2. All Around

Where We Stand: Testing of Well Water

In the United States, about 15 million families get their drinking water from private, unregulated wells. Studies show that a significant number of these wells have concentrations of nitrates that exceed federal drinking-water standards. These nitrates are a natural component of plants and nitrate-containing fertilizers that can seep into well water, and don’t pose any toxic risk to humans on their own. But in the body, they can be converted to nitrites, which ​are potentially hazardous.

In infants, they can lead to a condition called methemoglobinemia, a dangerous and sometimes fatal blood disorder that interferes with the circulation of oxygen in the blood. Babies whose formula is prepared using well water may have a high risk of nitrate poisoning.

The American Academy of Pediatrics recommends that if your family drinks well water, the well should be tested for nitrates. If the well water contains nitrates (above a level of 10 mg/L), it should not be used for infant formula or food preparation. Instead, you should prepare food or formula by using purchased water, public water supplies, or water from deeper wells with minimal nitrate levels.

Breastfeeding is the safest way to nourish your infant, since high levels of nitrates are not passed through breast milk.

How Often Should Well Water Be Tested?
Tests should be done every three months for at least one year to determine the levels of nitrates. If these tests show safe levels, then a follow-up test once a year is recommended.

Talk with your pediatrician

If you have questions about well water, talk with your pediatrician. Your regional Pediatric Environmental Health Specialty Unit (PEHSU) have staff who can also talk with parents about concerns over environmental toxins.

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Where We Stand: Lead Screening

Lead causes serious damage to children’s brains even at relatively low levels of exposure, and the effects are difficult to overcome.

The American Academy of Pediatrics supports widespread lead screening of children, as well as funding programs to remove lead hazards from the home, learning, and play environments. Primary prevention is the only way to combat lead poisoning.

Knowing the environment where your child will live, learn, and play and removing the source of lead before your child encounters it will prevent lead exposure and the adverse effects that result from it.

Talk with your pediatrician

If you have questions about lead screenings, talk with your pediatrician. Your regional Pediatric Environmental Health Specialty Unit (PEHSU) have staff who can also talk with parents about concerns over environmental toxins.

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Should My Child Be Retested for Lead Exposure?

A government alert about a faulty brand of lab test used by doctors to measure blood lead levels prompted some parents to wonder: should my child be tested again?

Who should be retested?

Most children don’t need to be retested. The children who may need a new test are those who are under age 6 as of May 17, 2017 and had a venous blood test—in which blood is drawn from the arm. Parents of these children should discuss with their pediatrician whether a new test is needed.


This recommendation followed a warning from the U.S. Food and Drug Administration (FDA) that a specific kind of venous blood lead test using Magellan LeadCare Testing Systems may be inaccurate. These tests have been found to underestimate the amount of lead in blood samples.

When are venous blood lead tests given to children?

A venous blood test usually is given after a child is first screened for lead poisoning with a drop of blood collected with a finger or heel stick. These stick tests, also known as capillary tests, are not affected by the FDA warning.

If a capillary blood test suggests a child has elevated blood lead levels, pediatricians may follow up with a venous blood test to confirm the results. Children under age 6 whose results were 10 micrograms per deciliter (µg/dL) or lower from the faulty brand of venous test may need to be re-tested.

How to prevent children’s exposure to lead

Most important, for all children, is to make sure their home environment is free of lead. Children can be exposed to lead in a variety of ways, such as living in an older home or a home undergoing renovations, or in a home with lead pipes. Certain toys, hobbies and parents’ occupations also increase the risk that a child could be exposed to lead.

“There is no safe level of lead exposure for children, and the best ‘treatment’ for lead poisoning is to prevent lead exposure before it happens,” said Jennifer Lowry, MD, FAAP, chair of the American Academy of Pediatrics Council on Environmental Health.

Children in at least 4 million U.S. households are exposed to high levels of lead, according to the Centers for Disease Control and Prevention (CDC). Even low-level lead exposure, at blood lead concentrations below 5 µg/dL, can raise risk of intellectual and academic disabilities in children. Lead exposure also is linked to higher rates of conditions such as hyperactivity and attention deficits, and lower birth weight.

