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PROTECTING
CHILDREN'S HEALTH
OCTOBER 201 8
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PROTECTING CHILDREN'S HEALTH
One of the most important things we can do to protect our children's future is make sure they grow up in a
healthy environment. Children are uniquely vulnerable to the potential health effects of environmental hazards
found in their everyday environment. For example:
Children crawl and play close to the ground making them more likely to be exposed to dirt and dust.
Children explore their environment through mouthing making them more likely to be exposed to dirt and
dust on their hands, toys, and other household objects.
Children's respiratory systems are still developing and they spend more time outdoors where they can
be exposed to air pollution.
In relation to their weight children, also eat and drink more than adults, putting them at greater when
exposed to contaminated water or food.
They are more likely than adults to have asthma, which puts them at greater risk from air pollutants that
exacerbate asthma.
EXECUTIVE ORDER ON THE PROTECTION OF CHILDREN FROM ENVIRONMENTAL HEALTH RISKS
AND SAFETY RISKS
On April 21, 1997, the president signed the Executive Order on the Protection of Children from Environmental
Health Risks and Safety Risks. This Executive Order requires ail federal agencies to assign a high priority to
addressing health and safety risks to children, coordinate research priorities on children's health, and ensure
that their standards take into account special risks to children. The Executive Order created a President's Task
Force on Environmental Health Risks and Safety Risks to Children (Task Force) to implement the Executive
Order.
PROTECTING CHILDREN'S HEALTH , OCTOBER 2018
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The Task Force is co-chaired by the U.S. Environmental Protection Agency (EPA) and the Department of
Health and Human Services (HHS) and its current priorities to improve children's environmental health are
focused on lead exposures, healthy settings, asthma disparities, and chemical exposures.
EPA'S COMMITMENT TO CHILDREN'S HEALTH
EPA is committed to protecting children where they live, learn, and play. To that end, EPA has many
initiatives currently underway in partnership with federal agencies, states, tribes, local governments, schools,
community groups, medical providers, and other stakeholders. The agency understands that to be protective
of children's health, as highlighted by the President's Task Force, it is essential that childhood lead exposures
be reduced, children's environments be safe from environmental hazards, the risk from asthma triggers be
actively reduced and harmful chemical exposures be minimized.
Through its regional programs, EPA provides grant funding to a wide range of initiatives from educating
childcare professionals about providing healthy settings for children, researching effects of pregnancy
exposure to environmental chemicals, deploying mobile asthma clinics, managing lead-based paint
accreditation and certification programs, removing asbestos and lead-based paint, funding enforcement of
lead-based paint regulations, and removing lead service lines.
The following are a few highlights of EPA's initiatives. Additional information on EPA's efforts to protect
children's health is found at: https://www.epa.gov/children.
REDUCE LEAD EXPOSURES
The Center for Disease Control has stated that no safe blood lead level in children has been identified. EPA is
committed to reducing lead exposures from multiple sources including: paint, water, soil contamination, and
ambient air. Key agency initiatives underway include:
FEDERAL LEAD STRATEGY
EPA, along with the partner agencies of the President's Task Force, is developing the forthcoming Federal
Strategy to Reduce Childhood Lead Exposures and Associated Health Impacts. The Federal Strategy is
designed to improve the effectiveness and efficiency of the federal government in reducing children's lead
exposures and lead-related health risks.
PROVIDING FOR REDUCING LEAD IN DRINKING WATER
EPA received more than $9.1 billion in collective loan requests for 2018 Water Infrastructure Finance and
Innovation Act Program funding. More information is available at: https://www.epa.gov/wifia.
EPA received $30 million for grant funding under the Water Infrastructure Improvements for the Nation
Act (WIIN Act), which addresses, supports and improves America's drinking water:
$10 million dollars for a new grant program for lead reduction projects including lead service line
replacement at water systems and homes.
$20 million dollars for states and tribes to test drinking water for lead contamination in schools
and child care programs that request it.
More information is available at: https://www.epa.gov/safewater/grants.
