Inches

Special Update INCHES

no.20 March 2002 INCHES
March 18, 2001-The International Network on Children's Health, Environment and Safety

Report and declaration of theInternational Conference on Environmental Threats to the Health of Children:
Hazards and Vulnerability,
Bangkok, 3-7 March 2002

A five-day conference organized by the World Health Organization in Bangkok examined the problems of environmental hazards faced by children.

In the conference participated more than 300 delegates from around the world including professionals from the health, environment and educational sectors, as well as children as part of a community based activity. New research results were presented to increase the awareness of different sectors about children's environmental health.

The Conference focused on children's exposure to lead, mercury, pesticides and organic pollutants, as well as issues such as tobacco smoke, radiation, climate change and food safety, and put special emphasis on environmental problems in the Asia-Pacific region. In Bangladesh and India, for example, arsenic in drinking water is a persistent problem. In some countries, concern exists about exposure to lead (that may cause anaemia and nervous system disorders in under-fives, and has been found to be correlated to subnormal IQ) and by exposure to waste sites. In China alone, an estimated 2.7 million people may suffer from skeletal fluorosis, an irreversible crippling condition that is caused by the consumption of fluoride-rich drinking water. WHO plans on launching pilot projects to help countries assess and improve children’s environmental health in the near future.

Research suggests that over 40% of the global burden of disease due to environmental risk factors may fall on children under five, even though they constitute about 10% of the world's population.

Researchers told the conference that children scavenging in waste dumps face serious health risks, particularly in Cambodian, Laotian and Vietnamese dumps, among the most hazardous in the world. "There's a lot of risk of infection," said Genandrialine Peralta, head of the Pacific Basin Consortium for Hazardous Waste based in Manila.

Panelists also said that dumping in South Asia is on the rise because of low environmental standards set by developing nations. "Economic development is still a priority compared to environmental protection," said Hisashi Ogawa, a regional adviser to the WHO (Daniel Lovering, Associated Press, March 4).

The WHO said that 3 million children die every year because of problems such as unsafe drinking water, indoor air pollution and accidents, injuries and poisonings. 1.3 million children under five in developing countries died from diarrhoeal diseases caused by unsafe water supply, sanitation and hygiene in the year 2000. According to WHO’s publication ”Health and Environment in Sustainable Development – Five Years after the Earth Summit“ 60% of the 2.2 million deaths a year in children under five caused by acute respiratory infections are associated with indoor air pollution (e.g., from the burning of biomass fuels in small, confined spaces), the lack of adequate heating and/or other unsanitary living conditions. Accidental injuries – including road traffic accidents, drowning, burns and poisonings - are the cause of over 400 000 deaths per year in children under five.

The conference looked for ways to make the environment safe for children in the home, at school and in the work place. "A commitment to child health means that hazards should be reduced in all places where children spend significant parts of their day, including the roads and forms of transport they use to get to and from these places," said Richard Helmer, director of the WHO department responsible for environmental health (WHO release). Children are not little adults, conference delegates were reminded. Since they are still growing and their immune systems and detoxification mechanisms are not fully developed, they are especially vulnerable to chemical, physical and biological hazards in air, water and soil. In industrialized as well as developing countries, the development, the health and well being of children is threatened by unsafe food and chemicals in household products and consumer goods.

Waste dumps in Southeast Asia called threat to children's health

Tuesday, March 05, 2002
By Daniel Lovering, Associated Press
BANGKOK, Thailand. Open waste dumps across Southeast Asia pose serious health risks for scavengers, who are often children, and should be closed, researchers said Monday.
Children picking through heaps of garbage are a common sight in poorer nations in the region, and dumps in Cambodia, Laos, and Vietnam were called some of the most hazardous by participants at an international conference on environmental threats to children's health. Genandrialine Peralta, head of the Manila-based Pacific Basin Consortium for Hazardous Waste, said that desperate families often rely on their children to gather scrap from dumps, exposing them to debilitating and sometimes deadly diseases. "There's a lot of risk of infection," she said. "Scavenging should be discontinued, but governments should provide alternative livelihoods."

Discarded batteries, pesticides, fluorescent light tubes, and medical waste are among the most serious health threats for young scavengers.
Choei Konda, a Bangkok-based director of the United Nations Environment Program, said that mercury contained in batteries and polychlorinated biphenyls in thrown-away electronics devices were particularly dangerous.
Peralta said that Southeast Asia should learn from countries that have successfully banned open dumping and turned to incineration or sanitary landfills. But dumping in the region is on the rise, in part because environmental problems are low on the policy agenda of governments in developing nations, participants said. "Economic development is still a priority compared to environmental protection," said Hisashi Ogawa, a regional adviser to the World Health Organization.

