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Publications
America's Children and the Environment
America's Children
and the Environment: Measures of
Contaminants,
Body
Burdens, and Illnesses (Second Edition)
| Paper Number |
Date |
Available Formats |
| EPA 240-R-03-001 |
2/2003 |
PDF
(1MB)/ HTML |
To view the PDF documents, the free Acrobat
Reader
 is required.
Printed copies of America's Children and the Environment: Measures of
Contaminants, Body Burdens, and Illnesses are available free of
charge from
EPA's National Service Center for Environmental Publications. Detailed
instructions for ordering online, by email, telephone, fax, or postal
mail are
available at http://www.epa.go
v/ncepihom/ordering.htm.
Please reference document number EPA 240-R-03-001 when ordering this
report.
America's Children and the Environment: A First
View of
Available
Measures
| Paper Number |
Date |
Available Formats |
| EPA 240-R-00-006 |
12/2000 |
PDF (1,091KB)/ HTML |
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Paper Series on Children's Health and the
Environment
The Office of Children's Health Protection (OCHP) at the U.S.
Environmental
Protection Agency (EPA) has created the Paper Series on
Children's Health
and the Environment to share scientific, regulatory, and policy
information
about children's health and the environment with a broad audience.
The Paper Series is comprised of papers written by EPA staff
members and
external
researchers receiving funding from OCHP. Each paper must receive an
approval
from OCHP prior to acceptance in the Series and undergo technical
peer
reviews
by experts from both in and outside EPA.
All papers in the Series are distributed for purposes of
information sharing
and discussion only. The opinions and findings expressed in these
papers are
those of the authors and do not necessarily represent those of
the U.S.
Environmental
Protection Agency or of the Office of Children's Health Protection.
No
official
Agency endorsement should be inferred from the papers.
The papers in the Series are only available online in PDF and
HTML format. For more
information about the Paper Series, including submissions and
questions,
please
contact Edward H. Chu at (202) 564-2188 or chu.ed@epa.gov.
| Paper Number |
Title |
View Paper |
| 2003-1 |
Overview of the Special Vulnerability and
Health
Problems of Children |
HTML/PDF |
| |
Children often experience different environmental exposures than
adults,
and may respond differently to such exposures. Thus, studies aimed
at
estimating
risks to adults need to be augmented by information on the
specific
vulnerabilities
of children, which are only beginning to be understood. The causes
of
illness
and death in infants and older children are different from adults,
and
need
to be analyzed separately to understand the potential effects of
environmental
exposures on children. Toxicological and epidemiologic studies are
useful
in identifying environmental exposures
that may harm children.
Substantial
evidence links specific exposures to increased risk of low birth
weight
and prematurity, congenital malformations, asthma and other
respiratory
illnesses, and neurological and behavioral problems. Individual
studies,
however, often provide only limited evidence of the risks to
children.
The
overall weight of evidence must be considered to evaluate
adequately the
magnitude of environmental health risks to children. A major
challenge is
translating research findings into a better overall understanding of
the
environmental risks facing children and developing programs to
effectively
reduce these risks. |
|
| 2003-2 |
Critical Periods in Development |
HTML/PDF |
| |
This paper reviews the major stages of human development and
discusses
how the effects of environmental exposures may vary depending on
when
during
development the exposures occur. There is strong evidence that
specific
developmental stages are especially sensitive to some environmental
agents.
The complexity, speed, and fragility of early development provide
many
targets
for environmental agents that are not present later in life.
Chemical and
other environmental exposures may affect germ cells (sperm and egg)
prior
to conception, resulting in impaired fertility and adverse effects
on
fetuses.
During the earliest (embryonic) stages of pregnancy, proper
development
of major organ systems may be disrupted by maternal exposures,
resulting
in congenital malformations (birth defects). Later in pregnancy,
adverse
effects on fetuses may include reduced growth and impaired organ
function.
Many organ systems are not fully developed at birth and therefore
infants
may experience adverse effects that are not seen in adults; the
effects
of lead exposure on children's neurological development and behavior
being
good examples. While it is not clear that children are generally
more
sensitive
to cancer causing chemicals than adults, the unique pattern of
children's
cancer causes concern for exposure to these agents. There are a
number of
examples where early exposures to environmental agents results in
adverse
effects that are not seen until adolescence or adulthood.
