UPDATE no. 54
Dear member of INCHES,
In this update:
News:
Official relationship with World Health Organisation
Call for factsheets
Articles:
Flame Retardants In Dust
Environmental Roots of Asthma
Conferences
INCHES website moved to www.inchesnetwork.net
We are looking for a volunteer who can assist in updating the pages of the website.
News
The WHO Executive Board admitted The International Network on Children's Health, Environment and Safety (INCHES) into official relations with WHO. For your information NGOs in official relations are invited to governing bodies and other intergovernmental conferences. As Network we can so bring forward more activities from our network members.
We have presented a workplan with activities for the coming years, such as making training modules for health care providers in addition to modules that WHO has produced. We will be cooperating in organizing international conferences and workshops with WHO. We will play a consultative role using those members of the INCHES network that can provide knowledge and expertise on certain fields in children’s health and environment. It would be useful to make an updated inventory of the members capabilities. Furthermore, INCHES will play an active role in the HECA movement, which brings together many governmental and non-governmental organizations.
Call for factsheets
We received quite a few factsheets or links to factsheets on the internet. These factsheets are mainly in the english language. We are calling members to send their available factsheets in other languages to be added to the database we are forming. So again, INCHES is calling all its members to send factsheets about any item on children’s environmental health. They could be in any language, ranging from lead poisoning, asthma, allergies, chemical, ventilation at school, etc. We are trying to build a very complete overview which we also share with the HECA network. So please send you electronic version or hard copy to the INCHES address: INCHES, pobox 163, 6950 AD Dieren, the Netherlands, or use this email of the update for your reply. Thanks very much in advance. Please try not to postpone your assistance as we would like to have a very substantial database of factsheets available in the next month for everyone.
Articles
Excerpt from Environmental Science
Flame Retardants In Dust - Dust and dryer lint may be significant PBDE sources
It is stated that household dust may be one of the most significant sources of polybrominated diphenyl ethers (PBDEs) for humans. This news was released in an exploratory study released by the National Institute of Standards & Technology and EPA [Environ. Sci. Technol., published online Dec. 29, http://dx.doi.org/10.1021/es0486824
Levels of PBDEs, used widely as flame retardants, have increased in
human blood and breast milk over the past 25 years. Scientists haven’t been able to pin down the greatest sources of human exposure. Earlier work found PBDEs in groceries, which suggested ingestion. However, because PBDEs are used in many household products, including computers, TVs, and couches, colleagues at NIST and EPA suspected that PBDEs might also be in household dust.
The scientists tested dust from 17 homes in the southern U.S., and found
high levels of PBDEs, ranging from 700 to 30,100 ng of PBDE per g of
dust. Outdoor dirt samples usually average around 100 nanogram per gram. Lint from clothes dryers also contained high PBDE levels. The PBDE levels
were not dependent on the year the house was built, what type of flooring it contained, or how many TVs or computers it held. The researchers caution that small children may be particularly susceptible to household dust inhalation because of their mouthing behaviour with hands and toys.
Environmental Roots of Asthma
From 1980 to 1999, the number of U.S. doctor's office visits for asthma jumped from about 6 million to nearly 12 million, according to data from the Centers for Disease Control and Prevention, and the World Health Organization estimates cases worldwide at 100-150 million. Epidemiologic studies have linked the disease to a plethora of modern lifestyle factors, but the traditional focus has been on heredity and a few identifiable triggers such as animal dander, fungi, ozone, and pollens. At an October 2004 symposium titled Environmental Influences on the Induction and Incidence of Asthma, cosponsored by the NIEHS and the U.S. Environmental Protection Agency, presenters reviewed the scientific evidence for a wider expanse of predisposing factors, including environmental tobacco smoke (ETS) exposure, obesity, dietary fat intake, oxidative stress, and in utero xenobiotic exposures. The emerging array of dynamic interactions between genes, allergens, and pollutants all point to a complex profile of susceptibility and to new possibilities for public health intervention.
