Of course reducing toxic exposures is an important way to reduce risks from unhealthy chemicals, but a growing body of research suggests paying attention to positive habits – such as good food, healthy sleep and active play can often reduce or even eliminate harm when exposed.

An update on this emerging field of research appeared in October 2011 in the NIH journal Environmental Health Perspectives, focusing on the physical effects of stress and relaxation.

Psychological stress can change how chemicals affect the body. Stress has been demonstrated to change the effects of lead exposure and of exposure to air pollution in children. But much remains to be learned about other chemicals and other types of exposures. And about how this all works.

We know that some stress is good for children; a little adrenaline or cortisol can fuel kids to reach new heights of achievement. And we know that when stress becomes too prolonged, too severe or too frequent the immune system can be altered in a way that increases the impact of chemical pollution.

Sadly, sometimes the most stressful environments are also the most polluted.

In January 2011, Science to Achieve Results (STAR) research grants totaling $7 million were awarded by the EPA to work on new approaches to understanding how stress changes what happens when kids are exposed – and what we can do about it.

I’m excited about this, and expect it to uncover valuable new knowledge. But in the meantime, common sense makes sense. Follow Healthy Child Healthy World’s Five Easy Steps: Minimize pesticide exposure; use nontoxic products; clean up indoor air; eat healthy; and be wise about plastics. And do what it takes to minimize un-useful stress. Have fun together!

Cooney CM. Stress-Pollution Interactions: An Emerging Issue in Children’s Health Research. Environmental Health Perspectives. 2011; 119:a430-a435.

I remember, not long ago, seeing many children with ear infections every day I was in the office – children that were often up screaming the night before. Today it’s not surprising to go an entire day in clinic without seeing a single one.

Visits to doctors’ offices for ear infections more than doubled between 1975 and 1990, from about 10 million per year to about 25 million per year. They kept increasing through about 1994, when they started to decline steadily by about 5% per year, now at their lowest level in three decades.

Over thirteen years, office visits for ear infections in kids under age 6 dropped from about 640 visits per 1000 children per year to about 380 visits. The drop for hospitalized children being diagnosed with an ear infection is even steeper. And the annual price tag for ear infection treatment in the US has fallen by about $2 billion.

Why the dramatic disappearance?

Several things have changed since the early 1990s. Air pollution, linked to ear infections, fell significantly after the Clean Air Act of 1990. Breastfeeding, protective against ear infections, increased modestly from less than 2/3 of babies starting on mother’s milk to more than ¾ today. A vaccine that may help prevent some ear infections came into wide use in 2002.

But the strongest link, according to a May 2011 study from researchers at Harvard University, came from a drop in tobacco smoke inside children’s homes. We’ve known since the 1990’s that exposure to second hand smoke causes millions of ear infections every year. In 1993, most US children were still exposed to tobacco smoke in their own home. Today only 14 percent of kids live in a home where smoking is allowed inside – a change big enough to account for the difference.

Four thoughts for responding to this good news.

1. If you smoke, smoke outside.
2. Keep the air in your home fresh. Avoid cleaners with harsh fumes. Consider houseplants to clean the air. Open windows when practical.
3. Given the option, breast feed. After weaning, choose foods that support healthy gut bacteria.
4. If your child does get an ear infection, choose a gentle treatment first, if appropriate. Antibiotics are wonderful, when needed, but each time they are given it makes another ear infection more likely. With more resistant bacteria.

Alpert HR, Behm, I, Connolly GN, Kabir Z. “Smoke-free households with children and decreasing rates of paediatric clinical encounters for otitis media in the United States.” Tobacco Control. May 2011; 20:207-211.

Bhattacharyya N and Shapiro NL. “Air quality improvement and the prevalence of frequent ear infections in children.” Otolaryngology – Head and Neck Surgery. Feb 2010; 142:242-246

I remember being a child and hearing my parents talk about how fast time was moving. Now I’m the parent and I know what they were talking about. But not only is time moving more quickly for us as adults, today things around us are actually changing more quickly.

Here are five trends (and a bonus trend) that I see emerging now and my predictions for the trends that will continue in 2011:

1) Electronic Connections — Parent communities are bigger than ever, but less local. Families are busier than ever, but finding new ways to connect.

