EPA Celebrates Children's Health Month
Protect Children Where
They Live and Learn
This is the theme for EPA's
fourth annual celebration
of Children's Health Month.
Protecting the health of children from
environmental risks is fundamental
to the mission of the United States
Environmental Protection Agency
(EPA). Children may be at greater risk
from harmful environmental pollutants
than adults. Consider that:
• Children's neurological, immuno-
logical, digestive and other bodily
systems are still developing;
• Children eat more food, drink
more fluids, and breathe more
air than adults in proportion
to their body mass; and
• Children's behavior patterns
— such as crawling and placing
objects in their mouths — may
result in greater exposure to
environmental contaminants.
Because of these characteristics,
children may not be sufficiently pro-
tected by regulatory standards that
are based on risks to adults. EPA has
forged more partnerships and taken
increasingly more steps to protect
children's environmental health from
the variety of contaminants and pol-
lutants that may affect them in the air
they breathe, the water they drink, the
food they eat, their homes, schools,
and playgrounds. Often, we direct our
effort to specific pollutants that have
been found to cause undue harm to
children, such as ultraviolet radiation,
mercury, lead, diesel fuel, asbestos,
and secondhand smoke. We also
target the places where children live,
learn, and play, in an effort to ensure
prevention of exposure. Here are
some highlights of recent work.
Helping Children
Breathe Easier
Both indoor and outdoor air
pollution can adversely affect
children's health. An estimated
6.3 million children under 18 years of
age had asthma in 2001. In 1994-96,
children with asthma missed approxi-
mately 14 million school days per year.
Visit www.epa.gov/asthma.
• Air Quality: This year, EPA identi-
fied new geographic areas that will
Discover ihe Rewards!
be required to reduce emissions
of air pollution to meet the new air
quality standards for ozone and
fine particles. When met, these
standards will prevent millions of
missed school days and millions
of respiratory symptom days each
year in children across the nation.
• States Asthma Project:
EPA provided support to the
Environmental Council of the States
(EGOS) and Association of State and
Territorial Health Officials (ASTHO) to
develop a national agenda to reduce
environmental triggers of child-
hood asthma. This project brought
many state environment and health
agencies together for the first time.
EPA will award eight more state
grants to supplement the five pilots
in California, Wisconsin, Wyoming,
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United States
Environmental Protection
Agency
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Idaho and Oregon. The report is
available at www.astho.org/pubs/
CatchingYourBreathReport.pdf.
Reducing Diesel Emissions:
The Clean Air Nonroad Diesel Rule
will cut emission levels from con-
struction, agricultural, and industrial
diesel-powered equipment by more
than 90 percent and will remove
99 percent of the sulfur in diesel
fuel by 2010, resulting in dramatic
reductions in soot from all diesel
engines. EPA predicts that when
the full inventory of older non-
road engines has been replaced,
the nonroad diesel program will
annually prevent up to 12,000
premature deaths, one million lost
work days, 15,000 heart attacks,
and 6,000 children's asthma-
related emergency room visits.
Clean School Bus USA:
Across the country, 24 million chil-
dren ride school buses to and from
school every day. School buses
provide our nation's children with
safe and convenient transporta-
tion, but the diesel exhaust from
school buses poses a health risk,
particularly to children. Clean School
Bus USA is an initiative sponsored
by the EPA to help communities
reduce pollution from school buses
by reducing idling time, retrofitting
current fleets with new technologies
and cleaner fuels, and replacing the
oldest buses with new buses that
meet more stringent pollution con-
trol strategies. In 2004, five million
dollars in grants will support school
bus retrofits, replacements, and use
of clean fuel in 20 projects that will
affect 5,000 buses nationwide. Visit
www.epa.gov/otaq/schoolbus.
• Hispanic Outreach:
Approximately two million Hispanics
living in the U.S. have asthma. EPA
released a new educational video,
Controlando los Factores delAsma,
to help families in the Hispanic
community more effectively man-
age asthma. The video provides
information on how to reduce
exposure to indoor and outdoor
asthma triggers. To receive a free
video, call 1-800-438-4318.
• Awards Program for
Health Plans and Health
Care Providers: EPA, in part
nership with America's Health
Insurance Plans (AHIP), launched
a national awards program that
will recognize outstanding leader-
ship by health plans and health
care providers who offer com-
prehensive asthma management
services that address environ-
mental risk factors. AHIP mem-
bers provide health coverage for
nearly 175 million Americans.
