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UPDATE no. 31 October 2002 INCHES
2002-The International Network on Children's Health, Environment and Safety
Dear member of INCHES,
In this update :
News items
Articles
Conferences
INCHES funding
INCHES website
Any items related to children’s are welcome. Someone who wants to do something or knows someone who can do some voluntary work for the website can reply to the secretariat.
New member: The Cincinnati Children's Environmental Health Center
The Cincinnati Children's Environmental Health Center at Cincinnati Children's Hospital Medical Center was established to conduct research and training aimed at reducing disease and disability in children caused by environmental hazards. The Center's goal is to promote health and prevent disease by conducting research on environmental antecedents of diseases that originate in childhood, especially residential hazards.
Children are especially vulnerable to environmental toxicants. Until recently, children were treated as "little adults". Pediatric environmental health is emerging as a new field of training and research. Cincinnati Children's is well positioned to conduct research and training in this field, with expertise in environmental neurotoxicants (such as lead and environmental tobacco smoke), ongoing research in environmental causes of asthma, and gene-environment interactions (such as the vitamin D receptor and dopamine-associated polymorphisms and asthma). In 2001, the Center was awarded one of 12 Children's Environmental Health Centers in the United States, strengthening its position as a leader in children's environmental health research
Current Projects
The Center is currently conducting the following research projects:
· 2001 Children's Environmental Health Center Award
· Project 1: Neurobehavioral Effects of Prevalent Toxicants in Children
· Project 2: Validation of Meconium Markers of Fetal Neurotoxicant Exposures
· Project 3: Identifying Residential Hazards Using Home Test Kits
· Project 4: Early Exposure to Lead and Adult Antisocial Outcome
· Project 5: Assessment of Brain Function Altered by Lead Exposure
Cincinnati Asthma Prevention Study
Cincinnati Children's Hospital Medical Center and the University of Cincinnati; Director: Professor Bruce P. Lanphear, 3333 Burnet Avenue ; Cincinnati, OH 45229-3039 ; telephone, 513-636-4420 or 1-800-344-2462
Conference Report:
The 5th International Conference "Health Insurance in Transition: Biotechnology and Public Health: Expectations, Gains and Costs" was held in Zagreb from 26 to 28 September 2002. The Conference was divided in 5 modules which covered health insurance, frontiers in biotechnology, ethics, impact of media in public health, writing a research paper in public health and biotechnology and bioethics in nursing. The lectures held by international experts raised great interest because they gave the latest overview of achievements in biotechnology and its applicability in medicine. The interaction between children and environment, specific needs or treatment was not represented except anecdotally in lectures related on monitoring of heritable diseases and ethics. It was stressed that the follow-up of cancer in children in small communities is very difficult to conduct anonymously . New recommendations about archiving study data are particularly disturbing. The recommendations are that all data should be destroyed after a study is finished. This cuts short any possibility of long-term epidemiologic study of cancer incidence, as well as any comparison with genotoxicological or immunological studies. This attitude is specifically dangerous for revealing the origin of cancer that could have etiology in exposures during childhood and in such case 20 years old archived data could be crucial in making such correlation .
Modern technology is approaching the stage when it will be possible to analyse a single DNA molecule, and when complete laboratory will be squeezed in a laptop-sized machine. The Human Genome Project was like a red thread connecting practically all lectures at the Conference, and confirming its great impact on all fields of biomedicine. It was pointed out that great attention should be given to the education of patients and to the forming of family alliance with children or family members suffering from the same disease in order to improve the treatment and support scientific research in the field of their interest. By gathering about 400 participants, this conference has definitely marked this conference season in Croatia with its topicality and excellent organization.
Report by Aleksandra Fucic
Lead Poisoning Is Not Child's Play by Mario Osava - Tierramérica
RIO DE JANEIRO, Oct 1 (IPS) - Children in Latin America can no longer play freely on the ground, say health and environmental experts, pointing out that industrial waste has contaminated the soil, with lead in particular poisoning their blood, causing stunted growth, deafness and mental disabilities. A study by the Pan-American Health Organisation (PAHO) conducted in the mid-1990s found that the concentration of lead in the blood of Latin American children in urban areas of several countries averaged 15 to 20 percent higher than the limit of 10 micrograms of lead per decilitre (10 ug/dl), established by the World Health Organisation WHO).
