Older infants and young children have increased risk of exposure to certain toxicants, because of their size, intake and behaviour. They have a more rapid breathing rate, and eat and drink more than adults per unit of body weight, resulting in higher exposures. They also have more hand-to-mouth activities and play in areas where they may have higher exposures, such as crawling on the floor or playing actively outside.
Finally, children who have been exposed in utero or early in life have more time throughout their life span for the adverse effects of environmental exposures to show themselves (Canadian Partnership for Children’s Health & Environment [CPCHE], 2008).
Widespread awareness of environmental toxicants; their effects on reproductive, fetal and child health; and how to avoid them; is essential in order to decrease exposures during the preconception, prenatal and early childhood periods.
Healthcare providers play a significant role in communicating environmental health risks to parents, as they are a key, trusted source of health information during the preconception and prenatal and postnatal periods.
However, it is important to understand that much of the research on environmental health needs to be interpreted with caution. Research on the impact of environmental exposures is often observational and researchers are not able to control for all of the factors that can influence the effects of exposure. They often cannot be sure of what all participants have been exposed to, exactly when the exposures took place, or for how long, and they often have ineffective ways of measuring the amount of exposure. This means that findings of effects are often uncertain, and sometimes conflicting between studies. As well, many studies are done on animals, which may or may not tell us much about how an exposure impacts humans. All of this leads us to be uncertain about the actual impact of many environmental exposures. The uncertainty of the research leaves healthcare providers in a difficult position of deciding what their role and responsibility is to inform the public of potential health risks.
The Precautionary Principle is a central concept of environmental policy. The principle essentially states that it is not essential to have decisive evidence of harm before action is taken to avoid or diminish the potential harm. This principle has increasingly been used to develop public health policy in Canada and elsewhere.
However, there is also the risk that use of the precautionary principle to protect the public’s health could paradoxically cause harm to the public’s health. This could be through the removal of potentially beneficial products or interventions because of theoretical concerns about harm, e.g. concerns around vaccines and fluoride. Other possible harms could include creating feelings of anxiety, fear or apathy, by providing information about risks due to exposures that the individual has little or no ability to avoid, or by providing information that is confusing and possibly conflicting.
In order for healthcare providers to provide appropriate guidance it is important they ensure that their information is: