Environmental Pollution: An Under-recognized Threat to Children's Health, Especially in Low- and Middle-Income Countries (original) (raw)
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The Impact of Pollution on Children's Health: A Call for Global Accountability and Enforcement
International Journal of Child Health and Nutrition, 2013
Environmental pollution in large industrial centers has had a negative impact on the population's health, specifically among children. Our objective is to provide a systematic review of the literature, focusing on the impact of environmental pollutants from urban and metropolitan areas on pediatric health. Disregard for the Earth's atmosphere can negatively impact our fragile ecosystem and create a global toxicity. The impact of industrial growth and economic development has become paramount to modern society. Unfortunately, future generations will pay the consequences of the world's failure to implement regulations to secure a safe environment for our children's health and development. Pollutants penetrate an organism through different routes and change physiological processes, which leads to a decrease in microbial resistance by weakening the child's immune system. The major contaminants are: polycyclic aromatic hydrocarbons, lead, manganese, sulfur dioxide, airborne fine particles, and nitrogen dioxide. Xenobiotics negatively affect the morphological, functional, biochemical parameters, genetics, and epigenetics of the body. It is well documented that the physical development and psychological well-being of children is adversely affected by pollution. The accumulation of heavy metals and other contaminants adversely affected a child's health has been found in the pediatric population. An effort has been made to develop detoxicant remedies, in particular, some enterosorbents and natural adaptogens. Research is ongoing to improve medical rehabilitation of children, who already are affected. Public education and regulations regarding emerging non-pollutant industrial technologies is called for. A global system of accountability and enforcement regarding environmental protection needs to be implemented.
The Lancet Commission on pollution and health
Lancet (London, England), 2017
Pollution is the largest environmental cause of disease and premature death in the world today. Diseases caused by pollution were responsible for an estimated 9 million premature deaths in 2015-16% of all deaths worldwidethree times more deaths than from AIDS, tuberculosis, and malaria combined and 15 times more than from all wars and other forms of violence. In the most severely affected countries, pollution-related disease is responsible for more than one death in four. Pollution disproportionately kills the poor and the vulnerable. Nearly 92% of pollution-related deaths occur in low-income and middle-income countries and, in countries at every income level, disease caused by pollution is most prevalent among minorities and the marginalised. Children are at high risk of pollutionrelated disease and even extremely low-dose exposures to pollutants during windows of vulnerability in utero and in early infancy can result in disease, disability, and death in childhood and across their lifespan. Despite its substantial effects on human health, the economy, and the environment, pollution has been neglected, especially in low-income and middle-income countries, and the health effects of pollution are underestimated in calculations of the global burden of disease. Pollution in low-income and middle-income countries that is caused by industrial emissions, vehicular exhaust, and toxic chemicals has particularly been overlooked in both the international development and the global health agendas. Although more than 70% of the diseases caused by pollution are non-communicable diseases, inter ventions against pollution are barely mentioned in the Global Action Plan for the Prevention and Control of Non-Communicable Diseases. Pollution is costly. Pollution-related diseases cause productivity losses that reduce gross domestic product (GDP) in low-income to middle-income countries by up to 2% per year. Pollution-related disease also results in health-care costs that are responsible for 1•7% of annual health spending in high-income countries and for up to 7% of health spending in middle-income countries that are heavily polluted and rapidly developing. Welfare losses due to pollution are estimated to amount to US$4•6 trillion per year: 6•2% of global economic output. The costs attributed to pollution-related disease will probably increase as additional associations between pollution and disease are identified.
Children's environmental health – an international perspective
International Journal of Hygiene and Environmental Health, 2003
Parents in all countries want and deserve safe and healthy environments for their children. Children in all countries need, as part of normal growth and development, regular and frequent opportunities to interact with their environments as they learn to crawl, run, climb, swim, and explore. Environmental scientists and regulators recognize that environmental hazards are not contained by international borders. This is of special concern for children, because they are intrinsically at greater risk, compared to adults. They have different opportunities for exposure, greater response to certain toxicants, and less empowerment to alter their environments. There is a growing awareness that adverse health effects in children can adversely affect a country's future productivity and well-being. Multiple government agencies, NGOs, and advocates are mobilizing to address these concerns. A sustained concerted effort will be needed to afford equitable and effective environmental health protection to the world's children, present and future.
