DR. PHILIP LANDRIGAN: A Prescription to Better Serve Kids
J. B., E Magazine
Dr. Philip Landrigan has long played an important role in advancing the field of pediatric environmental health--first as an officer in the U.S. Public Health Service, then as an epidemiologist with the Centers for Disease Control and Prevention, senior advisor on children's health to the Environmental Protection Agency and, most recently, director of the Mount Sinai Center for Children's Health and the Environment, which was established in 1998 as the first of eight such national research centers. He is widely recognized as one of the nation's foremost experts on children's diseases and environmental exposures. Dr. Landrigan's forthcoming book, 101 Ways to Raise Healthy Children in a World of Toxins, will be published in October by Rodale Press.
E: How have the patterns of childhood illness changed over the last few decades?
LANDRIGAN: Fifty or 75 years ago in this country, the dominant causes of illness in kids were infectious diseases--pneumonia, influenza, measles, dysentery, diphtheria, tetanus and polio. But today, the major causes of sickness and death are, after injuries, all chronic diseases. Asthma has become the leading cause of hospitalization, and cancer is the leading cause of death.
What appears to be the most insidious environmental threat to children's health?
I'm worried about a whole range of chemicals that have the potential to get into the developing brain and cause damage. Chemicals can be toxic to the brain at a pretty low level. We knew back in the 1950s and 1960s that a high level of lead exposure could damage the brain, but in the 1970s and 1980s, studies showed that there's a spectrum of damage. Children exposed to lead at lower levels who had no obvious symptoms still showed a loss of IQ, slowing of reflexes and poor performance on psychiatric tests. We now know that PCBs, mercury and probably pesticides act that way, too.
Are pediatricians and family practitioners trained to recognize environmental threats?
Over the next few years, I think we will see pediatricians become increasingly cognizant of these issues. Pediatricians have long been good about checking up on environmental causes of lead poisoning in children, and they are certainly attuned to looking for the environmental causes of asthma. But they have not systematically looked at children's exposures to toxins in the environment because most were not trained to think about environmental factors as causes of disease.
What would you consider the greatest accomplishment in the field of children's environmental health?
I think the removal of lead from gasoline was an enormous accomplishment. In the 25 years since then, we have seen a greater than 90 percent reduction in blood lead levels in American children. It means that there is a lot less lead in water, in air, in the food chain and in wildlife.
What, in the coming decade, has the potential to be as serious a threat as lead?
There are three big ones. We need to reduce the exposure of people of all ages to pesticides. Pesticides are used in enormous amounts in homes, schools and day care centers and on lawns and gardens. Once released, they are immediately widespread in the environment and create enormous potential for harmful health effects.
Number two is fine particulate air pollution, which is well known to be a trigger of asthma. Since the major source is cars, we are going to need to make some very fundamental changes in transportation.
The third threat is chemicals in our drinking water. Drinking water regulation is lagging way behind. …