Environmental Health: EPA Efforts to Address Children's Health Issues Need Greater Focus, Direction, and Top-Level Commitment
Published: 2008-09-16T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: According to EPA, children face disproportionate risks from contaminants such as air pollution and lead paint. The health consequences to the country's 74 million children are significant. In 2006, 55 percent of children lived in counties exceeding allowable levels for at least one of the six principal air pollutants such as ozone which causes or aggravates asthma. Asthma is the third-most common cause of childhood hospitalization, resulting in $3.2 billion in treatment costs and 14 million lost school days annually, according to the Centers for Disease Control and Prevention. In 1997, EPA created the Office of Children's Health and convened the Children's Health Protection Advisory Committee (Advisory Committee) to provide advice and recommendations to assist in developing regulations, guidance, and policies to address children's health. In April 1997, the President signed Executive Order 13045, creating an interagency Task Force to recommend federal strategies for protecting children. Our testimony is based on ongoing work on the extent to which EPA has used the Advisory Committee and addressed the committee's key recommendations. It also includes information about the Task Force. We met with numerous EPA officials and analyzed the committee's letters. GAO recommends, among other things, that EPA expeditiously complete its review of the Advisory Committee's key recommendations.
section_title: What GAO Found
paragraphs: EPA has not proactively used the Advisory Committee to ensure that the agency's regulations, guidance, and policies address the disproportionate risks that environmental contaminants pose to children. Our analysis found that the Advisory Committee met more than 30 times and discussed a variety of environmental health issues with dozens of officials from EPA offices such as Pesticides and Toxic Substances, and Research and Development. However, we identified just three instances where EPA specifically asked the committee for recommendations and advice on regulations--most notably an October 1997 request that the committee identify five regulations or standards for EPA to re-evaluate in order to better protect children. In the absence of focus and direction from EPA, the Advisory Committee has taken the initiative to write more than 70 letters to the Administrator since 1998 containing hundreds of recommendations on a wide variety of children's health concerns. EPA has not addressed key recommendations from its Advisory Committee, particularly those in a major April 2007 letter and in recent letters advising EPA on proposed revisions to national air quality standards. The April 2007 letter, which marked the 10th anniversary of the Executive Order, provided recommendations in seven key areas. These included the need for EPA to eliminate environmental health disparities among low-income and minority children. While EPA generally responds to the Advisory Committee's letters, the agency has not fulfilled the Administrator's commitment in his response to the 10th anniversary letter to collaboratively review recommendations from the advisory committee. The Office of Children's Health had begun forming internal workgroups, but a new acting director stopped the process in late 2007 to hold individual meetings with EPA's assistant administrators, and the process remains stalled. We also analyzed EPA's responses to the committee's specific recommendations on three recently-considered EPA air quality standards--the National Ambient Air Quality Standards for particulate matter, ozone, and lead--and we found that EPA either offered to consider the committee's recommendations as part of the public comment process or rejected them. The President's Task Force, which was authorized in April 1997, provided high-level interagency leadership and coordination on children's environmental health, but it expired in April 2005. According to the children's health experts with whom we spoke, the task force provided important leadership on initiatives such as the National Children's Study and the Healthy Schools Environmental Assessment Tool. The task force also developed federal strategies to address four threats to children--asthma, developmental disorders, cancer, and unintentional injuries. In 2003, the President ordered the task force to be extended by 2 years, but the order eliminated the provision for reassessing the task force. Since the task force's expiration, EPA no longer has a high-level infrastructure or mandate to coordinate federal strategies for children's environmental health and safety.

section_title: Letter
paragraphs: I am pleased to appear here today to discuss our ongoing work regarding  the Environmental Protection Agency’s (EPA) efforts to protect children  from environmental health risks such as pollution in the air, lead paint in  homes, pesticide residues on food, and treatment-resistant microbes in  drinking water. Many of the nation’s 74 million children are exposed to  such hazards daily. In 2006, for example, 55 percent of children lived in  counties that exceeded one or more of the six principal air pollutants, two  of which—ozone and particulate matter—are known to cause or aggravate  respiratory diseases such as asthma. Asthma is the third most common  cause of hospitalizations among children, resulting in $3.2 billion for  treatment and 14 million lost days of school annually, according to the  Centers for Disease Control and Prevention.
