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Environ Health Perspect. 2004 February; 112(2): 257–265.
PMCID: PMC1241836
Research Article

Children's health and the environment: public health issues and challenges for risk assessment.

Abstract

Infants and children are not little adults. They are uniquely vulnerable to environmental toxicants. To protect infants and children against toxicants, the National Research Council in 1993 called for development of an approach to risk assessment that considers children's unique patterns of exposure and their special vulnerabilities to pesticides. Many aspects of that call were codified into federal law in the Food Quality Protection Act (FQPA) of 1996. This report highlights the central elements needed for development of a child-protective approach to risk assessment: a) improved quantitative assessment of children's exposures at different life stages, from fetal life through adolescence, including acute and chronic exposures, exposures via multiple routes, and exposures to multiple agents; b) development of new approaches to toxicity testing of chemicals that can detect unanticipated and subtle outcomes and that evaluate experimental subjects over the entire life span from early exposure to natural death to replicate the human experience; c) development of new toxicodynamic and toxicokinetic models that account for the unique physiologic characteristics of infants and children; d) development of new approaches to assessment of outcomes, functional, organ, cellular and molecular, over the entire life span; these measures need to be incorporated into toxicity testing and into long-term prospective epidemiologic studies of children; and e) application of uncertainty and safety factors in risk assessment that specifically consider children's risks. Under FQPA, children are presumed more vulnerable to pesticides than adults unless evidence exists to the contrary. Uncertainty and safety factors that are protective of children must therefore be incorporated into risk assessment when data on developmental toxicity are lacking or when there is evidence of developmental toxicity. The adequate protection of children against toxic agents in the environment will require fundamental and far-reaching revisions of current approaches to toxicity testing and risk assessment.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Adams J, Lammer EJ. Neurobehavioral teratology of isotretinoin. Reprod Toxicol. 1993;7(2):175–177. [PubMed]
  • Amin-Zaki L, Majeed MA, Elhassani SB, Clarkson TW, Greenwood MR, Doherty RA. Prenatal methylmercury poisoning. Clinical observations over five years. Am J Dis Child. 1979 Feb;133(2):172–177. [PubMed]
  • Aris RM, Christian D, Hearne PQ, Kerr K, Finkbeiner WE, Balmes JR. Ozone-induced airway inflammation in human subjects as determined by airway lavage and biopsy. Am Rev Respir Dis. 1993 Nov;148(5):1363–1372. [PubMed]
  • Ashworth A. Effects of intrauterine growth retardation on mortality and morbidity in infants and young children. Eur J Clin Nutr. 1998 Jan;52 (Suppl 1):S34–S42. [PubMed]
  • Bakir F, Damluji SF, Amin-Zaki L, Murtadha M, Khalidi A, al-Rawi NY, Tikriti S, Dahahir HI, Clarkson TW, Smith JC, et al. Methylmercury poisoning in Iraq. Science. 1973 Jul 20;181(4096):230–241. [PubMed]
  • Bellinger D, Leviton A, Waternaux C, Needleman H, Rabinowitz M. Longitudinal analyses of prenatal and postnatal lead exposure and early cognitive development. N Engl J Med. 1987 Apr 23;316(17):1037–1043. [PubMed]