Children's Environmental Health: Intergenerational Equity in Action—A Civil Society Perspective
Since World War II, approximately 80,000 new commercial synthetic chemicals have been released into the environment, with approximately 1500 new chemicals released annually. Most of these have not been adequately tested for their impacts on human health or their particular impacts on children and the developing fetus. Yet, children are exposed to hazardous chemicals through residues in their food, indoor and outdoor air pollution, and through household products and contaminated house dust. Many of these synthetic chemicals are persistent and bio-accumulative, remaining in the human body long after exposure. Developing fetuses acquire toxic chemicals that have bio-accumulated in the mother's body and readily cross the placental barrier. Babies are now born with many man-made chemicals in their small bodies. Newborns take in more through breast milk or formula. There are no tests to assess the combined impacts of the " chemical soup " to which children are exposed. WHO, UNICEF, and UNEP have reported a growing number of children's health impacts caused by exposure to hazardous chemicals, including asthma, birth defects, hypospadias, behavioral disorders, learning disabilities, autism, cancer, dysfunctional immune systems, neurological impairments, and reproductive disorders. WHO states that approximately 3 million children under the age of five die every year due to environmental hazards, and this is not limited to developing countries. All children, both in the developing and developed world are affected by exposure to hazardous chemicals. In 2004, the European Union's Ministerial Conference on Children's Environmental Health identified air pollution, unsafe water conditions, and lead exposure as the main culprits in the death and disabling of children in Europe. The conference found that by reducing exposure to hazardous chemicals, the lives of many children could be saved. The key issues in children's environmental health and potential policy and management remedies are examined from both national (Australian) and international perspectives.
Pollution and health: a progress update
The Lancet Planetary Health
The Lancet Commission on pollution and health reported that pollution was responsible for 9 million premature deaths in 2015, making it the world's largest environmental risk factor for disease and premature death. We have now updated this estimate using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. We find that pollution remains responsible for approximately 9 million deaths per year, corresponding to one in six deaths worldwide. Reductions have occurred in the number of deaths attributable to the types of pollution associated with extreme poverty. However, these reductions in deaths from household air pollution and water pollution are offset by increased deaths attributable to ambient air pollution and toxic chemical pollution (ie, lead). Deaths from these modern pollution risk factors, which are the unintended consequence of industrialisation and urbanisation, have risen by 7% since 2015 and by over 66% since 2000. Despite ongoing efforts by UN agencies, committed groups, committed individuals, and some national governments (mostly in high-income countries), little real progress against pollution can be identified overall, particularly in the low-income and middle-income countries, where pollution is most severe. Urgent attention is needed to control pollution and prevent pollution-related disease, with an emphasis on air pollution and lead poisoning, and a stronger focus on hazardous chemical pollution. Pollution, climate change, and biodiversity loss are closely linked. Successful control of these conjoined threats requires a globally supported, formal science-policy interface to inform intervention, influence research, and guide funding. Pollution has typically been viewed as a local issue to be addressed through subnational and national regulation or, occasionally, using regional policy in higher-income countries. Now, however, it is increasingly clear that pollution is a planetary threat, and that its drivers, its dispersion, and its effects on health transcend local boundaries and demand a global response. Global action on all major modern pollutants is needed. Global efforts can synergise with other global environmental policy programmes, especially as a large-scale, rapid transition away from all fossil fuels to clean, renewable energy is an effective strategy for preventing pollution while also slowing down climate change, and thus achieves a double benefit for planetary health. Commission findings on pollution and health Pollution-ie, unwanted waste of human origin released to air, land, water, and the ocean without regard for cost or consequence-is an existential threat to human health and planetary health, and jeopardises the sustainability of modern societies. Pollution includes contamination of air by fine particulate matter (PM 2•5); ozone; oxides of sulphur and nitrogen; freshwater pollution; contami nation of the ocean by mercury, nitrogen, phosphorus, plastic, and petroleum waste; and poisoning of the land by lead, mercury, pesticides, industrial chemicals, electronic waste, and radioactive waste. The 2017 Lancet Commission on pollution and health, which used data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2015, found that pollution was responsible for an estimated 9 million deaths (16% of all deaths globally) and for economic losses totalling US$ 4•6 trillion (6•2% of global economic output) in 2015. 1 The Commission noted pollution's deep inequity: 92% of pollutionrelated deaths, and the greatest burden of pollution's economic losses, occur in lowincome and middleincome countries (LMICs). This report presents an updated estimate of the effects of pollution on health, made on the basis of the GBD 2019 data, and also makes an assessment of trends since 2000. These data show that the situation has not improved, and that pollution remains a major global threat to health and prosperity, particularly in LMICs. Since 2000, the steady decline in the number of deaths from the ancient scourges of household air pollution,
Children's Environmental Health in the Twenty-First Century
Annals of the New York Academy of Sciences, 2008
In the twenty-first century, the global burden of disease trends are the result of complex interaction among rapid industrialization and urbanization, unsustainable use of natural resources, and population growth. In addition, global environmental changes due to climate change, ozone depletion, desertification/deforestation, loss of biodiversity, and increased used of some biotechnologies are having an important impact on human health. Many other factors also play an important role in the population's health response to global environmental threats, including poverty, malnutrition, poor sanitation, and infectious diseases. Worldwide, the burden of environmental disease is much higher for children than adults, especially in young children under 5 years of age. Quantification of the burden of diseases attributable to environment shows that environmental risk factors can contribute to more than one-third of the disease burden in children, a fraction of disease that could be prevented. Children are often exposed to multiple environmental threats combined with other behavioral, social, and economic risk factors. Many of the environmental health risk factors are shared among children's home, school, and community. Therefore, an integrated approach should be considered in order to create healthy environments for children. The promotion of safe environments for children has to involve decision makers, nongovernmental organizations (NGOs), families, and various sectors including health, education, housing, environment, agriculture, industry, transport, and energy. Multiple initiatives have been proposed from collection, evaluation, and dissemination of information on children's health and the potential environmental threats to research, monitoring, risk assessment, and policies to improve the environmental conditions and ultimately children's growth and development.
