test2.expandit.io/selectively-photographing-nature-tips-for-nature.php A study in a Thai cohort has shown that arsenic exposure in utero increased expression of genes involved in various biological networks such as apoptosis, stress responses, and inflammation [ 69 ], and DNA damage in newborns, observed as increased levels of urinary 8-nitroguanine, which significantly correlated with increased expression of inflammatory genes COX2, EGR1, and SOCS3 in cord blood [ 60 ]. A follow-up study in these prenatally arsenic-exposed children showed an increase in oxidative and nitrative DNA damage, represented by increased levels of 8-OHdG and 8-nitroguanine [ 60 , 70 ], as well as decreased expression of human 8-oxoguanine DNA glycosylase 1 hOGG1 , suggesting a defect in the repair of 8-OHdG.
Taken together, these results suggest that individuals with prenatal to early childhood exposure to environmental carcinogens are at a higher risk for developing disease and cancer later in life. The total midyear population of Sri Lanka is The under-5 mortality rate is 10 per 1, live births and the infant mortality rate is 8 per 1, live births. It is important to note that although the infant mortality rate has declined, the majority of under-5 deaths are neonatal.
Congenital malformations are the most significant cause of neonatal death [ 50 ], but there are no studies yet to understand the environmental associations in Sri Lanka. Outdoor air pollution has increased in Sri Lanka, and the increase is correlated to an increase in private vehicle sales [ 73 ]. Open burning of plastics emits dioxins due to lack of formal waste disposal, and it is a common contributor to outdoor air pollution.
Estimates have noted that indoor air pollution remains a larger threat than outdoor air pollution in Sri Lanka as of , however data specific to Sri Lanka is limited. Poor ventilation, the absence of chimneys, and the practice of using polythene plastic bags, etc to initiate a fire all contribute to indoor air pollution. Unlike other countries in the region, heating is rarely a contributor to indoor air pollution due to the warm natural climate. A World Bank study in Sri Lanka found that indoor air pollution was a predictor of diabetes among adults and is a predictor of stunting, underweight, and wasting in children under five [ 76 ].
Increasing numbers of children are being exposed to dietary factors, sedentary behaviors, and unhealthy habits. There remains, however, a double burden of disease associated with nutritional problems in Sri Lanka because both malnutrition and obesity are increasing [ 79 , 80 ]. There are gaps in industries in terms of waste and chemicals disposal.
UN United Nations. A developmental approach to pediatric environmental health. Do their professional activities involve potentially hazardous substances, such as pesticides, metals, fibers, solvents, among others? Smart Growth State Department of Environmental Conservation web site that describes tools to promote the principles of Smart Growth and initiatives underway in the state. Additional methods and greater capacity to measure and respond to environmental hazards are needed. Health and the Built Environment: 10 Years After.
Inappropriate use of agricultural chemicals is common. CKDu is a major problem that may be related to pesticide and chemical use [ 82 ]. In , there were more than four times the number of cases compared to the and average. The country has seen an increase in floods, droughts, and landslides, and children and families are often forced to move due to these events. Children contribute substantially to the burden of disease in countries in South and Southeast Asia, as shown in Table 1.
Taken as plausibly representative of the current status of CEH in these regions, the country reports summarized in this paper show a high degree of similarity. Most common are problems with outdoor and household air pollution, with solutions not immediately apparent or implementable. Children are also often exposed to heavy metals, industrial chemicals, and pesticides. Despite advances in some countries, many children still do not have adequate access to clean water and improved sanitation. Infectious diseases remain a problem, especially for children living in poverty.
Child labour is still widely prevalent too common , generally without adequate training or personal protective equipment, exposing the child labourers to occupational hazards. The children of these regions are now facing the dual problems of undernutrition and stunting on the one hand, and overnutrition and obesity on the other. In conclusion, it is evident that some countries in these regions are doing better than others in varying areas of CEH. The Public Health Foundation of India organized and funded meeting space. This manuscript is based on information presented at the workshop and in the workshop report.
Peter Sly coordinated the preparation of the manuscript, and all authors were provided the opportunity to review and comment. Health consequences of environmental exposures: Causal thinking in global environmental epidemiology. Ann Glob Health. Environmental and health risks: A review of the influence and effects of social inequalaties; The Lancet Commission on pollution and health. Lancet Glob Health. Health consequences of environmental exposures: Changing global patterns of exposure and disease. Health consequences of environmental exposures in early life: Coping with a changing world in the post-MDG era.
