Children's health and the environment: public health issues and challenges for risk assessment
Philip J Landrigan1, Carole A Kimmel, Adolfo Correa
1Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA. phil.landrigan@mssm.edu
Insights
Children require specialized risk assessments due to unique vulnerabilities to environmental toxicants. New methods in exposure assessment, toxicity testing, and modeling are crucial for child protective policies like the Food Quality Protection Act (FQPA).
Area of Science:
- Environmental Health Sciences
- Toxicology
- Risk Assessment
Background:
- Infants and children possess unique vulnerabilities to environmental toxicants compared to adults.
- The National Research Council (1993) and the Food Quality Protection Act (FQPA, 1996) mandated child-protective risk assessment approaches.
- Current risk assessment methods inadequately address children's specific exposure patterns and toxicological sensitivities.
Purpose of the Study:
- To outline essential elements for developing a child-protective risk assessment framework.
- To emphasize the need for revised toxicity testing and risk assessment strategies for children.
- To ensure adequate protection against environmental toxicants for all pediatric age groups.
Main Methods:
- Improved quantitative assessment of children's exposures across life stages (fetal to adolescent) and routes.
- Development of novel toxicity testing strategies evaluating subtle outcomes and full lifespan effects.
- Creation of updated toxicodynamic and toxicokinetic models reflecting pediatric physiology.
- Implementation of comprehensive outcome assessments (functional, organ, cellular, molecular) over the lifespan.
- Application of specific uncertainty and safety factors for children in risk assessments.
Main Results:
- The FQPA presumes greater pesticide vulnerability in children than adults, requiring protective safety factors.
- Fundamental revisions in toxicity testing and risk assessment are necessary for child protection.
- Data gaps in developmental toxicity necessitate conservative safety factors under FQPA.
Conclusions:
- A child-protective risk assessment requires integrated approaches to exposure, toxicity testing, and modeling.
- Lifespan studies and advanced outcome assessments are vital for understanding children's toxicological risks.
- Robust application of safety factors is critical when data on developmental toxicity are limited or positive.
Abstract:
Infants and children are not little adults. They are uniquely vulnerable to environmental toxicants. To protect infants and children against toxicants, the National Research Council in 1993 called for development of an approach to risk assessment that considers children's unique patterns of exposure and their special vulnerabilities to pesticides. Many aspects of that call were codified into federal law in the Food Quality Protection Act (FQPA) of 1996. This report highlights the central elements needed for development of a child-protective approach to risk assessment: a) improved quantitative assessment of children's exposures at different life stages, from fetal life through adolescence, including acute and chronic exposures, exposures via multiple routes, and exposures to multiple agents; b) development of new approaches to toxicity testing of chemicals that can detect unanticipated and subtle outcomes and that evaluate experimental subjects over the entire life span from early exposure to natural death to replicate the human experience; c) development of new toxicodynamic and toxicokinetic models that account for the unique physiologic characteristics of infants and children; d) development of new approaches to assessment of outcomes, functional, organ, cellular and molecular, over the entire life span; these measures need to be incorporated into toxicity testing and into long-term prospective epidemiologic studies of children; and e) application of uncertainty and safety factors in risk assessment that specifically consider children's risks. Under FQPA, children are presumed more vulnerable to pesticides than adults unless evidence exists to the contrary. Uncertainty and safety factors that are protective of children must therefore be incorporated into risk assessment when data on developmental toxicity are lacking or when there is evidence of developmental toxicity. The adequate protection of children against toxic agents in the environment will require fundamental and far-reaching revisions of current approaches to toxicity testing and risk assessment.
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