children’s health

Advancing Children’s Environmental Health: Our Best Investment

Reposted from EPA Connect, the Official Blog of EPA’s Leadership

Group of children at schoolAnyone who has ever enjoyed watching a toddler explore their world knows that along with that marvelous sense of discovery comes potential trouble. Young children crawl around on the floor, play in the dirt, and don’t hesitate to retrieve a wayward cookie or other delectable treat hidden among the dust bunnies underneath the couch—and pop it straight into their mouth.

Behaviors like these, as well as their smaller bodies and still developing internal systems, make children more vulnerable to pollution and other environmental risks than us adults. That’s why we here at EPA make protecting children’s health a top priority.

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Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action.

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Changing the Health of a Community – Beyond Land Cleanup

By Mathy Stanislaus

When I went to Omaha, NE last week, I was excited for Superfund’s big announcement: the delisting of over 1,000 residential parcels from the Omaha Lead Superfund site. This was an important milestone in EPA’s overall site cleanup activities, particularly for the residents whose properties were contaminated with toxic lead from the ASARCO smelter cleaned up.

It was also important to the children of the community – our efforts resulted in measurable health improvements: the percentage of children in eastern Omaha with elevated blood lead levels have been reduced from nearly 33 percent before 1998 to less than two percent today.

By reducing blood lead levels, you change people’s lives. You protect a child for his/her entire life and you change the health of a community. As part of one of the largest cleanup projects – particularly in an urban setting – in the Superfund program with over 40,000 largely lower-income residencies, I was very proud to acknowledge the public health impacts from eliminating lead exposure (significant reduction of blood lead levels in children) and the economic benefits of the cleanup.

I spoke with several people when I made the announcement and two really stood out in my mind. One individual explained that what began as basic outreach on public health resulted in a permanent institution in the community to look at children’s health at a multiple of ways that go beyond the lead cleanup.

I also spoke with the person that fields the calls from residents to deal with their issues on a day-to-day basis. They explained how challenging the work can be but understood how EPA can deal with community concerns regarding cleanups and explain how cleanups are done in a way that is protective but also accommodates their lives.

This isn’t easy work. Nor was the cleanup. It was easy to see how challenging these resident-by-resident cleanups were and I’m proud of the work EPA and contractors have done. This cleanup created hundreds of high-paying seasonal jobs and contributed to the development of a skilled labor force with job training funded through an EPA cooperative agreement with the Omaha Metropolitan Community College. Not only are we contributing to improving children’s health, but we’re transforming the community economically.

About the author: Mathy Stanislaus is assistant administrator for EPA’s Office Solid Waste and Emergency Response.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

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Asthma Awareness Month: Tackling Prevention

By Sally Darney 

SoccerplayerwithballWhen my daughter decided to join a soccer team, I was delighted.  Sports would provide healthy exercise, along with a host of other physical and mental benefits.  So we were dismayed when she complained of tightness in her throat and difficulty breathing during the games.

A trip to the doctor revealed “exercise-induced asthma,” but thankfully she was able to manage her symptoms with an inhaler and stay on the team.  I had little awareness of this disease at the time, but now know that childhood asthma is common, affecting nearly one in ten American children.

This month we celebrate Asthma Awareness Month learning about asthma triggers and the latest advances in medical treatment and comprehensive care for our children.

But what causes asthma to begin with?  Asthma is a curious disease that can first appear in toddlers, school-aged children like my daughter, or even in adults. Furthermore, studies have shown ethnic and economic-related disparities of who is most at risk. African American children, children of certain Hispanic groups, and children living in poor communities are more likely to get asthma, and to suffer more severe attacks, than Caucasian children and those in the higher social-economic groups. (For more information, download America’s Children and the Environment.)

This disparity suggests that the causes of asthma involve a complex interplay of environmental and social-economic factors, which in turn interact with a genetic-based predisposition. These factors can  play a role in both causing the disease itself, and in exacerbating the symptoms.

EPA researchers and partners from across the federal government are banding together to address asthma causes and disparities.  I was fortunate to be on the taskforce behind the landmark report: The Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities.

Working with scientists from the Centers for Disease Control and Prevention, the U.S. Department of Housing and Urban Development, and other agencies, EPA is helping implement the Plan, which emphasizes how research into the causes of asthma can help inform ways to tackle this burdensome disease.

