
Chicago, IL 60604-3507
Phone:312-353-2000
Fax:312-353-4135
Contaminated Drinking Water, Surface Water, and Fish Publications and Sources
Publication
Before You Go to the Beach (EPA 820-K-97-00 1 ,
September 1997)
Drinking Water and Health (EPA 8 1 1 -F-95-002-C,
October 1995)
Drinking Water Counts on You: Blue Thumb Kit
(EPA810-B-97-001)
Drinking Water Health Fact Sheet on Atrazine
Drinking Water Health Advisories (fact sheet listing)
Great Lakes Water Quality Initiative Case Studies
Show Benefits Outweigh Costs (fact sheet,
EPA 820-F-95-002)
Great Lakes Water Quality Initiative: A Summary
(fact sheet, EPA 820-S-95-001)
Indicator I: Population Served by Community Drinking
Water Systems Violating Health-Based Requirements
(Safe Drinking Water Information System)
Source
Water Resource Center
Water Resource Center
NCEPI
Water Resource Center
Water Resource Center
Great Lakes National Program
Office, Region 5, 3 12-353-3612
Great Lakes National Program
Office, Region 5, 3 12-353-3612
Water Resource Center









ChildREN's HEAlrh RESOURCES
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                                                              EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                    Publication
                    Kids Can Help Save Our Streams!
                    (EPA 840-F-96-900)

                    Lead in Drinking Water: An Annotated List of
                    Publications (EPA 812-K-93-001, October 1993)

                    National Listing of Fish Consumption Advisories
                    (fact sheet, EPA 823-F-96-006)

                    National Listing of Fish Consumption Advisories
                    Software (7 disk set, EPA 823-C-96-011)

                    National Study of Chemical Residues in Fish (fact
                    sheet, EPA 823-F-92-001, 1992)

                    National Primary Drinking Water Standards
                    (EPA 810-F-94-001A, February 1994)

                    National Listing of Fish Consumption Advisories,
                    Update Fact Sheet (EPA 823-F-95-004)

                    Preamble to National Primary Drinking Water
                    Regulations for Lead and Copper

                    Protecting the Great Lakes: The Cost and Benefits
                    of Reducing Toxic Pollution in Three Communities
                    (EPA 820-F-95-004)

                    Public Water Systems Inventory and Compliance
                    Statistics, FY 1991-1995 (EPA 816-R-97-006)
Source
NCEPI
Water Resource Center
Water Resource Center
NCEPI
NCEPI
NCEPI
NCEPI
Federal Register,
Volume 56, Page 26460

Great Lakes National Program
Office, Region 5,312-353-3612
NCEPI
1 89
                   RESOURCES

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                                                                                         .-..v-
Publication
Safe Drinking Water Act Amendments of 1996:
General Guide to Provisions (EPA 810-S-96-001)

Should I Eat the Fish I Catch?
(EPA 823-B-97-009, September 1997)

Student Activity Sheets For Drinking Water
Projects (EPA 810-F-92-003)

Summary of U.S. Great Lakes Beach Closings,
1981 -1994 (EPA 905-R-97-003)

The Great Lakes: An Environmental Atlas and
Resource Book (EPA 905-B-95-001)

The Effects of Great Lakes Contaminants on Human
Health: Report to Congress (EPA 905-R-95-017,
September 1995)

U.S. EPA 1997 Supplementary Fish Consumption
Advisory for Michigan's Great Lakes Waters
Fact Sheet

Water on Tap: A Consumer's Guide to the Nation's
Drinking Water (EPA 810-K-97-002, July 1997)

Watersheds: Where We Live (poster)

We All Live Downstream (booklet)
Source
NCEPI
Water Resource Center
Water Resource Center
       NTIS
http://www.epa.gov/
reg5oopa/fish/index.htm

Great Lakes National Program
Office, Region 5,312-353-3612
Region 5 http://www.epa.gov/
reg5oopa/fish/index.htm
Water Resource Center
NCEPI

Region 3, Betty Ringkamp,
215-566-5663
               RESOURCES
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                                                                 EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                     ElNViRONMEINTAl  EduCAliON
                                RESOURCES FOR ENVIRONMENTAL EducAiioN
                     Environmental Education Division
                     U.S. Environmental Protection Agency
                     40 1M Street, S.W. (1701)
                     Washington, DC 20460
                     Phone: 202-260-4865
                     Fax: 202-260-4095
                     Internet: http://www.nceet.snre.umich.edu/epa.html
                     EPA's Environmental Education Division's mission is to advance and support national
                     education efforts to develop an environmentally conscious and responsible public, and to
                     inspire a sense of personal responsibility for the care of the environment in all individuals.
                     For more information regarding Environmental Education Grants, please call 202-
                     260-8619 or fax 202-260-4095.
                     National Education Association
                     Health Information Network (NBA, HIN)
                     1201 16th Street, NW
                     Washington, DC 2003 6
                     Phone: 202-822-7570
                     Fax: 202-822-7775
                     Internet: http://www.nea.org/hin
                     National Parent Teacher 's Association
                     National PTA Headquarters
                     330 N. Wabash Avenue, Suite 2 1 00
                     Chicago, IL 606 11
                     Phone:312-670-6782
                     Internet: http://www.pta.org/programs/envlibr.htm

Environmental Education Publications and Sources
Publication
1 997 PTA Green Almanac
Source
OAR-Sponsored National PTA
Resources

191
RESOURCES

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                                                                                            .-..v-
Publication
A Guide to Environmental Education Resources
(January 1996)

Acid Rain: A Student's First Source Book
(children's workbook, EPA 600-990-027 A)
Environmental Education Grants Program, Federal
Fiscal Year 1996

Environmental Justice Grants Bulletin
Environmental Hazards in Your School: A
Resource Handbook

Environmental Justice and the Indoor Environment
(November 1997)
Guidelines for Prevention, Recognition, and
Resolution of Environmentally-Related Illness
in Schools

HAZ-ED: Classroom Activities for Understanding
Hazardous Waste (EPA 540-K-95-005, April 1996)
Source
Region 1 http://www.epa.gov/
regionO 1/ra/ed/educres.html

http://www.epa.gov/acidrain/
student/student2.html,
Acid Rain Hotline,
202-233-9620.

