Structured expert judgement approach of the health impact of various chemicals and classes of chemicals.

INTRODUCTION: Chemical contamination and pollution are an ongoing threat to human health and the environment. The concern over the consequences of chemical exposures at the global level continues to grow. Because resources are constrained, there is a need to prioritize interventions focused on the greatest health impact. Data, especially related to chemical exposures, are rarely available for most substances of concern, and alternate methods to evaluate their impact are needed. STRUCTURED EXPERT JUDGMENT (SEJ) PROCESS: A Structured Expert Judgment (Research Outreach, 2021) process was performed to provide plausible estimates of health impacts for 16 commonly found pollutants: asbestos, arsenic, benzene, chromium, cadmium, dioxins, fluoride, highly hazardous pesticides (HHPs), lead, mercury, polycyclic-aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), Per- and Polyfluorinated Substances (PFAs), phthalates, endocrine disrupting chemicals (EDCs), and brominated flame retardants (BRFs). This process, undertaken by sector experts, weighed individual estimations of the probable global health scale health impacts of each pollutant using objective estimates of the expert opinions' statistical accuracy and informativeness. MAIN FINDINGS: The foremost substances, in terms of mean projected annual total deaths, were lead, asbestos, arsenic, and HHPs. Lead surpasses the others by a large margin, with an estimated median value of 1.7 million deaths annually. The three other substances averaged between 136,000 and 274,000 deaths per year. Of the 12 other chemicals evaluated, none reached an estimated annual death count exceeding 100,000. These findings underscore the importance of prioritizing available resources on reducing and remediating the impacts of these key pollutants. RANGE OF HEALTH IMPACTS: Based on the evidence available, experts concluded some of the more notorious chemical pollutants, such as PCBs and dioxin, do not result in high levels of human health impact from a global scale perspective. However, the chemical toxicity of some compounds released in recent decades, such as Endocrine Disrupters and PFAs, cannot be ignored, even if current impacts are limited. Moreover, the impact of some chemicals may be disproportionately large in some geographic areas. Continued research and monitoring are essential; and a preventative approach is needed for chemicals. FUTURE DIRECTIONS: These results, and potential similar analyses of other chemicals, are provided as inputs to ongoing discussions about priority setting for global chemicals and pollution management. Furthermore, we suggest that this SEJ process be repeated periodically as new information becomes available.

Pollution and health: a progress update.

The Lancet Commission on pollution and health reported that pollution was responsible for 9 million premature deaths in 2015, making it the world's largest environmental risk factor for disease and premature death. We have now updated this estimate using data from the Global Burden of Diseases, Injuriaes, and Risk Factors Study 2019. We find that pollution remains responsible for approximately 9 million deaths per year, corresponding to one in six deaths worldwide. Reductions have occurred in the number of deaths attributable to the types of pollution associated with extreme poverty. However, these reductions in deaths from household air pollution and water pollution are offset by increased deaths attributable to ambient air pollution and toxic chemical pollution (ie, lead). Deaths from these modern pollution risk factors, which are the unintended consequence of industrialisation and urbanisation, have risen by 7% since 2015 and by over 66% since 2000. Despite ongoing efforts by UN agencies, committed groups, committed individuals, and some national governments (mostly in high-income countries), little real progress against pollution can be identified overall, particularly in the low-income and middle-income countries, where pollution is most severe. Urgent attention is needed to control pollution and prevent pollution-related disease, with an emphasis on air pollution and lead poisoning, and a stronger focus on hazardous chemical pollution. Pollution, climate change, and biodiversity loss are closely linked. Successful control of these conjoined threats requires a globally supported, formal science-policy interface to inform intervention, influence research, and guide funding. Pollution has typically been viewed as a local issue to be addressed through subnational and national regulation or, occasionally, using regional policy in higher-income countries. Now, however, it is increasingly clear that pollution is a planetary threat, and that its drivers, its dispersion, and its effects on health transcend local boundaries and demand a global response. Global action on all major modern pollutants is needed. Global efforts can synergise with other global environmental policy programmes, especially as a large-scale, rapid transition away from all fossil fuels to clean, renewable energy is an effective strategy for preventing pollution while also slowing down climate change, and thus achieves a double benefit for planetary health.

Human Health and Ocean Pollution.

