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      Environmental Pollution: An Under-recognized Threat to Children’s Health, Especially in Low- and Middle-Income Countries

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          Summary

          Exposures to environmental pollutants during windows of developmental vulnerability in early life can cause disease and death in infancy and childhood as well as chronic, non-communicable diseases that may manifest at any point across the life span. Patterns of pollution and pollution-related disease change as countries move through economic development. Environmental pollution is now recognized as a major cause of morbidity and mortality in low- and middle-income countries (LMICs). According to the World Health Organization, pollution is responsible for 8.9 million deaths around the world each year; of these, 94% (8.4 million) are in LMICs. Toxic chemical pollution is growing into a major threat to children’s health in LMICs. The disease and disability caused by environmental pollution have great economic costs, and these costs can undercut trajectories of national development. To combat pollution, improved programs of public health and environmental protection are needed in countries at every level of development. Pollution control strategies and technologies that have been developed in high-income countries must now be transferred to LMICs to assist these emerging economies to avoid the mistakes of the past. A new international clearinghouse is needed to define and track the health effects of pollution, quantify the economic costs of these effects, and direct much needed attention to environmental pollution as a risk factor for disease.

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          Most cited references55

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
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            Trade, the pollution haven hypothesis and the environmental Kuznets curve: examining the linkages

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              The toxicology of climate change: Environmental contaminants in a warming world

              Climate change induced by anthropogenic warming of the earth's atmosphere is a daunting problem. This review examines one of the consequences of climate change that has only recently attracted attention: namely, the effects of climate change on the environmental distribution and toxicity of chemical pollutants. A review was undertaken of the scientific literature (original research articles, reviews, government and intergovernmental reports) focusing on the interactions of toxicants with the environmental parameters, temperature, precipitation, and salinity, as altered by climate change. Three broad classes of chemical toxicants of global significance were the focus: air pollutants, persistent organic pollutants (POPs), including some organochlorine pesticides, and other classes of pesticides. Generally, increases in temperature will enhance the toxicity of contaminants and increase concentrations of tropospheric ozone regionally, but will also likely increase rates of chemical degradation. While further research is needed, climate change coupled with air pollutant exposures may have potentially serious adverse consequences for human health in urban and polluted regions. Climate change producing alterations in: food webs, lipid dynamics, ice and snow melt, and organic carbon cycling could result in increased POP levels in water, soil, and biota. There is also compelling evidence that increasing temperatures could be deleterious to pollutant-exposed wildlife. For example, elevated water temperatures may alter the biotransformation of contaminants to more bioactive metabolites and impair homeostasis. The complex interactions between climate change and pollutants may be particularly problematic for species living at the edge of their physiological tolerance range where acclimation capacity may be limited. In addition to temperature increases, regional precipitation patterns are projected to be altered with climate change. Regions subject to decreases in precipitation may experience enhanced volatilization of POPs and pesticides to the atmosphere. Reduced precipitation will also increase air pollution in urbanized regions resulting in negative health effects, which may be exacerbated by temperature increases. Regions subject to increased precipitation will have lower levels of air pollution, but will likely experience enhanced surface deposition of airborne POPs and increased run-off of pesticides. Moreover, increases in the intensity and frequency of storm events linked to climate change could lead to more severe episodes of chemical contamination of water bodies and surrounding watersheds. Changes in salinity may affect aquatic organisms as an independent stressor as well as by altering the bioavailability and in some instances increasing the toxicity of chemicals. A paramount issue will be to identify species and populations especially vulnerable to climate-pollutant interactions, in the context of the many other physical, chemical, and biological stressors that will be altered with climate change. Moreover, it will be important to predict tipping points that might trigger or accelerate synergistic interactions between climate change and contaminant exposures.
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                Author and article information

                Journal
                Environ Health Perspect
                Environ. Health Perspect
                EHP
                Environmental Health Perspectives
                National Institute of Environmental Health Sciences
                0091-6765
                1552-9924
                1 March 2016
                March 2016
                : 124
                : 3
                : A41-A45
                Affiliations
                [1 ]Hazardous Substances Research Branch, Superfund Research Program, National Institute for Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, USA
                [2 ]Department of Allergy and Clinical Immunology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
                [3 ]Water Research Institute, Council for Scientific and Industrial Research, Accra, Ghana
                [4 ]Institute for Health and the Environment, University at Albany, Rensselaer, New York, USA
                [5 ]Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
                [6 ]Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
                [7 ]Shantou University Medical College, Shantou, China
                [8 ]Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
                [9 ]Chulabhorn Research Institute, Bangkok, Thailand
                [10 ]Department of Pediatrics, School of Medicine, University of Caxias do Sul, Caxias do Sul, Brazil
                [11 ]Children’s Health and Environment Program, Queensland Children’s Medical Research Institute, University of Queensland, Brisbane, Australia
                [12 ]Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
                [13 ]Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
                [14 ]Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, Republic of South Africa
                [15 ]Arnhold Global Health Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
                Author notes
                []Address correspondence to W.A. Suk, Superfund Research Program, Division of Extramural Research and Training, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709 USA. Telephone: (919) 541-0797. Email: suk@ 123456niehs.nih.gov
                Article
                ehp.1510517
                10.1289/ehp.1510517
                4786991
                26930243
                7bd42e7f-0093-44c5-9214-1f0bb65b2436

                Publication of EHP lies in the public domain and is therefore without copyright. All text from EHP may be reprinted freely. Use of materials published in EHP should be acknowledged (for example, “Reproduced with permission from Environmental Health Perspectives”); pertinent reference information should be provided for the article from which the material was reproduced. Articles from EHP, especially the News section, may contain photographs or illustrations copyrighted by other commercial organizations or individuals that may not be used without obtaining prior approval from the holder of the copyright.

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                Public health
                Public health

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