Children's Environmental Health: A Brief History

  • Philip J. Landrigan
    Address correspondence to Philip J. Landrigan, MD, MSc, FAAP, Department of Preventive Medicine and Pediatrics, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, 1216 Fifth Ave, Room 556, New York, NY 10029.
    Department of Preventive Medicine and Pediatrics, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY
    Search for articles by this author
Published:October 21, 2015DOI:



      Children's environmental health (CEH), the branch of pediatrics that studies the influence of the environment on children's health, has grown substantially in the past 3 decades and become an increasingly visible and important component of pediatric medicine.


      To trace the historical origins of CEH; to identify factors responsible for its recent growth.


      CEH has historical roots in toxicology, epidemiology, and occupational medicine. It arose in the second half of the 20th century through a melding of insights from pediatric toxicology, nutritional epidemiology, and social science research. Convergent research in these 3 fields has documented children's unique sensitivities to chemical, nutritional, and psychosocial hazards during windows of vulnerability in early development and has shown that early-life exposures can produce disease and disability in childhood and across the life span. Key events in the development of CEH were: 1) formation by the American Academy of Pediatrics in 1957 of a committee on environmental health that has nurtured the growth of the field for 5 decades and evolved into the Council on Environmental Health; 2) observations made in the 1980s that nutritional deficiency in utero increased risk for adult-onset obesity, diabetes, and cardiovascular disease—work that led to the hypothesis of the developmental origins of health and disease; 3) social science research showing that early exposure to psychosocial stress and trauma increases risk for chronic illness; and 4) publication in 1993 by the National Academy of Sciences of a report, Pesticides in the Diets of Infants and Children, which elevated awareness among national policy makers of children's vulnerability to toxic hazards, moved US environmental policy toward protection of children's health, and catalyzed research investment in CEH in the United States and globally.


