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EPA Celebrates Children’s Health Month

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Protect Children Where 

They Live and Learn

This is the theme for EPA’s 

fourth annual celebration 

of Children’s Health Month. 

Protecting the health of children from 

environmental risks is fundamental 

to the mission of the United States 

Environmental Protection Agency 

(EPA). Children may be at greater risk 

from harmful environmental pollutants 

than adults. Consider that: 

• Children’s neurological, immunological, digestive and other bodily 

systems are still developing;

• Children eat more food, drink 

more fluids, and breathe more 

air than adults in proportion 

to their body mass; and

• Children’s behavior patterns 

— such as crawling and placing

objects in their mouths — may 

result in greater exposure to 

environmental contaminants.

Because of these characteristics, 

children may not be sufficiently protected by regulatory standards that 

are based on risks to adults. EPA has 

forged more partnerships and taken 

increasingly more steps to protect 

children’s environmental health from 

the variety of contaminants and pollutants that may affect them in the air 

they breathe, the water they drink, the 

food they eat, their homes, schools, 

and playgrounds. Often, we direct our 

effort to specific pollutants that have 

been found to cause undue harm to 

children, such as ultraviolet radiation, 

mercury, lead, diesel fuel, asbestos, 

and secondhand smoke. We also 

target the places where children live, 

learn, and play, in an effort to ensure 

prevention of exposure. Here are 

some highlights of recent work. 

Helping Children 

Breathe Easier

Both indoor and outdoor air 

pollution can adversely affect 

children’s health. An estimated 

6.3 million children under 18 years of 

age had asthma in 2001. In 1994-96, 

children with asthma missed approximately 14 million school days per year. 

Visit www.epa.gov/asthma. 

• Air Quality: This year, EPA identified new geographic areas that will 

be required to reduce emissions 

of air pollution to meet the new air 

quality standards for ozone and 

fine particles. When met, these 

standards will prevent millions of 

missed school days and millions 

of respiratory symptom days each 

year in children across the nation.

• States Asthma Project:

EPA provided support to the 

Environmental Council of the States 

(ECOS) and Association of State and 

Territorial Health Officials (ASTHO) to 

develop a national agenda to reduce 

environmental triggers of childhood asthma. This project brought 

many state environment and health 

agencies together for the first time. 

EPA will award eight more state 

grants to supplement the five pilots 

in California, Wisconsin, Wyoming, 
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Idaho and Oregon. The report is 

available at www.astho.org/pubs/

CatchingYourBreathReport.pdf. 

• Reducing Diesel Emissions:

The Clean Air Nonroad Diesel Rule 

will cut emission levels from construction, agricultural, and industrial 

diesel-powered equipment by more 

than 90 percent and will remove 

99 percent of the sulfur in diesel 

fuel by 2010, resulting in dramatic 

reductions in soot from all diesel 

engines. EPA predicts that when 

the full inventory of older nonroad engines has been replaced, 

the nonroad diesel program will 

annually prevent up to 12,000 

premature deaths, one million lost 

work days, 15,000 heart attacks, 

and 6,000 children’s asthmarelated emergency room visits. 

• Clean School Bus USA:

Across the country, 24 million children ride school buses to and from 

school every day. School buses 

provide our nation’s children with 

safe and convenient transportation, but the diesel exhaust from 

school buses poses a health risk, 

particularly to children. Clean School 

Bus USA is an initiative sponsored 

by the EPA to help communities 

reduce pollution from school buses 

by reducing idling time, retrofitting 

current fleets with new technologies 

and cleaner fuels, and replacing the 

oldest buses with new buses that 

meet more stringent pollution control strategies. In 2004, five million 

dollars in grants will support school 

bus retrofits, replacements, and use 

of clean fuel in 20 projects that will 

affect 5,000 buses nationwide. Visit 

www.epa.gov/otaq/schoolbus.

• Hispanic Outreach:

Approximately two million Hispanics 

living in the U.S. have asthma. EPA 

released a new educational video, 

Controlando los Factores del Asma,

to help families in the Hispanic 

community more effectively manage asthma. The video provides 

information on how to reduce 

exposure to indoor and outdoor 

asthma triggers. To receive a free 

video, call 1-800-438-4318. 

• Awards Program for 

Health Plans and Health 

Care Providers: EPA, in partnership with America’s Health 

Insurance Plans (AHIP), launched 

a national awards program that 

will recognize outstanding leadership by health plans and health 

care providers who offer comprehensive asthma management 

services that address environmental risk factors. AHIP members provide health coverage for 

nearly 175 million Americans.