Region 1 http://www.epa.gov/
regionO l/ra/ed/t_grant96.html

OAR-Sponsored NBA
Health Information Network
Resources

Region 3, Betty Ringkamp,
215-566-5663

OAR-Sponsored NBA
Health Information Network
Resources

Region 2, Environmental
Education, 212-637-3671
http://www.epa.gov/
superfund/oerr/cio/products/
hazed/hazedtoc.htm
               RESOURCES
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                                                               EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                     Publication
                     Internet Teacher's Lounge
                     Kids Page
                     Leader's Guide to Environmental Issues,
                     February 1997

                     Meeting New York State's Crisis in School
                     Facilities Today
                    NBA Health Information Network: IAQ in Schools
                     Report to the New York State Board of Regents on
                     the Environmental Quality of Schools

                     School Recycling Programs: A Handbook for
                     Educators (booklet)

                     Student Activity Sheet: Tracking Pollution, a
                     Hazardous Whodunnit (EPA 810-F-93-003)

                     The ABC's of Environmental Education
                     (EPA 905-K-94-001)

                     The Source: Indoor Air, Water and Your Schools
                     (Volumes 1-4, June 1997)
Source
http://www.epa.gov/region07/
kids/teachres.htm

Region 7 http://www.epa.gov/
region07/kids/welcome.htm

O AR-Sponsored National
PTA Resources

Region 2, Environmental
Education, 212-637-3671
OAR-Sponsored NBA
Health Information Network
Resources

Region 2, Environmental
Education, 212-637-3671

Region 3, Betty Ringkamp,
215-566-5663

NCEPI
Region 5, http://www.epa.gov/
region5/enved/html/abc.htm

OAR-Sponsored NBA
Health Information Network
Resources
195
                   RESOURCES

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T[HE EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                             .-..v-
Publication
The Importance of Parent Involvement in Addressing
Children's Environmental Health Issues
Workshop Presentation Kit (for use by PTA leaders
to conduct environmental workshops at state PTA
conventions)
Source
OAR-Sponsored National
PTA Resources

OAR-Sponsored National
PTA Resources
           COMMUNITY Ri

iNfoRMATJON RESOURCES foR CoMMUNJTy Riqhl>TOl
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                                                               EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                     Publication
                     Consumer Labeling Initiative (CLI)
                     Current List of TRI Chemicals for Reporting
                     Year 1995

                     Guidance for Chemical Indexing Abstract
Source
http://www.epa.gov/opptintr/
Iabeling/index.h1ml