We can’t change our genetics, but we can change the “environmental stressors” that contribute to, and cause, asthma.  To advance that work, researchers in ORD and from across the network of Centers for Children’s Environmental Health and Disease Prevention, co-sponsored by EPA and the National Institutes of Environmental Health Sciences, are exploring causes of asthma that can be prevented even before a baby is born. For instance, recent research has revealed that women who smoke during pregnancy, or are exposed to high levels of air pollution and/or certain environmental chemicals, are at increased risk of having a baby who develops asthma as a child.

Armed with more knowledge about the causes of asthma, pregnant women, mothers of young children, health care providers and decision makers can take actions to avoid risky exposures and provide healthy, asthma-free environments for women and children—preventing asthma from the start.

I’ll never know why my daughter got asthma, but I am happy to work at a place that is looking to prevent it. I have faith that together our research will do that, and eliminate racial and ethnic asthma disparities. Whether you play soccer or not, it’s a goal we can all shoot for.

About the Author: Sally Perreault Darney, Ph.D. is a senior health scientist at EPA working on  coordinating Agency research on children’s environmental health.      

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action.

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Asthma Disparities: Making an Impact in Chicago’s Public Housing

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By Melissa Gutierrez Kapheim

It’s Asthma Awareness Month! For hundreds of asthma community programs across the country, raising asthma awareness is a year-round reality as we work to improve the lives of people living with asthma every day.

As a 2010 winner of EPA’s National Environmental Leadership Award in Asthma Management, my organization, Sinai Urban Health Institute (SUHI), is always excited to partner with EPA. We strive to share successful strategies that will help programs across the nation deliver environmental asthma management as part of their asthma care services to underserved communities.

Later this month, on May 16th, I will co-present an EPA webinar with Andy Teitelman from the Chicago Housing Authority (CHA) on our collaboration efforts for a program called Helping Children Breathe and Thrive in Chicago Public Housing (HCBT).

With funding from the U.S. Department of Housing and Urban Development, SUHI partners with the CHA to implement HCBT in a community where asthma affects 25–30 percent of children, a rate twice the national average. Through community engagement and partnerships, we provide asthma education, assistance navigating the healthcare system, and environmental home assessments.

HCBT uses a Community Health Worker (CHW) model to deliver its services. We hire and train people who live in the same building to educate residents about asthma management. This approach is effective in accelerating honest communications in which people with asthma and their families feel comfortable discussing their home environment.

The visits include a home assessment to identify asthma triggers. HCBT refers triggers to CHA’s case management service, which works with property management to resolve the issue. This referral system was developed so participants can report their housing concerns to CHWs, who shepherd them through the process of getting the problem fixed.  As a result, a variety of housing issues that exacerbate asthma, such as mold, roaches, carpet, and mice, are referred to property management. To date, 80 percent of those referrals have been resolved.

Through our partnerships with CHA and residents of the housing developments, we have achieved results indicative of improved asthma symptoms and control. Specifically, preliminary six-month outcomes of the HCBT program indicate a 56 percent reduction in asthma symptoms, significant reductions in health resource utilization, and statistically significant and clinically associated improvements in quality of life. The project is slated to end in the fall of 2013.

Please join us for our webinar on May 16th. For more information and to register, visit

About the author: Melissa Gutierrez Kapheim, MS, is an epidemiologist at the Sinai Urban Health Institute (SUHI) in Chicago, IL. She has worked in the field of health disparities and community-based health interventions for more than eight years. Since joining SUHI in 2006, she has worked on three consecutive asthma interventions that utilize the community health worker model to improve the health and well-being of children and adults with asthma living in Chicago’s most vulnerable communities.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

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A Brief Insight into the World of Asthmatics

By James T. Young

The expanded conversation about Asthma Awareness in recent years is very good. I imagine that only people who actually suffer from it can appreciate how frightening or fatal an attack can be.

I had a summer job at a bakery in Richmond, Virginia. There were several steps in baking commercially. Next to the last step was was placing the dough in a pan and placing the pan on a rack. When the rack was full it was pushed into the steam room, where the bread rose, before going into the oven. One day the foreman told me to go into the steam room and straighten the racks up because they were all stacked near the door. I opened the door and began to push the racks deeper into the steam room. I tried to inhale while in the back. I inhaled, nothing! So, I inhaled again, nothing! I came out of that steam room like a shot out of a rifle. Once outside I took a deep breath and my lungs filled with air as I inhaled deeply.

All of the regular employees were laughing because that was a sort of “initiation”. They all knew that once you left the area where the door was open that there was no oxygen further back in the steam room and after a little exertion one found that out. That is the same type of reaction that Asthma sufferers must go through, except their bronchial tubes constrict keeping the air from reaching their lungs.

