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By 2009, all 50 state public health agencies and federal agencies had issued fish consumption advisories because of mercury contamination. The individuals most affected by this problem are low- income, low-education and limited English proficiency immigrants, since they are often unaware of the nature of advisories. In fact, these individuals have been taught to consume more fish because omega-3 fatty acids and other nutrients in fish are associated with better birth and developmental outcomes. Many of the children bring packed lunches and store them in lockers without proper refrigeration. The overall topic is large and complex. (See complete discussion in Chapter 7, “Food Security and Protection.”)

Indoor Air Pollution

(See Chapter 2, “Air Quality (Outdoor [Ambient] and Indoor)”)

Indoor air pollutants affecting children, especially those with existing respiratory and allergic problems, include asbestos, carbon monoxide, formaldehyde from particle board, household cleaners, consumer home products, fire retardants, lead (especially in pre-1950 built homes) from lead-based paint, molds, particulate matter, pesticides (especially in crowded lower income housing typically because of severe roach infestation), radon gas, secondhand smoke (especially a very serious problem in crowded lower income housing), phthalates, burning of candles and incense, recent indoor painting, plastics emitting plasticizers, and other volatile organic compounds. Also of great concern is the inhalation of a mixture of these contaminants.

Environmental tobacco smoke is a problem for 43% of children from 2 months of age to 11 years of age. Environmental tobacco smoke is a mixture of some 4000 chemicals, some of which are extremely hazardous to the health of a small child. Children who are exposed to these chemicals tend to have greater problems with bronchitis, pneumonia, respiratory infections, middle ear infections, and asthma. Typically, the frequency of these health problems is related to the amount of smoke that is present in the child’s environment.

Allergens are found in the indoor air including those that come from dust mites, cockroaches, pet dander, pollen, molds, spores, bacteria, and viruses. These allergens combined with the environmental tobacco smoke and other chemicals found in the environment have a profound effect upon the child and serve as triggers for asthma, which is especially prevalent in minority children living in the inner city. The economic impact of this is considerable, resulting in lost school attendance, lost workdays for the parents, and a substantial number of emergency room visits which are very costly.

Volatile organic compounds including cleaning products, adhesives, paints, and dry-cleaning fluids are continuing problems in the child’s environment.

Nitrogen oxides from fuel combustion may be found in the indoor air as well as the outdoor air.

Illegal drug laboratories, especially used to produce methamphetamines, use a variety of toxic chemicals during the cooking process. A methamphetamine residue coats all the surfaces in the property.

Building materials can be hazardous to children if they are contaminated and if they release chemicals such as formaldehyde. Recently, drywall from China has been suspected of containing corrosive materials and also elevated levels of mercury. Another potential problem is the presence of asbestos.

Inadequate ventilation in the structure, especially close to the ground, may contribute to the inhalation of contaminants from cleaning and disinfecting products, air fresheners, and perfumes from adults.

Contaminated dust is present in the small child’s environment and is inhaled by the child. The chemicals come from furniture, carpets, plastic products, flame-retardants and pesticides, and are carried in from the outside or stirred up inside by people walking on surfaces. Mold spores from water-damaged walls or carpets add to this problem. Lead may be part of the dust from peeling paint in structures built before 1976 or from lead-based painted toys or lead toys. (See Chapter 2, “Air Quality (Outdoor [Ambient] and Indoor).”)

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