Medicina e società
Salute del bambino e tossici ambientali
CHILDREN’S HEALTH AND ENVIRONMENTAL TOXICITY
GIORGIO TAMBURLINI
Centro Europeo dell’OMS per l’Ambiente e la Salute, Roma
Novembre 2000 - pagg. 592 -597
Abstract
The main health effects on children of environmental toxicants are reviewed. Children are
particularly vulnerable to toxicants due to longer exposures, greater exposures and higher
sensitivity of developing organs. Children are exposed to indoor and outdoor air pollution,
contaminated food, water and building materials, radiation, and noise. The main health
consequences are acute and chronic respiratory diseases, congenital malformations, prematurity
and intrauterine growth retardation, neurodevelopmental delay and cancer. Emerging
problems include endocrine disruption and immunotoxicity. There is an urgent need to
pay specific attention to the health effects of a deteriorated environment on children. Improved
risk assessment and monitoring, policies aimed at protecting children by establishing
safety standards and by reducing exposures are necessary. Information on real hazards
and risks should be disseminated to the public to increase awareness, participation and
demand for interventions. Paediatricians should be able to provide appropriate advice to
families and to advocate for effective public health and environmental policies.
Classificazione MeSH
Air Pollution (29)
Child Health (73)
Congenital Abnormalities (70)
Endocrine Disruptors (8)
Environmental Pollutants (12)
Fetal Growth Retardation (15)
Lead Poisoning (7)
Neoplasms (44)
Neurodevelopmental Disorders (51)
Pesticides (5)
Radiation (3)
Respiratory Tract Diseases (14)
Tobacco Smoke Pollution (23)
Bibliografia
Ministries of Environment and Health, London,
June 16-18, 1999.
2. WHO Fact Sheet n. 187, Air Pollution, WHO Geneva, 2000.
3. Bates DV. The effects of air pollution on children. Environ Health Perspect 1995;103 (suppl 6):49-53.
4. American Academy of Pediatrics, Committee on Environmental Health. Ambient air pollution: respiratory hazards to children. Pediatrics 1993;91:1210-13.
5. Kunzli N, Kaiser R, Medina S, et al. Publichealth impact of outdoor and traffic related air pollution: an European assessment. Lancet 2000;356:795-801.
6. Martuzzi M, Galassi C, Forastiere F, Ostro B. L’inquinamento atmosferico in 8 città italiane. Stime di impatto sulla salute. Centro Europeo OMS Ambiente e Salute, Roma, 2000.
7. Ciccone G, Forastiere F, Agabiti N. Road traffic and adverse respiratory effects in children. Occupat Environ Med 1998;55:771-8.
8. ISAAC, The International Study of Asthma and Allergy in Childhood. Worldwide variations in the prevalence of asthma symptoms. Eur Resp J 1998;12:315-35.
9. Sciarillo WG. Lead exposure and child behaviour. Am J Public Health 1992;82:1356- 60.
10. Gold RD. Environmental Tobacco Smoke, Indoor allergens and Childhood Asthma. Environ Health Persp 2000;108:643- 51.
11. Jacobson JL, Jacobson SW, Humphrey HEB. Effect of in utero exposure to polychlorinated biphenyls and related contaminants on cognitive functioning in young children. J Pediatr 1990;116:38-45.
12. Jacobson JL, Jacobson SW. Intellectual impairment in children exposed to polychlorinated biphenyls in utero. N Engl J Med 1996;335:783-9.
13. Urquhart JD, Black RJ, Murhead MJ, et al. Case-control study of leukemia and non- Hodgkin’s limphoma in children in Caithness near the Dounreay nuclear installation. Br Med J 1991;302:687-92.
14. Savits DA, Wachtel H, Barnes FA, John EM, Tvrdik JG. Case-control study of childhood cancer and exposure to 60 Hz magnetic fields. Am J Epidemiol 1988;128:21-38.
15. Baverstock K, Egloff B, Pinchera A, Ruchti C and Williams D. Thyroid cancer after Chernobyl. Nature 1992;359:21-2.
16. American Academy of Pediatrics: Committee on Environmental Health. Ultraviolet Light: a hazard to children. Pediatrics 1999; 104:328-33.
17. Fry DM. Reproductive effects in birds exposed to pesticides and industrial chemicals. Environ Health Perspect 1995;103(suppl 7): 165-71.
18. Mocarelli P, Gerthoux PM, Ferrari E, et al. Paternal concentrations of dioxin and sex ratio of offspring. Lancet 2000;355:1858-63.
19. DiFranza RJ, Lew AR. Effect of maternal cigarette smoking on pregnancy complications and sudden infant death syndrome. Fam Pract 1995;40:385-94.
20. American Academy of Pediatrics: Committee on Environmental Health. Environmental tobacco smoke: a hazard to children. Pediatrics 1997;99:639-42.
21. American Academy of Pediatrics: Committee on Environmental Health. Noise: a hazard to the fetus and newborn. Pediatrics 1997;100:724-7.
