The oil spill in the Gulf of Mexico is unprecedented in size and scope. As a result, there may be extraordinary levels of chemical exposure to those who live in the affected areas. Children are especially vulnerable.

According to the American Academy of Pediatrics (AAP), children are vulnerable to the toxic effects of certain substances because they have higher respiratory and metabolic rates with systems, like the nervous system, that are still developing. "Asthma patients and young infants are more susceptible. They breathe faster than older children and adults, so they are exposed more," says Erica Liebelt, MD, an emergency medicine physician at Children's Hospital of Alabama and medical director of the Regional Poison Control Center.

Short-term effects of the exposure, Liebelt says, primarily are related to the route of exposure, such as through the skin or by inhalation. "Tar balls are not toxic, but can cause mild skin irritations. We recommend you don't pick up the balls and play with them," she says. "If a child gets oil on his or her skin, wash with soap and water or use a mild grease remover. Do not use harsh chemicals like turpentine or kerosene."

Inhalation of fumes from the oil can cause problems in some children. The AAP says that because some toxic agents are heavier than air, they accumulate close to the ground, right in the breathing zone of children. While the Centers for Disease Control (CDC) states that the level of vapors in the air will be below the level that can harm children, some may experience headache, vomiting or nausea.

"Crude oil contains hydrocarbons that go from an oil state to a gaseous state where they can be breathed," Liebelt says. "If there is a significant concentration in the air, it also can cause irritation of the eyes, nose and throat. Symptoms should go away if exposure stops."

The Environmental Protection Agency is monitoring the air quality in affected areas, but so far no high concentration levels of hydrocarbons have been reported.

A spokesperson for USA Pediatrics, a large pediatric practice in Mobile, says they have had a lot of questions from parents related to the dangers of exposure to the oil, but they have seen no direct effects on children who have come into their office.

Max Hale, MD, a pediatrician with Birmingham Pediatrics, says he has not treated anyone with problems related to exposure from the Gulf oil spill. "I am recommending that my patients avoid closed areas and use common sense – don't go into water that is obviously discolored," Hale says.

Liebelt says that long-term effects from the exposure are the big unknown. "We don't anticipate long-term effects in otherwise healthy children," she says. "If a child has a lung condition, a heart condition, or is a young infant, parents should be careful to avoid exposure to the oil and fumes."

Because of the unknowns related to the situation, the CDC recommends that pregnant women also avoid exposure to the oil and its vapors. "We know from animal studies that polycyclic aromatic hydrocarbons can have a chronic effect on a fetus," Liebelt says. "While this finding is not based on a lot of scientific evidence thus far, I still recommend that pregnant women avoid exposure."

Until the oil spill is resolved, the AAP recommends steps that can be taken to protect children from hazards:

• Standards for environmental testing and clean up should be adopted by local health officials, drawing upon relevant existing evidence-based guidelines and in consultation with experts in children's health and the environment.
• Parents and caregivers should become aware of local safety guidelines.
• Children should be supervised and should not be allowed to play in areas where the water or beach contains oil or sludge.
• Adults should handle clean-up efforts, including issues related to animals exposed to the oil.
• Children, whenever possible, should not be involved in clean-up efforts but should only return after the area is cleaned up. Children should be the last group to return to areas impacted by oil.
• Consider the potential for contamination of food and drinking water sources. These supplies should be closely monitored.