Presidential Address* Today’s environment: Tomorrow’s children

Abstract

have over the years contributed enormously towards improving infant and child survival rates of Sri Lanka. Today it is said that children are healthier than they have ever been before. However, the disease spectrum confronting children is changing rapidly. It is to this emerging situation that I wish to draw your attention. Having stepped into the 21 st century we find that the disease entities facing us are changing. It is public knowledge that asthma and cancers in children are on the rise. Literature documents a worldwide increasing incidence of bronchial asthma, autism, attention deficit hyperactivity disorder, developmental disorders, allergies, congenital abnormalities and malignancies, especially leukaemia and brain cancers 1,2. The present day paediatricians encounter these conditions almost daily. On closer scrutiny these conditions are mostly chronic illnesses of multifactorial origin. Having already combated acute infections of childhood, developed nations find themselves facing threats from new environmental hazards 3. If this trend is left unabated these disorders may soon mask the successes achieved in paediatrics and child care 4. Many of these disorders remain without an exact aetiology. Genetic factors account for 10 to 20%. In the remainder environmental factors are strongly suspect. We may not know with any great certainty the exact causative factor or have a clear understanding of pathogenesis but we know enough to worry about their environmental link and outcome. It is therefore up to us to safeguard our children, an