Lead is one of the most dangerous threats to children's health, says the WHO. Every day, 5,500 children worldwide die of illnesses related to environmental pollutants. The main source of lead contamination in cities is leaded fuel, particularly gasoline used by motor vehicles. But exposure to the lead used in several types of industries (mining, paints, ceramics, batteries) is increasingly common, and these hotpoints of contamination are sometimes not discovered until years or decades later. Such is the case of the neighbourhood of La Teja, in Montevideo, Uruguay, which in the last century was home to foundries, metal workshops and various industries, most of which have been shut down as a result of a series of economic crises. Two years ago, a child from La Teja was found to have more than 30 ug/dl of lead in his blood, three times the limit set by the WHO. Later, numerous other cases of lead poisoning were found in that neighbourhood, in other districts of the capital, and in other Uruguayan cities.
The community affected by the lead contamination launched a broad mobilisation to demand answers from the authorities, but ended up in a clash with the government. Of the approximately 7,500 children examined, the Health Ministry only recognises a few hundred cases: those with more than 20 ug/dl. The government "still does not have concrete data about the number of people affected," Raquel Rosas, a director at the Public Health Ministry, told Tierramérica. There is no reliable information about the true scope of lead poisoning among children in a given area, and the levels of exposure vary dramatically from country to country. Measurements made by PAHO in the mid-1990s ranged from concentrations of 3.4 ug/dl in Trinidad and Tobago to as high as 28.8 ug/dl in Ecuador. Peru, the world's fourth exporter of lead, is one of the most contaminated countries, largely because there is a lack of appropriate environmental standards or prevention measures, say experts. In several areas of the mining town of Oroya, 150 km east of Lima, the blood of 13 of every 30 children under age three is contaminated with at least 42 ug of lead per decilitre, according to a study conducted in July by toxicologists from the U.S.-based Columbus Children's Hospital. There are 2,000 children age two whose future is threatened, but the Peruvian authorities have yet to impose stricter environmental standards on the mining industry. Lead penetrates the body through inhalation, ingestion or through the skin and is more harmful to children because the metabolism of a child absorbs the lead more readily than does that of an adult. Furthermore, children are more exposed because games and play tend to put them in greater contact with the contaminated ground. In 1998, Peru's Health Ministry acknowledged that 5,000 children living near the mining areas in the port city of Callao registered 20 to 40 ug/dl of lead in the blood. Nearly 100 percent of the 350 students at the María Reich public school have more than 40 ug/dl.
A mobilisation led by Ida Ballasco, mother of two children with lead poisoning, convinced the city of Callao to close six mining installations that did not comply with standards for preventing contamination of the surrounding areas. In Brazil, the authorities of the southern city of Baurú closed the Ajax battery factory in January because it violated environmental laws. In April, the first cases of lead poisoning were found. Of 860 children living within a one-km radius of the factory, 301 surpass the WHO limit of lead in the blood, Jaira Rocco Kirchner, director of the city's mobile health units, told Tierramérica. The 22 who registered more than 30 ug/dl were hospitalised. All will be subject to medical observation and follow-up over the next 10 years. A major challenge facing eighbourhoods like Tangarás, in Baurú, is how to decontaminate the soil. Under consideration is the removal of the surface layer, where the lead particulate is concentrated, but then the problem is how to store such a large volume of contaminated soil. The situation is worse in the slum settlements of La Teja, in Uruguay, where the ground has 3,000 to 15,000 parts lead per million units of soil (ppm). Acceptable limits in industrialised countries like Canada and the United States range from just 140 to 400 ppm, says Luis Lazo, director of environmental development for the Montevideo municipal government. "Nobody should be living in those parts of La Teja,"
comments Lazo. At the first Summit of the Americas, held in the U.S. city of Miami in 1994, the presidents of North and South America declared that lead poisoning among children was a serious public health problem and agreed to eliminate leaded gasoline by 2000. To date, 15 countries have eradicated or dramatically reduced the lead in fuel (Mexico, Guatemala and Brazil were the pioneers), but few regulate the handling of industrial waste, which often ends up contaminating the ground where children play.
Interesting articles in Environmental Health Perspectives October 2002; 110(10)
The Lead Effect?
Although most experts in the field of neurotoxicology would agree that exposure to lead at certain levels is detrimental to human neurological development and function, debate is heating up in the United States over the link between lead exposure and such specific effects as increased antisocial and delinquent behavior. As some toxicologists and other environmental scientists call for better research methods and more advanced technological tools to concretely establish such correlations, economists and sociologists are weighing in with their own often controversial evidence. The number of lead-affected children in the United States continues to decline, but attention remains focused on eliminating sources of child lead exposure.
