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Children’s Environmental Health is the branch of pediatric medicine that studies the influence of the environment on children’s health, development and risk of disease (1). Children’s environmental health considers environmental exposures during pregnancy as well as exposures in infancy, childhood and adolescence. It studies parental environmental and occupational exposures that may influence the health of children. It traces the influence of early-life environmental exposures on health and development across the life span - from conception, through infancy, childhood and adolescence, and on into adult life and old age (2). The core concept of children’s environmental health is that children are unique. Because they are passing through the early, formative stages of human development, children are qualitatively and quantitatively different from different from adults in their patterns of exposure and in their vulnerabilities to environmental hazards (3). The health consequences of environmental exposures in infancy and childhood are often very different from the consequences of exposures later in life. Children’s environmental health is highly interdisciplinary and considers the environment broadly. It recognizes that children’s environments are complex, are comprised of many layers and change over the course of a child’s development. It therefore studies the influences on children’s health of chemical exposures in early life (4), the nutritional environment in the womb (2), the built environment (5), stress (6) and the social environment (7). It studies interactions among these multiple environments at different life stages, a broad view of the universe of children’s exposures termed the ‘exposome’ (8). It examines interactions between environmental exposures, poverty and social injustice (9). It examines the influences of the environment on the human genome and epigenome (10). Children’s environmental health is inherently translational. It translates the findings of research into evidence-based blue12 | The Bulletin | Second Quarter 2021
prints for the prevention of disease and the protection of children’s health. The ultimate goals are to safeguard children’s health and to improve the environments where children live, learn and play. Four great challenges confronting children’s environmental health discussed in this chapter are: 1. Rising rates of non-communicable disease among children worldwide. Environmental exposures are now known to be responsible in part for these increases. 2. Children’s exposure to thousands of inadequately tested chemicals of unknown hazard. 3. The global movement of toxic chemicals and hazardous waste from industrially developed countries to developing countries. 4. Inadequate training of physicians and other health professionals in environmental medicine, which results in missed diagnoses of environmental disease in children and lost opportunities for prevention and treatment. Historical Origins of Children’s Environmental Health
Children’s environmental health arose in the second half of the 20th century through a convergence of scientific insights from three fields: pediatric toxicology, nutritional epidemiology, and social science research. The Contributions of Pediatric Toxicology
Pediatric toxicology, the study of the effects of toxic chemicals on children’s health, is the oldest of the disciplines that have contributed to the formation of children’s environmental health. It derives many of its approaches and methodologies from toxicology and occupational medicine. Pediatric toxicology had its origins in clinical and epidemiologic studies of disease outbreaks in children that resulted from the dissemination of toxic chemicals, inadequately tested pharmacologic agents, www.sccma.org