Background: Pollution - unwanted waste released to air, water, and land by human activity - is the largest environmental cause of disease in the world today. It is responsible for an estimated nine million premature deaths per year, enormous economic losses, erosion of human capital, and degradation of ecosystems. Ocean pollution is an important, but insufficiently recognized and inadequately controlled component of global pollution. It poses serious threats to human health and well-being. The nature and magnitude of these impacts are only beginning to be understood. Goals: (1) Broadly examine the known and potential impacts of ocean pollution on human health. (2) Inform policy makers, government leaders, international organizations, civil society, and the global public of these threats. (3) Propose priorities for interventions to control and prevent pollution of the seas and safeguard human health. Methods: Topic-focused reviews that examine the effects of ocean pollution on human health, identify gaps in knowledge, project future trends, and offer evidence-based guidance for effective intervention. Environmental Findings: Pollution of the oceans is widespread, worsening, and in most countries poorly controlled. It is a complex mixture of toxic metals, plastics, manufactured chemicals, petroleum, urban and industrial wastes, pesticides, fertilizers, pharmaceutical chemicals, agricultural runoff, and sewage. More than 80% arises from land-based sources. It reaches the oceans through rivers, runoff, atmospheric deposition and direct discharges. It is often heaviest near the coasts and most highly concentrated along the coasts of low- and middle-income countries. Plastic is a rapidly increasing and highly visible component of ocean pollution, and an estimated 10 million metric tons of plastic waste enter the seas each year. Mercury is the metal pollutant of greatest concern in the oceans; it is released from two main sources - coal combustion and small-scale gold mining. Global spread of industrialized agriculture with increasing use of chemical fertilizer leads to extension of Harmful Algal Blooms (HABs) to previously unaffected regions. Chemical pollutants are ubiquitous and contaminate seas and marine organisms from the high Arctic to the abyssal depths. Ecosystem Findings: Ocean pollution has multiple negative impacts on marine ecosystems, and these impacts are exacerbated by global climate change. Petroleum-based pollutants reduce photosynthesis in marine microorganisms that generate oxygen. Increasing absorption of carbon dioxide into the seas causes ocean acidification, which destroys coral reefs, impairs shellfish development, dissolves calcium-containing microorganisms at the base of the marine food web, and increases the toxicity of some pollutants. Plastic pollution threatens marine mammals, fish, and seabirds and accumulates in large mid-ocean gyres. It breaks down into microplastic and nanoplastic particles containing multiple manufactured chemicals that can enter the tissues of marine organisms, including species consumed by humans. Industrial releases, runoff, and sewage increase frequency and severity of HABs, bacterial pollution, and anti-microbial resistance. Pollution and sea surface warming are triggering poleward migration of dangerous pathogens such as the Vibrio species. Industrial discharges, pharmaceutical wastes, pesticides, and sewage contribute to global declines in fish stocks. Human Health Findings: Methylmercury and PCBs are the ocean pollutants whose human health effects are best understood. Exposures of infants in utero to these pollutants through maternal consumption of contaminated seafood can damage developing brains, reduce IQ and increase children's risks for autism, ADHD and learning disorders. Adult exposures to methylmercury increase risks for cardiovascular disease and dementia. Manufactured chemicals - phthalates, bisphenol A, flame retardants, and perfluorinated chemicals, many of them released into the seas from plastic waste - can disrupt endocrine signaling, reduce male fertility, damage the nervous system, and increase risk of cancer. HABs produce potent toxins that accumulate in fish and shellfish. When ingested, these toxins can cause severe neurological impairment and rapid death. HAB toxins can also become airborne and cause respiratory disease. Pathogenic marine bacteria cause gastrointestinal diseases and deep wound infections. With climate change and increasing pollution, risk is high that Vibrio infections, including cholera, will increase in frequency and extend to new areas. All of the health impacts of ocean pollution fall disproportionately on vulnerable populations in the Global South - environmental injustice on a planetary scale. Conclusions: Ocean pollution is a global problem. It arises from multiple sources and crosses national boundaries. It is the consequence of reckless, shortsighted, and unsustainable exploitation of the earth's resources. It endangers marine ecosystems. It impedes the production of atmospheric oxygen. Its threats to human health are great and growing, but still incompletely understood. Its economic costs are only beginning to be counted.Ocean pollution can be prevented. Like all forms of pollution, ocean pollution can be controlled by deploying data-driven strategies based on law, policy, technology, and enforcement that target priority pollution sources. Many countries have used these tools to control air and water pollution and are now applying them to ocean pollution. Successes achieved to date demonstrate that broader control is feasible. Heavily polluted harbors have been cleaned, estuaries rejuvenated, and coral reefs restored.Prevention of ocean pollution creates many benefits. It boosts economies, increases tourism, helps restore fisheries, and improves human health and well-being. It advances the Sustainable Development Goals (SDG). These benefits will last for centuries. Recommendations: World leaders who recognize the gravity of ocean pollution, acknowledge its growing dangers, engage civil society and the global public, and take bold, evidence-based action to stop pollution at source will be critical to preventing ocean pollution and safeguarding human health.Prevention of pollution from land-based sources is key. Eliminating coal combustion and banning all uses of mercury will reduce mercury pollution. Bans on single-use plastic and better management of plastic waste reduce plastic pollution. Bans on persistent organic pollutants (POPs) have reduced pollution by PCBs and DDT. Control of industrial discharges, treatment of sewage, and reduced applications of fertilizers have mitigated coastal pollution and are reducing frequency of HABs. National, regional and international marine pollution control programs that are adequately funded and backed by strong enforcement have been shown to be effective. Robust monitoring is essential to track progress.Further interventions that hold great promise include wide-scale transition to renewable fuels; transition to a circular economy that creates little waste and focuses on equity rather than on endless growth; embracing the principles of green chemistry; and building scientific capacity in all countries.Designation of Marine Protected Areas (MPAs) will safeguard critical ecosystems, protect vulnerable fish stocks, and enhance human health and well-being. Creation of MPAs is an important manifestation of national and international commitment to protecting the health of the seas.

