CHILDREN'S HEALTH IN SOUTH ASIA AT RISK FROM POLLUTION?
By Professor Peter D. Sly (Australia)

International Conference Shows Need For More Government Action to Protect Children There is a growing recognition that a variety of environmental factors pose a risk to the health of children. To begin the task of addressing these factors in the Asian-Pacific region an International conference was held with the aim of fostering interest and action in this important area. A major focus of the conference was the link between degradation of the environment and a variety of adverse health outcomes. Children are particularly vulnerable to these problems. There is, however, a lack of basic data to show the extent of the problem. Air pollution, water contaminated with arsenic, mercury, and lead, and persistent organic chemicals (i.e., DDT, PCBs) - all are examples of environmental pollution which is responsible for illnesses ranging from asthma to immune system deficiencies. Children are particularly at risk because, proportionately, children breathe more air, drink more water, and eat more food than adults. The specific threats to children's health from environmental pollution in South Asia were focus of an international, conference, "Environmental Threats to the Health of Children" Sunday, April 11 at the EDSA Shangri-La Hotel, in Metro Manila. Sponsors included the U. S. National Institute of Environmental Health Sciences; the Pacific Basin Consortium on Hazardous Waste Research and Management; the World Health Organization; the U. S. Environmental Protection Agency; Fogarty International Center of the U. S. National Institutes of Health, University at Albany (U.S.); and the Mount Sinai School of Medicines (U.S.). The delegates at the conference produced a list of recommendations to address the major needs in this area. This list is reproduced below:

Major Needs / Recommendations

• Establishment of an Office of Children's Environmental Health in each of the countries of the region; in an appropriate, high-level position within each government, for purpose of - Collect Data, Do Research, Make Policy Recommendations
• Epidemiologic efforts within countries to fill gaps in our understanding of the relationship between environmental exposures and ill health in children.
• For more and better coordinated local and global data collection on environment exposures in children related to health impacts and to disease etiology.
• Promote inter-nation strategies to assist the least developed countries to provide safe drinking water, clean food, and waste disposal practices to protect the health of children.

The initial conference has raised interest in the region on this topic. A concerted effort is now needed to ensure the basic data are collected and that Governments are made fully aware of the problem. Each country needs to establish what environmental factors represent the major threat to the health of their children. In Australia, for example, we have an epidemic of asthma in children, with the prevalence increasing two to three fold over the past 20 years. This increase is most likely due to environmental factors. In other countries in our region, the same increase in asthma has not been seen. In some countries contamination of ground water by pesticides and heavy metals retards neurological development and decreases IQ. Without the data to confirm the major environmental threat to the health of children, governments cannot act to alleviate the problems. A second conference is planned for the year 2002 and is likely to be held in Bangkok. As the health of children is central to paediatric practice, this issue should be one of major interest and importance to paediatricians in the region.