• Video chatting, such as Skype, is becoming the norm for extended families to stay in touch. Look for this to accelerate as it goes mobile on smartphones and tablets.
• Online photo and video sharing through social networking will continue to grow. Again, watch for more mobile, as smartphones replace more cameras and videocameras. Think Qik.
• For older kids playing online, turn based, games with parents will become as common as board games were for the last generation. Games like Words with Friends will take advantage of smart phone and tablet technologies to keep families connected.
• Look for JumpScan and other QR programs to facilitate connections (and even start replacing things like business cards, luggage tags, and identification for lost kids).
• Innovative companies like HealthTap and Quora will become popular ways to use electronic connections to get parents the answers they most want.

2) Real Food for Babies (and other humans) – The 1950s launched us into 60 years of processed foods. It may be slow at first, but 2011 will see some big changes.

• 2011 will be the year white rice baby cereal goes away.

New first foods will be real foods – such as bananas, avocado, and sweet potatoes.

• The family meal will make a resurgence. It won’t be the norm in 2011, but more meals will be eaten at home than in 2010.
• Healthy, quick food options will grow in availability. Look for convenience stores such as Fresh and Easy to do well in 2011.

3) Kicking Out Risky Chemicals (chemical awareness) — Parents are reading ingredient labels more than ever, not just on food. The President’s Cancer Panel presented in 2010 had a major impact, as well as the 2010 study linking ADHD to pesticides. The trend will grow in 2011.

• The green movement got it’s start in organic food, but an increasing number of parents will be looking for hidden toxics in cleaning supplies, gardening supplies, textiles, etc.
• Parents are choosing BPA-free, phthalate-free, PVC-free, plastics. BornFree has been a pioneer in safe plastics for kids even before most parents had heard of BPA. Now BornFree, Ecomom.com, Ikea, and others are becoming trusted leaders for parents who don’t have time to research for themselves, but want safe products.

4) Kitchen Kids — Thanks to Michelle Obama, Jamie Oliver, Chef Anne, Chef Jessie Cool and a host of others kids-food is getting renewed attention..

• In 2011 kids will get more and more involved in creating meals together before sitting down to eat.
• 2011 will see more families planting a garden. It may be as small as one tomato plant or one herb on a windowsill, but more kids will get the opportunity to see their food start from a seed.

5) The Natural Connections to the Outdoors — The last generation of parents became afraid to let their children play alone outdoors. This generation of parents is seeing the value of connecting their kids to nature.

• Look for more families in the park, more families playing outdoor sports, and a return to the family bike ride.
• Kids have too much homework. As a result, parents have downplayed the need to do family chores. Look for parents to join their kids for outdoor chores as a way to get sunshine (needed Vitamin D) and connect to the earth.
• Houseplants were big in the 70s and 80s. Don’t expect macramé to come back into style, but parents are becoming aware of the value of houseplants as inexpensive air filters. You’ll see more of them in 2011.
• Plastic toys are about as far from the outdoors as possible. Look for more quality, heirloom wooden toys to make it in the market place in 2011. Tegu is a great example of a young company creating an innovative toy in a sustainable way.

Bonus: Hot New Birthday Party for 2011 — Chef School

• Mom or Dad will accompany kids to the party and participate, making it more interactive than in the past.
• The Chef leading the class will be both teacher and entertainment (no clowns needed).
• Everyone participates in the preparation and at the end of the party they enjoy the food together — including homemade birthday cupcakes.
• If there’s not one in your area, call the local cooking school and ask them to create one for your child’s next birthday party!

All-in-all, I think 2011 is shaping up to be a pretty good year for famiies. What do you think?

Note: Dr. Greene is on the Board of Ecomom.com, the Medical Director of HealthTap, and works closely with BornFree to provide safe feeding products for children. He does not have a financial connection to any of the other brands mentioned.

A new study suggests that typical BPA exposure may be affecting the masculinity, semen quality, and sperm count of the average American guy. And young boys often have even more BPA exposure than adult men.

Researchers from Oakland, California and Shanghai, China compared the urine samples and semen samples of 218 men from four different regions of China. Some of the men had occupational exposure to BPA, some were exposed to BPA in the environment at levels below the median level found in American men, and some had no detectable BPA exposure.

On average, the higher the urine BPA level,  [a] the lower the sperm concentration, [b] the lower the total sperm count, [c] the poorer the  sperm vitality, and [d] the worse the sperm motility. Those with any BPA in the urine had more than three times the likelihood of lowered sperm concentration and lower sperm vitality, more than four times the likelihood of lower sperm count, and more than likelihood the risk of lower sperm motility, compared with men who did not have any BPA detectable in their urine.