As terrifying as my “steam room” experience was, can you imagine what an asthmatic child or adult must cope with knowing that at any moment the air they breathe, food they eat or what they drink may trigger an attack? May the search for a cure and the dissemination of information about asthma awareness continue.

About the author: James T. Young, SEE empoloyee in the Office of Public Engagement.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

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Making Sure Chemicals Around Us are Safe

By Jim Jones, Acting Assistant Administrator, OCSPP

Chemicals are found in most everything we use and consume— from plastics, to medicine, to cleaning products, and flame retardants in our furniture and clothing. They can be essential for our health, our well being, our prosperity and our safety— it’s no understatement to say that the quality of life we enjoy today would be impossible without chemicals. However, our understanding of chemical safety is constantly evolving and there remain significant gaps in our scientific knowledge regarding many chemicals and their potentially negative impacts on our health, and the environment.

While you may be familiar with the Clean Air and the Clean Water Acts— you may not be as familiar with the Toxic Substances Control Act (TSCA), the environmental statute enacted in 1976 to regulate all chemicals manufactured and used in the U.S. When TSCA was enacted, it grandfathered in, without any evaluation, the 62,000 chemicals in commerce that existed in 1976.

Unlike the laws for drugs and pesticides, TSCA does not have a mandatory program where the EPA must conduct a review to determine the safety of existing chemicals. TSCA is the only major environmental law that has not been modernized. The process of requiring testing through rulemaking chemical-by-chemical has proven burdensome and time consuming.

Compared to 30 years ago, we have a better understanding of how we are exposed to chemicals and the distressing health effects some chemicals can have – especially on children. At the same time, significant gaps exist in our scientific knowledge of many chemicals, including those like flame retardants. Increasingly, studies are highlighting the health risks posed by certain chemicals and recent media coverage has heightened public awareness about the safety of flame retardants.

As part of EPA’s efforts to assess chemical risks, we will begin evaluating 20 flame retardants in 2013 in order to improve our understanding of the potential risks of this class of chemicals, taking action if warranted, and identifying safer substitutes when possible. Over the years, EPA has also taken a number of regulatory and voluntary efforts, including negotiating the voluntary phase-outs of several toxic flame retardants. EPA’s review of and action on flame retardants has spanned over two decades and while these are important steps forward, the long history of EPA’s action on flame retardants is tied in no small part to the shortcomings of TSCA and stands as a clear illustration of the need for TSCA reform.

We have the right to expect that the chemicals found in products that we use every day are safe and provide benefits without hidden harm. It is critical that we close the knowledge gaps and provide this assurance under a reformed, 21st century version of TSCA.

About the author: Jim Jones is the Acting Assistant Administrator of the Office of Chemical Safety and Pollution Prevention. He is responsible for managing the office which implements the nation’s pesticide, toxic chemical, and pollution prevention laws. The office has an annual budget of approximately $260 million and more than 1,300 employees. Jim’s career with EPA spans more than 24 years. From April through November 2011, Jim served as the Deputy Assistant Administrator for EPA’s Office of Air and Radiation. He has an M.A. from the University of California at Santa Barbara and a B.A. from the University of Maryland, both in Economics.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

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Proper Cleaning Prevents Poisonings

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By Lina Younes

Among the fondest memories of my childhood was the time that I spent at my grandmother’s home in Old San Juan. I loved walking through the city with such a rich history and unique architecture. Every time I visit the Island, I take a stroll through the old city and memory lane.

I remember one day, I must have been around 9 or 10. I attempted to help my grandmother in cleaning around the house. I wanted to make her proud of my efforts. So I started mixing some of the cleaning products under the misguided notion that “more is better.”  To this date, I still have a very vivid image of my cleaning experiment. I remember one of the liquid cleaners was a dark amber color that when you diluted it in water it would become white. The other was some sort of clear liquid. However, when I made my cleaning concoction, it turned into a bright red! I quickly flushed the cleaning potion down the toilet. It was a good thing that it didn’t explode, but who knows what chemical reaction occurred! I guess I will never find out, but that leads me to the real subject of this blog entry: how to prevent accidental poisonings and exposures to chemicals. The issue is very timely given that we are celebrating National Poison Prevention Week.