Environ Health Perspect. Bhutal Health J. A study on morbidity pattern of child labourers engaged in different occupations in a slum area of Calcutta. J Indian Med Assoc. Respiratory and general health impairments of ragpickers in India: A study in Delhi.
Int Arch Occup Environ Health. Open dumping site in Asian developing countries: A potential source of polychlorinated dibenz-p-dioxins and polychlorinated dibenzofurans. Environ Sci Technol. Polychlorinated biphenyls in settled dust from informal electronic waste recycling workshops and nearby highways in urban centers and suburban industrial roadsides of Chennai city, India: Levels, congener profiles and exposure assessment.
Sci Total Environ. Combined chemical and toxicological evaluation of leachate from municipal solid waste landfill sites of Delhi, India. Environ Sci Pollut Res Int. High prevalence of household pesticides and their unsafe use in rural South India. Neurological, biochemical and immunological manifestations in workers exposued to organophophate insecticides. Indian J Biochem Biophysics.
An environmental profile of brick kilns in Lucknow. J Environ Sci Eng. Prevalence of chest symptoms amongst brick kiln migrant workers and care seeking behaviour: A study from South India. J Public Health Oxf. Emissions from South Asian brick production. Saha A and Sadhu HG. Occupational injury proneness in young workers: A survey in stone quarries.
J Occup Health. Bhagia LJ. Non-occupational exposure to silica dust. Indian J Occup Environ Med. Indoor air pollution and health of children in biomass fuel-using households of Bangladesh: Comparison between urban and rural areas. Environ Health Prev Med. Household air quality risk factors associated with childhood pneumonia in urban Dhaka, Bangladesh. Am J Trop Med Hyg. Impacts of policy and market incentives for solid waste recycling in Dhaka, Bangladesh. Waste Manag. Assessment of impact on health of children working in the garbage dumping site in Dhaka, Bangladesh.
J Trop Pediatr. J Environ Monit. Global alliance to eliminate lead paint; Prevalence of and risk factors for lead poisoning in young children in Bangladesh. J Health Popul Nutr. Lead poisoning: An alarming public health problem in Bangladesh. Lead Elimination Project; cited July 24, Guney M and Zagury GJ. Heavy metals in toys and low-cost jewelry: Critical review of U. J Hazard Mater. Toxic toys: Heavy metal content and public perception in Bangladesh; Available from: pen. Alam T, Ahmed T, Sharifuzzaman, et al.
Risk factors for death in Bangladeshi children under 5 years of age hospitalized for diarrhea and severe respiratory distress in an urban critical care ward. Global Pediatric Health. Khanam R and Rahman MM. Child work and schooling in Bangladesh: The role of birth order. J Biosoc Sci. Investigation of the possible sources of heavy metal contamination in lagoon and canal water in the tannery industrial area in Dhaka, Bangladesh. Environ Monit Assess. Trace metals pollution in seawater and groundwater in the ship breaking area of Sitakund Upazilla, Chittagong, Bangladesh.
Mar Pollut Bull. Pant KP. Cheaper fuel and higher health costs among the poor in rural Nepal. Acute lower respiratory infection in childhood and household fuel use in Bhaktapur, Nepal. Gurung A and Bell ML. The state of scientific evidence on air pollution and human health in Nepal. Environ Res. Water quality, sanitation, and hygiene conditions in schools and households in Dolakha and Ramechhap Districts, Nepal: Results from a cross-sectional survey. Poverty, literacy and child labour in Nepal: A district-level analysis.
Asia Pac Popul J. National Statistics Bureau. Bhutan Living Standards Survey Thimphu , Bhutan: Royal Government Bhutan; Investing in the early years, for every child in Bhutan. Annual report ; Studying municipal solid waste generation and composition in the urban areas of Bhutan. Waste Manag Res. Ethnic minority health in Vietnam: A review exposing horizontal inequity.
Glob Health Action. Trinh HN and Korinek K.
