Children Risks From Environmental Hazards

June 11th, 2009 healthwiki Child Health 0

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.

Air pollution

Good ventilation in the home, clean fuels and improved cooking stoves decrease indoor air pollution and the exacerbation and development of acute respiratory infections.

Disease vectors

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.

Chemical hazards

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

The Rising Concern Childhood Weight

February 8th, 2009 healthwiki Child Health 0

Do you know when to be concerned about your child’s weight? Of course, all children gain weight as they grow older. But extra pounds — more than what is needed to support their growth and development — can lead to childhood obesity. Childhood obesity is a serious medical condition that affects children and adolescents.

It occurs when a child is well above the normal weight for his or her age and height. Childhood obesity is particularly troubling because the extra pounds often start kids on the path to health problems that were once confined to adults, such as diabetes, high blood pressure and high cholesterol.

Although there are some genetic and hormonal causes of childhood obesity, most excess weight is caused by kids eating too much and exercising too little.

Children, unlike adults, need extra nutrients and calories to fuel their growth and development. But children who eat more calories than needed gain weight beyond what is required to support their growing bodies.

Risk factors
Many factors — usually working in combination — increase your child’s risk of becoming overweight like diet, inactivity, genetics, psychological factors, family factors, socioeconomic factors and so on.

When to seek medical advice
Not all children carrying extra pounds are overweight or obese. Some children have larger than average body frames. And children normally carry different amounts of body fat at the various stages of development. So you might not know just by looking at your child if his or her weight is a health concern.

If you are worried that your child is putting on too much weight, talk to a physician. S/he will evaluate if your child’s weight is in an unhealthy range.

Obese children can develop serious health problems, such as diabetes and heart disease, often carrying these conditions into an obese adulthood.

Overweight children are at higher risk of developing Type 2 diabetes, Metabolic syndrome, High blood pressure, Asthma and other respiratory problems, Sleep disorders, Liver disease, Early puberty or menarche, Eating disorders, Skin infections

The social and emotional fallout also can hurt your child, especially resulted in low self-esteem and bullying, behavior and learning problems and depression.

Healthy eating
Parents are the ones who buy the food, cook the food and decide where the food is eaten. Even small changes can make a big difference in your child’s health.

* When buying groceries, choose fruits and vegetables over convenience foods high in sugar and fat. Always have healthy snacks available. And never use food as a reward or punishment.

* Limit sweetened beverages, including those containing fruit juice. These drinks provide little nutritional value in exchange for their high calories. They also can make your child feel too full to eat healthier foods.

* Sit down together for family meals. Make it an event — a time to share news and tell stories. Discourage eating in front of a screen, such as a television, computer or video game. This leads to fast eating and lowered awareness of how much you are eating.

* Limit the number of times you eat out, especially at fast-food restaurants. Many of the menu options are high in fat and calories.

Physical activity
A critical component of weight loss, especially for children, is physical activity. It not only burns calories but also builds strong bones and muscles and helps children sleep well at night and stay alert during the day. Such habits established in childhood help adolescents maintain healthy weight despite the hormonal changes, rapid growth and social influences that often lead to overeating. And active children are more likely to become fit adults.

To increase your child’s activity level:

* Limit recreational screen time to fewer than two hours a day.

* Emphasise activity, not exercise.

* Find activities your child likes to do.

* If you want an active child, be active yourself.

* Vary the activities.

Whether your child is at risk of becoming overweight or currently at a healthy weight, you can take proactive measures to get or keep things on the right track.

* Schedule yearly well-child visits. Take your child to the doctor for well-child checkups at least once a year.

* Set a good example. Make sure you eat healthy foods and exercise regularly to maintain your weight. Then, invite your child to join you.

* Avoid food-related power struggles with your child.

* Emphasise the positive. Encourage a healthy lifestyle by highlighting the positive — the fun of playing outside or the variety of fresh fruit you can get year-round, for example.

* Be patient. Many overweight children grow into their extra pounds as they get taller. Realise, too, that an intense focus on your child’s eating habits and weight can easily backfire, leading a child to overeat even more, or possibly making him or her more prone to developing an eating disorder.

