Case Studies
The following are anonymous studies of environmental cases that the network has investigated across New York State. Many required detective work on the part of environmental specialists, pediatricians and partners. The topics include everything from lead and mold to safety issues.
Toxic Chemicals
New York City CEHC
A pediatrician in Brooklyn received questions from patients about reports of toxic chemicals, such as Trichloroethylene (TCE), a volatile organic compound (VOC), leaking into buildings near the Gowanus canal. The pediatrician asked our program for information regarding the exposure risk and guidance on how best to advise these patients.The doctor also had specific questions about VOC home testing kits. Our center staff researched the problem by reviewing reports from DEC, DOH and EPA related to contamination issues at the Gowanus Canal. Staff also reviewed guidance on the health effects of TCE and on environmental testing. Because this was a complicated case, it was also presented at the weekly NYSCHECK/PEHSU case conference to get further industrial hygiene and medical advice from our team. The response to the pediatrician explained the key findings of the DEC study, health effects of TCE, information on home VOC testing, and action steps for both general indoor air quality and for those with documented vapor intrusion. We also shared guidance on environmental risk & exposure communication.
Asthma
Finger Lakes CEHC
Dr. Augusto Litonjua, Chief of Pediatric Pulmonology, shared a case where the FLCEHC-initiated Asthma Environmental Trigger Questionnaire directly helped to improve the clinical status of a child suffering from worsening asthma symptoms in the home environment. Due to the family situation, this child was sleeping in a common area of the home instead of in a bedroom with siblings. When the Asthma Environmental Trigger Questionnaire response was positive for furry pets, discussion revealed two cats frequented his sleeping area. The team worked with the family to find solutions to lessen the child’s exposure to the cats.
Healthy Homes Pilot
Hudson Valley CEHC
Our interdisciplinary team had the pleasure of working with a family within the scope of the Healthy Homes Program. The family has a 5-year-old son who has always struggled with asthma and allergies that were triggered by environmental factors in his home. The family was identified by their insurance provider as being qualified to receive services through the Healthy Homes program. Our social work team first met with the family in April, where the mother showed us her basement which had been completely flooded and had black water damage marks all over the walls. The floors had visible mold. There were areas of her home where water would simply leak through when it rained. Her porch was barely usable due to the water damage. The mother wanted to fix these concerns, but the cost was overwhelming. The basement, a former playroom, was unused because anytime their child went down there he would begin coughing.
The Healthy Homes program was able to provide the family services which the mother reports completely changed their lives. Healthy Homes provided them with a completely new floor in their basement, a new ventilation system, redid their porch, and put in more effective gutters in order to eliminate flooding. The family was in disbelief at how much work was provided to their home. The playroom is back in the basement, and the family is enjoying their safer home. Most importantly, the mother said her child has not had any significant asthma symptoms since the refurbishments have been completed.
Lead
Finger Lakes CEHC
A family contacted the Finger Lakes Children’s Environmental Health Center concerned about the development of their 3 year-old child who was not yet talking, had hand-to-mouth behaviors, and lived in a 100 year old farmhouse. Testing the child and the home showed high lead levels. The Center coordinated with the Genesse and Monroe County Health Departments to conduct a home inspection and referred the family to autism resources. The family relocated to a lead safe home and the child’s lead levels have declined.
Multi-Center Collaboration: Wildfire Smoke
Hudson Valley, Long Island, and New York City worked together to quickly respond to the wildfire smoke that blanketed NY in June 2023 creating a public health emergency. Within 24 hours, NYSCHECK disseminated messages to over 1,000,000 patients across the state. The messages were shared by local, regional and national partners including the New York State American Academy of Pediatrics, the American Lung Association, and the US Department of Health and Human Services.
Multi-Center Collaboration: Mold in Schools
New York City, Hudson Valley, Long Island
The NYCCEHC in partnership with the Long Island and Hudson Valley CEHCs fielded multiple calls from parents and local physicians concerned about mold found in four schools in the larger metropolitan area. NYSCEHC experts provided counseling to numerous families and pediatricians about evidence-based management of mold exposure.
Lead Poisoning, Pregnancy and Window Restoration
Western NY and Finger Lakes
An obstetrician contacted NYSCEHC about a pregnant 32-year-old woman whose 3-year-old child had an elevated blood lead level. On further history, it was noted that her recent hobby was restoring old window frames and that she had just started working on her first window. Her child joined her as she scraped and refinished the wooden window frame at the dining room table. Western NY and Finger Lakes CEHC worked with the Lead Poisoning Resource Center to share health messages to reduce lead exposures in the family.
Outdoor Air Pollution and Asthma at a School
Hudson Valley
A mother noticed that her son started returning from school with wheezing and coughing, initially thought to be due to a possible asthma trigger in his music class. The mother came for a consultation with the Hudson Valley CEHC. Our staff took a detailed history about possible exposures. The mother later discovered that 20 minutes before the end of the school day, a number of school buses were lined up immediately outside the music classroom windows, and were idling their engines. After NYSCEHC contacted the principal, the principal immediately instituted a policy prohibiting school buses from idling outside classrooms during class time. Within a week, this mother reported that her child was no longer coughing or wheezing and that she was able to reduce his asthma medications.
Ensuring Fire Safety in the Home
Capital Region
A 9 month-old baby boy seen in Albany Medical Center’s Pediatric Resident Clinic was noted to live in an apartment without working smoke detectors or carbon monoxide (CO) detectors. His mother reported that their landlord refused to install them. The Center referred this family to the local NY State Department of Health’s Healthy Neighborhoods Program, which performed an environmental health and safety evaluation of the home, and provided smoke detectors and CO detectors. The Healthy Neighborhood’s environmental worker later thanked our Center staff repeatedly for making this referral. “We couldn’t believe that they had NO smoke alarms in the entire home.”