Childhood Diseases and Household Toxins
(*based on information from Dr. Philip J. Landrigan, Mount Sinai School of Medicine, New York City)
Children's Changing Environment
Children today, inhabit a world that is fundamentally different from that of two generations past. The traditional infectious diseases have largely been eradicated. Infant mortality is greatly reduced. The expected life span of a baby born now, in a developed country, is more than two decades longer than that of a child born at the beginning of the twentieth century.
Children also face hazards in the environment that were neither known nor suspected only a few decades ago. At least 75,000 new synthetic chemical compounds have been developed and dispersed into the environment; fewer than half of these compounds have ever been tested for their potential toxicity to humans and fewer still have been assessed for their toxicity to children. Children's exposures to lead, pesticides, PCBs, and toxic air pollutants are widespread and increasing.
The Unique Environmental Exposures and Special Vulnerability of Children
Children are more heavily exposed to environmental toxins than adults.
Pound-for-pound, children breathe more air, drink more water, and eat more
food than adults. Thus, they are more exposed to whatever toxins are present
in those media. Children's exposures are further increased by the fact that
they tend to play close to the ground and to engage in repeated hand-to-mouth
activity.
Children are less able to metabolize and excrete most toxic substances.
Children's rapidly developing organ systems-the central nervous system,
reproductive organs, immune system, and lungs-are highly susceptible to toxic
insult.
Because children have more future years of life than adults, they are more
susceptible to chronic, multistage diseases such as cancer or
neurodegenerative disease that may be triggered by early exposures.
The New Pediatric Morbidity
Children's exposures to newly developed chemical toxins, in combination with the triumph of vaccines and antibiotics, have changed the face of childhood illness. The classic infectious diseases have largely been conquered. They have, however, been replaced by chronic, complex, handicapping conditions that affect multiple organs. In children, these diseases are largely unknown and have not been adequately studied. But environmental factors are strongly suspected to play an etiologic role, and these urgently need to be investigated.
Asthma and air pollution
Asthma incidence and mortality among both children and adults have
increased substantially over the past decade in the United States. These
increases are particularly evident in urban localities. In New York, Chicago,
Los Angeles, and other major cities, asthma has become the leading reason for
children's admission to the hospital. Urban air pollution, especially
ground-level ozone and fine particulates, appear to be important contributors
to the upward trend in asthma. Indoor air pollution, including insect dust and
environmental tobacco smoke, is an additional trigger.
Childhood Asthma Facts
- In the United States, 600 children die each year from asthma, and 150,000 are hospitalized
- From 1980 to 1993, the death rate for childhood asthma in the United States increased by 78%
- Nearly 5 million American children have asthma.
Childhood Cancer
Each year in the United States, an estimated 8,000 children up to age 14 are diagnosed with cancer. Leukemia and brain tumors are the most common malignancies in childhood. Cancer is the second most common cause of death after injuries in American children.
The death rate from childhood cancer has declined dramatically in recent years in the United States-thanks to the advent of vastly improved approaches to cancer treatment. But the occurrence of new cases of cancer among children- the incidence rate-has been steadily increasing. This upward trend has been most strongly evident for acute lymphoblastic leukemia and brain cancer, the two most common forms of cancer among American children.
These increases in the incidence of childhood cancer have not been explained. However, they are too rapid to reflect genetic changes. Nor is better diagnostic detection a likely explanation. The strong probability exists that environmental factors are playing a role. It is essential that research to identify the specific environmental causes of childhood cancer be undertaken and that the pace of this research be accelerated.
Childhood Cancer Facts in the US
Incidence rates for childhood cancer have been increasing steadily for two decades:
- Acute lymphoblastic leukemia is up 10.7%
- Brain cancer (glioma) is up 30%
- Osteogenic sarcoma (a form of bone cancer) is up 50%
- Testicular cancer (in young men) is up 60%
- 8,000 American children are diagnosed each year with cancer
Although death rates from childhood cancer are down and survival rates are much higher due to spectacular advances in treatment, the increasing incidence of childhood cancer threatens to undermine those achievements.
Endocrine Disruptors
Over the past five years, evidence has been growing that a variety of
environmental contaminants, particularly the chlorinated organic hydrocarbon
compounds, can have adverse health effects because of their ability to alter
the functions of hormones within the body. These effects, which include
cancer, reproductive disorders, neurologic impairment, and immune dysfunction,
have been observed in experimental animals exposed to specific chemicals in
the laboratory, in wildlife populations in several broadly contaminated
ecosystems such as the Great Lakes, and, to a more limited extent, in humans.
