Dear member of INCHES, In this update: Death rates for young children are related seasonal levels of particulate air pollution and cold temperatures Leukemia rates high for kids near gas stations INCHES website moved to www.inchesnetwork.net Death rates for young children are related seasonal levels of particulate air pollution and cold temperatures Posted By: News-Medical in Child Health News Led by Dr. J. Díaz of Universidad Autónomo de Madrid, the researchers reviewed weather and pollution monitoring data for Madrid from 1986 through 1997. They sought to determine how these environmental factors affect death rates among children less than 10 years old. The results showed significant interactions between daily temperatures and levels of specific air pollutants. In the wintertime, child mortality rates rose a few days after cold days with high levels of particulate air pollutants ("total suspended particles," or TSP). Death rates increased dramatically after cold days with temperatures less than 43° Fahrenheit (6° Celsius). In the summertime, child mortality rates rose also along with TSP levels, as well as with levels of nitrogen oxide pollutants. Most of the temperature- and pollution-related increases in death rates were limited to children between 1 and 5 years old. The effects of temperature and pollution in children differed from those in adults, based on previous studies from Madrid. For adults, death rates increased on both the warmest and coldest days, whereas temperature-related risks in children were limited to cold days. In contrast, the effects of pollution were greater in children. Child mortality rates were especially high on days with TSP levels of more than 100 micrograms per square meter, which occur mostly during the winter. Children's airways are narrower, meaning that they are exposed to a higher concentration of pollutants with each breath. Children are also more likely to be outdoors and physically active on warm summer days when pollutant levels are high. Recent years have seen "exceptionally abnormal" world weather patterns, including very cold winters on the east coast of North America and hot summers in Western Europe. These patterns have raised concerns about possible climate changes and their effects on human health. The study found no relationship between ozone levels high in the atmosphere, which have been linked to "global warming" and child mortality rates. However, the results provide new insights into how daily environmental conditions at ground level might affect health in infants and young children. High TSP levels are a hazard to children in both the winter and summer months, while temperature is a factor mainly on cold days. The public health policies needed to reduce the health dangers of pollution in infants and young children may not be the same as for older adults or the general population, the researchers conclude. ACOEM, an international society of 6,000 occupational physicians and other healthcare professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments. André Picard – Public Health Reporter Children who live in close proximity to gas stations and auto body shops have a dramatically higher rate of leukemia, according to a new study. The research, published in the journal Occupational and Environmental Medicine, provides powerful evidence that the common childhood cancer may be caused by exposure to the chemical benzene. Benzene, used in the manufacture of paints, plastics and pesticides, is also present in gasoline fumes. Previously, exposure to the chemical has been linked to leukemia in adults, but this is the first time the link has been made to children. Jacqueline Clavel, a researcher at the French National Institute of Health and Medical Research in Villejuif, said unleaded fuel -- which is the norm in Canada -- contains small amounts of benzene. But she said this is deceiving because the air around gas stations may actually be more polluted than in industrial settings where the chemical is used, or in neighbourhoods where there are emissions from refineries. "The benzene concentrations around petrol stations during refuelling may be relatively high compared to environmental background concentration," Dr. Clavel said. To conduct the study, researchers examined the background of 280 children with acute childhood leukemia living in four large French cities -- Paris, Lyons, Lille and Nancy. Another 285 children of similar age and gender who did not have leukemia were studied for comparison purposes. The scientists found that children living in proximity to gas stations and commercial garages were four times more likely to have developed leukemia. They were almost eight times as likely to have developed one specific form of the cancer, acute non-lymphocytic leukemia. The majority of children stricken by cancer were aged 2 to 6. The longer a child lived near a gas station, the higher the risk, according to the study. The risk of developing leukemia increased by about 3 per cent per month, including time spent in utero. The research did not reveal any increased cancer risk for children living in proximity to a host of other commercial and industrial