October 1 marked the beginning of Children’s Health Month, the month when health organizations, health professionals, government agencies, and others work to raise public awareness of children’s unique vulnerabilities and highlight their support for child health. And there certainly are many issues that merit our attention and efforts to protect and promote the health of our nation’s children, from prenatal care and adolescent health to immunization and nutrition.
These issues also include the environmental threats and hazards that affect the health and safety of our children, like air and water pollution, exposure to lead, pesticides, and other toxic chemicals and yes, even climate change.
From asthma to brain damage, exposure to chemicals and other environmental hazards can have both immediate and lasting effects on children’s health and well-being. What’s more, these hazards often affect children differently than they do adults, so it makes sense that public protections should take these differences into account. And, along with providing science, information, and expert advice, the Environmental Protection Agency (EPA) is supposed to be the cop on that beat.
Director of EPA’s Office of Children’s Health Protection: OUT
The EPA garnered significant news over the past week when it abruptly placed the director of its Office of Children’s Health Protection (OCHP) on administrative leave. The director, Dr. Ruth Etzel, is a pediatrician, health scientist, and renowned environmental health expert who literally wrote the book on children’s environmental health.
If the surgeon general is the nation’s doctor, Dr. Etzel has been the children’s doctor at the EPA and a tireless advocate for children’s environmental health throughout her career. Her expertise and experience, along with the work of the OCHP staff, have been vital to informing the EPA on the unique vulnerabilities of children and how the agency’s proposals, policies, and efforts could affect them. There are no other MDs, much less a pediatrician, in this office.
The persistent sidelining of science and other scientists at the EPA makes it essential for the agency to explain how OCHP will continue to play a meaningful role in the agency’s decisions.
Children are not little adults
Exposure to pollution, pesticides, and other toxic chemicals can make kids sick, as parents, family members, health care providers, teachers, and day care providers are generally well aware. They know, for example, that air pollution, second-hand smoke, mold, and some chemicals can trigger asthma attacks. Indeed, the most recent data from the Centers for Disease Control and Prevention (CDC) reports that more than 6.1 million children (8.3% of kids under the age of 18) suffer from asthma, and that there were 13.8 million asthma-related missed school days in 2013, plus the countless visits to doctors’ offices, emergency rooms, and hospitalizations.
They certainly know that lead can poison kids, seriously damage developing brains, and result in lasting cognitive and behavioral problems. They may know that there is no safe level of lead exposure in children and that lead exposure continues to be a significant problem in the US, with approximately 500,000 children ages 1 to 5 years having blood lead levels higher than the CDC reference level. And some may be waiting for the promised updated Federal Lead Strategy (see here and here), which is expected to be available for public comment in late 2018 (that means now, so what and where’s the hold-up?).
And then there’s the worry about the thousands of chemicals used in household and consumer products, home furnishings, building materials, and even toys. The saga of EPA’s decision on the pesticide chlorpyrifos is a story onto itself (see here, here), though one with a hopeful ending thanks to the courts (though the EPA intends to fight the decision).
In so many words, we know that in many cases chemicals and kids are a bad mix.
That’s why it’s particularly noteworthy that the EPA has both a policy and an office dedicated to children’s health.
OHCP: Not just another cog in a bureaucratic machine
In 1995, the EPA established a policy to “consistently and explicitly evaluate environmental health risks of infants and children in all of the risk assessments, risk characterizations, and environmental and public health standards.” In 1996, the agency established a national agenda to protect children’s health from environmental threats.
In 1997, the EPA Office of Children’s Health Protection (OCHP) was established by executive order. It is the only office in the agency totally dedicated to the health of children. The office was and for now remains located within the Office of the EPA Administrator. Its proximity to top EPA leadership reflects the importance of its fundamental goal, which is to “to ensure that all EPA actions and programs address the unique vulnerabilities of children.”
The OHCP’s web site further defines its major work as: “increasing environmental health literacy of health care providers through support of Pediatric Environmental Health Specialty Units; and evaluating and communicating trends in environmental contaminants that may contribute to childhood disease through publication of America’s Children and the Environment.”
Kids are uniquely sensitive and vulnerable to environmental hazards. As the OCHP also notes on its web site, children are more vulnerable to environmental exposures because “their bodily systems are still developing; they eat more, drink more, and breathe more in proportion to their body size; and their behavior can expose them more to chemicals and organisms.”
Our nation’s doctors and nurses rely on the expert advice and resources in the OHCP in caring for our children. EPA policy makers need the same to effectively safeguard our kids.
Speaking out and what worries me most
That’s why it’s particularly troubling to see the EPA potentially put the work of the office in jeopardy (not to mention the notable timing given Children’s Health Month). More than 120 organizations have written to EPA Acting Administrator Andrew Wheeler asking the EPA “to immediately clarify what action it has taken with regards to Dr. Etzel and with regards to OCHP, and make no further attempts to dismantle, re-organize, diminish, or otherwise reduce the abilities and authorities of OCHP.” Signatories include the American Academy of Pediatrics, the American Public Health Association, the March of Dimes, National Association of County and City Health Officials, National Association of Pediatric Nurse Practitioners, Moms Clean Air Force—and the Union of Concerned Scientists.
But what’s even more troubling is the context in which this occurs. This administration has an established track record of devaluing and sidelining science and scientists. We are tracking these assaults on science here—but I admit it’s hard to keep up.
Just in the past week, we have also seen the EPA disband its Office of the Science Advisor (see here, here) and then appoint the lead lobbyist for Koch Industries to the top political position inside the office that is now in charge of science advice and coordination at the EPA. And we also learned that a rule to restrict the use of scientific studies in EPA decisions was developed without involvement of the agency’s science advisor.
Also in the news this week are White House efforts to suppress attention to climate change and children’s health at the same time, scrubbing language about how climate change affects children’s health from a draft EPA proposal on heat-trapping chemicals.
So call me concerned? Heck Yeah. I’m troubled that there seems to be no due process in removing the EPA’s top expert in children’s environmental health. I’m worried that in the daily onslaught of the Trump administration’s efforts to sideline science, scientists, and elevate private profit over the public good, what’s happening to children’s health at the EPA will get lost in the shuffle as people move on to the next outrage.
We can’t let this happen
The health of each child in this country is just too important. The Trump administration’s EPA is actively reopening important protective rules—from mercury to methane, power plant emissions to how communities deal with chemical disasters. In the first two years of this administration, we have learned that reopening these rules is simply the first step in attempts to delay, weaken, or entirely gut health protections. We need strong science and scientists within the EPA to be in a position to stand up for children.
So please raise your voice again and again on this one. Call your elected representatives, tell your friends and neighbors, write a letter to the editor of your hometown newspaper. Tell them what children’s health means to you, and why the EPA needs to push forward, not retreat, on protecting our families.
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