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2003
FORUM:
Indoor
Environmental Health for Children |
Indoor
Environmental Health for Children Forum
The Indoor
Environmental Health for Children Forum was conducted at Christus
Santa Rosa Hospital in San Antonio on May 3. The U.S. Environmental
Protection Agency (EPA), Region VI Division, identified the target
area of San Antonio. Following the recommendation of the Steering
Committee and approval of EPA the target area was expanded to
include South Texas. The forum provided a starting point for introducing
the medical community in San Antonio and South Texas to the importance
of addressing childrenís environmental health issues.
Dr. Stephen Inscore, Division Chief of Pediatric Pulmonology,
University of Texas Health Science Center San Antonio, chaired
the conference planning committee.
Other
members of the planning committee included:
- Evelyn
Daniels, EdD, Regional Childrenís Environmental Health Program
Manager for the U.S. Environmental Protection Agency (EPA),
Region 6.
- Miguel
C. Fern·ndez, MD, FACEP, FAAEM, Dept of Surgery, University
of Texas Health Science Center San Antonio.
- Janie
D. Fields, MPA, Executive Director, Children's Environmental
Health Institute.
- Sarah
E. Griewahn, MPH, RN, Family Nurse Practitioner, B&W
Clinic, Eastland, Texas.
- Jann Harrison,
RN, MSN, Continuing Medical Education, CHRISTUS Santa Rosa Health
Care System.
- Freeman
Cornell Jardan, MD, Practicing Physician, San Antonio, Texas.
- Sarah
W. Jones, BA, Director of Education, Children's Environmental
Health Institute.
- Linda
Kaufman, MSN, RNCS, San Antonio Metropolitan Health District.
- Gladys
Keene, MD, MPH, Pediatrician and Immunologist, Executive Director
of the Area Health Education Center of the Mid Rio Grande Border
Area of Texas.
- Claudia
Miller, MD, Department of Family and Community Medicine, University
of Texas Health Science Center San Antonio.
- Alice
C. Murphy, MPH, BSN, RN, Baccalaureate and RN to BSN Program
Faculty, Abilene Intercollegiate School of Nursing.
- John Nava,
MD, San Antonio Metropolitan Health District.
- Juan Parra,
MD, Department of Pediatrics, University of Texas Health Science
Center San Antonio.
- Sam Sanchez,
RS, San Antonio Metropolitan Health District.
- Patty
Villareal, RN, MS, San Antonio Metropolitan Health District.
The
planning committee drafted the agenda and selected the presenters,
including Dr.
Emil Bardana as the keynote speaker. Dr.
Bardana is Professor of Medicine in the Department of Medicine,
Division of Allergy and Clinical Immunology at Oregon Health &
Sciences University in Portland, Oregon. Dr. Bardana is currently
Editor-in-Chief of AllergyWatch, a synopsis of the allergy and
asthma literature, resulting from a comprehensive review of eighteen
major medical journals. He is a member of the Editorial Boards
of Annals of Allergy, Asthma and Immunology, and serves as Editorial
Consultant to numerous other journals. He is author or co-author
of more than 200 publications. Dr. Bardana is a past President
of the American College of Allergy, Asthma and Immunology.
The
final agenda was as follows:
7:30-8:00
AM
Registration/Continental Breakfast
8:00-8:15
AM
Welcome Remarks
8:15-9:15
AM
Keynote Address - "Indoor Air Quality and Health with Emphasis
on the Toxic Mold Issue"
9:15-10:15
AM
"Children's Environmental Health: Indoor Environmental Toxicants
and Other Hazards"
10:15-10:30
AM
Break
10:30-11:30
AM
"Ethical Considerations in Children's Environmental Health"
(Ethics CME Credit)
11:30-12:00
PM
"Poison Center Utilization and Community Health Programs"
12:00-12:30
PM
Questions & Answers
12:30-1:15
PM
Roundtable Discussions with Facilitators
1:15-1:30
PM
Next Steps & Closing
1:30
PM
Evaluation and Adjournment
Roundtable
Discussion Topics and Facilitators included:
Food
and Diet - Fernando Guerra, MD, MPH, San Antonio Metropolitan
Health District
Allergies,
Asthma, and Indoor Air Pollution - Gladys Keene, MD,
MPH, Area Health Education Center of the Mid Rio Grande Border
Area of Texas
Toxins
in the Indoor Environment and Built Environment - Vince
Torres, PE, Texas Institute for the Indoor Environment, University
of Texas at Austin
Environmental
History Taking - Debbie Cherry, MD, MS, Southwest Center
for Pediatric Environmental Health
Outcomes
from Roundtable Discussions included:
Food
and Diet
Priority
Issue: Microbial contaminants in foods, pesticides, certain food
additives and mycotoxins in childrenís food.
Action
Statement: Identify major pathogens in childrenís food in South
Texas and increase public awareness through initiatives to target
specific populations.
Collaboration:
Convene a task force representative of nutritionist, school nurses
and food service personnel, health care workers/educators, physicians,
childcare administrators and the media to provide cross-training
education about toxic food-borne pathogens and develop a public
awareness campaign.
Allergies,
Asthma, and Indoor Air Pollution
Priority
Issue: Exposure to allergens in schools.
Action
Statement: Educate school personnel, students and parents on how
to identify harmful allergens and appropriate actions in response
to exposure.
Collaboration:
Convene a task force representative of school nurses and administrators,
teachers and parents to provide cross-training education about
the hazards of indoor pollution and remediation actions.
Toxins
in the Indoor Environment and Built Environment
Priority
Issue: Heating and ventilation systems in schools and childcare
centers.
Action
Statement: Improve the HVAC system including source control and
maintenance.
Collaboration:
Convene a task force representative of school and childcare administrators,
physicians, school nurses, maintenance and construction workers
to provide cross-training education about the hazards resources
and develop remediation actions.
Environmental
History Taking
Priority
Issue: Incorporating environmental history taking in routine medical
visits.
Action
Statement: Increase vital information available to assist physicians
with medical diagnosis and treatment plans.
Collaboration:
Identify a task force representative of physicians, nurses and
parents to review current instruments and methods for implementing
an environmental history instrument in medical practices. Recruit
medical practices to serve as a pilot in testing the instrument
and review the results to determine recommended modifications
to the instrument before making available for distribution through
interested medical associations.
Evaluation
Results:
Christus
Santa Rosa Division of Continuing Medical Education provided the
evaluation instrument. There were 40 participants that completed
the evaluation of the speakers and program as related to the program
objectives. These included 13 Medical Doctors, 11 Registered Nurses,
and 19 Public Health and other. All the results ranged from good
to excellent for all the speakers for meeting the program objectives:
Program
Objectives:
Upon completion
of this conference, participants should be able to: 1) Review
possible risks children are exposed to every day in a wide range
of potentially harmful toxic chemicals in food, toys and indoor
furnishings; 2) Discuss how exposures during critical periods
of development can have life-long adverse affects; 3) Review the
role of indoor air pollutants and other environmental triggers
in causing respiratory disease in infants and children; 4) Identify
effective strategies to reduce exposure of children to indoor
air pollutants and allergens; 5) Discuss the impact of the environment
on the increase in childhood cancer; 6) Discuss environmental
factors which play an important role in contributing to the incidence
of birth defects and developmental disorders; and 7) Describe
how children living in poverty and those in certain racial and
ethnic communities face a disproportionately higher risk of exposure
to environmental hazards.
In addition,
100% of participants responded yes to the following questions:
1.
The information presented increased my knowledge of this topic.
2.
The information presented is applicable and will enhance my practice.
3. This program
effectively met my educational needs.
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