Europe's five worst child killers

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Last Updated: Friday, 18 June, 2004, 01:07 GMT 02:07 UK
By Alex Kirby
BBC News Online environment correspondent

Five killer conditions account for one death in three among young Europeans, the World Health Organization says.

In a study published in the UK medical journal The Lancet, the WHO lists them as outdoor and indoor air pollution, unsafe water, lead, and injuries.

The organisation describes the report as the first major assessment of the overall impact of the environment on child health across Europe.

It will be discussed by ministers from 52 countries in Budapest next week.

They will be attending WHO Europe's conference on environment and health in Budapest, from 23 to 25 June.

The ministers are expected to adopt the Children's Environment and Health Action Plan for Europe (Cehape) after discussing the report.

Fuel danger

It is entitled Burden Of Disease And Injuries Attributable To Selected Environmental Factors Amongst Europe's Children And Adolescents.

Known as the Environmental Burden Of Disease (EBD) report, it was completed by two Italian institutions, the University of Udine and the Institute for Childhood Burlo Garofalo of Trieste.

It says 34% of deaths among Europeans from birth to the age of 19 are attributable to the five factors.

The leading cause of death is injuries, mostly unintentional, with road traffic accidents especially prominent in western Europe.

"There should be legislation about driving with no alcohol, about slowing the speed in urban areas and planning settlements so that children can play, walk and go to school safely," said lead author Georgio Tamburlini, from the WHO.

Fire, drowning and poisoning are frequent causes in other parts of the continent. Across Europe (which the WHO defines as including central Asian countries such as Kyrgyzstan and its neighbours) outdoor pollution kills up to 13,000 children aged under four every year.

But indoor air pollution, caused mainly by the use of solid fuel, is estimated to kill more than 50,000 under-fours annually throughout Europe, the report says.

It thinks a move by families from solid to less polluting liquid or gaseous fuels could save the lives of more than 9,000 children annually.

Child orientation

More than two million people in WHO's European region are thought to lack access to clean water, exposing children to a high risk of diseases linked to diarrhoea.

"Access to safe water is the main issue," Dr Tamburlini told the BBC. "In several countries in central and Eastern Europe we still have schools where there is no safe water and up to 20% of households don't have access."

The report says lead is "still the single most important chemical toxicant for children" in Europe, causing mild mental retardation in many of them.

WHO says the need for child-specific estimates of the burden of disease is critical for making decisions.

It says one of the fundamentals of paediatrics - that children are not simply small adults - has not normally been considered in policy-making, the setting of standards, or legislation.

Yet children are more vulnerable than adults to several environmental threats.

Their organs are developing rapidly, they live and play "closer to the ground", they have a longer time for latent agents to cause damage, and they have less control over their lives than adults.

"I consider the new WHO report to be very important," said Philip Landrigan, Professor of Paediatrics, Mount Sinai School of Medicine, New York, US. "We now know that the state of the environment can have profound effects on human health and we know also that children are the most vulnerable among us to toxic materials in the environment."

The Health Protection Agency (HPA) agrees that WHO's initiative is an important one.

"There is a need for more research into potential environmental threats to children's health," said an HPA spokesperson. "The Agency is currently making a substantial contribution to the development of Cehape, which will be launched at the WHO Europe Ministers' meeting next week in Budapest."

http://news.bbc.co.uk/1/hi/sci/tech/3816579.stm

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Pollution and roads kill 100,000 children a year in Europe

Sarah Boseley, health editor
Friday June 18, 2004
The Guardian

The profound and damaging impact of Europe's environment on children has been quantified for the first time by experts who have found that a third of their ill-health and 100,000 deaths a year are caused by air pollution, unsafe water, lead and injuries.

The UK and the rest of western Europe score better than the EU accession countries such as Ukraine and Belarus on indoor and outdoor air pollution, water and sanitation, but traffic accidents still take a big toll of our children, while lead in our water pipes, our housepaint and our soil is causing mild mental retardation in some, the World Health Organisation says.

The WHO study on the environmental burden of disease, published in today's Lancet medical journal, reveals that more than 13,000 children die of injuries in western Europe - predominantly in road traffic accidents - which is a third of all deaths under 19.