Ethnicity, education attainment, media exposure, and prenatal care in Vietnam. Ethn Health. Global, regional, and national levels of neonatal, infant, and under-5 mortality during — A systematic analysis for the Global Burden of Disease Study Perceptions of water, sanitation and health: A case study from the Mekong Delta, Vietnam.
Water Sci Technol. Household trends in access to improved water sources and sanitation facilities in Vietnam and associated factors: findings from the Multiple Indicator Cluster Surveys, — Prevalence of soil-transmitted helminths and molecular clarification of hookworm species in ethnic Ede primary schoolchildren in Dak Lak Province, Southern Vietnam. Korean J Parasitol. Geographical distribution of soil transmitted helminths and the effects of community type in South Asia and South East Asia: A systematic review.
Blood lead levels and risk factors for lead exposure in a pediatric population in Ho Chi Minh City, Vietnam. Childhood lead exposure from battery recycling in Vietnam. Biomed Res Int. Human exposure to arsenic from drinking water in Vietnam. Individual variations in arsenic metabolism in Vietnamese: The association with arsenic exposure and GSTP1 genetic polymorphism. Genome-wide DNA methylation at birth in relation to in utero arsenic exposure and the associated health in later life.
Environ Health. Toxicol Appl Pharmacol. J Med Assoc Thai. The cost of not breastfeeding in Southeast Asia. Health Policy Plan. Yamborisut U and Mo-Suwan L. Prevalence of childhood and adolescent obesity in Thailand: A review. Glyphosate and paraquat in maternal and fetal serums in Thai women. J Agromedicine.
Drinking water quality and chronic kidney disease of unknown etiology CKDu : Synergic effects of fluoride, cadmium and hardness of water. Environ Geochem Health. Exposure to benzene in various susceptible populations: Co-exposures to 1,3-butadiene and PAHs and implications for carcinogenic risk. Chem Biol Interact. Increased health risk in Bangkok children exposed to polycyclic aromatic hydrocarbons from traffic-related sources. PLoS Genet. Oxidative DNA damage and repair in children exposed to low levels of arsenic in utero and during early childhood: Application of salivary and urinary biomarkers.
Department of Census and Statistics. Available from: Department of Census and Statistics; Child Activity Survey , Sri Lanka. Air pollution and health in Sri Lanka: A review of epidemiologic studies. BMC Public Health. A profile of biomass stove use in Sri Lanka. World Bank. Diabet Med. High prevalence of cardio-metabolic risk factors in a uoung urban Sri-Lankan population. Trends and determinants of childhood stunting and underweight in Sri Lanka. Ceylon Med J.
Distribution of obesity-related metabolic markers among 5—15 year old children from an urban area of Sri Lanka. Ann Hum Biol. Trends in use and import of agricultural pesticides in Sri Lanka. Should we take steps to encourage democratic participation in environmental health decision-making?
The issues that arise in environmental health ethics are often complex, interdisciplinary, dynamic, and global in scope. Finding satisfactory solutions to environmental health problems will become increasingly important as the environmental impacts of human activities continue to mount and we learn more about the relationship between human health and the environment. All organisms depend on their environments for energy and materials needed to sustain life: clean air, potable water, nutritious food, and safe places to live.
For most of human history, increases in longevity were due to improved access to these necessities. Advances in agriculture, sanitation, water treatment, and hygiene have had a far greater impact on human health than medical technology. Although the environment sustains human life, it can also cause diseases.
Lack of basic necessities is a significant cause of human mortality. Environmental hazards increase the risk of cancer, heart disease, asthma, and many other illnesses. These hazards can be physical, such as pollution, toxic chemicals, and food contaminants, or they can be social, such as dangerous work, poor housing conditions, urban sprawl, and poverty. Unsafe drinking water and poor sanitation and hygiene are responsible for a variety of infectious diseases, such as schistosomiasis, diarrhea, cholera, meningitis, and gastritis. In , approximately , children under age 5 mostly in the developing world died from diarrheal diseases related to unsafe drinking water, and approximately 1.
More than 2 billion people lacked access to basic sanitation. By contrast, activities that promote health and extend human life can have adverse environmental effects. For example, food production causes environmental damage from pesticides and fertilizers, soil salinization, waste produced by livestock, carbon emissions from food manufacturing and transportation, deforestation, and over-fishing.
