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Children's Health Protection

About This Report

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America's Children and the Environment: A First View of Available Measures is the U.S. Environmental Protection Agency's (EPA) first report on trends in measures reflecting environmental factors that may affect the health and well-being of children in the United States. This report represents an initial step in the identification, development, and compilation of a set of measures that fully reflect environmental factors important for children.

Developed by EPA's Office of Children's Health Protection in collaboration with EPA's National Center for Environmental Economics in the Office of Policy, Economics and Innovation, America's Children and the Environment presents measures that reflect trends in levels of environmental contaminants in air, water, food, and soil; concentrations of lead measured in children's bodies; and childhood diseases that may be influenced by environmental factors.

As part of EPA's commitment to children's health, the Office of Children's Health Protection and the National Center for Environmental Economics will continue to work to obtain data needed for measures that more fully reflect how environmental contaminants affect children's health.

What are the purposes of this report?

This report has two principal objectives. First, America's Children and the Environment presents concrete, quantifiable measures for key factors relevant to the environment and children in the United States. This initial work offers a basis for a better understanding of time trends for some of these factors and for further investigation of others. The authors and sponsors hope it will contribute to the effort to integrate the environmental health needs of children into the nation's policy agenda.

The second purpose of this report is to provide a starting point for discussions among policymakers and the public about how to improve federal data on children and the environment.

The long-term purpose of America's Children and the Environment is to identify or develop measures that could be used by policymakers and the public to track and understand the environmental health experience of children and, ultimately, to identify and evaluate ways to improve it. The work involved in developing the measures for children and the environment will contribute to this long-term goal.

How is the report structured?

The report first presents a series of measures and then discusses the direction of future work.

The first section of the report presents measures reflecting trends in levels of environmental contaminants that are likely to affect children's health. These measures are intended to show the percentage of children exposed to critical concentrations of contaminants in air, water, food, and soil. When data on actual environmental concentrations of contaminants are not available, the report presents surrogate measures.

The second section presents measures that reflect trends in concentrations of key contaminants measured in children's bodies. Such data provide direct evidence of children's exposures and can be tracked to determine whether childhood exposures are changing over time.

The third section presents measures that reflect trends in certain childhood diseases, the frequency or severity of which may be related to environmental factors. Information is presented about changes in the frequency of occurrence of these diseases over time.

The sections presenting measures are followed by a discussion of future directions, including ways in which the existing measures could be improved, alternative data sources, and measures that might be included in future versions.

Appendix A provides tables that summarize the data on which the measures were based, and Appendix B describes the sources of the data used in this report and the construction of the measures. Appendix C has a list of health goals relevant to the topics in this report, developed by Healthy People 2010, a collaborative effort coordinated by the U.S. Department of Health and Human Services to establish national health objectives.

Children may be affected by environmental contaminants quite differently than adults are, both because children may be more highly exposed to contaminants and because they may be more vulnerable to the toxic effects of contaminants.

Children generally eat more food, drink more water, and breathe more air relative to their size than adults do, and consequently may be exposed to relatively higher amounts of contaminants in these media. Children's normal activities, such as putting their hands in their mouths or playing on the ground, create opportunities for exposures to contaminants that adults do not face. In addition, environmental contaminants may affect children disproportionately because their immune defenses are not fully developed or their growing organs are more easily harmed.

To fully integrate the needs of children into the work of EPA and other agencies, it will be helpful to define targets for research and for interventions to reduce contaminant exposures and improve health. 

In preparing this report, we have begun to assess the completeness of existing information for each of the three major types of measures: levels of contaminants in the environment, concentrations of contaminants in children's bodies, and frequency of key childhood diseases. We also have assessed how well the data sources reflected the particular experience of children. 

As would be expected in any first such endeavor, the analysis identified a number of areas in which better or more appropriate data are needed. The assessment of priorities for obtaining additional information is a continuing process that will be furthered by review and reaction to the initial presentation in this report.

Three principal criteria were used to select measures for the report: importance to the health of children, availability of data for much or all of the United States, and sufficient quality of data to generate a reliable measure.

For environmental contaminants, we first identified five important media for children's exposure: outdoor air, indoor air, drinking water, food, and soil. For each of these, we reviewed the data sources available from federal environmental and health agencies and selected the most informative sources that provided national coverage (or close to it) and a reasonable assurance of reliability. If data about concentrations of key contaminants could be identified and were of adequate quality, we used that source. If not, we selected the best available surrogate. 

For concentrations of contaminants in children's bodies, we selected lead, a pollutant long recognized as having major impacts on children's health, and obtained the best available information about lead concentrations in the blood of children.

For childhood diseases associated with environmental factors, we initially selected the two diseases identified as priorities by the Interagency Task Force on Environmental Health Risks and Safety to Children, organized by EPA and the U.S. Department of Health and Human Services: asthma and childhood cancer. We added an additional respiratory disease, chronic bronchitis, because it is associated with air pollution. We then identified the best available data to assess time trends for the frequency of these diseases in children.

For each data source and topic, we structured the measures primarily to portray changes over time. In future versions of this report, measures also may be designed to reflect regional differences and ethnic and racial differences in effects or exposures. 

What are the sources for the data in this report?

For most measures, federal agencies provided the data

The data on environmental contaminants are from data systems maintained by EPA and by state environmental agencies. The data on lead in blood and on respiratory diseases are from the National Center for Health Statistics in the Centers for Disease Control and Prevention. The data on cancer are from the National Cancer Institute. County-level population data from the Census Bureau are used to calculate how many children potentially were affected by environmental contaminants. Detailed descriptions of the data sources may be found in Appendix B.

What groups of children are included in this report?

Most of the measures include all children in the United States under the age of 18. Exceptions are noted in the descriptions of the measures.

What years are included in this report?

The report includes data for the 10 years from 1990 through 1999 whenever possible. In many cases, data were available for only some of these years. In other cases, data available before 1990 were included to provide an expanded depiction of trends.

What is the Office of Children's Health Protection at EPA?

The Office of Children's Health Protection (OCHP) supports and facilitates EPA's efforts to protect children from environmental threats. OCHP's mission is to make the protection of children's health a fundamental goal of public health and environmental protection in the United States. OCHP reviews EPA proposals for their impact on children and funds work designed to improve the protection of children from environmental hazards. 

What are the Office of Policy, Economics and Innovation and the National Center for Environmental Economics at EPA?

The Office of Policy, Economics and Innovation develops new approaches and provides analysis to enable EPA to better address emerging environmental challenges. The office addresses cross-cutting environmental management strategies, identifies emerging issues, and acts as a catalyst for testing and institutionalizing integrative approaches to environmental protection. Within the Office of Policy, Economics, and Innovation, EPA's National Center for Environmental Economics (NCEE) provides economic and health analysis of important environmental issues for the regulatory and policy process. NCEE also conducts research that will improve our current understanding of the impacts of environmental contaminants on public health. NCEE's staff includes specialists in air, water, solid waste, cross-media economics, and children's health risks. The center's health scientists emphasize new methods for assessing previously unidentified risks, assessing relationships between exposures and disease, and developing tools to communicate this information to the public. 

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