Introduction to the Mid-America Pediatric Environmental Health Unit (MAPEHSU)

1
Introduction to the Mid-America Pediatric
Environmental Health Unit (MAPEHSU)

• Jennifer Lowry, MD
• Co-Director, MAPEHSU
• University of Kansas Medical Center
• Kansas City, KS

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WHAT IS A PEHSU?

• PEHSU program established in 1998
• A PEHSU site is comprised of collaboration
  between an AOEC Occupational Environmental
  Medicine Clinic and supporting institutions
  pediatric department
• PEHSU staff include a project director, OEM
  physician, pediatrician, project coordinator and
  other specialists.
• Goal is to increase awareness and knowledge of
  pediatric environmental health

3
PEHSU Locations www.aoec.org

• Region 7 Kansas City, KS
• Region 8 Denver, CO
• Region 9 Irvine San Francisco, CA
• Region 10 Seattle, WA
• Alberta, Canada
• Morelos, Mexico

• Region 1 Boston, MA
• Region 2 New York, NY
• Region 3 Washington, D.C.
• Region 4 Atlanta, GA
• Region 5 Chicago, IL
• Region 6 Tyler, TX

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Insert PEHSU Map

• It is on a separate PPT file

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Pediatric Environmental Health Specialty Units
(PEHSU)

• The objective of the PEHSU Program is to
  increase the knowledge base of pediatric
  environmental medicine by providing a forum for
  environmental specialists and pediatricians to
  combine knowledge for the purpose of providing
• Education
• Consultation
• Referral

6
PEHSU BEGINNING

• 1996 ATSDR Child Health Initiative
• 1996 to 1998 PEHSU Program Catalyst
• Methyl Parathion Exposure in 400 children
• Mercury Exposure
• 1998 first 2 PEHSU sites formed in Seattle, WA
  and Boston, MA.

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PEHSU Purpose

• The overall purpose of the PEHSU program is to
  bring together the environmental and pediatric
  specialties to include not only pediatricians,
  but also primary care providers such as family
  medicine physicians, nurse practitioners and
  nurses

8
PEHSU Structure

• The structure of PEHSU sites is built around an
  arrangement between an Occupational and
  Environmental Medicine Clinic (an AOEC member
  clinic) and a supporting institutions pediatric
  department. Generally, a PEHSU is located within
  an academic institution.

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PEHSU SERVICES

• Consultation Provides clinical/medical
  consultation to practicing clinicians and health
  officials
• Education/Outreach Provides pediatric
  environmental health education to practicing
  clinicians/health professionals, clinical
  trainees and the general public
• Referral Provides referral to public health
  agencies and clinical sub-specialists with
  interest in pediatric environmental health

10
Funding and Program Management of PEHSU Program

• Agency for Toxic Substances Disease Registry
  (ATSDR)
• U.S. Environmental Protection Agency (EPA)
• Association of Occupational Environmental
  Clinic (AOEC) provides program management

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What is the MAPEHSU?

• Serve EPA Region 7 (Iowa, Kansas, Nebraska and
  Missouri)
• Serve health care professionals and general
  public
• Consultation
• To physicians and health care providers
• Referral
• To health agencies with an interest in pediatric
  environmental health
• Education Outreach
• Partnership with regional Poison Control Centers

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Activities to Date

• School bus particulate matter and health effects
  on school children grant, April 2005
• Pediatric Environmental Health Conference,
  December 2005, Kansas City, MO
• Web-based CME program, anticipated availability
  December 2005
• Educational presentations and exhibits at
  professional conferences
• Sponsor of EPA Region 7 Indoor Air Quality
  Conference, October 2005
• Consultation with ATSDR, EPA and health
  departments

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Poison Control Center Data (2003)

• Leading Toxic Exposures in children
• Cosmetics/personal care products
• Analgesics
• Cleaning substances (household)
• Cold and cough preparations
• Topical preparations
• Pesticides
• Antidepressants
• Foreign bodies/toys/miscellaneous
• Plants
• Antimicrobials

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Cleaning Substances (Household)

• Leading toxic substances
• Hypochlorite bleach
• Isopropanol glass cleaner
• Carpet/upholstery cleaner
• Alkali wall/floor/tile cleaner
• Granular dishwasher detergent
• Granular laundry detergent
• Liquid/gel dishwasher detergent
• Anionic/nonionic miscellaneous cleaner
• Alkali miscellaneous cleaner
• Unknown miscellaneous cleaner

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Plants

• Leading plant exposures
• Oxalates
• Dermatitis
• Gastrointestinal irritant
• Amygdalin/cyanogenic glycoside
• Solanine
• Cardiac Glycosides
• Hallucinogenic
• Other toxic
• Non-toxic
• Unknown toxic or if toxic

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Pesticides

• Leading Toxic Exposures
• Anticoagulant superwarfarin
• Insect repellant with DEET
• Borate/boric acid
• Pyrethroid
• Organophosphate
• Carbamate
• Insect repellant without DEET
• Naphthalene
• Chlorophenoxy
• Other insecticide

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Foreign body/toys/miscellaneous

• Leading Exposures
• Dessicants
• Small toys
• Glow products
• Mercury thermometers
• Feces/urine
• Bubble blowing solution
• Soil
• Coins
• Other

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• Our Team
• Jennifer Lowry, MD (Toxicologist)
• Kathryn Veal, MD, MPH (Pediatrician)
• H. William Barkman, MD, MSPH (Occupational
  Medicine)
• Mary Walker, Project Coordinator
• [phone] - toll free in EPA Region 7
• website www2.kumc.edu/mapehsu
• email address mapehsu_at_kumc.edu