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Young children, because of a number of differences that distinguish them from adults, are more vulnerable to substances in our environment. These differences include:
* mouthing objects,
* ingesting greater quantities of food proportional to body size,
* ingesting more milk, fruit, and vegetables, and
* spending time crawling and playing on the floor.
Also, enzyme systems involved in the breakdown of some compounds may not be fully developed in young children. Because children have a longer life span than adults, substances that they ingest, inhale, or absorb through skin have a longer period of time to produce harmful effects. Despite these differences, children are viewed as little adults when it comes to environmental protection.
Approximately 300 new chemicals are created each year, and the production of synthetic materials increased from 1.3 billion lbs in 1940 to 320 billion lbs in 1980.1 Little is known about the health effects on children of exposure to the majority of the 70 000 chemicals in commercial use today.2 A 1991 report by the US General Accounting Office suggests insufficient protection from reproductive and developmental hazards.3 Another government report identified fetuses and children as being at high risk for adverse effects from neurotoxic substances, but indicated that only a small number of chemicals have been evaluated adequately, even in adults, for potential effects on the central nervous system.4
Children are at risk from hazardous substances in homes, schools, and playgrounds. Examples of the association between hazards and health problems are lead with cognitive function,5 PCBs with growth and physical activity,6 and side stream tobacco smoke with acute and chronic respiratory diseases.7,8 Needleman and Landrigan identified radon, asbestos, and benzene as causes of cancer in children.9
Environmental exposures have been viewed in a singular fashion by physicians, policy leaders, and regulatory agencies. Arts and crafts hazards (eg, solvents in paints and glues, and lead in crayons), asbestos, radon, alar, and lead in paint and water have taken center stage at different times over the past decade, with little reference to the global problem of environmental hazards. Little is known about health, particularly in children, from multiple exposure, cumulative, or synergistic effects.
This article discusses why pediatrie environmental health demands attention now, and the important role pediatricians should play as advocates....