1. THE USE OF THE INTERNET FOR CHILDREN’S ENVIRONMENTAL HEALTH Jerome A. Paulson, MD Associate Professor of Pediatrics & Public Health Co-Director, Mid-Atlantic Center for Children’s Health & the Environment George Washington University June, 2007

2. THE MID-ATLANTIC CENTER FOR CHILDREN’S HEALTH & THE ENVIRONMENT (MACCHE) A PEDIATRIC ENVIRONMENTAL HEALTH SPECIALTY UNIT (PEHSU)

3. OBJECTIVES By the end of this session participants will be able to:  Describe uses of the Internet  Evaluate WWW documents using criteria discussed in the session  Understand some of the limitations of the WWW  Use a portal, a search engine and other types of search systems to maximize effective Web searching

4. THE WORLD WIDE WEB – THE INTERNET The World Wide Web = The Internet Essentially the same things

5. THE WORLD WIDE WEB A doorway to the world A rapid means of locating and retrieving information A rapid means of communication

6. TYPES of WEB SEARCH TOOLS General search engines – type in a word or phrase and retrieve information based on algorithm  AltaVista [www.altavista.com], Googlewww.altavista.com  Be cognizant of paid advertising Multiple search engines – retrieve information from multiple search engines simultaneously  Metacrawler, Dogpile [www.dogpile.com]www.dogpile.com Directories – select from categories  LookSmart [www.looksmart.com]www.looksmart.com

7. TYPES of WEB SEARCH TOOLS Portals – combination search engine, subject directory, e-mail, chat, etc.  Yahoo [http://www.yahoo.com/]http://www.yahoo.com/ Subject-specific search directories  MedWeb http://www.medweb.emory.edu/MedWeb/http://www.medweb.emory.edu/MedWeb/ Site-specific search tools – search box in corner Databases  MEDLINE, TOXLINE

8. TYPES of WEB SEARCH TOOLS On-line encyclopedias – Be very cautious  Some No oversight on content Anyone can change content  Political reasons  Advocacy reasons For example – Wikipedia and similar  Not appropriate tool for professional use  Others Have oversight, editors, peer-review, etc For example – Encyclopedia of the Earth

9. Evaluating Environmental Health Information & Avoiding Misinformation

10. EVALUATING RESOURCES Rationale  Anyone can publish anything on the Web  Unlike traditional print resources, web resources rarely have editors or fact-checkers  Currently, no web standards exist to ensure accuracy

11. EVALUATING RESOURCES Authority  Who is the author?  What is the author’s affiliation?  Can you contact the author? Objectivity  Is the purpose of the site clearly stated?  Is sponsorship acknowledged?  Is the information impartially presented?

12. EVALUATING RESOURCES Accuracy  Is it reliable and free from error?  Is the source of information clearly stated? Coverage  Is it complete for the topic and audience? Currency  When was the information produced?  Has it been updated recently?

13. EVALUATING RESOURCES Example  http://www.health-e-kids.org/ - About Us http://www.health-e-kids.org/  http://www.earthportal.org/ - About the Earth Portal http://www.earthportal.org/

14. EVALUATING RESOURCES Using domain names .com - a commercial site .net - a commercial site .gov - a US government site .org - a non-profit site .edu - an academic site .mil - a US military site

15. EVALUATING RESOURCES Using domain names – some new ones .biz - a commercial site .info – any type of site .int – international organization .aero – air transport industry site .coop - a co-op business site .museum – a museum site .name - a personals site .pro – a professional; e.g., MD, lawyer, etc

16. EVALUATING RESOURCES Criteria for Assessing the Quality of Health Information on the Internet  http://hitiweb.mitretek.org/docs/policy.html http://hitiweb.mitretek.org/docs/policy.html  The Good, The Bad & The Ugly: or, Why It's a Good Idea to Evaluate Web Sources  http://lib.nmsu.edu/instruction/evalcrit.html http://lib.nmsu.edu/instruction/evalcrit.html

17. CONCERNS Uncensored content Hoaxes, frauds, and “urban legends”  http://www.snopes.com/ http://www.snopes.com/  http://hoaxbusters.ciac.org/ http://hoaxbusters.ciac.org/

18. Evaluating Search Engines Search Engine Showdown: The Users Guide to Web Searching http://www.searchengineshowdown.com/ http://www.searchengineshowdown.com/ Google  www.google.com www.google.com  www.google.com/unclesam [http://www.google.com/ig/usgov] www.google.com/unclesam Mercury

19. Site-Specific Search Tools NIH – www.nih.govwww.nih.gov Centers for Disease Control and Prevention (CDC) -www.cdc.govwww.cdc.gov Environmental Protection Agency (EPA) – www.epa.gov www.epa.gov ATSDR - www.atsdr.cdc.govwww.atsdr.cdc.gov WHO – www.who.int/www.who.int/

20. US National Library of Medicine Databases http://www.nlm.nih.gov/

21. Toxicology and Environmental Health Information http://sis.nlm.nih.gov/enviro/environmentalhe althinformation.html http://sis.nlm.nih.gov/enviro/environmentalhe althinformation.html  TOXNET  TOXMAP  HAZ-MAP  TOX TOWN  Household Products Database

22. TOXNET http://toxnet.nlm.nih.gov/http://toxnet.nlm.nih.gov/ Hazardous Substances Database (HSDB) Integrated Risk Information System (IRIS) GENE-TOX TOXLINE Toxic Release Inventory (TRI) Others

23. TOXNET http://toxnet.nlm.nih.gov/http://toxnet.nlm.nih.gov/ Factual Databases - HSDB, IRIS, CCRIS, GENE-TOX Bibliographic Databases - TOXLINE, DART/ETIC, EMIC Toxic Chemical Releases - TRI Chemical Identification/Nomenclature - ChemIDplus