Talk with your pediatrician

If you’re concerned about lead exposure in your child, talk with your pediatrician. Your regional Pediatric Environmental Health Specialty Unit (PEHSU) have staff who can also talk with parents about concerns over environmental toxins.

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School Safety During an Emergency or Crisis: What Parents Need to Know

School Safety during Emergencies: What Parents Need to Know

As a parent, feeling confident in the safety of your child at the school they attend is extremely important. Read on to learn what schools may be doing to be safer and better prepared for an emergency or crisis, and key questions you can ask.

What’s the school crisis plan?

All schools should have an organized, systematic emergency operations plan in place to reduce risks or prevent, prepare for, respond to and recover from a crisis situation. These may range from a death or accident affecting a member of the school community to a natural disaster or crisis and affecting a lot of individuals in the school.

Many school districts have a safety coordinator or director, or have assigned this role to one of the district administrators. School faculty and staff are trained to assess the seriousness of incidents and respond according to the plan’s established procedures and guidelines. The federal Guide for Developing High-Quality School Emergency Operation Plans gives guidance for each type of community.

What parents can do

While the school staff has been trained and continue to receive guidance on how best to help students, the best advocate for your child is YOU! Ask your child’s teacher or a school administrator about the plans the school has in place for emergencies such as fires, blizzards, bomb threats and armed intruders. You can also ask how often school officials and safety experts meet to discuss safety procedures. While some schools may hesitate to share all parts of their plans and strategies, make yourself aware of the information available to you.

Live active shooter drills at schools

In recent years, many school districts adopted live crisis drills meant to help students and staff respond in the event of a school shooter. Some of these drills involved real gunfire or blanks, actors posing as shooters, and theater makeup to simulate blood or gunshot wounds. In some cases, students and staff were led to think there was an actual attack taking place.

Although well intended, these hyper-realistic drills can be psychologically harmful to students without much proof they effectively prepare them for a crisis. The American Academy of Pediatrics advises active shooter drills instead be conducted like fire drills—which don’t simulate an actual fire—using a calm approach to the safe movement of students and staff in the school building. It also encourages increased mental health support and violence prevention efforts in schools.

How are emergencies at schools communicated to parents?

To prevent possibly risking the safety of your child and their classmates, it is important for parents to understand what the school and local law enforcement require of them during emergency situations.

Misinformation can easily spread if a crisis situation occurs at your child’s school. Because of this, it is the responsibility of the school staff to provide parents with timely information on the status of their child’s safety. For example, some schools have an emergency communication system in place that notifies parents via email, voice and text messages. Schools typically inform parents of any unusual situation that demands one of the protocols listed above. However, they may not provide prior notice of drills.School emergency response terms to know

  • Evacuation: Used to move students and staff out of the building.
    • During an evacuation, students and staff leave and move to a nearby location and return to the school building right after the cause of evacuation is resolved. Schools practice evacuations regularly (often monthly) during fire drills.
  • Relocation: Used to move students and staff to a pre-designated alternate site following evacuation when it is determined that returning to the school building will not take place within a reasonable period of time.
    • Depending on the time of day and the circumstances, students may be released early or school activities may be changed or put on hold until they are able to return to the school building. Plans should also be in place for students and staff with limited mobility who may need assistance moving to the relocation site.
  • Shelter-in-place: Used during severe weather or other environmental threats (e.g., air contamination due to a local fire).
    • This is a precaution aimed to keep people safe while remaining indoors. (This is not the same thing as going to a shelter in case of a storm.) In schools, shelter-in-place involves having all students, staff, and visitors take shelter in pre-selected rooms that have phone access and stored disaster supplies kits and, preferably, access to a bathroom. The room doors are then shut.
  • Lockdown: Used when there is a perceived danger inside the building.
    • A lockdown includes securing each occupied room by locking the door(s) and directing people to move away from windows and doors. Hallways are cleared of students and school staff. Typically, local law enforcement arrives to secure the site and arrange for evacuation or return to usual building activities. Students are kept in their classrooms or other secured areas in the school until the lockdown has ended.
  • Lockout: Used to secure the building from a potential threat outside the building, such as when an unauthorized person is loitering on school grounds or when there is criminal activity in the neighborhood.
    • During a lockout, access to the building is restricted, but there may be some limited movement within the building.