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PROTECTING CHILDREN'S HEALTH OCTOBER 2018
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EPA revised its 3Ts for Reducing Lead in
Drinking Water in Schools and Child Care
Facilities, which includes guidance on:
Training school and child care officials
to raise awareness of 3Ts program and
summarize the potential causes and
health effects of lead in drinking water.
Testing drinking water in schools
and child care to identify potential lead
problems.
Taking action to reduce lead in drinking
water and communicate to parents, staff,
and the larger school community.
More information is available at:
https://www.epa.gov/safewater/3Ts.
EPA is working to revise regulations for the use of lead-free infrastructure to codify the new and
more stringent definition of lead-free and to clarify how manufacturers can meet these new lead-free
standards.
EPA issued a proposed rule in 2017. EPA is working to address comments and finalize the rule in
2019.
EPA is also working on revisions to update the Lead and Copper Rule.
EPA is evaluating input recently received from state, local and tribal partners as well as the best
available peer reviewed science to ensure the rule reflects the best ways to improve public health
protection.
EPA anticipates releasing the proposal in 2
REDUCING EXPOSURES ASSOCIATED WITH LEAD
Strengthening the standards for lead in dust is an
important component of EPA's strategy to curtail
childhood lead exposure.
Title IV of the Toxic Substances Control Act
(TSCA) requires EPA to establish hazard
standards for lead-contaminated dust. Lead
dust can be a major source of lead exposure in
children. Lead dust can be generated when lead-
based paint deteriorates or is disturbed (e.g.,
during renovation or repainting work).
In June 2018 EPA proposed to change the
dust-lead hazard standards from 40 |jg/ft2 and
250 |jg/ft2 to 10 |_ig/ft2 and 100 |jg/ft2 on floors
and window sills, respectively. These standards
apply to most pre-1978 housing and child-
occupied facilities, such as day care centers and
kindergarten facilities. EPA also continues to work toward ensuring that individuals and firms conducting
lead-based paint abatement, risk assessment or inspection are properly trained and certified.
More information is available at: https://www.epa.gov/lead.
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PROTECTING CHILDREN'S HEALTH , OCTOBER 2018
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EPA chairs the Global Alliance to Eliminate Lead Paint, a voluntary partnership of governments, industry,
and NGO's to eliminate lead paint around the world. EPA is working closely with the United Nations
Environment Programme and the World Health Organization, as well as the International Paint and
Printing Ink Council, the International POPs Elimination Network, the American Bar Association, and
other stakeholders to help countries develop laws to address lead paint. This fall, EPA is partnering on
an international project which aims to establish lead paint laws in 40 countries.
The sixth annual International Lead Poisoning Prevention Week of Action takes place from October
21-27, 2018. The Week of Action provides an opportunity for organizations and institutions around the
world to focus attention on lead, http://www.who.int/ipcs/lead campaian/en/
REDUCING EXPOSURES TO LEAD IN SOIL
Lead can be a relatively common soil contaminant because of past and current human activity or uses
(i.e., mining, lead smelter). Children who live near or play on lead-contaminated soil can be exposed
through incidental ingestion of small amounts of soil or soil-derived indoor dust. Contaminated soil can
also be tracked into the home. Young children often have higher rates of soil and dust ingestion because
of their unique behaviors such as crawling and hand/object-to-mouth contact.
EPA actions to reduce childhood exposure from lead in soil include: managing lead contamination
at Superfund, Resource Conservation and Recovery Act Corrective Action, and other sites through
removal, remedial and corrective actions; updating the Superfund Lead-Contaminated Residential Sites
Handbook; and offering technical assistance to brownfield communities to identify best management
practices, and potential funding opportunities.
More information is available at: https://www.epa.aov/superfund/lead-superfund-sites.
REDUCING EXPOSURES TO LEAD IN THE AMBIENT AIR
EPA actions to reduce childhood exposure from lead in ambient air include: working with state and
tribal air agencies to implement the National Ambient Air Quality Standard (NAAQS) for lead; evaluating
the impacts of lead emissions from aircraft using leaded aviation fuel under the Clean Air Act; and
conducting a research and development program to identify unleaded aviation fuels through the Piston
Aviation Fuel Initiative (a partnership with the Federal Aviation Administration).