  • Berkowitz GS, Wolff MS, Matte T, Susser E, Landrigan PJ. The rationale for a national prospective cohort study of environmental exposure and childhood development. Environ Res. 2001 Feb;85(2):59–68. [PubMed]
  • Birnbaum LS. The mechanism of dioxin toxicity: relationship to risk assessment. Environ Health Perspect. 1994 Nov;102 (Suppl 9):157–167. [PMC free article] [PubMed]
  • Blanck HM, Marcus M, Hertzberg V, Tolbert PE, Rubin C, Henderson AK, Zhang RH. Determinants of polybrominated biphenyl serum decay among women in the Michigan PBB cohort. Environ Health Perspect. 2000 Feb;108(2):147–152. [PMC free article] [PubMed]
  • Blanck HM, Marcus M, Tolbert PE, Rubin C, Henderson AK, Hertzberg VS, Zhang RH, Cameron L. Age at menarche and tanner stage in girls exposed in utero and postnatally to polybrominated biphenyl. Epidemiology. 2000 Nov;11(6):641–647. [PubMed]
  • Bobak M. Outdoor air pollution, low birth weight, and prematurity. Environ Health Perspect. 2000 Feb;108(2):173–176. [PMC free article] [PubMed]
  • Bobak M, Richards M, Wadsworth M. Air pollution and birth weight in Britain in 1946. Epidemiology. 2001 May;12(3):358–359. [PubMed]
  • Brody DJ, Pirkle JL, Kramer RA, Flegal KM, Matte TD, Gunter EW, Paschal DC. Blood lead levels in the US population. Phase 1 of the Third National Health and Nutrition Examination Survey (NHANES III, 1988 to 1991) JAMA. 1994 Jul 27;272(4):277–283. [PubMed]
  • Call RS, Smith TF, Morris E, Chapman MD, Platts-Mills TA. Risk factors for asthma in inner city children. J Pediatr. 1992 Dec;121(6):862–866. [PubMed]
  • Campbell CG, Seidler FJ, Slotkin TA. Chlorpyrifos interferes with cell development in rat brain regions. Brain Res Bull. 1997;43(2):179–189. [PubMed]
  • Chilmonczyk BA, Salmun LM, Megathlin KN, Neveux LM, Palomaki GE, Knight GJ, Pulkkinen AJ, Haddow JE. Association between exposure to environmental tobacco smoke and exacerbations of asthma in children. N Engl J Med. 1993 Jun 10;328(23):1665–1669. [PubMed]
  • Clarkson TW. The pharmacology of mercury compounds. Annu Rev Pharmacol. 1972;12:375–406. [PubMed]
  • Cody RP, Weisel CP, Birnbaum G, Lioy PJ. The effect of ozone associated with summertime photochemical smog on the frequency of asthma visits to hospital emergency departments. Environ Res. 1992 Aug;58(2):184–194. [PubMed]
  • Crump KS, Kjellström T, Shipp AM, Silvers A, Stewart A. Influence of prenatal mercury exposure upon scholastic and psychological test performance: benchmark analysis of a New Zealand cohort. Risk Anal. 1998 Dec;18(6):701–713. [PubMed]
  • Cullinan P, Taylor AJ. Asthma in children: environmental factors. BMJ. 1994 Jun 18;308(6944):1585–1586. [PMC free article] [PubMed]
  • Cunningham J, Dockery DW, Speizer FE. Maternal smoking during pregnancy as a predictor of lung function in children. Am J Epidemiol. 1994 Jun 15;139(12):1139–1152. [PubMed]
  • Dales RE, Zwanenburg H, Burnett R, Franklin CA. Respiratory health effects of home dampness and molds among Canadian children. Am J Epidemiol. 1991 Jul 15;134(2):196–203. [PubMed]
  • Davidson PW, Myers GJ, Cox C, Axtell C, Shamlaye C, Sloane-Reeves J, Cernichiari E, Needham L, Choi A, Wang Y, et al. Effects of prenatal and postnatal methylmercury exposure from fish consumption on neurodevelopment: outcomes at 66 months of age in the Seychelles Child Development Study. JAMA. 1998 Aug 26;280(8):701–707. [PubMed]
  • Dejmek J, Selevan SG, Benes I, Solanský I, Srám RJ. Fetal growth and maternal exposure to particulate matter during pregnancy. Environ Health Perspect. 1999 Jun;107(6):475–480. [PMC free article] [PubMed]