A school safety checklist for families

  • Review with your child the family emergency plan, including reunification and communication options.
  • Provide the school with information about any unique needs your children may have. You can do this by filling out an emergency information form and working with school health staff to be sure there is an emergency plan on file for your child. It should include information on health issues and what is needed during other school emergencies.
  • Consider having back up/extra medication or other items at your child’s school in case there is an emergency where your child needs to remain in the building for a longer period of time.
  • Provide the school and your child’s teacher with up-to-date contact information for family or friends who can pick up and care for your child if you are unavailable. Be sure to update this information as needed throughout the school year.
  • Learn about the school’s plan for emergency response, including parental access during emergencies, school emergency contact information, meet-up locations and other reunification plans.
  • Advise the school if your child has special needs during a crisis or drill. This may include the need for assistance with mobility or communication during an evacuation or additional support due to anxiety or prior traumatic experiences.

Helpful guidelines for talking with children about school safety

For some children, even participating in a drill may cause some emotional distress. This is especially true if it reminds them of a prior crisis event, or if they otherwise are feeling vulnerable or anxious.

As a parent, you are in the best position to help your child cope with trauma they experience during an emergency or safety drill at school. Any conversation with a child must be appropriate for their age and developmental stage.

  • Young children need brief simple information that should be balanced with reassurance. This includes informing children that their school and home are generally safe and that adults are available to protect them. Young children often gauge how threatening or serious an event is by adult reactions. This is why, for example, parents are encouraged not to get overly emotional when saying goodbye on the first day of school. Young children respond well to simple examples of school safety, like reminding them the exterior doors are locked, just as you lock your doors at home at night.
  • Upper elementary and early middle school children may be more vocal in asking questions about whether they are truly safe and what is being done at their school. They may need assistance separating reality from fantasy. Parents can share the information they have about the school’s safety plan and any other relevant communication to ease their child’s mind.
  • Upper middle school and high school students may have strong and varying opinions about causes of violence in school and society. Parents should stress the role that students have in maintaining safe schools by following the school’s safety guidelines (not providing building access to strangers, reporting strangers on campus, reporting threats to school safety made by students or community members, for example).

No matter how old your children are, it’s best not to provide false reassurance or minimize their distress. Especially after media coverage of violence in another school or community, or after damage from a natural disaster, children may become more concerned about their safety. Help children learn to cope with distressing feelings, rather than pretend they don’t or shouldn’t exist.

Helping children cope after a crisis

It is important to talk with your child and to provide emotional support in the aftermath of a crisis situation. Invite your child to talk, but wait for your child to accept the invitation. Some children may not express their concerns verbally. Be aware of signs that children might be in distress, such as changes in behavior, anxiety, sleep problems, acting out, problems at school or with academic work. Recognize that many children may hide their distress, at times in order to protect you and other caregivers.

If you have any questions or concerns, talk with your child’s doctor, a mental health professional, or the school nurse, counselor, or social worker at your child’s school.

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Protecting Children from Pesticides: Information for Parents

​​​Pesticides are used in many products and may affect children’s health in a variety of ways. However, there are things parents can do to protect their children from pesticides where they live and play.

The American Academy of Pediatrics (AAP) policy statement, Pesticide Exposure in Children, and accompanying technical report highlights some of the major health concerns linked to pesticide exposure—particularly prenatal exposure. Pesticide exposure during pregnancy may lead to an increased risk of birth defects, low birth weight, and fetal death. Exposure in childhood has been linked to attention and learning problems, as well as cancer.  

Children at Higher Risk for Exposure 

Children are at higher risk for health effects from exposure to pesticides than adults, because their internal organs are still developing and maturing. They can come into contact with pesticides stored or applied in their homes, yards, child care centers, schools, parks, or on pets. Young children, as parents know, love to put their hands in their mouth. They also crawl and play on floors, grass, or in spaces that might contain pesticides. Because pesticides are still in many places in our environment, a child’s amount of exposure can add up quickly.  

