Child Health and the EnvironmentDonald Wigle

Children, Youth and Environments Vol. 14 No. 1 (2004) ISSN: 1546-2250 Child Health and the Environment Wigle, Donald (2003). New York: Oxford University Press; 416 pages. $55.00. ISBN 0195135598. Scientists, clinicians, and public health practitioners have long recognized that the health of the environment is intricately linked to the health of the population. This recognition has become more focused over the past century to include a more detailed consideration of the effects of environmental exposures to the unborn child, infants and children. Recent trend data indicate that the incidence and prevalence of childhood diseases are on the rise. For example, national data show that the prevalence of asthma doubled from1980 through 1995 (CDC 1998; Woodruff et al. 2004). Additionally, the incidence of childhood cancers increased from 1975 until 1990 andhas stabilized since then (De Vesa et al. 1995; Linet et al. 1999). A recent report of the National Academy of Sciences estimated that 25percent of developmental disorders in children are caused by environmental factors (Committee on Integrating the Sciences 1999). Questions remain in understanding how much the chemical environment is contributing to these trends. Donald Wigle, in his book, Child Health and the Environment, considers environmental threats to children, including environmental sources, exposures and their specific pathways, and related health effects. From radiation to hormonally active agents, air pollution to water, lead to methyl mercury, and polychlorinated biphenyls to pesticides, Wigle presents detailed discussions on the major categories of environmental threats and the literature related to their impacts on the developing fetus, infants and children. The content of this book is closely aligned with traditional environmental health, namely, limited to air, food, and water contaminants; radiation; toxic chemicals; and wastes and their effects on human health. 282 Such a compendium of knowledge will be useful for students at the undergraduate and graduate level in public health, epidemiology, medicine, and health policy; and will be relevant for practitioners, risk assessors, policy makers in public health, and the general public interested in this subject area. This book introduces and describes the concept of children’s environmental health, vulnerabilities in children, and issues related to risk management in a cogent manner. For each chapter, Wigle describes exposures, health effects, and risk management as well as addresses gaps in research and basic knowledge for each topic area. Importantly, Wigle fills a gap in the content of traditional environmental health textbooks in that he weaves together important information on sources, markers and pathways of exposure, susceptibility, and health outcomes and brings together evidence from the sciences of toxicology, epidemiology, and clinical medicine as well as important tools such as risk assessment. His references are current and comprehensive, representing a wide array of research in the aforementioned disciplines. In his concluding chapter, Wigle calls for improved environmental health research programs and tracking systems to inform public health policy and provides limited recommendations to improve the science base for informed decision-making. Additional discussion in this chapter might have included some direction for the audience in terms of organizations and agencies involved in research translation and practice, such as the Canadian Institute of Child Health and the Children’s Environmental Health Network. I hope in future editions that this topic area will broaden to include a chapter on the role of the built environment on human health with a particular focus on the connections between land use, planning and public health. The Centers for Disease Control and Prevention, together with the National Institute of Environmental Health Sciences (NIEHS) have been instrumental in bringing together researchers from multiple disciplines including public health, planning, architecture, engineering, law, and business to advance a research agenda 283 that focuses on the built environment and health. In September 2003, the American Journal of Public Health and the American Journal of Health Promotion both issued special editions that featured research on the effects of land use and community design on public health (Srinivasanet al. 2003; O’Donnell 2004). Experts both from CDC and from a wide range of professional disciplines presented articles and commentaries on how the design of the built environment affects communities in terms of physical activity, air and water quality, injuries, mental health, social capital, and environmental justice...

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