More information is available at: https://www.epa.aov/lead-air-pollution.
INCREASING THE IDENTIFICATION OF AND ENFORCEMENT OF SOURCES NOT IN COMPLIANCE
EPA provides grant funding to states and tribes to conduct audits of lead-based paint abatement
certification programs and lead-based paint abatement activities to ensure compliance.
EPA works to increase the public's awareness of the risks associated with childhood lead exposures
by continuing to identify high-risk neighborhoods and increase work-site inspections and associated
compliance assistance, as well as increase enforcement actions.
More information is available at: https://www.epa.aov/lead/complvina-lead-laws-and-reaulations.
PROTECTING CHILDREN'S HEALTH OCTOBER 2018
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PROMOTE HEALTHY ENVIRONMENTS
EPA is committed to ensuring that children's environments are safe from environmental hazards. Key
initiatives underway include:
ADDRESSING ASBESTOS EXPOSURES IN SCHOOLS
EPA's $4.8 million TSCA Compliance Categorical
Grants build environmental partnerships with states
and tribes to strengthen their ability to address
environmental and public health threats from toxic
substances like asbestos, lead-based paint and
PCBs.
During the past eighteen months, EPA worked
with the Inspector General's (IG) office on an audit
of the prioritization of the TSCA Asbestos Hazard
Emergency Response Act compliance monitoring
program also known as the Asbestos-Containing
Materials in Schools Rule. The IG's audit identified
areas where EPA will utilize continual improvement t
reevaluate its outreach and compliance assistance
materials. EPA is committed to using all the tools in its toolbox to steadfastly maintain an asbestos
compliance monitoring program with our partners.
More information is available at: https://www.epa.aov/asbestos/asbestos-and-school-buildinas.
ADDRESSING POLYCHLORINATED BIPHENYLS IN SCHOOLS
Polychlorinated biphenyls (PCBs) are a ciass of synthetic organic chemicals that were widely used in
building construction, including schools built between about 1950 and the late 1970s. The manufacture
and use of PCBs were banned by TSCA and phased out by 1979, except for certain limited uses. PCBs
are toxic and continue to be closely regulated.
EPA developed guidance and outreach materials to assess and reduce exposure to PCBs in schools to
support schools and regions in ongoing regulatory implementation and compliance.
Each of EPA's 10 regions has a designated PCB Coordinator to oversee the proper management of PCB
issues within each region. They coordinate with interested stakeholders to ensure that their region's
needs are addressed and that EPA's PCB regulations are followed.
More information is available at: https://www.epa.aov/pcbs/polvchlorinated-biphenvls-pcbs-buildina-
materials
https://www.epa.aov/schools-healthv-buiidinas/renovations-and-polvchiorinated-biphenvls-pcbshv-
school-environment
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PROTECTING CHILDREN'S HEALTH , OCTOBER 2018
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INDOOR AIR QUALITY PROGRAMS
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EPA, through its national and regional indoor air programs (IAQ),
provides training and technical assistance through a coordinated
set of guidance, tools and assets to equip states, tribes and
school districts with the resources to reduce the risks from radon,
asthma triggers, mold, improper ventilation, pest (integrated Pest
Management), PCBs, lead, indoor particulate matter, and other
indoor environmental health issues and in emergency response
and recovery situations, such as floods, hurricanes, and wildfires.
Specific guidance includes:
Indoor Air Quality Tools for Schools Action Kit
Indoor Air Quality Design for Schools
Energy Savings Plus Health Guidance for Schools
IAQ Tools for Schools Preventative Maintenance Tools
and Resources
IAQ Tools for Schools Connector Network
For more information visit: https://www.epa.gov/indoor-air-
qualitv-iaq.