​Pesticides are still found in:

  • Food 
  • Insect ​repellents
  • Rodent control products​
  • Lawn and garden care products
  • Pet products

These exposures usually do not lead to instant poisoning symptoms. However, studies suggest that exposure may affect healthy child development.

Pesticide Poisoning

Poisons are absorbed through the skin, by the mouth, or by breathing sprays, dusts, or vapors. You or your children can be poisoned if you apply or are present during application of the chemical. Also if you touch contaminated grass, shoes, clothing, lawn furniture, etc., or put contaminated objects (e.g., toys, grass, etc.) or fingers in the mouth.

In recent years, products with some highly toxic pesticide ingredients have been removed from store shelves. And while more education on pesticides and better packaging have helped, thousands of cases of pesticide poisonings are still reported to US Poison Control Centers every year.

Signs of pesticide poisoning: 

The signs of pesticide poisoning may look like the flu. If your child shows any of the following signs after coming in contact with a pesticide, call the Poison Control Centers national hotline phone number, 1(800)222-1222, right away.

  • Headaches
  • Dizziness/Weakness
  • Muscle twitching
  • Difficulty breathing​​
  • Skin rashes
  • Eye burning 
  • Change in overall level of alertness

Tips to Reduce Your Child’s Chances of Pesticide Poisoning​:

Reducing your child’s exposure to pesticides is not difficult, so start today! 

  • Reduce exposure to pesticides in foods. Organic produce has been found to have less pesticides and a potentially lower risk of exposure to drug-resistant bacteria. However, the most important thing for children is to eat a wide variety of produce, whether it’s conventional or organic. See the AAP clinical report, Organic Foods: Health and Environmental Advantages and Disadvantages, for more information.
  • Wash and scrub fruits and veggies under running water. This can help reduce any traces of pesticides that remain on the surface, advises the U.S. Environmental Protection Agency​
  • Store chemicals safely to reduce the risks for children. Keep these common household pesticides out of children’s reach and never put poisonous products in containers that could be mistaken for food or drink:
    • Bath and kitchen disinfectants and sanitizers—including bleach
    • Products used to kill mold or mildew
    • Roach sprays and baits
    • Insect repellents
    • Rat and other rodent poisons
    • Weed killers
    • Flea and tick shampoos, powders and dips for pets
    • Swimming pool chemicals
  • Read pesticide labels first. Follow the directions as they are written on the label before using a product. For example, pesticides you use to control fleas and ticks on your pets can be transferred to your children. Protect your pets and children by carefully following the label directions and precautions. 
  • Never use bug bombs or broad spraying pesticides. Use chemical-free pest control products or the least toxic method for common household and garden pest problems. When chemicals are necessary, the AAP recommends the use of less-toxic choices, such as boric acid in crevices or bait stations and gels, which minimize exposure to children. Simple actions such as maintaining a clean home, taking out the trash, eliminating household sources of moisture and storing food properly can help the situation. These practices should take place in homes and schools to avoid having to use pesticides.
  • Children should not participate in the application of fertilizer. Kids should stay off the lawn after a chemical fertilizer has been applied until it’s been exposed to at least a quarter inch of rain or a good watering. Then, wait at least 24 hours before you allow kids to play on the lawn.
  • Do not use lindane on children. Talk with your child’s pediatrician about head lice control without pesticides. 
  • If you work with pesticides, be sure you don’t “take them home” on your clothes and shoes. Try to change clothes before coming home and remove and store shoes outside.
  • Work with schools and government agencies to encourage the use of products with the least-toxic pesticides. Promote community “right-to-know” procedures when pesticide spraying occurs in public areas. ​
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Poison Prevention and Treatment Tips for Parents

​Each year, approximately 3 million people— many under age 5— swallow or have contact with a poisonous substance.

The American Academy of Pediatrics (AAP) offers tips to prevent and to treat exposures to poison.

