Pediatric Environmental Health

by

Ruth Etzel

• LAST REVIEWED: 21 April 2021
• LAST MODIFIED: 21 April 2021
• DOI: 10.1093/obo/9780199756797-0202

Introduction

Pediatric environmental health is the academic discipline that studies how environmental exposures in early life — biological, chemical, nutritional, physical, and social—influence health and development in childhood and across the lifespan. This discipline emerged in the mid-1980s after the discovery that secondhand smoke exposure was linked to increased rates of lower respiratory illness in children. Before that, most people did not realize that smoking cigarettes harmed anyone but the smoker. When the harmful effects of secondhand exposure to tobacco smoke were uncovered, researchers began asking questions about other pollutants—could it be that other biological, chemical, physical, and social agents to which children are routinely exposed also harm their health? Children have environmental exposures that are different from and often larger than those of adults. Children also have enormous susceptibilities in early development—unique “windows of vulnerability”—to toxic exposures that have no counterpart in adult life. It is well understood that timing of exposure is critically important in early human development. The tissues and organs of embryos, fetuses, infants, and children are rapidly growing and developing. Adolescence also is a period of rapid growth. These complex and delicate developmental processes are uniquely sensitive to disruption by environmental influences. Exposures sustained during windows of early vulnerability, even to extremely low levels of toxic materials, can cause lasting damage.

General Overviews

Toxic chemicals and other hazards in the environment can exert a range of adverse effects—some are clinically evident (such as cancer), but others can be discerned only through special testing and are not evident on the standard physical examination. They are termed subclinical toxicity. There is a dose-dependent continuum of toxic effects, in which clinically obvious effects have their subclinical counterparts. In one of the first books for the lay reader Glasser 1976 suggested that society prioritize cancer prevention by taking steps to reduce environmental contamination. More recently, the World Health Organization 2017a and World Health Organization 2017b estimate that 26 percent of childhood deaths and 25 percent of the total disease burden among children below 5 years of age could be prevented through the reduction of environmental risks.

• Glasser, R. J. 1976. The greatest battle. New York: Random House.

  Written for the layperson and easy to understand. Currently out of print.

• World Health Organization. 2017a. Don’t pollute my future! The impact of the environment on children’s health. Geneva, Switzerland: World Health Organization.

  A twenty-nine-page high-level summary written for the lay reader.

• World Health Organization. 2017b. Inheriting a sustainable world? Atlas on children’s health and the environment. Geneva, Switzerland: World Health Organization.

  A 138-page atlas intended for the lay reader.