http ://www. epa.gov/opptintr/
tri/chemlst.pdf

http://www.epa.gov/reg3artd/
tchem/chemind.htm (fora
complete copy, contact DebraL.
Forman at 215-566-2073)
                     ChrlER FEdERAl AqENCiES YViTrl PROqRAMS RElATEd TO CrlildREN's
                     ENVIRONMENTAL
                    Nearly all federal agencies are pursuing children's environmental health. The Task Force
                    to Reduce Environmental Health Risks and Safety Risks to Children (established by
                    President Clinton's Executive Order on Protection of Children from Environmental Health
                    Risks and Safety Risks) involves:
                      • Office of Science and Technology Policy, National Science and Technology
                        Council (NSTC) Old Executive Office Building, 1 7th Street and Pennsylvania
                        Avenue, N.W., Washington, DC 20502, 202-456-71 16. Internet: http://
                        www.wMtehouse.gov/wh/eop/ostc/html/ntsc_home.html
                      • Council of Economic Advisers (CEA) Old Executive Office Building, 1 7th Street
                        and Pennsylvania Avenue, N.W., Washington, DC 20502, 202-395-5042. Internet:
                        http://www.whitehouse.gov/wh/eop/cea/html/whitepapers.html
                      • Council on Environmental Quality (CEQ)Old Executive Office Building, 1 7th
                        Street and Pennsylvania Avenue, N.W., Washington, DC 20502, 202-395-5042.
                        Internet: http://www.whitehouse.gov/ceq
                      • Office of Management and Budget (OMB) Old Executive Office Building, 1 7th
                        Street and Pennsylvania Avenue, N.W., Washington, DC 20502, 202-395-5042.
                        Internet: http://www.whitehouse.gov/wh/eop/html/ombhome.html
195
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 EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                                                                                      .-..v-
Department of Health and Human Services, National Institute of Environmen-
talHealthSciences(NIEHS)Building 101,Headquarters,P.O. Box 12233,
Research Triangle Park, NC 27709,919-541-3201. Internet: http://
www.niehs.nih.gov
Department of Health and Human Services, Agency for Toxic Substances and
Disease Registry (ATSDR) Building 16, Centers for Disease Control and
Prevention, 1600 Clifton Road, N.E., Atlanta, GA 30303,404-639-7000. Internet:
http://atsdrl.atsdr.cec.gov:8080/child
Department of Health and Human Services, Centers for Disease Control and
Prevention (CDC) Building 16, Centers for Disease Control and Prevention, 1600
Clifton Road, N.E., Atlanta, GA 30303,404-639-7000. Internet: http://
www.cdc.gov; and Rhodes Building, Kroger Center, 3005 Chamblee-Tucker Road,
Atlanta, GA 30341,770-488-5401.  Internet: http://www.cdc.gov/nceh/about/org/
bddd.htm
Department of Health and Human Services, Office of Disease Prevention and
Health Promotion (ODPHP) Hubert H. Humphrey Building, 200 Independence
Avenue, S.W., Washington, DC 20202,202-205-8611. Internet: http://
odphp.osophs.dhhs.gov
Department of Education (DoED) Federal Office Building Ten, 600 Pennsylvania
Avenue, S.W., Washington, DC 20202,202-401-3000. Internet: http://www.ed.gov
Department of Labor (DOL) Francis Perkins Building, 200 Constitution Avenue,
N.W, Washington, DC 20210,202-219-8271. Internet: http://www.dol.gov
Department of Justice (DO J) Main Justice Building, 950 Pennsylvania Avenue,
N.W, Washington, DC 20530,202-514-2001. Internet: http://www.usdoj.gov
Department of Energy (DOE) Forrestall Building, 1000 Independence Avenue,
S.W, Washington, DC 20585,
202-586-6210. Internet: http://www.doe.gov
Department of Housing and Urban Development (HUD) HUD Building, 451
Seventh Street, S.W, Washington, DC 20410,202-708-0417. Internet: http://
www.hud.gov
Department of Transportation (DOT) Nassif Building, 400 Seventh Street, S.W,
Washington, DC 20590,202-366-1111. Internet: http://www.dot.gov
            RESOURCES
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                                                              EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                       Department of Agriculture (USD A) Jamie L. Whitten Federal Building, 1400
                       Independence Avenue, S.W., Washington, DC 20250,202-720-3631.
                       Internet: http://www.usda.gov
                       Consumer Product Safety Commission (CPSC)East West Towers, 4330 East
                       West Highway, Bethesda, MD 20814,301-504-0213.
                       Internet: http://www.cpsc.gov
1 97
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                                   .-..v-


GlossARy
                               trn
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                                                                              GlossARy
                     The glossary is intended to assist readers in understanding terms used by the U.S. Envi-
                     ronmental Protection Agency. The definitions are not all-encompassing and should not be
                     construed as official EPA definitions. For terms not included in this glossary, the reader
                     may refer to standard health science and medical textbooks and dictionaries.

                     Acute Exposure: Exposure to one dose or multiple doses within a short time—24 hours
                     to a few days.

                     Acute Toxicity: A term used to describe immediate toxicity. Its former use was associ-
                     ated with toxic effects that were severe (e.g., mortality) in contrast to the term "subacute
                     toxicity" which was associated with toxic effects that were less severe.

                     Adverse Health Effect: Any change resulting in anatomical, functional, or psychological
                     impairment that may affect the performance of the whole organism.

                     Aquifer:  An underground geological formation, or group of formations, containing usable
                     amounts of groundwater that can supply wells and springs.

                     Allergic Reaction: Adverse reaction to a chemical resulting from previous sensitization to
                     that chemical or to a structurally similar one.
                     Asbestosis: Scarring of the lung from inhaling airborne asbestos fibers. This disease is
                     often fatal.
                     Bioaccumulate: To build up a large amount of a substance in the body by ingesting small
                     amounts of the substance over an extended period of time.

                     Cadmium: A heavy metal element that accumulates in the environment.


                     Carcinogen:  Any substance that can cause or promote cancer.

                     Carcinogenesis: The origin or production of cancer (very likely a series of steps). The
                     carcinogenic event so modifies the genome and/or other molecular control mechanisms in
                     the target cell that they can give rise to a population of altered cells.
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GlossARy

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                                                                                        .-..v-
Chronic Exposure: Multiple exposures occurring over an extended period of time, or a
significant fraction of the animal's or individual's lifetime.

Chronic Toxicity: A term used to describe delayed toxicity. However, the term "chronic
toxicity" also refers to effects that persist over a long time, whether or not they occur
immediately or are delayed.

Congenital: A condition existing from birth. Congenital conditions are acquired during
development in the womb. They are not inherited from the parents.

Cohort Study: An epidemiologic (human) study that observes subjects in different ex-
posed groups and compares the incidence of symptoms. Although ordinarily prospective
in nature, such a study is sometimes carried out retrospectively, using historical data.

Cumulative Risk Assessment: A process that involves the consideration of the aggre-
gate ecologic or health risk to a target organism caused by the accumulation of risk from
multiple stressors (any physical, chemical, or biological entity that can induce an adverse
response) and multiple pathways of exposure.

Developmental Toxicity: Adverse effects on the developing organism (including death,
structural abnormality, altered growth, or functional deficiency) resulting from exposure
prior to conception (in either parent), during prenatal development, or postnatally up to the
time of sexual maturation.

Dose: Administered dose is the mass of a substance given to an organism and in contact
with an exchange boundary (e.g., gastrointestinal tract) per unit body weight, per unit time
(e.g., mg/kg-day). Absorbed dose is the amount of a substance penetrating the exchange
boundaries of an organism after contact.