Protecting Children 

from Exposure to 

Secondhand Smoke

Millions of young children 

continue to be regularly exposed to secondhand smoke in homes and cars. 

Secondhand smoke can cause serious 

health consequences, including respiratory illness, ear infections, and more 

frequent and severe asthma attacks. 

More information on smoke-free home 

activities can be found at www.epa.

gov/smokefree.

• Reaching Vulnerable 

Communities: A national partnership has been created with the 

Department of Health and Human 

Services Head Start Bureau to 

inform parents about the harmful 

effects of secondhand smoke. The 

goal of the partnership is to reduce 

and eliminate children’s exposure to 

secondhand smoke in homes and 

cars. Also initiated this year is the 

project “Not in Mama’s House,” an 

expansion of a successful California 

program designed to reduce secondhand smoke exposure in the 

homes of African-American families. 

Protecting Children 

from Too Much Sun

Children need to be physically 

active, but also must protect 

themselves from overexposure 

to the sun. Sun overexposure can 

cause serious health effects, including 

skin cancer, eye damage and cataracts, and immune system suppression. Skin cancer is the most common 

type of cancer in the United States.
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• SunWise: The SunWise School 

Program is an environmental and 

health education program that aims 

to teach children and their caregivers how to protect themselves from 

sun overexposure. Currently over 

10,500 schools (up from 7,800 

in 2003) in all 50 states, Puerto 

Rico, and Washington D.C. are 

registered in the SunWise School 

Program, which started in 2000. 

Visit www.epa.gov/sunwise.

Protecting the Water 

Where Children Play

Good water quality is essential to 

the health of children, who are 

vulnerable to pathogens, bacteria, and nitrates in water. There are many 

sources of contaminants, including agricultural runoff, faulty septic systems, and 

storm sewers. Visit www.epa.gov/ow.

• Beach Watch: This program 

improves public access to information about the quality of the water 

at beaches and the health risks 

associated with swimming in polluted water. EPA’s Web site now 

includes an online directory of 

information about the water quality 

at our nation’s beaches. Visit www.

epa.gov/waterscience/beaches.

• Clean Waters for Children’s 

Recreation: EPA, through 

its National Pollutant Discharge 

Elimination System permitting 

program for wet weather sources 

of pollution, is working to provide 

cleaner waters for improved recreational opportunities. These wet 

weather pollution sources create 

significant amounts of contaminants 

that can cause illnesses in people 

who are exposed to them. The 

risk of illness is greatly increased 

for young children. Through its 

permitting program, EPA is requiring that these sources of pollution build controls that will greatly 

reduce the potential for exposure.

Protecting Children 

from Lead Poisoning

Childhood lead toxicity has been 

recognized for at least 100 

years. Lead poisoning in children may cause lowered intelligence, 

impaired language and hearing, hyperactivity, behavioral, and other adverse 

health outcomes. Approximately 

434,000 children in the United States 

have elevated blood lead levels. EPA 

celebrates Lead Poisoning Prevention 

Week from October 24-30, 2004. Visit 

www.epa.gov/lead.

• Educational Campaigns: 

EPA launched a nationwide campaign with the National Head 

Start Association to educate 

parents, teachers, and children 

about the dangers of lead poisoning. EPA developed a pamphlet and several fact sheets on 

lead poisoning prevention to be 

distributed to Head Start centers across the United States.

• Tribal Outreach: The TribalBased Environmental Protection 

Consortium in New England developed an educational activity book, 

“Mother Bear,” to teach children 

about lead poisoning prevention. 

The stories follow seasonal Native 

American themes while teaching children about lead hazards 

and lead safety. The book and 

accompanying teaching curriculum 

were distributed to tribal schools 

throughout the United States. 

• Hispanic Outreach: EPA and 

ethnic cultural centers, health clinics, and YMCA/YWCA centers in the 

greater Los Angeles area, Southern 

California, and Southern Arizona are 

providing childhood lead poisoning prevention materials to Hispanic 

children, who represent 85 percent 

of the reported cases of lead poisoning in Los Angeles County during the 

past decade. The Spanish edition 

of the EPA booklet, “Protect Your 

Family From Lead in Your Home,” 

is an important tool for reaching 

Hispanic families. This booklet is 

also available in English, Vietnamese, 

Chinese, Russian, and Arabic. 
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Protecting Children 

from Mercury

For fetuses, infants, and children, 

the primary health effects of 

methylmercury are on neurological development. Even low levels of 

mercury exposure, which can result from 

a mother’s consumption of fish containing methylmercury, can adversely affect 

the brain and nervous system. Impacts 

on memory, attention, language, and 

other skills have been found in children 

exposed to moderate levels in the 

womb. These changes produce learning 

disabilities in the child. Visit www.epa.

gov/mercury.