The critical interactions between genetic susceptibility and environmental exposures in the induction of asthma are likely to be heavily influenced by the developmental phase at which the exposures occur. For example, it has long been suspected that decreased exposure to microbes during early life may be contributing to the rise in asthma incidence. Of pivotal
interest, from a developmental perspective, is how, why, and when some people acquire immunological tolerance to common allergens, while others go on to develop asthma.
"The programming of this tolerance begins during prenatal and postnatal development," said Harald Renz, a research scientist at Germany's Marburg University. In studies of traditional farm environments in Switzerland, Austria, and Germany, Renz's team consistently found an inverse relationship between asthma rates and maternal blood levels of the bacterial endotoxin lipopolysaccharide (LPS), which is a marker for exposure to gram-negative bacteria common in farmyards. "Infants born to mothers who maintained their daily farm work during pregnancy were almost completely protected from asthma," he said. "Animal studies using LPS during gestation have confirmed these findings: the offspring are largely protected against the development of allergic inflammation and respiratory
hyperresponsiveness."
Other microbial factors also can help entrain healthy immune development. The intestinal bacterium known as Lactobacillus, for example, has immune-modulating roles and can develop mucosal tolerance in the gut. "If the mother receives Lactobacillus regularly during pregnancy, she can reduce her child's risk of atopic dermatitis by fifty percent at the age
of two and four years," said Renz, adding that antibiotic use during gestation may have the opposite effect. Other recent data indicate that exposure to cats and dogs in infancy and early childhood may offer similar protection against allergic sensitization and asthma. Other investigators urged caution against overly simplistic perspectives on the protective
impact of early-life exposures to microbes. "The focus on microbial exposure is only one piece of a much larger picture," said Peter Sly, a lung specialist at the Telethon Institute for Child Health Research in Perth, Australia. "Throughout early life, the immune system takes
maturational cues from the environment in the form of microbial stimulation, bowel flora, mother's milk, and dietary factors. At the same time, the infant is exposed to allergens in the diet and environment. If the allergen exposure coincides with those normal maturational cues, then you're less likely to develop allergic sensitization and asthma."
In western societies, however, said Sly, maturational cues are often missing due to factors such as more sanitary living conditions and use of antibiotics. Problems arise, moreover, when the fetus or infant is exposed to airborne pollutants such as ETS and diesel exhaust particles (DEP), which can cause airway inflammation and may enhance allergic sensitization and drive disease expression. Increased protection against asthma
therefore stems from a confluence of early-life microbial exposure, normal immune maturation, and low exposure to airway irritants or inflammatory factors. The concept of synergy was a repeated theme at the symposium. One prominent example was the interaction between ragweed pollens and DEP, which have received increasing attention as culprits in the rising incidence of asthma. "Many studies have found that DEP enhances airway responsiveness in asthmatics," said clinical immunologist Andre Nel of the
University of California Medical School in Los Angeles. "We also know that DEP has an adjuvant effect on the Th2 cytokine responses [specific immune responses that increase allergic tendencies] to ragweed pollens, causing an allergen-specific IgE response in humans and thus greater susceptibility to asthma."
Nel has studied the quinones, nitrogen oxides, and other pro-oxidative chemicals in DEP. These chemicals tend to increase oxidative stress and stimulate inflammatory pathways that, in turn, pave the way for asthma. Conversely, thiol antioxidants have been shown to interfere with the effects of DEP. Research is now needed to determine whether antioxidant
treatment may be beneficial for children living along roadways with increased traffic density, where asthma prevalence tends to be higher.
Maritta S. Jaakkola, a senior scientist at the Institute of Occupational Medicine of England's University of Birmingham, reported on several studies showing a strong relationship between the extent of smoke exposure and asthma. Jaakkola's research has shown that prenatal, infant, childhood, and adult exposures can all predispose individuals to asthma.
In a study in Finland, 8% of asthma cases that started in adulthood were attributable to ETS exposure within the preceding year. "Exposures to ETS in prenatal life, early childhood, and adulthood can all raise the risk of asthma," said Jaakkola. "For adults, even quite recent exposures can make a difference."
