Children are not Little Adults

Speeches & Testimony 
Testimony of E. Ramona Trovato
U.S. Environmental Protection Agency
before the U.S. House of Representatives' Committee on Appropriations
Subcommittee on Labor, Health and Human Services, and Education
EPA 2may00

Introduction - Children are not Little Adults

The single most important point I would like to make is that "children are not little adults." Environmental pollutants affect children differently than adults in three ways: first, children's organ systems are still developing, which may cause them to be more susceptible to environmental threats; second, pound for pound, children eat more food, drink more fluids, and breathe more air, thereby increasing their exposure to environmental hazards; and third, children's behaviors, including crawling on floors and spending more time playing outside, expose them to a different array of environmental hazards than adults.

Therefore it is important that we consider these differences in all our efforts to provide a safer, cleaner environment for our children. Environmental pollutants that currently threaten our children's health include: Air pollution, both indoor and outdoor, exacerbates asthma and other respiratory illnesses; Drinking water contaminants, such as cryptosporidium, can cause serious illness or death in children; Pesticides, which may cause cancer, nervous system damage, or respiratory illness in children, unless they are regulated specifically to protect those most vulnerable in our population; and Hazardous substances, such as lead, can cause reduced intelligence, impaired hearing, and behavior difficulties, and at higher levels can harm a child's organs.

To protect our children from these environmental threats, it is essential that environmental officials at local, state, and federal levels work together with their counterparts in the health community. It is essential that parents, day-care providers, school officials, and pediatricians work together to understand how to prevent exposures and mitigate harmful health effects. It is also essential to learn more about children's health needs with respect to their environments; therefore we support and encourage extensive, coordinated research to establish the scientific basis for our risk assessments and regulatory decision-making.

Successful Collaborations with HHS

The EPA is working with CDC, NIH, and NIEHS on high-priority issues, specifically asthma, lead poisoning, and research coordination. We have been successful on many fronts: the national asthma strategy was launched in January 1998; the national lead strategy has just been released; and we now have a database to catalog federally-funded or federally-conducted research efforts dedicated to children's environmental health. In addition, EPA and HHS have jointly funded eight research centers to investigate children's environmental health concerns, and EPA has funded an additional research center on its own. Five of the nine centers perform research related to asthma; the remaining four perform research on development disorders.

Asthma Strategy

There is an epidemic of asthma in the United States. While this epidemic affects people of all ages, children in particular are affected. Nearly one in 13 school-aged children has asthma. Asthma is one of the leading causes of school absenteeism, accounting for more than 10 million missed school days each year. Asthma is the leading cause of hospitalization for children. Asthma symptoms that are not severe enough to require a visit to the emergency room can still be severe enough to prevent a child with asthma from living a fully active life.

Last January, the First Lady announced a comprehensive interagency strategy to reverse the increasing rates of asthma among children in the United States. The strategy establishes a blueprint for a coordinated effort to understand the causes of the current asthma epidemic so that guidelines can be developed to help prevent children from developing asthma and to help children with asthma lead normal lives. EPA is providing $25 M as part of the Administration's initiative in FY 2000 and FY2001 to expand its research and public information programs to address indoor and outdoor asthma triggers in close cooperation with the Department of Health and Human Services program.

Lead Strategy

Another collaborative effort on behalf of the federal government is the federal strategy, released by Mrs. Gore on March 29, which is aimed at eliminating lead paint hazards in homes where children under age six live. Childhood lead poisoning is entirely preventable, yet it remains one of the greatest environmental health risks facing children today. In the United States, almost one million children under the age of six - 16 percent of low income children and 21 percent of African American children living in older housing - have toxic levels of lead in their bodies. Currently, three-quarters of the nation's housing contains lead paint.

The strategy coordinates measures in many federal departments and agencies aimed at preventing lead poisoning by:

Acting before children are poisoned by eliminating and preventing residential lead paint hazards.
Identifying and caring for children already poisoned.
Conducting research to drive down costs and promote innovation.
Continue surveillance and monitoring programs.

The FY 2001 President's budget request includes $164.5 million to support this strategy.

Providing a Scientific Basis for Protecting Children

On August 10, 1998, the Vice President announced the establishment of the first eight research centers dedicated solely to the study of children's environmental health hazards funded jointly by the EPA and the Department of Health and Human Services. Located within eight leading research institutions across the country, these unique Centers perform targeted research into children's environmental health, and translate their scientific findings into intervention and prevention strategies by working directly with communities. Later this year, EPA will award an additional research center. The Children's Environmental Health Research Centers focus includes asthma, pesticides exposure, and other toxins. Some examples of their activities are:

The Children's Health Center at the Mt. Sinai School of Medicine focuses on neurodevelopmental deficits that result from exposures to pesticides in the home and polychlorinated biphenyls (PCBs) in the diet. The center will work with community members to test whether Integrated Pest Management and dietary modification can reduce exposures in children.

The University of California at Berkeley, School of Public Health, will follow 550 pregnant women and their children for three years to investigate estimated levels of in-utero and postnatal exposures of the child to organophosphate pesticides and any relationship to neurodevelopmental growth and respiratory diseases.

With HHS and other Federal agencies, we have also developed the Federal Children's Environmental Health and Safety Inventory of Research (CHEHSIR) which contains information from six Departments and has 532 research projects totaling $150 million. CHEHSIR is available on-line and allows us to identify gaps in our knowledge regarding children's health and environmental exposures and target future research efforts.