The Indoor Air Quality Tools for Schools Action Kit is a comprehensive
collection of information necessary to develop, assess, improve and
implement an effective IAQ management plan at little or no cost using
straightforward activities and in-house staff. The Action Kit includes
information on best practices, industry guidelines, sample policies and
a sample IAQ management plan. https://https://www.epa.gov/iaq-
schools/indoor-air-qualitv-tools-schools-action-kit.
Air Quality Flag Program: More than 120 million people in the United
States live in communities with unhealthy levels of air pollution. Among
those most affected are children and teens, older adults, people with
heart or lung problems and people who are active outdoors. The Flag Program uses brightly colored
flags based on the EPA's Air Quality Indexthe AQI. Schools display the flags to inform students and
staff about daily air quality conditions and use the Flag Program as part of their science curriculum.
More information is available at: https://www.airnow.aov/air-qualitv-flaa-proaram.
EPA offers the School IAQ Assessment Mobile App to help schools maintain a healthy indoor
environment by identifying, correcting and preventing IAQ problems. The IAQ School Assessment
Mobile App provides schools access to EPA's comprehensive school IAQ management guidance and
detailed walkthrough assessment checklists that address critical building-related environmental health
issues. More information is available at: https://www.epa.qov/iao-schools/school-iao-assessment-
mobile-app.
EPA provides extensive technical assistance through web-based trainings to school districts to equip
them with the tools they need to create and maintain effective indoor air quality management programs.
The IAQ Master Class Professional Training series provides foundational knowledge on technical
topics including mold and moisture control, ventilation, cleaning and maintenance, asthma triggers and
preventive maintenance practices. More information is available at: https://www.epa.oov/iaq-schools/
ondemand-traininq-webinars. Additionally, the IAQ Knowledge-to-Action Professional Training Webinar
Series demonstrates how the knowledge gained in the IAQ Master Class Professional Training Webinar
Series can be translated into actionable steps to continue improving IAQ within your school district.
BY THE NUMBERS:
In 2018, EPA educated
more than 2,000 school
district representatives
on indoor air quality
best practices.
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PROTECTING CHILDREN'S HEALTH OCTOBER 2018
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REDUCING RADON RISK
Radon is a major public health risk. It's the second leading
cause of lung cancer and the leading environmental
cause of cancer mortality in the U.S. State and tribal
radon programs are critical to the Agency's national
goal of minimizing and preventing radon-related lung
cancer. States and tribes receive grant funds from EPA
that help finance their radon risk reduction programs.
Those receiving State Indoor Radon Grant funds must
align their projects and activities with the Agency's goals
which include building new schools with radon-reducing
features, where appropriate, and testing and fixing existing
schools when necessary. In Fiscal Year 2018, the State
Indoor Radon Grant total allocation was $7,867,000. More
information is available at: https://www.epa.gov/radon.
EPA has also developed and made available key guidance
on testing, mitigating, and building new schools to be
radon-resistant. We provide comprehensive guidance
documents and produce technical webinars and
conference sessions on practical radon management. To
find information about radon in schools, including the
publication, "Managing Radon in Schools" a document
that offers a practical framework and concrete steps for
managing radon from start to finish, visit https://www.epa.
gov/radon/radon-schools.
INTEGRATED PEST MANAGEMENT PROGRAMS
EPA's vision is that all of our nation's students
attend schools with verifiable and ongoing
Integrated Pest Management Programs
(IPM). Our mission is to build partnerships
and collaborations to promote and support
school IPM, demonstrate its value, and provide
information on the tools available to schools
interested in establishing new or improving
existing IPM programs. More information is
available at: https://www.epa.gov/manaaina-
pests-schools/epas-approach-intearated-pest-
manaaement-schools.
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REDUCE ASTHMA TRIGGERS
More than six million children in the United Statesan average of one out of every 12 school-aged children-
have asthma. Asthma is also a leading cause of school absenteeism.
Since asthma affects so many children, asthma management should be a priority for every school. Controlling
asthma as part of a comprehensive indoor air quality (IAQ) management program can lead to reduced
absenteeism and increased student performance for students and staff. Follow the tips below to reduce
asthma triggers and create a healthy indoor environment in
your school.