Protecting Children
from Exposure to
Secondhand Smoke
Millions of young children
continue to be regu-
larly exposed to second-
hand smoke in homes and cars.
Secondhand smoke can cause serious
health consequences, including respi-
ratory illness, ear infections, and more
frequent and severe asthma attacks.
More information on smoke-free home
activities can be found at www.epa.
gov/smokefree.
• Reaching Vulnerable
Communities: A national part-
nership has been created with the
Department of Health and Human
Services Head Start Bureau to
inform parents about the harmful
effects of secondhand smoke. The
goal of the partnership is to reduce
and eliminate children's exposure to
secondhand smoke in homes and
cars. Also initiated this year is the
project "Not in Mama's House," an
expansion of a successful California
program designed to reduce sec-
ondhand smoke exposure in the
homes of African-American families.
Protecting Children
from Too rluch Sun
Children need to be physically
active, but also must protect
themselves from overexposure
to the sun. Sun overexposure can
cause serious health effects, including
skin cancer, eye damage and cata-
racts, and immune system suppres-
sion. Skin cancer is the most common
type of cancer in the United States.
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• SunWise: The SunWise School
Program is an environmental and
health education program that aims
to teach children and their caregiv-
ers how to protect themselves from
sun overexposure. Currently over
10,500 schools (up from 7,800
in 2003) in all 50 states, Puerto
Rico, and Washington D.C. are
registered in the SunWise School
Program, which started in 2000.
Visit www.epa.gov/sunwise.
Protecting the Water
Where Children Play
ood water quality is essential to
the health of children, who are
vulnerable to pathogens, bacte-
ria, and nitrates in water. There are many
sources of contaminants, including agri-
cultural runoff, faulty septic systems, and
storm sewers. Visit www.epa.gov/ow.
• Beach Watch: This program
improves public access to informa-
tion about the quality of the water
at beaches and the health risks
associated with swimming in pol-
luted water. EPA's Web site now
includes an online directory of
information about the water quality
at our nation's beaches. Visit www.
epa.gov/waterscience/beaches.
Clean Waters for Children's
Recreation: EPA, through
its National Pollutant Discharge
Elimination System permitting
program for wet weather sources
of pollution, is working to provide
cleaner waters for improved rec-
reational opportunities. These wet
weather pollution sources create
significant amounts of contaminants
that can cause illnesses in people
who are exposed to them. The
risk of illness is greatly increased
for young children. Through its
permitting program, EPA is requir-
ing that these sources of pollu-
tion build controls that will greatly
reduce the potential for exposure.
Protecting
from Leac
Children
Poisoning
Childhood lead toxicity has been
recognized for at least 100
years. Lead poisoning in chil-
dren may cause lowered intelligence,
impaired language and hearing, hyper-
activity, behavioral, and other adverse
health outcomes. Approximately
434,000 children in the United States
have elevated blood lead levels. EPA
celebrates Lead Poisoning Prevention
Week from October 24-30, 2004. Visit
www.epa.gov/lead.
• Educational Campaigns:
EPA launched a nationwide cam-
paign with the National Head
Start Association to educate
parents, teachers, and children
about the dangers of lead poi-
soning. EPA developed a pam-
phlet and several fact sheets on
lead poisoning prevention to be
distributed to Head Start cen-
ters across the United States.
Tribal Outreach: The Tribal
Based Environmental Protection
Consortium in New England devel-
oped an educational activity book,
"Mother Bear," to teach children
about lead poisoning prevention.
The stories follow seasonal Native
American themes while teach-
ing children about lead hazards
and lead safety. The book and
accompanying teaching curriculum
were distributed to tribal schools
throughout the United States.
Hispanic Outreach: EPA and
ethnic cultural centers, health clin-
ics, and YMCA/YWCA centers in the
greater Los Angeles area, Southern
California, and Southern Arizona are
providing childhood lead poison-
ing prevention materials to Hispanic
children, who represent 85 percent
of the reported cases of lead poison-
ing in Los Angeles County during the
past decade. The Spanish edition
of the EPA booklet, "Protect Your
Family From Lead in Your Home,"
is an important tool for reaching
Hispanic families. This booklet is
also available in English, Vietnamese,
Chinese, Russian, and Arabic.