Lead Exposure Linked to Antisocial Behavior

CINCINNATI, Ohio, March 1, 2002 (ENS) – Exposure to lead in childhood could lead to antisocial or even criminal behavior in adults, a new study suggests. The first comprehensive lead study to track children over a period of time found that both prenatal and postnatal exposure to lead were associated with antisocial behavior in children and adolescents. "It appears that the neurodevelopmental effects of this avoidable environmental diseases of childhood may not be limited to declines in IQ or academic abilities," said Dr. Kim Dietrich, associate director of Cincinnati Children's Environmental Health Center and the lead author of the study. Researchers at the Environmental Health Center at Cincinnati Children's Hospital Medical Center, in collaboration with University of Cincinnati researchers, followed inner city adolescents recruited into the study before birth between 1979 and 1985. Mothers known to be addicted to drugs or alcohol, diabetic, or those with proven neurological disorders, psychoses or mental retardation were excluded from the study. Between 1997 and 1999, 195 of these adolescents received follow up exams. Ninety-two percent were African American and 53 percent were male. Blood lead levels were taken from mothers during pregnancy and from children every three months between birth and age six, covering the time period when most developmental growth involving the brain occurs. Researchers asked the adolescents and their parents or legal guardians to document antisocial or delinquent behavior. This method of self reporting has been proved to be more valid than official records, which reflect only a small portion of antisocial acts actually committed, the researchers explained. "Self reported acts of delinquent behavior were common," said Dietrich. "Adolescents with the highest blood lead concentrations when they were first graders reported, on average, 4.5 more delinquent acts in the previous 12 months compared to children with the lowest blood lead concentrations as first graders." Delinquency was defined as behaviors in violation of legal statutes involving some risk of arrest, including offenses against property or persons, or other illegal activities such as driving without a license and disorderly conduct. The researchers found that exposure to lead was associated with antisocial behavior, even after adjusting for other factors that could lead to similar behavior. These included quality of home environment, low birth weight, parental intelligence and social class. To their surprise, the researchers found no gender differences in antisocial behavior. Girls were just as likely as boys to be violent and to be institutionalized for their behavior. While lead could be interfering with the usual gender differences seen in behavior, it is more likely that gender is becoming less a predictor of behavior in inner city populations, said Dr. Dietrich, professor of Environmental Health and Pediatrics at the University of Cincinnati.

The study, which appears in the journal "Neurotoxicology and Teratology,"supports previous work at the University of Pittsburgh that suggested that children exposed to lead have significantly greater odds of developing delinquent behavior. University of Pittsburgh researcher Dr. Herbert Needleman, professor of child psychiatry and pediatrics, examined the bone lead levels of 216 youths convicted in a juvenile court and 201 non-delinquent controls from high schools in Pittsburgh. "Of all the causes of juvenile delinquency, lead exposure is perhaps the most preventable," said Needleman. "These results should be a call to action for legislators to protect our children by requiring landlords to not simply disclose known instances of lead paint in their properties, but to remove it." These reports join a growing body of evidence linking lead to health, cognitive and behavioral problems in children. In the U.S., almost a million children under the age of six suffer from lead poisoning. Lead exposure can cause permanent damage to the brain and other organs. Research shows that children with elevated blood lead levels are seven times more likely to drop out of school and twice as likely to lose a few years in language acquisition. Prior studies by Needleman linking lead exposure to lower IQ scores, short attention spans and poor language skills helped prompt nationwide government bans on lead from paint, gasoline and food and beverage cans.

But there are still a number of ways in which children, and adults, may be exposed to lead. Most children who suffer from lead poisoning are exposed to invisible lead dust that is released when older paint is peeling damaged or disturbed, or by eating chips of lead paint. Drinking water that comes from lead pipes or lead soldered fittings can expose children to lead, as can breathing air contaminated by the lead smelting, refining and manufacturing industries.

