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Salud Infantil Y Medio Ambiente En América Del Norte Un Primer Informe Sobre Indicadores Y Mediciones Disponibles

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Salud Infantil Y Medio Ambiente En América Del Norte Un Primer Informe Sobre Indicadores Y Mediciones Disponibles Salud infantil y medio ambiente en América del Norte Un primer informe sobre indicadores y mediciones disponibles Comisión para la Cooperación Ambiental Salud infantil y medio ambiente en América del Norte 1 Impreso en Canadá en papel hecho con 100% de fibra postconsumo. © Comisión para la Cooperación Ambiental, 2006 Legal Deposit-Bibliothèque nationale du Québec, 2006 Legal Deposit-Bibliothèque nationale du Canada, 2006 ISBN: 2-923358-33-3 Reproducción de imágenes con permiso autorizado NOTA SOBRE RESPONSABILIDAD El presente informe fue preparado por el Secretariado de la CCA en coordinación con el Grupo Coordinador para la Elaboración del Informe de Indicadores sobre Salud Infantil y Medio Ambiente en América del Norte, integrado por funcionarios de los gobiernos de Canadá, Estados Unidos y México, además de representantes de la CCA, el Equipo de Tarea de Profesionales de la Salud de la Comisión Conjunta Internacional (IJC), la Organización Panamericana de la Salud (OPS) y la Organización Mundial de la Salud (OMS). Este informe de América del Norte se basa principalmente en la información contenida en los Informes Nacionales preparados por los gobiernos de Canadá, Estados Unidos y México, mismos que se presentan por separado (disponibles en: http://www.cec.org/ninos). No toda la información y afirmaciones en el Informe reflejan necesariamente las opiniones de los gobiernos de Canadá, Estados Unidos o México, o las del Secretariado de la CCA, la CCI, la OPS o la OMS, en parte debido a que el informe es la recopilación de información proporcionada por separado por los tres diferentes países. Comisión para la Cooperación Ambiental 393, rue St-Jacques Ouest, Bureau 200 Montreal (Quebec) Canadá H2Y 1N9 t (514) 350-4300 f (514) 350-4314 [email protected] / www.cec.org ii Salud infantil y medio ambiente en América del Norte Un primer informe sobre indicadores y mediciones disponibles Preparado por: Secretariado de la Comisión para la Cooperación Ambiental En colaboración con: Comisión Conjunta Internacional, Equipo de Trabajo de Profesionales de la Salud Organización Panamericana de la Salud Organización Mundial de la Salud Gobiernos de Canadá, Estados Unidos y México ENERO DE 2006 Este informe constituye la contribución de América del Norte a la Iniciativa Global sobre Indicadores de Salud Ambiental Infantil, así como su compromiso de seguir trabajando juntos para asegurar un medio ambiente sano y seguro para nuestros niños. Índice Prefacio _______ _ vii Reconocimientos _______ _ viii Resumen ejecutivo _______ _ xi 1.0 Perspectiva general de la iniciativa sobre indicadores de salud infantil y medio ambiente _______ _ 1 1.1 Salud infantil y medio ambiente _______ _ 1 1.2 Necesidad de indicadores sobre la salud infantil y el medio ambiente en América del Norte _______ _ 2 1.3 Usuarios del informe _______ _ 4 1.4 Selección de los indicadores _______ _ 5 1.5 Un enfoque común para la elaboración de indicadores _______ _ 7 1.6 El primer informe de América del Norte _______ _ 9 2.0 Introducción de los países participantes _______ _ 11 2.1 Panorama demográfi co y tasas de nacimiento _______ _ 12 2.2 Mortalidad y morbilidad infantiles _______ _ 12 2.3 Tasas de inmunización como indicador del acceso a servicios públicos de salud _______ _ 13 2.4 Determinantes socioeconómicos de la salud _______ _ 13 3.0 Asma y otras enfermedades respiratorias _______ _ 15 3.1 Contaminación atmosférica exteriores _______ _ 16 3.1.1 Canadá 3.1.2 México 3.1.3 Estados Unidos 3.1.4 Oportunidades para el fortalecimiento de los indicadores de la calidad del aire en exteriores en América del Norte 3.2 Contaminación atmosférica interiores _______ _ 24 3.2.1 Canadá 3.2.2 México 3.2.3 Estados Unidos 3.2.4 Oportunidades para el fortalecimiento de los indicadores de la calidad del aire en interiores en América del Norte 3.3 Asma _______ _ 30 3.3.1 Canadá 3.3.2 México 3.3.3 Estados Unidos 3.3.4 Oportunidades para el fortalecimiento de los indicadores del asma y las enfermedades respiratorias en América del Norte 4.0 Plomo y otras sustancias tóxicas, incluidos los plaguicidas _______ _ 39 4.1 Carga corporal de plomo _______ _ 40 4.1.1 Canadá 4.1.2 México 4.1.3 Estados Unidos 4.1.4 Oportunidades para el fortalecimiento de los indicadores de la exposición infantil al plomo en América del Norte 4.2 Plomo en el hogar _______ _ 52 4.2.1 Canadá 4.2.2 México 4.2.3 Estados Unidos 4.2.4 Oportunidades para fortalecer el indicador de la exposición de los niños al plomo en el hogar en América del Norte 4.3 Emisiones industriales de plomo _______ _ 57 4.3.1 Canadá 4.3.2 México 4.3.3 Estados Unidos 4.3.4 Oportunidades para fortalecer los indicadores de plomo desde las actividades