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	Sustainability

Presentations

Raising Healthy Children in a Toxic World, Philip J. Landrigan, MD, MSc (45 min)
Environmental factors that impact children’s health include persistent organic pollutants, heavy metals, pesticides, trans fat, electronic media, and transportation options that promote sedentary lifestyles. National research initiatives are underway to clarify the impact of these factors. This talk will recommend specific actions that parents, health care providers, architects, and community planners can take to mitigate these factors. The cost of taking action is less than the long-term cost of failure to address environmental health risks. Objectives include (1) summarize current knowledge of environmental threats to children’s health; (2) describe major research initiatives that are seeking to further understand pediatric environmental hazards, with particular emphasis on the National Children’s Study; and (3) describe successful approaches to prevention of disease of environmental origin in children.

Leading by Example: Going Green in Pittsburgh, Devra Lee Davis, PhD, MPH (40 min)
Patterns of cancer and other chronic illnesses in children cannot be explained by known risk factors. The role of environmental factors in contributing to these patterns is a matter that merits serious concern. The University of Pittsburgh Medical Center (UPMC) has created programs within the hospital environment and community to reduce the use of materials and policies that involve cancer causing agents. Nine major teams have been developed to address activities ranging from retrofits and new construction, maintenance and operations, patient and staff nutrition and other quality of life issues. These changes have been well received and have had a positive impact on the community. The new children’s hospital of Pittsburgh will incorporate many of these policies into its new facility in an effort to promote the hospital serving as a living laboratory of toxic reduction and disease prevention. Objectives include (1) identify material and policies that contribute increased cancer risk; (2) define key features of healthy buildings; (3) outline the benefits of the green building program for the community; and (4) highlight policy opportunities to promote healthier practices within the health care environment and local community. Download the presentation here (pdf 3 MB).

Building Healthy Children: Economics and Ethics, panel (95 min)

Overview, Henry Falk, MD, MPH (15 min)
The health consequences and ecological consequences of construction practices in the last 50 years are now becoming apparent. By using materials that are recyclable or biodegradable, the burden of toxic waste and persistent pollutants in the environment can be greatly reduced. CDC has made some changes in their buildings to encourage exercise and improve the indoor air. CDC has several new initiatives and goals pertaining to healthy buildings. Key objectives include: (1) list the consequences and ethical concerns of traditional building design; (2) explain the importance of using new methods of green building; and (3) outline CDC’s initiatives promoting healthy indoor environments. Download the presentation here (pdf 7 MB).

Healthy Homes, Kristen Welker-Hood, RN, MSN, ScD (20 min)
Children are exposed to many pollutants that exist in the indoor environment. Various conditions that have been associated with these exposures include asthma, lead poisoning and poisoning or cancer associated with toxins found in household products. In particular, poor indoor air quality often exacerbates health problems. The American Nurses Association (ANA) is addressing environmental toxins found in homes through the Center for Occupational and Environmental Health. Nurses advocate and educate families on potential household hazards in order to protect the health of vulnerable populations. ANA, through its educational campaigns for nurses and legislative efforts, supports improved environmental conditions for children in their homes. Objectives include (1) list typical environmental exposures occurring in the home; (2) explain how the American Nurses Association is working to establish safe home environments through their work on chemicals policy; and (3) explore the ethical implication of failure to correct indoor environmental problems that impact children's health.

Healthy Schools and Day Care, Nancy Moreno, PhD (20 min)
Children are particularly vulnerable to ill effects from indoor air pollution because of their developing lungs, smaller airways, and frequent upper respiratory infections. School buildings sometimes have particular problems with poor ventilation, mold growth, pest management, and inappropriate cleaning chemicals. Administrators, teachers and children can learn about ways to reduce their exposures to indoor air pollution. In addition, schools provide unique opportunities to educate students, families, teaches and administrators about other local pollution issues that affect children’s health and wellbeing. Objectives include (1) explain the importance of the school and daycare environment for children’s health and the teaching of environmental health concepts; (2) identify resources for school and daycare administrators to address environmental issues that impact their facilities, personnel and students; and (3) provide examples of ways to infuse the pre-school and elementary school curriculum with environmental health science concepts.