Tobacco smoke contains some lead, and hobbies that use lead, such as leaded glass ceramics, can cause environmental exposures. Eating contaminated food grown on soil containing lead or food covered with lead containing dust is another source of exposure. Problems from lead exposure are not limited to children. A study by researchers at Johns Hopkins School of Hygiene and Public Health, found that lead exposure on the job can cause progressive declines in memory and learning abilities nearly two decades later. Another study, from Case Western Reserve University and University Hospitals of Cleveland, Ohio, demonstrated that people who have worked in jobs with high levels of lead exposure are up to 3.4 times more likely to develop Alzheimer's disease "Although lead has long been known to be toxic -and is believed to have affected the brains of some of the rulers of the Roman Empire, thereby causing its downfall - its long term damages are difficult to measure," said Elisabeth Koss, PhD, lead author of the study. "The extent of its negative effects have been largely overlooked."

ASIA: Unhealthy Environments Harm Children the Most
By Marwaan Macan-Markar
BANGKOK, Mar 6 (IPS)
At least once a week, Supaporn Boonmag spends her afternoons studying the quality of water in the river that flows by her school in Pathumthani, a province north of Bangkok. Likewise, her classmates among the school's 2,500 students pursue other activities aimed at generating a clean and healthy environment. They include waste management, where students help sort out rubbish, and creating organic fertiliser for use in the Kanaratbumroong Pathumthani secondary school. ''We have to do our share to make this environment healthy,'' says 16-year-old Supaporn, who is studying science and math. ''If we have an idea, we discuss it and then see how to include it in the school's health promoting programme.'' Supaporn says that the school's programme is helping to create a conducive atmosphere to study and grow up in. ''It is important for us to have such an environment. This place is good,'' explains Sikarin Jansingto, 16, who is studying French and English. But not all children across Asia enjoy spending days in such a health conscious environment, a reality that worries the region's public health experts. Equally troubling for them is the impact that hazardous environments are having on the region's youngest citizens, children under age five. Asian children, in fact, make up a sizeable number of those who die annually due to environmental hazards worldwide. Some of the leading hazards such as inadequate drinking water and sanitation, indoor air pollution, injuries and poisoning kill some three million children under five every year, states the World Health Organisation (WHO). This trend is the subject of a five-day international conference ongoing at a research institute outside Bangkok. The WHO meeting seeks to share available research on the environmental hazards most injurious to child's health and to identify appropriate remedies to help the vulnerable children. The conference on 'Environmental Threats to the Health of Children' is the first major initiative of the Geneva-based health body's newly created Task Force for the Protection of Children's Environmental Health. ''The lost or compromised ability to be active which children suffer from environment degradation is vast,'' states a WHO press statement. ''Yet, until recently, no specific efforts had been made to address the environment hazards which specifically affect children.' ''New research is proving that children exposed to environmental hazards are more vulnerable than we thought before,'' says Dr Jenny Pronczuk, leader of the WHO's task force on children's environmental health. ''Environmental health issues cannot be pushed back.'' Equally relevant, according to Dr William Suk, are the conclusions being reached by researchers that the hazards impacting children vary from country to country and also from community to community within countries. ''The environmental hazards in Asian countries vary from Japan, Thailand to China,'' adds Suk, a director at the U.S. government's National Institute of Environmental Health Sciences. ''Public health officials are consequently compelled to design specific preventive programmes.'' This is borne out by WHO researchers, who say, for instance, that arsenic contamination of groundwater is a serious problem in Bangladesh, India and China. Bangladesh is home to some 35 to 77 million people out of the world's 125 million people who are ''at risk of drinking contaminated water'', states a WHO backgrounder. The United Nations Children's Fund (UNICEF) echoes this view. ''We're mainly concerned about the deteriorating quality of drinking water in some countries in the region - contaminated by both chemicals and bacteria,'' says Dr Stephen Atwood, regional advisor for health and nutrition at UNICEF's East Asia and Pacific office. ''Children in many Asian countries have significant exposure to various organic chemicals, including pesticides, solvents, polychlorinated biphenyls, doxins,'' adds a paper co-authored by Suk, titled 'Environment Threats to the Health of Children: The Asian Perspective'. ''In a study in Cambodia, 23 percent of children 6 to 12 years of age in the village of Siem Reap suffered from skin lesions secondary to pesticide exposure, where the exposure came from both the living and play areas and from child labour in the agricultural fields,'' it notes. The Philippines has hazardous levels of air pollution that endanger children's health. ''Air pollution is a major problem for the children of the Philippines, both indoor air pollution from tobacco smoke and outdoor pollution from traffic (close to 60 percent) and industry (40 percent),'' it adds. A Thai public health official adds that Bangkok's air contains worrying amount of toxic chemicals. ''It has the potential to cause cancer,'' she says. But Asia's rural environment is far from safe either. In India, children in rural homes are exposed to contaminated air due to large use of bio mass fuels, says Dr Kalpana Balakrishnan, associate professor at Ramachandra Medical College in Chennai, India. ''Households using bio mass fuel are upwards of 80 percent.'' Dr Pronczuk, the WHO official, says the current conference is an ''important initiative'' to shape public health policies to protect children from environmental hazards. ''The WHO wants to get a sense of how acute this problem is globally. The solutions have to be science based.''