Chemical Pollutants of Pharmaceutical Origin Present in the Environment.

Competing Interests. The author declares no competing financial interests.

Children's health in Latin America: the influence of environmental exposures.

BACKGROUND: Chronic diseases are increasing among children in Latin America. OBJECTIVE AND METHODS: To examine environmental risk factors for chronic disease in Latin American children and to develop a strategic initiative for control of these exposures, the World Health Organization (WHO) including the Pan American Health Organization (PAHO), the Collegium Ramazzini, and Latin American scientists reviewed regional and relevant global data. RESULTS: Industrial development and urbanization are proceeding rapidly in Latin America, and environmental pollution has become widespread. Environmental threats to children's health include traditional hazards such as indoor air pollution and drinking-water contamination; the newer hazards of urban air pollution; toxic chemicals such as lead, asbestos, mercury, arsenic, and pesticides; hazardous and electronic waste; and climate change. The mix of traditional and modern hazards varies greatly across and within countries reflecting industrialization, urbanization, and socioeconomic forces. CONCLUSIONS: To control environmental threats to children's health in Latin America, WHO, including PAHO, will focus on the most highly prevalent and serious hazards-indoor and outdoor air pollution, water pollution, and toxic chemicals. Strategies for controlling these hazards include developing tracking data on regional trends in children's environmental health (CEH), building a network of Collaborating Centres, promoting biomedical research in CEH, building regional capacity, supporting development of evidence-based prevention policies, studying the economic costs of chronic diseases in children, and developing platforms for dialogue with relevant stakeholders.

Perfil de la salud ambiental de la niñez en la región noroeste de la Argentina / Children’s environmental health profile in the Northern West region of Argentina

INTRODUCCION: La carga ambiental de las enfermedades infantiles puede ser controlada y prevenida evitando daños irreversibles.OBJETIVO: Elaborar un perfil de la salud ambiental de la niñez en la región Noroeste de la Argentina. Esta herramienta aporta un elemento importante para orientar las acciones de prevención y protección de la salud y el ambiente de dicha región. Este estudio se nutrió de la capacidad, experiencias obtenidas y del impacto positivo derivado del Perfil de la Salud Ambiental de la Niñez en la Argentina (Perfil SANA) realizado por la Asociación Argentina de Médicos por el Medio Ambiente, el Ministerio de Salud de la Nación y la Sociedad Argentina de Pediatría.METODOS: El desarrollo del perfil promovió la interacción y la creación de vínculos entre los participantes de los sectores de ambiente y salud. El perfil permitió cuantificar la situación de la niñez utilizando los parámetros de salud en el análisis de los indicadores de contexto (población, edad, pobreza, género, entre otros), salud, exposición ambiental y de acción (por ejemplo, identificación de acciones y oportunidades).RESULTADOS: La definición y el análisis de los indicadores permitieron identificar los vacíos de información y las brechas de intervención y construir la línea de base como parámetro para comparar y evaluar en el tiempo y regionalmente el impacto de las acciones.CONCLUSIONES: La información obtenida brinda una base para que los responsables de la toma de decisiones, los investigadores, el sector privado y la comunidad en general, tengan una herramienta que les permita identificar situaciones de riesgo y desarrollar acciones para proteger mejor a los niños de los peligros ambientales.