Prevent poisoning in your home

Most poisonings occur when parents or caregivers are home but not paying attention. The most dangerous potential poisons are medicines, cleaning products, liquid nicotine, antifreeze, windshield wiper fluid, pesticides, furniture polish, gasoline, kerosene and lamp oil. Be especially vigilant when there is a change in routine. Holidays, visits to and from grandparents’ homes, and other special events may bring greater risk of poisoning if the usual safeguards are defeated or not in place.

  • Store medicine, cleaning and laundry products, (including detergent packets) paints/varnishes and pesticides in their original packaging in locked cabinets or containers, out of sight and reach of children. It is best to use traditional liquid or powder laundry detergents instead of detergent packets until all children who live in or visit your home are at least 6 years old.
  • Safety latches that automatically lock when you close a cabinet door can help to keep children away from dangerous products, but there is always a chance the device will malfunction or the child will defeat it. The safest place to store poisonous products is somewhere a child can’t see or reach or see.
  • Purchase and keep all medicines in containers with safety caps. Discard unused medication. Note that safety caps are designed to be child resistant but are not fully child proof. Never refer to medicine as “candy” or another appealing name.
  • Check the label each time you give a child medicine to ensure proper dosage. For liquid medicines​, use the dosing device that came with the medicine. Never use a kitchen spoon.
  • If you use an e-cigarette, keep the liquid nicotine refills locked up out of children’s reach and only buy refills that use child-resistant packaging. A small amount of liquid nicotine spilled on the skin or swallowed can be fatal to a child.
  • Never place poisonous products in food or drink containers.
  • Keep natural gas-powered appliances, furnaces, and coal, wood or kerosene stoves in safe working order.
  • Maintain working smoke and carbon monoxide detectors.
  • Secure remote controls, key fobs, greeting cards, and musical children’s books. These and other devices may contain small button-cell batteries that can cause injury if ingested.
  • Know the names of all plants in your home and yard. If you have young children or pets, consider removing those that are poisonous.

Poison treatment tips

If your child is unconscious, not breathing, or having convulsions or seizures due to poison contact or ingestion, call 911 or your local emergency number immediately.

To get help from Poison Control, use the webPOISONCONTROL online tool or call 1-800-222-1222. Both options are free, expert, and confidential.

Different types and methods of poisoning require different, immediate treatment.

  • Swallowed poison. Take the item away from the child, and have the child spit out any remaining substance. Do not make your child vomit. Do not use syrup of ipecac.
  • Swallowed battery. If your child has swallowed a button-cell battery or a battery is lodged in his or her nose, ear, or throat, seek treatment in a hospital emergency department immediately. Serious tissue damage can occur in as little as 2 hours.
  • Skin poison. Remove the child’s clothes and rinse the skin with lukewarm water for at least 15 minutes.
  • Eye poison. Flush the child’s eye by holding the eyelid open and pouring a steady stream of room temperature water into the inner corner for 15 minutes.
  • Poisonous fumes. Take the child outside or into fresh air immediately. If the child has stopped breathing, start cardiopulmonary resuscitation (CPR) and do not stop until the child breathes on his or her own, or until someone can take over.

Talk with your pediatrician

If you’re concerned about cleaning products, talk with your pediatrician. Your regional Pediatric Environmental Health Specialty Unit (PEHSU) have staff who can also talk with parents about concerns over environmental toxins.

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Pesticides, Herbicides and Children

​​Pesticides and herbicides represent a large group of chemical products designed to kill or harm unwanted insects, plants, molds, and rodents.

Pesticides are used in a variety of settings, including homes, schools, parks, lawns, gardens, and farms. While they may kill insects, rodents, and weeds, many are toxic to people when consumed in food and water.

More research is needed to determine the short- and long-term effects of pesticides and herbicides on humans. Although some studies have found connections between some childhood cancers and an exposure to pesticides, other studies have not reached the same conclusions. Many pesticides disrupt the nervous system of insects, and research has shown that they have the potential to damage the neurological system of children.


