A Call for Pediatric Clinicians to Address Environmental Health Concerns in Rural Settings
Rachel Criswell, Skowhegan Family Medicine, Redington-Fairview General Hospital, 46 Fairview Avenue, Suite 334, PO Box 468, Skowhegan, ME 04976, USA; Department of Epidemiology, Geisel School of Medicine and Children's Environmental Health and Disease Prevention Research Center at Dartmouth, 1 Medical Center Drive, Williamson Building, 7th Floor, Lebanon, NH 03756, USA; Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA. Electronic address: rcriswell@rfgh.net.
Kelsey Gleason, Department of Biomedical and Health Sciences, University of Vermont, 106 Carrigan Drive, Rowell Building, Burlington, VT 05405, USA.
Ahlam K. Abuawad, Department of Epidemiology, Geisel School of Medicine and Children's Environmental Health and Disease Prevention Research Center at Dartmouth, 1 Medical Center Drive, Williamson Building, 7th Floor, Lebanon, NH 03756, USA.
Margaret R. Karagas, Department of Epidemiology, Geisel School of Medicine and Children's Environmental Health and Disease Prevention Research Center at Dartmouth, 1 Medical Center Drive, Williamson Building, 7th Floor, Lebanon, NH 03756, USA.
Kathleen Grene, Pediatrics, Yale-New Haven Hospital, New Haven, CT, USA.
Ana M. Mora, Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, 1995 University Avenue, Suite 265, Berkeley, CA 94704, USA.
Brenda Eskenazi, Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, 1995 University Avenue, Suite 265, Berkeley, CA 94704, USA.
Katie Senechal, Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Center for Interdisciplinary and Population Health Research, MaineHealth Institute for Research, 1 Riverfront Plaza, Floor 4, Westbrook, ME 04902, USA.
Anne M. Mullin, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA.
Lisa B. Rokoff, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA; Center for Interdisciplinary and Population Health Research, MaineHealth Institute for Research, 1 Riverfront Plaza, Floor 4, Westbrook, ME 04902, USA.
Abby F. Fleisch, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA; Center for Interdisciplinary and Population Health Research, MaineHealth Institute for Research, 1 Riverfront Plaza, Floor 4, Westbrook, ME 04902, USA; Pediatric Endocrinology and Diabetes, Maine Medical Center, 887 Congress Street, Suite 300, Portland, ME 04102, USA.
Abstract
Children in rural communities encounter unique environmental exposures, many of which can result in negative long-term health consequences. Children are particularly at risk from these exposures due to their close interaction with the environment and developing physiology. The authors describe 3 rural environmental hazards: wood stove smoke, well water contaminants, and agricultural pollutants. Contaminants found in these exposures have adverse respiratory, neurodevelopmental, cardiometabolic, and carcinogenic effects, among others. The authors recommend that rural pediatric clinicians screen for these environmental exposures, and they provide tools and resources related to testing, mitigation, and medical monitoring.
