Children’s Environmental Health

toddler crawling on the floor of a living room

Why is Children’s Environmental Health important?

Children are not little adults. They are more vulnerable to environmental hazards because they breath more air, drink more water, and eat more food in proportion to their weight than adults do. Children have little control over their environments, they are not aware of risks and are unable to make choices to protect their health. This webpage shares how to create healthier environments for all Tennessee children to live, learn, grow, and play. 

Quick Tips for Promoting Children's Environmental Health

In addition to understanding environmental risks, here are some proactive steps you can take to ensure a healthier environment for your children:

   -  Avoid smoking and drinking during pregnancy to reduce their exposure to harmful substances in the womb
   -  Avoid smoking around children  to reduce their exposure to harmful substances
   -  Teach children good hygiene practices like proper handwashing after playing and before meals
   -  Use quality infant formula for safe and healthy nutrition, if necessary
   -  Check homes built before 1978 for lead-based paint hazards
   -  Limit the use of pesticides in and around the home
   -  Garden in clean soil to limit contact with harmful contaminants
   -  Clean and vacuum regularly using non-toxic cleaning products
   -  Test private well water sources to be sure the water is safe to drink
   -  Choose toys and furniture free of chemicals like phthalates, BPA, and flame-retardant chemicals
   -  Install carbon monoxide detectors to prevent poisoning
   -  Have your HEPA filters replaced yearly to reduce dust and allergens in the home
   -  Encourage physical activities to promote good health and wellbeing

Where can children be exposed to environmental contaminants or hazards?

The simple answer is anywhere and everywhere. Children can be exposed to environmental hazards at home, school, child care centers, or playgrounds. 

How can my child be exposed?

There are 4 common ways children can come in contact with environmental hazards. These ways are often called exposure routes.
     1. Through the placenta
     2. Skin contact
     3. Inhalation
     4. Ingestion

a baby with hand to mouth behavior

Environmental Health Risks by Stages of Development 

Children’s vulnerability to environmental risk varies based on their developmental stages. These vulnerabilities are due to their dynamic physiology, biological and behavioral differences when compared to adults.

1.  Prenatal stage (Before conception to Birth): This stage is critical because children can be exposed to any environmental hazards that their mother encounters, such as radiation, tobacco, alcohol, toxic chemicals and medications, heavy metals, and air pollution. There are 2 important time periods in this stage:  

Embryonic (8 days to 9 weeks of pregnancy): this is the period where the foundation of critical organs and systems such as the neural tube, is formed. Most women are unaware of their pregnancy during this period and their exposure to harmful substances may lead to developmental defects and delays that affects the child’s future health. 

Fetal (9 weeks of pregnancy to birth): during this period, organ maturation and fetal growth and development occurs. During pregnancy, the placenta supplies the fetus with oxygen and nutrients. It also acts as a barrier to protect and minimize fetal exposure to pollutants, toxicants, and infectious agents that can penetrate and cross the placental barrier. For instance, exposure to high levels of radiation, lead, and mercury can result in intellectual disability, low birth weight, or premature birth.  

2. Infants (birth to 12 months) and toddlers (1 to 3 years): as soon as a child is born, their risk of exposure to environmental hazards increases due to their dynamic physiology, physical, and behavioral characteristics.

Increased intake: Children, especially newborns and infants eat and drink more per kilogram of body weight compared to adults. Infants grow very fast and to accommodate for this growth, they require more calories. This can lead to higher rates of intake of harmful substances when there are contaminants in their food, water, or air. Toxic chemicals such as biphenols (e.g. BPA) can leach from plastic packaging and food contact materials into children’s foods and drinks.

Increased breathing rates: The breathing rates in early infancy is around 3 times higher than that of adults, which means they are more likely to breath in higher concentrations of pollutants. This makes them particularly vulnerable to air pollution.

Increased skin absorption: Newborns and infants have thinner, more permeable skin. This means their skin can absorb personal care products and harmful substances, such as pesticides and cleaning supplies, faster than adults.

Hand-to-mouth behavior: From infancy to early childhood, children explore objects and the world with their hands and mouth. They are often on the floor, crawling, and putting things in their mouths. Due to this behavior, children are at increased risk of ingesting dust, dirt, or small objects that may contain environmental toxins. Examples are lead in old paint, pesticides in soil and gardens, plasticizers in toys, or household cleaning solutions.

a toddler puts a toy in their mouth

3. Preschoolers (3-5 years): As children enter early childhood, their mobility and curiosity expose them to more risks. They also have more independence as they start exploring their environments, both indoors and outdoors. 

Increased time spent outdoors: As children enter preschool, they begin to spend more time outside, which is essential for their physical, cognitive, and mental health. When outdoor environments are unhealthy and lack safe open play spaces, this can put children at risk of exposure to air pollution, pesticides, contaminated water, climate hazards (heat waves and floods), and other toxic chemicals. 

Increased time spent indoors: Young children also need more sleep and naps and may spend more time indoors. When there is indoor air pollution in the home from volatile organic compounds, mold, dust, and particles from plastics, children may be at increased risk of exposure to toxic substances. 

Behavioral patterns: Children at this age tend to play close to the ground, where dust, dirt, and chemicals settle. They also have the hand-to-mouth and object-to-mouth behavior which increases their risk of ingesting toxic substances and infectious agents.  

4. School-aged children (6-12 years): The average school-aged child spends much of their time at school. Schools are complex environments with multiple functions including classroom education, sports and physical activity, and food services. Children can be exposed to a variety of chemicals, pollutants, and other hazards at school. 

Indoor air quality: school-aged children often spend extended periods of time in poorly-ventilated classrooms, locker rooms, and bathrooms where the air quality might be compromised by dust, mold, chalk dust, lead, fiberglass fibers, soot, pollen or other particulates. All these may cause respiratory and other health problems.  

Outdoor air quality: children may spend a lot of time on sports fields and playgrounds where they may be exposed to environmental contaminants. Outdoor air quality around schools depends on traffic patterns, proximity to industrial sites, herbicide and pesticide use, atmospheric conditions, and geography.  

Water quality:  lead-contaminated drinking water may be a significant concern in schools. Lead exposure can be from various sources such as the school’s main water supply pipes and individual fixtures and faucets, especially if they were installed before 1986. Schools can reduce these risks by leveraging resources like the WIIN (Water Infrastructure Improvements for the Nation) grant program which supports effort to reduce lead contamination in drinking water. More information on this initiative can be found here. Water may also contain other unhealthy compounds including flame-retardant chemicals, hydrocarbons, and bacteria, depending on the source of the water. The risk of exposure to these contaminants is more likely in private well water sources than public water systems because the latter is more regulated and undergoes regular testing.

Social and behavioral factors: as children get older and interact with peers, they may be exposed to secondhand cigarette smoke, alcohol, or other chemical pollutants especially if they are in close contact to adults who are unaware of the health risks.  

children enjoy playing soccer outside

Additional Resources  

NIEHS:  Children's Environmental Health
www.niehs.nih.gov/health/topics/population/children

WHO: Children's Environmetal Health
www.who.int/health-topics/children-environmental-health

PEHSU: Pediatric Environmental Health Specialty Unit
Environmental Health in Early Care and Education Project

EPA: Environmental Protection Agency
Ground Water and Drinking Water