The Real Risks to Children
July 13, 2004
By JANE E. BRODY
Many parents worry that their children may be harmed by
exposure to environmental factors they cannot avoid or
control, including pesticide residues on fruits and
vegetables, approved food additives, chlorinated drinking
water and hormones in milk.
They fear electromagnetic fields as a cause of childhood
leukemia, a mercury preservative in vaccines as a cause of
autism, and alar, a growth stimulant on apples, as a cause
None of these are actual hazards. But even if they were,
they are hardly the main threats to the health and lives of
fetuses, infants, children and adolescents, says Dr. Robert
L. Brent, a professor at Thomas Jefferson University in
Philadelphia and a leading expert on what is and is not
known about the effects of environmental chemicals and
physical agents on developing humans.
In the concluding chapter of a recent report, published as
a supplement in the journal Pediatrics, Dr. Brent and his
co-author, Dr. Michael Weitzman, a pediatrician at the
University of Rochester School of Medicine and Dentistry,
reviewed what are unquestionably the leading risks to
infants, children and adolescents.
Most of the hazards that take the greatest toll on the
health and lives of the young people in this country can be
prevented, without any need for further research,
legislation, environmental cleanup or any other measure
that requires the action of anyone besides parents and
caretakers. "Nearly every day a child in Florida dies in a
swimming pool," Dr. Brent said. "No environmental agent
exacts such a toll."
Accidents are the leading cause of death in children
15. But while the word accident implies an unexpected and
unavoidable event, most accidents involving children could
be prevented by vigilance. Here are the most important
Sudden infant death syndrome Risk is reduced by putting
infants to sleep on their backs and providing a nonsmoking
Falls Infants can suffer head injuries falling from
strollers, down stairs, off beds or against sharp-pointed
furniture. Toddlers and children aged 5 to 9 fall from
windows, stairs, trees, garage roofs and ladders.
Vehicular accidents Infants and children under 10 should
never ride in the front seat, and those under 80 pounds
should always ride in a properly installed car seat or
booster seat appropriate to the child's age and size.
Outside the car, children under 10 are at risk of death
from pedestrian accidents, including being run over by the
family car in their own driveway and ignoring safety rules
when crossing the street. Their small size makes them hard
for drivers to see.
For teenagers, reckless driving, impulsive behavior and
drunken driving make auto accidents a leading cause of
Burns Infants can suffer burns from kitchen equipment or
hot items pulled off the table, as well as hot water in a
tub and uncovered radiators. Toddlers should never have
access to matches, cigarette lighters or fuel-filled or
House fires can be started by adults who fall asleep while
smoking, faulty wiring, defective heating systems and space
Every home should be equipped with one or more working
Poisoning As soon as children can crawl, they are
of poisoning from medications, household chemicals
(including drain and oven cleaners, alcohol and paint
thinner), pesticides and
rodent killers. Such items should
be stored out of children's reach in cupboards with
Lead poisoning, though much reduced, is still a risk for
millions of children who live in old homes with lead-based
paint, plaster or putty, as well as those with old toys,
cribs and imported pottery.
A child's blood lead level should be checked and elevated
levels treated to prevent cognitive deficits.
Drowning "Pools, hot tubs and wading pools must have
supervision and be fenced in, locked or covered," the
Pediatrics authors wrote.
The incidence of childhood drownings varies by state
according to the number of backyard swimming pools and hot
tubs, but is also a problem in bathtubs, bathinettes and
kiddie wading pools. An infant or young child in or around
water should never be left unattended, not even for a
minute. Children relying on flotation devices and those
under 4 who can swim are not safe in the water. Children
should always swim with another swimmer.
Impetuous, risk-taking teens are also at risk of drowning.
When boating, every infant and child - even good swimmers -
should wear an approved life jacket.
Choking Any item that can block a child's airway is a
choking hazard. An infant or toddler can aspirate toys with
small parts, deflated balloons and foods like peanuts,
raisins, raw carrots and popcorn. In addition to preventing
exposure, every caretaker should know how to perform a
Heimlich maneuver on infants and small children.
Guns There are firearms in 40 million American
in the home, including the homes of law enforcement
officers, are dangers even to infants if there are older
children around. Firearms should be stored in locked
cabinets separate from their ammunition, and no child or
teenager should know how to get access to them.
Electrocution As soon as children can crawl, they are at
risk of electrocution from uncovered outlets and frayed or
brittle lamp or appliance cords. Older children should be
taught what to do when a thunderstorm approaches - get out
of the water immediately and never stand under a tall tree.
Secondhand smoke Parents or caretakers who smoke
house or car in the presence of infants or children
increase their risk of sudden death, asthma and pneumonia.
They also set a terrible example.
Sunburn Infants should have minimal exposure to the sun.
Parents should use covered carriages and strollers, hats
and other appropriate clothing. From age 1 onward, children
should be protected by sunscreen with an SPF of at least
15, with applications repeated if exposure is prolonged.
Even with protection, it is best to limit sun exposure
between 10 a.m. and 3 p.m. Remember, too, a child can get
sunburned even on cloudy days.
Sports injuries Riding a bicycle with an infant, even one
in a child carrier and wearing a helmet, is dangerous. A
child riding a tricycle, bicycle, scooter or skateboard
should always wear a properly fitted helmet, which can
reduce the risk of head injury and brain damage by 85
percent in a fall or crash. Cycling by children should be
restricted to safe locations in daylight only.
Children who play football, baseball, soccer, hockey and
lacrosse should always wear proper protective equipment and
be properly supervised.
Power tools Each year nearly 10,000 children 15 and younger
are injured by lawn mowers. A young child should not be
nearby when a power mower is in use, children under 12
should not be allowed to operate a walk-behind mower and
children under 14 should not operate a riding mower.
Obesity Children of all ages in America
today are getting
fatter and fatter, thanks to parents and caretakers who
allow them to spend hours a day in front of a television
set, who give them access to excessive amounts of snacks
and fast foods and to oversized portions, and who do not
make sure that they get regular physical activity.
Obesity that begins in childhood becomes a lifelong
problem, greatly increasing the risk of a host of health
and social problems, including premature death.