 PEDIATRIC
ENVIRONMENTAL HEALTH TOOLKIT
San
Francisco Bay Area PSR teamed up with sister chapter
Greater Boston PSR to develop an exciting, new clinical tool
for pediatric and family care practices that provides comprehensive
information about preventing exposures to toxic chemicals.
The Pediatric Environmental Health Toolkit, which has been
officially endorsed by the American Academy of Pediatrics
(AAP), includes laminated desk and pocket reference guides
for providers, patient handouts including "Prescription
for Prevention" sheets and refrigerator magnets, and
two colorful, bilingual Toolkit posters for clinics and exam
rooms.
 We
are pleased to have a distinguished group of pediatricians
involved in the planning and development group. They include
Guenter Hofstadler, MD, and Brian Linde, MD, who drafted
the initial guidelines, and Mark Miller, MD, MPH, Lisa Asta,
MD, Siobhan McNally, MD, and David Wallinga, MD, who are
participating in revising and editing and will help oversee
the pilot testing of the materials. SF Bay Area PSR's Program
Associate Lucia Sayre, MA, is another key player, with Maria
Valenti and Michelle Gottlieb, MEM, of GB PSR leading the
East Coast team.
Parents, Providers Concerned About Kids Environmental Health
Pediatric Environmental Health is a relatively new field
prompted by concerns about such things as pesticide residues
on foods, mercury in fish, and arsenic in drinking water
and on play structures. Yet, numerous providers have hardly
heard of it. Studies have shown few environmental histories
are taken, and that less than one-in-five pediatricians reports
having received training in environmental history-taking
even though they strongly believe in the importance of environmental
exposures in children's health. The issue is a high priority
with parents. In a recent paper written by Dr. Sophie Balk,
outgoing chair of the American Academy of Pediatrics environment
committee and editor of the AAP "Green Book" for
pediatricians, "…environmental exposures are
among parents' top concerns for their children." This
interest in environment and health issues has also been demonstrated
through GB PSR's In Harm's Way trainings for health professionals.
Pediatricians have regularly comprised the largest fraction
of physician attendees at conferences.
 Using "Teachable Moments" During Well-Child Visits
Initial assessment of need for the Toolkit was conducted
by surveying participants at In Harm's Way Trainings. Follow-up
discussions with practicing pediatricians, and the organization
of a pediatric planning group, led us to begin considering
the optimum framework for the type of succinct, easily accessible
reference materials the physicians told us they wanted. Noted
pediatrician T. Berry Brazelton's Touchpoints concept was
mentioned repeatedly as a model that could work for the materials,
which we began to think of as a multi-part environmental
health "toolkit" for both providers and patients.
The
beauty of the Touchpoints program is that it makes it quite
easy for the practitioner to impart environmental health
information during "teachable moments" with patients.
Toolkit Materials
The following items are in the Toolkit and are available
to download:
For Providers:
- A summary of children's unique susceptibilities to
toxic substances
- Brief summaries of major toxicants and their potential
health effects
- A two-sided, laminated pocket
reference card containing
priority anticipatory guidance keyed to specific developmental
stages to use during well-child visits.
- A two-sided, laminated Environmental
Health Reference Card:
- Brief descriptions of environmental toxins
- Health
effects summaries of those toxins
- Sources
and routes of exposure information
- Prevention
strategies
- Two colorful posters in English and Spanish for clinic
and exam rooms that highlight environmental health issues
in a child’s
indoor and outdoor environments.
For Patients and Their Families:
Additional Resources for Families
Pediatric Environmental Health Toolkit Trainings:
A Clinical Resource for Practitioners
A series
of trainings to introduce pediatric providers to the Toolkit
are happening around the country in the next six months.
Please visit Greater Boston PSR’s website for more
information about upcoming trainings at http://psr.igc.org
For more information
about our Toolkit work in California, please contact SF Bay
Area PSR’s Lucia Sayre at luciasayre@sbcglobal.net.
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