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Protecting Children
from Mercury
For fetuses, infants, and children,
the primary health effects of
methylmercury are on neuro-
logical development. Even low levels of
mercury exposure, which can result from
a mother's consumption of fish contain-
ing methylmercury, can adversely affect
the brain and nervous system. Impacts
on memory, attention, language, and
other skills have been found in children
exposed to moderate levels in the
womb. These changes produce learning
disabilities in the child. Visit www.epa.
gov/mercury.
• Fish Advisory: EPA and the
Food and Drug Administration
issued a joint consumer advisory on
methylmercury in fish and shellfish.
The advisory is for infants, children,
nursing mothers, pregnant women,
and women that may become
pregnant. It highlights the nutritional
value of eating fish and shell fish
and advises the previous groups of
people to avoid or limit eating some
types of fish. Visit www.epa.gov/
waterscience/fishadvice/advice.html.
Elemental mercury can be
found in fever thermometers
and other common household
products. When these products are
broken, toxic mercury vapors can be
released into the air. If these products
are discarded improperly in the trash
or down the drain, the mercury can
contribute to the build up of mercury
in fish.
• Education Campaign: Giant
Foods is conducting a year-long
campaign to educate consum-
ers about children's environmental
health. One effort focused on the
hazards of mercury in common
household products. Giant offered
discounts for the purchase of
digital (and therefore mercury-free)
thermometers, created education
materials for children, displayed
information for adults, and partici-
pated in a national radio show to
highlight mercury exposure issues.
Keeping Pesticides Away
from Children
Children can be exposed to
pesticides in their diets, their
drinking water, or through
activities at home and school. Too
much exposure to some pesticides
and other chemicals may lead to a
variety of adverse health effects, such
as acute poisoning, disruption of the
hormone and immune systems, respi-
ratory problems, neurological damage,
and cancer.
• Pesticide Registrations: EPA
is continuing to phase out the use
of pesticides that do not meet the
current strict safety standard that
emphasizes potential health effects
to children. For example, the treat-
ment of wood with chromated cop-
per arsenate for residential uses
ended in December 2003, and the
sale of diazinon, a popular pesticide
for outdoor residential use, will end
by December 2004. In addition, EPA
uses education and enforcement
actions to reduce availability and
use of illegal, unregistered pesticides
such as candy-colored mothballs
and unregistered insecticidal chalk.
• Hispanic Outreach: Through
collaboration with the Hispanic
Radio Network, public service
announcements were aired on
more than 190 radio station affili-
ates, covering 90 percent of the
Hispanic population and reaching
more than four million radio listen-
ers throughout the U.S. mainland
and Puerto Rico. This campaign
focused on protecting children
from exposure to pesticides and
other potentially harmful household
chemicals, emphasized the link
between cockroaches and asthma,
and provided tips for preventing
pest infestations in the home.
• Educating Kids: The new
activity book, Join Our Pest Patrol,
filled with word games, puzzles and
hands-on projects for kids, was
released in January of 2004. The
booklet helps kids understand the
effect that personal choices regard-
ing pesticide use can have on the
environment. It is available at www.
epa.gov/oppfead1/cb/csb_page/
publications/perstpatrol.pdf.
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Making Schools Healthier
More than 53 million children
and almost 3 million adults
spend a significant portion
of their days in approximately 112,000
public and private school buildings,
many of which are old and inad-
equately maintained, often containing
environmental conditions that inhibit
learning and pose increased risks to
the health of children and staff.
• Assessing Risks: EPA is devel
oping a software tool to help school
districts identify and prioritize the
environmental risks in their schools.
School districts may volunteer to
participate in the initial pilot effort
this spring. For more informa-
tion, visit www.epa.gov/schools.
• Lab Cleanout Program:
Existing stocks of outdated,
unknown, excessive, or unnecessar-
ily hazardous chemicals are present
in many schools. These chemicals
can pose safety and health risks to
students and staff; and a number
of widely reported incidents involv-
ing such chemicals have resulted
in school closures and costly
clean-ups. The Schools Chemical
Clean Out Campaign promotes
removal of existing stocks of hazard-
ous chemicals from schools; safe
chemical management; and national
awareness. Visit www.epa.gov/osw/
conserve/clusters/schools.htm.
