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,
                                                                    &EPA
                                                                          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
                                           50% Postconsumer) Process Chlorine Free

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