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Children’s Environmental Health: One Year in a Pediatric Environmental Health Specialty Unit



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  • Personal Author:
  • Description:
    Background/objective: As a result of an increasing desire among physicians and parents for clinical centers that can evaluate children with known or suspected exposures to environmental toxicants, a network of federally funded "pediatric environmental health specialty units" has recently been created. This descriptive study profiles the children seen in one unit of this program. Setting: A New England, university-affiliated Pediatric Environmental Health Center (PEHC). Methods: Review and analysis of all children seen in the PEHC in calendar year 1999. Results: Over the course of the year, 281 children made 863 visits to the PEHC. Presenting complaints fell into 4 major categories: new visit for management of lead intoxication (n = 248), return visit for management of lead intoxication (n = 569), new visit for evaluation of exposure to an environmental toxicant other than lead (n = 33), and return visit for the management of exposure to a non-lead toxicant (n = 13). Among those children with new visits for a non-lead toxicant, the most common chief complaints were exposure to solvent-contaminated water (n = 7), pesticide exposure (n = 6), illness associated with proximity to a hazardous waste site (n = 6), autism from suspected mercury intoxication (n = 4), and evaluation of school-induced, building-related illness ("sick school syndrome")(n = 4). Eleven children had autism or pervasive developmental delay. Families traveled distances as great as 450 kilometers for evaluation by a pediatric environmental health clinical specialist. Every child was evaluated by a pediatrician with subspecialty training in medical toxicology. Environmental investigation of air, water, paint, dust, or land was conducted for all except 4 children (all foreign-born adoptees). Therapeutic interventions included chelation therapy, relocation to a safe environment, removal from school, and termination of chelation therapy that had been initiated by another practitioner. Third-party payors provided full reimbursement for all visits. Conclusions: The chief complaints of the children brought to pediatric environmental health specialty units are diverse, involving exposures to a wide range of toxicants from all environmental media (air, water, soil, and food). Parents desiring such an evaluation must often travel extensive distances, suggesting the need for a broader network of such centers. Third-party payors and health maintenance organizations are willing to provide full reimbursement for these services. [Description provided by NIOSH]
  • Subjects:
  • Keywords:
  • ISSN:
    1530-1567
  • Document Type:
    Text
  • Funding:
    Grant
  • Genre:
    Journal Article
  • Place as Subject:
  • CIO:
    National Institute for Occupational Safety and Health (NIOSH)
  • Topic:
    Workplace Safety & Health
  • Location:
    North America
  • Pages in Document:
    53-56
  • Volume:
    3
  • Issue:
    1
  • NIOSHTIC Number:
    nn:20059395
  • Citation:
    Ambul Pediatr 2003 Jan-Feb; 3(1):53-56
  • Contact Point Address:
    Michael Shannon, MD, MPH, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115
  • Email:
    michael.shannon@tch.harvard.edu
  • CAS Registry Number:
  • Federal Fiscal Year:
    2003
  • Performing Organization:
    Harvard School of Public Health
  • Peer Reviewed:
    True
  • Start Date:
    20030701
  • Source Full Name:
    Ambulatory Pediatrics
  • End Date:
    20050630
  • Collection(s):
  • Main Document Checksum:
    urn:sha-512:452fe1a54014c892bf3f2d1b557a85debe6d0b02bbe149e762d5bdfa75488554f31d98dbb4242610a23df092387ef88af6e8c5f2fee89165345a407e1f5fbf78
  • Download URL:
  • File Type:
    Filetype[PDF - 40.48 KB ]
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