&EPA
United States
Environmental Protection
Agency
Off ice Of The
Administrator
(1101)
EPA175-F-96-001
September 1996
Environmental Health
Threats To Children
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UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
WASHINGTON, D.C. 20460
OFFICE OF
THE ADMINISTRATOR
September 1996
Dear Reader:
EPA's report on Environmental Health Threats to Children presents the latest
information on a major issue concerning today's families — how children's health is directly
and uniquely affected by our environment. Today, we recognize that children face an array
of complex environmental threats to their health — from asthma-inducing air pollution to
toxic chemicals. This report describes how and why children are affected by these threats.
The report also details the Clinton Administration's substantial efforts to protect
children from environmental health threats. These actions range from signing new laws that
explicitly protect children from pesticides and provide safer drinking water, to expanding
families' right-to-know about lead-based paint and other environmental pollutants, to issuing
tough new standards for industrial air pollution. I firmly believe that we can best protect the
health of all Americans and our environment by protecting our children.
Also contained in this report is EPA's National Agenda to Protect Children's Health
from Environmental Threats, in which we call for a national commitment to ensure a healthy
future for our children. We call on national, state and local policy makers — as well as each
community and family — to learn about the environmental threats our children face; to
participate in an informed national policy debate on how together we can best reduce health
risks for children; and to take action to protect our nation's future by protecting our children.
EPA is committed to providing the American people, with as much information as
possible about environmental issues affecting children's health. This report is a major step
forward in educating the nation about what we can do to ensure for our children a healthy
environment and a healthy future. ;
Sincerely,
Carol M*Browner
Recycled/Recyclable
Printed with Soy/Canota Ink on paper that
contains >t least 50% recycled fiber
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Executive Summary
Protecting Our Children Is Fundamental
Protecting our children is one of the Clinton
Administration's highest priorities. Healthy children and
strong families are fundamental to the future of our
nation. Protecting our environment is critical to our
children's health today, and lays the groundwork for a
healthier future for their generation, and for generations to
come. As a nation, we must remain vigilant about protect-
ing our children from environmental hazards—which we
now recognize pose many unique threats to children's
health. This report outlines the status of children's envi-
ronmental health; sets forth Environmental Protection
Agency (EPA) accomplishments in protecting children
from environmental health risks; and puts forward EPA's
agenda that challenges the nation to ensure our children's
healthy futures.
Children Are Particularly Vulnerable to
Environmental Health Risks
For several years, the Clinton Administration has recog-
nized and worked to improve our understanding of how
children are at increased risk from many environmental
threats, compared to adults. Children are particularly at
risk from environmental hazards in three ways:
• Because children's systems are still developing—
including rapid changes in growth and development,
immature body organs and tissues, and weaker immune
systems in infancy—they are more susceptible to environ-
mental threats.
• Because children eat proportionately more food, drink
more fluids, and breathe more air per pound of body
weight, and because they play outside more, they are
more exposed to environmental threats.
• Because children are least able to protect themselves,
their behavior—such as crawling on the ground or the
floor—exposes them to different environmental hazards.
Children Face a Wide Array of
Environmental Hazards
Children today face significant and unique threats from a
range of environmental hazards. Government and its
partners have never faced a more complex challenge in
protecting children. Environmental health hazards that
threaten children range from asthma-inducing air pollu-
tion and lead-based paint in older homes, to treatment-
resistant microbes in drinking water and persistent
industrial chemicals that may cause cancer or induce
reproductive or developmental changes. Just as the nation
rose to meet the challenge of uncontrolled industrial
pollution over the past 25 years, so too should we now
commit to meet this new and critical challenge for our
future.
The Clinton Administration Has
Acted to Protect Children from
Environmental Risks
The Clinton Administration has made great strides in
protecting children. The Administration's new policy
ensuring consideration of special environmental threats to
children in the development of risk assessments, as well as
its research agenda focusing on food pesticides and other
exposures unique to children are among the many efforts
the Clinton Administration has made to improve protec-
tion of children's health, based on cutting-edge science.
The centerpiece of EPA's effort has been Administrator
Carol M. Browner's national policy, announced on Octo-
ber 23,1995, to consistently and explicitly take into
account health risks to children and infants from environ-
mental hazards when conducting assessments of environ-
mental risks. This new policy directly responds to issues
raised by the National Academy of Sciences 1993 report,
Pesticides in the Diets of Infants and Children, and is an
extension of Administrator Browner's efforts to make
children's health a priority throughout the Agency.
The Clinton Administration also has made children's
health issues a high priority across all of EPA's work,
including: drinking water protections; toxic waste clean-
ups; toxic air pollution reduction; protections for rivers,
lakes and streams; safety controls for toxic chemicals used
at home; lead poisoning prevention; enforcement of
environmental laws; and, most critically, use of the best
scientific research to answer the many questions that
remain about how children's health is affected by environ-
mental hazards.
Responding swiftly to recommendations in the Na-
tional Academy of Sciences 1993 report, the Clinton
Administration took unprecedented steps to protect the
health of children from the risks posed by pesticides in
their food. The Administration committed to ensuring the
safety of foods our children eat by considering children's
unique exposures and risks, and by reducing the overall
use and risks of pesticides in the United States. EPA has
intensified its efforts to: reduce the use of high-risk
pesticides; increase the research and testing needed to
learn more about children's exposure to pesticides in food;
and establish new standards to protect children and
infants from dietary health risks posed by pesticides. EPA
also is expanding its assessment of the effects from sub-
stances on children's neurological, endocrine, and immune
systems.
More Remains to be Done
The array of environmental threats facing children to-
day—and the uncertainties in the adequacy of current
protections derived principally to protect adults—will
require great care and commitment to address. We
recognize that children's environmental health issues are a
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top priority and must become a central focus of all EPA's
efforts.
We thus challenge our partners in industry, govern-
ments, Congress, academics, health professions and
interest groups to commit to adopt and help to implement
EPA's
National Agenda to Protect Children's Health
From Environmental Threats.