  • Delfino RJ, Zeiger RS, Seltzer JM, Street DH, Matteucci RM, Anderson PR, Koutrakis P. The effect of outdoor fungal spore concentrations on daily asthma severity. Environ Health Perspect. 1997 Jun;105(6):622–635. [PMC free article] [PubMed]
  • Devesa SS, Blot WJ, Stone BJ, Miller BA, Tarone RE, Fraumeni JF., Jr Recent cancer trends in the United States. J Natl Cancer Inst. 1995 Feb 1;87(3):175–182. [PubMed]
  • Ekbom A, Hsieh CC, Lipworth L, Adami HQ, Trichopoulos D. Intrauterine environment and breast cancer risk in women: a population-based study. J Natl Cancer Inst. 1997 Jan 1;89(1):71–76. [PubMed]
  • Eskenazi B, Bradman A, Castorina R. Exposures of children to organophosphate pesticides and their potential adverse health effects. Environ Health Perspect. 1999 Jun;107 (Suppl 3):409–419. [PMC free article] [PubMed]
  • Eskenazi B, Prehn AW, Christianson RE. Passive and active maternal smoking as measured by serum cotinine: the effect on birthweight. Am J Public Health. 1995 Mar;85(3):395–398. [PubMed]
  • Euling SY, Kimmel CA. Developmental stage sensitivity and mode of action information for androgen agonists and antagonists. Sci Total Environ. 2001 Jul 2;274(1-3):103–113. [PubMed]
  • Fedrick J. Epilepsy and pregnancy: a report from the Oxford Record Linkage Study. Br Med J. 1973 May 26;2(5864):442–448. [PMC free article] [PubMed]
  • Forsberg B, Stjernberg N, Falk M, Lundbäck B, Wall S. Air pollution levels, meteorological conditions and asthma symptoms. Eur Respir J. 1993 Sep;6(8):1109–1115. [PubMed]
  • Friedman MS, Powell KE, Hutwagner L, Graham LM, Teague WG. Impact of changes in transportation and commuting behaviors during the 1996 Summer Olympic Games in Atlanta on air quality and childhood asthma. JAMA. 2001 Feb 21;285(7):897–905. [PubMed]
  • Gill WB, Schumacher GF, Bibbo M. Structural and functional abnormalities in the sex organs of male offspring of mothers treated with diethylstilbestrol (DES). J Reprod Med. 1976 Apr;16(4):147–153. [PubMed]
  • Ginsberg Gary, Hattis Dale, Sonawane Babasaheb, Russ Abel, Banati Prerna, Kozlak Mary, Smolenski Susan, Goble Rob. Evaluation of child/adult pharmacokinetic differences from a database derived from the therapeutic drug literature. Toxicol Sci. 2002 Apr;66(2):185–200. [PubMed]
  • Gold DR, Burge HA, Carey V, Milton DK, Platts-Mills T, Weiss ST. Predictors of repeated wheeze in the first year of life: the relative roles of cockroach, birth weight, acute lower respiratory illness, and maternal smoking. Am J Respir Crit Care Med. 1999 Jul;160(1):227–236. [PubMed]
  • Grandjean P, Weihe P, White RF, Debes F, Araki S, Yokoyama K, Murata K, Sørensen N, Dahl R, Jørgensen PJ. Cognitive deficit in 7-year-old children with prenatal exposure to methylmercury. Neurotoxicol Teratol. 1997 Nov-Dec;19(6):417–428. [PubMed]
  • Gray LE, Jr, Ostby J, Furr J, Price M, Veeramachaneni DN, Parks L. Perinatal exposure to the phthalates DEHP, BBP, and DINP, but not DEP, DMP, or DOTP, alters sexual differentiation of the male rat. Toxicol Sci. 2000 Dec;58(2):350–365. [PubMed]
  • Gray R, Peto R, Brantom P, Grasso P. Chronic nitrosamine ingestion in 1040 rodents: the effect of the choice of nitrosamine, the species studied, and the age of starting exposure. Cancer Res. 1991 Dec 1;51(23 Pt 2):6470–6491. [PubMed]
  • Guillette LJ, Jr, Gross TS, Masson GR, Matter JM, Percival HF, Woodward AR. Developmental abnormalities of the gonad and abnormal sex hormone concentrations in juvenile alligators from contaminated and control lakes in Florida. Environ Health Perspect. 1994 Aug;102(8):680–688. [PMC free article] [PubMed]