Leaded Gasoline Is Harming Asia's Young:
Thu Mar 7, 1:33 PM ET
NEW YORK (Reuters Health) - Asia should follow the lead of the West and ban the use of lead in gasoline, urged experts on children's health gathering in Bangkok this week. They said leaded gasoline is just one of a number of environmental toxins threatening the development of millions of children living on the world's largest continent. "Studies in Europe and the United States have shown conclusively that the removal of lead from gasoline reduced the levels of lead in children's blood by 90%," said Dr. Richard Helmer, director for environmental protection at the World Health Organization. Lead from gasoline fumes can impair children's neurological development, and Helmer noted that a decades-long ban on leaded gasoline in the West has "in turn led to a 30% to 40% reduction in learning disabilities caused by lead." Helmer was just one of over 300 experts gathered at the First International Conference on Environmental Risks to Children's Health, which wrapped up Thursday in Bangkok. Asia's children face more environmental threats than leaded gasoline, the experts stressed. Rapid industrialization means that formerly pristine waterways are now tainted by untreated waste, while chemical pesticides used to boost agriculture are entering the food supply. In Bangladesh and India, high levels of naturally occurring arsenic are poisoning community water supplies, and in China millions of children face the threat of bone disease linked to water contaminated with fluoride. Finally, high rates of adult smoking mean that children are often exposed to second-hand tobacco smoke at home, damaging their lungs. According to a WHO statement, the experts "recommend that governments both ensure that environmental tobacco smoke no longer pollute public areas and encourage parents to stop inconsiderate tobacco smoking in their homes."

THE BANGKOK STATEMENT

A pledge to promote the protection of Children’s Environmental Health

We, the undersigned scientists, doctors and public health professionals, educators, environmental health engineers, community workers and representatives from a number of international organizations, from governmental and non-governmental organizations in South East Asian and Western Pacific countries have come together with colleagues from different parts of the world from 3 to 7 March 2002 in Bangkok, Thailand, to commit ourselves to work jointly towards the promotion and protection of children’s health against environmental threats.

Global estimates state that more than one quarter of the global burden of disease (GBD) can be attributed to environmental risk factors. Over 40% of the environmental disease burden falls on children under 5 years of age, and yet these young children constitute only 10% of the world population. The environmental burden of pediatric disease in Asia and the Pacific countries is not well recognized and needs to be quantified.

WE RECOGNIZE

That a growing number of diseases in children have been linked to environmental exposures. These range from the traditional water, food and vector-borne diseases and acute respiratory infections to asthma, cancer, injuries, arsenicosis, fluorosis, certain birth defects and developmental disabilities.

That environmental exposures are increasing in many countries in the region; that new emerging risks are being identified and that more and more children are being exposed to unsafe environments where they are conceived and born, where they live, learn, play, work and grow. Unique and permanent adverse health effects can occur when the embryo, fetus, newborn, child and adolescent (“children” from now on) are exposed to environmental agents during periods of special vulnerability.

That in developing countries the main environmental health problems affecting children are exacerbated by poverty, illiteracy and malnutrition, and include: indoor and outdoor air pollution, lack of access to safe water and sanitation, exposure to hazardous chemicals, accidents and injuries. Furthermore, as countries industrialize, children become exposed to toxicants commonly associated with the developed world, creating an additional environmental burden of disease. This deserves special attention from the industrialized and developing countries alike.

That environmental hazards arise both from natural (e.g. plant toxins, fluoride, arsenic, radiations) and anthropogenic sources which separately and in combination can cause serious harm to children.

That restoring and protecting the integrity of the life sustaining systems of the earth is integral to assuring children’s environmental health now and in the future. Therefore, addressing global changes such as human population growth, land and energy use patterns, habitat destruction and bio-diversity loss and climate change must be part of efforts to promote children’s environmental health (CEH).