Dose Response:  How a biological organism's response to atoxic substance quantita-
tively shifts as its overall exposure to the substance changes (e.g., a small dose of carbon
monoxide may cause drowsiness; a large dose can be fatal).


 GlossARy
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                      DNA (deoxyribonucleic acid): The carrier of genetic information in cells.

                      Ecology: The relationship of living things to one another and their environment, or the
                      study of such relationships.

                      Endocrine Disrupters: Exogenous (outside the body) chemical agents that interfere with
                      the production, release, transport, metabolism, binding, or elimination of the natural
                      hormones in the body, which are responsible for the maintenance of homeostasis and
                      regulation of developmental processes.


                      Enteric: Relating to the intestines, alimentary.

                      Exposure: Contact of an organism with a chemical or physical agent. Exposure is
                      quantified as the amount of the agent available at the exchange boundaries of the organism
                      (e.g., gut, skin, lungs) and available for absorption.

                      Exposure Assessment: The determination or estimation (qualitative or quantitative) of
                      the magnitude, frequency, duration, and route of exposure.

                      Ground Water: Water that moves slowly underground in an aquifer.

                      Hazardous Waste: Waste defined by the Resource Conservation and Recovery Act
                      (RCRA) as those that may cause, or significantly contribute to illness or death, or that may
                      substantially threaten human health or the environment when not properly controlled.

                      Health Advisory: An estimate of acceptable drinking water exposure to a chemical
                      substance based on health effects information. A Health Advisory is not a legally enforce-
                      able federal standard, but serves as technical guidance to assist federal, state, and local
                      officials.

                      Incidence: The number of cases of a disease or occurrence of an effect within a specified
                      period of time.

                      Integrated Pest Management (IPM): A mixture of chemical and other non-pesticide
                      methods to control pests.
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                                                                                        .-..v-
Malignant: Tending to become progressively worse and to result in death if not treated;
having the properties ofanaplasia, invasiveness, and metastasis.

Maximum Contaminant Level (MCL): Maximum permissible level of a contaminant
delivered to any user of a public drinking water system. An MCL is an enforceable
federal regulation.

Metastasis: The transfer of disease from one organ or part to another not directly con-
nected with it.

Mitigation: Measures taken to reduce adverse impacts on the environment.

Morbidity: Sickness.

Mortality: Death.

Nitrate: Plant nutrient and inorganic fertilizer that enters water supply sources from septic
systems, animal feed lots, agricultural fertilizers, manure, industrial wastewaters, sanitary
landfills, and garbage dumps.

Nitrite: Nitrite is an intermediate in the process of nitrification.  Nitrous oxide salts are
used in food preservation.

Particulate Matter: Airborne materials that can, depending on their size and composi-
tion, lodge in various areas of the respiratory tract.

Pathogens: Microorganisms that can cause disease in other organisms or in humans,
animals, and plants (e.g., bacteria, viruses, or parasites) found in sewage, in runoff from
farms or rural areas populated with domestic and wild animals, and in water used for
swimming. Fish and shellfish contaminated by pathogens, or the contaminated water itself,
can cause serious illness.

Restoration: Measures taken to return a site to pre-violation conditions.


 GlossARy
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                      Risk: The probability of injury, disease, or death under specific circumstances. In quanti-
                      tative terms, risk is expressed in values ranging from zero (representing the certainty that
                      harm will not occur) to one (representing the certainty that harm will occur).

                      Risk Assessment: The determination of the kind and degree of hazard posed by an
                      agent, the extent to which a particular group of people has been or may be exposed to the
                      agent, and the present or potential health risk that exists due to the agent.

                      Smelter: A facility that melts or fuses ore, often with an accompanying chemical change,
                      to separate its metal content. Emissions cause pollution. "Smelting" is the process
                      involved.

                      Solvent: A liquid capable of dissolving a material and holding it in solution. For example,
                      paint remover is a paint solvent.

                      Superfund: Federal authority, established by the Comprehensive Environmental Response,
                      Compensation, and Liability Act of 1980 (CERCLA) as amended by the Superfund
                      Amendments and Reauthorization Act (SARA) of 1986, to respond directly to releases or
                      threatened releases of hazardous substances that may endanger health or the environment.

                      Surface Water: Water at the surface of the earth, including lakes, rivers, ponds, and
                      streams. It is the source of much ground water through the larger hydrologic cycle as
                      water moves from the surface to aquifers below ground.

                      Toxic: Poisonous.

                      Toxicology: The study of the adverse effects of chemicals in living organisms.

                      Transboundary Pollutants: Air pollution that travels from one jurisdiction to another,
                      often crossing state or international boundaries.

