Maryland Children’s Environmental Health Progress Report

Because of children’s special vulnerability, reducing environmental risks demands our society’s full attention. Government’s role in this is central. Emerging evidence suggests that the epidemics of obesity and diabetes as well as the rising prevalence of allergic diseases and autism are due, at least in part, to chemical exposures during those most sensitive and vulnerable windows of development, mainly in-utero and the first few years of life.


Maryland Environmental Health Network

Children make forts with sofa cushions treated with toxic flame retardants. They breathe in tobacco smoke, diesel exhaust, ozone, and small particles suspended in the air. They swim in streams and play in the grass, crawl on carpets and suck fingers covered with household dust. Whatever is in the water, the grass, the carpet, the dust, will be in our children. Homes, playgrounds, schools – even the hospitals children are born in – are treated with dangerous pesticides. Chemicals known to be endocrine disrupters or carcinogens are used to make toys, cleaning products and school supplies. When we take full stock of these threats, the need to be more proactive in protecting our children is apparent. Parents and pediatricians, teachers and child care workers can take some steps to reduce environmental risks children face. But the most effective protection must come from policy-makers and legislators. Because of children’s special vulnerability, reducing environmental risks demands our society’s full attention. Government’s role in this is central. Emerging evidence suggests that the epidemics of obesity and diabetes as well as the rising prevalence of allergic diseases and autism are due, at least in part, to chemical exposures during those most sensitive and vulnerable windows of development, mainly in-utero and the first few years of life. Sadly, few national laws address children’s exposure to environmental hazards. Existing laws and regulations such as the Occupational Safety and Health Act (OSHA) are designed to protect adults and do not address the unique points of vulnerability of children. Other laws such as the Toxic Substances Control Act have been found inadequate to protect adults and children alike. In some cases, sound laws are bypassed (e.g. fracking exemptions from the Clean Water Act and other federal environmental laws) when perceived economic gain is given greater weight than public health and environmental considerations.

Our report points out key successes in Maryland, and building from that strong foundation, examines the opportunities ahead to protect our children from environmental health threats. While we know more each year about these environmental threats, U.S. and state lawmakers have yet to enact, or in many instances enforce, key protections for children. In this realm, there is no substitute for government action. This report details only some of the environmental health concerns that deserve our attention. The focus here is on pesticides, toxic chemicals, air and water pollution, hydraulic fracturing for natural gas extraction (‘fracking’) and climate change. There are equally compelling issues to be examined in other areas. For instance, we do not explore the relationship between the built environment and the epidemic of childhood obesity, nor cover the role of food systems, food access, and food quality in children’s health. We touch only briefly on the continuing threat of lead poisoning, the impact of second hand smoke on children, and the impact of housing conditions on child health. We do not fully explore the disproportionate impact of environmental degradation on the lives of low income children and families of color. These are all significant environmental health issues and they deserve to continue to receive the attention of child health advocates, law-makers and policy-makers.

Maryland’s Progress in Protecting Children

Maryland has been a leader in child health and safety. The Maryland Children’s Environmental Health Protection Advisory Council created in 2000 is tasked with ensuring that the State protects children from environmental hazards. Maryland has passed nationally ground-breaking laws, such as requiring Integrated Pest Management in Schools, and banning bisphenol A in sippy cups, bottles and infant formula containers.

Yet in recent years, other proposed laws have failed – measures to identify carcinogenic chemicals in consumer products, protect school children from harmful construction dust, and require the tracking of pesticide use. Maryland has fallen behind other states such as New York which in 1999 adopted the Comprehensive Public School Safety Program. Contained in these regulations are Uniform Safety Standards which provide basic health protections for children and other school building occupants during renovation and construction. The Washington State Children’s Safe Products Act of 2008 is another model for state action to protect children from chemicals of concern. These and other steps offer Maryland a path to becoming a healthier and safer state for children and a role model for other states.


How Children Are Affected

Environmental health threats affect children and the developing fetus in unique ways. Compared to adults, children absorb more toxins relative to body weight from the food they eat, air they breathe and water they drink. Pregnant women, infants, and children during puberty are at critical moments of vulnerability, when a small exposure can have a long-term and significant impact. Low income children are often more exposed by virtue of living near industry and toxic waste sites, or by having less choice about what they buy and eat. The new science of epigenetics is discovering how prenatal and childhood exposure to pollution influences the risk of chronic conditions in adult life. A rapidly growing body of scientific literature links exposures even at very low levels to adverse impacts on children’s neurological, respiratory, immune, and endocrine systems. For some chemicals, there may be no safe level of exposure. Yet children are exposed daily to a far greater range and combination of chemicals and toxic substances than have been tested by the Centers for Disease Control and Prevention (CDC), the Food & Drug Administration (FDA), the Environmental Protection Agency (EPA) or the National Institutes of Health (NIH). From flame retardants in children’s sleepwear to lead in toys, new threats to our children’s health are being identified.

