Children require the care, love and stimulation of parents and families, as well as the best and safest of environments to survive and develop to their full potential. As children develop and grow, they interact with and explore a world that can offer either an array of life-enhancing discoveries and opportunities or a series of perils that can cause disease and suffering. This chapter reviews children’s special vulnerability and susceptibility to environmental threats at their each developmental stage. A more detailed discussion of key environmental hazards is presented in Chapter 3. A woman’s health directly influences the health and development of her child. Ensuring that pregnancies are healthy can be of profound benefit to women, children and society at large. It is now recognized that perinatal conditions, many of which are significantly influenced by environmental conditions, account for 20 per cent of the under-five mortality rate worldwide [1]. It is also recognized that a woman’s well-being helps determine the well being of her entire family. A healthy mother is better able in all ways to care for her family and participate fully in the life of her society. Protein energy malnutrition in pregnant women is a significant threat, causing anaemia, which can severely impact a foetus’ growth and development. An expectant mother’s malnourishment can result in long-term consequences for her child’s development. It has been estimated that eliminating malnutrition among pregnant women would reduce disabilities among their infants by almost one third [2]. Another risk comes from the presence of parasitic worms in the pregnant woman, which can adversely affect or even kill the developing foetus. Approximately 44 million pregnant women in developing countries have hookworm infections [3], which are directly related to environmental factors such as waste disposal. Congenital abnormalities are the second leading cause of death in high-income countries [4]. In the United States, these anomalies, along with sudden infant death syndrome and premature birth, account for more than 50 per cent of all infant mortalities [5]. Approximately 3 to 10 per cent of these cases have been attributed to exogenous and environmental agents [6]. Women can be exposed to harmful chemicals at home or through their work, and pass them to a foetus, such as in the case of lead exposure, raising the risks of abortion, birth defects, foetal growth retardation and prenatal death [7] (See Chapter 3). Scientific studies reveal that exposure during the early months of pregnancy can lead to an increased likelihood of mental retardation and development disabilities [8]. [ top
]
[ top ] Infants may be exposed to chemical pollutants through their mother’s breast milk (See Chapter 3). Yet, despite the risks of exposure to chemicals, breast milk remains the most nutritious and safe source of food for infants worldwide. Thus, the need to protect the environment where pregnant mothers live must be emphasized in order to promote healthy lactation. Children breathe more air, drink more water and eat more food than adults do per unit body weight, and this higher rate of intake results in greater exposure to pathogens and pollutants. Children drink more than two and a half times as much water as adults do and eat three to four times more per unit of body weight than the average adult [10]. Therefore, if the water contains residues of pesticides or other chemicals, infants will receive more than double the dose of an adult drinking the same water [11]. If the level of exposure to pollution continues from infancy onward, they will be at a greater corresponding lifetime risk. Children in developing countries are some 13 times more likely to die before they reach their fifth birthday than their counterparts in developed countries. There are many biological environmental factors associated with this high toll, among them the lack of clean water and sanitation, as well as environmental-related diseases such as malaria, dengue fever and Japanese encephalitis. (See Chapter 3) Children are curious and learn by exploring their world. They are, therefore, in close contact with their environment. Infants, for instance, explore their world by putting their hands and objects in their mouths and are at risk from pathogens and pollutants on these surfaces. Also, because children are small, they are close to the ground, where they also crawl and play and where they can be exposed to dust and chemical particulates that accumulate on floors and soil [12]. Close parental care and supervision is, therefore, crucial to the safe and healthy development of young children. Medical and educational research has shown that the development of intelligence, personality and social behaviour occurs most rapidly in humans during their first three to four years. It is estimated that half of all intellectual development potential is established by age four [13]. According to recent research, brain development is much more vulnerable to environmental influence than was previously suspected, and the influence of early environmental quality on brain development is long lasting [14]. Psychosocial and cognitive development begins at birth and parents are the children’s earliest teachers. Therefore, strengthening the ability of the mother and all family members to care for and stimulate their children and encourage them to learn, can set the stage for adult success [15]. However, the ability to care for children is greatly influenced by the physical environment. In many countries, particularly those where the environment is seriously degraded, collecting water, gathering firewood and tending crops take up large amounts of time and energy. When those tasks fall without relief on women, they have too little time to spend on ensuring the best possible care for their children. When parents are absent or ill, they are unable to keep children safe as they explore their world. [ top ] Children of School Age School age children’s