24. Factual Database Hazardous Substances Data Bank (HSDB) Human Health Effects Emergency Medical Treatment Animal Toxicity Studies Metabolism /Pharmacokinetics Pharmacology Environmental Fate/Exposure Environmental Standards & Regulations Chemical/Physical Properties Chemical Safety & Handling Occupational Exposure Standards Manufacturing and Use Laboratory Methods Special References Synonyms and Identifiers 4500 Chemicals (1 record/chemical)

25. Factual Database Integrated Risk Information System (IRIS) Noncarcinogenic Assessment - Oral (RfD) Noncarcinogenic Assessment - Inhalation (RfC) Carcinogenic Assessment - Oral Carcinogenic Assessment - Inhalation 535 Chemical Records

26. Factual Database Chemical Carcinogenesis Research Information System (CCRIS)  8000 Chemical Records Carcinogenicity Studies Tumor Inhibition Studies Tumor Promotion Studies Mutagenicity Studies GENE-TOX  3200 Chemical Records Mutagenicity Studies

27. Bibliographic Databases TOXLINE - TOXicology Literature onLINE DART/ETIC - Developmental and Reproductive Toxicology/Environmental Teratology Information Center

28. Chemical Information ChemIDplus Information on 350,000 chemicals Chemical structures for over 50,000 chemicals Search by chemical name, CAS RN, structure Superlist - “list of lists” of hazardous chemicals, e.g., California Prop 65, DOT, IARC

29. Other Specific Web Sites

30. Most National Governments Have Environmental Information on the Web Poland – Ministry of the Environment http://www.mos.gov.pl./index_main.shtml http://www.mos.gov.pl./index_main.shtml Canada – Health Canada – Environment & Workplace Health http://www.hc-sc.gc.ca/ewh- semt/index_e.html http://www.hc-sc.gc.ca/ewh- semt/index_e.html Japan – Ministry of the Environment http://www.env.go.jp/en/

31. Environmental Health Perspectives Access to full-text at no cost http://www.ehponline.org/  Children’s Health Resources  http://www.ehponline.org/children/resources.html http://www.ehponline.org/children/resources.html Children’s Health links  http://www.ehponline.org/children/links.html http://www.ehponline.org/children/links.html

32. World Health Organization WHO – Environmental Health Information http://www.who.int/topics/environmental_health/en/ http://www.who.int/topics/environmental_health/en/  Children’s Environmental Health http://www.who.int/ceh/en/http://www.who.int/ceh/en/  Healthy Environments for Children Alliance (HECA) http://www.who.int/heca/en/ http://www.who.int/heca/en/  Children's Environment and Health Action Plan for Europe http://www.euro.who.int/childhealthenv/policy/20020724_2 http://www.euro.who.int/childhealthenv/policy/20020724_2  Global Initiative on Children's Environmental Health Indicators http://www.who.int/ceh/indicators/en/http://www.who.int/ceh/indicators/en/

33. European Union European Union Home Page – Europa  http://europa.eu/ http://europa.eu/  Information resources http://europa.eu/geninfo/info/index_en.htm  Environmental issues http://europa.eu/pol/env/index_en.htm  Registration, Evaluation, Authorization and Restriction of Chemicals http://ec.europa.eu/environment/chemicals/reach/reach_ intro.htm http://ec.europa.eu/environment/chemicals/reach/reach_ intro.htm

34. The Health and Environment Alliance European Public Health Alliance Environmental Network - HEAL http://www.env-health.org/

35. International Research and Information Network on Children's Health, Environment and Safety (INCHES) http://inchesnetwork.net/

36. US EPA – Child Specific Information Office of Children’s Health Protection - www.epa.gov/children www.epa.gov/children Toxicity and Exposure Assessment for Children's Health (TEACH)  Contains over 1,400 references covering information on environmental contaminants that potentially impact children's health  www.epa.gov/teach/ www.epa.gov/teach/

37. US CDC – Child Specific Information National Center for Environmental Health/Agency for Toxic Substances & Disease Registry [NCEH/ATSDR]  National Report on Human Exposure to Environmental Chemicals - http://www.cdc.gov/exposurereport/ http://www.cdc.gov/exposurereport/  Toxicological profiles http://www.atsdr.cdc.gov/toxpro2.html http://www.atsdr.cdc.gov/toxpro2.html

38. Environmental Health News www.EnvironmentalHealthNews.org World-wide, English language press  Environmental health issues Summaries of scientific papers Other information

39. Earth Portal - http://www.earthportal.org/ http://www.earthportal.org/ All aspects of the earth “especially in regards to how these systems support life and underpin human existence.” EarthNews  http://www.earthportal.org/news/ http://www.earthportal.org/news/  News articles Encyclopedia of the Earth  http://www.eoearth.org/ http://www.eoearth.org/  Searchable set of reference articles written for EOE Earth Forum  http://www.earthportal.org/forum/ http://www.earthportal.org/forum/  Discussion

40. Information in Languages Other than English Many US government web sites have Spanish language materials  NIH – http://salud.nih.gov/http://salud.nih.gov/  CDC – www.cdc.gov/spanish/default.htmwww.cdc.gov/spanish/default.htm  EPA - http://www.epa.gov/espanol/http://www.epa.gov/espanol/ WHO – www.who.intwww.who.int EU – http://europa.euhttp://europa.eu

41. Other Specific Web Sites Pesticide Information  The Extension Toxicology Network – http://extoxnet.orst.edu/ http://extoxnet.orst.edu/ School Information  Center for Health, Environment and Justice - http://www.chej.org/ http://www.chej.org/  Healthy Schools Network - http://www.healthyschools.org/ http://www.healthyschools.org/