To meet this challenge, the Administration will:
1. As a national policy, ensure that all standards EPA sets
are protective of the potentially heightened risks faced by
children, and that the most significant current standards
be re-evaluated as we learn more;
2. Identify and expand scientific research opportunities on
child-specific susceptibility and exposure to environmen-
tal pollutants so that the best information can be em-
ployed in developing protections for children;
3. Develop new, comprehensive policies to address
cumulative and simultaneous exposures faced by chil-
dren—analogous to the goal of EPA's Common Sense
Initiative—moving beyond the chemical-by-chemical
approach of the past;
4. Expand community right-to-know—building on suc-
cesses under the current law and expanding the available
tools through a Family Right-to-Kxiow Initiative—to allow
families to make informed choices concerning environ-
mental exposures to their children;
5. Provide parents with basic information so they can take
individual responsibility for protecting their children from
environmental health threats in their homes, schools, and
communities;
6. Expand educational efforts with health and environ-
mental professionals to identify, prevent, and reduce
environmental health threats to children; and
7. Commit to provide the necessary funding to address
children's environmental health issues as a top priority
among relative health risks, as steirted in the President's
Fiscal Year 1997 Budget.
EPA's National Agenda to Protect Children's Health
from Environmental Threats will, together with the
efforts of our partners, ensure that children receive the
protection they need and deserve, and help our nation
fulfill its obligation to protect future generations.
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EPA's National Agenda to Protect Children's Health
from Environmental Threats
I. The Problem
The Clinton Administration has recognized and worked
to improve its understanding of how children are more at
risk from many environmental threats than adults.
Children are particularly at risk from environmental
hazards in thfee ways:
• Because children's systems are still developing, they
are more susceptible to environmental threats. Children
move through several stages of rapid growth and devel-
opment, from infancy through adolescence. Exposure to
toxic substances can affect fetal, infant, and childhood
growth, impairing development of their nervous systems,
and causing abnormal development because of hormonal
or immunologic effects. Infant immune systems are less
well developed, so, for example, they may be less able
than healthy adults to recover rapidly from microbes
found in drinking water, such as cryptosporidium.
• Because children eat proportionately more food, drink
more fluids, breathe more air, and play outside more,
they are more exposed to environmental threats. Chil-
dren eat more calories, drink more water and breathe
more air per pound of body weight than adults do, and
thus may ingest more pollutants per pound of body
weight. They eat far larger amounts of certain foods for
their body weight than adults. Their immature skin and
body tissues risk greater damage from the sun, and can
more readily absorb many harmful substances.
• Because children are least able to protect themselves,
their behavior exposes them to different environmental
hazards. Children's natural curiosity and tendency to
explore leaves them open to health risks adults can more
easily avoid. When young children crawl on the ground
or the floor or play outside, they are more exposed to
potentially contaminated dust and soil, lead paint, house-
hold chemicals, garden chemicals, and other potentially
hazardous substances.
II. Environmental Health Threats to
Children
We now recognize the magnitude of these healths threats
to our children. Asthma, for example is now the leading
cause of hospital admissions for our nation's children.
Children face a wide array of major environmental health
threats, including these areas:
• Lead poisoning is a top environmental health hazard
for young children, affecting as many as 1.7 million
children age five and under, according to Centers for
Disease Control and Prevention (CDC) data. Although
lead-based house paint has long since been taken off the
market, children living in older homes are threatened by
chipping or peeling lead paint, and excessive amounts of
lead-contaminated dust. More than 80 percent of U.S.
homes built before 1978-some 64 million—contain lead
paint. Lead poisoning in children causes IQ deficiencies,
reading and learning disabilities, impaired hearing,
reduced attention spans, hyperactivity, antisocial behav-
ior, and other problems.
• Pesticides pose a risk for children both as household
chemicals and in food, particularly because children
consume higher amounts of fresh produce than adults.
Some pesticides can cause cancer, central nervous system
damage, or respiratory illness. Each year, more than
100,000 children accidentally directly ingest pesticides.
EPA receives an average of 24,000 pesticide hotline calls
each year, two-thirds of which are from parents concerned
about pesticides' dietary or household risks for children.
• Asthma deaths are on the rise in children and young
people, increasing by a dramatic 118 percent between
1980 and 1993, according to the CDC. Many of the most
common air pollutants can cause or contribute to respira-
tory illnesses, including asthma, which is now the leading
cause of hospital admissions for our nation's children.
More than 25% of the nation's children live in areas that
don't meet national air quality standards.
• Drinking water contaminants pose a risk to children,
particularly to infants, who drink more fluids per pound
of body weight—and who may be more vulnerable to the
effects of microbial contaminants like cryptosporidium.
EPA estimates that last year, a total of 30 million Ameri-
cans drank water from systems that violated one or more
public health standards—and roughly 13 million of them
are served by systems that do not filter their water and
thus may not adequately protect against microbial con-
taminants. In Milwaukee in 1993, hundreds of thousands
of residents became severely ill and 100—including
children—died after the drinking water became contami-
nated with cryptosporidium.
• Polluted waters not only affect children when they
swim in our lakes and streams, but also when they eat
certain freshwater fish. Hundreds of beaches are closed
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each summer due to raw sewage and other contamination.
All over America, warning signs are posted near thou-
sands of rivers, lakes and streams, raising special concerns
that pregnant women, children, and others with sensitive
or compromised immune systems should not eat fish
caught in the water because of contamination. From
January to September 1994, some 1,500 fish advisories
were posted—with 73 percent of them related to mer-
cury contamination. Exposure to high doses of methyl
mercury during pregnancy and the first few months of life
may pose particular threats to a child's developing
nervous system.
• Toxic waste dumps are a neighborhood blight and a
health hazard to our communities, especially to our
children. Parents should not have to worry that their
children will be exposed to toxic waste when playing in
their neighborhood, yet one in four Americans—includ-
ing 10 million children under the age of 12—lives
within four miles of a toxic waste dump and our cities
are littered with thousands of abandoned industrial sites.
• PCBs, or polychlorinated biphenyls, were banned by
EPA in 1976 because they cause cancer; some 20 years
later, however, this toxic chemical continues to persist in
the environment, often in contaminated fish. Children
whose mothers have high levels of PCBs when pregnant
may develop learning disabilities and experience
delayed development.
* Second-hand tobacco smoke dramatically affects
children. A recent CDC study estimates that children
exposed to tobacco smoke in their homes have 16 million
more days of restricted activity, 10 million more days of
bed confinement, and miss 7 million more school days
annually than other children, primarily due to acute and
chronic respiratory conditions.