                      Volatile: Any substance that evaporates readily.
                      Vinyl Chloride: A chemical compound, used in producing some plastics, that is known
                      to be carcinogenic to humans.
205
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                                                            ACRONYMS ANC]
                                                             AbbREviAiioNS
                   AAP: American Academy of Pediatrics
                   AAP-PA: Pennsylvania Chapter of the American Academy of Pediatrics
                   AASA: American Association of School Administrators
                   AChE: Acetylcholinesterase
                   AHS: Agriculture Health Study
                   AID: U.S. Agency for International Development
                   AIRS: Aeromatic Information Retrieval System
                   ALA: American Lung Association
                   ALAEM: American Lung Association of Eastern Missouri
                   ALANYS: American Lung Association of New York State
                   ATSDR: Agency for Toxic Substances and Disease Registry
                   AWEsome!: Active Watershed Education
                   BBDR: Biologically-based dose-response
                   CCRI: Chicago Cumulative Risk Initiative
                   CDC:  Centers for Disease Control and Prevention
                   CERCLA: Comprehensive Environmental Response, Compensation, and Liability Act
                   CNS: Central Nervous System
                   CRITFC: Columbia River Intertribal Fish Commission
                   DEPM: Dietary Exposure Potential Model
                   EPA: U.S. Environmental Protection Agency
                   EPCRA: Emergency Planning and Community Right-to-Know Act
                   ETS: Environmental tobacco smoke
                   FDA: U.S. Food and Drug Administration
                   FCP: Fish Contamination Program
                   F1FRA: Federal Insecticide, Fungicide, and Rodenticide Act
                   FQPA: Food Quality Protection Act
                   GAO: Government Accounting Office
                   GREEN: Global Rivers Environmental Education Network
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HHS: U.S. Department of Health and Human Services
HUD: U.S. Department of Housing and Urban Development
IAQ: Indoor air quality
IEUBK: Integrated Exposure and Uptake Biokinetics
IPM: Integrated Pest Management
IRIS: Integrated Risk Information System
JET: Junior Environmental Training
MMT: Manganese - methylcyclopentadienyl manganese tricarbonyl
MPRA: Multi-pathway risk assessment
MWC: Municipal waste combustion
NAFTA: North American Free Trade Agreement
NEA-HIN: National Education Association Health Information Network
NCHS: National Center for Health Statistics
NETT: National Enforcement Training Institute
NHANES: National Health and Nutrition Examination Survey
Nffl: National Institutes of Health
NLM: National Library of Medicine
NPTA: National Parent Teachers Association
NPTN: National Pesticide Telecommunications Network
OCHP: Office of Children's Health Protection, U.S. Environmental Protection Agency
PAHs: Poly cyclic aromatic hydrocarbons
PCBs: Polychlorinatedbiphenyls
PCDF: Polychlorinatedbenzodifuran
ppb: Parts per billion
PRGs: Preliminary Remediation Goals
RCRA: Resource Conservation and Recovery Act
RTK-NET: Right-to-Know Network
SDWA: Safe Drinking Water Act


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                      TRI: Toxic Release Inventory
                      TSCA: Toxic Substances Control Act
                      USDA:U.S. Department of Agriculture
                      UV: Ultraviolet light
                      VOCs: Volatile organic compounds
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                                                                                       INCJEX
                     ENVIRONMENTAL JuSliCE  PROJECTS
                     Efforts to improve children's health protection are inextricably tied to EPA's initiatives to
                     address environmental justice. Environmental justice concerns the disproportionate health
                     risks to poor and disadvantaged communities resulting from their proximity to toxic waste
                     sites, industrial sites, and incinerators or their residence in highly polluted urban environ-
                     ments or substandard housing. These projects are listed in the index below. A great
                     number of EPA's children's health projects target urban environmental problems and tribal
                     health threats. The focus on all children will continue to grow, reflecting EPA's firm
                     commitment to the protection of children's health from environmental threats.
                     Urban Schools Initiative	15
                     American Lung Association Open Airways	 16
                     "Breathe Easier" Support	19
                     "Home Cleaning for Asthma Attack Control" Program	20
                     Asthma Outreach Initiative	24
                     Site Assessment in Response to Cancer in Children	41
                     Multi-Pathway PAH Exposure Field Evaluation for Children in Low-Income Families ..41
                     The Childhood Lead Action Project	53
                     Lead Poisoning Prevention Curriculum	54
                     Environmental Justice Grants	56
                     Urban Environmental Initiatives	58
                     Environmental Epidemiological Survey of Lead Exposure of Children in
                     Tijuana, Mexico	59
                     Tribal Children Blood Lead Hazards	60
                     Oregon Legal Services Corporation Grant	60
                     Migrant Worker Housing Facility Lead and Arsenic Survey	61
                     Lead-Based Paint Activities in Residences and Daycare Centers—State and
                     Tribal Program Development	64
                     National Lead Information Clearinghouse	66
209

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Educational Photo Literature for Integrated Pest Management in a
Low-Income Setting	93
English/Spanish Video on Integrated Pest Management Techniques to Reduce
Cockroaches and Rodents in Inner-City Dwellings	93
Tropical Fruits Enforcement Case	95
Exposure of Children to Pesticides in Yuma County, Arizona	97
Columbia River Intertribal Fish Commission (CRITFC) Study	 115
Technical Assistance on Risk from Consumption of Contaminated Fish 	 116
Guidance on Risk from Consumption of Contaminated Fish	 116
The Chester Environmental Justice Initiative	128
Sixteenth Street Community Health Center	129
U.S.-Canada Great Lakes Water Quality Agreement (GLWQA)	137
New Orleans Environmental Justice Education Teacher Training Program	143
Environmental Education Grants	143
Youth and the Environment	145
Appalachian Mountain Club	146


EPA PROqRAM  OFFICES

Office of A!R ANd RAdiAiioN
Indoor Air Quality Tools for Schools	12
American Association of School Administrators	13
National Education Association	13
National Parent Teachers Association	14
Urban Schools Initiative	15
School Intervention Study	15
American Lung Association Open Airways	 16
ETS Media Campaign	17
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                         Reducing Exposure to ETS through Child Care Outreach	17
                         Community-Based Pediatrician Outreach	17
                         Asthma Assessment	22
                         New National Ambient Air Quality Standards for Ozone and Fine Particles	23
                         Ozone Depletion Art Project	40
                         Sunwise School Program	40
                         Promulgation of Standards for Municipal Waste Combustion (MWC)	76