Healthy Communities, Reginald Adams (20 min)
Ethnic and racial minorities living in Houston often have the greatest exposure to pollution and live in substandard housing. By organizing around art, minority neighborhoods can express their concerns about the community in a highly visible manner that grabs the attention of politicians. Empowering the community through art also helps to stamp out problems with crime and drugs. Objectives include (1) describe some of the environmental justice problems that impact minority neighborhoods in Houston; (2) show how communities address environmental justice issues through art; and (3) demonstrate how community initiatives in Houston pertaining to environmental health have been successful. Click here to download the presentation (pdf 4 MB).

Green Healthcare, John Porretto, BA (20 min)
Sustainable buildings have clear health advantages for the occupants, require less fossil fuel to operate, and produce less waste than traditional buildings. Health benefits include better ventilation, cleaner water, and less airway irritation from synthetic chemicals. Although the initial construction costs are greater, the long term benefits result in cost savings to building owners. Objectives include (1) explain the designation “LEED-certified”; (2) list the benefits of sustainable buildings; (3) describe the ethical dimension of sustainable building for healthcare and tax-exempt institutions.

Ethics Panel Discussion…Question and Answer Session, Henry Falk, MD, MPH, moderator (30 min)

*Early Exposures…Long-term Impacts, Katherine M. Shea, MD, MPH (40 min)
The most critical windows of development occur during fetal life and early childhood. Two case studies will be discussed which illustrate the impact of fetal and early lifetime exposures on long-term health as well as the potential for prevention through public policies which minimize or prevent toxic exposures. Neurodevelopment will be highlighted in the context of larger global environmental challenges to children's health. Objectives include (1) describe critical windows of fetal and early childhood development; (2) describe how the history of chlorpyrifos use and regulation in the U.S. is a children's environmental health success story; (3) explain the statement "mercury is the new lead"; and (4) understand the challenges of preventing early toxic exposures within the context of larger environmental change. Download the presentation here (pdf 1 MB).

*Asthma and the City, Herman Mitchell, PhD (40 min)
The urban environment often exacerbates asthma. The most important indoor triggers include cockroaches, dust mites, rodents, and indoor cats. Outdoor air pollutants, including ozone and particulate matter, are also associated with increased respiratory morbidity in the population. City governments, builders, and homeowners can mitigate asthma risk through preventive actions. Objectives include (1) identify asthma triggers that are most important in urban environments; (2) list preventive actions that individuals, builders, and governments can take to decrease the risk of asthma exacerbations.

*Obtaining an Environmental History in the Well and Sick Child, Michael W. Shannon, MD, MPH (40 min)
The pediatrician is regularly faced with the need to obtain an environmental history. First this need appears in every well child visit in the form of anticipatory guidance; in such a setting, discussions about lead, tobacco smoke, carbon monoxide and other environmental threats to children are routine. Second, when a child is evaluated for an illness, environmental etiologies must be considered and ruled out through an appropriate history. Finally, parents may present with specific concerns about an environmental illness, e.g., lead poisoning. In this lecture, principles for obtaining an environmental history in all these situations will be reviewed. Objectives include: (1) describe proper anticipatory guidance pertaining to environmental concerns for well child visits; (2) explain how to uncover an environmental etiology with appropriate history taking; and (3) outline the principles of risk communication that apply to discussing environmental concerns with parents. Download the presentation here (pdf 1 MB).

*Diagnostic Conundrums, Teri Lee Turner, MD, MPH, MEd (40 min)
Careful history taking can reveal environmental illness that would otherwise go undetected. For instance, a patient with repeated emergency room visits for asthma could be exposed to cat dander at school. Repeated episodes of gastroenteritis could be caused by contaminated well water. A patient with unusual neurological symptoms and developmental delay could be exposed to mercury. These cases illustrate the importance of environmental toxicants in everyday pediatric practice. Objectives include (1) describe real cases where environmental factors caused or exacerbated illness in pediatric patients; and (2) identify resources in public health departments to aid the practicing pediatrician faced with environmental issues. Download the presentation here (pdf 394 KB).

*Audience Response System will be used.