* Overexposure to the sun's harmful ultraviolet light
can damage children's skin as they spend time playing
outdoors. The American Academy of Dermatology
estimates that up to 80% of a person's lifetime exposure to
potentially damaging ultraviolet light occurs before the
age of 18. Ultraviolet rays pose a threat to children
because severe sunburns experienced in childhood
increase the likelihood of developing malignant mela-
noma, the most deadly kind of skin cancer. Last year there
were an estimated one million new cases of skin cancer in
the United States.
Children also face several environmental risks that we are
just beginning to understand more fully:
• Potential Effects on the Endocrine System from
Pesticides and Industrial Chemicals: In recent years,
increasing scientific and public attention has been focused
on the potential effects of synthetic chemicals on the
hormone system. These chemicals—which have been
labeled "endocrine disrupters"—may pose a major health
concern for children. Although there is considerable
scientific uncertainty, it is clear that a number of chemi-
cals, including organochlorine pesticides such as DDT and
chemicals such as PCBs, can cause endocrine disruption in
wildlife and laboratory animals. Because very low levels
of chemicals that block or mimic reproductive and thyroid
hormones can determine, the course of prenatal develop-
ment, concern exists about the potential for birth defects
and alterations of normal growth and development in
children. Endocrine disrupters may also play an impor-
tant role in reproductive cancers.
• Potential Effects from Particulate Matter Air Pollution:
Epidemiological studies indicate that exposure to particu-
late matter—fine particles in the air, such as soot or dust—
at levels below the current national ambient air quality
standard can be associated with adverse effects on public
health. Studies have identified children as a sensitive
population to particulate matter, both in general and for
those with respiratory illness. Reports of restricted
activity days, school absences, increased respiratory
symptoms, and decreased lung function have all been
associated with children's exposure to particulate matter.
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III. The Clinton Administration Has Acted to
Protect Children from Environmental Health
Risks
The Clinton Administration has achieved important
progress in improving environmental health protection
for our children. From its new policy emphasizing the
need to ensure that environmental threats to children are
considered when conducting risk assessments, to its
research agenda focusing on food pesticides and other
exposures that are unique to children, the Administration
has been on the cutting edge of protective science.
Under President Clinton's leadership, EPA and other
federal agencies are making children's health consider-
ations a priority in all of their work to protect public
health and the environment, including work to: set strong
environmental and public health standards and protec-
tions; educate the public and ensure the public's right to
know; and conduct research to answer the many questions
that remain about how children's health is affected by
environmental problems.
The centerpiece of EPA's effort is the Administrator
Carol M. Browner's national policy, announced on
October 23,1995, to consistently and explicitly take into
account the health risks to children and infants from
environmental hazards when conducting environmental
risk assessments. This new policy directly responds to
issues raised by the National Academy of Sciences 1993
report, Pesticides in the Diets of Infants and Children, and is
an extension of Administrator Browner's efforts to make
children's health a priority throughout the Agency.
A. Applying the Best Science to Protect Our
Children's Future
The Clinton Administration has worked conscientiously to
ensure sound scientific underpinnings for its policy
initiatives on protecting children. It is critical that the best
science be applied to these problems; that the research be
of the absolute highest integrity and caliber; that it be on
the cutting-edge in sophistication, allowing for consider-
ation of the special mechanisms that affect children as
well as differences in susceptibility, and not just whether
an effect to the general population occurs; and that it
focus on the issues of greatest risk and concern.
Emblematic of EPA's efforts has been the develop-
ment of a cluster of new risk assessment and testing
protocol guidelines. These help ensure that assessments
are conducted using a consistent set of standards and a
framework that requires a focus on the unique factors
exhibited by infants and children. EPA has recently
proposed new guidelines for assessing cancer-causing
substances and neurotoxicological effects. Guidelines for
evaluating reproductive toxicity will be issued later this
year. EPA has also recently proposed new test guidelines
for the evaluation of chemicals that focus on developmen-
tal toxicity and reproductive toxicity testing. All of these
require a sophistication in scientific evaluations that looks
at the impacts of environmental agents on mechanisms
that specifically may affect infants, children, fetuses, and
the ability to bear children.
EPA research priorities have a special focus on issues
affecting children's health. From work on microbial
drinking water contaminants and support for research on
urban air issues, to consideration of reproductive and
developmental effects of endocrine disrupters, EPA's
research priorities are an important part of its agenda
focused on children. Included among the
Administration's efforts are:
Focusing Toxic Air Pollution Research
Asthma—both individual episodes and asthma-related
deaths—is increasingly on the rise in children and young
people. Ongoing research sponsored by the Administra-
tion is expected to provide new information critical to
understanding how air pollution affects the development
of asthma in children. A special effort funds research that
focuses on the link between health effects and exposure to
toxic urban air pollution. EPA is funding studies that
identify whether special subpopulations—such as infants
and children—are at increased health risks due to higher
exposure to toxic urban air pollution, or due to their
inherent biological sensitivities. These community-based
efforts will examine the pattern, frequency, and magni-
tude of exposures in specific communities.
Defining the Risks of Microbial Contaminants in
Drinking Water
To ensure that the water our children drink is safe from
contaminants that pose the greatest threat to their health,
our immediate priority is increasing our understanding of
microbial contaminants, most notably cryptosporidium. A
number of epidemiological surveys and day-care-center
outbreaks have shown that young children, especially
those under the age of two, may be more susceptible to
cryptosporidium-related illness. EPA has launched new
monitoring and treatment programs and is participating
in scientific efforts to find answers about deadly parasites
like cryptosporidium, including how we can better test for
them, how people are exposed to them through water,
and how to develop effective treatment programs. EPA is
also working with the Centers for Disease Control and
Prevention and others to assure that the risks associated
with cryptosporidium are communicated clearly and
accurately, particularly to protect those with sensitive
immune systems, including infants.
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Improving Scientific Knowledge About Children's
Exposure to Pesticides
A1993 National Academy of Sciences report, Pesticides in
the Diets of Infants and Children, concluded that then-
current scientific and regulatory approaches did not
adequately protect infants and children from pesticide
residues in food. The Academy called on EPA to make
significant changes in assessing exposure to pesticides,
analyzing the potential for harmful or toxic effects, and
using these data to characterize actual risks. Thus, the
Academy report provided a major challenge to EPA to
improve the safety of our food supply and provide greater
assurance that our children are protected. The Clinton
Administration moved aggressively and rapidly to
respond to the Academy report with a sweeping joint
effort by EPA, the U.S. Department of Agriculture
(USDA), and the Food and Drug Administration (FDA) to
carry out the Academy recommendations.
