Special vulnerability of children to environmental exposures

Fetal life and childhood are the periods most vulnerable to the harmful effects of exposure to environmental insults. This is because, during these periods, there is rapid cell division, organs are being formed, and growth is rapid. Thus, disruption of these processes may result in life-long abnormalities. Of particular concern are exposures that alter cognitive function and behavior, but exposures that alter growth, development, and reproductive and immune system function and that may increase risk of development of diseases like cancer later in life are also especially important. Exposure to environmental chemicals as well as infectious agents occurs via air, food, water, and absorption through the skin. Therefore, the environment in which fetal and childhood development occurs is very important. Unfortunately, poverty is a major risk factor for both exposures and childhood and later-life disease resulting from exposures to both environmental chemicals and infectious agents. It is very important to protect children because they are the future generation

Looking ahead at the potential benefits of biotechnology-derived allergen therapeutics

While biotechnology-derived allergen therapeutics show promise in improving the safety of immunotherapy, they may prove to have additional benefits in comparison to conventional allergenic extracts that deserve commentary. These issues range from product stability and compatibility to medical practice issues, which will be the focus of this article

Piloting a web-based continuing professional development program for asthma education

Purpose: Continuing professional development is an integral component of modern medical practice, yet traditional educational methods are impractical for many Primary Care Physicians. Web-based programs may fulfill the requirements of busy practitioners who have difficulty attending formal education sessions. Methods: We piloted the use of a learning management system to deliver asthma education materials to Primary Care Physicians in both Australia and Italy in their native languages. Each group of Physicians accessed an education module which contained content pages, self-tests, a quiz and a survey. Details of how the Physicians used the system, their preferences and performance on the assessment were monitored. Results: The learning management system was well received by both Italian and Australian Physicians. Thirty-eight (18 Australian, 20 Italian) Physicians used the system. Participants visited an average of 8.8 pages, with a mean time per hit of 2.9 min. Formative assessment was undertaken by 63.2% and summative assessment by 68.4% of participants. There were no substantial differences in performance between Physicians from both countries. Italian physicians tended to use the system after hours whereas Australian Physicians appear to do so between patient visits. Conclusions: Simple web-based systems are suitable for delivering educational materials to Primary Care Physicians in a manner likely to be used

Children's environmental health indicators in Australia: are we collecting the right information?

In order to assess progress in improving children’s health objectively standardized measurements are required. The World Health Organization (WHO) undertook a pilot project to develop and implement a series of children’s environmental health indicators (CEHI) to facilitate this process. No countries in Oceania were included in this pilot. This project was undertaken to determine whether data collected and publicly available in Australia were sufficient to address the CEHI. Government documents and websites were searched to obtain publicly available data. These data adequately reflected outcome indicators but data addressing many exposure indicators were either missing or not available in a child-specific format. Australia does collect data on child health and well-being but not in a form compatible with the WHO CEHI

Health consequences of environmental exposures: changing global patterns of exposure and disease

Environmental pollution is a major cause of disease and death. Exposures in early life are especially dangerous. Patterns of exposure vary greatly across countries. In low-income and lower middle income countries (LMICs), infectious, maternal, neonatal, and nutritional diseases are still major contributors to disease burden. By contrast, in upper middle income and high-income countries noncommunicable diseases predominate. To examine patterns of environmental exposure and disease and to relate these patterns to levels of income and development, we obtained publically available data in 12 countries at different levels of development through a global network of World Health Organization Collaborating Centres in Children's Environmental Health. Pollution exposures in early life contribute to both patterns. Chemical and pesticide pollution are increasing, especially in LMICs. Hazardous wastes, including electronic waste, are accumulating. Pollution-related chronic diseases are becoming epidemic. Future Global Burden of Disease estimates must pay increased attention to the short- and long-term consequences of environmental pollution

E-Waste and Harm to Vulnerable Populations: A Growing Global Problem

BACKGROUND: Electronic waste (e-waste) is produced in staggering quantities, estimated globally to be 41.8 million tonnes in 2014. Informal e-waste recycling is a source of much-needed income in many low- to middle-income countries. However, its handling and disposal in underdeveloped countries is often unsafe and leads to contaminated environments. Rudimentary and uncontrolled processing methods often result in substantial harmful chemical exposures among vulnerable populations, including women and children. E-waste hazards have not yet received the attention they deserve in research and public health agendas. OBJECTIVES: We provide an overview of the scale and health risks. We review international efforts concerned with environmental hazards, especially affecting children, as a preface to presenting next steps in addressing health issues stemming from the global e-waste problem. DISCUSSION: The e-waste problem has been building for decades. The increasingly observed adverse health effects from e-waste sites calls for protecting human health and the environment from e-waste contamination. Even if e-waste exposure intervention and prevention efforts are implemented, legacy contamination will remain, necessitating increased awareness of e-waste as a major environmental health threat. CONCLUSION: Global, national, and local levels efforts must aim to create safe recycling operations that consider broad security issues for people who rely on e-waste processing for survival. Paramount to these efforts is reducing pregnant women and children's e-waste exposures to mitigate harmful health effects. With human environmental health in mind, novel dismantling methods and remediation technologies, and intervention practices are needed to protect communities

Environmental pollution: an underrecognized threat to children’s health, especially in low- and middle-income countries

Exposures to environmental pollutants during windows of developmental vulnerability in early life can cause disease and death in infancy and childhood as well as chronic, non-communicable diseases that may manifest at any point across the life span. Patterns of pollution and pollution-related disease change as countries move through economic development. Environmental pollution is now recognized as a major cause of morbidity and mortality in low- and middle-income countries (LMICs). According to the World Health Organization, pollution is responsible for 8.9 million deaths around the world each year; of these, 94% (8.4 million) are in LMICs. Toxic chemical pollution is growing into a major threat to children's health in LMICs. The disease and disability caused by environmental pollution have great economic costs, and these costs can undercut trajectories of national development. To combat pollution, improved programs of public health and environmental protection are needed in countries at every level of development. Pollution control strategies and technologies that have been developed in high-income countries must now be transferred to LMICs to assist these emerging economies to avoid the mistakes of the past. A new international clearinghouse is needed to define and track the health effects of pollution, quantify the economic costs of these effects, and direct much needed attention to environmental pollution as a risk factor for disease