The financial crisis could lead to greater use of cheap heating fuels and burning of waste at home, increasing risks to children’s health. This adds urgency to discussions taking place in preparation for the Fifth Ministerial Conference on Environment and Health in 2010. On 28–29 January 2009, European policy-makers are gathered in Luxembourg at the Thematic Meeting on Healthy Environments to recommend actions and policies to protect children’s health from poor indoor air quality, obesity and injuries. “There is increasing evidence that disputes the assumption that children are safe in their own homes,” says Dr Marc Danzon, WHO Regional Director for Europe. “For too long, health systems have not done enough to promote healthy indoor environments. Public health authorities must protect those most vulnerable to environmental health hazards, especially when more people are at risk due to the economic crisis.” Indoor pollutants cause or aggravate health problems Housing and the indoor environment affect health and well-being more than is commonly recognized, resulting in acute effects, ranging from sneezing and coughing to outcomes such as cancer, chronic respiratory disorders and fatal injuries. With young children spending up to 90% of their time indoors, this places them at exceptional risk. In the WHO European Region, 10 000 children aged 0–4 years are estimated to die each year from households’ use of solid fuel, 90% of them in low- and middle-income countries. Owing to money or energy constraints, people burn waste or wood in rudimentary or badly maintained fireplaces for heating and cooking, instead of using cleaner but more expensive fuels. This increases exposure to carbon monoxide and the chances of house fires. For the poorest children in the Region, the risk of dying in accidental fires is almost 40 times that for the richest. In some European countries, 20–30% of households have problems with damp, which increases the risk of respiratory disorders by 50%. Children are particularly susceptible; according to recent evidence, damp housing could account for 13% of childhood asthma in developed countries. Compact housing developments have higher concentrations of indoor pollutants, and promote damp. Where schools have limited air exchange rates, students’ intellectual performance drops. “Clean indoor air is essential for the health of the population as a whole, and even more important for vulnerable groups like infants, children and the elderly, or people already suffering from chronic diseases, such as respiratory or allergic disorders,” says Mrs Androulla Vassiliou, European Commissioner for Health. “The European Commission, in close cooperation with the WHO Regional Office for Europe, supports the development of specific guidance for indoor spaces. Targeted action might also be needed to avoid hazardous exposures, particularly in schools or other places where children spend their time.”   Effective solutions to protect health from indoor hazards Today in Luxembourg, European countries are strengthening the commitments they made in the 2004 Children’s Environment and Health Action Plan for Europe (CEHAPE) to substantially reduce children’s mortality and morbidity by improving the quality of indoor air.  The WHO Regional Office for Europe is developing guidelines on this topic and recently reviewed examples of effective interventions, including adopting health-oriented building standards, providing financial incentives for switching to cleaner alternatives for heating and cooking, improving and maintaining indoor stoves, and quitting smoking. Healthy behaviour reduces disease and death; more determined action by citizens depends on the provision of scientifically sound and user-friendly information to parents and caregivers. “Specific action in homes and private buildings can be further encouraged by the provision of incentives and programmes such as the indoor-air survey programme carried out by the Ministry of Health in Luxembourg,” says Mr Mars Di Bartolomeo, Minister of Health of Luxembourg. “Survey methods have been developed, and the use of indoor-air surveys has caught on in many European countries in recent years. These programmes are beneficial, as they directly address the particular concerns of inhabitants. They also help health professionals understand potential exposures to chemicals and physical or biological stressors in homes and public places, which result in recurring health symptoms, such as acute asthma attacks, that they are repeatedly called on to treat.” Organized by the WHO Regional Office for Europe and hosted by the Ministry of Health of Luxembourg and the European Commission Public Health Directorate in Luxembourg, the Thematic Meeting on Healthy Environments will strengthen the political resolve to address indoor environments as a European priority for the years to come. Further information on the Regional Office’s work to improve air quality is available on its web site (http://www.euro.who.int/air). ________________________________________________________________________________ Note to editors: the Fifth Ministerial Conference on Environment and Health The environments in which children live affect their health. Recognized risk factors – such as inadequate water and sanitation, unsafe home and recreational environments, lack of spatial planning to promote physical activity, indoor and outdoor air pollution, and hazardous chemicals – must be placed in the context of broader threats, including socioeconomic and gender inequalities and climate change. The Fifth Ministerial Conference on Environment and Health, organized by the WHO Regional Office for Europe and hosted by the Government of Italy in 2010, is a new milestone in the twenty-year European environment and health process and a step towards fulfilling governments’ pledges to strengthen health systems. As the 2008 Tallinn Charter says, “health systems are more than health care and include disease prevention, health promotion and efforts to influence other sectors to address health concerns in their policies”. Ministers of health and the environment, along with key partners and experts from countries throughout the European Region, are assessing the progress made since the adoption of the CEHAPE in 2004. At the Conference, they will renew their commitments to strengthening health systems in order to protect children’s health in a changing environment; these commitments will determine Europe’s agenda for tackling environmental health challenges over the next five years. Further information on the Conference is available on the Regional Office web site (http://www.euro.who.int/envhealth/policy/20060320_1).