Basing Pesticides Standards on Children's
Actual Exposures
EPA is expanding its Pesticides in Children Research
Program. In FY97, EPA will conduct a survey of
children's exposure to pesticides through air, water, food,
and dust in homes, schools, day care facilities, and other
areas. From characterizing children's activity patterns to
addressing toxic effects as a function of age—including
response as a function of critical periods of neurological
and immunological development—EPA will be better
equipped to understand the special problems affecting
children.
The National Academy of Sciences report recom-
mended that EPA take into account children's unique
dietary patterns when setting pesticide standards and
registrations. EPA now routinely considers dietary risk to
infants and children in registering and re-registering
pesticides. In some cases, the Agency determines that
risks to children are unacceptable, resulting in the denial
of permission to use certain pesticides or voluntary
withdrawal. The U.S. Department of Health and Human
Services (HHS), USDA, and EPA are designing new
surveys to improve our knowledge of what infants and
children eat And EPA is also improving its methods of
analyzing the component parts of food as it is eaten (for
example, pizza is made up of wheat, tomatoes and milk),
so that exposure to pesticide residues can be estimated
more reliably.
The Academy also recommended that EPA account for
other exposures to the same pesticides found in children's
diets, to create a more complete picture of the unique risks
children face. EPA now uses an approach to risk assess-
ment that examines children's multiple routes of exposure
to pesticides at home and in schools, as well as in food.
EPA also has developed a new method for assessing
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acute—or short-term—exposures to toxic pesticides,
improving the Agency's ability to prevent children from
being exposed to pesticide residues that can cause illness
after only a single serving of the food is consumed.
The National Academy of Sciences report also recom-
mended improvements in monitoring and tracking
pesticide residues on the food children most frequently
eat. Since 1993, EPA, FDA, and USDA and the states of
California and Florida have been developing a National
Pesticide Residue Database to compile in one place all
data on pesticide residues gathered from monitoring of
food throughout the U.S. The Academy recommended
this step to provide a more reliable picture of pesticide
residues in our food. FDA and USDA food monitoring
programs have been redesigned to emphasize monitoring
of food that is particularly important in children's diets,
such as pears, apples, tomatoes, rice, and peas.
Conducting Better Assessment of Risks
Unique to Children
The National Academy of Sciences report recommended a
full assessment of unique risks to children because of
growth and developmental vulnerabilities. EPA is moving
to require pesticide and chemical manufacturers to
conduct new tests needed to assess potential toxic effects
of pesticides on the immune system, the nervous system,
reproduction and development, and the visual system of
children.
Setting Standards Based on Combined Exposures of
Chemicals with the Same Mode of Action
The National Academy of Sciences report concluded that
many pesticides on the market act in the same or similar
ways—both in their effectiveness as pest controls and in
the health effects they cause in humans. Yet EPA regulates
these chemicals one at a time. EPA has begun to phase in
an assessment process that will fully capture the com-
bined risk posed by such chemicals, starting with a special
review for the triazine herbicides.
Researching Potential Effects on the Endocrine System
from Pesticides and Industrial Chemicals
In recent years, increasing scientific and public attention
has been focused on the potential effects of synthetic
chemicals on the hormone system. EPA has acted to ban
many of these chemicals—including DDT and PCBs—and
has already taken many steps to regulate over 95% of '
known sources of dioxin in the U.S. In addition, the
Clinton Administration is involved in important research
to try to better understand increasing reports of reproduc-
tive, developmental and other problems linked to some
chemicals, including processes that may uniquely affect
children. The Administration is continuing to develop a
national research strategy, developing new strategies—
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with the involvement of stakeholders—for areas like
pesticide and chemical screening, testing and controls.
EPA's research in FY97 will focus on important questions
to determine: classes of chemicals that may affect the
endocrine system; how much exposure produces adverse
effects; how humans and wildlife are exposed; effects
actually occurring in humans and wildlife; and the
combined effects of exposure to multiple endocrine
disrupter chemicals.
Improving Scientific Knowledge About Fine Particle Air
Pollution
In FY97, EPA will significantly expand its research
program on particulate matter air pollution. Research will
be conducted to identify the way in which particles affect
human health, the critical exposure concentrations, and
the sizes, chemical compositions, and sources of particles
responsible for health effects. Research also will begin to
investigate technologies and control practices to reduce
fine particles.
Improving Scientific Knowledge About Mercury
Mercury in its organic form can produce a variety of
health effects depending on the amount and timing of
exposure. Data from both humans and experimental
animals indicate that methylmercury disrupts the devel-
opment of nervous systems, and is of particular concern
during the prenatal and postnatal period. These effects
may occur at lower levels of exposure for children and
fetuses.
EPA is examining the extent of these environmental
concerns. A draft report to Congress on mercury, includ-
ing analysis of exposure routes and risk characterization,
is undergoing peer review by EPA's independent Science
Advisory Board. EPA also is closely monitoring the
findings of ongoing human studies related to exposures to
methylmercury and their impact on nervous system
development. EPA will be refining its Oral Reference
Dose to set a standard for exposure.
B. Setting Strong Standards and Taking Tough
Actions to Protect Children's Health
The Clinton Administration has made great strides in
focusing EPA's efforts on matters of significant conse-
quence to children's environmental health and in setting
environmental standards that will be adequately protec-
tive. Among the Administration's accomplishments are:
Protecting Children from Toxic Lead Poisoning
One of the greatest steps in protecting children's health
was EPA's ban on lead in gasoline twenty years ago and
the Consumer Product Safety Commission's ban on lead
in paint—resulting in a 98% reduction in lead levels in
the air and protecting millions of children from serious,
permanent learning disabilities by helping to reduce
blood lead levels by 75 percent, according to CDC data.
