At the end of September, the Environmental Protection Agency (EPA), with no explanation, placed the director of the Office of Children’s Health Protection (OCHP), Dr. Ruth Etzel, on administrative leave. This sidelining of a vocal children’s health advocate as the office was heading into October, Children’s Environmental Health Month, was concerning for all who work in children’s environmental health.

The OCHP’s essential role.

The OCHP was created under an executive order in 1997 as public consciousness was increasing about the special vulnerabilities of children to environmental hazards. It is housed in the Office of the Administrator so as to be able to provide guidance to EPA leadership and ensure that children’s health protection is prioritized throughout the agency’s activities. This is essential because, as many have observed, children are not simply miniature adults—what they eat, drink, and breathe can profoundly affect their physical and mental development, while their hand-to-mouth and on-the-floor activities put them at greater risk for exposures from environmental hazards.

The office provides essential resources for health professionals and the public on environmental health issues such as environmental triggers of asthma and how parents can reduce exposures, reducing exposures to lead, and air quality in schools. The OCHP-produced report, America’s Children and the Environment (ACE), reviews key indicators for children’s environmental health. OCHP also supports Pediatric Environmental Health Specialty Units (PEHSU) in conjunction with the Centers for Disease Control. PEHSUs offer medical advice and guidance on environmental exposures affecting reproductive and children’s health to health professionals and the public. There are PEHSUs in each of the ten EPA regions.

Advocating for children’s health within the EPA.

Besides being an important educational resource for health professionals, families, schools, and others, the office also provides guidance to other offices within the agency. They review regulations in draft to ensure that the special vulnerabilities of children are being taken into account by other offices as new rules are being promulgated. For example, they have been a leading advocate for strong lead exposure rules that are currently under consideration by the EPA.

A letter of concern from 120 organizations.

The sudden change in the status of Dr. Etzel has caused many within the nursing and the public health community to express concerns that the power of the office is being diminished. As stated by Laura Anderko, PhD, RN, a professor at Georgetown University and the first nurse director of a PEHSU, “When we calculate safety levels of chemicals, we’re using adult men. Unless there are researchers at the Office of Children’s Health Protection at the table, children won’t be protected adequately. My fear is that they will dissolve the office.”

In response, over 120 organizations signed a letter to Acting Administrator Wheeler asking him to clarify what actions are being taken against Dr. Etzel and expressing support for a strong OCHP. Signatories included the American Public Health Association, the Alliance of Nurses for Healthy Environments (ANHE), the American Academy of Pediatrics, and the Emory University Nell Hodgson Woodruff School of Nursing. As nurses, our voices are especially powerful in ensuring a strong OCHP. We regularly see children and families affected by environmental exposures, such as children with asthma or high blood lead levels.

Recent efforts to weaken other EPA regulations.

Recent efforts have sought to weaken EPA regulations and diminish the power of the agency to protect public health from environmental hazards. These regulatory rollbacks have included efforts to repeal the Clean Water Rule, which protects the drinking water of one in three Americans, and weaken the vehicle emissions standards finalized during the Obama Administration. Nurses who frequently work with the EPA and support health-protective environmental regulations have been concerned that these efforts may expand to reducing the size and capacity of important offices within the EPA, including OCHP.

What nurses can do.

As this issue continues to unfold, nurses can call on Congress to push back on efforts to diminish the OCHP. You can also join the Alliance of Nurses for Healthy Environments Policy-Advocacy Work Group, which will be providing opportunities for nursing action. This group is free to join and holds monthly calls where all nurses and nursing students are welcome. To receive notice of calls and learn more, go to the Policy-Advocacy page on the ANHE website, where you can sign up for their Listserv.

By Katie Huffling, MS, CNM, RN, executive director, Alliance of Nurses for Healthy Environments