Pediatric Environmental Health Specialty Units (PEHSUs)

The Pediatric Environmental Health Specialty Units (PEHSUs) are a national network of experts in the prevention, diagnosis, management, and treatment of health issues that arise from environmental exposures from preconception through adolescence.

Role of the PEHSUs

Children are uniquely susceptible to the health effects of environmental hazards. Their rapid development, proximity to the ground, and the fact that they eat, drink, and breathe more per pound of bodyweight make children particularly vulnerable to environmental exposures. Children and families who are underrepresented and/or who live in underserved communities are even more likely to suffer the effects of environmental hazards and disasters.

Effectively addressing these challenges facing children and families requires a health care system that is knowledgeable and capable in environmental health and can address prevention, risk reduction, and early exposure detection. Collaboration among reproductive and pediatric health care professionals, who are routinely viewed as trusted sources of health information by families and communities, is necessary to increase the capacity of health care systems to ensure the health of children and families.

To address gaps in clinical education on these complex issues, PEHSU services include education, consultation, outreach, and referral for both health professionals and communities. These services are essential to reduce risk of environmental exposures to children and families and mitigate potential health effects before they happen.

There are 10 PEHSUs, each responsible for a different geographical region of the United States (US). Each PEHSU is based at an academic health institution with experts in pediatrics, allergy/immunology, neurodevelopment, toxicology, occupational and environmental medicine, nursing, reproductive health as well as other specialized areas. The PEHSUs work together to address any reproductive and children’s environmental health issue that affects families and communities, including safer disinfectant use (especially during the COVID-19 pandemic), wildfire smoke, PFAS, lead, pesticides, mold, and many more.

What do PEHSU do?

PEHSUs work with health care professionals, parents, schools, community groups, federal, state, and local government agencies, and others to address reproductive and children’s environmental health issues. The basic services of the PEHSU network include:

Community Education and Outreach

• Raise awareness about environmental conditions that may harm pregnant women, children, and families
• Provide guidance on ways to prevent and/or reduce harmful environmental exposures in everyday situations
• Provide practical advice on helping children cope and recover during and after environmental disasters (e.g., floods, wildfires, chemical spills, and other crises)

Health Professional Training

• Work with medical and nursing schools to add environmental health to curricula
• Train health professionals in practice
• Elevate the importance of public health
• Conduct a variety of educational trainings (in-person and remotely)
• Publish peer-reviewed articles that address environmental health
• Translate health care research into health practice

Consultation and Referral

• Provide medical management guidance to health professionals
• Evaluate suspected toxic exposures
• Identify and interpret appropriate diagnostic tests
• Refer, as necessary, to specialty care

PEHSU History & Operations

The PEHSU program was created in 1998 by the Agency for Toxic Substances and Disease Registry and the Environmental Protection Agency (EPA) through Executive Order 13405, "Protection of Children from Environmental Health Risks and Safety Risks.” These partnering federal agencies operate through a cooperative agreement with a national organization to manage the PEHSU operations and ensure its success.

The American Academy of Pediatrics (AAP) serves as the PEHSU National Program Office (NPO). The AAP was founded over 90 years ago to serve as an independent forum to address children’s unique health needs. The AAP is a nonprofit, professional membership association representing more than 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists. As the NPO, the AAP coordinates and supports each of the regional PEHSUs. Program partners at the American College of Medical Toxicology (ACMT) support the work of the NPO by providing additional technological and content expertise. The NPO works closely with the PEHSUs to effectively address the complex, multifaceted environmental health challenges facing children and families.

How Do I Learn More? 

• Visit the PEHSU website
• Find your regional PEHSU
• Contact National Program Office staff.

Additional AAP Resources for Providers

AAP Council on Environmental Health & Climate Change

Pediatric Environmental Health, 4th Edition

This material was supported by the American Academy of Pediatrics (AAP) and funded (in part) by the cooperative agreement award number 5 NU61TS000296-02-00 from the Agency for Toxic Substances and Disease Registry (ATSDR).