That despite the rising concern of the scientific community and the education and social sectors about environmental threats to children’s health, progress has been slow and serious challenges still remain concerning the health and development of children from environmental hazards.

That the health, environment and education sectors must take concerted action at all levels (local, national, global), together with other sectors, in serious efforts to enable our countries to assess the nature and magnitude of the problem, identify the main environmental risks to children’s health and establish culturally appropriate monitoring, mitigation and prevention strategies.

WE AFFIRM

That the principle “children are not little adults” requires full recognition and a preventive approach. Children are uniquely vulnerable to the effects of chemical, biological and physical agents. Every child should be protected from injury, poisoning and hazards in the different environments where they are born, live, learn, play, develop and grow to become the adults of tomorrow and citizens in their own right.

That every child with no exception should have the right to safe, clean and supportive environments that ensure his/her survival, growth, development, healthy life and well being. The recognition of this right is especially important as the world moves forward towards adopting sustainable development practices.

That it is the responsibility of professionals, community workers, local and national authorities and policy-makers, and organizations dealing with health, environment and education issues to ensure that actions are initiated, developed and sustained in all countries to promote the recognition, assessment and mitigation of physical, chemical and biological hazards that threaten children’s health and quality of life.

WE COMMIT OURSELVES

To develop active and innovative national and international networks with our colleagues for the promotion and protection of children’s environmental health in all areas, and especially in four critical areas:

1. PROTECTION AND PREVENTION - To strengthen existing programs and initiate new mechanisms to provide access for all children to clean water and air, adequate sanitation, safe food and appropriate shelter:

· Reduce or eliminate environmental causes and triggers of asthma and respiratory diseases, including exposure to environmental tobacco smoke and indoor air pollution caused by the use of biomass fuels.

· Reduce or eliminate exposure to toxic metals such as lead, mercury and arsenic, to fluoride, and to hazardous anthropogenic chemicals such as toxic wastes, pesticides and persistent organic pollutants.

· Reduce or eliminate exposure to known and suspected anthropogenic carcinogens, neurotoxicants, developmental and reproductive toxicants, immunotoxicants and naturally occurring toxins.

· Reduce the incidence of accidents, injuries and poisonings, as well as exposure to noise, radiations and other factors by improving the physical environments of children at home, in schools and in all environments where children spend time

2. HEALTH CARE AND RESEARCH - To promote the recognition, assessment and study of environmental factors that have an impact on the health and development of children:

· Establish centers in children’s environmental health.

· Develop and implement cooperative multidisciplinary research studies in association with centers of excellence, and promote the collection of harmonized data and its dissemination.

· Incorporate training on CEH for health care providers and other professionals, and promote the use of the environmental history.

· Seek financial and institutional support for research, data collection, education, intervention and prevention programs.

· Develop risk assessment methodologies that incorporate children as special groups.

3. EMPOWERMENT AND EDUCATION - To promote the education of children and patents-to-be about the importance of their physical environment and their participation in decisions that affect their lives, and to inform parents, teachers and caregivers and the community in general on the need and means to provide a safe, healthy and supportive environment to all children:

· Provide environmental health education through healthy schools and adult education initiatives.

· Incorporate in the school and high-school curricula lessons on health and the environment.

· Impart environmental health expertise to educators, curriculum designers and school administrators.

· Create and disseminate culturally relevant information about the special vulnerability of children to environmental threats and practical steps to protect children.

· Empower the community to identify toxic threats to children and to work with local authorities in developing prevention and intervention programmes.

4. ADVOCACY - To advocate for the protection and promotion of CEH at all levels, including the political spheres, decision-makers and the communities:

· Utilize lessons learned to prevent environmental illness in children, for example by promoting legislation for the removal of lead from all gasoline, paints and ceramics, and tobacco smoke-free environments in all public buildings.

· Sensitize decision-makers about the results of research studies and observations of front-line workers that need to be accorded high priority to safeguard children’s health.

· Promote environmental health policies that protect children

· Raise the awareness of decision-makers and potential donors about known children’s environmental health threats and work with them and other stakeholders to allocate necessary resources to implement interventions.

· Work with the media to disseminate information on core CEH issues and locally relevant environmental health problems

For all those concerned about the environmental health of children, the time to translate knowledge into action is now.

Bangkok, 7 March 2002

Last updated 12 June 2002

[Home] [Join Inches!] [About Inches] [Inches Activities] [Main Themes] [Coordination Group] [Support] [Site Index]