Clinical Practice
Resources for health care professionals to promote environmental health

Clinical Practice: Resources

Continuing Medical Education

View our Continuing Medical Education page here.

For recent PRHE publications, check out our Publications Page.

Pediatric Environmental Health Specialty Units

The Pediatric Environmental Health Specialty Units (PEHSU) form a respected network of experts in children's environmental health. The PEHSU were created to ensure that children and communities have access to, usually at no cost, special medical knowledge and resources for children faced with a health risk due to a natural or human-made environmental hazard.

Located throughout the U.S., Canada, and Mexico, PEHSU professionals provide quality medical consultation for health professionals, parents, caregivers, and patients. The PEHSU are also dedicated to increasing environmental medicine knowledge among healthcare professionals around children's environmental health by providing consultation and training. Finally, the PEHSU provide information and resources to school and community groups to help increase the public's understanding of children's environmental health.

The Western States Pediatric Environmental Health Specialty Unit (Western States PEHSU) is one of 10 regional federally funded clinical and educational centers. WS PEHSU is located at the University of California, San Francisco, and have regional consultants in other geographic areas served by the program. The program serves Arizona, California, Hawaii, Nevada, the Pacific Islands, and Tribal Nations.

Pediatric Environmental Health Toolkit

Physicians for Social Responsibility and PEHSU have introduced an updated Pediatric Environmental Health Toolkit (PEHT). The new PEHT, endorsed by the American Academy of Pediatrics, is a free web app that offers evidence-based information for clinicians to educate parents about how to reduce toxic exposures to common environmental hazards during well-child visits. The Toolkit includes: Anticipatory Guidance, Key Concepts in Child Environmental Health and a Resource Guide of Environmental Hazards with links for additional information.  

Toxic Chemicals fact sheets

The Western States PEHSU has released new guidance in the form of a fact sheet on Take-Home Workplace Exposures. Additionally, they created a fact sheet on why Toxic Chemicals are More Dangerous to Children than to Adults, which can also be viewed and downloaded in Spanish. Visit their fact sheet page for a fuller range of information about children's environmental health.

A Story of Health e-book

A Story of Health was developed in a collaboration among the federal Agency for Toxic Substances and Disease Registry (ATSDR), the Center for Integrative Research on Childhood Leukemia and the Environment (CIRCLE) at the University of California, Berkeley, the Collaborative on Health and the Environment (CHE), the Office of Environmental Health Hazard Assessment, California EPA (OEHHA), the Science and Environmental Health Network (SEHN), and the Western States PEHSU. Chapters include stories about developmental disabilities, asthma, reproductive health, infertility, childhood cancer and leukemia.

The story of Reiko & Toshio discusses the environment’s impacts on reproduction and infertility. Written for health care providers, prospective parents, health advocates, policy makers and others concerned about environmental influences on reproductive health, the story includes links to additional resources and scientific references on each page.

Prescriptions for Prevention

Partners from the NIEHS funded P30 Supplement: Environmental Health E-Screener project came together to create Prescriptions for Prevention, which provides information geared specifically to New York families - but applicable to families throughout the U.S. and beyond - on addressing common environmental health concerns such as lead, secondhand smoke, mold, and radon. With input from a diverse expert panel spanning five Children's Environmental Health Centers (CEC) and five PEHSUs across federal Regions 1,2,3, 5, and 9, collaborators worked on communication tools that connect CEC resources to health care professionals. The front of each prescription explains simple steps for reducing the exposure. The back of each prescription lists key resources that families can use to help address the concern.

Reducing Childhood Lead Poisoning in Immigrant Communities from Imported Makeup

Western States PEHSU has developed a set of fact sheets on the risks of using lead containing imported makeup products on children in response to an increase in lead poisoning among immigrant children in the Western States region. They are available in six languages: English, Dari, Pashto, Urdu, Hindi, Arabic and Somali. Each has an English version on the back, and is tailored to the relevant language speakers. If interested in using these fact sheets in your work with children, there is a space where a logo and contact information can be added; please contact the Western States PEHSU for more information at [email protected].