  • Guo YL, Hsu PC, Hsu CC, Lambert GH. Semen quality after prenatal exposure to polychlorinated biphenyls and dibenzofurans. Lancet. 2000 Oct 7;356(9237):1240–1241. [PubMed]
  • Ha EH, Hong YC, Lee BE, Woo BH, Schwartz J, Christiani DC. Is air pollution a risk factor for low birth weight in Seoul? Epidemiology. 2001 Nov;12(6):643–648. [PubMed]
  • Haddow JE, Knight GJ, Palomaki GE, McCarthy JE. Second-trimester serum cotinine levels in nonsmokers in relation to birth weight. Am J Obstet Gynecol. 1988 Aug;159(2):481–484. [PubMed]
  • Harrison PT. Endocrine disrupters and human health. BMJ. 2001 Dec 8;323(7325):1317–1318. [PMC free article] [PubMed]
  • Herbst AL, Ulfelder H, Poskanzer DC. Adenocarcinoma of the vagina. Association of maternal stilbestrol therapy with tumor appearance in young women. N Engl J Med. 1971 Apr 15;284(15):878–881. [PubMed]
  • Horstman DH, Folinsbee LJ, Ives PJ, Abdul-Salaam S, McDonnell WF. Ozone concentration and pulmonary response relationships for 6.6-hour exposures with five hours of moderate exercise to 0.08, 0.10, and 0.12 ppm. Am Rev Respir Dis. 1990 Nov;142(5):1158–1163. [PubMed]
  • Jacobson JL, Jacobson SW. Intellectual impairment in children exposed to polychlorinated biphenyls in utero. N Engl J Med. 1996 Sep 12;335(11):783–789. [PubMed]
  • Källén B, Robert E, Mastroiacovo P, Martínez-Frías ML, Castilla EE, Cocchi G. Anticonvulsant drugs and malformations is there a drug specificity? Eur J Epidemiol. 1989 Mar;5(1):31–36. [PubMed]
  • Kaufman RH, Adam E, Hatch EE, Noller K, Herbst AL, Palmer JR, Hoover RN. Continued follow-up of pregnancy outcomes in diethylstilbestrol-exposed offspring. Obstet Gynecol. 2000 Oct;96(4):483–489. [PubMed]
  • Klonoff-Cohen HS, Edelstein SL, Lefkowitz ES, Srinivasan IP, Kaegi D, Chang JC, Wiley KJ. The effect of passive smoking and tobacco exposure through breast milk on sudden infant death syndrome. JAMA. 1995 Mar 8;273(10):795–798. [PubMed]
  • Kogevinas M, Becher H, Benn T, Bertazzi PA, Boffetta P, Bueno-de-Mesquita HB, Coggon D, Colin D, Flesch-Janys D, Fingerhut M, et al. Cancer mortality in workers exposed to phenoxy herbicides, chlorophenols, and dioxins. An expanded and updated international cohort study. Am J Epidemiol. 1997 Jun 15;145(12):1061–1075. [PubMed]
  • Kreit JW, Gross KB, Moore TB, Lorenzen TJ, D'Arcy J, Eschenbacher WL. Ozone-induced changes in pulmonary function and bronchial responsiveness in asthmatics. J Appl Physiol (1985) 1989 Jan;66(1):217–222. [PubMed]
  • Lammer EJ, Chen DT, Hoar RM, Agnish ND, Benke PJ, Braun JT, Curry CJ, Fernhoff PM, Grix AW, Jr, Lott IT, et al. Retinoic acid embryopathy. N Engl J Med. 1985 Oct 3;313(14):837–841. [PubMed]
  • Landrigan PJ, Carlson JE. Environmental policy and children's health. Future Child. 1995 Summer-Fall;5(2):34–52. [PubMed]
  • Lanphear BP, Dietrich K, Auinger P, Cox C. Cognitive deficits associated with blood lead concentrations <10 microg/dL in US children and adolescents. Public Health Rep. 2000 Nov-Dec;115(6):521–529. [PMC free article] [PubMed]
  • Lebowitz MD, Sherrill D, Holberg CJ. Effects of passive smoking on lung growth in children. Pediatr Pulmonol. 1992 Jan;12(1):37–42. [PubMed]
  • Longnecker Matthew P, Klebanoff Mark A, Brock John W, Zhou Haibo, Gray Kimberly A, Needham Larry L, Wilcox Allen J. Maternal serum level of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene and risk of cryptorchidism, hypospadias, and polythelia among male offspring. Am J Epidemiol. 2002 Feb 15;155(4):313–322. [PubMed]
