ed States
Environmental Protectio'
Office of Children's
Health Protection
Washington, DC 20460
EPA100-S-98-002
April 1998
www.epa.gov
he EPA Children's
Environmental Health
Yearbo
Executive Summary
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UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
WASHINGTON, D.C. 20460
THE ADMINISTRATOR
April 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. Tn 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,
Carol M. Browner
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PA ChilcJREN's ENVIRONMENTAL HEAlrh YEARbook EXECUTIVE SUMMARY
EXECUTIVE SUMMARY
Children are exposed to a wide variety of toxic substances in their environments that can
affect their health. For instance, poor indoor and outdoor air quality are linked with an
increased incidence of respiratory illnesses, especially asthma, in children. The overall
incidence rate of new childhood cancers has increased over the past two decades, and
brain tumors and leukemia in children have been linked with pesticide use in and around
the home. Lead, a heavy metal, remains one of the most pervasive developmental toxic
substances in America. Children and women of childbearing age may be at increased risk
compared to other groups from exposure to contaminated fish and disease-causing
organisms in sewage-contaminated water. In recent decades, about 50,000 synthetic
chemicals have been produced in the United States, and many of these substances have
dispersed into the environment.
Children have a special vulnerability to certain toxic substances, such as lead, for a variety
of reasons. 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. Damage to developing organ systems may carry lifelong
consequences.
Protecting children's health against environmental threats are among the Clinton
Administration's highestpriorilies:
In April 1997, 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 address 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.
In May 1 997, EPA Administrator Carol M. Browner established the Office of Children's
Health Protection 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 the Office of Children's Health Protection is to make the protec-
tion of children's health a fundamental goal of public health and environmental protection
in the United States.
of ihE YEARbook
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
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The EPA ChildREN's ENVIRONMENTA! HEAlrh YEARbook EXECUTIVE SUMMARY
health from environmental hazards. The Yearbook includes sections on asthma and other
respiratory effects; childhood cancer; developmental and neurological toxicity; health
effects of pesticides; and potential risk from contaminated surface water and ground water.
Additional 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. The final section directs readers to
additional EPA resources for more information.
EPA's focus on children will continue to grow, reflecting an enduring commitment to the
protection of children's health from environmental threats. Efforts to protect children's
health will advance the cause of environmental justice by improving the environment of
urban and tribal communities where children may be particularly vulnerable and dispropor-
tionately exposed to environmental hazards.
ASTHMA AN
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The EPA ChildREN's ENVIRONMENTAL HEAtrh YEAnbook EXECUTJVE SUMMARY
Agency sets air standards for the most prevalent air pollutants and works with the states
to implement those standards. Recently, the Clinton Administration strengthened the air
standard for ozone to protect the health of asthmatics and children and established new
standards for fine airborne particles. The Agency estimates that the new standards will
save at least 15,000 lives per year and protect an additional 35 million children. EPA also
is studying the impacts of outdoor air pollutants on the physical development of children and
on the characteristics that make children more susceptible to the effects of air pollution.
Childhood CANCER
Cancer was the fourth leading cause of death in American children under age 15 in 1992.
While cancer death rates have decreased due to better treatment, the overall incidence
rate of new cancers in children increased between 1973 and 1994. 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.
Certain toxic substances and radiation in the environment have the potential of initiating or
accelerating the cell changes mat lead to cancer. Examples of environmental factors that
may be associated with cancer are environmental tobacco smoke, radon, asbestos,
ultraviolet light, certain hazardous wastes, and some pesticides.
EPA has an active program to address environmental threats that may contribute to
childhood cancer and cancer later in life. EPA works with state and local governments,
schools, and nonprofit organizations to reduce elevated radon levels in schools and
homes. Through these partnerships, EPA has promoted radon awareness, voluntary
testing programs, radon-resistant building practices, and methods to lower radon levels.
The Agency provides education and technical assistance to school districts to inspect
school buildings for materials containing asbestos and to take follow-up actions. EPA
also engages in outreach programs to educate parents, students, and teachers about the
potential damage ultraviolet light may cause to children's skin.