Environmental History

US Environmental Protection Agency; Agency for Toxic Substances and Disease Registry; University of Maryland

An environmental history is an important tool for clinician’s to gather information on their patient’s exposure to toxic chemicals. There are a number of useful online resources to become more familiar with environmental histories. EPA’s Office of Pesticide Protection and the CDC’s Agency for Toxic Substances and Disease Registry are two great places to start. The Agency for Toxic Substances and Disease Registry has two case studies called "Taking an Exposure History", here and here. The Clinicians at University of Maryland present the elements of environmental and occupational histories with counseling strategies for clinicians in a peer-reviewed article. We have also provided an excellent prenatal environmental exposure forms here. Dr. Susan Buchanan developed an exposure assessment for pregnant women that can be found here.

Environmentally Preferable Medical Products

Practice Greenhealth

Practice Greenhealth has developed a set of standardized environmental questions for medical products that can be used in the procurement process for medical products to identify environmentally preferable products. The questions cover key areas of concern in packaging, manufacturing, use, and the end-of-life of medical products based on environmental priorities in health care.

Drinking Water Information for Healthcare Providers

US Environmental Protection Agency

Doctors, nurses, local health officials and other health professionals play an important role in preventing waterborne illness. To inform this role, EPA has created “Tap Into Prevention”, a continuing education video for healthcare providers. The video explains potential health risks from exposure to microbial and chemical contaminants in drinking water and demonstrates actions health care providers can take in their practices. The video features doctors, nurses, and local health officials who discuss the connection between drinking water and health in their communities.

Environmental and Reproductive Health Resource Center

Association of Reproductive Health Professionals

Although the science is still emerging, strong evidence exists for linking environmental exposures to negative health outcomes such as increased infertility, recurrent miscarriage, early puberty in girls, and reproductive tract cancers and diseases such as endometriosis. This collection of evidence-based resources, compiled by the Association of Reproductive Health Professionals, helps answer questions about how pollutants in our air, water, homes, and general environment are affecting reproductive health. To learn more click here.

Guidance for Occupational Reproductive and Developmental Health Hazards

American College of Occupational and Environmental Medicine

A guidance document was developed by the American College of Occupational and Environmental Medicine (ACOEM) in order to provide occupational and environmental medicine (OEM) physicians, other health care professionals, labor, and management with a framework for evaluating and managing potential occupational reproductive and developmental health hazards. Several clinical scenarios that may be encountered by OEM professionals are discussed. A multidisciplinary approach may be required to assess each workplace for potential reproductive and developmental hazards and implement appropriate responses for managing such hazards.

Environmental Medicine Training

University of Arizona

The University of Arizona Center for Integrative Medicine has developed a new, online, interactive course on environmental medicine. It uses a case-based approach to organize and apply current research and recommendations in environmental medicine to guide our patients and their families. The 6-hour Introduction to Environmental Medicine CME course explores research on how what we eat, drink, breathe, place on our skin, or are otherwise exposed to in our environment has a direct effect upon our health. From lead poisoning to the safety of household cleaning products, cosmetics, and pesticides, this course explores the impact of environmental factors on the health of individuals and populations. The course is rich in resources for patients and clinicians and provides background on several important emerging areas of research in environmental medicine that have immediate clinical relevancy. Faculty who complete the course will receive 6 hours of CME credit.

Toxicology Textbook for Common Chemical Agents

A Small Dose of Toxicology by Steven G. Gilbert explores the principles of toxicology by examining the health effects of common chemical agents. Every day, we come into contact with many relatively harmless substances that could, at certain concentrations, be toxic. This applies not only to obvious candidates such as asbestos, lead, mercury, and gasoline, but also to such common compounds as caffeine, alcohol, nicotine, and headache tablets. While the field of toxicology has numerous technical books devoted to aspects of biology, chemistry, and mechanisms of action, A Small Dose of Toxicology places toxicology within the framework of our daily lives.

Professional and Scientific Societies

American Academy of Pediatrics

American College of Obstetricians and Gynecologists

American College of Preventive Medicine

American Society for Reproductive Medicine

American Society of Andrology

Association of Reproductive Health Professionals

Canadian Fertility and Andrology Society

Endocrine Society

International Society for Environmental Epidemiology

Society for Male Reproduction and Urology

Society for Reproductive Endocrinology and Infertility

Society for the Study of Reproduction

Society of Toxicology