The developing nervous system of children appears to be particularly
vulnerable to endocrine-disrupting chemicals, as evidenced by a variety of
behavioral alterations in women who have consumed PCB-contaminated fish.
Children's developing reproductive organs are also at risk, since endocrine
disruptors are suspected of being responsible, at least in part, for recently
observed increases in the incidence of cryptorchidism and testicular cancer,
as well as for the doubling in the incidence of hypospadias recently reported
by the CDC.
Endocrine Disruptor Facts
Children are widely exposed to endocrine disruptors in the environment,
especially DDT, PCBs, and chlorinated pesticides such as chlordane.
The incidence of hypospadias in newborn boys has doubled, with endocrine
disruptors being a likely cause.
The incidence of testicular cancer in young men has increased by 60%, with
endocrine disruptors being a likely cause.
The incidence of breast cancer is up in women. The risk of breast cancer is
related to women's body burdens of DDT and PCB.
Fetal exposure to PCB reduces intelligence.
Endocrine disruptors may be a factor in the increasing incidence of premature
puberty in young girls.
Tobacco
Each year, tobacco kills 350,000 Americans. Tobacco is a major threat to the health of children, who are at risk from both active smoking and passive exposure to cigarette smoke.
Smoking among children typically starts early. Ninety percent of all cigarette smoking begins before the age of 18 years.
More than 70 percent of all American high school students have tried cigarettes. Seventeen percent are regular smokers. Over the past decade, the number of boys who start smoking has declined. But there has been a steady increase in the number of girls and young women who smoke.
Passive smoking is also a hazard to children. Children exposed to passive smoke have more bronchitis, more pneumonia, and more viral respiratory infections than nonexposed children. The frequency of infection is a direct consequence of the amount of smoke in the home. Children who live with two smoking parents have more respiratory infections than children who have only one smoking parent. Maternal smoking has a stronger effect on children's respiratory infections than smoking by the father. The lowest rates of lung infection and asthma are found in the children of parents who do not smoke at all.
Smoking during pregnancy poses a serious danger to the unborn child. Study after study has shown that among women who smoke, the likelihood of giving birth to a premature, low-birth-weight infant is substantially higher than among women who do not smoke. Women who smoke are also at increased risk of a pregnancy ending in miscarriage.
Women who smoke often have a more difficult time conceiving than nonsmoking women of the same age. And their risk of not becoming pregnant at all-of sterility-is elevated. Finally, the children of parents who smoke have a higher than normal risk of death from sudden infant death syndrome (SIDS).
Acknowledgments
Research for this fact sheet was conducted under the auspices of the Office of
Children's Health Protection of the US Environmental Protection Agency. INFORM
acknowledges sole responsibility for its content.
About the Author
Dr. Philip J. Landrigan is Professor of Pediatrics, Chair of Community and
Preventive Medicine, and Director of Environmental and Occupational Medicine
at the Mount Sinai School of Medicine in New York City. At Mount Sinai, he has
directed research programs on environmental and occupational medicine, lead
poisoning, asbestos, AIDS, tuberculosis, and childhood asthma.
Dr. Landrigan is currently designing the Office of Children's Health
Protection, which was created under executive order of the President and is
housed at the US Environmental Protection Agency.
He is a member of the Institute of Medicine of the National Academy of
Sciences, editor-in-chief of the American Journal of Industrial Medicine, and
co-author, with Dr. Herbert L. Needleman, of Raising Children Toxic-Free,
published by Farrar, Straus and Giroux in 1996. Dr. Landrigan directed a major
study at the National Academy of Sciences on pesticides in children's diets
and has testified before Congress on many health-related issues. Before coming
to Mount Sinai he served as a Commissioned Officer at the Centers for Disease
Control and Prevention in Atlanta, Georgia, and at the National Institute for
Occupational Safety and Health in Cincinnati, Ohio. Dr. Landrigan graduated
from the Harvard Medical School and received a Master of Science in
occupational medicine from the University of London.
Dr. Landrigan has been a member of INFORM's Board of Directors since 1992.
For more information contact Cameron S. Lory, 212-361-2400 x232,
lory@informinc.org or Carol Westinghouse, 802-626-8643, westies@ecoisp.come