Try to limit your child’s unnecessary exposure to pesticides. To reduce such exposure:

  • Minimize using foods in which chemical pesticides were used by farmers.
  • Wash all fruits and vegetables with water before your child consumes them.
  • For your own lawn and garden, use nonchemical pest control methods whenever possible. If you keep bottles of pesticides in your home or garage, make sure they’re out of the reach of children to avoid any unintentional poisoning.
  • Consider that children and adults who eat organic foods have lower levels of pesticide metabolites in their system. You may want to choose organic (when possible) to decrease your family’s risk.
  • Avoid routinely spraying homes or schools to prevent insect infestations.
  • Consider integrated pest management, which focuses on the use of baits, and blocking the sources of entry.

Talk with your pediatrician

If you have questions about pesticides exposure for your child, talk with your pediatrician. Your regional Pediatric Environmental Health Specialty Unit (PEHSU) have staff who can also talk with parents about concerns over environmental toxins.

2. All Around

PFAS: Limiting Children’s Exposure to “Forever Chemicals”

PFAS: Limiting Children’s Exposure to “Forever Chemicals”

Some drinking water systems in the United States are contaminated with perfluoroalkyl and polyfluoroalkyl substances, which are sometimes called the “forever chemicals.” As a parent, you may wonder if these can affect your children’s health, and how to limit exposure to these chemicals. This article gives an overview of perfluoroalkyl and polyfluoroalkyl substances (PFAS) and simple steps you can take to reduce exposure.

What are PFAS and why are they called “forever chemicals?”

PFAS stands for “perfluoroalkyl and polyfluoroalkyl substances,” which are a group of human-made chemicals. PFAS have been used in many consumer and commercial products since the 1950s because they are durable and resistant to heat. They are known as the “forever chemicals” because they do not break down in the environment. As a result, they remain in soil and water for very long periods of time.​

There are thousands of types of PFAS chemicals. Two common types are:

  • PFOA (perfluorooctanoic acid)
  • PFOS (perfluorooctane sulfonic acid)

Where are PFAS found? How can my family be exposed?

The most common way PFAS can get into the body is when we eat or drink them. PFAS can be found in the following places:

  • PFAS may be in certain foods, like fish and shellfish raised in waters contaminated with PFAS.
  • Food packaging like pizza boxes, popcorn bags, and fast food containers may be coated with PFAS to prevent sticking and leakage.
  • Water supplies (including public water systems and private water wells) can be contaminated with PFAS from local industries or the use of firefighting foam.
  • Contaminated soil.

How long can PFAS stay in the body?

PFAS chemicals can remain in the body for many years.

How can PFAS affect health?

We currently do not have a clear answer on how PFAS can impact health but there are scientific studies going on right now to help us answer this question. Some of these studies show a possible connection between PFAS exposure and higher cholesterol levels, as well as effects on the hormone system, immune system, liver, and kidneys.

Can PFAS exposure be detected in a blood test?

Yes, but not for medical purposes. Blood testing for PFAS in children and adults has been done in several U.S. communities for public health research. While all people in the United States have a detectable level of PFAS in their bodies because of their widespread use, these studies are looking at the levels of PFAS in the blood of people using a contaminated water supply. At this time, the results of the tests cannot be used to predict risk of health effects from PFAS exposure.

​How can I reduce my family’s exposure to PFAS?While it is not possible to completely eliminate exposure to PFAS, since they are so widespread in the environment, there are ways to reduce your family’s exposure:Drinking water: If you live in a community with water contamination, use a water filter that is certified to remove PFAS. Keep in mind that th​​ese filters need to be carefully maintained to be effective (check the manufacturer instructions). You can also check with your local water system to find out if the PFAS levels in your community have been reduced through filtration or changing the water source.Infant formula: If you live in an area with PFAS concerns, use pre-mixed baby formula or mix it using alternative water sources that do not have PFAS.Local fish advisories: Check your local fish advisories before eating locally-sourced fish or seafood.
Dust control: Since PFAS (and other chemicals) can build up in household dust, dust regularly using a wet mop or wet cloth on solid surfaces, and vacuum on carpets.
Consumer Products:​Cookware: Get rid of any nonstick (“teflon”) pots and pans that are cracked or chipped. Safer alternatives for cooking include stainless steel and iron.​​Popcorn: Instead of popcorn from microwavable bags, buy corn kernels and pop them on the stovetop or in a microwavable glass popcorn popper.Food containers: Cut back on fast food and takeout containers since many are coated with PFAS.​Textiles: Avoid buy​ing stain-​resistant carpets and upholstery.​​​​

Should I ask my pediatrician to test my child’s blood for PFAS?

