Children's Health and the Environment

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Children's Health and the Environment Children’s Health and the Environment in North America A First Report on Available Indicators and Measures Commission for Environmental Cooperation Printed in Canada on paper containing 100% post-consumer waste fiber. © Commission for Environmental Cooperation, 2006 Legal Deposit-Bibliothèque nationale du Québec, 2006 Legal Deposit-Bibliothèque nationale du Canada, 2006 ISBN: 2-923358-32-5 All images used with permission DISCLAIMER This report was prepared by the CEC Secretariat in coordination with the Steering Group for the Development of Indicators of Children’s Health and the Environment in North America, which is composed of officials of the Governments of Canada, Mexico and the United States, and representatives of the CEC, the International Joint Commission’s Health Professionals Task Force (IJC HPTF), the Pan American Health Organization (PAHO), and the World Health Organization (WHO). This North American report is based primarily on information contained in separate “country reports” prepared by Canada, Mexico and the United States (available at http://www.cec.org/pubs_docs/documents/index.cfm?varlan=english&ID=1813). Not all information and statements in the report necessarily reflect the views of the Governments of Canada, Mexico and/or the United States, or the CEC Secretariat, IJC, PAHO and/or WHO, in part because the report is a compilation of information provided separately by the three different countries. Commission for Environmental Cooperation 393, rue St-Jacques Ouest, Bureau 200 Montréal (Québec) Canada H2Y 1N9 t (514) 350-4300 f (514) 350-4314 [email protected] / www.cec.org ii Children’s Health and the Environment in North America A First Report on Available Indicators and Measures Prepared by: Secretariat—Commission for Environmental Cooperation In collaboration with: International Joint Commission—Health Professionals Task Force Pan American Health Organization World Health Organization The Governments of Canada, Mexico and the United States JANUARY 2006 This report represents North America’s contribution to the Global Initiative on Children’s Environmental Health Indicators, as well as its commitment to continuing to work together to ensure a safe and healthy environment for our children. Table of Contents Preface _______ _ vii Executive Summary _______ _ xi 1.0 An Overview of the Children’s Health and the Environment Indicators Initiative _______ _ 1 1.1 Children’s Health and the Environment _______ _ 1 1.2 The Need for North American Indicators of Children’s Health and the Environment _______ _ 2 1.3 Who Will Use This Report _______ _ 4 1.4 Selecting the Indicators for This Report _______ _ 5 1.5 A Common Approach to Indicator Development _______ _ 7 1.6 The First North American Report _______ _ 9 2.0 An Introduction to the Participating Countries _______ _ 11 2.1 Population Data and Birth Rates _______ _ 12 2.2 Child Mortality and Morbidity _______ _ 12 2.3 Immunization Rates as an Indicator of Availability of Public Health Services _______ _ 13 2.4 Socioeconomic Determinants of Health _______ _ 13 3.0 Asthma and Respiratory Disease _______ _ 15 3.1 Outdoor Air Pollution _______ _ 16 3.1.1 Canada 3.1.2 Mexico 3.1.3 United States 3.1.4 Opportunities for Strengthening Indicators of Outdoor Air Pollution in North America 3.2 Indoor Air Pollution _______ _ 24 3.2.1 Canada 3.2.2 Mexico 3.2.3 United States 3.2.4 Opportunities for Strengthening Indicators of Indoor Air Pollution in North America 3.3 Asthma _______ _ 30 3.3.1 Canada 3.3.2 Mexico 3.3.3 United States 3.3.4 Opportunities for Strengthening Indicators of Asthma and Respiratory Disease in North America 4.0 Lead and Other Chemicals, including Pesticides _______ _ 39 4.1 Blood Lead Levels _______ _ 40 4.1.1 Canada 4.1.2 Mexico 4.1.3 United States 4.1.4 Opportunities for Strengthening Indicators of Children’s Exposure to Lead in North America 4.2 Lead in the Home _______ _ 51 4.2.1 Canada 4.2.2 Mexico 4.2.3 United States 4.2.4 Opportunities for Strengthening the Indicator on Children’s Exposure to Lead in the Home, in North America 4.3 Industrial Releases of Lead _______ _ 55 4.3.1 Canada 4.3.2 Mexico 4.3.3 United States 4.3.4 Opportunities for Strengthening Indicators of Lead from Industrial Activities in North America 4.4 Industrial Releases of Selected Chemicals _______ _ 59 4.4.1 Canada 4.4.2 Mexico 4.4.3 United States 4.4.4 Opportunities for Strengthening PRTR-based Indicators in North America 4.5 Pesticides _______ _ 65 4.5.1 Canada 4.5.2 Mexico 4.5.3 United States 4.5.4 Opportunities for Strengthening Indicators of Children’s Exposure to Pesticides in North America 5.0 Waterborne Diseases _______ _ 71 5.1 Drinking Water _______ _ 72 5.1.1 Canada 5.1.2 Mexico 5.1.3 United States 5.1.4 Opportunities for Strengthening