• Fish Advisory: EPA and the 

Food and Drug Administration 

issued a joint consumer advisory on 

methylmercury in fish and shellfish. 

The advisory is for infants, children, 

nursing mothers, pregnant women, 

and women that may become 

pregnant. It highlights the nutritional 

value of eating fish and shell fish 

and advises the previous groups of 

people to avoid or limit eating some 

types of fish. Visit www.epa.gov/

waterscience/fishadvice/advice.html.

Elemental mercury can be 

found in fever thermometers 

and other common household 

products. When these products are 

broken, toxic mercury vapors can be 

released into the air. If these products 

are discarded improperly in the trash 

or down the drain, the mercury can 

contribute to the build up of mercury 

in fish.

• Education Campaign: Giant 

Foods is conducting a year-long 

campaign to educate consumers about children’s environmental 

health. One effort focused on the 

hazards of mercury in common 

household products. Giant offered 

discounts for the purchase of 

digital (and therefore mercury-free) 

thermometers, created education 

materials for children, displayed 

information for adults, and participated in a national radio show to 

highlight mercury exposure issues.

Keeping Pesticides Away 

from Children

Children can be exposed to 

pesticides in their diets, their 

drinking water, or through 

activities at home and school. Too 

much exposure to some pesticides 

and other chemicals may lead to a 

variety of adverse health effects, such 

as acute poisoning, disruption of the 

hormone and immune systems, respiratory problems, neurological damage, 

and cancer.

• Pesticide Registrations: EPA 

is continuing to phase out the use 

of pesticides that do not meet the 

current strict safety standard that 

emphasizes potential health effects 

to children. For example, the treatment of wood with chromated copper arsenate for residential uses 

ended in December 2003, and the 

sale of diazinon, a popular pesticide 

for outdoor residential use, will end 

by December 2004. In addition, EPA 

uses education and enforcement 

actions to reduce availability and 

use of illegal, unregistered pesticides 

such as candy-colored mothballs 

and unregistered insecticidal chalk. 

• Hispanic Outreach: Through 

collaboration with the Hispanic 

Radio Network, public service 

announcements were aired on 

more than 190 radio station affiliates, covering 90 percent of the 

Hispanic population and reaching 

more than four million radio listeners throughout the U.S. mainland 

and Puerto Rico. This campaign 

focused on protecting children 

from exposure to pesticides and 

other potentially harmful household 

chemicals, emphasized the link 

between cockroaches and asthma, 

and provided tips for preventing 

pest infestations in the home.

• Educating Kids: The new 

activity book, Join Our Pest Patrol,

filled with word games, puzzles and 

hands-on projects for kids, was 

released in January of 2004. The 

booklet helps kids understand the 

effect that personal choices regarding pesticide use can have on the 

environment. It is available at www.

epa.gov/oppfead1/cb/csb_page/

publications/perstpatrol.pdf.
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Making Schools Healthier

More than 53 million children 

and almost 3 million adults 

spend a significant portion 

of their days in approximately 112,000 

public and private school buildings, 

many of which are old and inadequately maintained, often containing 

environmental conditions that inhibit 

learning and pose increased risks to 

the health of children and staff. 

• Assessing Risks: EPA is developing a software tool to help school 

districts identify and prioritize the 

environmental risks in their schools. 

School districts may volunteer to 

participate in the initial pilot effort 

this spring. For more information, visit www.epa.gov/schools. 

• Lab Cleanout Program:

Existing stocks of outdated, 

unknown, excessive, or unnecessarily hazardous chemicals are present 

in many schools. These chemicals 

can pose safety and health risks to 

students and staff; and a number 

of widely reported incidents involving such chemicals have resulted 

in school closures and costly 

clean-ups. The Schools Chemical 

Clean Out Campaign promotes 

removal of existing stocks of hazardous chemicals from schools; safe 

chemical management; and national 

awareness. Visit www.epa.gov/osw/

conserve/clusters/schools.htm. 

