Agency for Toxic Substances and Disease Registry 
Case Studies in Environmental Medicine (CSEM) 
Pediatric Environmental Health
Appendix C: Summary of Questions for an Environmental History

Issue: The child's home, school, or day-care center might expose him or her to potential toxicants.

• Do you live in an apartment, house, or mobile home?
• On what level of your dwelling is the child's room located?
• What are the age and condition of your home?
• How is your home heated?
• Do you have a fireplace or a wood stove?
• Do you use pesticides inside or outside your home (including use on children and pets)?
• What are the hobbies of your child and other family members?
• Is your home (day-care center, etc.) near a polluted body of water, industrial plant, commercial business, or dump site?

Issue: Family members' jobs might involve exposure to contaminants.

• What is your occupation?
• What is your spouse's occupation?
• Do other members of the family have jobs?
• If so, what are they?
• For teenagers:
  • Do you work?
  • What kind of job do you have and what hours do you work?

Issue: The child might be exposed to tobacco smoke.

• Do you smoke tobacco products?
  • If yes, do you smoke in your home?
• Does your spouse, other family member, or babysitter smoke?

• If you take your child to a babysitter, does he or she smoke at home?

• Do visitors smoke in your home?

• Does anyone smoke in your car?

Issue: The child might eat food contaminated with environmental toxicants.

• For breastfeeding mothers:
  • Have you tested your water supply for lead?
• If not and you make the baby's formula with tap water, what procedure do you follow?
  • Do you ever use hot tap water or water from instant hot taps or refrigerator taps to make the formula?
• Do you wash fruits and vegetables before giving them to your child?
  • What do you wash them with?
  • What kind of produce do you usually buy? Organic? Local? In season?
• Does the child live with an adult whose job or hobby involves exposure to lead?

Issue: The child might be at high risk for lead poisoning.

• Is there a brother, sister, housemate, or playmate being followed or treated for lead poisoning (i.e., blood lead 15 µg/dL)?

• Does the child live with an adult whose job or hobby involves exposure to lead?

• Does the child live near an active lead smelter, battery recycling plant, or other industry likely to release lead?

• Do you use home remedies or pottery from another country?

Adapted from Balk (1996).

When To Introduce Environmental Questions

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