Lead, the experts say, "is still the single most important chemical toxicant for children and is probably the best-known example of a neurotoxicant to which children are particularly vulnerable". Exposure in the first few years of life can cause lasting neurological problems, such as learning disabilities, attention difficulties, language disorders and anaemia.

In a recent study of children in the UK with learning disabilities, 10-15% had higher lead levels in their blood than the recommended maximum, said Giorgio Tamburlini of the Institute of Child Health in Trieste, one of the authors, at a briefing yesterday.

The experts looked at non-accidental as well as accidental injury and found that among the under 14s across the whole of Europe, 9.2% of deaths from injury were self-inflicted, rising to 22.4% of the 15-19 age group. But there is a stark difference between regions.

Suicide rates among teenagers were three to four times higher in the Nordic countries said Dr Tamburlini, and were also three times greater among boys than girls.

Across Europe outdoor pollution causes nearly 14,000 deaths of children under four each year through chest infections, asthma, low birth weight and impaired lung function.

Indoor air pollution from coal and wood fires is a problem in poorer countries like Turkey and the central Asian republics, where children are kept indoors during cold winters, with wood or coal fires. The report estimates that 10,000 under-fours die every year of pneumonia as a result.

Two million Europeans do not have access to clean water, exposing their children to a high risk of diarrhoeal diseases, which kill more than 13,000 under 14s each year in the region.

"Although the report carries some ominous warnings, it also opens the door to a healthier future for Europe's children," said Marc Danzon, WHO regional director for Europe. The data will be tabled at the ministerial conference on environment and health taking place in Budapest at the end of June, allowing policy makers to take action to protect children's health.

http://www.guardian.co.uk/waste/story/0,12188,1241651,00.html

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Environment Hazards a Big Killer of Children - Study

Thu Jun 17, 2004 07:13 PM ET
By Patricia Reaney

LONDON (Reuters) - Environmental hazards such as pollution, unsafe water, poor sanitation, lead poisoning and injuries are the cause of one third of child and adolescent deaths in the European region, health experts said on Friday.

Pollution from burning coal and wood indoors without ventilation is a leading killer of children in the central Asian republics and Turkey.

Unsafe water and sanitation is a major cause of young deaths in eastern European nations, while injuries, mainly from road traffic accidents, top the list across the European region, according to a report by the World Health Organization (WHO).

"One third of all deaths in children and adolescents in the European region can be attributed to environmental factors," said Dr Giorgio Tamburlini, an author of the report from the Institute of Child Health in Trieste, Italy.

The WHO report says that 100,000 deaths and 6 million years of healthy life are lost each year in children and adolescents from birth to 19 years of age in 52 countries in western and eastern Europe and the former Soviet Union.

"This is the first assessment of the health effects in children and adolescents of environmental factors in the European region," Tamburlini told a news conference to launch the report which is published in the Lancet medical journal.

It will form the basis of a plan to be discussed by European officials in Budapest on June 23-25 at the Fourth Ministerial Conference on Environment and Health and provide a model for similar reports elsewhere in the world.

CHILDREN MORE VULNERABLE

Children's growing bodies are more vulnerable to environmental factors. They are also more exposed than adults to hazards because they live and play closer to the ground and have less control over their environment.

The patterns and causes of death vary but the report highlights priorities to cut exposure to pollutants, improve sanitation and water supplies and to prevent injuries.

Injury caused by traffic accidents, falls, drownings poisonings or violence, war or suicide killed more than 75,000 youngsters throughout the European region in 2001.

About 23,000 children up to four years old died from pneumonia and other respiratory illnesses caused by outdoor and indoor air pollution.
Poor water and sanitation which causes diarrhea killed more than 13,000 children up to 14 years old and lead in paint, pipes and gasoline resulted in mild mental retardation in more than 156,000 years of healthy life lost.

"Interventions that are able to reduce the exposure of children to these risk factors, ranging from outdoor and indoor pollution to lack of water sanitation, to unsafe housing and transport, are going to produce substantial benefits in terms of disease, disability and death," said Tamburlini

The report identifies priority areas which differ between regions and emphasizes the importance of targeting specific populations such as children who are poor, exploited or living on the street because they are at the highest risk.

Tamburlini said the study also highlights the need to produce more databases to develop country-by-country pictures to identify priorities to help children and adolescents.

http://www.reuters.com/newsArticle.jhtml?type=healthNews&storyID=5452113