[Pediatric environmental health specialty units in Europe: from theory to practice]

Abstract

Background: The World Health Organization encourages the development of strategies to identify, increase awareness and solve problems of Pediatric Environmental Health (PEH) in units and centers of excellence. Pediatricians are in an excellent position to identify children at environmental risk, advise parents about the best way to reduce or prevent these risks, and recommend changes in health policies to politicians.

Objective: To inform pediatricians about the underlying principles and activities of pediatric environmental health specialty units (PEHSU) in Spain and Europe. To analyze up-to-date knowledge and the steps required for the development of PEH in Spain and Europe.

Material and methods: Review of the strategies, initiatives and examples of useful practices for national and international organizations involved in the development and implementation of PEH. Report of activities of PEHSUs.

Results: In Spain and Europe pediatricians do not receive training in PEH. PEHSUs are centers specialized in the diagnosis, treatment, and prevention of environmentally-related diseases. These centers are composed of multidisciplinary teams of health and other professionals, coordinated by pediatricians specialized in PEH, that have the study of environment-related pediatric problems as a common denominator. The activity of these units emphasizes teaching, research, scientific activity, the development of environmental history in pediatrics, diagnosis and treatment of the "pediatric environmental wound", assessment of risks in pediatrics, and specialization in the critical review of the literature on PEH to train pediatricians to be experts in environmental health. The activities and fields of PEHSU can be summarized as: medical care, training, research, and community health (school health).

Conclusions: PEH should be considered by Ministries of Health and Pediatrics Associations as an important emergent area for current and future generations of pediatricians. Thus, it is necessary: a) to develop an integral plan for pediatric training in PEH; b) to actively seek funding and support to increase the presence of PEHSUs in Europe, and c) to create expert committees in PEH in National Associations of Pediatrics in Europe.