Similar associations were found among men with environmental BPA exposure at levels just below the typical levels found in the average American man. More than 90 percent of American men tested have BPA in their urine.

An earlier study by the same group found decreased sexual function and sexual satisfaction with higher levels of BPA. Both studies demonstrate an association between BPA and reproductive problems, but neither can prove that BPA is the cause. The findings are consistent, though, with the results of randomized studies in other animals that do point to BPA as the cause. We can’t randomly give some men BPA to see the effects, so this is the best evidence we have.

We do know that BPA levels in humans can be markedly decreased by avoiding placing objects containing BPA in the mouth. While we wait to see what the American government will do about limiting BPA exposure, families can limit their own exposure by minimizing canned food, avoiding plastic food and beverage containers that contain BPA, and washing the hands after handling thermal cash register receipts.

Pregnancy and early childhood may be the most important time to minimize BPA exposure, but as an adult guy, I’m increasingly motivated to avoid exposure myself.

De-Kun Li, M.D., Ph.D, and Wei Yuan, M.D., Ph.D.c,e. “Urine Bisphenol-A (BPA) Level in Relation to Semen Quality.” Fertstert.org. Web. <http://www.fertstert.org/article/S0015-0282(10)02587-2/abstract>.

Li DK, Zhou Z, Miao M, He Y, Qing D, and Wu T. “Relationship between Urine Bisphenol-A (BPA) Level and Declining Male Sexual Function. J Androl.” Ncbi.nlm.nih.gov. Web. 01 Nov. 2010. <http://www.ncbi.nlm.nih.gov/pubmed/20467048>.

Li D, Zhou Z, Qing D, He Y, He Y, Wu T, and Miao M. “Occupational Exposure to Bisphenol-A (BPA) and the Risk of Self-Reported Male Sexual Dysfunction — Hum Reprod.” Oxford Journals | Medicine | Human Reproduction. N.p., 2010. Web. 01 Nov. 2010. <http://humrep.oxfordjournals.org/cgi/content/abstract/25/2/519>.

I pulled this ParentsTV video out of the vault of oldies, but goodies. In it, host Juli Auclare asks, “What parent doesn’t love making choices that are not only healthy for their kids, but safe for the environment, too?” That’s the premise of Dr. Greene’s book, Raising Baby Green.

I hope you enjoy watching this video packed with information and tips that will help you do what’s great for your kids and the planet.

For years doctors have encouraged parents to store toxic household cleaning products in locked cabinets, out of sight and reach of children. While this advice may have helped considerably, with injury from cleaning products in children declining 46 percent since 1990, a new study demonstrates that children under age 6 years are still at high risk of poisoning and other injuries from cleaning products in the home.

Spray bottles are the most common source of injury, and bleach is the most common agent.

Despite our best efforts, exposures and injuries are still common. US poison control centers still receive hundreds of thousands of calls each year because of unintentional poisonings from cleaning products. Each call is more than a statistic; it’s an important moment in the life of a family. And nearly 12,000 children were sick enough to be treated in US hospital emergency departments in 2006 alone.

To me, the old childproofing strategy has become out of date. Children are still being harmed. We haven’t seen much improvement in overall injury rates since 1996, and injuries from cleaners in spray bottles have actually increased. Meanwhile, effective non-toxic cleaning products are now available to get the job done at home.

When it comes to childproofing, I now recommend that expectant mothers and parents of young children replace their toxic household cleaning products with safer alternatives – reducing the risk both of immediate injury and of ongoing low-level exposure to dangerous chemicals.

Who is at risk?

The Center for Injury Research and Policy reviewed 17 years of ER data for children under age 6 to analyze the landscape of injuries from household cleaners. The results will be published in the September 2010 Pediatrics.

• Children age 1 to 3 account for 72 percent of injuries.
• One-year-olds alone account for 46 percent of injuries.
• Boys (59 percent) are more likely affected than girls (41 percent).
• More than 80 percent of poisonings occur while at home.

How are they injured?

• Poisoning is the most common (68 percent), followed by chemical burns (16 percent) and other injuries to the skin or eyes (10 percent).
• Spray bottles are the most common source (40 percent), followed by regular containers 30 percent), kitchenware (14 percent) and recently cleaned items (8 percent).
• Bleach is the most common product ingredient (37 percent), followed by hydrocarbons, acids/alkalis, detergents, and ammonia.

What’s the Solution?

None of the children’s injuries that resulted in the 267,269 emergency department trips in the study was necessary. Effective, safer ingredients are now available for every common household cleaning job.

