Many parents of severely food-allergic children, and food-allergic teenagers cannot correctly administer their self-injectable epinephrine and may not have the medication readily available. Pediatricians are not familiar with these devices and may fail to review their use with patients. Improved patient and physician education is needed to ensure proper use of this life-saving medication.
ROR is an important intervention, promoting parental literacy support and enhancing language development in impoverished preschool children. Integration of literacy promoting interventions such as these into routine pediatric health care for underserved populations can be recommended.
Phytoestrogens and PCBs are environmental exposures that may delay breast development, especially in conjunction with BMI, which governs the endogenous hormonal milieu. Further research to confirm these findings may improve our understanding of the role of early life development in breast cancer risk and other chronic diseases related to obesity.
The US market for organic foods has grown from $3.5 billion in 1996 to $28.6 billion in 2010, according to the Organic Trade Association. Organic products are now sold in specialty stores and conventional supermarkets. Organic products contain numerous marketing claims and terms, only some of which are standardized and regulated. In terms of health advantages, organic diets have been convincingly demonstrated to expose consumers to fewer pesticides associated with human disease. Organic farming has been demonstrated to have less environmental impact than conventional approaches. However, current evidence does not support any meaningful nutritional benefits or deficits from eating organic compared with conventionally grown foods, and there are no well-powered human studies that directly demonstrate health benefits or disease protection as a result of consuming an organic diet. Studies also have not demonstrated any detrimental or disease-promoting effects from an organic diet. Although organic foods regularly command a significant price premium, well-designed farming studies demonstrate that costs can be competitive and yields comparable to those of conventional farming techniques. Pediatricians should incorporate this evidence when discussing the health and environmental impact of organic foods and organic farming while continuing to encourage all patients and their families to attain optimal nutrition and dietary variety consistent with the US Department of Agriculture’s MyPlate recommendations. This clinical report reviews the health and environmental issues related to organic food production and consumption. It defines the term “organic,” reviews organic food-labeling standards, describes organic and conventional farming practices, and explores the cost and environmental implications of organic production techniques. It examines the evidence available on nutritional quality and production contaminants in conventionally produced and organic foods. Finally, this report provides guidance for pediatricians to assist them in advising their patients regarding organic and conventionally produced food choices.
Drinking water for approximately one sixth of US households is obtained from private wells. These wells can become contaminated by pollutant chemicals or pathogenic organisms, leading to significant illness. Although the US Environmental Protection Agency and all states offer guidance for construction, maintenance, and testing of private wells, there is little regulation, and with few exceptions, well owners are responsible for their own wells. Children may also drink well water at child care or when traveling. Illness resulting from children's ingestion of contaminated water can be severe. This report reviews relevant aspects of groundwater and wells; describes the common chemical and microbiologic contaminants; gives an algorithm with recommendations for inspection, testing, and remediation for wells providing drinking water for children; reviews the definitions and uses of various bottled waters; provides current estimates of costs for well testing; and provides federal, national, state, and, where appropriate, tribal contacts for more information. Pediatrics 2009;123:e1123-e1137 BACKGROUND Approximately 15% to 20% of households in the United States obtain their water from private wells. 1 Public drinking water systems are regulated by the US Environmental Protection Agency (EPA), with national drinking water regulations providing the legally enforceable standards. Unlike municipal water supplies and some community wells, private wells are not subject to federal regulations and are minimally regulated by states. States sometimes require that a well be dug or drilled by a certified contractor and that the water from the well be tested at least once for nitrate and coliform bacteria. After that, the owner of the well is not required to inspect the well or test the water; only New Jersey requires testing at the time of resale. The states, the Navajo Nation, and the EPA offer suggested inspection and testing schedules (Appendix).Well water is not sterile, nor does it need to be, but it should be free of fecal contamination; such contamination is usually detected by coliform bacteria counts. In Iowa wells in the 1990s, 27% had coliforms. 2 Rigorous data are not available to compare the frequency of illness between children drinking well water versus municipal water. In a Canadian study of 235 rural households using well water, the odds of a child younger than 10 years having an episode of gastrointestinal illness, given the presence of at least 5 colony-forming units of Escherichia coli in the water, was 4.2 (95% confidence interval: 1.1-16.2) times higher than that for adults older than 50 years. 3 However, the risk as compared with the child drinking uncontaminated water was not studied. In a clinical trial of reverse-osmosis water filters, which should remove all infectious agents, in families drinking municipal water meeting bacteriologic standards, approximately 30% of acute gastrointestinal illnesses were prevented by the filters, with no difference according to age group. This study showed that even...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.