Today, however, lead poisoning is still a leading
environmental health hazard for young children,
affecting as many as 1.7 million children age five and
under—one out of every 11. Although lead-based house
paint has long since been taken off the market, children
living in older homes are threatened by chipping or
peeling lead paint, or excessive amounts of lead-contami-
nated dust. More than 80 percent of homes built before
1978 contain lead paint. Even at low levels, lead poisoning
in children can cause IQ deficiencies, reading and learning
disabilities, impaired hearing, reduced attention spans,
hyperactivity and other behavior problems. Pregnant
women poisoned by lead can transfer lead to a developing
fetus, resulting in adverse developmental effects.
To address this most pressing remaining need in lead
poisoning prevention, EPA works with the U.S. Depart-
ments of Housing and Urban Development (HUD) and
Health and Human Services (HHS) to ensure that the
nation's housing is "lead safe." The Clinton Administra-
tion has expanded this initiative to include: the control of
hazardous lead paint in housing where children live;
research on lead poisoning and lead abatement; training
and certification of lead removal workers to ensure
effective abatement; public education on the health risks
posed by lead paint, particularly targeted to parents and
children; and enforcement efforts.
Protecting Children from Pesticides
Going beyond the recommendations of the 1993 National
Academy of Science's report, the Clinton Administration
launched a major effort to improve the safety of food for
children, while the work to carry out the Academy's
recommendations is underway. These efforts include
three major components:
• Strengthening Pesticide Standards to Limit the Health
Risk to Infants and Children: In August 1996, President
Clinton signed an across-the-board strengthening of our
nation's food safety laws (Food Quality Protection Act)
which included three important Administration-recom-
mended reforms: a stronger health-based standard to limit
the risks of pesticide exposure; special protections for
infants and children; and expansion of the consumer's
right-to-know about pesticide risks.
• Reducing the Risks—and Minimizing the Use—of
Pesticides Now: To speed the reduction of pesticide
risks—even while awaiting the results of new and emerg-
ing scientific data—EPA, FDA and USDA have pledged to
take several steps to reduce pesticide use overall. These
include: ensuring the availability of cost-effective methods
of integrated pest management as an alternative to
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traditional pesticides; encouraging the use of biological
pesticides and other alternatives; and working to achieve
the goal that 75 percent of U.S. agricultural acreage will
use some form of integrated pest management by the year
2000. Through a cooperative partnership, EPA is working
with more than 40 pesticide users—including growers,
utilities, and non-agricultural associations—to reduce
environmental health risks from pesticides through
laboratory research and improved management systems.
Many of these partnerships are with growers of foods that
children eat frequently, including potatoes, apples, citrus
fruits, pears, peaches and tomatoes.
* Getting Safer Pesticides on the Market Faster: EPA has
greatly accelerated its reregistration program for reevalu-
ating and reducing risks associated with the older, often
more toxic pesticides currently in use. Reevaluations are
being done at a rate of 40 per year and are complete for
121 pesticide chemical cases, covering 65 percent of
pesticide use in the U.S. In 1995, EPA significantly in-
creased its registrations of new, "safer" or reduced risk
pesticides. Twenty-four new active ingredients that are
biopesticides or reduced-risk pesticide ingredients were
approved for use, quadrupling the rate of approval of
safer pesticides.
Protecting Infants from Microbial Contaminants in
DrinkingWater
Drinking water contaminants pose a particular risk to
infants, who drink more fluids per pound of body
weight—and whose immature systems may be more
vulnerable to microbial contaminants such as
cryptosporidinm. To ensure that drinking water is safe for
children, our immediate priority is control of microbial
contaminants. The Clinton Administration has taken a
number of steps to reduce health risks from microbial
contaminants in drinking water systems across the nation:
• Successfully proposed the first-ever state revolving
fund to help achieve safer drinking water through funds
that go straight to the states for loans to communities to
upgrade and improve their drinking water treatment
facilities;
• Targeted safety standard development and available
resources to focus on contaminants in drinking water
that pose the greatest threats to public health, such as
microbial contaminants, including cryptosporidium^ and on
special populations such as the elderly, children, people
with HIV/AIDS, and others who are most at risk from
unsafe drinking water. In August 1996, Congress passed
new safe drinking water legislation which includes these
principles based upon Administration recommendations.
• Required that large water systems test source water—
and, in some cases, treated water—for cryptosporidium.
Data from this 18-month test, along with information
collected by EPA, will help develop new safety rules and
standards to protect further against cryptosporidium and
other microbials; and
• Launched the Partnership for Safe Water with the nation's
water suppliers in March 1995, to achieve voluntary
improvements in surface water filtration plants around
the nation. Filtration substantially reduces—but may not
entirely eliminate—cryptosporidium contamination.
The Clinton Administration is also working to bring
clean running water to the children and families who
live in the 1.4 million rural households across this
country. With its Water 2000 initiative, the Administration
is working with states, companies,, banks, and non-profit
groups to bring safe, affordable drinking water to
America's most remote and needy corners by the end of
the century.
Protecting Children from Dangerous Air Pollution
Air pollution has long been implicated in childhood
deaths and hospitalizations, and reduced quality of life
resulting from respiratory trauma and disease. A number
of studies have associated childhood exposure to air
pollution (ground level ozone, particulate matter, sulfur
dioxide, nitrogen dioxide) with increases in school ab-
sences, decreased lung function, and increased incidences
of bronchitis and asthma. According to the CDC, asthma
is the most chronic childhood illness in the U.S., affect-
ing some 4.8 million children below the age of 18.
Between 1980 and 1993, asthma alone accounted for 3,850
deaths among people under 24 years of age. During the
same period, the annual age-specific death rate from
asthma increased 118%, and the hospitalization rate
increased 28%. Currently, more than 25% of the nation's
children live in areas that don't meet national air quality
standards.
EPA's air pollution control efforts, taking place largely
under the Clean Air Act, are focused on protecting
children and others from the harmful effects of air pollu-
tion by improving air quality in communities. The Agency
develops health protective standards that set safe limits
for the most prevalent pollutants, and works with the
states and sources to implement those standards.
In the last three years, the Clinton Administration has
put new pollution control requirements in place that
dramatically lower both toxic and smog causing emissions
from a variety of sources, including chemical plants,
refineries, trucks and buses, large landfills, and gasoline.
When combined with efforts at the state and local level,
the result has been an unprecedented number of com-
munities achieving cleaner air for their citizens to
breathe as they come into compliance with the health
based national air quality standards.