Different groups of mechanisms seem to be involved: ETS may promote chronic respiratory infections in early life, contributing indirectly to asthma risk. In contrast, ETS-related irritants that inflame the airways may play a stronger role in adult cases of asthma. Obese adults might also be at greater risk, given data presented by Stephanie Shore of the Harvard
School of Public Health showing increased inflammatory cytokine levels and airway hyperresponsiveness in these individuals.
Additional discussions focused on the identification of inflammatory markers that can serve as potential indicators of asthma risk. Karin Yeatts, a researcher at the University of North Carolina Center for Environmental Medicine, Asthma, and Lung Biology, spearheaded a study on the effects of different particle sizes and their impact on inflammatory markers in adult asthma patients. Preliminary results indicate that a subgroup of the asthmatic adults had increased levels of inflammatory markers in their lungs in response to increases in ambient concentrations of particles smaller than 2.5 microns. "The levels of particulate matter triggering the upper airway responses were actually lower than those specified by the current national regulations," said Yeatts. "This suggests that a subgroup of asthmatic adults who show this diverse spectrum of inflammatory cytokines in their blood may be at greater risk where the rest of the population would be relatively safe."
The symposium yielded a number of suggestions for public health interventions to lower asthma incidence. Among the proposed strategies were "healthy home" design and building remediation to minimize humidity and improve indoor air quality; changes in infection control to curb rising asthma rates in the elderly; increased education on maternal smoking as a preventable risk factor; more green belts in urban areas as pollution buffers; stricter sanctions on emissions from automobiles and diesel engines, mandating diesel particle traps; a large-scale shift away from fossil fuel use; greater efforts to reduce exposures to known sensitizers in the workplace (including a ban on smoking at work); and better public health communication to all high-risk groups.
The public health challenge of asthma will call for a confluence of scientific and policy directives. "Ultimately, in tackling the problem of factors associated with asthma incidence, we are facing a new challenge to understand the complexity in host-environment interactions as well as the practical issues in developing social policy," said presenter Kevin B.
Weiss, a professor of medicine at Northwestern University. "The challenge is great, but the potential for public health impact is even greater."
Conferences:
Children's World Summit (repeat announcement)
UNEP is organizing the first Children's World Summit for the Environment in Japan from 26 to 29 July 2005 in conjunction with Expo 2005. It will be
hosted by the Aichi Prefectural Government, the City of Toyota and the City of Toyohashi.
If you have any question contact Joyce.Sang@unep.org
World Information Transfer's 14th International Conference on Health and Environment: Global
Partners for Global Solutions
Theme: "Millennium Development Goals: Bridging Health and Environmental Policies for Action"
At United Nations Headquarters, New York; April 28th and 29th, 2005
FOR INFORMATION PLEASE EMAIL wit1986@aol.com OR VISIT WEBSITE www.worldinfo.org
The organization of the Health and Environmental Ministerial Meeting of the Americas will cooperate with NGOs to prepare this meeting. This meeting will be attended by the health and environment ministers. We hope for a powerful agenda with children’s health and environment as an important topic.
The Ministerial meeting (HEMA) will take place in Mar del Plata, Argentina, on June 18 and 19, 2005
Reports
REPORT OF THE PREPARATORY COMMITTEE FOR THE DEVELOPMENT OF A STRATEGIC APPROACH TO INTERNATIONAL CHEMICALS MANAGEMENT
SAICM PrepCom2
4-8 October 2004
English version now available on SAICM website at: http://www.chem.unep.ch/saicm/prepcom2/Default.htm
Arabic, Chinese, French, Spanish and Russian translations of the report will be posted on this web site as soon as they are available.
Interesting website
National Protocol for Medical Evaluation of Children found in Drug Labs
http://www.nationaldec.org/medical%20protocol/medicalprotocol.htm
http://www.nationaldec.org/medical%20protocol/DECNationalProtocol.pdf
Each day in the developing world, 30,500 children die from preventable diseases such as diarrhea, acute respiratory infections or malaria. Malnutrition is associated with over half of those deaths. (UNICEF, World Health Organization)
