Challenges faced in protecting children’s health from hazardous environments

Socioeconomic inequities and climate change can hamper recent progress to reduce environmental health risks in Europe, and the current economic downturn might further exacerbate existing risks. This is the focus of the final meeting in preparation for the Fifth Ministerial Conference on Environment and Health hosted by the German Government in Bonn, on 27–29 April 2009. On this occasion, WHO calls on all European countries to strengthen health systems and maintain investment in measures aimed at protecting children’s health from increasingly hazardous environments.

A total of over 1.7 million deaths, or 18% of all deaths, are attributable every year to known environmental factors. Climate change can affect some of the most fundamental determinants of health: water, air and food. Water stress is projected to increase over central and southern Europe and central Asia, affecting 16–44 million additional people by 2080. Higher temperatures may increase regional ozone pollution, which already causes 20 000 premature deaths in the European Union. Food production could decrease by up to 30% in central Asia by the middle of the 21st century and threaten food security. Yet, these impacts are not uniform across Europe.

According to evidence, there is no biological reason why the health of a child, an old person, or someone less affluent living in a poor country should suffer up to fourfold from a contaminated environment. While poor people tend to live in worse environments and are often more exposed, their health is influenced by the capacity and political determination of countries to reduce environmental health risks. The knowledge and experience currently available on risks and solutions need to be used to ensure that everybody in Europe enjoy environment and health equity.

Effective interventions include developing water safety plans to ensure safe drinking water from source to tap; enforcing the strictest policies to contain emissions from motorized transport and to promote public transport, cycling and walking; providing health-oriented building standards and financial incentives for cleaner alternatives for heating and cooking; ensuring proper controls and practices during food production, processing, and distribution to reduce chemical contamination; and adapting to climate change and reducing emissions especially for those most at risk.

Decision-makers, partners and experts gathered in Bonn will provide their final input to the Ministerial Conference declaration that includes inequity and climate change as core issues. Taking into account differences and needs of the 53 European countries stretching from the Atlantic to the Pacific Oceans, they will finalize the future Europe’s environment and health agenda for years to come.
Examples of inequity gaps in environment and health issues affecting European children

* Nowadays most Europeans take clean water for granted, however millions of people are still without a regular supply of safe water. Over 13,000 children die annually from diarrhoeal diseases in central and eastern Europe.
* Five out of six childhood deaths from injuries occur in poor countries, but poor children living in affluent western urban environments, suffer and die from injuries up to five times more than their wealthier peers.
* By 2010, one in ten children will be obese: a total of 15 million across Europe. Poor children and their families have more difficulty in affording the healthiest food choices and have fewer opportunities to be active, thus increasing their risk of becoming obese.
* Less affluent children tend to live in areas where traffic emissions are higher, putting them at higher risk of suffering from respiratory diseases. A recent French study shows that they can be exposed to up to 25% higher traffic-related air pollution than those from the least deprived group.
* 10 000 children aged 0–4 years are estimated to die each year from the use of solid fuel at home, 90% of them are from low- and middle-income countries.
* The phasing out of lead in petrol has resulted in a decrease in lead levels in children’s blood. However, in some countries of central Europe levels remain almost three times as high as in Germany in the 1990s, and industrial emissions continue to be a source of exposure.
* Children are at high risk from work-related diseases due to early exposure. While a slightly decreasing trend can be noted recently in a few countries, others still report over 5,000 accidents per 100,000 employed people below 18 years of age.

Climate change can significantly worsen health inequities and put additional stress on vulnerable groups. Deaths and disease during cold weather may be most serious for poorer households. Deprived populations are more likely to be living within zones at risk from flooding and be less well-prepared to respond. The elderly and people with pre-existing illnesses are most affected by heat waves. The rural poor, whose income is based on food production, can suffer from malnutrition if crop yields fall.

The successes achieved by some European countries in reducing child mortality from the environment show that most of this burden can be averted. This makes the inequity gap even more unacceptable. As the current financial crisis may seriously hinder efforts to ensure environment and health justice to all children, action is needed now to prevent this from happening.

Background: the Fifth Ministerial Conference on Environment and Health, Parma, 2010

More than ever, children’s health is at risk from a changing environment. The health impacts of environmental risk factors – inadequate water and sanitation, unsafe home and recreational environments, lack of spatial planning for physical activity, indoor and outdoor air pollution, and hazardous chemicals – are amplified by recent developments including financial constraints, broader socioeconomic and gender inequalities and more frequent extreme climate events. They pose new challenges for health systems to reduce death and disease through effective environmental health interventions.

Building on 20 years of environment and health action in Europe, the Fifth Ministerial Conference will set the European agenda on emerging environmental health challenges for years to come. Organized by the WHO Regional Office for Europe and hosted by the Government of Italy in Parma in 2010, the Conference will renew governments’ pledges in an era of new global challenges, to improve health systems’ performance and their collaboration with other sectors to ensure better environments for children’s health. 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 …”

Further information on the Conference is available on the Regional Office web site http://www.euro.who.int/parma2010