22. Landrigan PJ, Schechter CB, Lipton MJ, et al. Pediatric environmental disease in the United States: estimates of morbidity, mortality and costs. JAMA 2000 (in press).
23. Smith K, Corvalan C, Kjellstrom T. How much global ill health is attributable to environmental factors? Epidemiology 1999:10; 573-84.
24. Third Ministerial Conference on Environment and Health. Access to information, public participation and access to justice in environment and health matters. WHO EUR/ICP/EHCO/02025712, 1999.
25. The Rio de Janeiro Conference on the Environment, 1992.
26. Bertollini R, Faberi M, Di Tanno N (a cura di), Ambiente e Salute in Italia, Centro OMS Ambiente e Salute. Roma: Il Pensiero Scientifico Editore, 1997.
27. Associazione Medici per l’Ambiente (ISDE, Italia). Per il diritto del bambino a non essere inquinato. Arezzo, 1999.
2. WHO Fact Sheet n. 187, Air Pollution, WHO Geneva, 2000.
3. Bates DV. The effects of air pollution on children. Environ Health Perspect 1995;103 (suppl 6):49-53.
4. American Academy of Pediatrics, Committee on Environmental Health. Ambient air pollution: respiratory hazards to children. Pediatrics 1993;91:1210-13.
5. Kunzli N, Kaiser R, Medina S, et al. Publichealth impact of outdoor and traffic related air pollution: an European assessment. Lancet 2000;356:795-801.
6. Martuzzi M, Galassi C, Forastiere F, Ostro B. L’inquinamento atmosferico in 8 città italiane. Stime di impatto sulla salute. Centro Europeo OMS Ambiente e Salute, Roma, 2000.
7. Ciccone G, Forastiere F, Agabiti N. Road traffic and adverse respiratory effects in children. Occupat Environ Med 1998;55:771-8.
8. ISAAC, The International Study of Asthma and Allergy in Childhood. Worldwide variations in the prevalence of asthma symptoms. Eur Resp J 1998;12:315-35.
9. Sciarillo WG. Lead exposure and child behaviour. Am J Public Health 1992;82:1356- 60.
10. Gold RD. Environmental Tobacco Smoke, Indoor allergens and Childhood Asthma. Environ Health Persp 2000;108:643- 51.
11. Jacobson JL, Jacobson SW, Humphrey HEB. Effect of in utero exposure to polychlorinated biphenyls and related contaminants on cognitive functioning in young children. J Pediatr 1990;116:38-45.
12. Jacobson JL, Jacobson SW. Intellectual impairment in children exposed to polychlorinated biphenyls in utero. N Engl J Med 1996;335:783-9.
13. Urquhart JD, Black RJ, Murhead MJ, et al. Case-control study of leukemia and non- Hodgkin’s limphoma in children in Caithness near the Dounreay nuclear installation. Br Med J 1991;302:687-92.
14. Savits DA, Wachtel H, Barnes FA, John EM, Tvrdik JG. Case-control study of childhood cancer and exposure to 60 Hz magnetic fields. Am J Epidemiol 1988;128:21-38.
15. Baverstock K, Egloff B, Pinchera A, Ruchti C and Williams D. Thyroid cancer after Chernobyl. Nature 1992;359:21-2.
16. American Academy of Pediatrics: Committee on Environmental Health. Ultraviolet Light: a hazard to children. Pediatrics 1999; 104:328-33.
17. Fry DM. Reproductive effects in birds exposed to pesticides and industrial chemicals. Environ Health Perspect 1995;103(suppl 7): 165-71.
18. Mocarelli P, Gerthoux PM, Ferrari E, et al. Paternal concentrations of dioxin and sex ratio of offspring. Lancet 2000;355:1858-63.
19. DiFranza RJ, Lew AR. Effect of maternal cigarette smoking on pregnancy complications and sudden infant death syndrome. Fam Pract 1995;40:385-94.
20. American Academy of Pediatrics: Committee on Environmental Health. Environmental tobacco smoke: a hazard to children. Pediatrics 1997;99:639-42.
21. American Academy of Pediatrics: Committee on Environmental Health. Noise: a hazard to the fetus and newborn. Pediatrics 1997;100:724-7.
22. Landrigan PJ, Schechter CB, Lipton MJ, et al. Pediatric environmental disease in the United States: estimates of morbidity, mortality and costs. JAMA 2000 (in press).
23. Smith K, Corvalan C, Kjellstrom T. How much global ill health is attributable to environmental factors? Epidemiology 1999:10; 573-84.
24. Third Ministerial Conference on Environment and Health. Access to information, public participation and access to justice in environment and health matters. WHO EUR/ICP/EHCO/02025712, 1999.
25. The Rio de Janeiro Conference on the Environment, 1992.
26. Bertollini R, Faberi M, Di Tanno N (a cura di), Ambiente e Salute in Italia, Centro OMS Ambiente e Salute. Roma: Il Pensiero Scientifico Editore, 1997.
27. Associazione Medici per l’Ambiente (ISDE, Italia). Per il diritto del bambino a non essere inquinato. Arezzo, 1999.