UCSF Sustainability Stories

Deborah Fleischer, Green Impact, July 2017

New Pediatric Environmental Health Web Toolkit

According to the U.S. EPA, children are often more vulnerable to pollutants than adults due to differences in behavior and biology. This can lead to greater exposure and periods of unique susceptibility during development. Yet medical and nursing school curriculums often do not address environmental health issues. To address this gap, the Pediatric Environmental Health Toolkit (PEHT) web-app was developed to help clinicians and parents better understand the everyday environmental interactions of children and steps to decrease harmful exposure.

Beginning in the womb and continuing throughout life, multiple environmental factors are strong determinants of health, even decades later, making it ever more important to provide the most current and scientifically-based advice to patients to reduce their family’s exposure to unhealthy chemicals. “There are specific windows of vulnerability for babies and adolescents where exposure can have lifelong impacts on health,” explained Dr. Michael T. Hatcher, DrPH, Chief, Environmental Medicine Branch Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry. According to Dr. Hatcher, part of the problem is that medical and nursing schools do not provide students the education they need to understand the harmful health effects related to exposure to natural and man-made hazardous substances.

Filling a Key Gap: Easily Accessible and Credible Information
“Clinicians tend to not think about the environmental causes of health issues because they often do not feel competent to address them,” agreed Dr. Mark Miller, UCSF Assistant Clinical Professor in the Departments of Pediatrics and Internal Medicine (Division of Occupational and Environmental Health), Co-Director of the Western States Pediatric Environmental Health Specialty Unit (PEHSU) at UCSF, and the director of the Children’s Environmental Health Center at the California Environmental Protection Agency. The PEHT addresses this gap by providing easily accessible and credible environmental health information to clinicians so they feel comfortable using it.

Free, Mobile-Friendly Tool to Decrease Harmful Exposure
Developed by the Western States Pediatric Environmental Health Specialty Unit (PEHSU) at UCSF, in partnership with the national PEHSU network and Physicians for Social Responsibility, and endorsed by the American Academy of Pediatrics (AAP), the PEHT toolkit is a free, web-based resource that offers peer-reviewed information to help pediatricians, nurse practitioners, physician assistants, and residents educate and guide parents about environmental health issues.  “The toolkit makes sure that clinicians understand environmental health exposures and how to guide patients and families in avoiding or lowering exposure risk,” stressed Dr. Hatcher.

It is an easy-to-use reference guide for health providers on preventing exposures to toxic chemicals and other substances that affect infant and child health. The tool provides examples of how and where we live, eat, sleep, work, and play can impact our health, and what we can do about it.
A key aspect of this new web-based reference is that clinicians can access the information on their mobile devices. “It provides concise information and guidance, created and peer-reviewed by experts in the field nationwide,” said Dr. Nick Newman, a pediatrician and the Medical Director of the Pediatric Environmental Health and Lead Clinic in Cincinnati. “It is also free of charge and without advertising so there is no reason not to bookmark it and use it.”

It includes three key sections: environmental hazards, anticipatory guidance keyed to thirteen age groups from prenatal through teen years, and key concepts, including the unique vulnerability of children. For each key environmental hazard, clinicians can easily learn about health effects, exposure sources, and prevention strategies, as well as access links to resources for learning more.

For example, for Triclosan, the site explains, “The main routes of exposure are oral and dermal. Oral exposure occurs with use of some mouthwash and toothpaste formulations. Dermal exposure occurs from cosmetics and anti-bacterial hand soap. Studies have shown that triclosan can be dermally absorbed.” The site also explains how to prevent exposure:

Learn More
To learn more about the tool and who developed it, go HERE