Here are some tips to prevent accidental poisonings:

  • At EPA we stress the fact that “the label is the law.” Read labels carefully and follow instructions when using household cleaning products and pesticides.
  • As I learned from my experience decades ago, mixing products will not make your house cleaner. In fact, mixing cleaning household cleaners and pesticides can be dangerous.
  • Always keep cleaning products away from children’s reach. If you are in the process of cleaning and you get a phone call or someone knocks on the door, don’t keep the cleaning products unattended. That can be an accidental poisoning waiting to happen.
  • Since most poisonings occur in the home, make sure that you household cleaners and pesticides are properly stored. We even have a checklist to help you in a room-by-room inspection to ensure safety.

So, if in spite of your best efforts, someone in your home becomes accidentally exposed to a toxic chemical, please call the National Poison Control Centers at 1-800-222-1222. There are English and Spanish-speaking operators available round the clock anywhere in the United States, including Puerto Rico.

About the author: Lina Younes has been working for EPA since 2002 and currently serves the Multilingual Outreach and Communications Liaison for EPA. She manages EPA’s social media efforts in Spanish. Prior to joining EPA, she was the Washington bureau chief for two Puerto Rican newspapers and she has worked for several government agencies.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

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Science Matters: Predicting the Future of Children’s Health

Children's Health MonthTo observe October as Children’s Health Month, we will periodically post Science Matters feature articles about EPA’s children’s health research here on the blog.  Learn more about EPA’s efforts to protect children’s health by going to www.epa.gov/ochp.


According to the Centers for Disease Control and Prevention, approximately one in every 33 babies born in the United States is born with a birth defect. Birth defects can heighten the risk of long-term disability as well as increase the risk of illness, potentially impacting a child for the rest of his or her life. Unfortunately, the causes of most birth defects are unknown.

EPA researchers are tapping powerful, high-tech computer systems and models to better determine how prenatal exposure to environmental factors might impact embryo and fetal development. Working on EPA’s Virtual Embryo (v-Embryo™) project, they create computer models of developing body systems and combine them with data from a number of EPA studies and toxicity databases to “virtually” examine the effects of a variety of prenatal exposures.

Virtual Embryo simulates how chemicals and pesticides, including those that disrupt the endocrine system, interact with important biological processes that could disrupt fetal development.  The chemicals used in simulations are identified by EPA’s Toxicity Forecaster as having the potential to affect development.

The predictions from the computer simulations need to be further tested against non-virtual observations. However, the models provide scientists with a powerful tool for screening and prioritizing the chemicals that need to be more closely examined, greatly reducing the cost and number of targeted studies needed.

“We’ve built small prototype systems, now what we want to do is move into complex systems models that will be more relevant to environmental predictions,” said Thomas B. Knudsen, Ph.D., an EPA systems biologist who is leading the project.

Virtual Embryo models have focused on blood vessel development and limb development, but are being expanded to include early development of the male reproductive system, which is known to be particularly sensitive to endocrine disrupting chemicals.

Knudsen says that having more models is important because different chemicals can affect biological systems in various ways. Luckily, the time it takes to develop new models decreases as researchers’ model-developing knowledge grows.

“The important challenge for us is to try to integrate some of this work with other issues of broad importance to children’s health,” said Knudsen. “We’re focused primarily on embryonic development, but a person doesn’t stop developing at birth. We have to take what we are learning from the embryo and extend that information into life stages beyond birth.”

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action.

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Science Matters: Closing the Asthma Gap

To observe October as Children’s Health Month, we will periodically post Science Matters feature articles about EPA’s children’s health research here on the blog. Learn more about EPA’s efforts to protect children’s health by going to www.epa.gov/ochp.

Nearly 26 million Americans, including seven million children, are affected by asthma. But when emergency room doors burst open for someone with an asthma attack, chances are the patient will be a poor, minority child.

According to the Centers for Disease Control and Prevention (CDC), minority children living in poor socioeconomic conditions are at greatest risk. For instance, 16% of African American children had asthma in 2010 compared to 8.2% of white children, and they are twice as likely to be hospitalized with an asthma attack and four times more likely to die than white children. The asthma rate among children living in poverty was 12.2% in 2010, compared to 8.2% among children living above the poverty line.

“Across America we see low-income and minority children and families at a disproportionately higher risk for asthma and respiratory illnesses. Air pollution and other challenges are having serious health effects, which compound economic challenges through medical bills and missed school and work days,” said EPA Administrator Lisa P. Jackson. “As the mother of a child with asthma, I know what it means for our children to have clean and healthy air to breathe.”

Administrator Jackson made those remarks during the unveiling of the Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities, a blueprint for how EPA and other federal agencies can team up to reduce asthma disparities.

