Academic journal article Environmental Health Perspectives

Children's Health in Latin America: The Influence of Environmental Exposures

Academic journal article Environmental Health Perspectives

Children's Health in Latin America: The Influence of Environmental Exposures

Article excerpt

Introduction

Physical, chemical, and biological hazards in the environment are responsible for > 24% of the global burden of disease and for 36% of all deaths in children worldwide (Pruss-Ustun and Corvalan 2006). The Pan American Health Organization (PAHO) estimates that nearly 100,000 children in the Americas < 5 years of age die each year from physical, chemical, and biological hazards in the environment (PAHO 2011). Hazardous environmental exposures in early life can produce disease in childhood and also influence health across the life span (Barker 2004).

The > 300 million children < 20 years of age who live in Latin America and the Caribbean (LAC) face a complex and rapidly changing array of environmental threats to health (PAHO 2011). These include the traditional hazards of indoor air pollution and contaminated drinking water (PAHO 2012a; WHO 2000). But additionally, children today are exposed to newer environmental threats such as urban air pollution, toxic synthetic chemicals, pesticides, heavy metals, unsustainable urban growth, hazardous wastes including electrical and electronic waste (e-waste), and global climate change [Barreto 2004; Barreto et al. 2012; PAHO 2012b; World Health Organization (WHO) and United Nations Environment Programme (UNEP) 2010].

The diseases caused by traditional environmental hazards are predominantly the ancient scourges of diarrhea and pneumonia plus a wide range of parasitic and other infectious diseases, especially malaria, dengue, and Chagas disease (Pronczuk et al. 2011). By contrast, modern environmental threats are linked mainly to chronic diseases: asthma, neuro-developmental disorders, birth defects, obesity, diabetes, cardiovascular disease, mental health problems, and pediatric cancer (Haggerty and Rothman 1975; PAHO 2012b). This change in patterns of disease is termed the "epidemiological transition." Countries passing through the epidemiological transition must deal simultaneously with epidemics of both infectious and chronic diseases.

The mix of environmental hazards and the diseases that they cause varies among countries in Latin America and even regionally within countries, depending on demographics, socioeconomic factors, urbanization, and degree of industrial development (Barreto 2004; De Maio 2011; PAHO 2007). Disparities in health status by race, ethnicity, and social class are powerful determinants of disease (PAHO 2011, 2012b). Some countries such as Argentina, Chile, and Uruguay have largely completed the epidemiological transition; some such as Brazil, Colombia, Costa Rica, Mexico, and Venezuela are passing through it now; and in others such as Ecuador and Guatemala the transition has been delayed, and infectious diseases are still the predominant causes of morbidity and mortality (Marinho et al. 2013).

Toxic chemicals are important causes of disease in Latin America. Many thousands of new chemicals and pesticides have been invented and spread into the environment over the past 50 years (Landrigan and Goldman 2011). Most did not previously exist in nature. Although not well publicized, this "chemical revolution" is one of the most important environmental changes that have transformed the developing world in the past half-century. Evidence of widespread exposure is provided by national surveys in industrially developed countries documenting measurable levels of > 100 synthetic chemicals in the bodies of virtually all persons (Centers for Disease Control and Prevention 2014). Children are exquisitely vulnerable to toxic chemicals [National Research Council (NRC) 1993; Pruss-Ustun and Corvalan 2006].

Urbanization is a powerful driving force in health and disease. Latin America is the most highly urbanized region of the world, with approximately 72% of the population living in urban centers [UN Habitat (United Nations Program for Human Settlement) 2012]. The fraction of the population residing in cities is rising steadily. …

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