Report Finds Rising Number Of Childhood Asthma Cases

The first report on children's health and environment indicators in North America found a rising number of childhood asthma cases across three countries. The report -- issued on Jan. 26 by a North American Free Trade Agreement (NAFTA) commission -- also found improvements in children's blood lead levels.

The report, by the Commission for Environmental Cooperation (CEC) in partnership with public health organizations and the governments of Canada, Mexico and the United States, presents 13 indicators under three thematic areas: asthma and respiratory disease, effects of exposure to lead and other toxic substances, and waterborne diseases. It finds that North American children remain at risk from environmental exposures and that children's health reporting must be improved to address the data gaps identified in the report. Only one of the indicators, addressing asthma in children, was fully reported by all three countries.

According to the report, one possible contributor to the rising number of asthma cases is outdoor air pollution such as ground-level ozone and particulate matter, which remains a problem for all three countries. In Mexico, exposure to smoke from indoor burning of wood or charcoal is also a problem, as 18 percent of the country's population continued to burn biomass for cooking and heating in 2000. And while Canadian and American children are increasingly less likely to be exposed to environmental tobacco smoke, data from the United States shows that certain minority groups remain disproportionately affected.

For lead exposure, case studies from all three countries demonstrate improvements in children's blood lead levels due to interventions such as the removal of lead from gasoline. However, there is little biomonitoring data available in Canada since there has been no national blood level survey in the country since 1978. Other exposure pathways for lead remain a concern, such as older homes with lead-based paint. Recently collected data in the United States showed that 25 percent of homes had a "significant lead based paint hazard, which could be from deteriorating paint, contaminated dust or contaminated soil outside the house."

Mexico faces the region's largest challenges in the area of water and sanitation. Data from 2003 indicate that 17 percent of the Mexican population did not have water of appropriate bacteriological quality. However, advances in water and sanitation in Mexico have contributed to a decline in diarrheic diseases from a rate of 125.6 deaths per 100,000 children in 1990 to 20 deaths per 100,000 children in 2002. In the United States, the percentage of children living in an area served by a public water system having at least one major monitoring and reporting violation decreased from 22 percent in 1993 to 10 percent in 1999.

"This first set of children's environmental health indicators will help improve public policy and promote the cause of improved air and water quality, pollution prevention and better management of toxic chemicals," said William V. Kennedy, the executive director of the CEC. "While this report finds improvement in some indicators and challenges in others, it's clear that measurable progress will require a uniform data set for policy-makers to adequately address the risks to children's health."

Indicators are important to tracking and communicating the health and well-being of North America's 123 million children because environmental contaminants can affect the young quite differently than adults. Children generally eat more food, drink more water and breathe more air relative to their size than adults do, and children's normal activities -- such as putting their hands in their mouths or playing outdoors -- can result in higher exposures to certain contaminants. In addition, environmental contaminants may affect children disproportionately because their immune defenses, for example, are not fully developed and their organs are more easily harmed.

Along with the CEC and the three governments, the International Joint Commission, the Pan American Health Organization and the World Health Organization (WHO) collaborated in the development and selection of the children's environmental health indicators and the release of this report.

As the first regional report under the Global Initiative on Children's Environmental Health Indicators (CEHI) -- led by WHO, spearheaded by U.S. EPA and launched at the World Summit for Sustainable Development in Johannesburg -- it is anticipated that this report will contribute to worldwide efforts to improve children's health. Children's Environmental Health regional indicator pilot projects are currently underway in Africa, Europe, Latin America and the Caribbean, and the Eastern Mediterranean. WHO plans on rolling out similar projects in its Southeast Asia and Western Pacific regions in the coming years.

A copy of the report, along with the national reports compiled by each of the three governments as source material for the CEC's North American report, can be downloaded from

This article originally appeared in the 01/01/2006 issue of Environmental Protection.

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