A major part of that effort is the work conducted by EPA scientists and their partners exploring environmental causes and triggers of asthma, including how socioeconomic factors contribute to childhood asthma. The overall goal is to illuminate the underlying factors of asthma to support work on prevention and intervention strategies.

What increases the risk of developing asthma? While part of the answer certainly lies with genetics, as more than half of all children with asthma also have close relatives with the illness, the environment also plays a key role. Air pollutants, allergens, mold, and other environmental agents trigger asthma attacks.

EPA researchers and their partners are leading the effort to develop new scientific methods, models, and data for assessing how such triggers increase the risk for asthma and asthma attacks. The impact of this research has already contributed to current regulatory standards for two priority air pollutants regulated under the National Ambient Air Quality Standards (NAAQS): ozone and particulate matter. EPA’s asthma research has also been factored into health assessments for diesel emissions.

The next step is to learn ways to better protect those most at risk.

“Now we’re digging into the disparities side of the asthma problem,” said Martha Carraway, MD, a researcher at EPA. “Kids with poorly controlled asthma are more likely to be treated in the emergency room than kids with controlled asthma. So for public health reasons we need to understand how environmental factors, including air pollution, affect asthma control in vulnerable populations.”

To advance that work, EPA researchers and their partners took advantage of a 2008 lightning strike that occurred in Pocosin Lakes National Wildlife Refuge in North Carolina. The 40,000-acre (16,000-hectare), smoldering peat fire sparked by the lightning sent thick, billowing clouds of smoke wafting into the air.

In collaboration with scientists at the University of North Carolina Center for Environmental Medicine, Asthma, and Lung Biology, a team of EPA researchers led by David Diaz-Sanchez, PhD compared emergency room visits for asthma with air quality reports. Looking at the results geographically, they found that low income counties had significantly more visits than more affluent counties, even though air quality and exposure levels were the same.

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“EPA studies suggest that children and others living in low-income counties could be less resilient to air pollution, possibly because of social factors such as inadequate nutrition. For example, if you’re poor and you’re not eating well, your asthma may be more severe,” said Nsedu Obot Witherspoon, MPH, Executive Director of the Children’s Environmental Health Network, a national multi-disciplinary organization whose mission is to protect developing children from environmental health hazards and promote a healthier environment. “Of course, other factors may also be involved, such as whether kids take medications correctly and whether they have access to good medical care.”

EPA’s research on asthma disparities can help guide newer and better interventions for reducing exposure to asthma triggers and limiting the impacts of the ailment, helping to close the gap for minority and poor children and improving the health of children everywhere.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action.

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Exercise: Leading By Example

By Lina Younes

How often do we give our children advice to adopt healthy eating habits and lifestyles, yet our actions send another message? To say that “actions speak louder than words” is not just another cliché. Our actions, good and bad, can be even more influential on our children’s outlook on life than endless preaching. In this case, I want to emphasize the need for us to become more active to encourage children to exercise more as well. Let us lead by example.

I still remember as I was growing up, I was often outside with my friends or riding my bike after finishing my homework. During the summer, I was usually outside “from dawn to dusk” with my friends. However, now things have changed. I’ve even seen the difference with my own children. They prefer indoor activities over “the great outdoors.” I guess that I’m largely responsible for that.

Statistics show that childhood obesity has nearly tripled in the last three decades. Childhood obesity has led to numerous other health problems in children from diabetes, high cholesterol, high blood pressure, to name a few. Healthy eating habits AND physical activity are the best practices to address the issue with long term positive effects. We cannot leave it to the kids alone. These are good habits that we all should adopt, children and adults, as a family to have a better quality of life.

Increasingly, there are new opportunities to make this family project fun. How about encouraging children to walk or bike more? How about encouraging children in your community to get involved in the Let’s Move Initiative? Just simple steps can go a long way to get more active. Physical activity does not require a gym membership. Sports, gardening, hiking, bicycling, and good old walking can be equally effective. And if you enjoy these activities as a family you get multiple rewards.

Since we’re celebrating Children’s Health Month during October, wouldn’t this be a good time to start? Do you have any family activities planned? Please share them with us.

About the author: Lina Younes has been working for EPA since 2002 and currently serves the Multilingual Outreach and Communications Liaison for EPA. She manages EPA’s social media efforts in Spanish. Prior to joining EPA, she was the Washington bureau chief for two Puerto Rican newspapers and she has worked for several government agencies.

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

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