The protection of children, pregnant women, and other high-risk workers poses special challenges to occupational health services. Fetuses, infants, and children have unique susceptibilities that differ qualitatively from those of adults. Evidence is accumulating that children’s pre- and postnatal exposures to occupational and environmental factors are contributing to changing patterns of pediatric disease, as well as to increased risk of disease in adult life. Yet neither occupational health services nor systems for risk assessment or regulation are geared to their protection. Instead, these systems are based on the assumption that all workers are at equal risk. To protect infants and children against toxicants, fundamental revisions to current approaches are required. The central elements are (i) improved quantitative assessment of children’s exposures, (ii) the development of new approaches to toxicity testing, and (iii) the application of conservative uncertainty and safety factors in risk assessment that specifically considers children’s risks.

Key terms child; children; high-risk worker; occupational health services; OHS; precautionary principle; risk assessment; special population; toxicity testing; worker