  • Longnecker MP, Rogan WJ, Lucier G. The human health effects of DDT (dichlorodiphenyltrichloroethane) and PCBS (polychlorinated biphenyls) and an overview of organochlorines in public health. Annu Rev Public Health. 1997;18:211–244. [PubMed]
  • Mannino DM, Siegel M, Husten C, Rose D, Etzel R. Environmental tobacco smoke exposure and health effects in children: results from the 1991 National Health Interview Survey. Tob Control. 1996 Spring;5(1):13–18. [PMC free article] [PubMed]
  • Martinez FD, Cline M, Burrows B. Increased incidence of asthma in children of smoking mothers. Pediatrics. 1992 Jan;89(1):21–26. [PubMed]
  • McConnochie KM, Roghmann KJ. Parental smoking, presence of older siblings, and family history of asthma increase risk of bronchiolitis. Am J Dis Child. 1986 Aug;140(8):806–812. [PubMed]
  • Mocarelli P, Gerthoux PM, Ferrari E, Patterson DG, Jr, Kieszak SM, Brambilla P, Vincoli N, Signorini S, Tramacere P, Carreri V, et al. Paternal concentrations of dioxin and sex ratio of offspring. Lancet. 2000 May 27;355(9218):1858–1863. [PubMed]
  • Molfino NA, Wright SC, Katz I, Tarlo S, Silverman F, McClean PA, Szalai JP, Raizenne M, Slutsky AS, Zamel N. Effect of low concentrations of ozone on inhaled allergen responses in asthmatic subjects. Lancet. 1991 Jul 27;338(8761):199–203. [PubMed]
  • Monson RR, Rosenberg L, Hartz SC, Shapiro S, Heinonen OP, Slone D. Diphenylhydantoin and selected congenital malformations. N Engl J Med. 1973 Nov 15;289(20):1049–1052. [PubMed]
  • Montealegre F, Chardon D, Tarrats H. Environmental factors precipitating bronchial asthma exacerbations in southern Puerto Rico: a pilot study. J Asthma. 1993;30(3):219–227. [PubMed]
  • Moore SJ, Turnpenny P, Quinn A, Glover S, Lloyd DJ, Montgomery T, Dean JC. A clinical study of 57 children with fetal anticonvulsant syndromes. J Med Genet. 2000 Jul;37(7):489–497. [PMC free article] [PubMed]
  • Morris K, Morgenlander M, Coulehan JL, Gahagen S, Arena VC, Morganlander M. Wood-burning stoves and lower respiratory tract infection in American Indian children. Am J Dis Child. 1990 Jan;144(1):105–108. [PubMed]
  • Morrow PE. Toxicological data on NOx: an overview. J Toxicol Environ Health. 1984;13(2-3):205–227. [PubMed]
  • Neas LM, Dockery DW, Koutrakis P, Tollerud DJ, Speizer FE. The association of ambient air pollution with twice daily peak expiratory flow rate measurements in children. Am J Epidemiol. 1995 Jan 15;141(2):111–122. [PubMed]
  • Neas LM, Dockery DW, Ware JH, Spengler JD, Speizer FE, Ferris BG., Jr Association of indoor nitrogen dioxide with respiratory symptoms and pulmonary function in children. Am J Epidemiol. 1991 Jul 15;134(2):204–219. [PubMed]
  • Needleman Herbert L, McFarland Christine, Ness Roberta B, Fienberg Stephen E, Tobin Michael J. Bone lead levels in adjudicated delinquents. A case control study. Neurotoxicol Teratol. 2002 Nov-Dec;24(6):711–717. [PubMed]
  • Needleman HL, Schell A, Bellinger D, Leviton A, Allred EN. The long-term effects of exposure to low doses of lead in childhood. An 11-year follow-up report. N Engl J Med. 1990 Jan 11;322(2):83–88. [PubMed]
  • O'Brien PC, Noller KL, Robboy SJ, Barnes AB, Kaufman RH, Tilley BC, Townsend DE. Vaginal epithelial changes in young women enrolled in the National Cooperative Diethylstilbestrol Adenosis (DESAD) project. Obstet Gynecol. 1979 Mar;53(3):300–308. [PubMed]
