Leading Health Indicator 5 Environmental Quality Florida 2010 Goal for Children and Youth Prevent early death, disease and disability in children and youth from exposure to environmental contaminants HP 2010 Goal Promote health for all through a healthy environment

Environmental toxins in the air, land, food and water compromise the health of all persons. Pregnant women, children and youth are more seriously affected by environmental toxins^(1-3)   due to the:

Children with Special Health Care Needs and Environmental Toxins Our knowledge of environmental toxins, their affects and antidotes is a relatively new research field of increasing importance in our industrial society which utilizes numerous substances that have not been tested over time. Some childhood health concerns known to be or strongly suspected of being related to environmental toxins include:10-18) Asthma and Respiratory Diseases9) Neurological disorders such as Attention Deficit Hyperactivity Disorder (ADHD)(2, 19) Mental Retardation19) Congenital Anomalies (Birth Defects) Childhood Cancer Autism19) SIDS20) Kidney Failure(21, 22)

• Effect that toxic absorption can have on developing bodies and brains of young children and fetuses



• Smaller bronchial passageways of young children, developing organs and brain, higher metabolism and intake of air, and greater ingestion of dirt and substances while playing^(4-6)



• Greater likelihood of children of all ages to – spend more time outside, have increased hand to mouth activity and infrequent washing of their hands, eat more per body weight, and eat foods that have greater concentrations of pesticides^{(3, 7, 8)}



• Less developed immune systems of children

The Environmental Protection Agency (EPA) lists 180 air pollutants in the Clean Air Act. EPA also develops an air quality index to help citizens monitor outside activity when pollutant levels of the following are high: ozone, carbon monoxide, lead, sulfur dioxide, nitrogen dioxide, particulate matter.

Indoor Air Pollution:⁽⁹⁾   Second-hand smoke, mold, emissions from combustible sources such as fireplaces, building materials and cleaning fluids (e.g., chlorine and paint).

Water Contaminants: Water borne microbes and contaminants such as lead, mercury and nitrates. The protection of water systems is an important public health function.

Pesticide Residues, Industrial (e.g. dioxins, PCBs, mercury) and Bacterial Contaminants in Foods: Over exposure may cause gastrointestinal and neurological disorders, kidney failure, endocrine and immune system dysfunctions and/or death. Of particular seriousness to children is E. coli O157:H7.

Hazardous Waste Sites: Industrial pollutants from abandoned waste sites can be very hazardous especially for children who play in or near them. Waste sites can be a source of toxicity to drinking water sources, to air, and to foods grown in soils nearby and polluted from water run-off. While substantial progress in cleaning hazardous waste sites has been made, the Environmental Protection Agency (EPA) charged with the task reported that as of July 2002, Florida had 17 counties with 30 priority sites for which construction of protections to the general public were not completed, 22 sites have protections completed and are in various stages of being cleaned, and 18 have been fully cleaned and deleted from EPA's list. For a list of Florida's EPA superfund sites and an explanation of terms see http://www.epa.gov/superfund/sites/npl/npl.htm.

Lead: Lead exposure in pregnant women and young children can cause developmental disabilities including neurological problems and mental retardation.^{(1, 2)}   Elevated blood lead level was chosen as a lead indicator because a major Florida and National campaign is underway to eliminate elevated blood levels in young children by 2010. Lead is an environmental danger for which much progress has been made through elimination of lead in paints and gas, but remains a danger, particularly for low income children most likely to be residing in areas of the state where lead in soil and in paint in older houses may be more prevalent. One major strategy required is to identify children at risk through screening. To accomplish this goal, public awareness and education, a provider commitment to screen and report children with elevated blood levels of lead, and environmental testing of the child's primary residence or secondary site such as day care, are required. In screening, the goal is to screen many children in order to identify the few with elevated lead levels. While only around 69,477 of the approximately 300,000 Medicaid eligible children were screened in 2001, Florida's screening efforts are increasing and making a difference. Florida is experiencing an increase in screenings and a significant decline in the number and rate of positive screening results.