• Asbestos in Schools:
Asbestos is a naturally-occur-
ring mineral fiber once used to
strengthen and provide heat insula-
tion and fire resistance in building
products. It is also a known human
carcinogen that can cause serious
lung diseases. The updated ver-
sion of The ABC's of Asbestos in
Schools is available by calling (202)
554-1404 or through this Web site:
www.epa.gov/asbestos/asbestos_
in_schools.html. A Spanish transla-
tion of The ABC's of Asbestos in
Schools will be available soon.
• Pest Management in
Schools: EPA encourages school
officials to adopt Integrated Pest
Management (IPM) practices to
reduce unnecessary pesticide use
and exposure. EPA's brochure,
Protecting Children in Schools from
Pests and Pesticides, is available
by phone at 1-800-490-9198. For
information on starting a program,
visit www.epa.gov/pesticides/ipm.
Smart Growth and
Children's Environmental
Health
Alternative approaches to
development can provide
clear health benefits to chil-
dren, including improved air and water
quality, re-use of brownfields sites and
preservation of open space. Visit www.
epa.gov/smartgrowth to learn more.
• Creating Smart Growth
Schools: EPA worked with
the National Trust for Historic
Preservation and Smart Growth
America to develop outreach
material demonstrating the oppor-
tunity for environmentally-respon-
sible school siting. The project
included the publication entitled
"Build Smart" in the October 2003
American School Board Journal
that focuses on building small,
community-based schools.
• School Siting: The study, Travel
and Environmental Implications
of School Siting, examines the
relationship between school loca-
tions, the built environment around
schools, how kids get to school,
and the impact on air emissions
of those travel choices. It shows
that school siting and design can
affect walking, biking, or driv-
ing choices. Visit www.epa.gov/
smartgrowth/school_travel.htm.
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Increasing Knowledge to
Better Protect Children
EPA recognizes that soci-
ety does not yet have all
the answers to questions
about the role of environment in
children's health. We are working
to increase that understanding.
• Handbook for Pediatric
Health Professionals: EPA
supported the publication and dis-
tribution of the American Academy
of Pediatrics (AAP) Handbook of
Pediatric Environmental Health, 2nd
edition. The Handbook addresses
numerous environmental health
concerns and can be ordered by
calling AAP at (866) 843-2271.
• National Academy of
Sciences (MAS) Evaluation:
An internal review of EPA's prac-
tices for assessing chemical toxic-
ity concluded that existing testing
guidelines result in numerous gaps,
especially with respect to under-
standing mechanisms of toxicity and
possible early life-stage sensitivity.
EPA has asked the MAS to assess
current approaches to toxicity test-
ing to meet regulatory data needs.
Polybrominated diphenyl
ethers (PBDE's): The Agency
is developing an action plan for
PBDE's, a class of chemicals used
as flame-retardants. PBDE's have
been in the news because higher
than expected levels have been
observed in human breast milk and
environmental samples, and there is
increasing evidence of developmen-
tal neurotoxicity. The current work is
a follow-up to the recent voluntary
phase-out of penta-BDE and octa-
BDE by the only US manufacturer.
Research Centers: EPA
and the National Institute of
Environmental Health Sciences
(NIEHS) sponsor Centers
of Excellence for Children's
Environmental Health and Disease
Prevention Research. These centers
conduct new research on the role
of environmental exposures in the
health of children and promote the
translation of basic research findings
into a heightened awareness among
children, their families, and health
care practitioners regarding
detection, treatment, and prevention
of environmentally-related
disease and illness.
National Children's Study:
This study is being planned to
examine the effects of environ-
mental influences on the health
and development of more than
100,000 children across the United
States. The study is authorized by
the Children's Health Act of 2000
and will drive our actions to protect
children for decades to come.
• Pediatric Environmental
Health Specialty Units
(PEHSUs): EPA and the Agency
for Toxic Substances and Disease
Registry of the Department of Health
and Human Services established
the PEHSUs program as a national
resource for pediatricians, other
health care providers and the public
because most health care provid-
ers are not prepared to answer
questions about the effects of the
environment on children's health.
Health care providers need a way
to learn about health problems
related to the environment in order
to meet the needs of the public.
PEHSUs aim to: reduce environ-
mental health threats to children;
improve access to expertise in
pediatric environmental medicine;
and strengthen public health pre-
vention capacity. Visit www.atsdr.
cdc.gov/child/ochchildhlth.html
or www.aoec.org/pesu.htm.
