I Wish I Were Far From the Madding Crowd

March 28, 2010

Environmental exposures and child development

Came across several articles in Current Opinion in Pediatrics because of a blog post on Autism and environmental chemicals: a call for caution. Unfortunately, only the abstracts are free to view.

But what these show is that medical science is beginning to look more closely at possible environmental causes of childhood diseases.  This  does not mean that environmental factors in and of themselves cause disease, but as Dr. Philip Landrigan notes, genetic factors account for only a small fraction of autism cases and do not explain key features of autism.

What causes autism? Exploring the environmental contribution

Landrigan, Philip J.  Current Opinion in Pediatrics. 22(2):219-225, April 2010. doi: 10.1097/MOP.0b013e328336eb9a

Excerpts from the abstract:

Autism is a biologically based disorder of brain development. Genetic factors – mutations, deletions, and copy number variants – are clearly implicated in causation of autism. However, they account for only a small fraction of cases, and do not easily explain key clinical and epidemiological features. This suggests that early environmental exposures also contribute. This review explores this hypothesis.

Expanded research is needed into environmental causation of autism. Children today are surrounded by thousands of synthetic chemicals. Two hundred of them are neurotoxic in adult humans, and 1000 more in laboratory models. Yet fewer than 20% of high-volume chemicals have been tested for neurodevelopmental toxicity.

Environmental exposures and development

Mattison, Donald R. Current Opinion in Pediatrics. 22(2):208-218, April 2010. doi: 10.1097/MOP.0b013e32833779bf

Excerpts from the abstract:

Summarizes recent studies exploring the relationship between paternal and maternal environmental exposures to chemicals before, at the time of and after conception to adverse developmental outcomes including preterm birth, death, structural and functional abnormalities and growth restriction.

Recent studies have demonstrated that human pregnancy and development are vulnerable to environmental exposures of the father and mother to chemical, biological and physical agents.

Whereas single genes and individual chemical exposures are responsible for some instances of adverse pregnancy outcome or developmental disease, gene-environment interactions are responsible for the majority.

Gene-environment interaction and children’s health and development

Wright, Robert O; Christiani, David. Current Opinion in Pediatrics. 22(2):197-201, April 2010. doi: 10.1097/MOP.0b013e328336ebf9

Excerpt from the abstract:

Purpose of review: A systematic approach to studying gene-environment interaction can have immediate impact on our understanding of how environmental factors induce developmental disease and toxicity and will provide biological insight for potential treatment and prevention measures.

Summary: Using a genome-wide approach, combined with prospective longitudinal measures of environmental exposure at critical developmental windows, is the optimal design for gene–environment interaction research. This approach would discover susceptibility variants, and then validate the findings in an independent sample of children. Designs that combine the strengths and methodologies of each field will yield data that can account for both genetic variability and the role of critical developmental windows in the etiology of childhood disease and development.

Childhood obesity and the built environment

Galvez, Maida P; Pearl, Meghan; Yen, Irene H. Current Opinion in Pediatrics. 22(2):202-207, April 2010. doi: 10.1097/MOP.0b013e328336eb6f

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March 17, 2010

EPA and Children’s Environmental Health

Lax regulations on toxics put kids at risk, experts testify

(from CNN’s “Paging Dr. Gupta” blog)

The above post concerns a hearing held to hear about a report from the Government Accountability Office (GAO) on EPA’s progress in protecting children from environmental threats.  It discusses the challenges EPA faces in protecting children’s health.  (To be fair, many people acknowledge that shortcomings in the Toxic Substances Control Act, or TSCA, are responsible for EPA’s being unable to protect children and others from environmental pollutants.)

I’m not usually one to plug particular networks, but I thought the following mentioned in the Dr. Gupta blog might be of interest.

CNN editor’s note: Dr. Sanjay Gupta looks at the environment and health in an upcoming hourlong investigation, Toxic Towns USA, airing April 24 at 8 p.m. ET

Documents from the hearing

Children are exposed to many sources of potentially-harmful environmental pollutants

from the GAO Report Highlights

Selected report contents:

  • Background
  • EPA Has Not Focused Attention on Children’s Health in Agencywide Priorities, Strategies, and Rulemakings

Includes a figure showing the steps where children are considered in the EPA rulemaking progress.  The report does note that some offices within EPA more consistently incorporate considerations for children’s health in their work than others, but notes that at least one other federal agency does not even seem to do that.

  • In Recent Years, EPA Has Not Fully Utilized Its Office of Children’s Health and Other Child-Focused Resources
  • Opportunities Exist for EPA to Lead and Coordinate National Efforts to Protect Children from Environmental Threats
  • Recommendations for Executive Action
  • Matter for Congressional Consideration
  • Appendix II
    EPA Policy on Evaluating Health Risks to Children
  • Appendix III
    Executive Order 13045 and Amendments
  • Appendix IV
    EPA Regulations Subject to Executive Order 13045

From GAO’s summary: “In 1997, Executive Order 13045 (from the EPA website) mandated that agencies place a high priority on children’s risks and required that policies, programs, activities, and standards address those risks. In response, the Environmental Protection Agency (EPA) created the Office of Children’s Health Protection and convened the Children’s Health Protection Advisory Committee….

