The Region 2 Pediatric Environmental Health Specialty Unit (PEHSU) provides evidence-based messages and resources on common environmental exposures where children live, learn, and play. It is easy to become sick or hurt from household products and irritants. Our unit is here to provide you with the necessary information you need to navigate the normal world we are living.
Environmental Information for Patients
Cleaning and disinfecting your home can provide extra protection against infection. While disinfectants like hydrogen peroxide or bleach are important to kill coronavirus on household surfaces, they must be used safely to avoid harming your health. When cleaning and disinfecting, open windows for fresh air, keep children out of the area, and securely store cleaning materials out of the reach of children.
Learn More About Safe Cleaning and Disinfecting:
- Rx for Prevention
- Green Cleaning (Español: Limpieza ecológica)
- Safer Disinfecting (Español: Desinfección más segura en el hogar)
- COVID-19: Safely Cleaning Your Home (answers to your frequently asked questions, from our environmental pediatricians)
- Centers for Disease Control and Prevention (CDC): Guide on Cleaning and Disinfecting
- Health information from the American Academy of Pediatrics (AAP): 2019 Novel Coronavirus (COVID-19)
Effective Disinfectants Against COVID-19:
The Environmental Protection Agency (EPA) has a list of disinfectants that effectively kill coronavirus. All of these products must be used safely!
Local Resources for Region 2:
- New York City
- New York State
- New Jersey
- Puerto Rico
PFAS (perfluoroalkyl & polyfluoroalkyl substances) are a group of human-made chemicals used in many consumer products such as non-stick pans and food take-out containers.These chemicals can also get into water supplies (public water systems & private water wells), sometimes at levels higher than recommended guidelines. Studies show a possible link between PFAS exposure and certain health effects, such as higher cholesterol. There are simple steps to reduce your exposure to PFAS.
Learn More About How to Limit Your Exposure to PFAS:
- PEHSU/NYSCHECK Factsheet: PFAS & Children's Health
- PEHSU national network website on PFAS
- Agency for Toxic Substances and Disease Registry (ATSDR): Information on PFAS
Simple Steps to Reduce Your Exposure to PFAS:
Environmental Working Group (EWG) has a guide on how to reduce exposure to PFAS chemicals in everyday life by reducing the use of certain consumer products such as microwave popcorn bags, food take-out containers, non-stick pots and pans.
Blood Tests for PFAS:
For communities impacted by PFAS, there may be research studies that involve PFAS blood testing for local residents - contact your Department of Health for more information. Aside from these studies, we do not recommend routine testing of children for PFAS. Although PFAS can be measured in blood, the results do not help doctors make medical decisions or predict future health effects. If you do want to have your child tested for PFAS, testing is usually not available at commercial or clinical laboratories. At labs that offer PFAS testing, insurance usually does not cover the expense of testing, which can range from $500-$800.
Local Resources for Region 2:
ATSDR is conducting research studies in Region 2 and across the United States to understand the health effects of PFAS exposure.
- New York State
- New Jersey
- Puerto Rico
Lead is a metal that can be found in paints, water pipes, soil, consumer products, and others. The most common way for children to be exposed to lead is from peeling paint in old homes (built before 1978). Given that lead can affect the developing brain and other organ systems, it is important to prevent exposure in children and pregnant women.
Learn More About Lead:
- Rx for Prevention: Lead Paint (Español: Pintura a Base de Plomo)
- Mount Sinai’s Children's Environmental Health Center: Lead Infographic
- National Institute of Health Tox Town: Information about lead
Local Resources for Region 2:
- New York City
- Rx for Prevention: Lead Based Paint for NYC Residents (Español: Pintura a Base de Plomo- La ciudad de Nueva York)
- In NYC, landlords must inspect for lead hazards if children under 6 reside in the home: Lead-Based Paint
- New York State requires that healthcare providers test all 1- and 2-year-old children for lead. NYC Department of Health (DOH) Lead Poisoning Prevention
- NYC DOH hazardous consumer products (may contain lead)
- For more information about lead programs in NYC, call 311 and ask for Healthy Homes Information.
- New York State
- New York State requires that healthcare providers test all 1- and 2-year-old children for lead.Learn what your child’s lead test means here.