Health care facilities also have adverse environmental impacts. Hospitals use large quantities of electricity and fossil fuels and produce medical wastes. To prevent some diseases, it may be necessary to damage the environment.
For example, malaria was eradicated in the United States and other developed nations in the s and 50s as a result of draining wetlands and spraying DDT to kill mosquitoes. A reduction in mortality from starvation or disease can lead to overpopulation, which stresses the environment in many different ways—increasing use of fossil fuels, clearing of land, generating pollution and waste, and so on. Relationships between human health and the environment raise many ethical, social, and legal dilemmas by forcing people to choose among competing values.
These considerations can be grouped into the following categories. Managing benefits and risks. Many of the issues at the intersection of health and the environment have to do with managing benefits and risks. For example, pesticides play an important role in increasing crop yields, but they can also pose hazards to human health and the environment. Alternatives to pesticide use create trade-offs in health. The extreme action of stopping all pesticide uses could significantly reduce agricultural productivity, leading to food shortages and increased food prices, which would, in turn, increase starvation in some parts of the world.
Public health authorities have opted to regulate the use of pesticides to enhance food production while minimizing damage to the environment and human health. Energy production and use helps sustain human life, but it can also pose hazards to human health and the environment, such as air and water pollution, oil spills, and destruction of habitats. No issue demands greater care in balancing benefits and risks than global warming.
A significant percentage of global climate change is due to the human production of greenhouse gases. Climate change is likely to cause tremendous harm to the environment and human health, but taking steps to drastically reduce greenhouse gases could have adverse consequences for global, national, and local economies, which would result in a general decline in human health and health care. For example, greatly increasing taxes on fossil fuels would encourage greater fuel efficiency and lower carbon dioxide emissions, but it would also increase the price of transportation, which would lead to widespread inflation and reduced consumer spending power.
For many years some politicians and scholars argued that we should wait for more evidence of global warming before taking action, since the steps needed to prevent or minimize it could have disastrous economic consequences. Others have argued that society cannot afford to wait for complete evidence because the consequences of global climate change could be catastrophic and irreversible.
This difference of opinion raises fundamental questions about the ethics of risk management: what is the role of scientific evidence in decision-making? Most regulatory agencies in the U. Agencies often refrain from making regulatory decisions until they have complete scientific evidence. Many commentators and organizations have endorsed an alternative approach called the precautionary principle. The idea is that society should take reasonable steps to prevent or minimize irreversible and significant harm, even when scientific evidence is incomplete, and that regulatory decisions to avoid harm need not await the accumulation of complete scientific evidence.
Although the precautionary principle has gained many adherents, especially in Europe and California, it remains controversial. Social justice. Managing benefits and risks raises social justice concerns. In general, people with lower socioeconomic status have greater exposure to certain detrimental environmental conditions in their homes or at work, such as lead, mercury, pesticides, toxic chemicals, or air and water pollution.
Communities and nations should minimize such injustices when making decisions such as choosing a site for a factory, a power plant, or waste dump, or regulating safety in the workplace. The decision-making process should be fair, open, and democratic, so that people who will be affected by environmental risks have a voice in these deliberations and can make their concerns known. When drafting and implementing environmental health regulations, it is important to consider vulnerable subpopulations. A vulnerable subpopulation is a group with an increased susceptibility to the adverse effects of an environmental risk factor, due to their age, genetics, health status, or some other condition.
For example, children are more susceptible to the effects of lead, mercury, and some pesticides than adults. Some people have a genetic mutation that increases their susceptibility to cancer caused by passive smoking. If an environmental regulation is designed to protect average members of the population it may fail to adequately protect vulnerable subpopulations.
Justice demands that we take care of people who are vulnerable. However, almost everyone in the population has an above-average susceptibility to at least one environmental risk factor. Since providing extra protections to everyone would be costly and impractical, protections must be meted out carefully and the populations who are vulnerable to a particular environmental risk factor must be defined clearly.
For example, about 0. Banning the sale of peanuts would be a costly and impractical way of protecting people with peanut allergies, but requiring that products containing peanuts be labeled clearly would be reasonable. Social justice must be a factor in allocating resources for health care. Governments spend billions of dollars trying to improve the health of citizens and prevent diseases.