                         OfficE of COMMUNICATION, EducAiioN, ANd MediA REkiioNs
                         Newton's Apple "Environmental Impacts on Children's Health"	142
                         The GREEN Leadership Initiative	142
                         New Orleans Environmental Justice Education Teacher Training Program	143

                         OfficE of ENFORCEMENT ANd CoMpliANCE ASSURANCE
                         Enforcement Program for Hazardous Air Pollutant Emissions	24
                         Example of Asbestos Enforcement Case	39
                         Lead-Based Paint Compliance Assurance Program—Compliance Assistance,
                         Inspections, and Enforcement	51
                         Lead-Based Paint Compliance Monitoring and Enforcement Cooperative
                         Agreement Funding for States	53
                         Community/University Partnership for Lead Education	53
                         Monitoring Compliance with and Enforcing the Requirements of the National
                         Drinking Water Regulations for Lead and Copper	62
                         Investigations and Enforcement at Nonferrous Metal Smelters	62
                         Targeting Criminal Violations that Threaten Health and Safety of Children	63
                         PCB Compliance Monitoring Cooperative Agreement Funding for States	76
                         Urban and Residential Pesticide Control and Enforcement Program—A National
                         Initiative	94
                         Example of Illegal Pesticide Use Case	95
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Example of Enforcement Case in Antimicrobials Program	96
Monitoring Compliance with and Enforcing the Requirements of the National
Drinking Water Regulations on Lead and Copper	Ill
Ongoing Nitrate/Nitrite Compliance Monitoring	Ill
Enforcement of Drinking Water Regulations Governing Microbial Quality of
Drinking Water	 113
Enforcement Activities to Help Ensure Compliance with the Emergency
Planning and Community Right-to-Know Act (EPCRA)	154

OffiCE of llNTERNAliONAl AffAJRS
Children's Lung Function Study in China	134
U.S.-Canada Air Quality Agreement	134
Children's Blood Lead Level Screening in Russia	135
National Strategy for Lead Risk Reduction in Russia	135
Mobile Source Training/Lead Phase-Out Training	136
Mobile Source Program in India	136
Pesticides Management Project in Central America	136
U.S.-Canada Great Lakes Water Quality Agreement (GLWQA)	137
Microbiologically Safe-Drinking Water Laboratory Capacity in Latin America	137
Municipal Water Management in Latin America	137
The Central American Small Community Wastewater Treatment Proj ect	137

OfficE of Policy
Link between Death Rates in Infants and Exposure to Particulate Air Pollution	28
Cumulative Exposure Proj ect	128
Children's Environmental Health Index for the United States .......,,.....,..,.....,,.....,..,...; 155
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Office of PREVENTION, PEsiicidEs, ANd Toxic SubsiANCEs
Lead in Children's Products	63
Lead-Based Paint Activities in Residences and Daycare Centers—State and
Tribal Program Development	64
Lead-Based Paint Activities in Buildings and Other Structures	64
Disposal of Lead-Based Paint Debris	64
Evaluating the Risks of Lead Hazards from Renovation and Remodeling	65
Lead-Based Paint Hazard Standards	65
Lead-Based Paint in Housing Disclosure Requirements and Implementation	65
Redefining Childhood Blood Lead Level Reduction Goals and Lead Strategic Plan	66
Environmental Indicators Bulletin	66
National Lead Information Clearinghouse	66
Lead Poisoning Prevention and Lead Hazard Awareness Public Education and
Outreach Grant Program	67
Lead-Based Paint Maintenance Training Program	67
Renovation and Remodeling Study Phases 1 and2	67
Laboratory Study of Lead Cleaning Products	67
Renovation and Remodeling Study Phase 3	68
Guidance for Testing Lead Products	68
Repair and Maintenance Study	69
Milwaukee Low-Cost Intervention Studies	69
National Lead Laboratory Accreditation Program (NLLAP)	69
Assessment of the Effectiveness of Risk Assessments	69
CD-ROM Release of Technical Reports	69
Dissemination of Technical Information	69
Test Guidelines for Developmental Neurotoxicity	72
Test Methodologies for Endocrine Disrupters	72
Pesticide Re-Registration Program	89
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National Pesticide Telecommunications Network (NPTN) .......................................... 90
Poison Prevention [[[ 91
Integrated Pest Management in Schools Project [[[ 92
Methyl Parathion Outreach Project [[[ 94
Toxic Release Inventory [[[ 154
Consumer Labeling Initiative [[[ 157
Poison Prevention [[[ 157
Consumer Pesticide Right-to-Know Brochure [[[ 157
OfficE of RESEARC^ ANd
Allergens in the Development of Asthma in Children (Studied in Immature Rats) .......... 22
Environmental Influences on Asthma in Children [[[ 23
Total and Regional (Area) Deposition of Inhaled Particles in Children .......................... 25
Contributions of Oral versus Nasal Breathing to Fine Particle Deposition in Children ... 25
Deposition of Air Pollutants in the Developing Human Lung ........................................ 25
Childhood Susceptibility to Air Pollutants: Harvard-Mexico Studies ............................ 26
Lung Growth Study [[[ 26
Acute Respiratory Illness Study [[[ 26
Air Toxics and Pregnancy Outcome [[[ 27