The Lancet Planetary Health
Background WHO estimates that, in 2015, nearly 1 million children younger than 5 years died from lower respiratory tract infections (LRIs). Ambient air pollution has a major impact on mortality from LRIs, especially in combination with undernutrition and inadequate health care. We aimed to estimate mortality due to ambient air pollution in 2015, particularly in children younger than 5 years, to investigate to what extent exposure to this risk factor affects life expectancy in different parts of the world. Methods Applying results from a recent atmospheric chemistry-general circulation model and health statistics from the WHO Global Health Observatory, combined in integrated exposure-response functions, we updated our estimates of mortality from ambient (outdoor) air pollution. We estimated excess deaths attributable to air pollution by disease category and age group, particularly those due to ambient air pollution-induced LRIs (AAP-LRIs) in childhood. Estimates are presented as excess mortality attributable to ambient air pollution and years of life lost (YLLs). To study recent developments, we calculated our estimates for the years 2010 and 2015. Findings Overall, 4•55 million deaths (95% CI 3•41 million to 5•56 million) were attributable to air pollution in 2015, of which 727 000 deaths (573 000-865 000) were due to AAP-LRIs. We estimated that AAP-LRIs caused about 237 000 (192 000-277 000) excess child deaths in 2015. Although childhood AAP-LRIs contributed about 5% of air pollutionattributable deaths worldwide, they accounted for 18% of losses in life expectancy, equivalent to 21•5 million (17 million to 25 million) of the total 122 million YLLs due to ambient air pollution in 2015. The mortality rate from ambient air pollution was highest in Asia, whereas the per capita YLLs were highest in Africa. We estimated that in sub-Saharan Africa, ambient air pollution reduces the average life expectancy of children by 4-5 years. In Asia, all-age mortality increased by about 10% between 2010 and 2015, whereas childhood mortality from AAP-LRIs declined by nearly 30% in the same period. Interpretation Most child deaths due to AAP-LRIs occur in low-income countries in Africa and Asia. A three-pronged strategy is needed to reduce the health effects of ambient air pollution in children: aggressive reduction of air pollution levels, improvements in nutrition, and enhanced treatment of air pollution-related health outcomes.
Pollution and Global Health – An Agenda for Prevention
Environmental Health Perspectives
Pollution is a major, overlooked, global health threat that was responsible in 2015 for an estimated 9 million deaths and great economic losses. To end neglect of pollution and advance prevention of pollution-related disease, we formed the Lancet Commission on Pollution and Health. Despite recent gains in understanding of pollution and its health effects, this Commission noted that large gaps in knowledge remain. To close these gaps and guide prevention, the Commission made research recommendations and proposed creation of a Global Observatory on Pollution and Health. We posit that successful pollution research will be translational and based on transdisciplinary collaborations among exposure science, epidemiology, data science, engineering, health policy, and economics. We envision that the Global Observatory on Pollution and Health will be a multinational consortium based at Boston College and the Harvard T.H. Chan School of Public Health that will aggregate, geocode, and archive data on pollution and pollution-related disease; analyze these data to discern trends, geographic patterns, and opportunities for intervention; and make its findings available to policymakers, the media, and the global public to catalyze research, inform policy, and assist cities and countries to target pollution, track progress, and save lives.