Every weekday morning when children file into their classrooms, they may be exposed to more than higher learning. In too many cases they'll be breathing a stale mix of dust, molds, chalk dust, pesticides and hydrocarbons. Or perhaps, paint fumes and carpet chemicals might be the villains.
For some children this indoor air pollution, both at school and at home, can make them sick. Dr. Doris J. Rapp, who speaks for a small but growing group of specialists, classifies the ailment as EI, or Environmental Illness. "Having EI means that something you breathe, touch or smell is making you ill."
A pediatric allergist who turned to environmental medicine in the 1970s, she is convinced that EI is on the rise. "I've been practicing for 40 years, and in the past 10 years the children have been sicker than ever," she said, citing a 50% jump in childhood asthma as well as symptoms including fatigue, weakness, despondency and agitation.
These were the illnesses she treated for years as founder of the Practical Allergy Foundation in Buffalo, N.Y. Many of her patients were children with extreme sensitivities that had been misdiagnosed as learning disorders or psychological problems. "Environmental illnesses," she maintains, "are poorly understood by physicians and parents alike."
In a recent survey by the American Academy of Pediatrics and the National PTA, 71% of the teachers stated that they are now seeing more children with health problems than ever, she noted, adding that "the number of children being treated for hyperactivity with the drug Ritalin, has doubled in two years and is now estimated at 4 million."
That's why she has written a handbook aimed at raising consciousness and helping parents and teachers pinpoint environmental dangers and tackle them. At age 67, Rapp acknowledges that she is on a soapbox for reform. She recently closed her Buffalo clinic and moved to Scottsdale, Ariz., where hopes to open a treatment/education center.
"We have to take the responsibility for cleaning up our act, cleaning up our schools and our homes," she declared last week in Los Angeles while on tour promoting the book "Is This Your Child's World? How You Can Fix the Schools and Homes That Are Making Your Children Sick" (Bantam Books). It's a 600-page action guide for concerned parents, targeting ways to identify common symptoms experienced by children and teachers in "sick schools," ways to evaluate which chemicals might be affecting children and suggestions for healthier diets and rooms.
Rapp is very big on personal detective work. After 20 years of what she called "traditional pediatric allergy treatment," (giving allergy shots, prescribing drugs and "telling them to clean up the house and maybe get rid of the cat") she turned to environmental medicine, a specialty now practiced by about 3,500 physicians.
San Diego allergist Dr. Michael Schatz, public education chairman of the American Academy of Allergy, Asthma and Immunology, says that, while asthma is clearly increasing, the data is not clear on allergies. "People may use the term 'environmental illness' rather loosely," he said. "However there are some lifestyle aspects that could potentially cause more allergies, including more household pets and better insulated houses conducive to holding allergy materials in." In general, he said, "It's a field that needs more work."
Rapp, however, likes environmental medicine's broad focus on finding the source of the trouble. In a chapter on "Early Detection," she provides a road map of information for parents trying to pinpoint an illness, including pages of detailed forms for record-keeping and diets that can detect food-related problems.
She also offers a checklist for making comparisons before and after exposure to a possible room or food that could be causing trouble. Simply comparing appearance, breathing, pulse, behavior and how the child writes and draws before and after an exposure can provide visible clues to the trouble, she says. Much of the work, she acknowledges is tedious, especially in a "quick-fix nation, geared to the medicine cabinet."
As for schools: "The schools must change the filters at a certain time, they must clean the ducts regularly, they must check the water supply.
"I did not write this book to alarm people," she stressed. "I am just saying this is a much bigger problem than most people realize."