INTRODUCTION: Children’s environmental burden of diseases can be controlled and preventes to avoid irreversible health damages.OBJECTIVE: To build children’s environmental health profile of the North-western Region of Argentina. This tool is an important element to protect health and envirtonment in the selected region. The project took into account the positive impact of the experience Profile of Children’s Environmental Health in Argentina (SANA Profile), developed by the Argentine Society of Doctors for the Environment, the Ministry of Health of the Nation and the Argentine Society of Pediatrics.METHODS: Different actors participated in the development of the profile, promoting interaction and creating links between environment and health. The profile allowed to quantify the children’s situation using health parameters in the analysis of context indicators (population, age, poverty, gender, etc.), health, environmental exposure and action (for example, identification of actions and opportunities).RESULTS: The definition and the analysis of the indicators allowed to identify the gaps of information and intervention, so as to build a base line to evaluate and compare the impact of the actions throughout time and regionally.CONCLUSIONS: The information is a preliminary basis for decision makers, researchers, private sector and community actors. It represents a tool to identify danger situations and develop actions to protect children from environmental hazards.

Perfil de la salud ambiental de la niñez en la región noroeste de la Argentina / Childrens environmental health profile in the Northern West region of Argentina

INTRODUCCION: La carga ambiental de las enfermedades infantiles puede ser controlada y prevenida evitando daños irreversibles.OBJETIVO: Elaborar un perfil de la salud ambiental de la niñez en la región Noroeste de la Argentina. Esta herramienta aporta un elemento importante para orientar las acciones de prevención y protección de la salud y el ambiente de dicha región. Este estudio se nutrió de la capacidad, experiencias obtenidas y del impacto positivo derivado del Perfil de la Salud Ambiental de la Niñez en la Argentina (Perfil SANA) realizado por la Asociación Argentina de Médicos por el Medio Ambiente, el Ministerio de Salud de la Nación y la Sociedad Argentina de Pediatría.METODOS: El desarrollo del perfil promovió la interacción y la creación de vínculos entre los participantes de los sectores de ambiente y salud. El perfil permitió cuantificar la situación de la niñez utilizando los parámetros de salud en el análisis de los indicadores de contexto (población, edad, pobreza, género, entre otros), salud, exposición ambiental y de acción (por ejemplo, identificación de acciones y oportunidades).RESULTADOS: La definición y el análisis de los indicadores permitieron identificar los vacíos de información y las brechas de intervención y construir la línea de base como parámetro para comparar y evaluar en el tiempo y regionalmente el impacto de las acciones.CONCLUSIONES: La información obtenida brinda una base para que los responsables de la toma de decisiones, los investigadores, el sector privado y la comunidad en general, tengan una herramienta que les permita identificar situaciones de riesgo y desarrollar acciones para proteger mejor a los niños de los peligros ambientales.

INTRODUCTION: Childrens environmental burden of diseases can be controlled and preventes to avoid irreversible health damages.OBJECTIVE: To build childrens environmental health profile of the North-western Region of Argentina. This tool is an important element to protect health and envirtonment in the selected region. The project took into account the positive impact of the experience Profile of Childrens Environmental Health in Argentina (SANA Profile), developed by the Argentine Society of Doctors for the Environment, the Ministry of Health of the Nation and the Argentine Society of Pediatrics.METHODS: Different actors participated in the development of the profile, promoting interaction and creating links between environment and health. The profile allowed to quantify the childrens situation using health parameters in the analysis of context indicators (population, age, poverty, gender, etc.), health, environmental exposure and action (for example, identification of actions and opportunities).RESULTS: The definition and the analysis of the indicators allowed to identify the gaps of information and intervention, so as to build a base line to evaluate and compare the impact of the actions throughout time and regionally.CONCLUSIONS: The information is a preliminary basis for decision makers, researchers, private sector and community actors. It represents a tool to identify danger situations and develop actions to protect children from environmental hazards.

Herramienta de capacitación para el manejo responsable de plaguicidas y sus envases: efectos sobre la salud y prevención de la exposición

Este libro reúne información actualizada, científicamente confiable sobre los químicos utilizados como plaguicidas, sus coadyuvantes y vehículos presentes en las mezclas comerciales o que forman parte de las fórmulas que se aplican. Se abordan los mecanismos y las propiedades que hacen a los químicos tóxicos la vulnerabilidad de la población, la población en riesgo, las vías de exposición, consecuencias tóxicas agudas y crónicas (sobre el dessarrollo y para las generaciones futuras), las formas de protección de la exposición para actuar en prevención, aplicando el principio precautorio para proteger la salud de los trabajadores, la familia rurarl, la comunidad toda y el ambiente.