Protecting Children
Beyond Our Borders
Children's environmental health
issues span the globe and cross
political boundaries. EPA works
with developing and developed coun-
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tries, international organizations and non-
governmental organizations to highlight
issues and build political will to address
these issues. International cooperation
and collaboration on children's environ-
mental health continues to build.
• Global Children's
Environmental Health
Indicators: Protecting children
from exposure to environmental
hazards requires that we better
understand the relationship between
environmental conditions and health
outcomes. Several recent interna-
tional agreements have highlighted
the need for assessing the state of
children's environmental health and
monitoring progress and have called
for action to develop children's
environmental health indicators.
With EPA support, the World Health
Organization (WHO) is leading the
effort to develop global indica-
tors. For more information, see
www.who.int/ceh/indicators/en.
• Children's Exposure to
Indoor Cooking Smoke: Two
billion people, almost half of the
world's population, still burn tradi-
tional fuels such as firewood, coal,
crop residues, and dung indoors for
cooking and heating, filling homes
with particulate matter and smoke.
The World Health Organization esti-
mates that 1.6 million people, mainly
women and children, die each year
from breathing the dense smoke
from traditional cooking and heat-
ing fires. In an effort to save lives,
over 65 public and private organiza-
tions have joined the Partnership
for Clean Indoor Air, led by EPA and
launched in South Africa in 2002.
The Partnership's mission is to
reduce exposure to indoor air pollu-
tion from household energy use for
five million people by 2010. To learn
more, visitwww.PCIAonline.org.
• Partnership for Clean Fuels
and Vehicles: Motor vehicles
account for a significant por-
tion of urban air pollution around
the world. EPA is a key partner
in the Partnership for Clean Fuels
and Vehicles, established at the
World Summit on Sustainable
Development in Johannesburg,
South Africa in 2002. The partner-
ship's goals are to eliminate lead in
gasoline and reduce sulfur in diesel
and gasoline fuels while concurrently
adopting cleaner vehicle technolo-
gies. For more information on the
Partnership for Clean Fuels and
Vehicles, visit www.unep.org/PCFV
• Atlas of Children's
Environmental Health: To
illustrate the impact of the environ-
ment on children's health, EPA
funded an effort by the World Health
Organization (WHO) to launch
a first-ever "Atlas of Children's
Environmental Health and the
Environment." Presented at the
Fourth European Conference of
Health and Environment Ministers
in Budapest, Hungary, this book
brings together a range of facts
about the effects of environmental
risks to our children's health, and
paints a graphic picture of the haz-
ards we all face and the reasons for
over three million annual deaths in
children under age five worldwide.
Visit the atlas at www.who.int/ceh/
publications/atlas/en/index.html.
• Materials for Health Care
Providers: EPA supports the
World Health Organization to
develop a handbook for physicians
in developing countries, modeled
after the American Academy of
Pediatrics "Handbook of Pediatric
Environmental Health" but adapted
and expanded to address issues in
developing countries. In addition,
pamphlets are being created to
address water and sanitation, lead,
vector-borne diseases, chemical
exposures, air pollution and respira-
tory diseases. Trainings for health
care providers have been organized
in India, Thailand, Argentina, and
Uruguay. EPA is supporting the
International Pediatric Association
pre-congress workshop to train
up to 100 pediatricians from
developing countries on children's
environmental health issues.
Global Mercury
Assessment: Because mer-
cury can be transported globally
and deposited far from its origin,
it is a concern for all countries.
EPA is actively engaged in bilat-
eral, regional and global efforts
to better characterize and reduce
the adverse impacts of mercury.
EPA and the Department of State
are providing technical and finan-
cial support to the global mer-
cury program under the United
Nations Environment Program. Visit
www.chem.unep.ch/mercury.
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Children, by their very nature, deserve
our assiduous attention. Their bodies
are different than aduits, their behaviors
are different, and their interactions with
the environment are different. Protecting
the heaith of children is a compelling
inducement to improving our environment,
both during Children's Health Month and
throughout the year, both in the United
States and throughout the world.
visit EPA's Office of Children's Health
For more information, VISIT O-MO ^,,._,
Protection Web site: www.epa.gov/children.
&EPA
United States
Environmental Protection
Agency
Office of Children's Health Protection
EPA100-F-04-017
September 2004
Q$ Recycled/Recyclable Printed with Vegetable
Oil-Based Inks on Recycled Paper (Minimum
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