Why should a parent who drives with a car seat clean with out-of-date chemistry?

For parents of children age 6 or under, doctors’ advice to lock-up toxic cleaners is no longer adequate. Instead, childproof by replacing products whose labels must say Danger, Warning, Harmful if Swallowed, or Use in a Well-Ventilated Space. If the label gives instructions for calling poison control or for emergency treatment, the product is dangerous.

Poisonings, burns, or other injuries from household cleaning products never need to happen again. Any injury to a child from a household cleaning product is one too many.

Most of us spend the vast majority of each day indoors, where air quality can be 2-5 times worse than outside. Indoor air quality issues revolve around environmental contaminants such as allergens and airborne chemicals.

• Chemicals that release fumes, called volatile organic compounds (VOCs), are in solvents, cleaning products, air fresheners, polishes, adhesives, paints, new carpeting and furniture. One study found that young kids in homes with high VOC levels were four times as likely to develop asthma.
• Dust mites and other indoor allergens love pillows and mattresses, and we often hear the statistic that up to 10 percent of the weight of a two-year-old pillow is made up of dust mites, living and dead, and their droppings. Enclosing mattresses and pillows in allergen-proof covers can keep the mites at bay, as can washing sheets and blankets in hot water weekly. Dust mite populations can also be controlled by reducing indoor humidity to below 60 percent and removing carpets from the bedroom.
• Stoves or heaters that burn gas, propane, kerosene, wood or charcoal produce carbon monoxide, and the gas can accumulate in poorly ventilated areas. Another dangerous source is from gasoline motors (such as cars or lawn mowers) that are running in enclosed spaces. Carbon monoxide is second only to heroin as a cause of death by poisoning in the US. A carbon monoxide detector is a simple tool that will give you peace of mind.
• One six-inch houseplant per 100 square feet of living area can filter VOCs and vastly improve your indoor air quality. Bamboo palms, Chinese evergreens and English ivies are the three best in removing formaldehyde, benzene and carbon monoxide from indoor air.
• Opening your windows to let polluted air out and fresh air in can noticeably improve indoor air quality.
• Household chores can help with air quality: dust often, keep your ducts clean and forego chemical cleaning products and air fresheners. Also, use a HEPA-filtered vacuum at least twice a week (plus a HEPA air purifier in a the bedroom of a child with asthma), and keep your plumbing in good repair to avoid mold growth.
• Keep the chemicals outside by taking your shoes off at the door to avoid tracking of contaminants, hanging dry-cleaned clothes outside before they make it to the closet and never smoking inside (better yet – take the pledge to never smoke!).

One of the most exciting reports I have ever read, Reducing Environmental Cancer Risk – What We Can Do Now, was released this week by the President’s Cancer Panel, along with significant coverage by Nicholas Kristof in The NY Times, Lyndsey Layton in The Washington Post and Liz Szabo in USA Today.

This signals a pivotal change in how we approach cancer (and, I hope, how we approach other illnesses that have increased in our lifetimes). The report acknowledges that we face “grievous harm” from chemicals that surround us every day and that we have “grossly underestimated” the amount of illness caused by these exposures – illness “that could have been prevented through appropriate national action.”

Why is this so exciting? By recognizing the importance of chemical and environmental causes of disease, we open the door to achievable environmental solutions. We can run in the right direction as we race toward prevention – not just race toward a cure. This report is about cancer – but the same issues apply to asthma, autism, learning disabilities, allergies, and more.

And it starts with kids. The report highlights the game-changing Environmental Working Group studies on umbilical cord blood that I helped EWG develop and release, where we found 180 carcinogens in babies (and 217 chemicals that were toxic to the brain or nervous system), even before the babies were born – chemicals that could set a trajectory for disease much later in life.

Parents can take simple steps right now to lower their children’s risk, from the cleaners you use in your home, to the plastics you use around food and beverages (watch our for BPA and phthalates!), to the sunscreens you put on your family’s skin.

In particular, the report highlights the value of organic food. There are ten foods (eleven, if you count wine) that I see as most important to choose organic.

And we can work together to change our chemical laws, under which the government has only assessed about 200 chemicals for safety out of the 80,000 chemicals on the market.

It’s a new era in our fight against cancer. It’s a new era for health.

An important study of chronic illness in children uncovered a dramatic change between 1994 and 2006. The study followed thousands of 2 to 8 year old children for 6 years. Twice a year, the researchers looked for the presence of any physical or mental condition that prevented the child from attending school regularly, enjoying usual childhood activities that required frequent doctor visits, ongoing medication, or special medical equipment.