No. Although some PFAS chemicals can be measured in blood, it involves specialized technology that is typically not available​ at commercial or clinical laboratories. Also, the results do not help doctors make medical decisions or predict future health effects. At most, the levels can be compared to the average levels in the blood of people in the United States.

Should I ask my pediatrician to test my child’s blood for evidence of PFAS health effects?

No. It is not necessary to do blood work to look at cholesterol, liver, kidney, and hormones in children because of PFAS in the water supply. However, your pediatrician may order these tests for other reasons that are not related to PFAS. Remember, routine check-ups, immunizations, screening for cholesterol in children between age 9 to 11 years, and other standard preventive services and screening tests with your pediatrician is recommended.

Is there a treatment to remove PFAS from the body?

No. The best treatment is to prevent future exposures as much as possible. There is no known medication that can speed up the body’s removal of PFAS.

Can I breastfeed my baby if I live in a community with PFAS water contamination?

Yes. There is no medical reason to stop breastfeeding due to PFAS concerns. The advantages of breastfeeding for mom and baby outweigh potential risks of exposure to PFAS through breastmilk. Breastfeeding moms can reduce further exposure to PFAS chemicals by drinking bottled water until their water system improves.

Can PFAS be removed from the drinking water supply?

Yes. There are ways to reduce PFAS levels in water systems with elevated levels of these chemicals. Some water systems have installed state-of-the-art filters that remove PFAS and other chemicals. Others have found new sources of water that do not have elevated levels of PFAS.

What is being done to reduce PFAS in water supplies across the country?

The Environmental Protection Agency (EPA) set a federal “health advisory” level of 70 parts per trillion for PFOS and PFOA in public water systems; however, this is not a required or enforceable standard. Several states have set their own enforceable limits for PFAS in public water systems that are stricter than the EPA health advisory level.

Yearly Consumer Confidence Reports are available so you can learn more about your local water system, and review the most recent water testing results. If you have a private water well, Learn more about what tests are recommended to ensure your well water is safe to drink. You can also find out if the Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR) are working on PFAS studies in your area.

Talk with your pediatrician

If you have questions about PFAS exposure, talk with your pediatrician. Your regional Pediatric Environmental Health Specialty Unit (PEHSU​) have staff who can also talk with parents about concerns over environmental toxins.​

2. All Around

Lead Exposure: Steps to Protect Your Family

The most important step parents, doctors, and others can take is to prevent lead exposure before it occurs.

9 steps to keep your home lead safe

  • Test your home for lead. If your home was built before 1978, talk with your local health department about getting your home tested for lead. If you don’t know how old your home is, assume there is lead. In the United States, lead is in paint in 87% of homes built before 1940, 69% of homes built from 1940–1959, and 24% of homes built from 1960–1977. Homes in the Northeast and Midwest are most likely to have lead in paint. Ask the landlord about lead before you sign a lease. Before you buy a home, have it inspected for lead.
  • Before any work is done on your home, learn about safe ways to make repairs. When repairs are being done, seal off the area until the job is done and keep your child away until everything is cleaned up. Be sure to use a certified contractor. Removing lead paint on your own can often make the condition worse. If work is not done the safe way, you and your child can be harmed by increased exposure to lead in dust.
  • Keep your children away from old windows, old porches, and areas with chipping or peeling paint. If it is in your home, cover it with duct tape or contact paper until it can be completely removed. If you rent your home, let your landlord know about any peeling or chipping paint. Landlords are legally required to repair lead problems found on their property.
  • Do not allow your child to play in the dirt next to your old home. Plant grass over bare soil or use mulch or wood chips.
  • Clean your home regularly. Wipe down floors and other level surfaces with a damp mop or sponge. Taking shoes off at the door can help reduce tracking in dirt.
  • Teach your children to wash their hands, especially before eating. Wash pacifiers and toys regularly.
  • Keep clean. If your work or hobbies involve lead, change your clothes and shoes and shower when finished. Keep your clothes at work or wash your work clothes as soon as possible.
  • Use cold flushed tap water for mixing formula, drinking, or cooking. If you are in an older home, run the water for several minutes before using it in the morning and start with cold water for drinking or cooking.
  • Eat healthy. Some foods, especially baby and toddler foods, are known to have detectable levels of lead in them. Reducing your child’s exposure to lead is key. Give your child a well-balanced diet that includes a variety of foods that are high in calcium and iron and follow the American Academy of Pediatrics (AAP) recommendations on fruit juice. A good diet can help your child absorb less lead.

