title: The environment in pediatric practice: a study of New York pediatricians' attitudes, beliefs, and practices towards children's environmental health.
abstract: Chronic diseases of environmental origin are a significant and increasing public health problem among the children of New York State, yet few resources exist to address this growing burden. To assess New York State pediatricians self-perceived competency in dealing with common environmental exposures and diseases of environmental origin in children, we assessed their attitudes and beliefs about the role of the environment in children's health. A four-page survey was sent to 1,500 randomly selected members of the New York State American Academy of Pediatrics in February 2004. We obtained a 20.3% response rate after one follow-up mailing; respondents and nonrespondents did not differ in years of licensure or county of residence. Respondents agreed that the role of environment in children's health is significant (mean 4.44 +/- 0.72 on 1-5 Likert scale). They voiced high self-efficacy in dealing with lead exposure (mean 4.16-4.24 +/- 0.90-1.05), but their confidence in their skills for addressing pesticides, mercury and mold was much lower (means 2.51-3.21 +/- 0.90-1.23; p < 0.001). About 93.8% would send patients to a clinic "where pediatricians could refer patients for clinical evaluation and treatment of their environmental health concerns." These findings indicate that New York pediatricians agree that children are suffering preventable illnesses of environmental origin but feel ill-equipped to educate families about common exposures. Significant demand exists for specialized centers of excellence that can evaluate environmental health concerns, and for educational opportunities.
authors.affiliation: Center for Children's Health and the Environment, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA. leo.trasande@mssm.edu
authors.forename: Leonardo
authors.initials: L
authors.lastname: Trasande
authors.forename: Joseph
authors.initials: J
authors.lastname: Boscarino
authors.forename: Nathan
authors.initials: N
authors.lastname: Graber
authors.forename: Raphael
authors.initials: R
authors.lastname: Falk
authors.forename: Clyde
authors.initials: C
authors.lastname: Schechter
authors.forename: Maida
authors.initials: M
authors.lastname: Galvez
authors.forename: George
authors.initials: G
authors.lastname: Dunkel
authors.forename: Jessica
authors.initials: J
authors.lastname: Geslani
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Moline
authors.forename: Evonne
authors.initials: E
authors.lastname: Kaplan-Liss
authors.forename: Richard K
authors.initials: RK
authors.lastname: Miller
authors.forename: Katrina
authors.initials: K
authors.lastname: Korfmacher
authors.forename: David
authors.initials: D
authors.lastname: Carpenter
authors.forename: Joel
authors.initials: J
authors.lastname: Forman
authors.forename: Sophie J
authors.initials: SJ
authors.lastname: Balk
authors.forename: Danielle
authors.initials: D
authors.lastname: Laraque
authors.forename: Howard
authors.initials: H
authors.lastname: Frumkin
authors.forename: Philip
authors.initials: P
authors.lastname: Landrigan
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002669:Child Welfare; D002675:Child, Preschool; D003625:Data Collection; D004782:Environmental Health; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D010372:Pediatrics; D010820:Physicians