Scientists are
only slowly beginning to understand the patterns of sensitivity to
environmental
agents at different life stages. Effectively applying the available
evidence
to improve the health of children and the general population is
an
ongoing
challenge. |
|
| 2003-3 |
Children's Environmental Exposures |
HTML/PDF |
| |
This paper discusses the potential health significance of the
unique
patterns
of children's exposures to environmental agents. Children's
environmental
exposures are clearly different from those of adults. Starting in
the
womb,
fetuses are exposed to environmental agents indirectly through
maternal
circulation. After birth, infants consume mother's milk or formula
and
limited
diets containing much higher proportions of some foodstuffs than
adults
consume. Thus, infants and young children may be disproportionately
exposed
to chemical residues in specific foods. Children have a smaller
body mass
than adults, have generally higher metabolic rates and activity
levels,
and spend their time in different locations performing different
activities.
Young children's exposures to soil and house dusts may be
substantial,
owing
to short stature, mode of locomotion, play patterns, and mouthing
behaviors.
Older children also may engage in behaviors that increase
their
environmental
exposures. When children
are
exposed to chemicals, the amount
absorbed
and
persisting
in
the
body
may be higher than for adults. Children's
skin is
more permeable to many chemicals, and the metabolic pathways for
transforming
and eliminating chemicals may be less well-developed in children
than in
adults. Where differences in absorption and metabolism result in
higher
levels of harmful environmental agents in children's bodies, there
is
increased
concern for adverse effects. Because of the inherent differences
between
children and adults, it is important to continue characterizing
children's
environmental exposures and developing methods for reducing, where
possible,
the external factors contributing to these exposures. |
|
2003-4 |
Asthma-Related Medical
Expenditures in the United
States: Distributions and Trends |
PDF |
| |
This paper presents national asthma-related medical use and
expenditure
estimates from the 1996 Medical Expenditure Panel Survey (MEPS).
Asthma-related
medical expenditures totaled $5.8 billion in 1996 and 8.5 million
individuals
had some asthma-related medical expenditure. Prescription medication is
the
largest expense category accounting for 42% of the 1996 total
expenditures
while inpatient hospitalization and inpatient physician services
account for an
additional 33% of the total. The distribution of these expenses is
highly
skewed: 52% of total asthma-related expenditures are accounted for by
5% of the
individuals with such expenses. Comparing the 1996 results with
similar results
from the mid-1980s shows that asthma-related medical expenditures more
than
doubled. However, when price increases for medical goods and services
are
accounted for, asthma-related medical expenses did not increase in
proportion
to the 67% increase in asthma prevalence, meaning per person
expenditures were
lower on average in 1996 compared to the mid-1980s on a
price-adjusted basis.
In addition, this comparison shows that the increase in prescription
medicine
expenditures from the mid-1980s to 1996, after adjusting for price
increases,
is greater than the increase in asthma prevalence, and that the
total number of
inpatient hospitalizations and emergency room visits stayed the same
or
declined. In terms of sources of payment for asthma-related medical
services,
the MEPS data show that out-of-pocket payments account for 23% of
total medical
expenditures for asthma, well above the national average of 14% for
all
illnesses. The out-of-pocket payment shares are highest (40%) for
prescription
medications and physician office visits. Finally, it appears that
although
asthma-related prescription medicine expenditures have increased, the
use of
anti-inflammatory medication is not as high as would be expected if
current
treatment guidelines were being fully followed. High out-of-pocket
costs for
prescription medicines may be causing a compliance challenge,
especially for
low income families. |
|
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Outreach
- Children's
Environmental
Health Yearbook [PDF 1327K]
- Children's
Environmental
Health Yearbook Supplement [PDF 3710K]
- Child Health
Champion
Resource
Guide [PDF 896K]
- The Office of Children's Health Protection, in coordination with
other EPA
program offices, has developed a new children's environmental health
brochure
titled, "Protect; Children, Protect Our Future." The brochure's
purpose
is to raise awareness about children's environmental health issues
among
citizens, government, and other organizations and to enable them to
take action
to protect children. It includes facts about children's health and
EPA
online
resources.
Printed copies are available free of
charge
from EPA's National
Service Center
for Environmental Publications. Detailed
instructions
for ordering
online,
by
e-mail, telephone, fax, or postal mail are available at
http://www.epa.gov/ncepihom/ordering.htm.
Please reference document number EPA 100-F-03-002 when ordering this
brochure.
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