Should my child be tested for lead?

Pediatricians should screen all children for risk factors that may result in lead exposures by asking about the age of the home, parental occupations and hobbies, use of ethnic foods and spices, and hand to mouth activity. The only way to know for sure if your child has been exposed to lead is with a blood test. Lead tests sometimes take blood from the finger, but it is better and more accurate to take the blood from a vein in the arm. The test measures the amount of lead in the blood. If you think that your child has been exposed to lead, talk with your pediatrician about getting a blood test to check for lead.

Childhood Lead Exposure - AAP Infographic

Talk with your pediatrician

If you have questions about lead exposure, talk with your pediatrician. Your regional Pediatric Environmental Health Specialty Unit (PEHSU) have staff who can also talk with parents about concerns over environmental toxins.

2. All Around

Keeping Your Child Safe From Asbestos

About Asbestos:

Asbestos is a natural fiber that was widely used as a spray-on material for fireproofing, insulation, and soundproofing in schools, homes, and public buildings from the 1940s through the 1970s. It does not pose health risks unless it deteriorates and becomes crumbly, when it can release microscopic asbestos fibers into the air. When asbestos fibers are inhaled, they can cause chronic health problems to the lungs, throat, and gastrointestinal tract, including a rare type of chest cancer (called mesothelioma) that can occur as long as five decades after asbestos exposure.

Today, schools are mandated by law to either remove asbestos or otherwise ensure that children are not exposed to it. However, it is still in some older homes, especially as insulation around pipes, stoves, and furnaces, as well as in walls and ceilings.

Locations in Homes Where Asbestos May Be:

  • Insulation around pipes, stoves, and furnaces (the most common locations)
  • Insulation in walls and ceilings, such as sprayed-on or troweled-on material or vermiculite attic insulation.
  • Patching and spackling compounds and textured paint
  • Roofing shingles and siding
  • Older appliances, such as washers and dryers
  • Older floor tiles

Determining Whether Your Home Contains Asbestos:

  • Evaluate appliances and other consumer products by examining the label or the invoices to obtain the product name, model number, and year of manufacture. If this information is available, the manufacturer can supply information about asbestos content.
  • Evaluate building materials. A professional asbestos manager with qualifications similar to those of managers employed in school districts may be hired. This person can inspect your home to determine whether asbestos is present and give advice on its proper management.
  • Test for asbestos. State and local health departments as well as regional EPA offices have lists of individuals and laboratories certified to analyze a home for asbestos and test samples for the presence of asbestos.

If Asbestos Is Found in Your Home:

In most cases, asbestos-containing materials in a home are best left alone. If materials such as insulation, tiling, and flooring are in good condition and out of the reach of children, there is no need to worry. However, if materials containing asbestos are deteriorating or if you are planning renovations and the materials will be disturbed, it is best to find out whether the materials contain asbestos before renovations begin and, if necessary, have the materials properly removed.

Asbestos Removal:

  • Improper removal of asbestos may cause serious contamination by dispersing fibers throughout the area.
  • Any asbestos removal in a home must be performed by properly accredited and certified contractors. A listing of certified contractors in your area may be obtained from state or local health departments or from the regional office of the EPA. Many contractors who advertise themselves as asbestos experts have not been trained properly. Only contractors who have been certified by the EPA or by a state-approved training school should be hired. The contractor should provide written proof of up-to-date certification.
  • Children should not be permitted to play in areas where there are asbestos-containing materials.