- NY State DOH Childhood Lead Poisoning Prevention Program
- Find your local Lead Poisoning Prevention program.
- Find your local Regional Lead Resource Center.
- New Jersey
- The New Jersey Department of Community Affairs requires landlords to maintain housing in a lead-safe manner: Tenant information on lead-safe maintenance
- New Jersey State law requires doctors to test the blood lead levels for all 1 and 2 year olds. Learn more at the NJ DOH- Testing for Lead Exposure site.
Mold can grow indoors if there is high humidity, water damage, or water leaks. Breathing in mold spores can cause asthma attacks and allergies in some people. It is important to reduce exposure to mold by fixing any underlying water problems and safely cleaning the mold-damaged material in your home.
Learn More About Mold:
- Rx for Prevention: Mold (Español: Moho)
- Advice for parents from environmental pediatricians: FAQs about mold in the home
- Infographic: Say no to mold! How to safely take care of mold in your home
- Environmental Protection Agency (EPA): Guide to Mold and Moisture and your Home
Local Resources for Region 2:
- New York City
- NYC Department of Health (DOH): Information about mold
- Did you know that New York City law requires that landlords take steps to keep their tenants’ homes free of pests and mold? Learn more: What NYC Tenants should know about Local Law 55 (Asthma Free Housing Act of 2018) (Español: Lo que los inquilinos deben saber sobre la presencia de alérgenos en interiores (Ley Local 55 de 2018))
- If you or your child have asthma, talk to your doctor to see if you qualify for the “NYC Healthy Neighborhoods” program to help address asthma triggers in your home
- New York State
- If you or your child have asthma, talk to your doctor to see if you qualify for the Healthy Neighborhoods program (available in certain zip codes)
- For NY renters: Landlords should address underlying structural problems (like water leaks). Contact your local building code office if structural problems are not repaired. For more information from the NY State DOH, visit the Mold and Your Home - What you Need to Know site.
- New Jersey
- NJ DOH mold information
- For NJ renters: there are no regulations on mold specifically, however, landlords should address underlying structural problems (like water leaks). Contact your local building code office if structural problems are not repaired.
- Puerto Rico
- Departamento de Salud:Health Eliminar Los Hongos
- Rx for Prevention: Hongo
- US Virgin Islands
- Distillery Fungus (Hongo de Destilería y Sus Efectos En La Salud)
- Rx for Prevention: Mwazi, Mold, Hongo
Exposure to pests (like cockroaches and mice) can lead to allergy symptoms and asthma attacks in both children and adults. However, the use of chemical pesticides can also pose a risk to health. There are safe and effective ways to get rid of pests without harmful pesticide chemicals.
Reduce Your Use of Pesticides By Getting Rid of Entry Points, Food and Water Sources, and Shelter for Pests:
- Rx for Prevention: Safer Pest Control (Español: Control de Plagas)
- Environmental Protection Agency (EPA): Pest Control- Resources for Residents
- Infographic: Asthma, Pests, and Pesticides: How to safely get rid of pests in your home
Learn More About Pests:
- Rx for Prevention: Cockroaches (Español: Plagas (Cucarachas))
- National Pesticide Information Center (NPIC): Learn how to identify and safely control pests
Learn More About Pesticides:
- Environmental Protection Agency (EPA): Pesticides
Outdoor Pesticide Safety
- Glyphosate (Roundup) Weed killer: Weed Killer Fact Sheet
- Learn about IPM for lawn care and garden care from NPIC
Bed Bugs
- Infographic: Don’t Let the Bed Bugs Bite!
- National Pesticide Information Center (NPIC): Bed bugs
Local Resources for Region 2:
- New York City
- Did you know that New York City law requires that landlords take steps to keep their tenants’ homes free of pests and mold? Learn more: What NYC Tenants should know about Local Law 55 (Asthma Free Housing Act of 2018) (Español: Lo que los inquilinos deben saber sobre la presencia de alérgenos en interiores (Ley Local 55 de 2018))
- If you or your child have asthma, talk to your doctor to see if you qualify for the “Healthy Neighborhoods” program to help address asthma triggers in your home
- Pest Control NYC Department of Health (DOH): Information for Building Residents and Tenants
- Pest Management Tips for Building Residents
- Getting rid of Bed Bugs
- New York State
- If you or your child have asthma, talk to your doctor to see if you qualify for the “Healthy Neighborhoods” program (available in certain zip codes)
- NY State DOH: Reducing Pesticide Exposure
- Learn more about the NY “Neighbor Notification Law” for pesticide use.
