Environmental illness: educational needs of pediatric care providers

Abstract

Background Assessing the impact of children's exposures to environmental toxins is an emerging new subspecialty in clinical pediatrics. However, pediatric health professionals in practice may not be familiar with critical information necessary to diagnose and manage environmental toxic exposures in children.

Objective The objective of this study was to investigate the perceptions of pediatricians, nurses, and nurse practitioners regarding their own practices and educational needs concerning pediatric environmental exposures.

Methods Health professionals attending a general pediatric postgraduate course were administered a 22-item questionnaire on their practices and educational needs in children's environmental health.

Results A total of 93% of participants returned usable questionnaires. Within the previous 6 months, over 90% of pediatricians and nurse practitioners had diagnosed food poisoning; almost 50% had diagnosed lead poisoning; 50% had diagnosed a child's illness as due to exposure to a toxic chemical; and 24% had diagnosed ‘building-related illness.’ Although 90% of pediatricians and 82% of nurses and nurse practitioners stated that they routinely asked families about parental occupations, only 35% of both groups asked about parental hobbies. Only 58% of the groups asked about smoke detectors in the home, and only 18% of nurses and 9% of pediatricians queried families about their use of radon detectors. Over 70% of all three groups indicated a high interest level in the following postgraduate educational topics: taking in environmental history, breast milk contaminants, food allergies, food contamination, and illness related to tobacco smoke. Topics that did not garner as high an interest level included: childhood lead poisoning, radon poisoning, and building-related illness.

Conclusion Pediatric health professionals commonly diagnose environment-related illnesses, and they include such topics during well child care. They indicate a variety of educational needs concerning pediatric environmental health issues.

Implications for practice Health care professionals are increasingly asked by parents to include environmental toxins among the possible causes of a child's ill health. Our results suggest that clinicians recognize their own need for further training in the principles of pediatric environmental health. Further research is needed in determining which modalities are best suited to achieve such educational objectives.