Children’s environmental health is a complex but vitally important subject.  The federal government has therefore taken several steps to make it a  priority and to ensure that it has access to the best available expert advice.  In April 1997, for example, the President signed Executive Order 13045,  Protection of Children from Environmental Health Risks and Safety Risks  (Executive Order), which mandated a concerted federal effort to address  children’s environmental health and safety risks. Among other things, the  Executive Order established an interagency President’s Task Force on  Environmental Health Risks and Safety Risks to Children (President’s  Task Force) for a period of 4 years and charged it with recommending  strategies to the President for protecting children’s environmental health  and safety. The President’s Task Force was co-chaired by the  Administrator of EPA and the Secretary of Health and Human Services and  included the heads of at least 14 other departments, agencies,  commissions, and councils.
Also in 1997, EPA established the Office of Children’s Health Protection to  support its efforts. In addition, EPA formed the Children’s Health  Protection Advisory Committee (Advisory Committee) to provide advice,  information, and recommendations to assist the agency in the  development of regulations, guidance, and policies relevant to children’s  health. Instead of a panel of experts on a single academic discipline, the  Advisory Committee is made up of a broad cross-section of children’s  health experts from the academic, healthcare, industry, local government,  and non-profit sectors.
In April 2007, the Advisory Committee wrote to the Administrator to  reflect on EPA’s achievements protecting children from environmental  health threats in the 10 years since the Executive Order was signed. The  committee cited successes such as increased margins of safety for  pesticides mandated under the Food Quality Protection Act and the  creation of the National Children’s Study. However, the committee also  expressed serious concerns about EPA’s continued lack of focus on  children’s environmental health issues and the lack of progress in  addressing its many recommendations.
My testimony is based on ongoing work for the Senate Committee on  Environment and Public Works, which we expect to complete in mid-2009,  that examines the extent to which EPA has maintained its focus on  children’s environmental health issues and capitalized on opportunities to  solve some significant and emerging environmental health challenges in  the decade since the Executive Order was signed. My statement today  addresses: (1) the extent to which EPA has used the Children’s Health  Advisory Committee and (2) the extent to which EPA has addressed the  Advisory Committee’s key recommendations. In addition, as you  requested, my statement includes information about the activities and  status of the President’s Task Force on Environmental Health Risks and  Safety Risks to Children. In conducting our work, we met with EPA and  Advisory Committee officials and analyzed documents—including  committee meeting agendas, summary documents, letters to the EPA  Administrator, and EPA’s response letters—using the content analysis  software NVivo. We also reviewed key documents and interviewed agency  officials to determine the major activities and current status of the  President’s Task Force. We also obtained EPA’s views on the facts  presented in my statement and made minor modifications based on the  agency’s comments.  Our ongoing work for this performance audit began  in December 2007, and continues in accordance with generally accepted  government auditing standards.
EPA has not proactively used the Advisory Committee to ensure that the  agency’s regulations, guidance, and policies address the disproportionate  risks to children that result from environmental contaminants. Our  analysis found that the Advisory Committee met more than 30 times since  1997 and discussed a variety of environmental health issues with dozens of  officials from EPA offices such as Pesticides and Toxic Substances, Air  and Radiation, and Research and Development. However, we identified  just three instances where EPA specifically asked the committee for  recommendations and advice on regulations—most notably an October  1997 request that the committee identify five regulations or standards for  EPA to re-evaluate in order to better protect children. In the absence of  focus and direction from EPA, the committee has taken the initiative to  write more than 70 letters to the Administrator since 1998 offering  hundreds of recommendations on a wide variety of children’s  environmental health concerns.
EPA has largely disregarded key recommendations from its Advisory  Committee, particularly those in its 10th anniversary letter and in several  recent letters advising EPA on proposed revisions to national air quality  standards. In April 2007, to mark the 10th anniversary of the Executive  Order, the Advisory Committee provided recommendations in seven key  areas of concern, including the need for EPA to eliminate environmental  health disparities among low-income and minority children, strengthen the  national approach to regulating toxic chemicals, and provide necessary  leadership and infrastructure to protect children’s health. While EPA  generally provides a letter in response to the committee, the agency has  not fulfilled the Administrator’s commitment in his June 2007 response  letter to review the advisory committee’s recommendations and EPA’s  children’s environmental health activities. In his response to the Advisory  Committee’s letter, the Administrator agreed that the 10th anniversary of  the Executive Order was an appropriate time to review EPA’s children’s  health activities. He directed the Office of Children’s Health to collaborate  with EPA’s program offices and the Advisory Committee to review their  recommendations. In addition, the acting director of the office committed  to engage the staff involved with Children’s Health Advisory Management  Partners (CHAMPS)—actions which have yet to happen. We also analyzed  EPA’s response to the committee’s specific recommendations related to  three recently-considered EPA air quality standards, and we found that  EPA did not acknowledge, was noncommittal, rejected, or offered only to  consider them along with comments from the general public.
