2P-S1-3
ENVIRONMENTAL
THREATS TO THE HEALTH OF CHILDREN LIVING NEAR HAZARDOUS WASTE SITES IN THE USA
Robert
W. Amler
Agency
for Toxic Substances and Disease Registry (ATSDR), U.S. Department of
Health and Human Services, Atlanta, USA
An estimated 1.3 million children under 6 years of age live within 1 mile of at least one of the 1,300 (national priority list) hazardous waste sites in the USA. But children are not simply small adults; they often have greater exposures, greater potential for health problems, and less ability to avoid hazards. Children have greater exposures than adults because they are more likely to come into contact with contaminated media. They play vigorously outdoors and often bring food into contaminated areas. They are shorter than adults, breathing dust, soil, and heavy vapors close to the ground; and they are smaller than adults, getting higher doses per kilogram. If exposed during critical times in development, they can sustain permanent damage out of proportion to the expected dose response. They also are completely dependent on adults for risk management decisions.
Most
pediatricians are not trained to recognize how exposures to environmental
contaminants can can cause, trigger, or exacerbate pediatric diseases. After widespread
illegal spraying of >2,000 homes with a highly toxic pesticide in 1996-1997,
most clinicians misdiagnosed the respiratory, gastrointestinal, and
neurological problems that occurred in the children exposed to the toxic spray.
Anticipating future incidents of this kind, ATSDR has established pediatric
environmental medicine units and initiated development of clinical guidelines
so children with unusual exposures or unusual clinical signs can be assessed.
ATSDR=s child health programs incorporate applied research and epidemiology,
community involvement and risk communication, and specialized training and
referral guidelines for pediatric health care providers. ATSDR has formed a
nationwide collaborative partnership among >25 professional, voluntary, and
grassroots organizations to address the special environmental risks of
children. Education programs are sponsored for children and their parents in
targeted communities to promote healthy environments, and prevent exposure of
children to hazardous substances.