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Philip J. Landrigan,¹ Joy E. Carlson,² Cynthia F. Bearer,³ Joan Spyker Cranmer,⁴ Robert D. Bullard,⁵ Ruth A. Etzel,⁶ John Groopman,⁷ John A. McLachlan,⁸ Frederica P. Perera,⁹ J. Routt Reigart,¹⁰ Leslie Robison,¹¹ Lawrence Schell,¹² and William A. Suk¹³

¹Mount Sinai School of Medicine, New York, New York
²Children's Environmental Health Network, Emeryville, California
³Case Western Reserve University, Cleveland, Ohio
⁴University of Arkansas, Medical School, Little Rock, Arkansas
⁵Clark University, Atlanta, Georgia
⁶Centers for Disease Control and Prevention, Atlanta, Georgia
⁷Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland
⁸Tulane University School of Medicine, New Orleans, Louisiana
⁹Columbia University School of Public Health, New York, New York
¹⁰Medical University of South Carolina, Charleston, South Carolina
¹¹University of Minnesota School of Medicine, Minneapolis, Minnesota
¹²State University of New York at Albany, Albany, New York
¹³National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina

Abstract

Patterns of illness in American children have changed dramatically in this century. The ancient infectious diseases have largely been controlled. The major diseases confronting children now are chronic and disabling conditions termed the "new pediatric morbidity" -- asthma mortality has doubled ; leukemia and brain cancer have increased in incidence ; neurodevelopmental dysfunction is widespread ; hypospadias incidence has doubled. Chemical toxicants in the environment as well as poverty, racism, and inequitable access to medical care are factors known and suspected to contribute to causation of these pediatric diseases. Children are at risk of exposure to over 15,000 high-production-volume synthetic chemicals, nearly all of them developed in the past 50 years. These chemicals are used widely in consumer products and are dispersed in the environment. More than half are untested for toxicity. Children appear uniquely vulnerable to chemical toxicants because of their disproportionately heavy exposures and their inherent biological susceptibility. To prevent disease of environmental origin in America's children, the Children's Environmental Health Network (CEHN) calls for a comprehensive, national, child-centered agenda. This agenda must recognize children's vulnerabilities to environmental toxicants. It must encompass a) a new prevention-oriented research focus ; b) a new child-centered paradigm for health risk assessment and policy formulation ; and c) a campaign to educate the public, health professionals, and policy makers that environmental disease is caused by preventable exposures and is therefore avoidable. To anchor the agenda, CEHN calls for long-term, stable investment and for creation of a national network of pediatric environmental health research and prevention centers. -- Environ Health Perspect 106(Suppl 3) :787-794 (1998) .

http://ehpnet1.niehs.nih.gov/docs/1998/Suppl-3/787-794landrigan/abstract.html

Key words: environmental health, pediatrics, environmental toxicology, health policy