International Conference on Environmental Threats to the Health
of Children: Hazards and Vulnerability, Bangkok, 3-7 March 2002
A pledge to
promote the protection of Children's Environmental Health
undersigned scientists, doctors and public health professionals, educators, environmental
health engineers, community workers and representatives from a number of international
organizations, from governmental and non-governmental organizations in South East Asian
and Western Pacific countries, have come together with colleagues from different parts of
the world from 3 to 7 March 2002 in Bangkok, Thailand, to commit ourselves to work jointly
towards the promotion and protection of children's health against environmental
Worldwide, it is
estimated that more than one-quarter of the global burden of disease (GBD) can be
attributed to environmental risk factors. Over 40% of the environmental disease burden
falls on children under 5 years of age, yet these constitute only 10% of the world
population. The environmental burden of paediatric disease in Asia and the Pacific
countries is not well recognized and needs to be quantified and addressed.
growing number of diseases in children have been linked to environmental exposures. These
range from the traditional waterborne, foodborne and vector-borne diseases and acute
respiratory infections to asthma, cancer, injuries, arsenicosis, fluorosis, certain birth
defects and developmental disabilities.
environmental exposures are increasing in many countries in the region; that new emerging
risks are being identified; and that more and more children are being exposed to unsafe
environments where they are conceived and born, where they live, learn, play, work and
grow. Unique and permanent adverse health effects can occur when the embryo, fetus,
newborn, child and adolescent (collectively referred to as "children" from
here onwards) are exposed to environmental threats during early periods of special
developing countries the main environmental health problems affecting children are
exacerbated by poverty, illiteracy and malnutrition, and include: indoor and outdoor air
pollution, lack of access to safe water and sanitation, exposure to hazardous chemicals,
accidents and injuries. Furthermore, as countries industrialize, children become exposed
to toxicants commonly associated with the developed world, creating an additional
environmental burden of disease. This deserves special attention from the industrialized
and developing countries alike.
environmental hazards arise both from anthropogenic and natural sources (e.g. plant
toxins, fluoride, arsenic, radiations), which separately and in combination can cause
serious harm to children.
restoring and protecting the integrity of the life-sustaining systems of the earth are
integral to ensuring children's environmental health now and in the future.
Therefore, addressing global changes such as human population growth, land and energy use
patterns, habitat destruction, biodiversity loss and climate change must be part of
efforts to promote children's environmental health.
despite the rising concern of the scientific community and the education and social
sectors about environmental threats to children's health and development, progress
has been slow and serious challenges still remain.
health, environment and education sectors must take concerted action at all levels (local,
national, global), together with other sectors, in serious efforts to enable our countries
to assess the nature and magnitude of the problem, identify the main environmental risks
to children's health and establish culturally appropriate monitoring, mitigation and
principle "children are not little adults" requires full
recognition and a preventive approach. Children are uniquely vulnerable to the effects of
many chemical, biological and physical agents. All children should be protected from
injury, poisoning and hazards in the different environments where they are born, live,
learn, play, develop and grow to become the adults of tomorrow and citizens in their own
children should have the right to safe, clean and supportive environments that ensure
their survival, growth, development, healthy life and well-being. The recognition of this
right is especially important as the world moves towards the adoption of sustainable
is the responsibility of community workers, local and national authorities and
policy-makers, national and international organizations, and all professionals dealing
with health, environment and education issues to ensure that actions are initiated,
developed and sustained in all countries to promote the recognition, assessment and
mitigation of physical, chemical and biological hazards, and also of social hazards that
threaten children's health and quality of life.
To developing active and
innovative national and international networks with colleagues, in partnership with
governmental, nongovernmental and international organizations for the promotion and
protection of children's environmental health, and urge WHO to support our efforts in
all areas, especially in the following four:
PROTECTION AND PREVENTION
To strengthen existing programmes and initiate new mechanisms to provide all children with
access to clean water and air, adequate sanitation, safe food and appropriate shelter:
Reduce or eliminate environmental
causes and triggers of respiratory diseases and asthma , including exposure to indoor air
pollution from the use of biomass fuels and environmental tobacco smoke.
Reduce or eliminate exposure to
toxic metals such as lead, mercury and arsenic, to fluoride, and to anthropogenic hazards
such as toxic wastes, pesticides and persistent organic pollutants.
Reduce or eliminate exposure to
known and suspected anthropogenic carcinogens, neurotoxicants, developmental and
reproductive toxicants, immunotoxicants and naturally occurring toxins.
Reduce the incidence of diarrhoeal
disease through increased access to safe water and sanitation and promotion of initiatives
to improve food safety.
Reduce the incidence of accidents,
injuries and poisonings, as well as exposure to noise, radiation, microbiological and
other factors by improving all environments where children spend time, in particular at
home and at school.
Commit to international efforts to
avert or slow global environmental changes, and also take action to lessen the
vulnerability of populations to the impact of such changes.
HEALTH CARE AND RESEARCH
To promote the recognition, assessment and study of environmental factors that have an
impact on the health and development of children:
Establish centres to address issues
related to children's environmental health.
Develop and implement cooperative
multidisciplinary research studies in association with centres of excellence, and promote
the collection of harmonized data and their dissemination.
environmental health into the training for health care providers and other professionals,
and promote the use of the environmental history.
Seek financial and institutional
support for research, data collection, education, intervention and prevention programmes.
Develop risk assessment methods
that take account of children as a special risk group.
EMPOWERMENT AND EDUCATION
To promote the education of children and parents about the importance of their physical
environment and their participation in decisions that affect their lives, and to inform
parents, teachers and caregivers and the community in general on the need and means to
provide a safe, healthy and supportive environment to all children:
Provide environmental health
education through healthy schools and adult education initiatives.
Incorporate lessons on health and
the environment into all school curricula
Empower children to identify
potential risks and solutions.
Impart environmental health
expertise to educators, curriculum designers and school administrators.
Create and disseminate to families and
communities culturally relevant information about the special vulnerability of children to
environmental threats and practical steps to protect children.
Teach families and the community to
identify environmental threats to their children, to adopt practices that will reduce
risks of exposure and to work with local authorities and the private sector in developing
prevention and intervention programmes.
ADVOCACY To advocate
and take action on the protection and promotion of children's environmental health at
all levels, including political, administrative and community levels:
- Use lessons learned to prevent environmental illness in children,
for example by promoting legislation for the removal of lead from all gasoline, paints,
water pipes and ceramics, and for the provision of smoke-free environments in all public
- Sensitize decision-makers to the results of research studies and
observations of community workers and primary health care providers that need to be
accorded high priority to safeguard children's health.
- Promote environmental health policies that protect children.
- Raise the awareness of decision-makers and potential donors about
known environmental threats to children's health and work with them and other
stakeholders to allocate necessary resources to implement interventions.
- Work with the media to disseminate information on core
children's environmental health issues and locally relevant environmental health
problems and potential solutions.
For all those concerned about
the environmental health of children, the time to translate knowledge into action is now.
Bangkok, 7 March 2002