Preventing child exposures to environmental hazards: research and policy issues.

This monograph contains 39 papers presented at the Symposium on Preventing Child Exposures to Environmental Hazards: Research and Policy Issues held March 1994. This national invitational meeting brought together 200 researchers, clinicians, policymakers, and community advocates to develop recommendations for action for the federal government and the research community. It was the first time that policy and research issues concerning child exposures were discussed by multidisciplinary experts at the national level. The purpose of the symposium was to: * Develop a set of recommendations for federal agencies, the research community, and community-based organizations that incorporate a multidisciplinary and mul-ticultural perspective; * Increase communication between the research, policy, clinical practice, and advocacy arenas by building a national network of organizations and individuals who are dedicated to issues of pedi-atric environmental health; and * Define the field of pediatric environmental health through the commission and presentation of papers that identify and explore cutting-edge research and policy issues. Four plenaries formed a framework for discussion. The plenary topics covered chil-dren's unique vulnerabilities to environmental exposures, environmental justice for children, the federal government's agenda for protecting children from exposures, and successful community models for participa-tory research. Thirteen workshops were held during the 2-day meeting and included topics such as Age-Specific Carcinogenesis:

This monograph contains 39 papers presented at the Symposium on Preventing Child Exposures to Environmental Hazards: Research and Policy Issues held March 1994. This national invitational meeting brought together 200 researchers, clinicians, policymakers, and community advocates to develop recommendations for action for the federal government and the research community. It was the first time that policy and research issues concerning child exposures were discussed by multidisciplinary experts at the national level.
The purpose of the symposium was to: * Develop a set of recommendations for federal agencies, the research community, and community-based organizations that incorporate a multidisciplinary and multicultural perspective; * Increase communication between the research, policy, clinical practice, and advocacy arenas by building a national network of organizations and individuals who are dedicated to issues of pediatric environmental health; and * Define the field of pediatric environmental health through the commission and presentation of papers that identify and explore cutting-edge research and policy issues.
Four plenaries formed a framework for discussion. The plenary topics covered children's unique vulnerabilities to environmental exposures, environmental justice for children, the federal government's agenda for protecting children from exposures, and successful community models for participatory research. Thirteen workshops were held during the 2-day meeting and included topics such as Age- graph is by far the largest collection on the subject of environmental exposures and children to be published to date. It will provide a different context within which to discuss environmental health and children. These papers represent a significant contribution to the literature because they address both research and policy issues. The relationship between research and policy is a delicate one. Policy makers depend on good scientific data in order to develop sound public health policy, yet how can sound public health policy be developed in the face of limited or no data on a given population? The report on Pesticides and the Diet of Infants and Children (1) confronts that very issue as it cites limited databases on the exposure patterns and effects of pesticides on children and infants. With the exception of lead, adequate databases on the health effects of environmental exposures to children are lacking.
With 70,000 chemicals in common use today, it is imperative to understand the health effects resulting from exposures. For the majority of compounds, the health effects on children are unknown. Less than 10% of these chemicals have been tested for their effects on the central nervous system, with the exception of drugs controlled by the U.S. Food and Drug Administration (2).
Children are not routinely included in risk assessment processes, and most environmental regulations are based on exposure data of adult males. Because children have very different metabolic, physiologic and developmental processes, diets, and exposure patterns than adults, their health outcomes can differ drastically. There is a clear need for increased funding and increased research in this area.
Science, in order to remain objective, often does not want to be associated with policy, let alone with the political process. However, it is clear that funding for Environmental Health Perspectives research is certainly within the political process, and environmental health policy is dependent on research and data to provide a framework. It is also clear that the solutions to the complex issues in environmental health require the creativity, brilliance, commitment, and cooperation of many disciplines and perspectives. It is in this spirit that the symposium recommendations to the research community are given.

Other Recommendations for Action
Policy Recommendations for Action: the Federal Government * When drafting laws and policies, a public health approach, which considers long-term, prevention-oriented and socially equitable policies, should be taken particularly in the absence of information. This approach would establish health-based policies to protect vulnerable populations. Recommendations are as follows: -Set environmental standards to protect children, especially in the most vulnerable subpopulations such as low income and racial/ethnic communities. -In cases where the effects of an environmental hazard are uncertain, policies should be considered that prevent or eliminate exposure to that hazard. -Use a health-based rather than a cost-benefit standard in evaluating policies.
-Require industry to estimate and label products regarding risks to children. -Encourage each Federal agency to consider policies that are especially protective of children. For example, the U.S. Department of Agriculture and U.S. Environmental Protection Agency should be encouraged to promote reduced pesticide use in agriculture, schools, and homes. -While public policies should be grounded in science rather than in the public's perception of risk, the availability of scientific data should not be a barrier to timely policy.
-Include multidisciplinary and multicultural perspectives in the policymaking process. -Consider the numbers of people exposed when prioritizing environmental hazards. For example, the numbers of men and women of reproductive age, pregnant women, and children exposed to lead and environmental tobacco smoke make the eradication of these exposures of utmost importance. (It is important to consider that high-risk groups may be affected at a higher rate but may not be reflected in the actual numbers.) Children must be incorporated into the risk assessment process. The risk assessment process must be amended to include children's special sensitivities; cumulative, synergistic, and transgenerational effects of exposure; and cultural differences. * Federal legislation, regulation, and agency mandate should undergo immediate review to identify where children are not taken into account. Recommendations for improvement are as follows: -Review existing laws and regulations, and amend any environmental laws undergoing reauthorization to specifically require that environmental standards incorporate consideration of children and other special subgroups. -Expand the Federal government's definition of diversity to include children under 18 years of age. This will increase opportunities for capitalizing on the diversity requirement for granting research funding and will allow for more youth participants at federally funded conferences. * A Federal interagency workgroup should be convened to coordinate policies and activities regarding pediatric environmental health. Policy should be developed in partnership with members of affected communities to ensure that policy is culturally appropriate and reflects community needs. * An international approach to pediatric environmental health should be adopted. Transborder regulation, liability, and health issues, such as those addressed in the debate over the North American Free Trade Agreement, should be addressed and the most stringent standard should be adopted. Comprehensive pediatric environmental health centers should be created and funded with a multidisciplinary framework, including clinical intervention and environmental toxicant identification. Elements would include basic and applied science, epidemiology, medicine, policy, community, law, urban planning, and education.