Asthma triggers that affect children in schools include:
Animal allergens
Cockroach and pest allergens
Mold and moisture
Dust mites
Outdoor air pollutants, like ozone and particle pollution
or school bus diesel exhaust
BY THE NUMBERS:
More than 1100 community-based
programs participate in EPA's Asthma
Community Network to share best
practices and successful approaches
to address asthma.
www.AsthmaCommunityNetwork.org
EPA's coordinated approach on asthma promotes
scientific understanding of environmental asthma
triggers and ways to manage asthma in community
settings through research, education and outreach.
With federal, state and local partners, we are building
the nation's capacity to control asthma and manage
exposure to indoor and outdoor pollutants linked to
asthma.
Advance public awareness and action and enable
community programs to deliver sustainable in-home
environmental interventions improving asthma control
and saving thousands of dollars in avoided health care
costs per child per year. With EPA's federal partners at
CDC and HUD, we are working to advance nationally
policy to support reimbursement of these in-home
interventions by health plans and Medicaid. More
information is available at https://www.epa.gov/asthma.
"WHEN I HAVE AN
ASTHMA ATTACK
I FEEL LIKE A FISH
WITH NO WATER."
-JESSE. AGE 5
PROTECTING CHILDREN'S HEALTH OCTOBER 2018
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SCHOOL BUS REBATE PROGRAM
School buses travel over four billion miles each year,
providing the safest transportation to and from school
for more than 25 million American children every day.
However, diesel exhaust from these buses has a negative
impact on human health, especially for children who have
a faster breathing rate than adults and whose lungs are
not yet fully developed. EPA designed this rebate program
to encourage school bus fleet turnover so more children
can ride buses with
BY THE NUMBERS:
In 2017, EPA awarded
$8.78 million toward replace-
ment or retrofit of 453 school
buses. Cleaner buses will
transport students at 143
school districts because of
this grant funding.
the cleanest emissions
standards or buses
that have been
retrofitted to reduce
emissions.
The 2018 School Bus Rebate Program will provide approximately $9.0
million to public and private fleet owners for the replacement or retrofit of
older school buses.
More information is available at: https://www.epa.gov/cleandiesel/clean-
school-bus.
EPA and ATSDR support this national network of academically-based experts who
provide medical information and advice on environmental conditions that impact
children's health. PEHSUs are active in all 10 EPA Regions and work with health care
professionals, parents, schools and community groups to raise awareness about
environmental health, provide guidance on reducing exposures in everyday settings
and provide practical advice to help children and families cope and recover during
and after floods, wildfires, chemical spills and other crises. More information is
available at: https://www.pehsu.net/About PEHSU.html
ADDRESS CHEMICAL EXPOSURES
PEDIATRIC ENVIRONMENTAL HEALTH SPECIALTY UNITS
Chemicals are used in schools for a range of activities including building
maintenance and classroom learning. High schools usually have larger
inventories and more hazardous chemicals than middle and elementary
schools, but hazardous chemicals can be found in all schools, especially
in science classes and labs (e.g., mercury), shop classes, and store rooms.
Thoughtful chemical purchasing, use and management is critical for
reducing chemical exposures and costly accidents, which ultimately affect
student learning and attendance. EPA offers comprehensive technical
resources for safe chemical management in K-12 schools, https://www.epa.aov/schools-chemicals/toolkit-
safe-chemical-manaaement-k-12-schools
EPA's emergency response team is available 24/7 to provide technical assistance to the local authorities
as well as lead investigations and response actions when necessary in schools in the event of chemical
emergencies such as mercury spills and school science lab incidents. More information is available at:
https://www.epa.gov/ert.
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CHILDREN'S HEALTH RESEARCH
CHILDREN'S ENVIRONMENTAL HEALTH AND DISEASE PREVENTION RESEARCH CENTERS
(CHILDREN'S CENTERS)
EPA and the National Institute of Environmental Health Sciences have partnered to investigate new frontiers
in the field of children's environmental health research by supporting Children's Environmental Health and
Disease Prevention Research Centers.