The President’s Task Force on Environmental Health Risks and Safety  Risks to Children provided important high-level leadership and  interagency coordination on children’s environmental health from 1997  until it expired in April 2005. According to the EPA staff and children’s  health experts we spoke with, the President’s Task Force provided critical  leadership on several important initiatives such as the National Children’s  Study and the Healthy Schools Environmental Assessment Tool. The task  force also developed national strategies to coordinate federal programs to  address the four major environmental and safety threats to children that it  identified—asthma, developmental disorders, cancer, and unintentional  injuries. Since the task force’s expiration, EPA no longer has a high-level  infrastructure to coordinate federal strategies for children’s environmental  health and safety. According to the experts, the task force could have  helped the federal government respond to the recent health and safety  concerns that prompted the recall of 45 million toys and children’s  products in 2007.
subsections: section_title: Background
paragraphs: According to EPA, children face disproportionate and unique threats from  environmental hazards for many reasons. For example, EPA has noted that  children may receive higher doses of environmental contaminants because  they spend more time close to the ground, touch their hands to their  mouths more often, and, in proportion to their body weight, breathe more  air, consume more food, and drink more water than adults. Contaminants  may also affect children disproportionately because they have unique  exposure pathways—through the placenta and breast milk. Furthermore,  children are more vulnerable to contaminants than adults because of the  relative immaturity of their biochemical and physiological functions. For  example, air pollutants that would produce slight breathing difficulties in  adults may contribute to more serious breathing problems in young  children because of their smaller airways. Also, EPA has noted that  children have limited ability to communicate and urge action about  protecting their environment, so others must act on their behalf.
The Children’s Health Protection Advisory Committee, as a committee  chartered under the Federal Advisory Committee Act must follow broad  requirements for balance, independence and transparency. The  membership of the Advisory Committee includes a diverse range of  viewpoints from 29 individuals including researchers, academicians,  health care providers, environmentalists, children’s advocates,  professionals, and government employees who advise EPA on regulations,  research, and communication issues relevant to children. The current  chairman of the Advisory Committee, only the second since the committee  began meeting in 1998, has been in place since 2003. As required under  FACA, a designated federal official from EPA’s Office of Children’s Health  oversees the Advisory Committee’s activities, including approving meeting  agendas and attending all meetings. To ensure that suitable speakers are  invited to committee meetings, the meeting agendas and speakers are set  by a steering committee comprised of the director of EPA’s Office of  Children’s Health, the chairman of the Advisory Committee, and the chairs  of any active workgroups created by the committee to examine a specific  children’s issue. According to the Advisory Committee’s charter, the  committee is to send its letters to the EPA Administrator. In addition, the  Advisory Committee announces meetings ahead of time and gives notice  to interested parties about such meetings. The plenary sessions of  meetings are open to the public and EPA ensures that meeting minutes are  prepared and posted to their website.
As shown in figure 1, the committee has directed the vast majority of its  letters to the EPA Administrator but periodically directs letters to other  EPA officials such as the Director of the Office of Research and  Development.
According to the committee’s operating procedures and principles, “all  recommendations must reflect the consensus of the committee and that in  achieving consensus, all relevant perspectives, interests and concerns of  committee members are reflected.” To accomplish detailed reviews of  children’s health issues in order to achieve consensus, the committee  typically forms a taskgroup from its members that meets separately with  staff from the Office of Children’s Health. Taskgroups consider  information presented during full committee meetings, identify relevant  recommendations, and draft letters for full committee review. The  committee has formed nearly three dozen such taskgroups over its history,  including taskgroups that considered EPA’s proposed revisions to air  quality standards for particulate matter, ozone, and lead. Although the  committee typically reviews these letters during plenary sessions, the  committee uses a between-meeting process—to ensure that the full  committee has an opportunity to review materials, provide input, and  reach consensus without a plenary session—when a letter must be written  before the next meeting, as was the case for the letters that addressed the  air quality standards.