Julie Wakefield
Pollutants Alter Play
Another Way PCBs Affect Children
A prospective Dutch study that has tracked various health consequences of perinatal exposure to polychlorinated biphenyls (PCBs) and dioxins since 1990 continues to offer new insights into children's health [EHP 110:A593-A598]. The latest assessment by the team, headed by Hestien J. I. Vreugdenhil of Erasmus University Rotterdam and Sophia Children's Hospital, finds that prenatal exposure to these pollutants can influence play behaviors that reflect sex differences.
In this latest stage of the study, 189 children, average age 7.5 years, were evaluated using the Pre-School Activities Inventory, a questionnaire asking parents about their children's play behaviors. The inventory consists of 24 questions that distinguish play behavior between the sexes by focusing on three key aspects of play-type of toys, activities, and child characteristics. Representative questions include whether a child prefers playing with tools versus playing with dolls, taking care of babies versus climbing, and avoiding dirt versus taking risks. Three scales are derived from the inventory: a feminine scale, a masculine scale, and a composite scale integrating both masculine and feminine behaviors.
Each child's perinatal exposure to 4 environmentally important PCBs was estimated from levels of the pollutants in the mother's blood, umbilical cord blood, and breast milk. Breast milk assessments also measured 17 dioxins. About half the children were breastfed for at least six weeks, which increased their exposure to the pollutants, because these pollutants are passed through breast milk. The other half were fed formula containing no PCBs and dioxins from birth.
Boys with higher prenatal exposure to PCBs scored significantly lower on the masculine scale of play behaviour, whereas girls with higher prenatal exposure to PCBs scored higher on the masculine scale. Prenatal exposure to dioxins was associated with higher scores on the feminine scale of play behaviour in both boys and girls. Breastfeeding was not associated with behavioural changes, suggesting that PCBs and dioxins probably disrupt hormones related to childhood play behaviour early in fetal development. However, the children's levels of steroid hormones were not measured at birth. At some later time in the study, the children will be re-evaluated to observe their sex-related behavioural development.
The authors propose that the alterations in play behaviour may be due to steroid hormone imbalances caused early in development, but just how PCBs and dioxins influence steroid hormones remains unknown. The authors recommend following up with this cohort to assess potential implications of these results on later development.
Carol Potera
Diarrhea in Children in Mexico City
Cifuentes et al. assessed the risk of enteric diseases among children living in a water reclamation area using a geographic information system (GIS) to define eligible wells and surrounding homesteads. Groundwater was often contaminated by fecal coliform bacteria, and the endemic pattern of diarrhea mostly reflected the occurrence of inadequate housing, sanitation, and water-related practices. Cifuentes et al. (p. A619)
Asthma, Air Particulates, and Medications
Delfino et al. examined the associations between pollutants and asthma symptoms in asthmatic children who were or were not taking anti-inflammatory medications. The authors found that divergence of exposure-response relationships by anti-inflammatory medication use is consistent with experimental data on inflammatory mechanisms of airborne pollutants and allergens. Delfino et al. (p. A607)
Blood Lead and Tooth Decay in Children
Gemmel et al. evaluated the potential association between blood lead and dental caries in 543 children 6-10 years of age from the Children's Amalgam Trial. The authors' findings add to the evidence supporting a weak association between children's lead exposure and caries prevalence. Gemmel et al. (p. A625)
Anyone been at one of these conferences and can give us a short report?
Charting the Course: Birth Defects, Developmental Disabilities, Disability and Health
September 17-19, 2002 ; Atlanta, GA, USA
The First Mid-Atlantic Conference on Children's Health and the Environment: Clinically Important Issues in Children's Health and the Environment; September 21, 2002; Washington, DC, USA
In Harm's Way: Toxic Threats to Child Development; October 12, 2002; Minneapolis, Minnesota. USA
Healthy Children Conference; October 10-11, 2002; Chernivtsy (Ukraine) at the Bucovinian Medical Academy Conference Center.
Previously announced:
Scientific Symposium on Children's Health as Impacted by Environmental Contaminants
1-2 November; San Antonio, Texas.
Information: The Children’s Environmental Health Institute, PO Box 50342, Austin TX, 78763-0342, 512-657-7405, fax: 512-341-3925, email: Sarah.Jones@CEHI.org www.cehi.org/symposium.htm
QUESTION to INCHES members: Who of you is working with a environmental history taking tool?
Is this tool available for other members? Where can it be found if it is in electronic format? Can your list be distributed as an example to the other members of INCHES? Can you send us more information?
Did you locate a possible sponsor? Do you a private sponsor? Can we mail some information on INCHES to one of your friends? Any donations (or suggestions of possible donors) are welcome at bank account nr.: 526292490 ABN AMRO (swiftcode ABNANL 2A), Dieren, Netherlands.
Last updated 18 October 2002
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