In particular, successful implementation of the acid
rain provisions of the Clean Air Act have helped reduce
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substantially the particulate pollution implicated in recent
studies as the cause of tens of thousands of premature
deaths, as well as increases in hospitalization and illness
in children. However, new scientific data on the effects
of smog (both ozone and particulate matter) indicate the
need to continue a strong focus on reducing exposure,
especially childhood exposure, to these pollutants.
Other specific air pollutants such as mercury are
particular threats to children because of damage to the
nervous system that can occur during fetal and childhood
development, among other concerns. Since 1993, the
Administration has completed or begun developing
requirements that would substantially reduce the emis-
sions of mercury from the largest sources, including
municipal waste combustors, medical waste incinerators,
and hazardous waste incinerators. Over the next several
years, the Agency also expects to complete and issue a
study on mercury emissions from other sources, including
coal-fired power plants.
The Administration has also issued new, more protec-
tive controls on air emissions from incinerators that burn
hazardous waste—a process that can result in emissions
of dioxin, a family of toxic chemicals that causes cancer in
animals. The 99% reduction in dioxin emissions
achieved by these rules has special protective benefits for
nursing infants, because dioxin and other bioaccumulative
chemicals concentrate at higher levels in breast milk.
The Clinton Administration has maintained a strong
commitment to the phasing put of stratospheric ozone
depleting substances, the primary way to limit the in-
crease in ultraviolet radiation that reaches the earth. This
commitment has particular benefits for children, as the
American Academy of Dermatology estimates that up to
80% of the lifetime exposure to potentially damaging
ultraviolet radiation occurs before age of 18. The likeli-
hood of developing malignant melanoma, the most
deadly kind of skin cancer, is linked to the number of
severe sunburns experienced in childhood. The Adminis-
tration will continue to work with the international
community to complete these phaseouts.
Protecting Children from Exposure to Carelessly Dumped
Toxic Waste
The Clinton Administration has moved aggressively to
address the threat to children from toxic and industrial
waste sites in communities. To clean up toxic waste sites,
the Clinton Administration has fundamentally redirected
the Superfund toxic waste cleanup program to make it
faster, fairer and more efficient. Cleanups have been
dramatically accelerated: in the past two years, nearly as
many Superfund cleanups were completed in each of
the past two years than in the program's entire first
decade. EPA and the Agency for Toxic Substance Disease
Registry are collaborating on a children's health initiative
that will further enhance the prevention of exposure to
hazardous substances released from Superfund sites.
Together with businesses and communities, the Adminis-
tration also is cleaning up the old industrial properties —
the so-called "brownfields" that lie idle in the middle of
urban neighborhoods—so that they can be redeveloped
and returned to a revitalized community. The President
has proposed a Brownfields Tax Incentive to help leverage
more than $10 billion in private cleanups at these sites.
The Clinton Administration also is aggressively
enforcing anti-pollution laws to avoid threats to the
health and safety of our children from illegal dumping
of toxic waste. Not long ago in Florida, two children died
because they inhaled a toxic chemical illegally dumped
near an open lot where they were playing. The Clinton
Administration has consolidated and toughened EPA's
environmental enforcement program to improve compli-
ance with environmental laws and to penalize polluters
who break these laws.
Protecting Mothers and Infants from Contaminated Fish
and Polluted Waters
Clean water is America's first line of defense in protecting
our children's health. Americans need clean safe water for
drinking and swimming. Polluted waters not only affect
children when they swim in our lakes and streams, but
also when they eat certain fish from these areas. PCBs and
mercury continue to persist in the environment, often
taken up by fish. Children whose mothers are exposed to
high levels of PCBs or mercury when pregnant may
develop learning disabilities and experience delayed
development.
The Clinton Administration has funded actions in
thousands of communities across the country to protect
and restore our rivers and lakes and coastal areas. The
Clinton Administration also has acted to protect the
nation's largest body of fresh water with its Great Lakes
Water Quality Initiative. This landmark effort estab-
lishes consistent, common-sense, cost-effective guidelines
to protect the Great Lakes—which constitute 95% of the
nation's fresh water and provide drinking water for 23
million Americans. By addressing the long-term toxic
pollution that persists in the Great Lakes, this initiative is
protecting children and families by decreasing their
exposure to toxic pollutants that can pose particular
health effects on reproduction, and children's develop-
ment and immune systems.
In addition to working with the states to implement
the Guidance, EPA has undertaken a number of specific
activities to reduce sources of PCS and mercury contami-
nation. EPA has brought together all of its programs to
develop an integrated strategy, and has undertaken
particular efforts in the Great Lakes and to control emis-
sions jointly with our North American neighbors. For
example, EPA has been working to encourage the volun-
tary phase out of electrical equipment with contain PCBs.
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As a result, 12 major utility companies have reported that
they have removed almost 90 percent of PCBs from their
equipment
C. Expanding Community Right-to-Know and
Public Education to Provide Tools for Families to
Make Informed Choices
The Clinton Administration has vigorously expanded the
public's right-to-know about pollutants in their commu-
nity. It is essential that families and communities have the
tools with which to make informed decisions concerning
their environment and any potential health risks they may
face and that industry disclose its toxic pollution.
President Clinton has used his powers to expand and
strengthen the Community Right-to-Know laws.
The Administration in a 1993 rulemaking nearly doubled
the number of chemicals on which industry must report-
adding 286 chemicals. These expansions were protected
against Congressional efforts to undermine them when
the President issued a Pollution Disclosure Executive
Order in August 1995, requiring federal contractors to
meet EPA's pollution disclosure standards. In June 1996,
the Administration expanded the categories of facilities
required to disclose information about toxic releases by 30
percent—bringing the total to more than 31,000 facilities
that must report their toxic emissions to the public.
Further expansions to community right-to-know are
being planned to provide families with more complete
information about toxic chemicals being released in their
neighborhoods—including expanding the type of infor-
mation reported to provide critical information about
industry's use of toxic chemicals.
In keeping with right-to-know, EPA has also expanded
public access to Agency information—particularly
Internet access. Armed with this information, parents can
work to reduce and prevent pollution within their neigh-
borhood and protect the health of their children and their
community's children.
Tlte Clinton Administration successfully proposed
giving every American the right to know about
tap water contaminants.