  • O'Flaherty EJ. Pharmacokinetics, pharmacodynamics, and prediction of developmental abnormalities. Reprod Toxicol. 1997 Mar-Jun;11(2-3):413–416. [PubMed]
  • Ogston SA, Florey CD, Walker CH. Association of infant alimentary and respiratory illness with parental smoking and other environmental factors. J Epidemiol Community Health. 1987 Mar;41(1):21–25. [PMC free article] [PubMed]
  • Paulozzi LJ, Erickson JD, Jackson RJ. Hypospadias trends in two US surveillance systems. Pediatrics. 1997 Nov;100(5):831–834. [PubMed]
  • Perera Frederica P, Rauh Virginia, Tsai Wei-Yann, Kinney Patrick, Camann David, Barr Dana, Bernert Tom, Garfinkel Robin, Tu Yi-Hsuan, Diaz Diurka, et al. Effects of transplacental exposure to environmental pollutants on birth outcomes in a multiethnic population. Environ Health Perspect. 2003 Feb;111(2):201–205. [PMC free article] [PubMed]
  • Peterson RE, Theobald HM, Kimmel GL. Developmental and reproductive toxicity of dioxins and related compounds: cross-species comparisons. Crit Rev Toxicol. 1993;23(3):283–335. [PubMed]
  • Pirkle JL, Flegal KM, Bernert JT, Brody DJ, Etzel RA, Maurer KR. Exposure of the US population to environmental tobacco smoke: the Third National Health and Nutrition Examination Survey, 1988 to 1991. JAMA. 1996 Apr 24;275(16):1233–1240. [PubMed]
  • Pope CA., 3rd Respiratory hospital admissions associated with PM10 pollution in Utah, Salt Lake, and Cache Valleys. Arch Environ Health. 1991 Mar-Apr;46(2):90–97. [PubMed]
  • Reed BD, Lutz LJ. Household smoking exposure--association with middle ear effusions. Fam Med. 1988 Nov-Dec;20(6):426–430. [PubMed]
  • Rennick GJ, Jarman FC. Are children with asthma affected by smog? Med J Aust. 1992 Jun 15;156(12):837–841. [PubMed]
  • Ritz B, Yu F. The effect of ambient carbon monoxide on low birth weight among children born in southern California between 1989 and 1993. Environ Health Perspect. 1999 Jan;107(1):17–25. [PMC free article] [PubMed]
  • Ritz B, Yu F, Chapa G, Fruin S. Effect of air pollution on preterm birth among children born in Southern California between 1989 and 1993. Epidemiology. 2000 Sep;11(5):502–511. [PubMed]
  • Ritz Beate, Yu Fei, Fruin Scott, Chapa Guadalupe, Shaw Gary M, Harris John A. Ambient air pollution and risk of birth defects in Southern California. Am J Epidemiol. 2002 Jan 1;155(1):17–25. [PubMed]
  • Robin LF, Less PS, Winget M, Steinhoff M, Moulton LH, Santosham M, Correa A. Wood-burning stoves and lower respiratory illnesses in Navajo children. Pediatr Infect Dis J. 1996 Oct;15(10):859–865. [PubMed]
  • Romieu I, Meneses F, Sienra-Monge JJ, Huerta J, Ruiz Velasco S, White MC, Etzel RA, Hernandez-Avila M. Effects of urban air pollutants on emergency visits for childhood asthma in Mexico City. Am J Epidemiol. 1995 Mar 15;141(6):546–553. [PubMed]
  • Rosenstreich DL, Eggleston P, Kattan M, Baker D, Slavin RG, Gergen P, Mitchell H, McNiff-Mortimer K, Lynn H, Ownby D, et al. The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma. N Engl J Med. 1997 May 8;336(19):1356–1363. [PubMed]
  • Schechter CB. Re: Brain and other central nervous system cancers: recent trends in incidence and mortality. J Natl Cancer Inst. 1999 Dec 1;91(23):2050–2051. [PubMed]
  • Schwartz J, Slater D, Larson TV, Pierson WE, Koenig JQ. Particulate air pollution and hospital emergency room visits for asthma in Seattle. Am Rev Respir Dis. 1993 Apr;147(4):826–831. [PubMed]
  • Strachan DP, Jarvis MJ, Feyerabend C. Passive smoking, salivary cotinine concentrations, and middle ear effusion in 7 year old children. BMJ. 1989 Jun 10;298(6687):1549–1552. [PMC free article] [PubMed]