Coping and support
Parents play a crucial role in helping children who are obese feel loved and in control of their weight. Take advantage of every opportunity to build your child’s self-esteem.

Consider the following advice:

* Find reasons to praise your child’s efforts.

* Talk to your child about his or her feelings. Help your child find ways to deal with his or her emotions that don’t involve eating.

* Help your child focus on positive goals.

Childhood Diabetes Needs Extra Care

November 19th, 2008 healthwiki Diabetes 0

When a child is diagnosed with diabetes, along with the child the parents will experience everything as new.

Diabetes mellitus ( DM) is not a single entity but rather a heterogeneous group of disorders in which there are distinct genetic patterns as well as other etiological and pathophysiological mechanism that lead to impairment of glucose tolerance. There are two types of diabetes, those are:

Type 1 diabetes: Type 1 diabetes is an immune system disease where the body makes little or no insulin. It usually begins in childhood or teens. Children with type 1 diabetes need daily insulin shots to help their bodies use food. Type 1 diabetes often runs in families.

Type 2 diabetes: Type 2 diabetes is a disease where the body cannot make enough or cannot properly use insulin. Although this form of diabetes usually occurs most often in adults, it is becoming more common in youth. The average age of diagnosis of type 2 diabetes in youth is 12-14 years. It is more common among girls than boys.

Most of the children suffer from type 1 diabetes, so insulin is the treatment of choice. Some are treated with oral drugs. But proper nutritional plan and exercise can reduce the blood glucose effectively.

When choosing foods for a child who has diabetes, it is important to know how different foods affect blood glucose levels. Children who have diabetes basically need the same foods that all children need to grow and thrive. The recommended calorie intake is based on size or surface area of the child.

The following guideline will help provide a healthy diet to help control a child’s diabetes:

Offer balanced meals at regular intervals every day; Learn how different foods affect the child’s blood glucose level; Offer healthy snacks between meals; Encourage the child to drink water when thirsty; Choose whole-grain foods with higher fiber contents; Limit sweets, regular soft drinks, pastries, candy, jam, and honey; Limit saturated fat and cholesterol; Avoid trans fat (found in foods with hydrogenated or partially-hydrogenated oils) etc.

Aerobic exercise, that gets the heart beating faster and uses the large muscles, can help keep blood glucose levels in balance. It can also help lower cholesterol and blood pressure. Exercise also can help the child sleep better, feel more relaxed and even help concentrate better.

Hypoglycemia during or in the 2-8 hours after exercise can be prevented by careful monitoring of blood sugar level before, during or after exercise, sometimes by reducing dosage of insulin or giving extra snacks

Signs of low blood glucose include confusion, grouchiness, irritability, tiredness etc.

If the child has signs of low blood sugar, check blood glucose levels. If the level is under 70 mg/dL, try one of the following:

Have the child drink ½ cup of grape or orange juice, 1 cup of milk, a juice box, or ½ can of a regular (not diet) soft drink Give the child 1-2 tablespoons of sugar or honey

Parents cannot manage there child’s diabetes alone. The stress imposed on the family around the time of initial diagnosis of DM may lead to feeling of shock, denial, sadness, anger, fear and guilt. Meeting with a specialist to express these feelings at the time of diagnosis helps with long term adaptation. The physician must discuss various aspects of child’s diabetes with the child as also with the parents. The exercise has got to be a continuing programme. This needs a good rapport between the physician on one hand and the child and the family on the other hand. Parents need to learn administration of insulin injection, blood sugar testing, recognition of warning signals of hypoglycemia, hyperglycemia, ketoacidosis, infection etc.

Although children can be taught to perform many of the tasks of diabetes management. They do better when supportive — NOT over bearing-parents continue to be involved in management of their disease. Schools have the responsibility to provide diabetic students with a medically safe environment as well as equal access to the same opportunities and activities enjoyed by other students.

Diabetes is a very complicated and life threatening disease. There is no cure for diabetes, it can be controlled. So people of all corners should work together and create awareness, so that a diabetic child can lead a healthy, active and fun-filled life.

Dr Abu Sayeed Shimul