Creating a Network to Protect Children from Environmental Health Threats: The U.S. Experience

1. Creating a Network to Protect Children from Environmental Health Threats: The U.S. Experience Workshop on Environmental Threats to the Health of Children in the Americas Lima, Peru 9-11 April 2003 Edward H. Chu (for Martha Berger) U.S. Environmental Protection Agency Office of Children’s Health Protection

2. Protecting Children in the United States • Institutional Framework • Political • Legal • Regulatory • Developing information about children’s health and the environment • “Environment” and “Health” • Bridging the gap • Building and supporting the network to take action • Short- and long-term • Getting the word out

3. Protecting Children’s Health in the United States • 1993 – Pesticides in the Diets of Infants and Children (NAS Report) • 1996 – Food Quality Protection Act • 1996 – Safe Drinking Water Act • 1996 – EPA’s National Agenda to Protect Children • 1997 – Executive Order • 1997 – Office of Children’s Health Protection Established • 1999 – Children’s Environmental Health Research Centers Established • 2000 – Children’s Health Act • 2000 – EPA’s Children’s Health Research Strategy • 2001 – Administrator Whitman makes children’s health a priority • 2001 – President Bush renews the Executive Order

4. Food Quality Protection Act of 1996 Expands EPA’s pesticide testing authority Requires a 10x safety factor for infants and children Requires examination of “common mechanism of action” and “total exposure” Safe Drinking Water Act of 1996 Requires consideration of disproportionately affected sub-populations – children, elderly, immune compromised Children’s Health Act of 2000 Authorizes the Federal government to conduct a national longitudinal study of environmental influences (including physical, chemical, biological, and psychosocial) on children's health and development “National Children’s Study” Primary Agencies responsible: National Institute of Child Heath and Human Development Centers for Disease Control EPA Legislation to Protect Children

5. EPA’s National Agenda to Protect Children • Set protective standards • Expand research on risks to children • Develop new policies to address cumulative & simultaneous exposures faced by children • Expand Community Right-To-Know • Provide basic information to parents and care givers • Expand education efforts with health & environmental officials • Provide funding

6. Executive Order to Protect Children • Executive Order 13045 requires all Federal Agencies to • make it a high priority to identify and assess environmental health risks and safety risks that may disproportionately affect children • ensure that its policies, programs, activities and standards address disproportionate risk to children • The Task Force on Environmental Health Risks and Safety Risks to Children, Co-chaired by the DHHS Secretary and the EPA Administrator, includes 10 federal agencies and 6 White House offices

7. Department of Health & Human Services Department of Housing & Urban Development Department of Justice Department of Defense Department of Energy Department of Labor Department of Education Department of Agriculture Department of Transportation Environmental Protection Agency Consumer Product Safety Commission White House Office Of Management and Budget Council on Environmental Quality Office of Science and Technology Policy Domestic Policy Council National Economic Council Task Force Departments and Agencies

8. Task Force Activities • Priorities • Asthma • Childhood cancer • Developmental disorders • Unintentional injuries • National Children’s Study – Longitudinal cohort study to establish relationship between environmental factors and health from preconception through adolescence • Federal research data base

9. Office of Children’s Health Protection (OCHP) • Established in 1997 to institutionalize EPA’s National Agenda and the Executive Order • Mission – To make the protection of children’s health a fundamental goal of public health and environmental protection

10. Building and Supporting the Network • Inside EPA • Regulations • Science • Economics • Outside EPA • Partnerships (States, Doctors, Nurses, Youth) • Outreach • President’s Task Force • Children’s Health Protection Advisory Committee • International

11. Science • 12 Children’s Research Centers • Children’s Health Research Strategy • Guidance documents: Cancer Guidelines, Cumulative Risk Guidance, Children’s Exposures Factors Handbook, Integrated Risk Information System • Voluntary Children’s Chemical Evaluation Program • High Production Volume Chemical Testing Program • Support multi-agency National Children’s Study • Relationship between environmental factors and health outcomes from the womb to adolescence • Support Health Tracking System for Chronic Diseases • Develop science and methods for children’s risk assessments

12. Economics • Economic analysis is critical to decision-making at EPA • Benefits to children in past have not been well quantified or studied by economists • Children’s Health Valuation Handbook • First to deal with children’s health valuation anywhere • Research • Economic Impact Reports • Indicators of national burden

13. Regulations:Ensure Consideration of Children • Disproportionate and differential impact on children are not addressed in many risk assessments due to lack of toxicity and exposure data • Most rules are unable to address children’s health because of lack of data (toxicity and exposure) • Results in incomplete benefit-cost analyses

14. Collaborating with States • ECOS and ASTHO • State profiles • “Tool box” for the Catching Your Breath asthma project • ECOS Asthma Resolution • NCSL (Legislators) • Children’s Environmental Health Legislative Bill Tracking • Legislative Policy Options Guide • National Governor’s Association • Connection between Smart Growth and Children’s Environmental Health

15. Collaborations with Health Care Providers • Pediatric Environmental Health Specialty Units (ATSDR and EPA) • American Academy of Pediatrics - Chief Pediatric Residents Training (EPA) • American Nurses Association - Continuing Education for Nurses (EPA) • Ambulatory Pediatric Association - Planning for Pediatric Environmental Health Fellowships (EPA)

16. Outreach:Information for Prevention • Web site • Children’s Environmental Health Yearbook • Catalog of EPA activities • Healthy Schools Initiative to Improve Learning • Improve coordination and integration of EPA school-based programs • Tips on ways to protect children • Plain language tips for parents and care givers • Sheets, refrigerator magnets, growth charts • Work with other program offices • Sunwise, indoor air, fish advisories, “Take the Smoke Free Home Pledge”

17. Children’s Health Protection Advisory Committee • Provides consensus advice to the EPA Administrator on children’s environmental health • Members represent industry, environmental organizations, children’s advocacy groups, federal/state/local governments, trade associations, non-government organizations, academia, tribal organizations, health care providers, economists

18. Working to Protect Children Around the World • Global interest • G8 Environment Ministers (1997) • London Declaration (1999) • North American Council on Environmental Cooperation (2000/2002) • Health and Environmental Ministers of the Americas (2002) • G8 Environment Ministers (2002) • UN Special Session on Children (2002) • World Summit on Sustainable Development (2002)

19. Working to Protect Children Around the World • Global action • WHO, CEC, OECD, and PAHO • Children’s environmental health indicators • Indoor fires for cooking and heating • Secondhand smoke • Lead in gasoline

20. Aloha • Lessons from the U.S. • Political will • Building network • Maintaining momentum • Environment AND health information about children very important • Significant progress has been made… • …significant work remains

21. Edward H. Chu 202.564.2196 or 202.564.2188 chu.ed@epa.gov Martha Berger 202.564.2191 or 202.564.2188 berger.martha@epa.gov Mahalo! U.S. Environmental Protection Agency Office of Children’s Health Protection 1200 Pennsylvania Avenue, N.W. MC1107A Washington, DC 20460 U.S.A Website: www.epa.gov/children