section_title: EPA Has Not Proactively Used the Children’s Health Protection Advisory Committee in the Development of Regulations, Guidance, and Policies
paragraphs: While EPA has convened the committee for dozens of presentations and  discussions with EPA and non-EPA officials, the agency has made few  requests for the committee’s advice or recommendations on regulations,  guidance or policies to address the disproportionate risks to children’s  health. Nonetheless, the committee has sent more than 70 letters to the  Administrator offering hundreds of recommendations on a wide range of  children’s health concerns.
subsections: section_title: The Advisory Committee Has Met With Many Officials from EPA and Other Agencies
paragraphs: Since 1997, EPA has convened the Advisory Committee 32 times for  meetings which included presentations and discussions with many EPA  and non-EPA officials on a wide variety of children’s health topics. Staff  from the EPA Office of Children’s Health told us that the committee’s  value comes, in part, from the verbal input that committee members  provide to EPA officials during the discussions surrounding those  presentations. According to our analysis of agendas and meeting  summaries, EPA and non-EPA speakers made 189 presentations for the  committee during the past decade. As shown in figure 2, EPA officials  made 79 percent of the presentations to the advisory committee, with the  Office of Children’s Health (OCHP) accounting for the largest proportion.  Since 2006, for example, officials from OCHP have given regular updates  to the committee on EPA’s revisions to the National Ambient Air Quality  Standards for particulate matter, ozone, and lead. In addition, the Office of  the Administrator (OA) has given a number of presentations, and three of  the four EPA Administrators since 1997 have met with the committee.
The figure also shows that EPA’s program offices made regular  presentations to the Advisory Committee, including the agency’s Office of  Prevention, Pesticides and Toxic Substances (OPPTS), Office of Air and  Radiation (OAR), Office of Research and Development (ORD), and Office  of Water (OW). For example, officials from the Office of Air and Radiation,  and the Administrator himself, gave three presentations to the committee  on the air quality standards between 2005 and 2007.
Although the Advisory Committee was established to provide EPA with  advice, information and recommendations—and reports directly to the  Administrator—it also regularly hears from non-EPA officials to gather  additional information. As the figure also shows, 21 percent of Advisory  Committee presentations were made by representatives from other federal  agencies, industry, academic experts, states and localities, and advocacy  and non-profits. For example, the committee has heard from  representatives from the Centers for Disease Control and Prevention and  the National Academy of Sciences.
section_title: EPA Has Rarely Sought the Advisory Committee’s Advice on Regulations, Guidance, and Policies that Address Children’s Health
paragraphs: Despite convening the Advisory Committee more than 30 times over the  last 10 years for discussions with a variety of speakers, EPA has rarely  sought out the committee’s advice and recommendations to assist it in  developing regulations, guidance, and policies that address children’s  health. We identified only three instances where EPA specifically asked  the committee for advice on regulations, three instances on guidance, and  one instance on policies. The clearest example is EPA’s request in October  1997—prior to the committee’s first meeting—that the committee identify  five regulations or standards for the agency to re-evaluate in order to  better protect children. In another instance, in 2005, EPA asked CHPAC  for comments on data that the agency planned to use to support the Clean  Air Mercury Rule. In addition to these requests regarding regulations,  guidance, and policies, we identified 14 other instances where EPA asked  for the committee’s advice on programs, plans, or other issues. The  requests varied in topic and scope, ranging from a 2005 request for advice  on evaluating EPA’s pilot version of the Voluntary Children’s Chemical  Evaluation Program (VCCEP) to a request in 2002 to suggest a health  organization to be asked to join EPA’s Smart Growth Network.
Although EPA has not proactively requested the Advisory Committee’s  advice on regulations, guidance, and policies, the members of the  committee have nonetheless devoted considerable time to drafting and  reviewing 70 letters that the committee has sent to the Administrator since  1998. Those letters contained a range of advice, information and  recommendations, to which EPA has responded a total of 51 times. As  figure 3 shows, the committee typically sends 8 or fewer letters a year.
section_title: The Advisory Committee Has Offered Hundreds of Recommendations to EPA on a Range of Children’s Health Issues
paragraphs: The Advisory Committee’s letters offered EPA hundreds of  recommendations about a variety of topics related to reducing  environmental health risks to children. We identified over 600  recommendations during our review of the committee’s letters. A small  number of letters contained recommendations relating to multiple  children’s environmental health issues, such as a May 2008 letter with  recommendations about mercury regulation, farm worker protection  standards, organophosphate pesticides, and air quality. However, most  letters contained recommendations on a single issue. As shown in figure 4,  the number of recommendations varied from year to year, ranging from  more than 120 recommendations in 2000 to 20 thus far in 2008.
