Children are especially vulnerable to environmental harms, thus increasing their knowledge about risk factors caused by environmental exposures, in addition to epidemiology by providing practical experiences through a non-computer based educational game in environmental epidemiology may lead to more promising behavioral outcomes. Because no educational game exists in environmental epidemiology, we augmented an existing epidemiology game by adding an environmental health theme, involving practical decision-making and problem solving in environmental epidemiology. A cross-sectional survey assessed the game's impact, on children's knowledge, experience, and attitudes regarding environmental health, and experience and attitudes toward epidemiology following game exposure in 2016. Participants from Croatia had a median age of 11.5 years with interquartile range (IQR) 11-13. The majority of children indicated they had learned a lot about the environmental health concepts newly added to an existing epidemiology game. Our modified game offers interactive and practical examples, which may facilitate teaching environmental epidemiology to elementary school students.