Environmental causes account for a high proportion of childhood diseases worldwide, with climate change magnifying the effects on children. To help address this, the American Academy of Pediatrics (AAP) has released updated recommendations for pediatricians on identifying and managing the effects of environmental hazards on children.
The policy statement, "Environmental Issues in Global Pediatric Health," and an accompanying technical report are published in the February 2025
Pediatrics.
"The environment has a far greater impact on children's health than what is generally known or appreciated," said
Lauren Zajac, MD, MPH, FAAP, a lead author of the AAP policy statement.
"While some children may be treated for a condition readily associated with the environment, such as asthma, others may not show any signs of exposure to a hazardous environment. This is why it is important for pediatricians to ask families about their environmental history, learn about major local or regional environmental threats, and include those factors in their diagnosis when appropriate."
Environmental causes account for a high proportion of childhood diseases worldwide, according to the policy statement. Nearly 92% of all pollution-related deaths occur in low- and middle-income countries, where environmental hazards account for twice as great a proportion of deaths in children younger than 5 years than in high-income countries.
In addition, the impacts of global climate change fall most severely on children in low-and middle-income countries and will magnify the effects of pollution on children's health.
The AAP recommends:
That pediatricians understand the importance of environmental hazards, including climate change, and their impacts on children's health;
That those from high-income countries who plan to work in low-to middle-income countries become familiar with the environmental hazards in the region and country where they will be serving;
Questions about environmental health hazards should be added to standardized questionnaires for new patients. Ask about possible exposures to toxic materials brought into the home by parents on clothing, shoes or vehicles
Ask environmental health questions during appropriate medical encounters with existing patients who have an environmentally related disease (such as asthma);
Refer patients with suspected environmental exposures to public health or environmental health agencies or community organizations for further help with exposure assessment and management.
The AAP outlines how health organizations and governments can increase awareness through education and training, and points to how the United States has reduced pollution in the past, such as the passage of the Clean Air Act in 1970.
"We need to develop environmental policies that put children's health first," Dr. Zajac said. "There are many steps we can take to reduce children's exposure to toxic environments—whether it's in the doctor's office, at a city council meeting or when developing global policy."
Both policies come from the AAP Council on Environmental Health and Climate Change. All policy statements and reports by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in
Pediatrics.
More information