Internationally there exists the need for a preventive health approach to environmental exposure which protects the most vulnerable subsets of populations, particularly children. Child-based standards for pollution levels are required to regulate air, food, water, and household pollution levels. Children must be incorporated into the existing risk assessment processes and special notice taken of their health requirements. Existing national and international legislation and regulation, require review to identify where children are not taken into account.
Children today live in an environment that is very different from that of a few generations ago. Economic development, increasing urbanization and industrialization, as well as the consequences of war in many countries, have added to "traditional" environmental hazards, i.e. the problems associated with environmental pollution. In addition to the persistence of some traditional diseases of childhood, such as diarrhoea, malnutrition and infectious diseases, health effects associated with environmental causes such as asthma and lead poisoning, as well as mortality and morbidity due to injuries, are becoming increasingly prevalent.
Children require special protection because they are more vulnerable to the effects of environmental hazards. Children receive greater exposures per unit of body weight than adults, and they are more susceptible to their effects because of their immature and developing systems. The fetus has been found to be particularly vulnerable to the effects of chemical exposures. Children are also more likely to have accidents and be injured. In addition, because children have more years to live than most adults, they have more time to develop diseases with long latency periods such as cancer, more years of life to be lost and more suffering to be endured as a result of disability, impaired health or the loss of human functions such as the ability to procreate.
Health care providers, including physicians and nurses, should be trained in the diagnosis, treatment, and prevention of pediatric environmental health hazards. A broad spectrum of service providers such as physicians, social workers, teachers, school nurses, community members, and parents should be educated about pediatric environmental health issues. Funding is required for patient education regarding pediatric environmental health.
Pediatricians should become informed about air pollution problems in the community. Those caring for children at special risk, such as those with asthma and cystic fibrosis, should be aware that current levels of air pollution may cause deterioration in these children's pulmonary function and may aggravate their symptoms. Physicians for schools and for students participating in team sports need to be aware of the health implications of pollution alerts in order to provide appropriate guidance to schools and other public agencies on the health hazards of air pollution. Parents can be made more aware of the predictable daily variation in ozone, especially the tendency to peak in the afternoon. This awareness is essential in areas with recognized high ozone levels. When ozone levels are elevated, it may be possible to decrease children's exposure by scheduling outdoor activities earlier in the day.
The Declaration of the Environmental Leaders of the Eight on Children's Environmental Health should serve as the framework for all European countries to follow, particularly the policy approaches that it lays down, which include: (a) preventing exposure is the most effective way of protecting children's health from environmental threats. Governments should therefore develop policies that seek to prevent childhood diseases by preventing exposures to environmental agents, on the basis of the precautionary principle. (b) national policies should take into account the specific exposure pathways and dose-response characteristics of children when conducting environmental risk assessment and setting protective standards. (c) research should be promoted in order to gain a better understanding of the particular exposure and sensitivities of infants and children to environmental hazards. Exchange of information on research results and the development of regulatory systems should also be promoted. (d) awareness of the environment and health should be promoted, so as to enable families to better protect their children's health.