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Published in Spring 2006
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First children’s health and environment indicators
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By Joshua Ostroff
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© Christ Chavez / CEC
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Parents face a constant struggle keeping their children safe from busy roads and accidental injury, but a new report shows kids are also threatened by dangers lurking in our environment.
After several years of gestation, Canada, Mexico and the United States have compiled the world’s first regional report on indicators of children’s environmental health, providing the public and policymakers alike with an eye-opening picture.
“The whole area of linking health and the environment is still evolving,” says consultant Erica Phipps, project coordinator for the Commission for Environmental Cooperation’s report Children’s Health and the Environment in North America: A First Report on Available Indicators and Measures. “Traditionally, health and environment ministries have been very separate and it’s only
recently that they’ve tried to integrate on issues like children’s health.”
The process began in earnest back in 2002 when the CEC Council adopted a trinational cooperative agenda which called for, among other things, periodic reporting of indicators of children’s environmental health. It laid out the report’s priorities: asthma and respiratory diseases; lead and other toxic chemicals; and waterborne diseases. The CEC worked closely with representatives from all three national governments and members of the International Joint Commission’s Health Professionals Task Force, Pan American Health Organization and the World Health Organization. The report also marked North America’s contribution to a global initiative on children’s environmental health indicators launched at the 2002 World Summit on Sustainable Development.
“Traditionally, the studying of toxic chemicals was on healthy adult males,” Phipps notes. “We know now a lot more about why children are different—they’re developing their organ systems, they breathe more and eat and drink more per kilogram of bodyweight. Also, their activities are different—they’re down near the ground, they’re picking stuff up and putting it in their mouths, they’re doing all sorts of things most adult males don’t do.”
“Children aren’t little adults and they need to be treated differently when it comes to environmental exposures and risk levels.”
It may seem surprising that this is the first report of its kind, but drawing conclusive links between the environment and health has proven difficult. Future studies will need to look at agents that are not just proven to be causally linked but also suggested if the researchers hope to “capture the full universe of information that might be important,” says the Environmental Protection Agency’s Tracey Woodruff, a technical lead for the report.
As it stands, there were already difficulties in gathering information on the 13 agreed upon indicators and asthma proved to be the sole indicator that was fully reported across all three countries.
“In the last 20 years, the rate of childhood asthma has really been on the rise to the point that we’re seeing one of every ten children diagnosed,” says Theresa To, senior scientist at Toronto’s Hospital for Sick Children and member of the report’s expert review panel. “It’s one of the most prevalent chronic conditions in North America that requires hospitalization and emergency
visits. The burden both on the family and the health
care system is large.”
Asthma is a concern across North America where some areas have seen a fourfold rise as the lung disease affects millions of children, reaching as high as 20 percent of boys aged 8-11 and 15 percent of girls. Some of this increase can be attributed to better diagnoses, however, indoor and outdoor contaminants are believed to be a major contributing factor.
The report reveals that ground-level ozone levels and particulate matter in the air are still of concern across all three countries, but that considerable progress has been made in reducing children’s exposure to tobacco smoke which puts them at risk of asthma, pneumonia and sudden infant death syndrome.
In Canada, the percentage of children under the age of five exposed to second-hand smoke in the home dropped from 23 to 14 percent between 1999 and 2002, while rates in the United States fell even more precipitously for kids six and under, from 27 percent to 11 percent between 1994 and 2003.
However, US data also suggests that black children face disproportionately higher exposure rates than white or Hispanic children, though poor children are more likely to be exposed to tobacco smoke regardless of ethnicity.
The Mexican government did not present data on tobacco exposure, instead focusing on the more pressing problem of the un-vented burning of firewood and charcoal indoors for cooking and heating, which affects 18 percent of Mexicans and, like cigarette smoke, also disproportionately affects the underclass.
“Children who live below poverty [also] tend to have a much higher median blood lead concentration than those children that live above poverty,” says Woodruff. “Kids who live in older housing and housing that is
deteriorating are at a higher risk of exposure to lead-based paint, that’s an example where we see a potential link between economic disadvantage and exposure to an environmental pollutant.”
This is particularly notable in Mexico when it comes to waterborne disease, which is much less of a problem in the other two nations. However, the report reveals that Mexico has made impressive progress—cutting the percentage of the population without sanitation removal from 50 to 24 percent while similarly decreasing the number of people without access to potable water from 29 to 12 percent. One of the impacts of this action has been a dramatic decrease in diarrheic-related mortality, from a rate of 125.6 deaths per 100,000 children in 1990 to 20 deaths per 100,000 in 2002.
“Mexico is not doing too badly,” Teresa To says, “but since the free trade agreement took place between the US and Mexico there’s a lot of traffic between the two countries. It’s good because it creates a lot of jobs for people, but from an environmental perspective it has stirred up a lot of issues with factories and [automobile] traffic that makes the environment not very ideal for respiratory health. So
in recent years there’s also a slight increase in respiratory
ailments, especially in major cities like Mexico City.”
Tracey Woodruff agrees that the proximity and increased interconnection between the three North American countries is precisely why this joint-report was so necessary.
“Environmental contaminants don’t respect borders so it helps move that process along for the countries to all start thinking together and starts a mutual sharing amongst the countries about different aspects of covering children’s environmental health.”
Everyone agrees this report is vital to creating awareness and momentum amongst policymakers, but it’s just a first step. For Phipps, the biggest surprise of the whole report was what wasn’t in it, such as blood lead levels in Canadian children which haven’t been measured since 1987.
“We thought the indicators we selected were going to be the sure bets. [Thirteen] is not a very long list, and they are in areas in which the governments felt pretty confident and yet we have a lot of data gaps,” she says, noting that publishing a report with holes can focus attention on the research that still remains to be done.
“Boy, we’ve got a lot of work to do.”
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