American Academy of Pediatric: Pioneer in Environmental Health

By: Ruth A. Etzel, MD, FAAP

After World War II the scientists who had developed the bomb turned their attention to peaceful uses of nuclear energy. By the end of the 1940s, many magazines and radio shows featured articles promoting these peacetime uses. CBS aired a documentary in 1947 entitled, The Sunny Side of the Atom. Scant attention was paid to the potential harms from radiation exposure.

In 1946 the US government started conducting above-ground nuclear tests in the South Pacific. They would eventually conduct over 100 tests there. In 1954 errant fallout from a nuclear weapons test on Bikini Island, an atoll of the Marshall Islands, caused acute burns from radiation to develop in people on neighboring islands. Subsequently, severe hypothyroidism developed in 2 infants exposed to fallout before their first birthday. Of 18 children exposed before 10 years of age, 14 developed thyroid neoplasia (13 benign and 1 malignant), and 1 developed leukemia. This caused great concern among some pediatricians in the United States.

In 1951, the US government began conducting above-ground tests of nuclear devices in Nevada. During the decade that followed, 100 above-ground tests were conducted, and the prevailing winds blew radioactive substances eastward towards the farm belt. Radioactive fallout in southwestern Utah from tests in Nevada apparently caused sickness in sheep, and people who were exposed worried about their own health and the health of their families. When a St Louis newspaper reported that the city milk supply contained some of the highest levels of strontium-90 in the nation, many people started to wonder about the effect that exposure to radioactive substances would have on their children.

Expert committees of the National Academy of Sciences and the British Medical Research Council published reports in 1956 on the biological effects of ionizing radiation in humans. These reports led to a marked reduction in unnecessary exposures from the use of radiotherapy for benign disorders and fluoroscopy.

In 1957, because of concerns about fallout from weapons testing and fears of nuclear war, the American Academy of Pediatrics established the Committee on Radiation Hazards and Epidemiology of Malformations to develop policy on exposure of children to ionizing radiation. Robert A. Aldrich, MD, FAAP served as the first chair of this committee, which was the forerunner of the present Council on Environmental Health.

At the time the committee was established, no other medical organizations were focused on the environment in the way that the AAP was. The Academy was an early and important leader in considering the effects of environmental exposures on health and remains a leading voice today.

Additional Reading:
1. AAP Council on Environmental Health. History and growth of pediatric environmental health. In: Etzel RA, Balk SJ, eds. Pediatric Environmental Health. 4th ed. Itasca, IL: American Academy of Pediatrics; 2018:5-15.
2. Reiss LZ. Strontium-90 absorption by deciduous teeth. Science. 1961;134(3491):1669-1673.
3. Mangana JJ, Gould JM, Sternglass EJ, Sherman JD, McDonnell W. An unexpected rise in strontium-90 in US deciduous teeth in the 1990s. Sci Tot Environ. 2003;317:37-51.
4. Gerl E. Scientist-citizen advocacy in the atomic age: A case study of the Baby Tooth Survey, 1958-1963. Prism. 2014;11(1):1-14.

All research and preparation was conducted by Dr Etzel on behalf of the AAP Council on Environmental Health independent of the AAP Gartner Pediatric History Center.