- New Jersey
- NJ DOH: Use of Pesticides in Child Care Centers
- NJ DOH: Information on Bed Bugs
- Puerto Rico
- U.S. Virgin Islands
- Rx for Prevention: Safer Pest Control , Elimine bèt Nuizib yon fason ki pi San Danje , Control de Plagas
Having good indoor air quality is important because we spend most of our time indoors. Pollutants in the indoor air can come from sources inside the home such as appliances and cleaning products. Pollutants can also enter the home from outdoors such as radon gas. Some indoor air pollutants like mold can trigger allergies and asthma, while others like carbon monoxide can lead to more serious health effects. There are simple steps you can take to improve the quality of air in your home including good ventilation and regular cleaning (wet dusting, wet mopping).
Learn More About Indoor Air Quality:
Rx for Prevention:
- Indoor Air Quality (Español: Calidad del Aire Interior)
- Green Cleaning (Español: Limpieza ecológica)
- Safer Disinfecting (Español: Desinfección más segura en el hogar)
- Mold (Español: Moho)
- Dust Mites (Español: Ácaros)
- Cockroaches (Español: Plagas (Cucarachas))
- Radon (Español: Gas Radón)
- Secondhand Smoke (Español: Humo de Segunda Mano)
- Smoking (Español: Tabaquismo)
- Mount Sinai Infographic: Simple Steps to a Healthy Indoor Environment
- Environmental Protection Agency (EPA): General information about indoor air quality
- American Lung Association: Achieving clean air at home, work, and school
- EPA Tools for Schools Program: Guidance to improve indoor air quality in schools
Air Purifiers/Filters
Air purifiers/filters can effectively remove indoor air pollutants like dust, pollen, and some gases; but should not replace good ventilation and routine cleaning of your home. If you do choose to use an air purifier, choose one with a HEPA (High-Efficiency Particulate Air) filter with the recommended Minimum Efficiency Reporting Values (MERV) and Clean Air Delivery Rate (CADR) ratings. We do not recommend Photo Electrochemical Oxidation (PECO) or Photocatalytic Oxidation (PCO) filters as these have been shown to be less effective than HEPA filters. In addition, make sure the air purifier does not generate ozone (because ozone can irritate the lungs). Look up approved air cleaners or methods to reduce the number of indoor allergens here.
Local Resources for Region 2:
- New York City
- Did you know that New York City law requires that landlords take steps to keep their tenants’ homes free of pests and mold? Learn more: What NYC Tenants should know about Local Law 55 (Asthma Free Housing Act of 2018) (Español: Lo que los inquilinos deben saber sobre la presencia de alérgenos en interiores (Ley Local 55 de 2018))
- New York State
- If you or your child have asthma, talk to your doctor to see if you qualify for the Healthy Neighborhoods program (available in certain zip codes)
Many states and Puerto Rico have an indoor air quality program or resources that provide answers to localized indoor air quality questions. Learn more about EPA Regional Office and State Indoor Air Quality Information.
There are many sources of allergens in the home such as dust mites, pests, mold, dust, and pet dander. Some children with allergies or asthma may be sensitive to these allergens. It is important to take simple steps to reduce the levels of these allergens in the home. Make sure to clean regularly (wet dust/mop, vacuum), open your windows to circulate fresh air into the home, and prevent pests and mold growth. Additional steps may be needed if your child has allergies or asthma.
Rx for Prevention:
- Dust Mites (Español: Ácaros)
- Mold (Español: Moho)
- Cockroaches (Español: Plagas (Cucarachas))
- Safer Pest Control (Español: Control de Plagas de Manera Segura)
Local Resources for Region 2:
- New York City
- Did you know that New York City law requires that property owners take steps to keep their tenants’ homes free of pests and mold? Learn more: What NYC Tenants should know about Local Law 55 (Asthma Free Housing Act of 2018) (Español: Lo que los inquilinos deben saber sobre la presencia de alérgenos en interiores (Ley Local 55 de 2018))
- Learn more about resources in NYC to help manage your child’s asthma!