Indicators on Availability and Quality of Drinking Water in North America 5.2 Sanitation _______ _ 81 5.2.1 Canada 5.2.2 Mexico 5.2.3 United States 5.2.4 Opportunities for Strengthening Indicators on Sewage Systems and Treatment in North America 5.3 Waterborne Diseases _______ _ 84 5.3.1 Canada 5.3.2 Mexico 5.3.3 United States 5.3.4 Opportunities for Strengthening Indicators on Childhood Morbidity and Mortality from Waterborne Diseases in North America 6.0 Lessons Learned and Actions Needed _______ _ 93 List of Figures and Charts _______ _ 96 List of Abbreviations _______ _ 98 Glossary _______ _ 99 References _______ _ 104 Appendix 1: Council Resolution 02-06 _______ _ 107 Appendix 2: Overview of Recommended Indicators from the CEC Council _______ _ 109 Appendix 3: Council Resolution 03-10 _______ _ 111 Appendix 4: Members of the Steering Group for the Development of Indicators of Children’s Health and theEnvironment in North America _______ _ 112 Appendix 5: Expert Review Panel _______ _ 115 Appendix 6: 153 Matched Chemicals _______ _ 116 Children's Health and the Environment in North America Children deserve not only our love and affection; they deserve special diligence on our part to ensure that they have the chance to thrive in a safe and nurturing world. PHOTO: CHRIST CHAVEZ / CEC CHILDREN’S HEALTH AND THE ENVIRONMENT IN NORTH AMERICA Preface Indicators play a key role in informing us about the status of an issue, encouraging action and tracking progress towards stated goals. We use indicators every day for numerous purposes, from tracking the stock market to following trends in diseases to measuring unemployment. What are much less common, however, are indicators that tell us about the environmental health challenges facing our children. The WHO-led “Global Initiative on Children’s Environmental Health Indicators,” spearheaded by the US Environmental Protection Agency and launched at the World Summit on Sustainable Development (Johannesburg, 2002), is an effort to change all that. There is increasing recognition that unless we get serious about systematically tracking environmental infl uences on children’s health, our efforts to prevent and mitigate those effects will remain piecemeal. This report represents North America’s contribution to the Global Initiative, as well as its commitment to continuing to work together to ensure a safe and healthy environment for our children. The partial picture provided by this fi rst report shows us that, despite improvements on many fronts, our children remain at risk from environmental threats. In the area of air quality and respiratory health, we see that childhood asthma continues to increase across North America; levels of ozone and particulate matter remain a problem; and, despite declines in exposure to environmental tobacco smoke in Canada and the US, the US data suggest that certain minority groups are disproportionately affected. In Mexico, exposure to smoke from the indoor burning of biomass fuels is still widespread. With respect to toxics and pesticides, we see that toxic chemicals—including lead, a metal well known for its damaging effects on the neurological development of children—continue to be released in large amounts from industrial activities. Although the data are thin, it appears that while lead levels in children’s blood are on the decline in many parts of the continent, particular socio-economic groups remain at higher risk. On the positive side, available data indicate that pesticides residues in foods in Canada and the US, and acute poisonings in Mexico, are on the decline. With respect to water quality and waterborne disease, Mexico continues to face the largest challenges regarding access to safe drinking water and sanitation services, although progress is being made which no doubt is contributing to the decline in diarrheal diseases among Mexican children. Children deserve not only our love and affection, they deserve special diligence on our part to ensure that they have the chance to thrive in a safe and nurturing world. On an individual level, we can do our part to care for our children and keep them out of harm’s way. But the ever- increasing evidence of the overt and subtle effects that a degraded environment can have on children’s health means that we also must act collectively. Acting alone, none of us can stem the problems of urban air pollution, toxic contamination, or poor water quality. But working as neighbors, communities, countries, and globally, we can make a difference. This report marks the beginning of an important new direction for North America. It is the culmination of many months of work by dedicated people from across the continent and globally, representing the governments of Canada, Mexico and the United States and the partner institutions, namely CEC, IJC, PAHO and WHO.
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