• Asbestos in Schools:

Asbestos is a naturally-occurring mineral fiber once used to 

strengthen and provide heat insulation and fire resistance in building 

products. It is also a known human 

carcinogen that can cause serious 

lung diseases. The updated version of The ABC’s of Asbestos in 

Schools is available by calling (202) 

554-1404 or through this Web site: 

www.epa.gov/asbestos/asbestos_

in_schools.html. A Spanish translation of The ABC’s of Asbestos in 

Schools will be available soon. 

• Pest Management in 

Schools: EPA encourages school 

officials to adopt Integrated Pest 

Management (IPM) practices to 

reduce unnecessary pesticide use 

and exposure. EPA’s brochure, 

Protecting Children in Schools from 

Pests and Pesticides, is available 

by phone at 1-800-490-9198. For 

information on starting a program, 

visit www.epa.gov/pesticides/ipm. 

Smart Growth and 

Children’s Environmental 

Health

Alternative approaches to 

development can provide 

clear health benefits to children, including improved air and water 

quality, re-use of brownfields sites and 

preservation of open space. Visit www.

epa.gov/smartgrowth to learn more.

• Creating Smart Growth 

Schools: EPA worked with 

the National Trust for Historic 

Preservation and Smart Growth 

America to develop outreach 

material demonstrating the opportunity for environmentally-responsible school siting. The project 

included the publication entitled 

“Build Smart” in the October 2003 

American School Board Journal 

that focuses on building small, 

community-based schools. 

• School Siting: The study, Travel 

and Environmental Implications 

of School Siting, examines the 

relationship between school locations, the built environment around 

schools, how kids get to school, 

and the impact on air emissions 

of those travel choices. It shows 

that school siting and design can 

affect walking, biking, or driving choices. Visit www.epa.gov/

smartgrowth/school_travel.htm.
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Increasing Knowledge to 

Better Protect Children

EPA recognizes that society does not yet have all the answers to questions 

about the role of environment in 

children’s health. We are working 

to increase that understanding. 

• Handbook for Pediatric 

Health Professionals: EPA 

supported the publication and distribution of the American Academy 

of Pediatrics (AAP) Handbook of 

Pediatric Environmental Health, 2nd 

edition. The Handbook addresses 

numerous environmental health 

concerns and can be ordered by 

calling AAP at (866) 843-2271.

• National Academy of 

Sciences (NAS) Evaluation: 

An internal review of EPA’s practices for assessing chemical toxicity concluded that existing testing 

guidelines result in numerous gaps, 

especially with respect to understanding mechanisms of toxicity and 

possible early life-stage sensitivity. 

EPA has asked the NAS to assess 

current approaches to toxicity testing to meet regulatory data needs. 

• Polybrominated diphenyl 

ethers (PBDE’s): The Agency 

is developing an action plan for 

PBDE’s, a class of chemicals used 

as flame-retardants. PBDE’s have 

been in the news because higher 

than expected levels have been 

observed in human breast milk and 

environmental samples, and there is 

increasing evidence of developmental neurotoxicity. The current work is 

a follow-up to the recent voluntary 

phase-out of penta-BDE and octaBDE by the only US manufacturer.

• Research Centers: EPA 

and the National Institute of 

Environmental Health Sciences 

(NIEHS) sponsor Centers 

of Excellence for Children’s 

Environmental Health and Disease 

Prevention Research. These centers 

conduct new research on the role 

of environmental exposures in the 

health of children and promote the 

translation of basic research findings 

into a heightened awareness among 

children, their families, and health 

care practitioners regarding 

detection, treatment, and prevention 

of environmentally-related 

disease and illness. 

• National Children’s Study:

This study is being planned to 

examine the effects of environmental influences on the health 

and development of more than 

100,000 children across the United 

States. The study is authorized by 

the Children’s Health Act of 2000 

and will drive our actions to protect 

children for decades to come.

• Pediatric Environmental 

Health Specialty Units 

(PEHSUs): EPA and the Agency 

for Toxic Substances and Disease 

Registry of the Department of Health 

and Human Services established 

the PEHSUs program as a national 

resource for pediatricians, other 

health care providers and the public 

because most health care providers are not prepared to answer 

questions about the effects of the 

environment on children’s health. 

Health care providers need a way 

to learn about health problems 

related to the environment in order 

to meet the needs of the public. 

PEHSUs aim to: reduce environmental health threats to children; 

improve access to expertise in 

pediatric environmental medicine; 

and strengthen public health prevention capacity. Visit www.atsdr.

cdc.gov/child/ochchildhlth.html 

or www.aoec.org/pesu.htm.

