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Nikki Kilpatrick,¹ Howard Frumkin,^2,3 Jane Trowbridge,¹ Cam Escoffery,¹ Robert Geller,^3,4,5 Leslie Rubin,^3,4,6,* Gerald Teague,^3,4 and Janice Nodvin^3,6,*

¹Department of Behavioral Sciences and Health Education, and ²Department of Environmental and Occupational Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA; ³Pediatric Environmental Health Specialty Unit, and ⁴Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia, USA; ⁵Georgia Poison Center, Atlanta, Georgia, USA; ⁶Marcus Institute, Atlanta, Georgia, USA

Abstract

We conducted a mail survey of practicing pediatricians in Georgia to assess their knowledge, attitudes, and behaviors regarding recording patients' environmental histories. Of 477 eligible pediatricians, 266 (55.8%) responded. Fewer than one in five reported having received training in environmental history-taking. Pediatricians reported that they strongly believe in the importance of environmental exposures in children's health, and 53.5% of respondents reported experience with a patient who was seriously affected by an environmental exposure. Pediatricians agreed moderately strongly that environmental history-taking is useful in identifying potentially hazardous exposures and in helping prevent these exposures. Respondents reported low self-efficacy regarding environmental history-taking, discussing environmental exposures with parents, and finding diagnosis and treatment resources related to environmental exposures. The probability of self-reported history-taking varied with the specific exposure, with environmental tobacco smoke and pets most frequently queried and asbestos, mercury, formaldehyde, and radon rarely queried. The pediatricians' preferred information resources include the American Academy of Pediatrics, newsletters, and patient education materials. Pediatricians are highly interested in pediatric environmental health but report low self-efficacy in taking and following up on environmental histories. There is considerable opportunity for training in environmental history-taking and for increasing the frequency with which such histories are taken. Key words: children's environmental health, clinical history, environmental history, environmental medicine, medical history. Environ Health Perspect 110:823-827 (2002) . [Online 8 July 2002]

http://ehpnet1.niehs.nih.gov/docs/2002/110p823-827kilpatrick/ abstract.html

Address correspondence to H. Frumkin, Department of Environmental and Occupational Health, Rollins School of Public Health of Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA. Telephone: (404) 727-3697. Fax: (404) 727-8744. E-mail: medhf@sph.emory.edu

*Current address: May South, Atlanta, GA, USA.

We thank the many busy pediatricians who took the time to participate in this study.

This research was partially funded by the Southeast Pediatric Environmental Health Specialty Unit at Emory University, a project funded by the U.S. Environmental Protection Agency and the Agency for Toxic Substances and Disease Registry, through the Association of Occupational and Environmental Clinics. A preliminary version of these results was presented at the annual meeting of the American Public Health Association in Boston, Massachusetts, in November 2000.

Received 30 August 2001 ; accepted 3 February 2002.