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Lead is recognized as the most prevalent source of environmental disease among children in the United States primarily due to its widespread presence and serious health effects. Lead exposure often occurs through deteriorating lead-based paint in older homes, contaminated soil, and plumbing systems that utilize lead pipes. Children are particularly vulnerable to lead exposure because their bodies are still developing, and lead can adversely affect their cognitive development, leading to learning disabilities, lower IQ, and behavioral issues.

In addition to lead, other substances such as asbestos, pesticides, and mercury pose health risks, but their prevalence and impact differ. Asbestos exposure is less common today due to regulations but can still occur, particularly in older buildings. Pesticides are used frequently in agricultural and residential settings, but the overall exposure levels tend to be lower compared to lead. Mercury exposure, while concerning, often arises in specific contexts, such as fish consumption or industrial activities, making it less widespread in children's environments.

Thus, the high prevalence of lead and its significant health consequences mark it as the leading environmental health risk for children.