In addition, we organized the Advisory Committee’s recommendations into  10 categories to help demonstrate the breadth and depth of children’s  health issues that have concerned the committee Figure 5 shows that the  largest number of recommendations were focused on improving indicators  and data used for tracking children’s health information (133), urging that  children’s health vulnerabilities are considered in EPA risk assessments  (127), and improving or developing agency guidance documents (125). The  committee also offered many recommendations on topics such as research  (99), external partnerships and inter-agency coordination (97), policy (96),  and regulations and standards (80).
section_title: EPA Has Largely Disregarded Key Recommendations from the Children’s Health Protection Advisory Committee
paragraphs: The process that EPA initiated to carry out the Administrator’s  commitment, in a June 2007 letter, to address the Advisory Committee’s  key recommendations has stalled. In addition, EPA has largely disregarded  the advisory committee’s recommendations on air quality standards,  mercury, and the Voluntary Children’s Chemical Evaluation Program.
subsections: section_title: EPA Commitment to Review Key Advisory Committee Recommendations Has Stalled
paragraphs: On the 10th anniversary of the Executive Order, the Advisory Committee  wrote to EPA to express its views on key elements of a comprehensive  vision for protecting children’s health and made recommendations for  action. The committee’s April 10, 2007 letter provided recommendations in  seven areas for renewing EPA’s vision on children’s environmental health  and its commitment to the principles outlined in the Executive Order. As  illustrated in figure 6, the areas of concern to the committee included the  need for EPA to (1) eliminate environmental health disparities among low- income and minority children, (2) strengthen the national approach to  regulating toxic chemicals, and (3) provide necessary leadership and  infrastructure to protect children’s health.
The Administrator’s June 13, 2007 response letter directed the Office of  Children’s Health to work collaboratively with program offices across the  agency and committed the agency to working with the committee to  review these recommendations. However, EPA has not yet fulfilled the  Administrator’s commitment. The Office of Children’s Health had  established workgroups within its Children’s Health Advisory Management  Partners (CHAMPS) to address each of the seven areas outlined by the  committee, and the program offices had begun identifying representatives  to serve on the workgroups. However, a new acting office director  stopped the process in late 2007, opting instead to hold individual  meetings with EPA’s assistant administrators. The acting director decided  that strengthening relationships with senior management would be a  quicker way to identify leadership issues related to children’s health,  ensuring that they would be engaged and invested in the agency’s  response. In March 2008, a new permanent director replaced the acting  director. At present, the process of addressing the Administrator’s  commitment remains stalled.
section_title: Advisory Committee Recommendations on Air Quality Standards Have Not Been Substantially Addressed
paragraphs: We also examined the Advisory Committee’s recommendations related to  three air quality standards—the National Ambient Air Quality Standards  (NAAQS) for particulate matter, ozone, and lead, which EPA recently  reviewed. The committee was particularly concerned about the air quality  standards because of rising rates of asthma among U.S. children and the  relationship between poor air quality and the incidence and severity of  asthma. To express its concern, the committee wrote a number of letters  to urge EPA to tighten the standards based on scientific evidence that they  were not sufficiently protective of children’s health. Specifically, we  identified seven letters containing 23 recommendations with respect to  EPA’s proposed revisions to the particulate matter, ozone, and lead  standards. In general, the committee’s recommendations were further  supported by recommendations from EPA’s Clean Air Science Advisory  Committee (CASAC), which also has been sharply critical of several of  EPA’s decisions. For example, CASAC wrote to the administrator stating  unanimously that the revised air quality standard for particulate matter  “does not provide an adequate margin of safety … requisite to protect the  public health.” Table 1 shows that EPA’s revised air quality standards for  particulate matter, ozone, and lead are at or above the upper limits of  recommendations from both advisory committees.
