Carcinogen risk assessment guidelines and children.

Over two years ago, the White House issued Executive Order 13045, "Protection of Children from Environmental Health Risks and Safety Risks," which called upon federal agencies to identify and assess environmental health and safety risks that may disproportionately affect children and to ensure that their policies, programs, and standards address these risks (1). The executive order reflected a growing emphasis on well-recognized differences in the exposures, metabolism, and disease responses of infants and children to chemical exposures. Concern about the special vulnerability of infants and children to environmental exposures, particularly pesticides, prompted the U.S. Congress in 1988 to request that the National Academy of Sciences study this issue. This study resulted in the important 1993 report Pesticides in the Diet ofInfants and Children (2). In its National Agenda to Protect Children from Environmental Health Threats, the U.S. Environmental Protection Agency (EPA) committed itself to ensuring that all standards it adopts will protect children (3). In 1997, the EPA solicited comments from the public on which standards to reevaluate to assess special needs of children, and a national advisory committee identified several topics-mercury emissions, protection from farm chemicals, atrazine in food and water, and organophosphate and carbamate pesticides (4). The focus on children is reengaging the public health community in the environmental health arena after a period of seeming indifference. This shift, coupled with a renewed emphasis on the safety of food and water supplies, represents a renaissance for environmental health and an important challenge. The protection of children will require, among other things, that guidelines for carcinogen risk assessment address children. These concerns make the proposed revised EPA guidelines for carcinogen risk assessment of particular interest. It is important to ensure that the guidelines address cancer risks for children and to protect children and infants. The most recent draft of the guidelines was issued in 1996 (5). The draft was released before adoption of the executive order and did not include any direct mention of how to assess the particular needs of children. This draft remains under review. Federal policy has one example of a statute written with the intent of providing special protections for infants and children. The Food Quality Protection Act (FQPA) (6), passed in 1996 by a unanimous vote of the Congress, amended federal laws regarding pesticides in two ways that were particularly important for children. First, the statute requires that when allowable levels of pesticides for …