Status and trends of children's environmental health in the United States: Indicators from America's Children and the Environment

America's Children and the Environment is the U.S. EPA's compilation of children's environmental health indicators. The indicators, drawn from data sets that are nationally representative and updated regularly, are useful for tracking trends in the conditions of children's environments and related childhood health effects. Environments and Contaminants indicators present information on trends in environmental contaminants in air, water, and food, and other aspects of children's environments, including indoor environments, contaminated lands, and climate change. Biomonitoring indicators present data on environmental chemicals measured in blood and urine samples from children and women of child-bearing age, including lead, mercury, cotinine, phthalates, bisphenol A, perchlorate, perfluorinated chemicals (PFCs), polybrominated diphenyl ethers (PBDEs) and polychlorinated biphenyls (PCBs). Health indicators present information on childhood health conditions that may be influenced by environmental contaminants and other environmental factors, and include respiratory diseases, neurodevelopmental effects, childhood cancer, adverse birth outcomes, and obesity. Other important topics lacking national, regularly updated data are addressed as Special Features, including indicators for birth defects and for children's learning environments. Key findings from the most recent indicator updates identify both areas of progress and areas needing further attention. Substantial progress has been made in reducing children's exposure to air pollutants, lead, environmental tobacco smoke (ETS), and PFCs. An increasing proportion of children are being diagnosed with asthma, attention-deficit/hyperactivity disorder, autism, and cancer; exposure to environmental contaminants may be contributing to these increases. Minority and low-income children are disproportionately affected by many environmental exposures and by health outcomes that may be related to environmental contaminants. Significant disparities are observed in childhood blood lead levels, exposure to ETS, asthma prevalence, low birth weight, and preterm delivery, among others. EPA will update these indicators on an annual basis to identify changes in children's environmental health over time.