enterprises such as plastic factories, printing plants, metal works and retail shops. Nor was any link found between childhood leukemia and living in close proximity to high-traffic roads. Several other studies, however, have shown such an association, particularly in adults. Dr. Clavel said researchers were careful to compare two groups of children from similar socioeconomic backgrounds because cancer is more prevalent among low-income groups. Almost 1,300 children are diagnosed with cancer in Canada each year, and about 230 die, according to the National Cancer Institute of Canada. Almost one-third of the cases and the deaths are due to leukemia. Overall, an estimated 3,900 Canadians will be diagnosed with leukemia in 2004, and 2,200 will die of the disease. The causes of leukemia are largely unknown. What is known, however, is that exposure to radiation and certain types of chemotherapy can cause leukemia. Children with Down syndrome and certain other rare diseases such as ataxia-telangiectasia also have a much higher risk of developing the cancer that starts in white blood cells. http://www.guardian.co.uk/uk_news/story/0,3604,1290880,00.html Fumes given off by cleaning products and solvents in the home may be a cause of asthma in young children, according to new research. Australian researchers measured the levels of chemicals, called volatile organic compounds (VOCs), in the homes of children under three with asthma. These VOCs are given off by commonly used cleaning products, polishes and air fresheners as well as paints, floor adhesives, fitted carpets and cigarette smoke. Excerpts from editorial in Lancet – July 2004 Chemicals could be the next tobacco for WHO, which put this issue high up on the agenda of their 52-country conference on environment and health in Budapest, Hungary. There are thousands of artificial chemicals floating around in each individual and according to Vyvyan Howard, a toxicopathologist at Liverpool University, this chemical soup is major worry. “We’re talking literally of 10s of thousands of novel molecules”, he says. Far from being harmless, as the chemical industry protests, these substances have been linked to several diseases—and children are particularly at risk. “We know these chemicals are contributing to disease in children. This is not speculation. It’s fact”, says Philip Landrigan, Chair of the Department of Community and Preventive Medicine at the Mount Sinai School of Medicine, New York. The danger posed by day-to-day chemicals has led WHO to make moves to strengthen existing guidelines on safety testing. The chemical industry looks set to take on WHO’s challenge, but if past tussles with industry are anything to go by, WHO could be in for a fight. The organisation’s anti-tobacco legislation was met by massive opposition from industry leaders and similar reactions were seen by the food industry to WHO’s resolution on diet, nutrition, and exercise, announced earlier this year. But the chemical industry is keeping a close eye on developments. Observers and lobbyists from large companies journeyed to Budapest to argue their case. According to Marc Danzon, European regional director for WHO, the chemical industry has “ignored health for many years”. He said chemical industry executives have “been a bit stressed by what’s happening with the tobacco industry” and nerves are starting to show. But, he emphasised that WHO was looking for “consensus and dialogue” not conflict. “Health cannot be negotiated . . . We cannot be weak on that.” The European council for the chemical industry (CEFIC) welcomed a European Commission directive on chemical safety that was put together in 2000. “Broadly we agree there’s a need for sensible precaution” said Colin Humphris, Executive Director for Research and Science at CEFIC. “No manufacturer would want to put out products that harm children”. He says that industry representatives want a framework, proportionality, and a fair basis in relative risk—which they believe the EC guidelines provide—but he says WHO wants to move further. WHO seems committed to targeting chemicals. Although the conference declaration had no targets or timelines, even environmental groups came away impressed at WHO’s motivation. Danzon believes the conference marked a real achievement. He has made his name by establishing detailed interactions with countries in Europe, and does not believe in setting global targets. Using the Declaration, WHO’s European office will help member countries define their own specific priorities, and measure progress during the next 3 years. “We are not obsessed by models”, he explains. “We give directions, share experience, and then help every member state adapt.” Howard says chemicals can be found in breast milk and travel across the placenta. They can cause malformation of tissues in the growing fetus because as they occur in similar concentrations to the cell signalling molecules at work during organ building. According to Landrigan, chemicals also contribute to asthma, childhood cancer, birth defects, and learning disabilities. “Asthma has more than doubled. Pollution is part of the problem. Rates of cancer are going up. Rates