More than 80,000 new chemicals have been developed and released into the environment in the past four decades. And during the same period, the rates of birth defects, autism, attention-deficit/hyperactivity disorder, asthma and other disorders that affect children have increased. Is this a coincidence, or have all these chemicals increased the prevalence of such disorders among infants, children and teens? Not all the evidence is in, but the field of children’s environmental health has grown, as researchers have been studying the influence of chemicals and pollutants on youngsters. They are reaching the conclusion that there is a “window of susceptibility” during which exposure to such substances can trigger changes in cells that lead to disease and disability in youngsters.
The Seventh International Conference on Children’s Health and the Environment, called “A Healthier World for Our Children” was held recently at Jerusalem’s Dan Panorama Hotel, where an interdisciplinary group of scientists compared notes. It was initiated and hosted by Prof.
Yona Amitai, a toxicologist and pediatrician who served for eight years as head of the Health Ministry’s Department of Mother, Child and Adolescent Health (and is now at Bar-Ilan University’s department of management), and by Prof. Peter van den Hazel, board chairman of the International Network on Children’s Health, Environment and Safety (INCHES).
This is a global network of people and organizations interested in promoting the protection of children from environmental and safety hazards, and it distributes data and initiates research on the relationship between environmental factors and child health.
VAN DEN Hazel, who has been involved in the organization since 1998, attended the first international conference, which was held in his native country of Holland. “The gathering is multidisciplinary, combining pediatricians, policymakers, representatives of non-governmental organizations and others,” he said in an interview at the conference with The Jerusalem Post.
“Everyone is working in his own niche, so at this international meeting, we have the opportunity to speak to people in other disciplines.
My daily work as a physician in environmental health involves consulting to the local authorities on air pollution, asbestos, radiation, fo r m a l d e - hyde gases from furniture, e l e c - t r i - cally heated blankets and pollution in old houses, among others.”
Old buildings often contain lead pipes that contaminate the water with the toxic element. In recent years, the Dutch authorities have worked to get them replaced with PVC pipes, which are safe, and new homes of course do not have the dangerous pipes.
However, lead pipes still exist, and excessive levels of lead in babies can retard their development, he said.
Radon, an odorless, invisible gas that builds up in the ground from natural radioactivity in some areas, may lead to lung cancer among residents of lower floors.
When it’s detected, blowers in the basements or foundations can be used to eliminate the gas and prevent health dangers, van den Hazel said.
Air pollution caused by heavy traffic near homes is one of the most major threats to the health of children as well as adults. The best solution is encouraging the use of public transport and establishing traffic- free zones where there are many children, he continued. “We advise local councils not to build schools and other public buildings such as hospitals and old-age homes near roads with heavy traffic. There are conflicts between health and economics.
It’s very difficult to put these health issues onto the political agenda,” said van den Hazel, who has been to Israel before and is participating in a European-funded project with Haifa’s Technion-Israel Institute of Technology.
Specializing in public health is not popular among young doctors, continued van den Hazel. “It is a matter of money, but also that public health experts have to think in the long term. Practising physicians want immediate results. I worked as a general practitioner in the Caribbean tropics, where I realized that so many diseases can be prevented. That’s what got me into the public health field.”
His organization, INCHES, collaborates with the World Health Organization (WHO), and there was a special environmental health unit in Rome, but it closed when the Italians stopped paying for it, he said. More money and support are needed for research and policymaking. “We know a great deal know about chemicals and the need for protecting children against [them]. For example, mercury is one of them. Now we have to implement what we have learned. The same stupid mistakes of exposing children to pollutants continues.
In Nigeria, for example, we see unbelievable levels of lead in the drinking water.
Former Soviet Union countries still import lead paint. Smoking continues to harm children exposed to tobacco. The countries must implement action.”
The battle is still not won. But despite the problems, the Dutch physician is optimistic.
“There are more people willing to find solutions, to join up with the European Parliament and try to do something. In Scandinavia, for example, there is a phone line where children can call to complain if their parents smoke at home. This promotes awareness.”
PROF. RUTH Etzel, an environmental epidemiologist at the University of Wisconsin in Milwaukee who attended the conference has just edited the new Textbook of Children’s Environmental Health, along with Prof.
The heavy volume codifies the knowledge base in the field and offers an authoritative and comprehensive guide to the subject.
Etzel (who is not Jewish despite the Hebrew-sounding surname), was born in Wisconsin and worked for 13 years as a “medical detective” in the US Centers for Disease Control in Atlanta, where she investigated environmental epidemics. She recalls vividly an event with fatalities that was thought to involve lassa fever, an acute viral illness that occurs in West Africa caused by animals. But after further investigation, she discovered that the deaths came from eating bread that was contaminated by pesticides.
