Preserving Children's Futures Through Healthy Environments
A call for stronger commitment to protect our children's health and their future from environmental threats comes at the start of the preparations for the WHO Fifth Ministerial Conference on Environment and Health, which take off in Milan, hosted by Italy and organized by the WHO Regional Office for Europe in collaboration with the European Environment and Health Committee (EEHC). The first of three high-level meetings in preparation for the European Ministerial Conference aims to reinforce the partnership between health, the environment and other sectors, to ensure better health for all Europe's people, with special emphasis on the younger generation. The Fifth Ministerial Conference on Environment and Health, due to take place in Italy in 2009, aims to review national implementation of the commitments countries have made in the last five years to assess if they have indeed made a change.
Well tested environmental health interventions could save nearly 1.8 million lives a year in the 53 countries of the WHO European Region. As children are among the most vulnerable members of society, action targeted at them would benefit the entire population: 6 million years of healthy life in children and adolescents could be gained by tackling air pollution, unsafe water, injuries and chemicals. Emerging threats that magnify the impact of the environment on health are a new challenge: most importantly, the changing climate.
"Europe is at the forefront of a process that aims to cut the most significant environmental threats to health as rapidly as possible", says Dr Marc Danzon, WHO Regional Director for Europe. "Over the last 20 years, much progress has been made and many lives have already been saved by countries adopting and implementing strong policies. Still, marked differences across the Region indicate the need for targeted action."
While in western countries concern for the environmental impact on health focuses mainly on chronic diseases associated with exposures to pollution, a significant part of Europe's population still struggles with "traditional" environmental health problems, such as access to safe drinking-water. In central and eastern Europe, water is safe in only 30--40% of households. Evidence shows, however, that provision of safe water and adequate sanitation reduces morbidity from diarrhoeal diseases by 26%. Recognizing this, many European countries are already taking action to strengthen their health systems and provide guidance on detecting outbreaks of water-related diseases.
This should go along with action to reduce damage to health from exposure to other factors such as air pollution, climate change and injuries, which recent research has shown to have a far bigger impact than initially thought. Reducing emissions of air pollutants could save over 1 million years of life in the European Union each year. Many of the 70 000 excess deaths due to the 2003 heat-wave could have been avoided by ensuring health systems' preparedness and ability to respond. If all countries in the Region had the same death rate from injuries as the country with the lowest rate, some 500 000 lives could be spared each year.
Tackling environmental risks to health in the European Region and in Italy
Examples of measures European countries have taken to preserve children's future through healthy environments encompass: the prevention and treatment of infectious diseases in children including through better access at school to safe drinking-water (Uzbekistan); regulations to reduce mortality from everyday accidents by 50% in children aged under 14 (France); projects to ensure clean indoor air in primary schools through improved ventilation (Netherlands); and the reinforcement of regulations and awareness-raising in the younger generation to protect health from chemical pollution (Albania and Armenia).
"Investment in research is essential to identify effective responses to environmental risks to health, in particular those generated by climate change", says Corrado Clini, Chair of the EEHC. "In all countries, health could be significantly improved through the adoption of new environment-friendly technologies for energy production. Italy, with its programmes for environmental cooperation, has started this virtuous circle to disseminate experiences and know-how."
"European countries are now working eagerly on implementing their national programmes for children's health and environment, as committed to in Budapest 2004. Our children's health cannot be negotiated. Children need and deserve a fundamental human right to a clean and healthy environment. Youth participation in this work started at the Budapest Conference in 2004 and is of the outmost importance for implementing the Children's Environment and Health Action Plan for Europe. Youth participation is also important to help reduce and stop the health hazards of climate change", says Dr Jon Hilmar Iversen, Deputy Chair of the EEHC.
Italy is one of the countries in Europe where the health impact of environmental risks has been assessed in detail. A WHO/Europe study in 2006, for example, estimated that over 8000 annual deaths in major Italian cities were attributable to the long-term effects of air pollution from particulate matter (PM) and ozone and identified policies to improve air quality. In 2007, the first report on climate change and health in Italy calculated an average 3% increase in deaths for each degree Celsius of temperature rise and predicted more deaths and diseases from heat-waves and floods, new vector-, water-, and foodborne diseases, and longer pollen seasons in present and future scenarios.
"Following the WHO European strategy, Italy has fully adopted the concept of health in all policies", says Donato Greco, Head of the Prevention and Communication Department, Ministry of Health, "recognizing the etiological role for most chronic diseases of risk factors that are not directly related to health, such as tobacco, alcohol, nutrition and physical activity. To tackle them, the country has formalized a commitment to the programme "Gain health - make healthy choices easy" by all ministries and by many social and production associations".
Local authorities play a key role in identifying the problems of the community and in tackling them with the involvement of citizens. "The Padania plain has unfavourable natural conditions for the dispersion of pollutants", concludes Roberto Formigoni, president of Regione Lombardia. "We have long implemented courageous policies, welcomed by the European Union, in terms of emissions limits and incentives for the renewal of equipment, cars and fuels. We have forbidden the use of combustible oil and invested in public transport. PM10 concentrations have been reduced by 8%, which prompts us to persist in a difficult but winnable battle".