EPA is conducting research to determine how much exposure children receive to toxic
substances in the environment, and is developing methods and techniques to assess the
effects of exposure to the body.
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TkE EPA CMdREN's ENVIRONMENTAL HEAlih YEARbook EXECUTIVE SUMMARY
DEVELOPMENTAL Ai\d NEURoloqicAl Toxiciry
Exposures to neurotoxic substances may have only temporary effects on adults but may
cause permanent damage to a child's developing nervous system, especially the brain.
Neurotoxic substances—such as heavy metals, solvents, pesticides, andpolychlorinated
biphenyls (PCBs)—may have harmful effects on brain function, including intelligence and
behavior, and interfere with the normal workings of the entire nervous system.
Lead is one of the most pervasive developmental toxic substances in the United States
today. To prevent lead exposures in children, EPA and other federal agencies enforce the
regulations on the use and removal of lead-based paint, promote public education on the
health risks posed by lead-based paint, and conduct research on lead poisoning and on the
impact lead-contaminated hazardous waste sites may have on children. The Safe Drinking
Water Act controls children's exposure to lead via drinking water by imposing strict
requirements on public water systems to minimize lead levels at the tap, as well as on the
lead content in solder, water pipes, and plumbing fixtures.
EPA has completed a report to Congress on mercury and is studying the adverse health
effects of mercury on nervous system development in children. EPA has begun a public
education program to prevent mercury poisoning.
The Agency is developing a multi-year research strategy on endocrine (hormone) disrup-
ters and is coordinating research throughout the federal government. EPA conducts
research on methods to assess reproductive, embryo, and fetal toxicity. Also, EPA
routinely conducts risk assessments of reproductive and developmental effects.
HEAtrh EffecTs of PEsiicidEs
Pesticides are a concern to children because of their widespread use and children's special
vulnerabilities. Children can be exposed to pesticides in their diets and drinking water, or
through contact with pesticides on lawns and in their homes.
The 1996 Food Quality Protection Act (FQPA) includes specific regulatory requirements
to protect susceptible members of the population, including children, from pesticide residues
in food. EPA regulates pesticide residues in food through a system of standards called food
tolerances. Under FQPA, the Agency will reassess approximately 10,000 existing p%stij|3e
tolerances and will focus first on those pesticides that pose the greatesthazards.
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The EPA ChildREN's ENVIRONMENTAL HEAlrh YEAnbook EXECUT!VE SUMMARY
EPA is committed to ensuring the safety of foods children eat by increasing the research
and testing needed to learn more about children's exposure to pesticides in food. EPA
also is collaborating with the states to assure compliance with existing pesticide laws and
regulations, and establish new standards to protect children and infants from dietary health
risks posed by pesticides. EPA is working to speed registration of newer and safer
approaches to pest control and ensure the availability of cost-effective alternatives to
pesticide use. In addition, EPA is developing new methods to assess multiple pesticide
exposures in children.
POTENT!Al Risks FROM CONTAIN!NATEC! WATER
Contaminants, where present in drinking water and surface water are a potential health
threat to children in the United States. Swimming may result in contact with disease
causing organisms in sewage-contaminated surface water, which may cause hepatitis,
dysentery, gastrointestinal illness, fever, and ear infections. Bodies of water and their
sediments also maybe contaminated with toxic substances, such as PCBs and heavy
metals. If women of childbearing age and children eat fish from these waters, the con-
taminants may cause serious health effects, such as cancer, birth defects, and nervous
system damage.
Drinking water in the United States is safe for most healthy adults and children, and
contamination of drinking water is rare. However, outbreaks of waterborne illness, such
as that caused by Cryptosporidium, may occur. EPA currently is developing more
stringent standards to further reduce the low rate of waterborne disease.
EPA's efforts to protect people from drinking water and surface water contamination
include creation of the National Drinking Water Standards and Health Advisories, en-
forcement of the standards, and enforcement against those who violate permits or improp-
erly discharge raw sewage. The Safe Drinking Water Act calls for better regulatory
science, including an analysis of the health effects to children. The Act provides for
special consideration of the risks to susceptible members of the population, such as
children, in determining which contaminants to regulate. EPA is conducting several studies
to determine the health effects of drinking water contaminants in children. The results will
allow EPA to better document the susceptibility of children to rnicrobial and chemical
contaminants and to respond appropriately.
