Environmental threats to children's health in Southeast Asia and the Western Pacific.

The Southeast Asia and Western Pacific regions contain half of the world's children and are among the most rapidly industrializing regions of the globe. Environmental threats to children's health are widespread and are multiplying as nations in the area undergo industrial development and pass through the epidemiologic transition. These environmental hazards range from traditional threats such as bacterial contamination of drinking water and wood smoke in poorly ventilated dwellings to more recently introduced chemical threats such as asbestos construction materials; arsenic in groundwater; methyl isocyanate in Bhopal, India; untreated manufacturing wastes released to landfills; chlorinated hydrocarbon and organophosphorous pesticides; and atmospheric lead emissions from the combustion of leaded gasoline. To address these problems, pediatricians, environmental health scientists, and public health workers throughout Southeast Asia and the Western Pacific have begun to build local and national research and prevention programs in children's environmental health. Successes have been achieved as a result of these efforts: A cost-effective system for producing safe drinking water at the village level has been devised in India; many nations have launched aggressive antismoking campaigns; and Thailand, the Philippines, India, and Pakistan have all begun to reduce their use of lead in gasoline, with resultant declines in children's blood lead levels. The International Conference on Environmental Threats to the Health of Children, held in Bangkok, Thailand, in March 2002, brought together more than 300 representatives from 35 countries and organizations to increase awareness on environmental health hazards affecting children in these regions and throughout the world. The conference, a direct result of the Environmental Threats to the Health of Children meeting held in Manila in April 2000, provided participants with the latest scientific data on children's vulnerability to environmental hazards and models for future policy and public health discussions on ways to improve children's health. The Bangkok Statement, a pledge resulting from the conference proceedings, is an important first step in creating a global alliance committed to developing active and innovative national and international networks to promote and protect children's environmental health.

Potential effects of certain persistent organic pollutants and endocrine disrupting chemicals on the health of children.

Persistent organic pollutants are lipophilic, man-made chemicals that are highly resistant to degradation. Due to their persistence, they have become distributed in small quantities throughout the world. They bioaccumulate in thefood chain and are stored in fatty tissues. Biomagnifications up the food chain result in potential widespread human exposure to these chemicals. Exposure to persistent organic pollutants has been associated with many adverse human health effects, including impaired neurodevelopment, immune and reproductive function. Many persistent organic pollutants also possess the ability to disrupt the normal functioning of the endocrine system. There is an increasing concern that low-level exposure to these endocrine disrupting chemicals may have adverse health impacts, particularly during fetal, neonatal, and childhood development. Both the nature and severity of health outcomes may depend on the developmental time-period during which chemical exposure occurs. This report summarizes scientific evidence on health effects of low-level exposure to persistent organic pollutants and endocrine disrupting chemicals.