CHAPTER 5

Environment is a key determinant of health, and children are uniquely vulnerable to environmental hazards. Children’s genetic predisposition, social milieu, and nutrition play an important role in their susceptibility to environmental hazards.¹ Recent estimated costs of the burden of disease in children from environmental hazards is $76.6 billion annually.² The burden of disease stems primarily from exposure to toxic chemicals and air pollutants, and the related health conditions include lead poisoning, exposure to mercury pollution, childhood cancers, asthma, autism, intellectual and learning disabilities, and attention-deficit/hyperactivity disorder.²

Toxic substances are those chemicals in the environment capable of causing harm. Toxicants are environmental hazards from chemical pollutants, and toxins are environmental hazards from biological sources. Children have a larger ratio of surface area to body mass than adults which increases their susceptibility to pesticides and other environmental toxicants. Therefore, children absorb larger amounts of environmental toxins, kilogram (kg) for kg, than adults. Infants have three times as large a surface area and children have twice the surface area to body mass of an adult.¹ Young children breathe more air and drink more water per pound of body weight than adults. They have greater exposure to toxic chemicals and air pollutants for their body weight than adults, and they absorb toxic substances at a higher rate than that of adults.³ The skin, respiratory tract, and gastrointestinal tract in children are particularly vulnerable to toxic substances and absorb them more readily and efficiently than in the adult. The high gastric pH in children facilitates absorption of environmental toxins. The developing fetus and the young child are particularly vulnerable to the neurodevelopmental effects of environmental toxins because of their rapid periods of brain growth and development in the first 2 years of life.

Children also live and play closer to environmental hazards on the ground, which increases their concentrations of inhaled toxic substances. The breathing zone of a child is lower than adults, and chemical pollutants such as lead or mercury and chemicals vaporizing from carpets, flooring or nap mats impact children at a greater rate than adults.¹ Children’s metabolic pathways are immature, and they metabolize toxic chemicals differently than adults because they lack the enzymes to break down and remove toxic chemicals from the body.³ Their higher metabolic rate increases their oxygen consumption and production of carbon dioxide (CO₂). The increased CO₂ requires higher minute ventilation in infants and children and increases exposure to particulate matter in the air.¹ The dose-response rate for exposure in children is far more rapid than in adults.

Environmental health is defined as “freedom from illness or injury related to exposure to toxic agents and other environmental conditions encountered in the home, workplace, and community environments that are potentially detrimental to human health.”⁴ It is critically important for pediatric health care providers to understand the impact of environmental hazards and exposures on the healthy growth and development of infants, children, and adolescents. Health care providers have a professional responsibility to identify and understand the environmental health risks present in the communities they work in, to access available health risk data from community surveillance programs, and to report exposures to appropriate local and state authorities. Furthermore, providers are mandated to conduct appropriate screening tests and to educate children and families about toxic environmental health risks.

Stay updated, free articles. Join our Telegram channel

Join