CHILDRENS HEALTH AND THE ENVIRONMENT - A NEW AGENDA FOR PREVENTION RESEARCH

Patterns of illness in American children have changed dramatically in this century. The ancient infectious diseases have largely been contro lled. The major diseases confronting children now are chronic and disa bling conditions termed the ''new pediatric morbidity'' - asthma morta lity has doubled; leukemia and brain cancer have increased in incidenc e; neurodevelopmental dysfunction is widespread; hypospadias incidence has doubled. Chemical toxicants in the environment as well as poverty , racism, and inequitable access to medical care are factors known and suspected to contribute to causation of these pediatric diseases. Chi ldren are at risk of exposure to over 15,000 high-production-volume sy nthetic chemicals, nearly all of them developed in the past 50 years. These chemicals are used widely in consumer products and are dispersed in the environment. More than half are untested for toxicity. Childre n appear uniquely vulnerable to chemical toxicants because of their di sproportionately heavy exposures and their inherent biological suscept ibility. To prevent disease of environmental origin in America's child ren, the Children's Environmental Health Network (CEHN) calls for a co mprehensive, national, child-centered agenda. This agenda must recogni ze children's vulnerabilities to environmental toxicants. It must enco mpass a) a new prevention-oriented research focus, b) a new child-cent ered paradigm for health risk assessment and policy formulation; and c ) a campaign to educate the public, health professionals, and policy m akers that environmental disease is caused by preventable exposures an d is therefore avoidable. To anchor the agenda, CEHN calls for longter m, stable investment and for creation of a national network of pediatr ic environmental health research and prevention centers.