- If you or your child have asthma, talk to your doctor to see if you qualify for the Healthy Neighborhoods program to help address asthma triggers in your home
- Safe Pest Control
- Mold
- New York State
- If you or your child have asthma, talk to your doctor to see if you qualify for the “Healthy Neighborhoods” program to(available in certain zip codes)
- Mold and your home
- New Jersey
- Puerto Rico
- EPA Regional Office and State Indoor Air Quality Information
- Many states and Puerto Rico have an indoor air quality program or resources that provide answers to localized indoor air quality questions.
- U.S. Virgin Islands
There are many sources of irritants in the indoor air such as tobacco smoke, cleaning products, and other chemicals used in the home. These irritants can be harmful to both adults and children when exposed, and people with asthma may be particularly sensitive. Make sure to clean regularly using safer green cleaning products, open your windows to circulate fresh air into the home, prohibit smoking inside the home, and use/store chemicals safely.
Rx for Prevention:
- Green Cleaning (Español: Limpieza ecológica)
- Safer Disinfecting (Español: Desinfección más segura en el hogar)
- Secondhand Smoke (Español: Humo de Segunda Mano)
- Smoking (Español: Tabaquismo)
- Centers for Disease Control and Prevention (CDC): Guidance on How to Quit Smoking
- Infographic: How to stop secondhand smoke drift into your apartment
Local Resources for Region 2:
- New York City
- Information on smoke-free housing
- Safe and green cleaning
- Harmful chemicals and household products
- Poison prevention in the home
- New York State
- Smoking and Secondhand smoke
- Exposure to chemicals and poison
- Volatile organic compounds in the home
- New Jersey
- Puerto Rico
- Rx for Prevention: Tabaquismo
- U.S. Virgin Islands
- Rx for Prevention:Smoking Fimen Tabaquismo
Radon is a radioactive gas with no smell, color, or taste. It is formed naturally in the soil in some areas of the world. Radon can enter homes through cracks in the foundation, and levels tend to be highest in the basement and lower floors. Breathing in high levels of radon over time can lead to lung cancer. You can protect your health by testing your home for radon. If levels are too high, there are options to lower the levels in your home.
- Visit sosradon.org or call 1-800-767-7236 to purchase a radon testing kit.
Learn More About Radon:
- Rx for Prevention: Radon (Español: Gas Radón)
- Environmental Protection Agency (EPA): Citizen's Guide to Radon
Local Resources for Region 2:
- New York State
- FAQ Radon
- Testing your home for radon is inexpensive. Visit the NYS Department of Health website on how to purchase a kit in New York state.
- Radon mitigation (getting rid of radon in your home)
- New York provides free radon in air testing for residents who have had a radon mitigation system installed within a year. Visit Free Radon post-mitigation test for more information.
- New Jersey
- Radon information. Check with your local health department or municipality to find out if they are giving away free radon test kits.
- Puerto Rico
Carbon monoxide is a gas with no smell, color, or taste. It is formed when fuel is burned from gas generators, gas stoves, grills, running cars, etc. Carbon monoxide poisoning can lead to headaches, dizziness, shortness of breath, and in severe cases, death. Protect your health by installing carbon monoxide detectors in your home and using fuel-burning appliances in well-ventilated areas.
Local Resources for Region 2:
- New York City
- Building owners are responsible for installing approved carbon monoxide detectors, while owners must test them regularly and change the batteries. Learn more at the NYC Carbon monoxide information site.
- New York State
- New Jersey
- Carbon monoxide
- Most residential buildings are required by law to have a carbon monoxide sensor device located inside the unit (within 10 feet of a sleeping area)
- Puerto Rico
Asbestos is a group of mineral fibers found in older buildings (insulation, roofing, tiles) and rarely in consumer products. If asbestos-containing materials are disturbed in a way that releases asbestos fibers into the air, people can be exposed. Breathing in asbestos fibers over long periods can lead to mesothelioma (cancer in the lining of the lungs) and lung cancer. You can protect your health by hiring a licensed abatement contractor to remove damaged asbestos-containing materials or if you are planning to remodel your home that contains asbestos. Asbestos-containing material that is intact may not need to be removed.
