title: Pediatric Environmental Health Specialty Units: An Analysis of Operations.
abstract: BACKGROUND
  In 1998 the Agency for Toxic Substances and Disease Registry (ATSDR) secured the first federal funding to develop an innovative network of public health-oriented entities: Pediatric Environmental Health Specialty Units (PEHSUs). PEHSU goals were to provide pediatric and environmental health education to health care providers and health profession students, to offer consultation to health care professionals, parents, and others regarding environmental health exposures, and to provide referrals to specialized medical resources when necessary. This report analyzes the productivity of US PEHSUs from 1999 to 2014.
  
  
  METHODS
  This was a retrospective analysis of federally mandated quarterly reports filed by each PEHSU. These reports document specific goal-related deliverables outlined under cooperative agreements awarded to the Association of Occupational and Environmental Clinics (AOEC) with funding from the Environmental Protection Agency (EPA) and ATSDR. Costs were obtained from grant budget information available from the administrator of the grants, AOEC.
  
  
  RESULTS
  Total EPA/ATSDR funding for PEHSUs paid to AOEC during 1999-2014 was $23,847,452. The average cost to the EPA/ATSDR of running each PEHSU in 2014 was $169,256. Through over 8000 consultations and educational activities, PEHSUs reached 702,506 people: 298,936 health professionals, 61,947 health professional trainees, 323,817 members of the public, and 17,806 public health officials and others.
  
  
  CONCLUSIONS
  PEHSUs have grown into an established, productive network of clinical and educational centers whose expertise and activities have benefited both the public and health care professionals alike. The federal contributions to the cost of operating these centers have been more than offset by the benefits PEHSUs have conferred on the communities they serve.
authors.affiliation: Pediatric Environmental Health Center, Division of General Pediatrics, Boston Children's Hospital, Region 1 New England Pediatric Environmental Health Specialty Unit (PEHSU), and Harvard Medical School, Boston, Mass. Electronic address: alan.woolf@childrens.harvard.edu.
authors.forename: Alan D
authors.initials: AD
authors.lastname: Woolf
authors.affiliation: Association of Occupational and Environmental Clinics, Washington, DC.
authors.forename: Christopher
authors.initials: C
authors.lastname: Sibrizzi
authors.affiliation: Association of Occupational and Environmental Clinics, Washington, DC.
authors.forename: Katherine
authors.initials: K
authors.lastname: Kirkland
mesh_terms: D004501:Education, Medical / Q000458:organization & administration*; D004782:Environmental Health / Q000191:economics / Q000458:organization & administration*; D035082:Federal Government; D005380:Financing, Government; D006801:Humans; D010372:Pediatrics / Q000191:economics / Q000458:organization & administration*; D011634:Public Health; D012017:Referral and Consultation / Q000458:organization & administration*; D012189:Retrospective Studies; D014481:United States; D014484:United States Environmental Protection Agency
keywords: Pediatric Environmental Health Specialty Unit (PEHSU); maternal and child health; pediatric environmental health; toxicology