industriales 4.4 Emisiones industriales de ciertas sustancias químicas tóxicas _______ _ 61 4.4.1 Canadá 4.4.2 México 4.4.3 Estados Unidos 4.4.4 Oportunidades para fortalecer los indicadores basados en los RETC en América del Norte 4.5 Plaguicidas _______ _ 67 4.5.1 Canadá 4.5.2 México 4.5.3 Estados Unidos 4.5.4 Oportunidades para fortalecer los indicadores de la exposición de los niños a los plaguicidas en América del Norte 5.0 Enfermedades transmitidas por el agua _______ _ 73 5.1 Agua para consumo humano _______ _ 74 5.1.1 Canadá 5.1.2 México 5.1.3 Estados Unidos 5.1.4 Oportunidades para fortalecer los indicadores sobre disponibilidad y calidad del agua potable en América del Norte 5.2 Servicios sanitarios _______ _ 83 5.2.1 Canadá 5.2.2 México 5.2.3 Estados Unidos 5.2.4 Oportunidades para fortalecer los indicadores sobre sistemas de drenaje y tratamiento en América del Norte 5.3 Enfermedades transmitidas por el agua _______ _ 86 5.3.1 Canadá 5.3.2 México 5.3.3 Estados Unidos 5.3.4 Oportunidades para fortalecer los indicadores de morbilidad y mortalidad infantil por padecimientos propagados por el agua en América del Norte 6.0 Lecciones aprendidas y acciones necesarias _______ _ 95 Índice de ilustraciones y gráfi cas _______ _ 98 Siglas y abreviaturas _______ _ 100 Glosario _______ _ 101 Referencias _______ _ 106 Apéndice 1: Resolución de Consejo 02-06 _______ _ 109 Apéndice 2: Resumen de los indicadores recomendados _______ _ 111 Apéndice 3: Resolución de Consejo 03-10 _______ _ 113 Apéndice 4: Miembros del Grupo Coordinador para la elaboración del informe de indicadores sobre salud infantil y medio ambiente en América del Norte _______ _ 114 Apéndice 5: Lista de expertos del grupo de revisión _______ _ 117 Apéndice 6: 153 sustancias combinadas _______ _ 118 Salud infantil y medio ambiente en América del Norte Los niños merecen no sólo nuestro amor y cariño; merecen que pongamos especial atención para asegurarles la oportunidad de desarrollarse en un mundo seguro y propicio. FOTO: CHRIST CHAVEZ / CCA SALUD INFANTIL Y MEDIO AMBIENTE EN AMÉRICA DEL NORTE Prefacio Los indicadores desempeñan un papel fundamental en nuestro conocimiento del estado que guarda un asunto, impulsan las acciones y sirven para dar seguimiento a los avances hacia las metas planteadas. Empleamos indicadores todos los días para una diversidad de propósitos, desde el análisis del mercado de valores hasta las tendencias de las enfermedades para medir el desempleo. Sin embargo, son mucho menos comunes los que nos hablan de los retos de salud ambiental a que se enfrentan nuestros niños. Encabezada por la OMS, la Iniciativa Global sobre Indicadores de Salud Ambiental Infantil, emprendida en la Cumbre Mundial sobre Desarrollo Sostenible (Johannesburgo, 2002) y cuya punta de lanza es la Agencia de Protección Ambiental de Estados Unidos, se propone cambiar todo eso. Es generalizado el reconocimiento de que a menos que tomemos muy en serio y de manera sistemática el seguimiento de esos efectos en la salud infantil, nuestros esfuerzos para prevenir y mitigar dichos efectos seguirán siendo irregulares. El presente informe constituye la contribución de América del Norte a la Iniciativa Global, así como su compromiso de continuar trabajando juntos para asegurar un medio ambiente sano y seguro para nuestros niños. La imagen parcial brindada por este primer informe indica que, pese a los avances en diversos frentes, nuestros niños permanecen en riesgo por las amenazas ambientales. En el campo de la calidad del aire y la salud respiratoria se observa que el asma infantil no deja de aumentar en toda América del Norte; los niveles de ozono y de partículas siguen siendo un problema, y pese a la disminución en la exposición al humo de tabaco en Canadá y Estados Unidos, datos de este último país sugieren que ciertos grupos minoritarios son afectados de modo desproporcionado. En México la exposición al humo generado por la quema en interiores de combustibles de biomasa sigue siendo generalizada. Con respecto a las sustancias tóxicas y los plaguicidas se observa que las actividades industriales siguen emitiendo grandes cantidades de las primeras, incluido el plomo, metal bien conocido por sus efectos dañinos en el desarrollo neurológico infantil. Aunque los datos no son abundantes, todo indica que mientras que los niveles de plomo en la sangre de los niños está disminuyendo en muchas partes del continente, algunos grupos socioeconómicos permanecen en alto riesgo. Del lado positivo, los datos disponibles señalan que los residuos de plaguicidas en los alimentos de Canadá y EU, así como las intoxicaciones agudas en México, van a la baja. En lo que toca a la calidad del agua y las enfermedades por ésta propagadas, México se sigue enfrentando a grandes retos en cuanto al acceso al agua potable y servicios de saneamiento, aunque se han logrado avances que sin duda contribuirán a la disminución de las enfermedades diarreicas entre la niñez mexicana.
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