Protecting Children 

Beyond Our Borders

Children’s environmental health 

issues span the globe and cross 

political boundaries. EPA works 

with developing and developed coun-
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tries, international organizations and nongovernmental organizations to highlight 

issues and build political will to address 

these issues. International cooperation 

and collaboration on children’s environmental health continues to build.

• Global Children’s 

Environmental Health 

Indicators: Protecting children 

from exposure to environmental 

hazards requires that we better 

understand the relationship between 

environmental conditions and health 

outcomes. Several recent international agreements have highlighted 

the need for assessing the state of 

children’s environmental health and 

monitoring progress and have called 

for action to develop children’s 

environmental health indicators. 

With EPA support, the World Health 

Organization (WHO) is leading the 

effort to develop global indicators. For more information, see 

www.who.int/ceh/indicators/en.

• Children’s Exposure to 

Indoor Cooking Smoke: Two 

billion people, almost half of the 

world’s population, still burn traditional fuels such as firewood, coal, 

crop residues, and dung indoors for 

cooking and heating, filling homes 

with particulate matter and smoke. 

The World Health Organization estimates that 1.6 million people, mainly 

women and children, die each year 

from breathing the dense smoke 

from traditional cooking and heating fires. In an effort to save lives, 

over 65 public and private organizations have joined the Partnership 

for Clean Indoor Air, led by EPA and 

launched in South Africa in 2002. 

The Partnership’s mission is to 

reduce exposure to indoor air pollution from household energy use for 

five million people by 2010. To learn 

more, visit www.PCIAonline.org.

• Partnership for Clean Fuels 

and Vehicles: Motor vehicles 

account for a significant portion of urban air pollution around 

the world. EPA is a key partner 

in the Partnership for Clean Fuels 

and Vehicles, established at the 

World Summit on Sustainable 

Development in Johannesburg, 

South Africa in 2002. The partnership’s goals are to eliminate lead in 

gasoline and reduce sulfur in diesel 

and gasoline fuels while concurrently 

adopting cleaner vehicle technologies. For more information on the 

Partnership for Clean Fuels and 

Vehicles, visit www.unep.org/PCFV.

• Atlas of Children’s 

Environmental Health: To 

illustrate the impact of the environment on children’s health, EPA 

funded an effort by the World Health 

Organization (WHO) to launch 

a first-ever “Atlas of Children’s 

Environmental Health and the 

Environment.” Presented at the 

Fourth European Conference of 

Health and Environment Ministers 

in Budapest, Hungary, this book 

brings together a range of facts 

about the effects of environmental 

risks to our children’s health, and 

paints a graphic picture of the hazards we all face and the reasons for 

over three million annual deaths in 

children under age five worldwide. 

Visit the atlas at www.who.int/ceh/

publications/atlas/en/index.html.

• Materials for Health Care 

Providers: EPA supports the 

World Health Organization to 

develop a handbook for physicians 

in developing countries, modeled 

after the American Academy of 

Pediatrics “Handbook of Pediatric 

Environmental Health” but adapted 

and expanded to address issues in 

developing countries. In addition, 

pamphlets are being created to 

address water and sanitation, lead, 

vector-borne diseases, chemical 

exposures, air pollution and respiratory diseases. Trainings for health 

care providers have been organized 

in India, Thailand, Argentina, and 

Uruguay. EPA is supporting the 

International Pediatric Association 

pre-congress workshop to train 

up to 100 pediatricians from 

developing countries on children’s 

environmental health issues.

• Global Mercury 

Assessment: Because mercury can be transported globally 

and deposited far from its origin, 

it is a concern for all countries. 

EPA is actively engaged in bilateral, regional and global efforts 

to better characterize and reduce 

the adverse impacts of mercury. 

EPA and the Department of State 

are providing technical and financial support to the global mercury program under the United 

Nations Environment Program. Visit 

www.chem.unep.ch/mercury.
Children, by their very nature, deserve 

our assiduous attention. Their bodies 

are different than adults, their behaviors 

are different, and their interactions with 

the environment are different. Protecting 

the health of children is a compelling

inducement to improving our environment, 

both during Children’s Health Month and 

throughout the year, both in the United 

States and throughout the world.

For more information, visit EPA’s Office of Children’s Health 

Protection Web site: www.epa.gov/children.

Office of Children’s Health Protection

EPA 100-F-04-017

September 2004

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