Overview of EPA’s Work on 

Children’s Environmental Health

National Advisory Council for Environmental Policy & Technology 

January 20, 2011
2

Indicator B1

Blood lead in children ages 1 to 5 years

Concentration of lead in blood ( g/dL)

0

5

10

15

20

25

30

95th percentile blood lead

Median blood lead

DATA: Centers for Disease Control and Prevention, National Center for Health 

Statistics, National Health and Nutrition Examination Survey 

1976-

1980

1988-

1991

1991-

1994

1999-

2000

*

DRAFT Indicator for Third Edition of America's Children and the Environment

2001-

2002

2003-

2004

2005-

2006

2007-

2008

Indicator B1

Blood lead in children ages 1 to 5 years

Concentration of lead in blood ( g/dL)

0

5

10

15

20

25

30

95th percentile blood lead

Median blood lead

DATA: Centers for Disease Control and Prevention, National Center for Health 

Statistics, National Health and Nutrition Examination Survey 

1976-

1980

1988-

1991

1991-

1994

1999-

2000

*

DRAFT Indicator for Third Edition of America's Children and the Environment

2001-

2002

2003-

2004

2005-

2006

2007-

2008
Indicator ND1

Percentage of children ages 5 to 17 years reported to 

have attention-deficit/hyperactivity disorder, by gender

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

0%

2%

4%

6%

8%

10%

12%

14%

All children

Boys

SOURCE: U.S. EPA. America's Children and the Environment. 

www.epa.gov/envirohealth/children

Girls

DATA: Centers for Disease Control and Prevention, National Center for 

Health Statistics, National Health Interview Survey 

Percentage of children ages 5 to 17 years reported to 

have attention-deficit/hyperactivity disorder, by gender

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

0%

2%

4%

6%

8%

10%

12%

14%

All children

Boys

SOURCE: U.S. EPA. America's Children and the Environment. 

www.epa.gov/envirohealth/children

Girls

DATA: Centers for Disease Control and Prevention, National Center for 

Health Statistics, National Health Interview Survey 

Indicator ND1

Percentage of children ages 5 to 17 years reported to 

have attention-deficit/hyperactivity disorder, by gender

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

0%

2%

4%

6%

8%

10%

12%

14%

All children

Boys

SOURCE: U.S. EPA. America's Children and the Environment. 

www.epa.gov/envirohealth/children

Girls

DATA: Centers for Disease Control and Prevention, National Center for 

Health Statistics, National Health Interview Survey 

Indicator ND1

Percentage of children ages 5 to 17 years reported to 

have attention-deficit/hyperactivity disorder, by gender

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

0%

2%

4%

6%

8%

10%

12%

14%

All children

Boys

SOURCE: U.S. EPA. America's Children and the Environment. 

www.epa.gov/envirohealth/children

Girls

DATA: Centers for Disease Control and Prevention, National Center for 

Health Statistics, National Health Interview Survey 

Indicator ND1

Percentage of children ages 5 to 17 years reported to 

have attention-deficit/hyperactivity disorder, by gender

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

0%

2%

4%

6%

8%

10%

12%

14%

All children

Boys

SOURCE: U.S. EPA. America's Children and the Environment. 

www.epa.gov/envirohealth/children

Girls

DATA: Centers for Disease Control and Prevention, National Center for 

Health Statistics, National Health Interview Survey 

DATA: Centers for Disease Control and Prevention, National Center for 

Health Statistics, National Health Interview Survey 

Binder S, Falk H. Strategic plan for the elimination of childhood lead 

poisoning. Atlanta: Centers for Disease Control, 1991.

5

Indicator D5

Cancer incidence and mortality for children under 20 years

1992 1994 1996 1998 2000 2002 2004 2006

Cases per million children

0

50

100

150

200

Incidence

Mortality

DATA: National Cancer Institute, Surveillance, Epidemiology and 

End Results Program

DRAFT Indicator for Third Edition of America's Children and the Environment

2007

Indicator D5

Cancer incidence and mortality for children under 20 years

1992 1994 1996 1998 2000 2002 2004 2006

Cases per million children

0

50

100

150

200

Incidence

Mortality

DATA: National Cancer Institute, Surveillance, Epidemiology and 

End Results Program

DRAFT Indicator for Third Edition of America's Children and the Environment

2007
6

Indicator ND1

Percentage of children ages 5 to 17 years reported to 

have attention-deficit/hyperactivity disorder, by gender

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

0%

2%

4%

6%

8%

10%

12%

14%

All children

Boys

SOURCE: U.S. EPA. America's Children and the Environment. 