While EPA provided the Advisory Committee with official response letters  to six of its seven NAAQS-related letters, we found that the agency  generally did not acknowledge or was noncommittal to the committee’s  recommendations, or that it offered merely to consider them as part of the  public comment process. EPA did not specifically acknowledge 11 of the  committee’s 23 recommendations, but provided a generic statement about  considering the recommendations with all others. For example, EPA did  not directly address the committee’s recommendations related to the lead  standards or the ability of a national lead-monitoring system to accurately  measure and facilitate effective control of the complex exposure routes of  airborne lead. Instead, EPA responded that it would consider the  committee’s recommendations along with all other public comments. EPA  acknowledged another 5 of the committee’s recommendations, although it  was noncommittal, providing no details about whether or how the agency  would address them. In one instance, EPA rejected a committee  recommendation. In its February 2007 letter, the committee recommended  that EPA reinstate the opportunities for public review and input provided  for in the previous NAAQS process to allow for scientific input and public  review. This letter, as well as a similar one from CASAC, warned that the  new process could significantly reduce opportunities for scientists to  provide input, as they had at key steps of previous NAAQS reviews. In its  response, EPA stated that changes to the review process would enhance  the agency’s ability to issue timely decisions while promoting participation  by scientific experts and the public. While there are periods in the  rulemaking process where EPA officials are in ongoing deliberations and  may not commit to actions until a standard is finalized, EPA did not  provide the Advisory Committee with any explanation after deliberations  were complete and officials were free to comment.
section_title: Advisory Committee Recommendations on Mercury and Voluntary Children’s Chemical Evaluation Program
paragraphs: We also reviewed the Advisory Committee’s recommendations on mercury  and EPA’s Voluntary Children’s Chemical Evaluation Program (VCCEP).  As with the air quality recommendations, EPA either did not acknowledge  or remained noncommittal toward most of the committee’s  recommendations related to mercury and VCCEP. Specifically, we  identified five Advisory Committee letters containing 29 recommendations  focused on the need to protect children from the risks posed by mercury  and three EPA response letters. Our review of EPA’s response letters  indicates that the agency did not acknowledge 10 of the recommendations.  For example, EPA did not acknowledge the recommendation that EPA  create incentives in its proposed Interstate Air Quality Rule to reduce  children’s exposure to mercury. Furthermore, EPA acknowledged but  provided no details about how the agency would address another 4  recommendations.
EPA did not provide a response to address 13 of the 29 recommendations that we  identified. be prevented under any Interstate Air Quality Rule. EPA acknowledged the  recommendation in its response, but did not address how this would be  ensured, stating instead that in implementing cap-and-trade programs in  the past, the agency has not observed the creation of hot spots, and that a  cap-and-trade program creates incentives for the utility sector to  aggressively seek reductions in nitrogen oxides (NOX) and sulfur dioxide  (SO), which ultimately provide early mercury reductions. Only in its 1998  response to the committee’s mercury-related recommendations did EPA  acknowledge the recommendations offered by the committee and detail  how it had addressed or intended to address each of the recommendations  raised. For example, to address the committee’s recommendation about  the need to take a holistic approach to evaluate all sources of mercury  emissions, EPA pointed to a November 1998 draft strategy that addressed  the multimedia nature of mercury. With respect to the committee’s  recommendation to consider mercury releases from municipal and  medical waste combustion sources, EPA described actions that, once fully  implemented, would reduce mercury emissions caused by human  activities at these types of sources by 50 percent from 1990 levels.
Similarly, our review of EPA’s responses to the Advisory Committee’s 14  recommendations regarding VCCEP indicates that the agency largely did  not acknowledge the committee’s recommendations. Half of the  recommendations were in a June 2006 letter to EPA. In its response, EPA  stated that it would carefully consider the committee’s comments and  undertake a thorough evaluation of the program in the coming months,  but, stopped short of providing detail or information on if or how it would  address six of the seven recommendations in this committee letter.  Moreover, in addition to its specific recommendations, the committee  concluded in its letter to EPA that the pilot program, as implemented, was  not on track to fulfilling its stated goal, and that there has been limited  information on specific chemicals relevant to children’s health provided to  the public. The Advisory Committee added that an opportunity had been  lost to develop and disseminate more advanced methods for assessing  children’s exposures and consequent risks.
section_title: President’s Task Force on Children’s Environmental Health Risks and Safety Risks Expired in 2005, Eliminating An Important Opportunity for EPA Leadership and Interagency Coordination
paragraphs: The President’s Task Force was authorized by executive order in April  1997 for a period of 4 years to provide high-level leadership and  interagency coordination on children’s environmental health. It was  comprised of nine cabinet officials and seven White House office directors  and was co-chaired by the Administrator of EPA and the Secretary of  Health and Human Services. The task force convened for meetings five  times—in October 1997, April 1998, January 1999, September 1999, and in  October 2001 after the President extended it until April 2003. At the urging  of the EPA Administrator in April 2003, the President ordered the task  force to be extended for a final 2 years. However, this order eliminated the  provision for reassessing the need for continuance of the task force, which  was not convened after October 2001. Nonetheless, a senior-staff steering  committee continued to meet until 2005 to provide coordination and draft  strategies to address the threats to children’s health.