There are currently 5 active Centers of Excellence for Children's Environmental Health Research. All 5
centers are actively engaged in the outreach and research translation for improving the health and well-
being of children in various communities.
Impacts of this research are summarized in the Children's Environmental Health and Disease Prevention
Research Centers Impact Report: Advances in protecting children's health where they live, learn, and
play.
In-house research at EPA also addresses children's environmental health. Highlights of the Children's Centers
and EPA research portfolio include:
Asthma: Understanding and interventions for children and their families to better manage this chronic
disease. The Children's Centers research is now moving toward exploring the links between asthma
and other emerging factors, including obesity and immune function. In-house EPA research includes
the impacts of hurricanes on asthma health and mold contamination.
Birth Outcomes: The Children's
Centers have identified links
between environmental
pollutants and preterm birth
and lower birthweight and
engaged with communities to
address concerns about how the
environment may be impacting
pregnancy and how to prevent
exposures. In-house EPA
research is identifying alternative
testing strategies that are faster,
cheaper to evaluate impacts of
chemicals on the developing
child.
General Neurodevelopment:
Researchers have engaged with
parents, childcare providers,
and decision makers to help them identify ways to reduce exposures that can affect cognitive and
behavioral outcomes and improve children's neurodevelopment. Children's Centers findings have
helped develop public health policy and interventions aimed at protecting pregnant women and their
babies from toxic environmental exposures. In-house EPA research is developing rapid, economical
methods to screen chemical compounds for their potential to interfere with neural development. In
addition, important research related to environmental risk factors for childhood leukemia, autism and
spectrum disorder, obesity, and other important health concerns is on-going. More details can be
found at: https://www.epa.gov/research-arants/niehsepa-childrens-environmental-health-and-disease-
prevention-research-centers.
PROTECTING CHILDREN'S HEALTH OCTOBER 2018
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SCHOOL SITING GUIDELINES
BYTHE NUMBERS:
EPA and NIEHS have together
invested more than $300
million in 24 Children's Centers
to expand our knowledge on
the environmental exposures
and health outcomes.
EPA's voluntary school siting guidelines can help local school districts,
local education agencies (LEAs), and community members evaluate
environmental factors to make the best possible school siting
decisions. The guidelines should be used prior to: deciding whether
to renovate the existing school, or build a new school on the current
site or on a new site; acquiring land for school facilities; using legacy
property already owned by the LEA; leasing space; and/renovating or
reusing existing properties and structures already owned by the LEA.
More information is available at: https://www.epa.gov/schools/basic-
information-about-school-siting-guidelines.
CHILDREN'S HEALTH PROTECTION ADVISORY COMMITTEE
The Children's Health Protection Advisory Committee (CHPAC) is a body of external researchers,
academicians, health care providers, environmentalists, state and tribal government employees, and
members of the public who advise EPA on regulations, research, and communications related to children's
health. The CHPAC acts in the public interest and supports EPA in performing its duties and responsibilities
under Executive Order 13045 of April 21, 1997 (62 Fed Reg 19885; April 23, 1997). The legal authority
for CHPAC is the Federal Advisory Committee Act (FACA), 5 USC App 2. Members of the CHPAC serve
voluntarily and the CHPAC meets about two or three times per year to provide specific recommendations to
the EPA administrator. More information is available at: https://www.epa.gov/children.
PARTNERSHIPS
Protection of children through exposure reduction and being responsive in addressing past exposures is most
effective if accomplished through collaboration. EPA will continue to forge partnerships with other federal
agencies, as well as with other public and private partners to extend the reach and effectiveness of efforts
and to enhance the public's awareness, understanding, and ability to effect change to address these issues.
Leveraging each partner's unique expertise, resources (human, facilities, funding mechanisms), perspectives,
and diverse stakeholder networks greatly improves the ability to create effective and productive collaborations
to address children's environmental health issues.
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