“I studied epidemiology at the University of North Carolina at Chapel Hill and medicine at the University of Wisconsin. I am now – after a 40-year absence – at the University of Wisconsin’s School of Public Health. It is the first school of public health in the state. It was established only four years ago, so we have only 45 students, but it is vital for training the next generation,” she said in an interview.
“When I studied pediatrics, it and public health were completely separate. We didn’t know about the impact of pollution on child health and of food on child development.
For 30 years, I’ve been trying to put pediatrics and environment health together.
Incredibly, in the US alone, 90 percent of pediatricians dismiss the importance of public health issues on their patients.
“The new school of public health in Wisconsin was made possible by a Jewish realtor, Joe Zilber, who died and left the university money for such an institution. He said that it was desperately needed in the inner city, which is populated mostly by African Americans. Today, the community comes to us for advice and help. There are black faculty members. Joe didn’t want it to be an ivory tower but close to the people,” said Etzel. “So far, it has been working very nicely.”
“Milwaukee is famous for its brewery.
Pabst Blue Ribbon beer was the most famous brand in town, but then the facility closed and moved elsewhere. Joe donated one of the historic, cream-colored-brick brewery buildings in the center of town to the university, and it was turned into our school of public health.”
Researchers there investigate the effects of poor housing on infant mortality, lead poisoning from old pipes, the pollution in industrial cities and more. “The great 19th-century nurse Florence Nightingale believed in the combined influence of environment and safety, but in recent years, they have been separate. The environment,” said Etzel, “underlies almost all illnesses.” Later, wearing an official uniform that made her look as if she were a member of the US Navy, she was posted by the US Public Health Service in Washington, D.C., where the fought Creutzfeldt-Jakob (“mad cow”) disease to make sure American cattle were not infected by the fatal prion disorder that suddenly appeared in Britain.
Her next stop was Alaska, where she was sent to work with the Indian Health Service, to give medical care to the native residents in that state. “Whites had been imposing care on the Alaskan native people; my colleagues and I wanted them to be led by their own. I did a training program of Inuit and hundreds of different tribes,” Etzel recalled.
A GERMAN toxicologist at the conference, Dr. Marike Kolossa, personally witnessed the challenge of bringing the high environmental standards of West German to East Germany after the unification. She has been head of toxicology at Berlin’s Federal Environmental Agency since 1992. A biology graduate, she said she “wanted to protect man and the environment. It was known already in the early 1980s that the disappearance of species was affecting the environment,” she said. “The eastern part of the unified country had many ecological problems, with polluted bodies of water, respiratory disease and animal and plant species that had nearly gone extinct to due governmental neglect. Those in the east first wanted economic progress and only later to take care of the environment.
“There are still old houses in the east containing lead pipes that must be replaced. Many parts of Russia and central Europe are also still like that. There wasn’t a single university in the east that offered a degree in toxicology,” said Kolossa, who did both her master’s and doctoral degrees in the field.
Highly industrialized parts of China have high levels of carcinogenic pollution – sometimes ten times the safe amount.
Mexico and Japan, however, are improving, Kolossa continued.
The German toxicologist recalled that German chancellor Angela Merkel used to be environment minister in the cabinet.
“She studied physics and was a very well informed person. She cared about the environment.”
The government ministers in Germany are politicians, as in Israel, but there are state secretaries who are public servants and have professional backgrounds and expertise. Today, there are five Germany universities that offer master’s degree programs in toxicology. Graduates work for companies and government offices, register chemicals, conduct research in scientific agencies or serve as private counselors.
“I work on the effects of exposure to chemicals. There are plasticizers, heavy metals, lead, phthalates, bishphenol A and other chemicals, all of which can cause harm to infants and children. Plasticizers alone can have cumulative effects to lower sperm counts in young men and cause testicular cancer. Pthalates, which are a type of plasticizers can cause asthma and may be responsible for premature births.”
Kolossa also investigates outdoor and indoor air pollution (“sick building” syndrome), radon and the effects of tobacco smoking. “Half of children are exposed to secondhand smoke; it is not yet forbidden to smoke in vehicles with child passengers.
This can be very harmful,” she noted She is also concerned about the effects of polychlorinated biphenyls (PCBs), which were widely used as coolant fluids and in electric motors. These chemicals are so dangerous and carcinogenic that their production was banned by the US Congress in 1979 and by the Stockholm Convention on Persistent Organic Pollutants in 2001. “But we found children born many years after the ban who had them in their blood,” she said.
Kolossa said she was “absolutely impressed by Israel’s new bio-monitoring program of pesticides, heavy metals and other dangerous substances. Israel now has a modern and high scientific level, and its research in the field is very good. Our countries now cooperate with each other and exchange methods, and we are open to remove the shadow of our difficult history together,” the German toxicologist concluded.