www.epa.gov/envirohealth/children

Girls

DATA: Centers for Disease Control and Prevention, National Center for 

Health Statistics, National Health Interview Survey 
Indicator ND3

Percentage of children ages 5 to 17 years reported to 

have autism

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

0%

1%

2%

3%

4%

5%

6%

7%

SOURCE: U.S. EPA. America's Children and the Environment. 

www.epa.gov/envirohealth/children

DATA: Centers for Disease Control and Prevention, National Center for 

Health Statistics, National Health Interview Survey 

*
A. Use the best science to ensure that regulations and 

other agency actions protect children’s environmental 

health

B. Establishing standards, policies, and guidance to help 

eliminate harmful prenatal and childhood exposures to 

pesticides and other toxic chemicals

C.Coordinate community-based programs to help 

eliminate threats to children’s health and to measure 

progress

Administrator Jackson’s 2/4/10 Memo: 

EPA’s Leadership in Children’s Environmental Health

8
Children’s Health Risk Assessment Guidance 

Documents & Methodologies

• Guidelines for Developmental Toxicity Risk Assessment (1991) 

• Guidelines for Reproductive Toxicity Risk Assessment (1996)

• Supplemental Guidance for Assessing Susceptibility from Early-Life 

Exposure to Carcinogens (2005)

• Guidance on Selecting Age Groups for Monitoring and Assessing 

Childhood Exposures to Contaminants (2005)

• A Framework for Assessing Risks of Environmental Exposures to 

Children (2006)

• Child-Specific Exposure Factors Handbook (2008)

See www.epa.gov/risk for links

Regulations and Risk Assessments
Regulations to Protect Children’s Health

• NO2: Strengthened the health-based National Ambient Air Quality Standard for 

nitrogen dioxide

• The new 1 hour NO2 standard of 100 parts per billion will protect the health of 

sensitive populations – including people with asthma, children and the elderly

• SO2: Set new standards for short term exposures to sulfur dioxide, associated with 

power plant emissions

• EPA revised the primary SO2 standard by establishing a new 1-hour standard at a 

level of 75 parts per billion

• Proposed the Clean Air Transport Rule that will require power plants in the eastern half 

of the country to reduce both pollutants

• Additionally, we're working on a number of other air pollution regulations: 

• standards for power plants and industrial boilers for hazardous air pollutants like 

mercury, cadmium and hydrogen chloride

• national standards for ozone and particulate matter 

Regulations and Risk Assessments
Regulations and Risk Assessments

Future Risk Assessment Needs

1. Continued development of high throughput toxicity testing assays that 

utilize human cell lines to prioritize and predict early life susceptibility to 

carcinogens and chemical mixtures

2. Data, including biomonitoring of children <6 yrs old, to support improved 

estimates of exposure to infants and toddlers

3. Better methods to develop and assess epidemiology data since children 

will never ethically be used in direct dosing studies

4. Understanding lifestage differences in metabolism and other TK 

parameters

5. Understanding why asthma, neurodevelopmental disorders and other 

health outcomes may differ for children in socioeconomically 

disadvantaged communities

6. Improved childhood cancer and neurological disease surveillance linking 

data from longitudinal studies
1996 - Food Quality Protection Act 

PUBLIC LAW 104–170 - AUG. 3, 1996 (1516-1519)

When setting a tolerance, the Administrator shall assess the risk of the pesticide 

chemical residue based on:

I. consumption patterns among infants and children that are likely to result in 

disproportionately high consumption of foods containing the pesticide among 

infants and children in comparison to the general population;

II. the special susceptibility of infants and children to pesticide residues, 

including: neurological differences between infants and children and adults; 

and effects of in utero exposure to the pesticide; and

III. cumulative effects on infants and children of pesticide residues and other 

substances that have a common mechanism of toxicity; and

The Administrator shall ensure that there is a reasonable certainty that no harm 

will result to infants and children from aggregate exposure to the pesticide 

chemical residue; and shall publish a specific determination regarding the 

safety of the pesticide chemical residue for infants and children.

