1. Our Stake in Promoting Healthy Environments Where Children Live, Learn and Play Maryann Suero, PhD US Environmental Protection Agency Region 5 (IL, IN, MI, MN, OH, WI) Suero.maryann@epa.gov 312-886-9077 Disclaimer: Information provided here does not necessarily reflect the views and policies of the USEPA. Mention of trade names or commercial products or the inclusion of web links to non-USEPA sites does not constitute USEPA endorsement or recommendation.

2. What do you think about when you hear the word “Environment?”

3. Did Your View of “Environment” Include a Person? 1.Yes 2.No

4. Environment????

5. Environment!!!!!

6. Our Environment OutdoorIndoor 10% 90% Opportunity

7. Objectives: To learn about How and why children are more susceptible to environmental exposures than adults Why individuals / institutions should take steps to protect children from environmental hazards

8. PUTTING THINGS INTO CONTEXT

9. What’s the difference? ToxicityExposure How bad? How much? RISK TIMING Susceptibility Lifestage

10. Safe Unsafe

11. Safe Unsafe

12. A Child’s Environment Is All Around Them Eating Drinking Breathing Touching

13. Children Are Not Little Adults Children’s Increased Vulnerability Windows of Vulnerability in Development Differences in Behaviors Differences in Physiology

14. Exposure Differences : Physiology Increased Exposures Relative to Adults Pound for pound, kids breathe more air than adults drink more water than adults eat more food than adults have increased surface area to body mass ratio relative to adults May also have different metabolism routes, speeds due to enzyme availability or activity

15. How many twelve ounce drinks/day would an adult male need to consume in order to take in proportionately as much as an infant? 1.5 2.10 3.20 4.35 5.50

16. Exposure Differences : Behaviors Increased Exposures Relative to Adults Closer to the ground Diet and eating habits differ Newborns - breast milk or formula Infants / Toddlers - more fruit and milk products “Fussy Eaters” abound “Grazing” is common

17. How many times more apples does an average child eat compared to an adult, not accounting for child’s smaller size? 1.3 2.7 3.11 4.15 5.Adults eat more apples than children

18. Exposure Differences : Behaviors Increased Exposures Relative to Adults Engage in more potentially high-risk behavior increased hand contact with “stuff” increased mouthing behaviors more time spent outdoors

19. Why We Care: Indoor / Outdoor Environmental Pollutants Can lead to neurodevelopmental disabilities, e.g. Mental retardation, ADHD, Poor Impulse Control Can cause or worsen respiratory diseases Can increase risk of cancer Can affect hormone systems Implicated in adult diseases May affect multiple generations

20. Environmentally Attributed Childhood Healthcare Costs IllnessCost Lead Poisoning$ 50.9 Billion Asthma$ 2.2 Billion Neurobehavioral Disorders $ 23.4 Billion Cancers$ 0.01 Billion $76.6 Billion Represents ~ 3% Total US Healthcare Costs Trasande, L. and Liu, Y., Health Affairs, 2011, 39, http://dx.doi.org/10.1377/hlthf.2010.1239

21. The Significance of Small Effects: Effects of a Small Shift in IQ Distribution in a Population of 300 Million 160140120100 80 6040 70130 I.Q. mean 100 6.9 million "gifted" 6.9 million “developmental disability"

22. The Significance of Small Effects: 5 Point Decrease in Mean IQ 16014012010080 60 40 mean 95 70130 2.4 million " gifted " 9.4 million “ developmental disability " 57% INCREASE I.Q.

23. Estrogenic agents and obesity Healthcare costs due to Obesity ~ $190 Billion / year. If only 1% attributable to environmental exposures, accounts for nearly $2 Billion

24. Region 5 Center for Children’s Environmental Health 866-967-7337, 312-864-5526 Co-funded by EPA and ATSDR Serves as a Regional resource to: evaluate, treat and prevent environmental illness in children train pediatricians and others in environmental health issues promote children’s environmental health in communities

25. Framework for Rest of Today’s Sessions Children are more susceptible to environmental exposures than adults Indoor environments account for large % of childhood exposures Individual / Institutional opportunities to reduce Toxicity Exposure Be Open to New Ideas / New Approaches!