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The Child as Susceptible Host: A Developmental Approach to Pediatric Environmental Medicine

Key Concepts
  • Childhood is a time of rapid growth and development. It is accompanied by changes in organ system functioning, metabolic capabilities, physical size, and behavior that can dramatically modify the effects, the illness, or both caused by toxicant exposure. Pediatricians and other clinicians caring for children need to understand these special susceptibilities.
  • Pediatric environmental medicine is a new subspecialty. It concentrates on the prevention, diagnosis, and treatment of illnesses due to preconception, prenatal, perinatal, and childhood exposures to environmental hazards.
  • Pediatric environmental medicine experts staff 10 pediatric environmental health specialty units (1 in each of 10 U.S. Environmental Protection Agency regions). These experts are available for consultation and referral.
About This and Other Case Studies in Environmental Medicine

This educational case study document is one in a series of self-instructional modules designed to increase the primary care provider’s knowledge of hazardous substances in the environment and to promote the adoption of medical practices that aid in the evaluation and care of potentially exposed patients. The complete series of Case Studies in Environmental Medicine is located on the ATSDR Web site at URL: In addition, the downloadable PDF [PDF – 724 KB] version of this educational series and other environmental medicine materials provides content in an electronic, printable format, especially for those who may lack adequate Internet service.


We gratefully acknowledge the work that the medical writers, editors, and reviewers have provided to produce this educational resource. Listed below are those who have contributed to development of this version of the Case Study in Environmental Medicine.

Please Note: Each content expert for this case study has indicated that there is no conflict of interest to disclose that would bias the case study content.

CDC/ATSDR Developer: Pamela G. Tucker, MD

CDC/ATSDR Planners: Charlton Coles, PhD; John Doyle, MPA; Kimberly Gehle, MD; Trang Nguyen, MPH, CHES; Barbara M. Riley, RN; Delene Roberts, MSA

Contributing Authors: Rose Goldman, MD; Alan Woolf, MD; Michael Shannon, MD

Peer Reviewers: Sophie Balk, MD; Cynthia Bearer, MD

Content Experts: Rose Goldman, MD; Alan Woolf, MD; Sophie Balk, MD; Cynthia Bearer, MD

Disclaimer and Disclosure

The state of knowledge regarding the treatment of patients potentially exposed to hazardous substances in the environment is constantly evolving and is often uncertain. In developing its educational products, ATSDR has made a diligent effort to ensure the accuracy and the currency of the presented information. ATSDR, however, makes no claim that the environmental medicine and health education resources discussed in these products comprehensively address all possible situations related to various substances. The products are intended for educational use to build the knowledge of physicians and other health professionals in assessing the conditions and managing the treatment of patients potentially exposed to hazardous substances. The products are not a substitute for a health-care provider’s professional judgment. Please interpret the environmental medicine and the health education resources in light of specific information regarding the patient and in conjunction with other medical authorities.

Use of trade names in ATSDR products is for identification purposes only and does not imply endorsement by the Agency for Toxic Substances and Disease Registry or the U.S. Department of Health and Human Services.

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U.S. Department of Health and Human Services
Agency for Toxic Substances and Disease Registry
Division of Toxicology and Environmental Medicine
Environmental Medicine and Educational Services Branch