Children are more vulnerable to all kinds of environmental influences than adults are for a great range of reasons, but the main cause for their susceptibility is their developing body, in particular the brain. For environmental health, I rely on the definition adopted by the U.S. Department of Health and Human Services:

“In its broadest sense, environmental health comprises those aspects of human health, disease, and injury that are determined or influenced by factors in the environment. This includes not only the study of the direct pathological effects of various chemical, physical, and biological agents but also the effects on health of the broad physical and social environment, which includes housing, urban development, land-use and transportation, industry, and agriculture.” (1). Furthermore, building on that definition, my concerns related to children’s environmental health are based on the developmental origins of disease and dysfunction, strongly influenced by environmental factors and early childhood exposures of harmful agents, as described by a number of researchers and organisations, such as WHO (2-9).

Most commonly the concept children's environmental health refers to toxic exposures that interfere with the normal development of children, particularly those by endocrine disrupting compounds.  This used to be also my primary focus, but when I was interviewing people for my PhD research, I realised that most of the people appear to connect children’s health and the environment much more holistically. This made sense to me and therefore I choose to define paediatric environmental health as a state of physical, mental and social well-being of children, which has had minimal negative environmental exposures, by external physical, chemical, and social factors. (This was freely adapted from the definition of health by the World Health Organisation.)

That said, my personal research interests keep focusing on the chronic aspects of children's environmental threats. Although the paediatric mortality rates related to infectious diseases have been improving since the 20th century, the growing body of evidence associating environmental exposures in childhood to a range of neurodevelopmental and metabolic disorders as well as other chronic diseases (7) makes CEH a potential key component in future public health efforts.

There are biological, behavioural and socioeconomic reasons why children are more vulnerable to environmental contaminants than adults (7-16). Toxic exposures to chemical pollutants, in particular small doses of endocrine disrupting compounds, during the periods of embryonic, foetal and infant development (5, 16-18) can cause disease and disability not only in children but across the entire span of human life. For instance, reproductive disorders are usually first recognised when people reach the reproductive age, yet they may have been caused by foetal xenobiotic chemical exposures (8). Indeed, toxic exposure in childhood may lead to the development of chronic disease later in life (4). Just to illustrate the degree of severity of these issues, OECD (13) reported that 1 in 13 of American school-age children has asthma, a rate that has been increasing more rapidly than asthma frequency in any other age group.

References:

1. USHHS (2000). U.S. Department of Health and Human Services. (November 2000:8-1). Healthy People 2010. With understanding and improving health and objectives for improving health. 2 volumes; vol. 1 (2nd ed.). Washingotn, DC: U.S. Government Printing Office.

2. Colborn, T., Dumanoski, D., and Myers, J. P. (1997). Our Stolen Future: Are We Threatening Our Fertility, Intelligence, and Survival?. New York: Penguin Group.

3. Chance, G. W. (2001). Environmental contaminants and children's health: Cause for concern, time for action. Paediatrics and Child Health, 6(10), 731-743.

4. Landrigan, P. J., and Garg, A. (2002). Chronic effects of toxic environmental exposures on children's health. Journal of Toxicology - Clinical Toxicology, 40(4), 449-456.

5. Grandjean, P., Bellinger, D., Bergman, Å., Cordier, S., Davey-Smith, G., Eskenazi, B., . . . Weihe, P. (2008). The Faroes statement: Human health effects of developmental exposure to chemicals in our environment. Basic and Clinical Pharmacology and Toxicology, 102(2), 73-75.

6. Gavidia, T. G., Pronczuk de Garbino, J., and Sly, P. D. (2009). Children's environmental health: An under-recognised area in paediatric health care. BMC Pediatrics, 9(1)

7. Barouki, R., Gluckman, P. D., Grandjean, P., Hanson, M., and Heindel, J. J. (2012). Developmental origins of non-communicable disease: Implications for research and public health. Environmental Health: A Global Access Science Source, 11(1)

8. WHO (World Health Organization) (2012).  Endocrine Disruptors and Child Health: 

9. Possible Developmental Early Effects of Endocrine Disrupters on Child Health (No. ISBN 978 92 4 150376 1). Geneva, Switzerland: WHO

10. Birnbaum, L. S. and Fenton, S. E. (2003). Cancer and Developmental Exposure to Endocrine Disruptors. Environmental Health Perspectives, 111, 389-394.

11. Wigle, D. T. (2003). Child Health and the Environment. Oxford; New York: Oxford University Press.

12. Koppe, J. G., Bartonova, A., Bolte, G,, Bistrup, M. L.….and Zuurbier, M. (2006). Exposure to multiple environmental agents and their effect. Acta Pædiatrica, 95 (Suppl 453): 106-113

13. OECD (2006). Economic Valuation of Environmental Health Risks to Children. Organisation for Economic Co-operation and Development. Paris, France: OECD/PUMA.

14. Etzel, R. A. (2010). Developmental milestones in children's environmental health. Environmental Health Perspectives, 118(10), A420-A421.

15. Casals-Casas, C., and Desvergne, B. (2011). Endocrine disruptors: From endocrine to metabolic disruption. Annual Review of Physiology. 73, 135–62

16. Birnbaum, L. S. (2012). Environmental chemicals: Evaluating low-dose effects. Environmental Health Perspectives, 120(4), A143-A144.

17. Melnick, R., Lucier, G., Wolfe, M., Hall, R., Stancel, G., Prins, G., . . . Kohn, M. (2002). Summary of the national toxicology program's report of the endocrine disruptors low-dose peer review. Environmental Health Perspectives, 110(4), 427-431.

18. Mendola, P., Selevan, S. G., Gutter, S., and Rice, D. (2002). Environmental factors associated with a spectrum of neurodevelopmental deficits. Mental Retardation and Developmental Disabilities Research Reviews, 8(3), 188-197.

19. Euling, S. Y., Selevan, S. G., Pescovitz, O. H., and Skakkebaek, N. E. (2008). Role of environmental factors in the timing of puberty. Pediatrics, 121(SUPPL.3), S167-S171.