“Children are often exposed to. . . contaminants through their behavior—when they crawl on the floor or explore their environment by touching and tasting objects indiscriminately. In addition, because they are young, there is the potential for environmental exposures to negatively impact their health for a long time.”

Photo © Associated Press

Chemicals are ubiquitous

In “Project TENDR,” an article in this month’s issue of AJN, author Laura Anderko, PhD, RN, a professor at the Georgetown University School of Nursing and Health Studies, discusses why children are particularly susceptible to environmental exposures to chemicals.

Aside from children’s vulnerability to chemical exposures as still developing individuals, Anderko observes that chemicals are also especially hazardous to children simply because they are everywhere: “ . . . in health care supplies and equipment, the food we eat, the water we drink, the air we breathe, and the cosmetics and personal products (such as shampoos, baby bottles, toys, and thousands of other consumer products) we use.”

Developmental harms of children’s exposure to chemicals

Anderko summarizes the concerns raised by a growing body of evidence linking environmental exposures and pediatric health outcomes:

“ . . . widespread exposure to toxic chemicals can increase the risk of cognitive, behavioral, and social impairment in children, as well as specific neurodevelopmental disorders, such as autism and attention deficit–hyperactivity disorder (ADHD).”

The article also describes Project TENDR, a collaborative effort by scientists, health care professionals, and children’s advocates to promote chemical policy reform. Nurses from the Alliance of Nurses for Healthy Environments participated in this project.

Chlorpyrifos: EPA acts against own evidence on health risk to children

Anderko mentions one insecticide, chlorpyrifos, that has been in the news recently. In late March, the new administrator of the EPA, Scott Pruitt, announced the agency would not ban the use of this insecticide on foods such as strawberries, broccoli, and citrus.

The decision, welcomed by industry groups that have lobbied against restricting the chemical’s use, contradicts the EPA’s own evidence and its recommendation, in the fall of 2015, to start moving toward a complete ban of chlorpyrifos. It also follows, by 17 years, an EPA decision to partially ban chlorpyrifos, which the agency had concluded posed a health risk to people—especially children—when used in and around houses, schools, and other buildings in which children spend time.

‘A preventable cause of harm’

Although the recent EPA decision signals that the agency may now be less willing to consider health effects of commonly used chemicals children are exposed to every day, Anderko explains in her article why, from a public health perspective, such scrutiny of chemicals in the environment is needed now more than ever:

“Among the multiple causes of disability, exposure to chemicals deserves special scrutiny, because this is a preventable cause of harm.”

For nurses who are interested

Nurses can become involved in these efforts. The nursing curriculum, Anderko advises, should include information about potential chemical exposures and the effect these can have on health outcomes. And nurses, she writes, can “become informed about the evidence linking chemical exposures to health; integrate this knowledge into our standards of practice; educate the public; and advocate for a cleaner, healthier world.”