EPA also regulates discharges of contaminated waste, and manages the Beach Health
Protection Program. Through a fish consumption advisory program, EPA supports state
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The EPA CMdREN's ENVIRONMENTAL HEAlrh YEARbook EXECUTJVE SUMMARY
programs and develops informational materials on the risks to developing fetuses and
children when their mothers consume fish contaminated with mercury, other heavy metals,
orPCBs.
Risks TO ChildREN
EPA uses a risk assessment process to identify and judge the severity of potential harmful
effects to humans or ecosystems from exposure to environmental hazards. Some sub-
stances, such as lead, mercury, and nitrates, have prompted the Agency to conduct more
research and develop better risk assessment methods designed specifically to protect
children. In addition, EPA has begun developing new methods to account for combined
exposures to a variety of substances and routes of exposure. For instance, an individual
may be exposed to lead from several sources, such as contaminated drinking water, lead-
based paint, and airborne lead in densely industrial or populated areas. The exposures
from all sources could be combined into one measure for an assessment of combined risk
to children.
PROTECT! i\q ChildREN WoRldwids
The United States plays a role in promoting children's environmental health in international
organizations and other nations. The 1997 Declaration of the Environmental Leaders of
the Eight on Children's Environmental Health signifies the support and willingness to
collaborate on environmental hazards that threaten children among the eight most economi-
cally influential countries. EPA will coordinate U.S. efforts to implement the steps called
for in the Declaration.
EPA and Environment Canada provide joint leadership in efforts to better protect children
from the adverse effects of smog through the U.S.-Canada Air Quality Agreement. EPA
supports ajointproject with the U.S. Agency for International Development to improve
pesticide management and regulation in Central America. EPA is leading worldwide
efforts to reduce the use of lead in gasoline that threatens millions of children. The Agency
supports several initiatives throughout the world to improve human health and child survival
through better access to microbiologically safe drinking water. Under the Great Lakes
Water Quality Agreement, EPA and Environment Canada assess and report on discharges
of toxic substances and their effects in the Great Lakes Basin. %%J^
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The EPA ChildREN's ENVIRONMENTAL HEAlih YEARbook EXECUTJVE SUMMARY
ENVIRONMENTAL EduCATJON
TO
As part of EPA's National Agenda to Protect Children 's Health from Environmental
Threats, the Agency is committed to expanding educational efforts with health and
environmental professionals to identify, prevent, and reduce environmental health threats
to children.
EPA awards $3 million annually to support approximately 250 grants for environmental
education projects nationwide. Some EPA sponsored environmental education programs
teach children about environmental health issues of particular interest to them and their
families. Other programs provide skills and knowledge that parents, educators, and
community leaders may use to help protect children from environmental health risks. 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 improved
access to information and educational programs for poor and disadvantaged communities.
EN^ANCEC! COMMUNITY RiqkMrO'Kixow
EPA is enforcing the requirements of the Emergency Planning and Community Right-to-
Know Act and is vigorously expanding public access to Agency information on pollution.
With this information, parents can help prevent pollution in their neighborhoods and
protect the health of the community's children. The Toxic Release Inventory (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. Over 3 1 ,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. Because of TRI's reporting
requirements, hazardous emissions have been reduced by 6 1 percent since 1987. EPA
will use the TRI program to ensure that parents, teachers, and health care providers are
aware of potential sources of contamination that may affect children's health.
The Safe Drinking Water Act Amendments of 1 996 also contain extensive provisions for
consumer involvement. The provisions are founded on the principle that consumers have
a right-to-know what is in their drinking water and where the water comes from before
they turn on the tap. The Food Quality Protection Act (FQPA) includes special
right-to-know provisions that provide more public information about risks from pesticides
on foods. Such information can be the means for consumers to make more informed
decisions.
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Office of ChildREr/s HEAlrh PROTECTION
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