The President’s Task Force identified four major environmental and safety  threats to children—asthma, developmental disabilities (including lead  poisoning), cancer, and unintentional injuries, and it recommended  national strategies for each of them. The task force recognized that an  integrated solution was needed across the federal government to address  the complex interaction between a child’s biology, behavior, and the  physical, chemical, biological, and social environment. According to the  children’s health experts with whom we spoke, the task force provided  critical leadership on several important initiatives such as the National  Children’s Study and the Healthy Schools Environments Assessment Tool  (Healthy SEAT). These national programs focus heavily on the  environmental influences on children, with the National Children’s Study  examining the role of environmental factors on health and disease and  Healthy SEAT offering school districts a self assessment tool for  evaluating environment, safety and health hazards. In addition, the  departments and agencies that made up the task force partnered to  prepare a fiscal year 2001 interagency budget initiative to fund the task  force’s initiatives in the four priority areas. The Secretary of Health and  Human Services and the Administrator of EPA submitted the request to  the Office of Management and Budget with the recommendation that it be  included as part of the President’s budget request that year. Officials told  us that OMB’s involvement helped ensure that adequate funds were  available to these agencies to address children’s health.
Since the task force’s expiration, EPA and HHS no longer have a high-level  infrastructure or mandate to coordinate federal strategies for children’s  environmental health and safety. According to the EPA staff and children’s  health experts with whom we spoke, the task force could have helped the  federal government respond to the health and safety concerns that  prompted the 2007 recall of 45 million toys and children’s products, 30  million of them from China. Furthermore, since the provision of the  executive order expired in 2005, the task force no longer reports the  results of its efforts to the President. Those reports collected and detailed  the interagency research, data, and other information necessary to  enhance the country’s ability to understand, analyze, and respond to  environmental health risks to children.
section_title: Conclusions
paragraphs: In 1997, the President issued an executive order on Protection of Children  from Environmental Health and Safety Risks calling on federal agencies to  work together to protect children’s health from environmental risk. In the  same year, EPA established an Office of Children’s Health Protection and  formed its Children’s Health Protection Advisory Committee. In the  intervening decade, we have seen a number of successful efforts to  strengthen environmental protections for children, including the landmark  Food Quality Protection Act, which provides protections from pesticides.  However, we also have seen growing evidence that children’s  environmental experience before birth, early in life, and through  adolescence may have lifelong consequences and may affect subsequent  generations.
EPA’s Advisory Committee and others have recently raised concerns that  the agency’s focus on children’s environmental health has diminished  since the executive order was signed. Based on our review of EPA’s use of  the Advisory Committee and the agency’s general unresponsiveness to the  committee’s key recommendations, coupled with the expiration of the  President’s Task Force, we believe the agency needs to reinvigorate its  focus and leadership on children’s environmental health in order to meet  current and emerging challenges facing the nation’s children.
section_title: Recommendations for Executive Action
paragraphs: To honor the Administrator’s commitment to the Children’s Health  Protection Advisory Committee, we are recommending that the Office of  Children’s Health Protection expeditiously complete the cross-agency  process to review the committee’s key recommendations. We are further  recommending that the Administrator examine ways to more proactively  use the committee to reinvigorate its focus on protecting children’s  environmental health.
Madam Chairman, this concludes my prepared statement. I would be  happy to respond to any questions that you or members of the Committee  may have at this time.
section_title: Contact and Staff Acknowledgments
paragraphs: Contact points for our Offices of Congressional Relations and Public  Affairs may be found on the last page of this statement. For further  information about this testimony, please contact John Stephenson at (202)  512-3841 or stephensonj@gao.gov. Key contributors to this testimony were  Diane Raynes, Terrance Horner, Aaron Shiffrin, and Corissa Kiyan. Other  contributors included Elizabeth Beardsley, Mark Braza, Muriel Brown, and  Benjamin Shouse.
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