National Environmental
Health Association Position on

Children's Environmental Health 

Adopted July 2, 1997


Background and General Discussion

"Protecting our environment is critical to protecting our children's health."
-Carol Browner

In 1988, the Agency for Toxic Substances and Disease Registry (ATSDR) published The Nature and Extent of Lead Poisoning in Children in the United States: A Report to Congress (2). This document, which discussed the potential for lead contamination to disproportionately affect the health of our nation's children, represented one of the earliest efforts to identify environmental health threats to children and call for their reduction. With the institution of ATSDR's Child Health Initiative in April 1996 and the publication of the U.S. Environmental Protection Agency's (U.S. EPA's) Environmental Health Threats to Children in September 1996, the nation's research and policy communities began to focus on children as specific susceptible populations for a multitude of environmental insults(3).


The purpose of this position paper is to review current, information on the status of children's environmental health, with particular emphasis on the implications for environmental public health. Further, this paper reviews and provides support for the National Agenda to Protect Children's Health from Environmental Threats.

It is intended to be used as a basis from which environmental and public health practitioners and colleagues in related fields can initiate discussions of children's environmental health with policy makers at all levels-local, state, national, and worldwide.

Problem Statement

Children are different; that is, they are not "little adults." Children one through five years of age eat three to four (or more) times as much food per pound of body weight as the average American adult. The air intake of a resting infant is twice that of an adult (2). In their first six months of life, children drink seven times as much water pound per pound as the average adult (4). Because children eat more calories, drink more water, and breathe more air per pound of body weight than do adults, they are exposed to more pollutants per pound of body weight (3). Children's systems are still developing; therefore, they are more susceptible to environmental threats. Exposure to toxic substances can affect growth of fetuses, infants, and children. In addition such exposures may impair development of children's nervous systems and cause abnormal development because of hormonal or immunologic effects. Finally, infant immune systems are less well developed; thus, they may be less able than healthy adults to recover rapidly from exposure to microbes such as cryptosporidium (3).

Increasingly, statistics are being reported that point out the dangers confronting children: Ten million children under 12 years of age live within four miles of a hazardous waste dump (1).

  • An estimated 50 percent of all pesticides a human being ingests in a lifetime are ingested in the first five years of life (5). Each year, U.S. EPA receives an average of 24,000 calls to the Pesticide Hotline, primarily from parents concerned about dietary or household risks to children from pesticides (3). In addition, pesticides can pass into breast milk, thus placing many infants at increased risk of exposure not only to the pesticide but to its metabolites.

  • U.S. EPA estimated that in 1995, 30 million Americans drank water from systems that were in violation of public health standards. Almost 13 million Americans are served by water systems that may not adequately protect against microbial contaminants. Contaminated surface waters also place children at risk. From January to September 1994, some 1,500 fish advisories were posted; 73 percent of the advisories were for mercury contamination, which poses a particular threat to a child's developing nervous system (3).

  • Although there has been a 80 percent reduction in blood lead levels in the past 20 years because of the ban on leaded gasoline, over one million U.S. children under the age of five years still have elevated blood lead levels (1). As many as 1.7 to 2.0 million children are at risk of lead poisoning (3,4). In addition, an estimated 874,000 U.S. children have brain damage caused by lead exposure (6).

  • Asthma is the most chronic childhood illness in the United States, affecting some 4.8 million children below the age of 18 years. Between 1980 and 1993, asthma alone accounted for 3,850 deaths among people under 24 years of age. Asthma deaths increased in children and young people by 118 percent between 1980 and 1993. In addition, more than 25 percent of the nation's children live in areas that do not meet national air quality standards. Inadequate air quality can cause or contribute to respiratory illnesses, including asthma (3). Asthma has become the leading cause of hospital admissions of children to hospitals and has increased by 28 percent between 1980 and 1993 (4,3).