In August 1996, President Clinton signed new drinking
water legislation that provides strengthened protections to
ensure that American families have clean, safe tap wa-
ter—improvements that the Clinton Administration has
called for since 1993—including provisions to improve
consumer information about local tap water. The new law
gives Americans access to direct, simple information
about local water quality, water sources, contaminants,
and whether the water poses a risk to health.
The Clinton Administration successfully recommended
new measures to expand consumers' right to know about
pesticide health risks.
New food safety legislation, signed by President Clinton
in August 1996, provides a comprehensive overhaul to
strengthen the nation's food safety system that regulates
pesticides on foods—reforms that the Clinton Administra-
tion has urged since 1993. To ensure that Americans have
both comprehensive health protection and the tools they
need to protect themselves and their families from pesti-
cide risks, the new law includes special right-to-know
provisions that provide more public information than ever
before about risks from pesticides on foods.
The Clinton Administration has taken steps to protect
children from lead-based paint poisoning.
The Clinton Administration has taken steps to protect
children from lead-based paint poisoning by ensuring that
parents have the right to know about lead-based paint
hazards when they buy or rent a home. As part of the
Administration's community right-to-know efforts, EPA
and HUD recently took action to require sellers and
landlords to disclose any known lead-based paint to home
buyers, allowing them the option of conducting a lead
hazard assessment. Approximately 64 million dwellings—
all built before 1978—contain some lead-based paint,
although much of it can be managed and maintained
safely buy using simple, low-cost common sense proce-
dures. Particularly at risk are families renovating older
structures and low-income families living in dilapidated
housing. Parents can unknowingly poison their children
when they disrupt lead-based painted surfaces during
renovations, for example. This new effort will provide the
tools to assist families in avoiding lead contamination.
The Clinton Administration is moving to prevent danger-
ous ultraviolet light overexposure through education and
information.
Ultraviolet radiation overexposure poses significant risks
to children because sunburns experienced in childhood
are linked to the onset of skin cancer later in life. EPA,
along with the National Weather Service and the Centers
for Disease Control and Prevention instituted the federal
UV Index program. The Index, which is expressed as a
number between 0 and 10+, is made available daily in 58
cities nationwide. Developed in cooperation with medical
organizations, broadcast meteorologists, and educators,
the UV Index program is giving people the information
they need to protect themselves and their children from
overexposure to the sun.
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The Clinton Administration is providing Americans with
more information about contaminated fish.
EPA has developed a database of fish consumption
advisories which is available to the public. The "National
Listing of Fish Consumption Advisories" includes all
available information describing state-issued fish con-
sumption advisories in the United States. Included in the
database is information on the geographic location of the
advisory, species of fish of concern, chemicals, and
segments of the population that are affected.
In the Great Lakes, levels of bioaccumulative toxic
substances in fish are lower than in the early 1970s,
however, the levels still justify issuance of public health
advisories regarding fish and wildlife consumption.
Specific advisories are also issued that apply to vulnerable
consumers, such as children and women who anticipate
bearing children. EPA, the Agency for Toxic Substances
and Disease Registry, the Great Lakes states and EPA's
other partners will continue to research the health impli-
cations and impacts of consuming contaminated Great
Lakes fish.
EPA is providing information to help parents and teach-
ers prevent environmental risks to children.
EPA has worked to educate parents and teachers about
potential environmental risks and how to avoid them.
EPA has produced a number of consumer information kits
on preventing exposures around the home to lead, radon,
and other indoor air contaminants and pesticides. EPA
has directed a number of efforts toward schools, notably
the Tools for Schools kit for protect the indoor air environ-
ment in schools and the Integrated Pest Management in the
Schools kit for reducing the need for and the use of haz-
ardous pesticides.
The Clinton Administration is seeking ideas to make
informational labels on toxic products clearer and more
protective.
EPA recently initiated a Consumer Labeling Initiative to
expand the amount of hazard and health information on
pesticide and related consumer product labels, analogous
to the new food nutrition labels. EPA also is working on
this effort with the Consumer Product Safety Commission
and the Food and Drug Administration, and a number of
leading industry groups and companies, as well as
parents, health professionals, and others.
IV. EPA's National Agenda to
Protect Children From Environmental
Health Threats:
Recommended Actions
Children today face significant and unique threats from a
range of environmental hazards. Governments and its
partners have never faced a more complex challenge in
protecting children, due to environmental health hazards
that range from asthma-inducing air pollution and lead-
based paint in older homes, to treatment-resistant mi-
crobes in drinking water and persistent industrial chemi-
cals that may cause cancer or induce reproductive or
developmental changes. As the nation rose to meet the
challenge of uncontrolled industrial pollution over the
past 25 years, so too should we now commit to meet this
new and critical challenge for our future.
The array of environmental threats facing children
today—and the uncertainties in the adequacy of current
protections derived principally to protect adults but that
may not do enough to protect our children—will require
great care and commitment to address. We recognize that
children's environmental health issues are a top priority
and must become a central focus of all of EPA's efforts
to protect public health and the environment.
We thus challenge our partners in the private sector,
throughout the many levels of government, in Congress,
in academia, and in interest groups to commit to adopt
and help to implement EPA's National Agenda to Protect
Children's Health From Environmental Threats. To meet
this challenge, the Administration will:
1. As a national policy, ensure that all standards EPA
sets are protective enough to address the potentially
heightened risks faced by children—so as to prevent
environmental health threats wherever possible—and
that the most significant current standards be re-evalu-
ated as we learn more. It is essential that our national
pollution control standards protect our nation's most
valuable future resources, placing children at the center of
our protection efforts, and that these standards be
grounded in the best scientific information available. The
Clinton Administration will move aggressively to adopt
this policy. In addition, EPA will select—with public
input and scientific peer review—five of its most signifi-
cant public health and environmental standards to re-
issue on an expedited basis under this new policy.
2. Identify and expand scientific research opportunities
on child-specific susceptibility and exposure to environ-
mental pollutants so that the best information can be
employed in developing protections for children. The
Clinton Administration has worked conscientiously to
ensure sound scientific underpinnings for its policy
initiatives on protection children. It is critical that the best
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science be applied to EPA's efforts to address these
problems: that the research be of the absolute highest
integrity and caliber; that it be on the cutting-edge in
sophistication, allowing for consideration of the special
mechanisms that affect children, and not just whether an
effect to the general population occurs; and that it focus
on the issues of greatest risk and concern. Because growth
and development are the primary tasks of childhood,
EPA's research agenda will increasingly focus on the
effects on growth and development, including intellectual
and physical development. EPA will also have a special
focus on windows for particularly damaging exposure
from environmental insults in utero and in developing
infants and children.
