A growing body of research ties environmental pollutants to worse health and shorter life spans for childhood cancer survivors. Yet medical providers lack sufficient resources to address these risks with patients, a recent federally funded study found.
The study , published in Cancers, revealed 80% of pediatric oncology providers surveyed received questions from families about the impact of environmental pollutants on children's health, but only 25% of providers said they felt comfortable discussing the topic.
If you believe children in every state should have the cleanest air, water, and environment, then we need policymakers, medical providers, and communities to come together.
"Medical providers receive little to no education or clinical training on the impacts of environmental pollutants like pesticides and wildfire smoke but need resources to better treat patients," said Mark Miller , MD, MPH, senior author of the study and an associate professor in UCSF's Occupational and Environmental Medicine division.
To fill the gap, UCSF's Western States Pediatric Environmental Health Specialty Units (WSPEHSU) is partnering with physicians from across the country to help develop a pediatric cancer environmental referral service. The service will take children's environmental health histories and risk assessments, then provide a toolkit to their families. The kit will include air quality and carbon dioxide monitors, an air purifier, and simple and cost-effective strategies to reduce exposure to harmful pollutants.
"Many families express frustration that there are not enough resources to prevent and reduce the impact of environmental pollutants on their kids," said first author Omar Shakeel, MD, a pediatric hematologist and oncologist at Texas Children's Hospital. "Ninety-six percent of pediatric cancer providers reported in our study that an environmental referral service would help address these families' concerns."
Exposure to pollutants - like pesticides, wildfire smoke, and tobacco smoke - largely goes unnoticed day to day but has serious long-term consequences. Studies have shown pesticides decrease brain and behavioral function in children, while wildfire smoke has the following impacts, according to past research by Miller:
- Developing or worsening chronic lung diseases like asthma
- Exacerbating ADHD and autism, and worsening school performance
- Decreasing birth weight and height and increasing obesity
- Increasing exposure to known carcinogenic chemicals like benzo(a)pyrene, formaldehyde, and benzene
One Texas study showed childhood cancer survivors had higher death rates if they resided at the time of diagnosis near an oil or gas well, which emit hazardous pollutants. Another found that pediatric cancer survivors living in Utah zip codes with higher levels of particulate air pollutants had an increased risk of respiratory hospitalization and death.
Additional research has found that paternal smoking before conception and secondhand smoke exposure during and after pregnancy both increase the death rate of childhood cancer survivors.
"If you believe children in every state should have the cleanest air, water, and environment, then we need policymakers, medical providers, and communities to come together," said Miller. "Increasing federal funding for research and resources could help reduce children's exposure to dangerous pollutants, while improving health and survival outcomes."
Authors: Please see the paper for a full list of authors.
Funding: The Centers for Disease Control and Prevention's Agency for Toxic Substances and Disease Registry, the U.S. Environmental Protection Agency (EPA), and the Public Health Institute.
Disclosures: The authors declare no conflicts of interest. The funders had no role in the writing of the manuscript or in the decision to publish the results.
About UCSF Benioff Children's Hospitals
UCSF Benioff Children's Hospitals are among the nation's leading pediatric specialty hospitals, according to U.S. News & World Report 2023-24 rankings. Their expertise covers virtually all pediatric conditions, including cancer, heart disease, neurological disorders, pulmonology, diabetes and endocrinology, as well as the care of critically ill newborns. The two campuses in San Francisco and Oakland are known for basic and clinical research, and for translating research into interventions for treating and preventing pediatric disease. They are part of UCSF Health, whose adult hospital ranks among the top medical centers nationwide and serves as the teaching hospital for the University of California, San Francisco, a national leader in biomedical research and graduate-level health/sciences education. Visit https://www.ucsfhealth.org .
