March 2002

According to the World Health Organisation, globally environmental hazards kill three million children under five every year

Environmental health threats include inadequate drinking water and sanitation, air pollution, accidents, injuries and poisonings

In India, child mortality rates due to environmental hazards and toxins are on the rise

55 per cent of child mortality originates in the perinatal period

Our children’s future depends on our past. Grim, but true.

Environmental degradation of the past impacts the very air that the children breathe, the water that they drink and the food that they eat.

Children are humankind’s most treasured investment. In fact, sustainability (and future) of any species depends on the quality of progeny it produces. However, the quality of progeny is affected by the environment that they are born into and the environment in which their parents lived in. Children, especially the unborn, are most vulnerable to any form of pollution. Even minor impact on health of the parent particularly the mother threatens the health of the child, which manifests later as poor health in adulthood. The recently concluded World Health Organisation (WHO) conference on children’s health in Bangkok estimated that globally, environmental hazards kill three million children under five every year. And this is a very conservative estimate.

More vulnerable
There is increasing evidence that foetal growth is the most important aspect of life for any child. Foetal lung growth studies indicate that abuses such as smoking and hazards such as ambient air pollution can result in reduced lung function. But most exposures that occur in a mother and young children are accidental. Plastics and plasticisers, dioxins, pesticides, and other chemicals invade the body through every possible portal of entry. The growing evidence of invasive chemicals that impair or retard growth of children is overwhelming. Often these substances work in bewildering new combinations that are difficult to analyse. Consequently, there is an upsurge of pediatric cancers, neurological impairments, mental retardation, low birth weight and chronic anaemia and still births (see table: Dangerous pollutants). Children are particularly susceptible to environmental hazards because they consume more food and fluids (volume by volume), inhale more air and constantly explore their environment. This means that more pollutants accumulate in their bodies, which may immediately begin to impair normal development or cause unexplained syndromes as children grow.

Children are particularly susceptible to environmental hazards because they consume more food and fluids and inhale more air

In India, children have to bear the double burden of diseases that have persisted for generations as well as of new diseases caused by various environmental factors. In rural India, a mother is most likely to be anaemic or malnourished. She works for long hours in smoke-filled kitchens and in the field. The constant assaults of both traditional diseases such as diarrhoea, malaria and other infectious diseases etc., and modern diseases caused by poisoning and contamination by pesticides and fertilisers in dusts, air, water and food, plastic wastes, agricultural or industrial effluents etc., make her specially vulnerable to a range of infections. This affects the unborn foetus as well. In urban India, another emerging challenge are the lifestyle-related diseases such as diabetes, attention-deficient disorders and obesity that are also on the rise, as urban children are getting addicted to "junk" food with little or no nutritive value and are leading an increasingly sedentary life.

Dangerous pollutants
Pollutant	Source	Health effect
Endocrine disruptors (chemicals like dioxins, polychlorinated biphenyls- PCBs, pesticides -dichlorodiphenyl trichloroethane-DDT, dieldrin,lindane, etc)	Food, human milk, water	Cancer, immune system dysfunction, delayed neurological development, low birth weight babies, abnormalities of the reproductive tract
Benzene, polyaromatic hydrocarbons	Vehicle exhaust, indoor pollutants like biomass burning, cigarette smoke	Asthma, bronchitis, reduced lung function, other respiratory illnesses
Heavy metals (lead, mercury, chromium etc)	Soil, air, water	Neurological impairments, mental retardation
Asbestos	Air and water	Lung cancer and respiratory illnesses

The Health Information of India reports show that environmental reasons are increasingly responsible for increased mortality in women and children (see graphs: What kills India’s children…). According to the report, 55 per cent of child mortality in India is due to conditions originating in the perinatal period. A significant proportion of the other 45 percent, as shown in the table, are strongly related to environmental causes. But this data is only that of recorded deaths. The World Health Report (1999) of the WHO shows that 429,000 children in India die every year due to childhood diseases (pertussis, polio, diphtheria, measles and tetanus) alone. This estimate is about three times the figure given in the Health Information of India report.

Price of development
There is little doubt that modern development has occurred due to rapid growth in the discovery and use of new chemicals. But many of these chemicals are neurotoxic in nature, affect the brain and interfere with the workings of the nervous system. These substances have the ability to affect intelligence, language ability, and attention span. Children are especially vulnerable to the effects of these neurotoxic substances. They may cause behavioural and social adjustment problems as well as affect mood. At very high doses, neurotoxins may produce such effects as coma, convulsions, respiratory paralysis, and death.

While definitive numbers do not exist, estimates are that in the order of 100,000 chemicals are used in commerce worldwide; of these, 75,000 are registered in the United States. Worldwide, more than one new chemical (including industrial chemicals, pesticides, pharmaceuticals and food additives) is introduced into the environment every day. Only a fraction of the new compounds are completely tested for their safety. Little is known about carcinogenicity or other, often fatal, health effects for the majority of chemicals in use today. In developed countries, chemical substances are loosely regulated by technical and enforcement agencies. For example, as of 1984, 10 per cent of the pesticides in common use in the United States had been assessed for hazards, while for 38 per cent virtually nothing was known. As of 1997, between 1.5 and 3.0 per cent of the approximately 75,000 industrial chemicals in US commerce had been tested for carcinogenicity. The problem in assessing chemical toxicity is that different age groups and sexes respond differently to the varying levels of chemicals, and most of these outcomes manifest several years later. Often, combinations of chemicals act overtly and insidiously to produce confounding results. Despite being a serious threat, chemical and toxins are least studied by the medical fraternity. Even basic investigation protocols and therapeutic interventions are not developed.

What kills India’s children… Environmental reasons are increasingly responsible for increased  mortality in children (excluding 55 per cent of perinatal conditions)

Strong environmental cause: respiratory illnesses, infectious diseases, endocrine disorders, congenital anomalies and injuries & poisonings	Moderate environmental cause: neoplasms, nervous system and circulatory system
Somewhat moderate environmental cause: digestive system, genito-urinary system, blood diseases and ill-defined symptoms
Source: Anon 2000, Health Information of India 1997 and 1998, Central Bureau of Health Intelligence, Ministry of Health and Family Welfare, Government of India.

Even when evidences of toxicity exist, the costs of producing and developing viable, safer, non-toxic alternatives are prohibitive. Large and wealthy companies from developed countries therefore build manufacturing units in developing nations, to exploit the weak and corrupt regulation or enforcement regimes of those nations. This ensures the continued production of hazardous chemicals and pollutants outside the home country and puts people in developing nations at risk. Toxic products that have been phased out, restricted in use or banned for production or import to developed countries are then liberally marketed in developing and poor countries.