Dramatic rises in childhood obesity and in the incidence of autism have made recent news. Parents and pediatricians, teachers and child care professionals are increasingly aware of how air pollution, pesticides, chemicals and other environmental factors are affecting our children. As the chart below indicates, many childhood health harms are on the rise. The 2008 report Maryland’s Children and the Environment, issued under the joint leadership of the Maryland Department of Health and Mental Hygiene (DHMH) and the Maryland Department of Environment (MDE), acknowledged that we do not know enough about how children are harmed by environmental factors. That report documented data gaps and highlighted the lack of testing to establish the levels of contaminants in children. Lead in children’s blood is the only example of routine biomonitoring and it takes place only in certain communities. Like the authors of that report, we conclude that disclosure of hazards and monitoring of exposures is a critical component of protecting our children.


Where Should Maryland Focus to Protect Children?

Maryland can do more to address our children’s daily exposure to environmental health threats in the following areas:


Pesticides are a serious threat to Maryland’s children. Just one exposure at a critical stage of fetal or child development can have long-term health consequences. Of the forty pesticides commonly used in homes and schools, 28 may cause cancer, 26 can affect reproduction, 26 are nervous system poisons, 14 can affect the endocrine system, and 13 can cause birth defects. As this breakdown illustrates, many pesticides have multiple health effects.

While Maryland passed groundbreaking laws on Integrated Pest Management (IPM) in public schools in 1998 and 1999, implementation and enforcement is lacking. Maryland needs centralized reporting of what is applied by non-homeowner applicators, when and where. Public health officials must be empowered to assess the link between certain pesticides and illness clusters in communities, such as asthma, autism spectrum disorders, and childhood cancers.

“Fracking” is a new and fast growing energy technology with health implications that we are just beginning to understand, based on problems emerging in other states. The health threats related to hydraulic fracturing and extraction of gas from shale formations are now being studied, while shale gas exploitation proceeds at full tilt in nearby Pennsylvania and West Virginia. The chemicals used in the fracking process are linked to respiratory, immune system, nervous system, gastrointestinal and cardiovascular problems, as well as cancer. Before Maryland becomes the next state to engage in unconventional gas drilling practices, we need to fully understand the health implications for children and families. Pursuing clean energy sources will better secure the future health of our children through lower greenhouse gas emissions, and cleaner water and air.

Chemicals and Toxic Substances in consumer products have been linked to many health problems – premature birth, learning disabilities, behavioral disorders, asthma and allergies, early puberty, obesity, diabetes, infertility, and some types of cancer. BPA, formaldehyde, flame retardants, phthalates, and many other chemicals enter children’s bodies in too many ways for parents to prevent. They are in plastic food containers, hand lotions, drinking water, fabric treatments, household dust, and foam pads, and many more consumer products. Maryland state agencies need the resources to conduct timely biomonitoring and other data collection activities. The public must also have access to better information, but government action is critical to truly protect Maryland families.

Air Pollution in Maryland remains a threat to our children’s health, in spite of many recent advances. Sources of concern include incinerators and power plants that emit mercury, particulate matter, and sulfur dioxide. Ground level ozone scars young lungs and air pollution as a trigger for asthma can have impact on young lives in the form of missed school days, increased hospitalizations and reduced participation in sports.

Air pollution has been linked to acute and long-term health impacts for children including impaired lung function and growth, increased cancer risk, preterm birth, and even infant death. In addition to respiratory effects, air pollution has been linked to heart disease, high blood pressure and neurodegenerative diseases. To protect communities that are most vulnerable to air pollution, Maryland must adopt a policy of considering the cumulative effect of industrial land uses and vehicle traffic. Schools and athletic fields especially should not be sited near polluting industries, highways, or transportation hubs.

Polluted waterways and contaminated land pose threats to Maryland children ranging from toxic waste sites and lawn care chemicals, to contaminated streams and agricultural runoff. Last year, Maryland took a major step by banning arsenic in chicken feed. But relatively little has been done to protect children and others from dangerous toxics on land and in water. The health of the Bay is linked to the health of our residents. Pesticides, pharmaceuticals and antimicrobials have been linked to intersex fish in several of Maryland’s waterways that are also the source of our drinking water. Low income children are likely to eat fish from polluted waters with a real risk of ingesting toxics such as PCBs.When Maryland takes steps to reduce the sources of toxic pollution contributing to the Bay’s deterioration, we also take steps to protect our children. Many new storm water management practices bring benefits for children, such as greening urban neighborhoods, restoring streams thereby making them safe recreational areas, and reducing children’s accidental exposure to raw sewage during floods.


Parents and pediatricians, teachers and childcare workers can take some steps …. But the most effective protection must come from policy-makers and legislators.

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