Children's Health (21)

Question 1

**1904, Queensland Australia

Answer 1

lead poisoning in young children exposed to lead-based paint

Question 2

**Herbert Needleman:

Answer 2

identified subclinical effects of lead associated with low environmental exposures including loss of intelligence and disruptive behavior

Question 3

**What event established that infants and fetuses are more susceptible than adults to radiation-induced leukemia?

Answer 3

Leukemia among young children exposed to ionizing radiation in the 1945 atomic bombing of Hiroshima and Nagasaki.

Question 4

**Chemical involved in Minamata, the results of exposure to it, and what type of exposure led to the most severe effects:

Answer 4

methylmercury

cerebral palsy, mental retardation, convulsions

in utero exposure

Question 5

result of thalidomide (anti-nausea drug) ingestion during early pregnancy

Answer 5

phocomelia (limb malformation)

Question 6

result of women exposed in utero to diethylstilbestrol to prevent premature labor

Answer 6

vaginal adenocarcinoma

Question 7

**NRC 1993 Report:

Answer 7

“Diets of Infants and Children”

Question 8

**Act passed in 1996:

Answer 8

Food Quality Protection Act

Question 9

**National Children’s Study in 1997:

Answer 9

Executive Order on Children’s Health and the Environment

Question 10

**Act passed in 2008:

Answer 10

Consumer Product Improvement Act

Question 11

**Number of chemicals produced since the 1950s

Answer 11

nearly 80,000

Question 12

Number of synthetic chemicals classified as high production volume (HPV)

Answer 12

2800

Question 13

Percentage of HPV synthetic chemicals tested for toxicity, developmental toxicity

Answer 13

43%, 28%

Question 14

What does IRIS stand for?

Answer 14

Integrated Risk Information System

Question 15

% of DALYS attributed to the environment for children (0-14) vs overall

Answer 15

36% children to 24% overall

Question 16

**Major issue in developed countries:

Answer 16

chronic diseases (e.g. asthma, developmental disorders, childhood leukemia, brain cancer

Question 17

It is hypothesized that how much of childhood disease is due to environmental influence?

Answer 17

the majority

Question 18

Estimated cost due to lead poisoning, asthma, cancer, and neurobehavioral disorders: (dollars and percentage of total annual illness cost)

Answer 18

$54.9 billion dollars

2.8% of total annual illness cost

Question 19

**Primary issue in developing countries, and why:

Answer 19

poverty

due to environmental injustice, more risky behaviors (e.g. smoking, diet), poor access to services

Question 20

**Major threats in developing countries (5):

Answer 20

1. perinatal diseases
2. respiratory diseases
3. diarrheal diseases
4. insect-borne diseases
5. physical injuries

Question 21

Why time in DALYs is so large for children?

Answer 21

The issues happen so much earlier in life.

Question 22

**Health problems associated with lead poisoning in kids (6):

Answer 22

1. decreased bone and muscle growth
2. poor muscle coordination
3. damage to the nervous system, kidneys, and/or hearing
4. speech and language problems
5. developmental delay
6. seizures and unconsciousness (in extreme cases)

Question 23

Lead is what type of toxicant?

Answer 23

Neurotoxicant

Question 24

**Observed effects of pesticides on children?

Answer 24

1. multiple organ effects (incl. CNS, lungs, kidneys, digestive, immune)
2. cancer (incl. brain, non-Hodgkin’s lymphoma, leukemia)
3. from in utero exposure: limb reduction, undescended testes, neural tube defects, heart problems, impaired fetal growth

Question 25

Are children little adults?

Answer 25

No; they’re particularly susceptible to environmental contaminants

Question 26

Reasons that children are more highly exposed (relative to adults and adjusted for body weight):

Answer 26

• drink more water
• eat more food
• diets include oft-contaminated fruit juices
• breathe more air
• hygiene/hand-to-mouth behaviors

Question 27

What pathways in children are underdeveloped?

Answer 27

Metabolic detoxification pathways

Question 28

What systems are particularly vulnerable due to the rapid growth and development of children?

Answer 28

nervous, immune, reproductive, endocrine, cardiovascular

Question 29

NRC Report Recommendations (4):

Answer 29

1. Better data on children’s exposure to pesticides
2. need toxicological studies to examine the long-term and delayed effects of early exposure to pesticides
3. examine pesticide interactive effects
4. set standards providing extra margin of safety for children

Question 30

First regulation to protect children’s health against environmental hazards

Answer 30

Food Quality Protection Act of 1996

Question 31

Food Quality Protection Act of 1996 did what?

Answer 31

1. health-based standards oriented toward children and infants
2. extra margin of safety to protect children
3. requires consideration of interactive and endocrine effects

Question 32

Executive Order on Children’s Environmental Health and Safety of 1997?

Answer 32

1. recognizes children’s environmental health as a priority

2. established cabinet-level committee on children’s environmental health (EPA and DHHS co-chairs)

Question 33

Study with the goal of systematically examining the impact on children’s health and development from early exposure to environmental toxicants

Answer 33

The National Children’s Study

Question 34

the most serious consequence of pediatric lead poisoning

Answer 34

brain injury

Question 35

why children are particularly vulnerable to lead

Answer 35

rapidly developing brains, normal hand-to-mouth behavior increases the risk that they will take lead from the environment into their bodies

Question 36

There are certain periods during a child’s life when they are more susceptible to certain environmental pollutants than at other times, true or false?

Answer 36

True

Question 37

Four main exposure factors for children:

Answer 37

1. contact rates (more food/water, hygiene, high dermal surface area to volume ratio, ventilation rate)
2. contact with contaminated environmental media (hygiene, oral exploratory behavior, soil/dust/carpet, diet contains food likely to be contaminated)
3. time activity patterns (time indoors/outdoors)
4. location (schools, daycare, grandparents, playground… breathing zone closer to floor)

Question 38

Three concerns:

Answer 38

1. developmental vulnerability
2. biological components
3. exposure components

Question 39

ADMT:

Answer 39

absorption, distribution, metabolism, target organ specificity

Question 40

two exposure circumstances unique to children:

Answer 40

trans-placental transfer, breast milk ingestion

Question 41

Ways to reduce exposure in children:

Answer 41

buying organic fruits and vegetables, rinsing food, peeling, diverse diet

Question 42

PBDEs:

Answer 42

Polybrominated Diphenyl Ethers

may have hormone disruption effects/be neurodevelopmental toxicant, banned in Europe in 90s and CA in 2006

Question 43

Aftermath of the mis-represented CHEERS study:

Answer 43

1. researchers should seek community consultation and participation in studies
2. studies should not have unfair representation of the poor or under-represented populations
3. avoid controversial financial conflicts of interest
4. make clear “observational” nature of study (in contrast to intentional dosing)

Question 44

Ethical concerns of research conducted with children:

Answer 44

children are vulnerable and unable to provide informed consent