“…While EPA leadership is key to national efforts to protect children from environmental threats, EPA’s efforts have been hampered by the expiration in 2005 of certain provisions in the executive order. For example, the Task Force on Children’s Environmental Health provided EPA with a forum for interagency leadership on important federal efforts, such as the National Children’s Study.”

GAO recommended that Congress consider the following:

Because EPA alone cannot address the complexities of the nation’s challenges in addressing environmental health risks for children, Congress may wish to consider re-establishing a government-wide task force on children’s environmental health risks, similar to the one previously established by Executive Order 13045….

Full Committee Hearing entitled, “Hearing on the Government Accountability Office’s Investigation of EPA’s Efforts to Protect Children’s Health”

The hearing mentioned in CNN’s blog – Held by the Senate Committee on Environment and Public Works, Wednesday, March 17, 2010, 10:30 AM EDT

[Webcast]

From the Committee’s Hearing page:

Chairman Barbara Boxer will convene the Full Committee for a hearing on the Government Accountability Office’s (GAO) investigation of the Environmental Protection Agency’s (EPA) children’s health program. The committee will also examine what can be done to strengthen protections for children.

Senator Bill Nelson (D-FL) is also expected to give testimony on the federal government’s role in investigating children’s health issues and how that can be improved.

GAO documents

Environmental Health: High-level Strategy and Leadership Needed to Continue Progress toward Protecting Children from Environmental Threats
GAO-10-205,  January 28, 2010
Summary (HTML)   Highlights Page (PDF)   Full Report (PDF, 83 pages)

Environmental Health: Opportunities for Greater Focus, Direction, and Top-Level Commitment to Children’s Health at EPA

GAO-10-545T,  March 17, 2010
Summary (HTML)   Full Report (PDF, 12 pages)

EPA’s response

Peter Grevatt, the director of EPA’s Office of Children’s Health Protection, stated in his written testimony:

EPA agrees that the GAO report reflects well the early history and progress of the Agency’s children’s health protection efforts. The report accurately portrays the Agency’s challenges in addressing children’s  environmental health, and sets forth sound recommendations on steps that could be taken to better incorporate protection of children’s health as an integral part of EPA’s everyday business.

Grevatt also noted that EPA Administrator Lisa Jackson had designated the protection of children’s health as one of her top priorities.  He then described how EPA would implement its strategy to protect children’s health.

EPA’s strategy on children’s health (starts on p.4 of the testimony—specific components are listed under each item in the testimony)

  1. EPA will use the best science to ensure that regulations provide for protection of children’s environmental health by actively addressing the potential for unique childhood vulnerability and exposure. Our goal is to reduce negative environmental health impacts on children through rulemaking, policy, enforcement and research that focus on prenatal and childhood vulnerabilities.
  2. Protecting children through safe chemicals management.
  3. Coordinate national and international community based programs to eliminate threats to children’s health while measuring and communicating our progress.

Children’s health protection at EPA

Office of Children’s Health Protection website

Basic information about the Office of Children’s Health Protection

America’s Children and the Environment

(more…)

March 6, 2010

Parenting resources page added

Have added a page on Parenting Resources.  This is by no means meant to be comprehensive and, in fact, so far I only have one site listed.  (But I figure small steps, right?)

The site I’ve listed is KidsHealth.org.  It has three sections, one for parents, one kids, and one for teens.

Topics covered in the Parents section include:

  • General health
    Body basics • Sleep • Aches, Pains, and Injuries • & more
  • Infections
    Infectious diseases • Immunization • Parasitic infections • Medical tests
  • Emotions & Behavior
  • Growth & Development
  • Nutrition & Fitness
  • Recipes (for kids with cystic fibrosis, lactose intolerance, etc.)
  • Pregnancy & Newborns
  • Medical Problems
  • Positive Parenting
  • First Aid & Safety
  • Medications

Different topics are covered in the Kids and Teens sections (or at least are organized differently).  Articles are, of course, written with those audiences in mind.

KidsHealth is part of The Nemours Foundation’s Center for Children’s Health Media (which is a part of the The Nemours Foundation).  KidsHealth provides families with facts about health as well as perspective, advice, and comfort about a wide range of physical, emotional, and behavioral issues that affect children and teens.  (from “About KidsHealth“)

The Nemours Foundation’s Center for Children’s Health Media also sponsors KidsHealth in the Classroom, a site providing free health curriculum materials for all grades and subject areas.

(more…)

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