of certain birth defects of the male reproductive organs in baby boys have doubled”, he says. “These are new problems that relate to new exposures that need new solutions”, he adds. Landrigan believes a change of a change in thinking is required. He suggests that chemicals need to be tested more thoroughly before they get on the market. And that agents already approved for sale should be retested with revised criteria. “Individuals, families, leaders of local and national governments must know what is in the products they are purchasing so they can make decisions”, he says. Politicians need to take steps that will minimise exposure to chemicals by first assuming they cause harm. “If chemicals persist and accumulate in the body then they should be phased out. That’s the short message”, Howard says. Adherence to this “precautionary principle” will be the new bone of contention between WHO and industry. It was endorsed in the Rio Declaration on Environment and Development in 1992, and was reiterated in a more subtle way in the EC document that satisfied CEFIC in 2000. Now, the health and environment ministers of the 52 delegate countries that participated in the Budapest conference, have also pledged to abide by the precautionary principle “as a risk management tool”. Great scientific uncertainty about many of the issues debated remains, however. “We know from painstaking efforts over decades what lead, PCB and methyl mercury can do, and we have a long list of chemicals that we believe can act the same way but we just don’t have the evidence”, says Philippe Grandjean, of the Institute of Public Health, University of Southern Denmark. The precautionary principle is one immediate solution, but there were also calls for a European version of the US National Children’s Study, which aims to follow environmental exposures and consequences to brain development in 100 000 children from birth to 21 years of age.”They’ll be enrolled when their mums come in for prenatal care” says Landrigan. Unlike previous studies which have looked at one chemical at a time, attraction of the NCS cohort, according to Landrigan, is that investigators will be able to look at several chemicals in a vast number of children and look at how these agents interact. The study will cost a huge $250 million. But Landrigan says this figure is tiny compared to the cost of exposurerelated disease. He estimates that the annual cost of environmental diseases in children in the USA is $54·9 billion. “While Europe is ahead of us in policy, we have made some good advances in the science”, he says. McGlade affirms the need for more large-scale studies. “If we told our children what we don’t know and what we do know, I think many of them would be shocked”, he says. Meanwhile WHO is addressing the fact that the impact of the environment on health, especially of children, is not just an issue for Europe. All the six WHO regions are likely to become involved. WHO Director-General Lee Jong-wook told The Lancet in Budapest “To me this meeting is very important because WHO Euro is not only traditional Western Europe, but East Europe, Central Asia and the Far East.” A spokeswoman added: “We hope all six regions of WHO will take up the issue.” But Lillian Corra, of INCHES in Argentina, is concerned that European resolutions will mean chemical companies look to the developing world for business. “Many European chemical companies make profits on dirty business outside Europe” she claims. “We want equality. When [European country] makes a decision we want the same decision to be made for our industry. And we want to be sure that the dirty business and chemicals are not going to be relocated [to the developing world].” Margaret Chan, Director of Health and Environment Coordination at WHO in Geneva, told The Lancet that WHO is looking at this issue. “Globally 25–35% of diseases have an environmental cause, particularly in vulnerable people like children and women . . . So WHO is working with other regional offices trying to role out the same kind of process as Europe’s meetings of ministers of environment and health.” Lee concluded that environmental action in Europe is providing the lead to WHO. “Yesterday, [22 June] I spent a whole day in a meeting on the implementation of the tobacco free initiative. Countries of the EU like Norway and Ireland are already taking very strong measures” by banning smoking in public places. “WHO is concerned with whole world”, he said, “but Europe is giving us lessons.” Conference: In Bukovinian State Medical Academy, Chernivtsy (Ukraine), the 2-nd Healthy Children Conference will take place on September-October 2004. We invite all member of INCHES to take part in this conference. Contact: Head of Department of Developmental Pediatrics, Bukovinian State Medical Academy, Professor Yuriy Nechitailo "Healthy Children Conference will take place on September 30-October 1, 2004 in Chernivtsy (Ukraine) at the Bucovinian Medical Academy Conference Center. The Conference Program Committee invites you to submit abstracts. Conference will provide several opportunities for presentations by participants: oral presentations (10-30 minute presentations