Through the fourth National Health and Nutrition Examination Survey(NHANES), EPA and CDC are obtaining data on children's health, diet, nutrition, and exposures, including information on active and passive smoking, blood lead levels, blood mercury, and mercury in hair.

EPA is developing a Strategy for Research on Environmental Risks to Children, which will be the foundation for improved risk assessment methods for children. Through it Extramural Grants Program, Science to Achieve Results (STAR), EPA is supporting a balanced research program to expand information on children and: exposure; effects; risk assessment; and risk reduction. Under this program, EPA is also supporting research on mechanisms of action by which environmental agents produce toxic effects in children and research on the impact of intermittent high exposures of children at home and in other environments.

EPA is also monitoring children's exposure to pesticides, metals, and volatile organic compounds of children aged 3-12 in Minnesota and studying the relationship between environmental agents and childhood asthma.

EPA Accomplishments: Community Outreach and Education

While EPA has a substantial effort to assure that children's environmental health protection is addressed by federal agencies, we also recognize that we must continue to get the word out to families and communities.

EPA developed the Tips to Protect Children from Environmental Threats, a list of relatively simple and effective things that parents and others can do to help protect children from environmental hazards. More than 50,000 copies have been distributed to schools and communities. EPA and the National Safety Council developed a 2 hour television program based on the Tips, and it was nominated for a regional Emmy Award. An estimated 2.2 million people saw this program. This video has been produced in both English and Spanish - 3000 copies are already in circulation. We will also use the Tips as the basis for a nationwide Spanish radio series that will reach an estimated 75% of the U.S. Latino population.

Two years ago we launched the Child Health Champion Campaign for Communities-- a new program designed to encourage local citizens, community-based organizations, and businesses to protect their children from environmental health threats, such as lead paint in homes and environmental pollutants that worsen asthma. Eleven communities were chosen for the pilot program. They include urban, agricultural, border, and Native American communities. Each community assessed and prioritized potential environmental hazards to their children and set community-specific goals to mitigate those hazards. In one of these communities, East L.A., the program targets asthma by working in homes, schools, and across the community to increase awareness and reduce exposure to asthma triggers.

EPA established a Federal Advisory Committee that includes members from industry, pediatric medicine, science/academia, nursing, environmental organizations, citizens groups, Federal, state/local/tribal government, environmental justice communities, community organizations, economists, and citizens-at-large. This advisory committee ensures that EPA obtains expert advice on children's environmental health protection issues.

Last year, EPA issued the Children's Environmental Health Yearbook, a 200 page inventory of all agency activities related to protecting children from environmental threats. The Yearbook is on our web site at http://www.epa.gov/children/ . An updated inventory is coming later this Spring.

Regulating Chemicals and Protecting Children: An EPA-Wide Endeavor

In November 1998, EPA published final guidance for EPA rule writers to comply with the President's Executive Order on the Protection of Children from Environmental Health Risks. As a result, EPA standards now consistently call for data on hazards, exposures, and dose-response functions that may indicate disproportionate risk to kids.

The Food Quality Protection Act, passed by Congress and signed into law in 1996, establishes a more stringent health standard for pesticide residue in food, particularly to protect infants and children. EPA's Office of Prevention, Pesticides and Toxic Substances is undertaking an extensive scientific review of all pesticide tolerances to ensure they meet the more rigorous standards. Currently, we are focusing our scientific reviews on the organophosphates, which appear to pose the most significant risks. This reassessment process for the existing tolerances is based on sound scientific principles and extensive consultations with our stakeholders to ensure our decisions are protective of public health, and provide a reasonable transition for agriculture to move to safer pest control methods. Consistent with our commitment of August 2, 1999, we are on schedule to complete risk management decisions for all the organophosphates by the end of 2000.

Endocrine disrupting chemicals have the potential to alter or mimic hormones. EPA is developing a scientific screening and testing program to identify pesticides and chemicals which may interact with the endocrine system. Children are particularly susceptible to endocrine disruption because of their rapid growth and development.

In August, 1996, Congress amended the Safe Drinking Water Act and directed EPA to consider disproportionate risks to subpopulations, including children. The Office of Water is working to control microbiological contaminants, which pose a particular threat to infants and children.

Future Plans

One of the Task Forces' highest priorities is to begin a multi-year study of the impact of exposure to environmental pollutants on children. As the Framingham study provided us most of what we now know about heart disease, this study could be the watershed in children's environmental health protection, allowing us to point with certainty to areas where prevention, intervention, and treatment would help America's children. It will require the dedicated and determined effort of both the environmental community and the health community to fill the gaps that exist in our understanding of children and how they interact with pollutants in the environment.

We are working with the Environmental Council of States and the Association of State and Territorial Health Officials to develop State Profiles, a compendium of information on how States are addressing children's environmental health. Alaska, South Carolina, and Illinois are leading the effort to develop these state profiles. In addition, we are pleased to note that several states, including Florida, California, and Maryland are developing legislation to establish their own offices or requirements to protect children from environmental hazards.

Conclusion

We are implementing a strategy that will lessen the impacts of asthma on our children. In 10 years, through implementation of the Federal Lead Strategy, we can have lead-paint-free housing for all of our children under six. Beyond that, we hope to conduct a multi-year study to better understand the effects of environmental pollution on the health and well-being of our children. We will continue to write regulations to protect children.

I look forward to working with all of my colleagues here today and with you to assure that our children and grandchildren enjoy long and healthy lives. Protecting our environment is about protecting where we live and how we live. Protecting our environment is about protecting our health.

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