Learn More About Asbestos:
Asbestos in Schools
Public and non-profit private schools are required to check for asbestos-containing materials and to develop and update school asbestos management plans.
- To learn more, visit the Asbestos and School Buildings site.
Local Resources for Region 2:
- New York City
- New York State
- New Jersey
- Puerto Rico
Many states, Puerto Rico, and the US Virgin Islands have an asbestos program that provides answers to localized asbestos questions: State Asbestos Contacts | Asbestos | US EPA.
Outdoor air pollutants can be released into the air by car/truck traffic, factories, and coal ash from power plants. These pollutants can be gases, smog, or small particles called particulate matter; and can lead to asthma, lung disease, or heart disease. To stay safe, check your local “air quality index” (a measure of air quality) and plan outdoor activities when pollution levels are lower.
Learn More About Outdoor Air Quality:
- Rx for Prevention:
- Infographic: Outdoor Air Pollution
- Check your air quality alerts:
- On your phone (the weather app usually has air quality alerts)
- Download an air quality app
- Visit airnow.gov
- Seasonal allergies? Check pollen counts.
- Saharan dust storms in the Caribbean? Learn more here. (En Español)
Local Resources for Region 2:
- New York City
- NYC Air Pollution & Regulations
- If you would like to file an air quality, vehicle idling, or odor complaint, call 311 or visit NYC 311
- Report idling vehicles in NYC and make some money while improving local air quality!
- New York State
- New Jersey
- Puerto Rico
- U.S. Virgin Islands
Mercury is a metal that can be found in large predator fish (such as shark and swordfish) and some consumer products (such as skin lightening cream). Exposure to high levels of mercury can have harmful effects on the developing brain and nervous system. You can protect your family by choosing fish wisely and not using products that contain mercury.
Learn which type of fish to consume:
Eat Fish, Choose Wisely! FDA/EPA guide to eating fish
Learn More About Mercury:
- Rx for Prevention: Eat Fish (Español: Coma Pescado)
- Beware of Mercury in Consumer Products: Mercury in Consumer Products
- Elemental Mercury (Quicksilver): Basic Information about Mercury, including how to clean up mercury spills safely
In the News: Mercury in Gym Floors:
Local Resources for Region 2:
- New York City
- New York State
- Partnership to Reduce Mercury in Schools
- NY State Fish Advisory
- What to do if there is a mercury spill
- New Jersey
Drinking water can come from public (municipal) water systems or private wells. Public systems are monitored and regulated to make sure they meet drinking water standards (and you can review yourlocal water report). However, well water is not monitored or regulated, so families have to test their well water regularly to make sure it is safe to drink.
Well Water
Homeowners should test their well water at least annually for common contaminants of concern using a state-certified lab. Local health departments can provide guidance on testing and any needed treatment for your well.
- Rx for Prevention: Well Water (Español: Agua de Pozos Privados)
- Information about private water wells
- Environmental Protection Agency (EPA) infographic and more detailed information about protecting your private well
Tap Water (Public Water Supplies)
Public water systems are monitored for a variety of contaminants and must meet federal regulations developed to protect public health.
- Know your water: Find your local water system’s annual report
Learn More About Drinking Water:
- Centers for Disease Control and Prevention (CDC) information about healthy water for drinking, swimming, and hygiene
- Water-related diseases and contaminants
- Groundwater and drinking water information
- Information on preventing water pollution
- Fluoride in the water for healthy teeth - learn more
Drinking Water Pollutants:
- Learn about what pollutants are regulated in public water systems in the United States:
- Lead in drinking water
- Arsenic in well water
- Infographic: PFAS contamination (The “Forever Chemicals”)
Local Resources for Region 2:
- New York City
- Frequently asked questions (FAQ) about NYC drinking water
- NYC water is lead-free when it enters the drinking water system, older buildings may have lead in the water pipes. Learn more about free testing for lead in NYC.
- New York State:
- Frequently asked questions (FAQ) about NY state drinking water
- Apply for a free lead test for your drinking water
- Learn more about well water testing in NY
- New Jersey
- Drinking Water and Public Health
- NJ well water information (including how to test your well water)
- NJ Arsenic initiative (to reduce arsenic exposure from well water)
- Puerto Rico
- U.S. Virgin Islands
Our PEHSU receives inquiries from parents about contaminants found in children’s food products, such as pesticides, mercury in fish, arsenic in rice, and heavy metals in baby food. There are simple steps that families can take to ensure a healthy diet while reducing exposure to chemicals.