12

Safe Chemicals Management
Essential Principles for Reform of Chemicals 

Management Legislation

1. Chemicals Should be Reviewed Against Safety Standards that are Based on 

Sound Science and Reflect Risk-based Criteria Protective of Human Health 

and the Environment

2. Manufacturers Should Provide EPA with the Necessary Information to 

Conclude That New and Existing Chemicals are Safe and Do Not Endanger 

Public Health or the Environment

3. Risk Management Decisions Should Take into Account Sensitive 

Subpopulations, Cost, Availability of Substitutes and Other Relevant 

Considerations

4. Manufacturers and EPA Should Assess and Act on Priority Chemicals, Both 

Existing and New, in a Timely Manner

5. Green Chemistry Should Be Encouraged and Provisions Assuring 

Transparency and Public Access to Information Should Be Strengthened

6. EPA Should Be Given a Sustained Source of Funding for Implementation

Safe Chemicals Management
Healthy Homes

• Interagency Healthy Homes Working Group

– Marketing sub-group is developing an outreach strategy to the public 

on creating healthy home environments

• EPA is developing voluntary Healthy Indoor Environment 

Protocols for Home Energy Upgrades

– Protocols are being developed in conjunction with the Department of 

Energy Workforce Guidelines for Home Energy Upgrades 

• Training offered through National Center for Healthy Housing

– 5-year contract to offer 26 trainings each year

– Including training on Bed Bugs, IPM, Health and Energy and Healthy 

Homes

Community-Based Programs
Healthy Schools - TSCA Title V: Healthy High Performance Schools

• Voluntary guidelines for siting of school facilities that account for—

• the special vulnerability of children to hazardous substances or pollution 

exposures in any case in which the potential for contamination at a 

potential school site exists

• modes of transportation available to students and staff

• the efficient use of energy

• the potential use of a school at the site as an emergency shelter

• Voluntary guidelines for state school environmental health programs that 

include—

• environmental problems, contaminants, hazardous substances, pollutant 

emissions

• natural day lighting, ventilation, heating and cooling, acoustics

• moisture control, mold, maintenance, cleaning, pest control

• other issues relating to the health, comfort, productivity, and 

performance of occupants of the school facilities

Community-Based Programs
Health Care Providers - Pediatric Environmental Health Specialty Units

• EPA and ATSDR co-fund 10 Pediatric Environmental Health Specialty Units 

(PEHSUs) across the country

• These PEHSUs form a network that is capable of responding to requests for 

information throughout North America and offering advice on prevention, 

diagnosis, management, and treatment of environmentally-related health effects in 

children

• PEHSUs work with health care professionals, parents, schools and community 

groups, and others to provide information on protecting children from 

environmental hazards

• At www.PEHSU.net there are many sources of information on specific threats to 

children's health from the environment, including links to resources for health 

professionals, fact sheets for health professionals and parents, and trainings

Community-Based Programs
Children’s Health Protection Advisory 

Committee

• CHPAC is a federal advisory committee with legal authority 

under the Federal Advisory Committee Act 

• 27 volunteers from communities, academia, industry, 

NGOs, state and local government

• Committee includes experts in children’s environmental 

health from clinical, research, regulatory and advocacy 

groups

• Committee advises EPA Administrator on regulations, 

policies, programs, communication, and specific issues 

related to health of children
2009 Advice on Chemicals Management

• Improve evaluation of risks to fetuses, infants, children 

and adolescents

• Take action to protect children when warranted

• Use biomonitoring and modeling that evaluate exposures 

through unique infant and child pathways

• Obtain adequate chemical use information from chemical 

manufacturers

Children’s Health Protection Advisory Committee
2009 Advice on Health Disparities

• Partner with federal and state agencies and others to address 

environmental health issues that disproportionately affect lowincome and minority populations 

• Disparities include asthma prevalence, proximity to toxic chemicals, 

lead and pesticide exposures

• Address the health concerns of children in inner city, rural, Native 

American, subsistence fisher and farm worker communities

Children’s Health Protection Advisory Committee
2010 Advice on Draft School Siting Guidelines

• Support approaches to school siting decisions that lead to health benefits to 

both the school population and larger community

• Provide regional and national EPA technical support for school siting

activities

• Develop additional guidelines in related areas including construction 

materials and operations/maintenance procedures used in new and existing 

schools

• Extend the school siting guidelines to additional learning environments, such 

as child care centers, preschools, and charter and private schools

• Establish effective coordination with multiple federal agencies

Children’s Health Protection Advisory Committee
2010 -2011 Workgroups

• America’s Children and the Environment – providing 

review and final comment on latest version of the 

indicators report

• Indoor Environments – providing insight on the quality of 

places where children live and learn and play. 

• Prenatal Exposures – specific look at the earliest 

environments of children and the vulnerabilities and 

opportunities for EPA leadership

Children’s Health Protection Advisory Committee