The Administration will continue to prioritize its
research to have a special focus on issues affecting
children's health. From work on microbial drinking-water
contaminants, to supporting research on urban air issues,
to considering reproductive and developmental effects of
endocrine disrupters, EPA's research priorities are an
important part of its efforts to better protect children.
EPA will also coordinate these efforts with the re-
sources of other federal science agencies and work to
foster academic and private sector research in these areas.
To this end, EPA will challenge Congress to work with it
to establish and fund two National Centers of Excellence
on Children's Environmental Health at established
medical institutions to provide a critical concentration of
these efforts.
3. Develop new policies to address cumulative and
simultaneous exposures faced by children—analogous
to the goal of EPA's Common Sense Initiative—not just
the chemical-by-chemical approach of the past. Among
the areas of greatest scientific and regulatory need is the
ability to discern real world circumstances—including the
fact that children are exposed to many chemicals all at
once and through multiple routes. Just as EPA has worked
to integrate its authorities and approaches to particular
industrial sectors through the Common Sense Initiative, so
too must it address children's health issues through a
similar effort that deals with the complexities of our
modern industrial world in a realistic fashion and places
children at the center of those considerations.
4. The dramatic results of the current Community Right-
to-Know law—yielding substantial decreases in the
emissions of toxic pollutants and empowering commu-
nities to be effective partners in working with industry
to protect their communities' health and safety—should
be built upon. The Clinton Administration is already
working with Congress to guarantee the public's right to
know about contaminants in drinking water. In addition,
the Administration will continue its work to expand the
categories of industrial facilities that report this informa-
tion and the types of information—including data on
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chemical inputs and uses— that industry makes publicly
available.
To enhance the usefulness of this information, it
should be available for families to make informed choices
about the products they use in their homes. The Clinton
Administration will work with parents, scientists, the
business community and the Congress to provide better
information for families, so that they will have the tools to
protect themselves. This proposal—the Family Right to
Know Initiative—should provide common sense and
cost-effective ways to meet the following principles:
• assist parents in assessing and avoiding unique environ-
mental health risks to children from, products and chemi-
cals designed for child or home use;
• provide information on the whole range of environmen-
tal health risk from toxics, including cancer, developmen-
tal, endocrine and reproductive risks; and
• allow for informed consumer choices by providing
improved information.
This initiative can be a major step forward in further
protecting our children from environmental health risks.
An informed family is best able to protect its child's health
and future.
5. Call on American parents, teachers and community
leaders to take personal responsibility for learning
about the hazards that environmental problems pose to
our children—and provide them with the information
they need to help protect children from those risks at
home, at school and at play. The Clinton Administration
believes that an informed, involved local community will
always do a better job of making environmental decisions
than a distant bureaucracy—and never more so than
when it comes to our children. Parents, teachers and
community leaders can and should play a vital, day-to-
day role in learning about the particular environmental
hazards their children face in their own communities, and
then use that knowledge to make more informed decisions
that protect children and prevent environmental health
problems.
Through its community right-to-know efforts, environ-
mental education programs, and efforts to improve public
access to information about environmental health hazards
in the home, school and community, the Clinton Adminis-
tration has greatly expanded the availability of informa-
tion that parents, teachers and community leaders can
use—in simple, everyday ways—to protect children's
environmental health. This Agenda aims to take the next
step: to make every effort to ensure that parents, teachers
and community leaders take responsibility for learning
about these risks, and to ensure that they have the infor-
mation they need to take actions to protect children.
For example, through information already widely
available from EPA, parents, teachers and community
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leaders can: learn about the amount and type of releases
of toxic chemicals in their zip code area, and work with
manufacturing facilities to reduce the amount of local
pollution; improve indoor-air quality and reduce pesti-
cides risks in school buildings, where children spend most
of their days; purchase less toxic pesticides for use in the
yard and garden, and use techniques to reduce the use of
those products; learn about and test for radon and lead
paint hazards before buying or renting an older home;
learn about the availability of blood tests to measure lead ,
levels for children at risk; find out about fish advisories
issued in their community to avoid eating contaminated
fish; and much more.
To advance personal responsibility and understanding
of this important issue, EPA will expand its efforts to
reach parents, teachers and community leaders so that
they are aware of the need to know—and their right to
know—more about the environmental health hazards our
children face. The Clinton Administration also will
expand its efforts to ensure that more information is made
available through toll-free numbers, Internet access,
environmental education programs and other means so
that adults can make careful and informed decisions that
will protect our children in every local setting, from the
backyard to the schoolroom to the dinner table.
6. Expand educational efforts in partnership with health
and environmental professionals to identify, prevent,
and reduce environmental health threats. As recognized
by the Institute of Medicine and leading groups such as
the Children's Environmental Health Network and the
National Environmental Education and Training Founda-
tion, there is a pressing need to build routine awareness of
environmental health threats into the training and medical
practice of pediatric health professionals. EPA will work
to expand its partnerships with these and other profes-
sional groups and other government agencies, particularly
the CDC, to provide a continuing forum for exchange on
these issues and to encourage development of appropriate
curriculum and training materials essential for effective
prevention of children's environmental health threats.
7. Commit to provide the necessary funding to address
children's environmental health issues as a top priority
among relative health risks, as started in the President's
FY '97 Budget. The purest of intentions—or the most
cynical of commitments based solely on appearances—are
equally meaningless without the commitment of the
resources that will be necessary to accomplish this ambi-
tious Agenda. The Clinton Administration challenges
Congress to meet this need by providing sufficient fund-
ing to EPA to carry out this Agenda. Our nation's com-
mitment to this challenge can be measured only by the
dedication of critical resources to achieve the goals
outlined in EPA's Agenda. As demonstrated by the
President's FY97 Budget, substantial resources dedicated
to these efforts are critical. EPA's future budget submis-
sions will contain specific line items for many of the
elements of this Agenda.
EPA's National Agenda to Protect Children's Health
from Environmental Threats will ensure that children
receive the protection they need and deserve, and help
our nation fulfill its obligation to protect future genera-
tions.
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