environments expand beyond their homes and care centres, giving them frequent interaction with a wider range of people in more places than when they were younger. Several potential environmental risks are particularly associated with children in this age period. Helminth diseases, which are caused by intestinal worms found in soils and vegetables, are one of the common health problems among school age children in developing countries. Those children commonly carry up to 1,000 hookworms, roundworms and whipworms at a time, which can cause anaemia and other debilitating conditions [16]. These illnesses can result in impaired learning, poor school performance and more absences from school (See Chapter 3). Injuries (usually road traffic injuries, falls and drowning) are now the number-one killer of children aged five to 14 years in developed countries [17]. In developing countries, environmental factors such as exposed cooking set-ups, dangerous tools and equipment, open sewers, heavy traffic, dangerous construction or electrical sites and hazardous chemicals pose threats. A child’s health and growth may also be affected when he or she engages in wage-earning work or domestic chores unsuitable for his or her age and ability, such as working long hours in a field, carrying heavy loads, and walking long distances for fuel wood or water. Asthma and childhood cancers are now major concerns in developed countries (see box 10 for asthma). In the United States, cancer is the second biggest killer of children after accidents, with the median age of child victims of cancer being six years old [18]. Acute leukaemia is the most common type of cancer found in children, and its incidence appears to be rising in some developed countries. While the causes remain unclear [19], certain toxic substances and radiation in the environment are believed to be factors in the cell changes that lead to cancer [20]. Among the environmental factors that may play a role are tobacco smoke, radon, asbestos, ultraviolet light radiation, hazardous waste and some pesticides [21]. While not all children
are able to attend or remain in school, classrooms are important places
for bringing about behavioural changes, promoting better health for
students, and teaching about caring for the community environment. Schools
have a special role in encouraging urban children to develop a relationship
with the natural world. Healthful school environments can raise children’s
learning opportunities significantly, but often sanitary and environmental
conditions in rural and urban schools can be appalling in poor areas,
greatly affecting a child’s health and learning (See
box 4).
[ top ] Adolescence Unsafe schools pose risks for the health and development of many adolescents. Some conditions, such as the lack of proper sanitary facilities or latrines for girls, discourage young women from attending school. In addition, adolescence is a time when young people often need to work to support their families. Poverty and resource degradation in an adolescent’s community can significantly diminish employment possibilities. Hazardous working conditions are also of prime concern for this age group. Adolescents’ lighter body weight and lack of skills may predispose them to injuries in the workplace. One of the gravest
risks facing adolescents is that of HIV/AIDS, a major killer in this
age group, particularly in sub-Saharan Africa and Asia (See
Box 5). HIV/AIDS victims reportedly suffer most from diarrhoeal
diseases, to which they succumb more readily due to the weakened state
of their immune systems. An improved environment is necessary to protect
infected people from other preventable diseases that are caused by unhygienic
and degraded environments and further strain health conditions for people
infected with HIV/AIDS.
[ top ] Children in Need of Special Protection Approximately
half of the worldwide refugee and internally displaced populations are
children [22].
At least 10 million people are estimated to be environmental refugees,
more than half of them believed to be in sub-Saharan Africa [23].
These are people displaced from their homes because of weather-related
catastrophes, such as earthquakes, floods and cyclones, degraded land,
lack of natural resources to support livelihoods or armed conflict and
land mines. In the past decade two million children have been killed
in armed conflict [24].
Children are hardest hit by all these catastrophes, the ensuing outbreaks
of diseases and famines in refugee conditions, and the associated psychological
traumas.
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The
environment influences children at all stages of their lives, before
birth and in their homes, schools and communities. They are affected
by media such as water, air, food, objects or soil; and they are affected
by their daily activities or circumstances, including eating, drinking,
working and playing (
The
metabolic functions of babies and infants are in a dynamic state of
development and their nervous, immune, reproductive and digestive systems
are not fully developed. A child’s lungs continue to develop long
after his or her first breath of air. A child’s kidneys, which
serve as the principal pathway for elimination of most toxicants from
the body, do not reach full functional capacity until the child’s
first birthday [
More
than 1.4 billion children from age five to 14 – approximately 87
per cent of all children – live in developing countries, where
many of the biggest environmental challenges exist (
During
the critical phase of adolescence, the ability of young people to develop
their capacities and life skills and to participate meaningfully in
society hinges on a number of cultural, socio-economic and environmental
factors.
Every
day, children of all ages are exposed to a harsh world, with few or
no protections from environmental hazards, ill health and injuries.
They may be orphans, or living on the streets, begging or selling goods
or even their bodies to survive. Many others labour (