Children are exposed to serious health risks from environmental hazards. Over 40 percent of the global burden of disease attributed to environmental factors falls on children below five years of age, who account for only about 10 percent of the world’s population.
Environmental risk factors often act in concert, and their effects are exacerbated by adverse social and economic conditions, particularly conflict, poverty and malnutrition. Timely action needs to be taken to allow them to grow up and develop in good health, and to contribute to economic and social development.
Polluted indoor and outdoor air, contaminated water, lack of adequate sanitation, toxic hazards, disease vectors, ultraviolet radiation and degraded ecosystems are all important environmental risk factors for children and in most cases for their mothers as well.
Particularly in developing countries like Bangladesh, environmental hazards and pollution are a major contributor to childhood deaths, illnesses and disability from acute respiratory disease, diarrhoeal diseases, physical injuries, poisonings, insect-borne diseases and perinatal infections.
Childhood death and illness from causes such as poverty and malnutrition are also associated with unsustainable patterns of development and degraded urban or rural environments.
Major environment-related killers in children under five years of age
Diarrhoea kills an estimated 1.6 million children each year, caused mainly by unsafe water and poor sanitation.
Indoor air pollution associated with the still-widespread use of biomass fuels kills nearly one million children annually, mostly as a result of acute respiratory infections. Mothers, in charge of cooking or resting close to the hearth after having given birth, are most at risk of developing chronic respiratory disease.
Malaria, which may be exacerbated as a result of poor water management and storage, inadequate housing, deforestation and loss of biodiversity, kills an estimated one million children under five annually, mostly in Africa.
Unintentional physical injuries, which may be related to household or community environmental hazards, kill nearly 300000 children annually: 60000 are attributed to drowning, 40000 to fires, 16000 to falls, 16000 to poisonings, 50000 to road traffic incidents and over 100000 are due to other unintentional injuries
Health-damaging exposure to environmental risks can also begin before birth. Lead in air, mercury in food and other chemicals can result in long-term, often irreversible effects, such as infertility, miscarriage, and birth defects.
Women’s exposure to pesticides, solvents and persistent organic pollutants may potentially affect the health of the fetus. Additionally, while the overall benefits of breastfeeding are recognised, the health of the newborn may be affected by high levels of contaminants in breast milk. Small children, whose bodies are rapidly developing, are particularly susceptible — and in some instances the health impacts may only emerge later in life.
Furthermore, children as young as five years old sometimes work in hazardous settings. Pregnant women living and working in hazardous environments and poor mothers and their children are at a higher risk, as they are exposed to the most degraded environments, are often unaware of the health implications, and lack access to information on potential solutions.
WHO recognises the need to educate and train health care providers at all levels in the prevention, diagnosis and management of children’s diseases linked to environmental risk factors. Efforts are undertaken to enable those “in the front line”, the health professionals dealing with children and adolescents’ health, to recognise, assess and prevent diseases linked to, or triggered by environmental factors.
With low-cost solutions for environment and health problems can be applied in many cases. For instance, simple filtration and disinfection of water at the household level dramatically improves the microbial quality of water, and reduces the risk of diarrhoeal disease at low cost. Improved stoves reduce exposures to indoor air pollution. Better storage and safe use of chemicals at community level reduces exposures to toxic chemicals, especially among toddlers, who explore, touch and taste the products found at home.
Hygiene and sanitation
Washing hands with soap before food preparation, before meals and after defecating significantly reduces the risk of diarrhoeal disease.
Good ventilation in the home, clean fuels and improved cooking stoves decrease indoor air pollution and the exacerbation and development of acute respiratory infections.
As children usually go to bed earlier than adults at the time mosquitoes become active, the use of insecticide-treated mosquito nets and the screening of windows, doors and eaves provide a very effective means of protecting them against malaria.
Ensure safe storage, packaging, use and clear labelling of cleaners, fuels, solvents, pesticides and other chemicals used at home and in schools.
Children are our future, numbering over 2.3 billion worldwide and representing boundless potential. Child survival and development hinge on basic needs to support life; among these, a safe, healthy and clean environment is fundamental.
Dr Md Rajib Hossain