Impact of environmental factors on pediatric health: Risks, vulnerabilities, and preventive strategies. The view of the European Pediatric Association, Union of National Pediatric Societies and Associations

Children represent a population uniquely susceptible to harm from environmental agents due to distinct physiological, developmental, and behavioral characteristics. The global burden of pediatric disease, encompassing neurodevelopmental disorders, respiratory illnesses, and metabolic dysfunction, is increasingly attributed to a complex interplay of environmental determinants. These determinants extend beyond chemical toxicants (e.g., lead, endocrine-disrupting chemicals) and physical hazards (e.g., air pollution, climate change) to include profound socio-environmental stressors (e.g., poverty, substandard housing, inadequate parental support). Exposure during critical windows of development can lead to irreversible damage and long-term consequences that persist throughout adulthood. A nuanced understanding of gene-environment interactions, cumulative risk, and non-monotonic dose responses is essential for accurately characterizing pediatric risk. Effective public health measures must transition from reactive treatment to proactive, multi-tiered prevention strategies, emphasizing primordial interventions that address structural inequities and systemic failures in chemical assessment, thereby safeguarding health trajectories from conception through adolescence. This overview article presents the position of the European Pediatric Association–Union of National Pediatric Societies and Associations (EPA-UNEPSA), developed in collaboration with the International Pediatric Association (IPA). It addresses a topic of growing urgency that will increasingly shape the health of the pediatric population in the coming decades. Central to this position is the integration of environmental determinants into a comprehensive vision of future public health. EPA-UNEPSA is committed to promoting this perspective and emphasizes that adopting the One Health model, recognizing the inextricable links among human, animal, and ecosystem health, can enhance our ability to anticipate and mitigate the environmental threats facing children today.