with discussion) and attended poster sessions. Working languages: Ukrainian, Russian, English, French and Polish. Topics of paper: Children health, growth and development. Problems of adaptation newborns and infants Developmental nutrition guidelines. Environmental health of children. If you would like to participate in Healthy Children Conference please complete the form below. First Name - Last Name (family name) - Title - Organization - Address - Country - Phone: Fax.: Email: Preferred attendance type: Passive (abstract); active-presentation: Oral - - Poster - - Abstracts requirements. Abstracts can be written in any of working languages and submitted by e-mail in attachment not later than 10 September 2004. Summaries received after this date will not be accepted. Please note that if your abstract is accepted, this is how it will appear in the conference program. Abstracts must not exceed 1 page with 1.5 interval between lines, Times New Roman 12 point, all margins - 2 cm and be preferably in RTF file format (*.rtf). The file must be named by the second name of author (the first author if many) - for example - Smith.rtf. First line - names of authors; second line - title of the report (in capital letters); third line - affiliation, city, country; then 2 intervals below - text of abstract without list of references. All references if any must be in a body of text (for example - J.Smith et al., 1999). You will be notified via e-mail about acceptance and additional information as it becomes available. The cost of travel, accommodation and daily expenses will be the responsibility of the participant. Please feel free to contact Sophy Fokina at pediatr2@msa.cv.ua if you have any questions. Conference secretariat: Department of Developmental Pediatrics Bukovinian State Medical Academy 3/70 Khudiakova str., Chernivtsi, 58002, Ukraine E-mail - chernivtsi2002@yandex.ru, pediatr2@msa.cv.ua www.msa.cv.ua "
Cleaning chemicals linked to asthma in young children
Conference in Ukraine
Seasonal variations in death rates for young children are related to high levels of particulate air pollution and cold temperatures during the winter months, and to high levels of particulate pollutants and nitrogen dioxide during the summer months, according to a Spanish study in the August Journal of Occupational and Environmental Medicine. Leukemia rates high for kids near gas stations
Cleaning chemicals linked to asthma in young children
Their study, published today in the journal Thorax, says that although the number of children in the study was relatively small - 88 toddlers with asthma and 104 without - it showed a marked increase in asthma risk among those children with higher levels of VOCs in their homes. Yet the levels measured were below the levels generally recommended as acceptable indoors. Krassi Rumche, of the school of public health at Curtin University of Technology in Perth, Australia, and colleagues, who conducted the study, say some of these VOCs are carcinogenic as well as having a possible association with asthma.
"There is insufficient evidence concerning the health implications of VOCs at concentrations commonly found inside houses," they write. "Research in this area is complicated by the wide range of relevant VOCs and the continual appearance of new products which release different combinations of these compounds."
They studied children aged six months to three years who had been admitted with asthma symptoms to the accident and emergency department of the Princess Margaret hospital in Perth and compared them with a second group of children without asthma recruited from very similar backgrounds.
Two weeks after the emergency hospital visit in the winter and again in the summer, the researchers took measurements in the children's homes to establish the levels of VOCs. The parents also completed questionnaires on the children's health and the children were subjected to a test for allergies. More children were allergic (77%) among those with asthma than among those without (50%), as would be expected, but the significant finding was that levels of indoor pollutants were higher in thehomes of children with asthma. The highest risk was for the chemical benzene, followed by ethylbenzene and toluene. For every 10 unit increase in toluene and benzene, the risk of asthma increased by almost two times and three times, respectively.
A second study in the journal from a different group of Australian researchers suggests that children exposed to fumes from indoor heaters in the first year of life could be 47% more likely than others to develop wheezing and hyperactive airways (rapid narrowing) which are features of asthma. Gas appliances, in particular, emit higher levels of nitrogen dioxide than would be found outdoors, say the authors, Guy Marks from the Woolcock Institute of Medical Research at the University of Sydney and colleagues. Some epidemiological studies have linked nitrogen dioxide with an increased risk of respiratory symptoms and illnesses.
The authors of the study say that if their findings are backed by further researches, the type of heaters used in homes with babies should be reviewed. City/Town -