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                                           EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
Evaluating Food Contamination Scenarios in Dietary Exposure
Studies—Child Dietary Lead Study	71
Effects of Lead on Adolescent Development	71
Long-Term Potentiation as a Model System for Cognitive Function	71
The Integrated Exposure Uptake Biokinetic (IEUBK) Model	71
Pollutant-Specific Risk Assessments	72
The Effects of Pesticides on Reproductive Toxicity	73
Effects of Endocrine Disrupters on Disposition of Testosterone in Adult and
Developing Rats	73
Mechanisms of Abnormal Reproductive Development Produced by Endocrine
Disrupting Chemicals Administered during Critical Developmental Periods	73
Effects of Environmental Toxicants on the Steroid Hormone Pathway	74
Polychlorinated Biphenyls (PCBs) and Polychlorinated Benzodifuran (PCDF)
Biomarkers of Risk Assessment in Adolescent Children and Mothers	74
NeurotoxicityofPCBs	75
Developmental Toxicity of PCBs	75
The Ototoxicity of Developmental Exposure to PCBs	75
Toxicokinetics in Pregnant and Lactating Rats	75
Pollutants and Neurobehavioral Function in the Czech Republic	78
Developmental Biologically-Based Dose-Response (BBDR) Model for
Mercury Vapor	78
Prenatal Developmental Research	78
Perinatal Exposure of Rats to Toxic Chemicals and the Effects on Immune
Function Development	79
Molecular Mechanisms Common to Toxicant-Induced Neural Injury	79
Individual Variability for Neurotoxic Effects 	79
Environmental Exposures and Human Neurological Function	79
Dietary Exposure Models and Related Databases to Estimate Exposure to
Chemical Residues	96
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National Health and Nutrition Examination Survey (NHANES)	97
Exposure of Children to Pesticides in Yuma County, Arizona	97
Measuring and Apportioning Children's Exposure to Pesticides in Urban,
Suburban, and Rural Communities	97
Pesticide Exposure of Young Children in Minnesota	98
Total Organophosphorus Pesticide Exposure among Children in Urban and
Rural Environments	98
Children's Exposure to Pesticides in the Agriculture Health Study (AHS)	98
Pesticides in Young Children Study in Border States	99
The Effects of Pesticides on the Immune System and Allergic Response	99
The Biochemical Effects of Pesticides on the Central Nervous System	99
The Effects of Pesticides on Learning and Memory	99
Neurochemical Changes and Behavioral Effects Induced by Pesticides	100
Neurotoxicity of Cholinesterase-Inhibiting Pesticides	100
Neurobehavioral Characterization of Susceptible Populations and Pesticide
Neurotoxicity	100
Age-Related Sensitivity to Cholinesterase-Inhibiting Pesticides	101
Organophosphate Insecticide Exposure from Pets Treated with Flea Control
Insecticides	101
Community Enteric (Intestinal) Disease Study	Ill
Determination of Human Infective Dose and Antibody Levels for
Cryptosporidium Parvum	 112
Feasibility of a Cultural Method for Detecting Viable Cryptosporidium
Parvum Oocysts in Environmental Samples	 112
Airway Anatomical Structure	127
Exposure Factors Handbook	 127
Semen Quality in 18 Year Olds and Air Pollution in Czech Republic	138
Potential Exposure to Environmentally Released Chemicals and Childhood Cancer... 155
OfficE of Solid WASTE ANd EiviERqEi\icy RESPONSE
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                          Rulemaking on Do-It-Yourself Debris from Removal of Lead-Based Paint	63
                          ATSDR Implementation	126
                          Office of Solid Waste Risk Assessments	126
                          Combustion Rulemaking	127

                          OfficE of WATER
                          Microbial Disinfectant/Disinfection Byproducts (M-DBP) Rules	109
                          Information Collection: Sensitive Subpopulations	109
                          Microbial Diseases: Effects of Age and Sex on Morbidity and Mortality	 110
                          Water Consumption Estimates for Subpopulations, Including Children	 110
                          Source Water Protection Activities	 112
                          Children's Health Protection	 113
                          Technical Assistance on Risk from Consumption of Contaminated Fish	 116
                          Guidance on Risk from Consumption of Contaminated Fish	 116
                          Children Health Protection-Improvement in Risk Assessment Methods for
                          Drinking Water	122
                          Children's Health Protection-Biosolids	123


                          EPA

                          REqioixil
                          TtegionallAQ Tools for Schools Programs	14
                          Indoor Air Environment Program for Children	18
                          "Breathe Easier" Support	19
                          AmeriCorps Outreach on Asthma	19
                          Ozone Outreach Project	23
                          Examples of Regional Lead-Based Paint Activities	52
                          The Childhood Lead Action Project	53
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Urban Environmental Initiative	54
Lead Poisoning Prevention Curriculum	54
New England Lead Coordinating Committee	54
Daycare Provider Lead Awareness Course	55
Vermont Lead Safety Project	55
River Revitalization Program	144
Youth Star Program	144
Teacher Training Program	144
Teacher Training Workshops	145
Youth and the Environment	145
That Magnificent Groundwater Connection	145
A World in Our Backyard/Adopt-a-Wetland Program	145
Junior Environmental Training (JET) Program	146
Save the Sound	146
Appalachian Mountain Club	146
Harvard Human Health and the Environment Project	146
E.N. Rogers Environmental School	147
The Connections Project	147
Teacher Training on Integrated Pest Management and Pesticides	147
Active Watershed Education (AWEsome!) Program	148
Water Quality Information Sharing Program	148

ReqioN 2
Regional IAQ Tools for Schools Programs	14
Training School Nurses in Open Airways andlAQ Tools for Schools	 16
Indoor Air Environment Program for Children	18
Harlem Prevention Center Community University Partnership Grant	18
Asthma Outreach and Education in the Bronx[[[ 20