The percentage of American kids with chronic illnesses about doubled between the group ending in 1994 and the group ending in 2006! A stunning 51.5 percent of the kids in the most current group suffered from a chronic illness at some point during the six years they were followed.

Many conditions in children are on the rise, including asthma, autism, ADHD, allergies, genital birth defects, early puberty, and some types of cancers. When illnesses increase so rapidly, it’s not that more kids are suddenly inheriting these conditions, it’s something that has changed in our environment: how we eat, how we move, the toxic chemicals to which we are exposed.

These environmental factors, especially early in life, can turn on and off different genes and have lasting effects (epigenetics).

The good news is that if there are environmental causes of the increases of our most pressing pediatric problems, it suggests there are environmental solutions. Little changes can make a big difference.

Van Cleave, J., Gortmaker, S.L., and Perrin, J.M. “Dynamics of Obesity and Chronic Health Conditions Among Children and Youth” JAMA. 2010;303(7):623

Whether your child is a baby learning to crawl across the floor, a toddler taking tentative steps of independence, or a confident older child, we pediatricians have recommended for years that parents lock up their cleaning products or keep them out of reach.

And for good reason. Even with our earnest reminders, there are more than 200,000 poisonings each year in the US from household cleaning products. Most of these are not very serious – but some are. In a recent annual report from the Poison Control Centers there were deaths from ingesting household cleansers, from dishwashing detergent, from laundry detergent, from toilet bowel cleaners, and from mixed cleaners (someone thought this last was Gatorade).

More than half of these poisonings were in children under six, but those over 6 still accounted for tens of thousands of poisonings.

Poisons in Our Midst: Cabinet Locks are Not the Answer

As concerning as these poisonings are, I’m perhaps even more concerned about these products when they are used as directed. When we spray, sponge, or splash them around our homes we’re releasing harsh chemicals into our air and leaving toxic residues on our surfaces.

Many parents choose their cleaning products because they grew up with them, or they’ve seen a cute ad, or they’re on special this week – without ever considering what toxic chemicals they’re bringing into their homes.

If a warning label must say Poison, or Danger, or Hazard, or Harmful or Fatal if Swallowed, or Use in a Well-Ventilated Area, there’s a good chance that this toxic chemical can have negative health effects on your children.

Ingredients in common cleaners have been linked to increased risk for asthma, cancer, reproductive problems, developmental problems, neurological problems, and endocrine disruption.  Even using certain cleaners during pregnancy before a child’s born, has been linked to higher rates of asthma in the child.

Take Charge: Do A Cleaning Cabinet Makeover

Updating this one small part of your home could make your whole home – and family – healthier and safer. It’s a little step, but the effects can really add up.

Whether you store your cleaning supplies in the laundry room, in the garage, in a cupboard up high, or like millions of Americans under the kitchen sink, you owe it to your family to look at the labels of the products in your home.

Warnings that you do see on labels give you good clues to dangers, but sadly what you don’t see on the label may still fool you. Companies aren’t required to list all of their ingredients and, frighteningly, many chemicals have never been tested for safety.

If the product is toxic, or if you don’t know whether it is or not, why continue to use it routinely?

Getting Rid of Hazardous Waste

When you’ve decided you’re done with these toxic cleaners, don’t put them in the garbage or pour them down the shower or bathtub drain, flush them down the toilet, or dump them in your backyard. Instead take a celebratory trip to your nearest hazardous waste collection site for safe disposal. And treat yourself on the way home – you’ve done something great for your family.

To find out how to do this where you live, do a quick search on “hazardous waste” along with the name of your town. There should be an easy option close by. And yes, if a label says Hazard, etc.,  it is hazardous.

Restock Right

Choose today’s new generation of green cleaner that can get the job done and do it safely. Use only companies that commit to listing all of their ingredients on the label. Or choose one of the safe homemade cleaners described in Raising Baby Green. Look for safe ingredients that you’d be glad to have in your home.

Now THAT’S child-proofing done right, for the 21st century. No longer just preventing injuries, but going beyond that to choose health.

^{Lai, M.W., Klein-Schwarz, W., Rodgers, G.C., Abrams, J.Y., Haber, A.B., Bronstein, A.C., and Wruk, R.N. “2005 Annual Report of the American Association of Poison Control Centers’ National Poisoning and Exposure Database.” Clinical Toxicology, 2006, 44:803-932.}