      CEH has made substantial progress but faces emerging challenges, including new chemicals and pesticides; increasing movement of polluting industries to poor countries where environmental and public health protections are few; and global climate change. In the future, CEH will require continued investment in research and education and will need to adopt an increasingly global perspective.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Landrigan P.J.
        • Etzel R.A.
        Textbook of Children's Environmental Health.
        Oxford University Press, Oxford, UK2013
        • Landrigan P.J.
        • Goldman L.
        Children's vulnerability to toxic chemicals: a challenge and opportunity to strengthen health and environmental policy.
        Health Aff. 2011; 30: 842-850
        • Barker D.J.P.
        The fetal and infant origins of adult disease.
        Br Med J. 1990; 301: 1111
        • Jackson R.J.
        • Sinclair S.
        Designing Healthy Communities.
        Jossey-Bass, San Francisco, Calif2011
        • National Academy of Sciences
        From Neurons to Neighborhoods: The Science of Early Childhood Development.
        National Academies Press, Washington DC2000
        • Wright R.J.
        Psychological stress: a social pollutant that may enhance environmental risk.
        Am J Respir Crit Care Med. 2011; 184: 752-754
        • Binswanger H.C.
        • Smith K.R.
        Paracelsus and Goethe: founding fathers of environmental health.
        Bull World Health Organ. 2000; 78: 1162-1164
        • Major R.H.
        Classic Descriptions of Disease, With Biographical Sketches of the Authors.
        2nd ed. Charles G. Thomas, Baltimore, Md1939
        • Agricola G.
        Hoover H.C. Hoover L.H. De Re Metallica. Dover Publications, New York, NY1950
        • Ramazzini B.
        De Morbis Artificum Diatriba. Modena, 1700. Translated by Wright WC.
        University of Chicago Press, Chicago, Ill1940
        • Pott P.
        Chirurgical Observations Relative to the Cataract, the Polypus of the Nose, and Cancer of the Scrotum.
        T. J. Carnegy, London, UK1775
        • Hamilton A.
        Exploring the Dangerous Trades.
        Little, Brown, Boston, Mass1943
        • Selikoff I.J.
        • Churg J.
        • Hammond E.C.
        Asbestos exposure and neoplasia.
        JAMA. 1964; 188: 22-26
        • Gibson J.L.
        A plea for painted railing and painted walls of rooms as the source of lead poisoning among Queensland children.
        Aust Med Gazette. 1904; 23: 149-153
        • Miller R.W.
        Delayed effects occurring within the first decade after exposure of young individuals to the Hiroshima atomic bomb.
        Pediatrics. 1956; 18: 1-18
        • Miller R.W.
        • Blot W.J.
        Small head size after exposure to the atomic bomb.
        Lancet. 1972; 2: 784-787
        • Harada H.
        Congenital Minamata disease: intrauterine methylmercury poisoning.
        Teratology. 1978; 18: 285-288
        • Lenz W.
        Chemicals and malformations in man.
        in: Second International Conference on Congenital Malformation. International Medical Congress, New York1963: 263-276
        • Herbst A.L.
        • Hubby M.M.
        • Azizi F.
        • et al.
        Reproductive and gynecologic surgical experience in diethylstilbestrol-exposed daughters.
        Am J Obstet Gynecol. 1981; 141: 1019-1028
        • Carson R.
        Silent Spring.
        Houghton Mifflin, Boston, Mass1962
        • US Environmental Protection Agency
        The Guardian: Origins of the EPA.
        EPA Historical Publication 1, 1992 (Available at:) (Accessed January 25, 2015)
        • Goldman L.
        • Falk H.
        • Landrigan P.J.
        • et al.
        Environmental pediatrics and its impact on government health policy.
        Pediatrics. 2004; 113: 1146-1157
        • Needleman H.L.
        • Gunnoe C.
        • Leviton A.
        • et al.
        Deficits in psychologic and classroom performance of children with elevated dentine lead levels.
        N Engl J Med. 1979; 300: 689-695
        • Landrigan P.J.
        The toxicity of lead at low dose.
        Br J Ind Med. 1989; 46: 593-596
        • Barker D.J.
        • Winter P.D.
        • Osmond C.
        • et al.
        Weight in infancy and death from ischaemic heart disease.
        Lancet. 1989; 2: 577-580
        • Roseboom T.J.
        • Meulen van der J.H.P.
        • Ravelli A.C.J.
        • et al.
        Blood pressure in adults after prenatal exposure to famine.
        J Hypertens. 1999; 17: 325-330
        • Barker D.J.P.
        • Eriksson J.G.
        • Forsen T.
        • et al.
        Fetal origins of adult disease: strength of effects and biological basis.
        Int J Epidemiol. 2002; 31: 1235-1239
        • Skinner M.K.
        Role of epigenetics in developmental biology and transgenerational inheritance.
        Birth Defects Res C Embryo Today. 2011; 93: 51-55
        • Felitti V.J.
        • Anda R.F.
        • Nordenberg D.
        • et al.
        Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) study.
        Am J Prev Med. 1998; 14: 245-258
        • Garbarino J.
        Raising Children in a Socially Toxic Environment.
        Jossey-Bass, San Francisco, Calif1995
        • Chapman D.P.
        • Whitfield C.L.
        • Felitti V.J.
        • et al.
        Adverse childhood experiences and the risk of depressive disorders in adulthood.
        Affect Disord. 2004; 82: 217-225
        • Chen E.
        • Miller G.E.
        Socioeconomic status and health: mediating and moderating factors.
        Annu Rev Clin Psychol. 2013; 9: 123-149
        • Johnson S.B.
        • Riley A.W.
        • Grange D.A.
        • et al.
        The science of early life toxic stress for pediatric practice and advocacy.
        Pediatrics. 2012; 131: 319
        • Wright R.J.
        Stress-related programming of autonomic imbalance: role in allergy and asthma.
        Chem Immunol Allergy. 2012; 98: 32-47
        • Wright R.J.
        Epidemiology of stress and asthma: from constricting communities and fragile families to epigenetics.
        Immunol Allergy Clin North Am. 2011; 31: 19-39
        • National Academy of Sciences
        Pesticides in the Diets of Infants and Children.
        National Academies Press, Washington, DC1993
        • Clinton W.J.
        • Gore A.
        Executive Order 13045: Protection of children from environmental health and safety risks. 62. Fed Reg, 1997: 19883-19888 (Available at:) (Accessed February 6, 2015)
      1. 1997 declaration of the environment leaders of the eight on children's environmental health. Environment Leaders' Summit of the Eight; Miami, Fla. Available at: Accessed February 6, 2015.

        • Eskenazi B.
        • Gladstone E.A.
        • Berkowitz G.S.
        • et al.
        Methodologic and logistic issues in conducting longitudinal birth cohort studies: lessons learned from the centers for children's environmental health and disease prevention research.
        Environ Health Perspect. 2005; 113: 1419-1429
        • Gray K.
        • Lawler C.P.
        Strength in numbers: Three separate studies link in utero organophosphate pesticide exposure and cognitive development.
        Environ Health Perspect. 2011; 119: 326-329
        • Wilborne-Davis P.
        • Kirkland K.H.
        • Mulloy K.B.
        A model for physician education and consultation in pediatric environmental health—the Pediatric Environmental Health Specialty Units (PEHSU) program.
        Pediatr Clin North Am. 2007; 54: 1-13
        • Etzel R.A.
        • Balk S.J.
        • American Academy of Pediatrics
        • Council on Environmental Health
        Pediatric Environmental Health.
        3rd ed. American Academy of Pediatrics, Elk Grove Village, Ill2012
        • Landrigan P.J.
        • Woolf A.D.
        • Gitterman B.
        • et al.
        The Ambulatory Pediatric Association fellowship in pediatric environmental health: a 5-year assessment.
        Environ Health Perspect. 2007; 115: 1383-1387
        • Landrigan P.J.
        • Trasande L.
        • Thorpe L.E.
        • et al.
        The National Children's Study: a 21-year prospective study of 100,000 American children.
        Pediatrics. 2006; 118: 2173-2186
      2. Japan Environment and Children's Study. Available at: Accessed January 28, 2015.

