TAILIEUCHUNG - Environmental Toxicants and Maternal and Child Health: An Emerging Public Health Challenge

Patients with kidney disease may present with abnormal urinary findings. A carefully performed urinalysis using physical, chemical, and microscopic examination is an easy and informative tool to the practicing physician [4]. The American Academy of Pediatrics recommends a urinalysis as a part of preventive pediatric health care at age 5 years and mid-adolescence [5]. An abnormal urinalysismay be the only presenting sign of chronic GN. The most common urinary abnormalities are hematuria and proteinuria. Hematuria may be gross or microscopic, discovered during a routine urinalysis. Evaluation of the child with hematuria may be easily initiated by the primary care and, when indicated, an audiogram on immediate family members should be performed, since recurrent. | Envi ental Toxicants anj Maternal and Child Health3 r Ju An Emerging PubliclHealth Challenge This brief provides an overview of environmental toxicants with regard to preconception and perinatal health summarizes efforts to inform women and health care providers outlines possible strategies for increasing awareness and surveillance efforts and identifies resources for additional information for public health professionals. A growing body of research suggests that maternal exposure to environmental toxicants poses a risk to women s health as well as to fetal and child health and development. While the evidence is not entirely conclusive there is substantial evidence linking hazardous toxicants with increased risk of Miscarriage Intrauterine growth restriction Low birth weight Preterm birth Birth defects Motor and cognitive delays in children 1-8 Of equal concern is the potential effect of toxins on a woman s health regardless of her reproductive plans choices or history. Environmental toxicants have been implicated in asthma breast cancer and hormonal imbalances among women. There has been recent notable action in addressing the impact of environmental toxicants on child health including the creation of the Environmental Protection Agency s EPA Office of Children s Health Protection in 1997. However there has been much less focus on the effect of toxic substances on the health of women preconceptionally and during pregnancy. As public health programs face the intractable problems of low birth weight and preterm birth even with advanced technology and enhanced prenatal care the arena of environmental toxicants is ripe for investigation and action. To ensure population health maternal and child health MCH professionals need to expand their focus to include the environmental factors that influence health in the earliest stage of life and the preconception This topic is important to MCH generally since many exposures are ubiquitous but also because the impact .

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