  • Strömland K, Nordin V, Miller M, Akerström B, Gillberg C. Autism in thalidomide embryopathy: a population study. Dev Med Child Neurol. 1994 Apr;36(4):351–356. [PubMed]
  • TAUSSIG HB. A study of the German outbreak of phocomelia. The thalidomide syndrome. JAMA. 1962 Jun 30;180:1106–1114. [PubMed]
  • Taylor JA, Sanderson M. A reexamination of the risk factors for the sudden infant death syndrome. J Pediatr. 1995 Jun;126(6):887–891. [PubMed]
  • THIERSCH JB. Therapeutic abortions with a folic acid antagonist, 4-aminopteroylglutamic acid (4-amino P.G.A) administered by the oral route. Am J Obstet Gynecol. 1952 Jun;63(6):1298–1304. [PubMed]
  • Verhoeff AP, van Strien RT, van Wijnen JH, Brunekreef B. Damp housing and childhood respiratory symptoms: the role of sensitization to dust mites and molds. Am J Epidemiol. 1995 Jan 15;141(2):103–110. [PubMed]
  • Wang X, Ding H, Ryan L, Xu X. Association between air pollution and low birth weight: a community-based study. Environ Health Perspect. 1997 May;105(5):514–520. [PMC free article] [PubMed]
  • Wang X, Wypij D, Gold DR, Speizer FE, Ware JH, Ferris BG, Jr, Dockery DW. A longitudinal study of the effects of parental smoking on pulmonary function in children 6-18 years. Am J Respir Crit Care Med. 1994 Jun;149(6):1420–1425. [PubMed]
  • Warkany J. Warfarin embryopathy. Teratology. 1976 Oct;14(2):205–209. [PubMed]
  • WARKANY J, BEAUDRY PH, HORNSTEIN S. Attempted abortion with aminopterin (4-amino-pteroylglutamic acid); malformations of the child. AMA J Dis Child. 1959 Mar;97(3):274–281. [PubMed]
  • Weisglas-Kuperus N, Patandin S, Berbers GA, Sas TC, Mulder PG, Sauer PJ, Hooijkaas H. Immunologic effects of background exposure to polychlorinated biphenyls and dioxins in Dutch preschool children. Environ Health Perspect. 2000 Dec;108(12):1203–1207. [PMC free article] [PubMed]
  • Weitzman M, Gortmaker S, Walker DK, Sobol A. Maternal smoking and childhood asthma. Pediatrics. 1990 Apr;85(4):505–511. [PubMed]
  • Welsch F, Blumenthal GM, Conolly RB. Physiologically based pharmacokinetic models applicable to organogenesis: extrapolation between species and potential use in prenatal toxicity risk assessments. Toxicol Lett. 1995 Dec;82-83:539–547. [PubMed]
  • White MC, Etzel RA, Wilcox WD, Lloyd C. Exacerbations of childhood asthma and ozone pollution in Atlanta. Environ Res. 1994 Apr;65(1):56–68. [PubMed]
  • Whitney KD, Seidler FJ, Slotkin TA. Developmental neurotoxicity of chlorpyrifos: cellular mechanisms. Toxicol Appl Pharmacol. 1995 Sep;134(1):53–62. [PubMed]
  • Wilhelm Michelle, Ritz Beate. Residential proximity to traffic and adverse birth outcomes in Los Angeles county, California, 1994-1996. Environ Health Perspect. 2003 Feb;111(2):207–216. [PMC free article] [PubMed]
  • Winneke G. Endpoints of developmental neurotoxicity in environmentally exposed children. Toxicol Lett. 1995 May;77(1-3):127–136. [PubMed]
  • Wright AL, Holberg C, Martinez FD, Taussig LM. Relationship of parental smoking to wheezing and nonwheezing lower respiratory tract illnesses in infancy. Group Health Medical Associates. J Pediatr. 1991 Feb;118(2):207–214. [PubMed]
  • Wu Tiejian, Buck Germaine M, Mendola Pauline. Blood lead levels and sexual maturation in U.S. girls: the Third National Health and Nutrition Examination Survey, 1988-1994. Environ Health Perspect. 2003 May;111(5):737–741. [PMC free article] [PubMed]

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