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                                                                     EPA ChildREN's ENVIRONMENTA! HEAlih YEARbook
                          Cockroach Movement and Allergen Distribution in Inner-City Apartments	20
                          Asthma Conference in New York City	21
                          Puerto Rico Department of Health Asthma Projects	21
                          Environmental Interventions for Asthma	21
                          Examples of Regional Lead-Based Paint Activities	52
                          AmeriCorps/EPA Neighborhood Improvement Project	55
                          Environmental Justice Grants	56
                          Superfund Risk Assessment for Children	56
                          An Adult Lead Model at Hazardous Waste Sites	56
                          Vega Baja Solid Waste Disposal Site Assessment	57
                          Roebling Playground Remediation	57
                          Grand Street Relocation	77
                          Sustainable Reduction of Cockroaches and Rodents in Inner-City Dwellings
                          Using IPM Techniques	92
                          Educational Photo Literature for Integrated Pest Management in a
                          Low-Income Setting	93
                          English/Spanish Video on Integrated Pest Management Techniques to Reduce
                          Cockroaches and Rodents in Inner-City Dwellings	93
                          New Jersey Schools and Pesticides	93
                          Cornell University Non-Ag Sector IPM Program	93
                          Tropical Fruits Enforcement Case	95
                          Fish Advisories in Region 2	 114
                          Determining Potential Exposure of Children Near Superfund Sites	123
                          Environmental Education Grants	143

                          ReqioN ^
                          TtegionallAQ Tools for Schools Programs	14
                          Program-Specific Activities and Strategies	57
                          Urban Environmental Initiatives	58
                          Fish Consumption/Toxics in the Harbor Program	 114
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The Chester Environmental Justice Initiative	 1128
Philadelphia Public Environmental Education Center	 1149
Chemical Indexing System for Toxic Release Inventory, Part It:
Vulnerability Index	156

ReqioN 4
Regional IAQ Tools for Schools Programs	14
Indoor Air Environment Program for Children	18
Radon Mitigation for School Maintenance Personnel	37
School Visits in Counties with the Highest Radon Risk	38
EPA Region 4, U.S. Department of Energy (DOE), and State of South
Carolina Contaminated Fish Public Involvement Campaign	 114

ReqioN 5
Regional IAQ Tools for Schools Programs	14
Asthma Outreach Initiative	24
Air Sampling Project, Winton Hills, Ohio	24
Asbestos-in-Schools Rule	38
Examples of Regional Lead-Based Paint Activities	52
Endocrine Disrupters	74
Great Lakes Binational Toxics Strategy	76
Pesticides: Food Safety	89
Great Lakes Binational Toxics Strategy: Virtual Elimination of Persistent
Toxic Substances	90
Pesticide Safety for Agricultural Workers and Their Families	90
Methyl Parathion Investigation	94
Reduction/Elimination of Persistent Toxic Substances in Great Lakes	 115
Cleanup Actions	124
Chicago Cumulative Risk Initiative (CCRI) Project	128
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                         Sixteenth Street Community Health Center	129
                         Pollution Prevention Education Toolbox	143

                         ReqioN 6
                         RegionallAQ Tools for Schools Programs	14
                         Asbestos-in-Schools Rule	38
                         Examples of Regional Lead-Based Paint Activities	52
                         Superfund Evaluation of Lead-Contaminated Soil	58
                         Oklahoma Agin the Classroom Program	91
                         Texas Structural Pest Control Board IPM in Schools Program	92
                         Superfund Site Evaluation	123
                         Human Health Risk Assessments/Risk Assessment Work Plans	124
                         Give Water a Hand	144
                         Aquatic Education Exhibit	148
                         Environmental Awareness and Testing Program	149
                         Use of a Geographic Information System (GIS) to Gather and Analyze Information
                         for Regional Programs	156

                         ReqioN 7
                         RegionallAQ Tools for Schools Programs	14
                         Indoor Air Environment Program for Children	18
                         "Home Cleaning for Asthma Attack Control" Program	20
                         Radon Outreach	38
                         Asbestos-in-Schools Rule	38
                         Examples of Regional Lead-Based Paint Activities	52

                         ReqioN 8
                         RegionallAQ Tools for Schools Programs	14
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Indoor Air Environment Program for Children	18
Industrial Chrome Plating Emergency Response	58
Residential Cleanups of Lead-Contaminated Soil	59
Emergency Response	76
Mercury Neurotoxicity in Children	77
Flood-Related Disease in Children	 113
Hazardous Waste	124

ReqioN 9
Regional IAQ Tools for Schools Programs	14
Indoor Air Environment Program for Children	18
Asbestos-in-Schools Rule	38
Vinyl Chloride Risk Assessment Approach for Children	40
Site Assessment in Response to Cancer in Children	41
Examples of Regional Lead-Based Paint Activities	52
Environmental Epidemiological Survey of Lead Exposure of Children in
Tijuana, Mexico	59
Risk Assessment in Region 9	125
Preliminary Remediation Goals to Protect Children	125
Epidemiological Survey of Lead Exposure of Children in Tijuana, Mexico	135

ReqioN 10
Tribal Children Blood Lead Hazards	60
Oregon Legal Services Corporation Grant	60
Migrant Worker Housing Facility Lead and Arsenic Survey	61
Bunker Hill Superfund Site Childhood Blood Lead Study	61
Yakima Children Blood Lead Study	61
Columbia River Intertribal Fish Commission (CRITFC) Study	 116
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