        • Golding J.
        Children of the nineties. A longitudinal study of pregnancy and childhood based on the population of Avon (ALSPAC).
        West Engl Med J. 1990; 105: 80-82
        • Magnus P.
        • Irgens L.M.
        • Haug K.
        • et al.
        • MoBa Study Group
        Cohort profile: the Norwegian Mother and Child Cohort Study (MoBa).
        Int J Epidemiol. 2006; 35: 1146-1150
        • Klebanoff M.
        The Collaborative Perinatal Project: a 50-year retrospective.
        Paediatr Perinat Epidemiol. 2008; 23: 2-8
        • Brown R.C.
        • Dwyer T.
        • Kasten C.
        • et al.
        • International Childhood Cancer Cohort Consortium (I4C)
        Cohort profile: the International Childhood Cancer Cohort Consortium (I4C).
        Int J Epidemiol. 2007; 36: 724-730
        • Landrigan P.J.
        • Baker D.B.
        The National Children's Study—end or new beginning?.
        N Engl J Med. 2015; 372: 1486-1487
        • Heindel J.J.
        • Balbus J.
        • Birnbaum L.
        • et al.
        Developmental origins of health and disease: integrating environmental influences.
        Endocrinology. 2015; 156: 3416-3421
        • Guilarte T.R.
        • Toscano C.D.
        • McGlothan J.L.
        • et al.
        Environmental enrichment reverses cognitive and molecular deficits induced by developmental lead exposure.
        Ann Neurol. 2003; 53: 50-56
        • Kile M.L.
        • Houseman E.A.
        • Baccarelli A.A.
        • et al.
        Effect of prenatal arsenic exposure on DNA methylation and leukocyte subpopulations in cord blood.
        Epigenetics. 2014; 9: 774-782
        • Pronczuk J.
        • Bruné M.N.
        • Gore F.
        Children's environmental health in developing countries.
        in: Nriagu J.O. Encyclopedia of Environmental Health. Elsevier, Burlington, Mass2011: 601-610
        • World Health Organization
        The paediatric environmental history. Recording children's exposure to environmental health threats: a “green page” in the medical record.
        2012 (Available at:) (Accessed February 9, 2015)
        • Prüss-Üstün A.
        • Corvalán C.
        Preventing Disease Through Healthy Environments: Towards an Estimate of the Environmental Burden of Disease.
        World Health Organization, Geneva2006 (Available at:) (Accessed February 9, 2015)
      3. US Centers for Disease Control and Prevention. National biomonitoring program. Available at: Accessed September 13, 2015.

        • National Institute of Environmental Health Sciences
        Toxicology testing in the 21st century—a new strategy.
        2004 (Available at:) (Accessed February 9, 2015)
        • US Environmental Protection Agency
        Registration of Enlist Duo.
        2014 (Available at:) (Accessed February 9, 2015)
        • Guyton K.Z.
        • Loomis D.
        • Grosse Y.
        • et al.
        Carcinogenicity of tetrachlorvinphos, parathion, malathion, diazinon, and glyphosate.
        Lancet Oncol. 2015; 16: 490-491
        • Landrigan P.J.
        • Benbrook C.
        GMOs, herbicides, and public health.
        N Engl J Med. 2015; 373: 693-695
        • Laborde A.
        • Tomasina F.
        • Bianchi F.
        • et al.
        Children's health in Latin America: the influence of environmental exposures.
        Environ Health Perspect. 2015; 123: 201-209
        • Mishra P.K.
        • Samarth R.M.
        • Pathak N.
        • et al.
        Bhopal gas tragedy: review of clinical and experimental findings after 25 years.
        Int J Occup Med Environ Health. 2009; 22: 193-202
        • Frank A.
        • Joshi T.K.
        The global spread of asbestos.
        Ann Global Health. 2014; 80: 257-262
        • Perkins D.
        • Brune Drisse M.N.
        • Nixele T.
        • et al.
        E-waste: a global hazard.
        Ann Global Health. 2014; 80: 286-295
        • Sheffield P.
        • Landrigan P.J.
        Global climate change and children's health: threats and strategies for prevention.
        Environ Health Perspect. 2011; 119: 291-298
      4. National Institutes of Health. Environmental influences on Child Health Outcomes (ECHO) Program (National Children's Study Alternative). Notice No. NOT-OD-15-117. Available at: Accesed September 13, 2015.

        • Mora A.M.
        • Arora M.
        • Harley K.G.
        • et al.
        Prenatal and postnatal manganese teeth levels and neurodevelopment at 7, 9, and 10.5 years in the CHAMACOS cohort.
        Environ Int. 2015; 84: 39-54