Pesticides
- Fresh fruits and veggies are an important part of a child’s diet. Some simple steps to reduce exposure to pesticide residue (find a good source):
- Pesticides and Food: Healthy, Sensible Food Practices
- Simple steps to reduce pesticide residues on your fruits and veggies
- Environmental Working Group (EWG) Food Guide.
- Learn about EWG “dirty dozen”, these have the highest levels of pesticides, so buy organic when possible (or make sure you wash thoroughly) and the “clean fifteen” that have the lowest levels of pesticides, so no need to buy organic (but still make sure you wash thoroughly).
Heavy Metals
- Advice for parents from environmental pediatricians: Heavy metals in baby food and fruit juice
- How to reduce arsenic in your diet (Interactive infographic)
- Eat Fish, Choose Wisely (to reduce mercury)! FDA/EPA guide to eating fish
Food Safety
- Food & Drug Administration (FDA) food recall website
- Centers for Disease Control and Prevention (CDC)’s 4 Steps to Food Safety
Other Topics
Local Resources for Region 2:
- New York City
- Beware! imported bulk spices may contain heavy metals
- Know before you go! Check out restaurant food safety grades.
- Find an NYC Green Market (including those who take SNAP/EBT)
- NYC food pantries and applying for food-related benefits
- New York State
- Food safety information for consumers
- Learn more about food-related outbreaks and recalls
- Find Your Regional Food Bank
- New Jersey
- NJ DOH Consumer Food Safety
- Link to Community FoodBank of New Jersey, the state’s largest anti-hunger and anti-poverty organization.
Consumer and personal care products include shampoo, soaps, perfumes, deodorants, and many others. These products sometimes contain harmful chemicals that can disrupt our hormonal systems (called “endocrine-disrupting chemicals”). It is best to use products that are fragrance-free, and use this Environmental Working Group (EWG) guide to select safer products when possible.
Learn More About Consumer and Personal Care Products:
- Rx for Prevention
- Bisphenol A: BPA
- Phthalates (Español: Ftalatos)
- Infographic: BPA and Phthalates (Español: El BPA y los Ftalatos)
- PEHSU: Phthalates and Bisphenol A Factsheet for Patients
- Myths and Facts about personal care products
- Food and Drug Administration (FDA): Parabens in cosmetics
- Environmental Protection Agency (EPA): Information about triclosan
- Information about endocrine-disrupting chemicals in personal care products
Safe and Green Cleaning Options for your Home
- Rx for Prevention
- Green Cleaning (Español: Limpieza ecológica)
- Safer Disinfecting (Español: Desinfección más segura en el hogar)
- 10 tips to green your family
- Look for the EPA “Safer Choice” label when buying cleaning and household products!
Local Resources for Region 2:
- New York City
- NYC warning about skin lightening products that contain mercury
- NYC Department of Health (DOH) hazardous consumer products (contains heavy metals)
- New York State
- New Jersey
The rise in greenhouse gases in our atmosphere (mostly from burning fossil fuels) is changing the climate, and leading to hotter temperatures, more frequent and severe extreme weather events, disrupted supplies of safe and healthy water and food, and increased air pollution and certain infectious diseases. Children are particularly vulnerable to the effects of climate change. There are a number of ways to protect your family’s health and help slow down climate change.
Learn More About Climate Change and Health:
- American Academy of Pediatrics (AAP): How Climate Change Affects Children
- Mount Sinai Infographic: Climate Change and Your Health (Español: Cambio Climático Y Su Salud)
- Tips for returning to school after a hurricane
- New York City
- Learn about NYC’s plan to confront climate change: OneNYC 2050
- Be prepared for a changing climate:
- New York State
- NYS Children’s Environmental Health Center
- Learn more about the relationship between health, the weather, and climate
- Impacts of Climate Change in New York
- New Jersey
- Click here to learn what households can do to take action against climate change.
- Puerto Rico
- US Virgin Islands: What Climate Change Means for the US Virgin Islands