Preface xiii Preface The publication of Pediatric Environmental Health, 4th Edition, reflects many advances in our understanding of the etiology, identification, management, and prevention of diseases and conditions linked to the environment. The field of environmental health is growing rapidly, and new information becomes available every day. Hardly a week goes by in which parents don’t read a blog or hear a story about the effects of the environment on health, and they may ask their pediatrician for advice about this topic. In 2018, stories about the disas- trous wildfires in California featured prominently in the news. Dramatic events such as these offer an opportunity to bring focus to environmental issues, to teach children about them, and to bring attention to prevention and remedia- tion. They also highlight the many different “environments” in which a child lives: the bedroom, the home, the school, the neighborhood, the community or town, the state, the country, the world—these are concentric circles. Although large-scale events, such as massive forest fires, heighten our awareness that environmental crises have important physical and psychological effects on children and their families, it is easy to overlook the fact that less visible (or invisible) environmental threats also can have profound physical and psycho- logical effects on children and their families. We as pediatricians must attend to both. This book provides a foundation for understanding where to begin. First published in 1999, this book is intended for pediatricians and others who are interested in preventing children’s exposures to environmental hazards during infancy, childhood, and adolescence. In this edition, we present updated summaries of the evidence that has been published in the scien- tific literature about environmental hazards to children. Eight new chapters have been introduced in this edition, including topics such as fracking, green offices, community design, and exposures to perfluoroalkyl and polyfluoro­ alkyl substances. Major modifications have been made to all 59 chapters from the third edition. Knowledge, research, and information relevant to pediatric practice began growing at an exponential pace after the children’s environ- mental health and disease prevention research programs were established by the US Environmental Protection Agency and the National Institute of Environmental Health Sciences. New associations are being discovered and our knowledge of existing ones is constantly being refined and expanded. As the field of pediatric environmental health evolves, appropriate guidance may change with the publication of additional research findings. Although all of the 72 contributors to this book are from the United States, most of the information presented here should be useful to those in other parts of the world. Children’s exposures to some contaminants may be higher in low- income countries nonetheless, the book can be expected to provide reliable 00_PEH_ch00_fm_i-xvi.indd 13 10/4/18 2:08 PM
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