The CEHAPE: activities to improve childrens health and environment in the European Region

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The CEHAPE activities to improve childrens
health and environment in the European Region
6th annual North West Public Health conference
incorporating the 17th annual conference of the
WHO Regions for Health Network Manchester, United
Kingdom 9 and 10 November 2009

• Christian SchweizerTechnical OfficerWHO
  Regional Office for Europe, European Centre for
  Environment and Health (Rome)

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Outline

• Childrens health and environment in Europe
• Why children?
• Health effects and their burden
• What is being done? - The environment and health
  process in Europe
• Childrens environment and health action plan for
  Europe
• Tools from WHO
• Parma 2010

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Why children deserve special attention
Until recently, childhood environmental health
risks were "scaled down" from adult risks.But
children have/are

• Different and unique exposures
• Dynamic developmental physiology
• Longer life expectancy
• Politically powerless

Giotto, National Gallery, Washington DC
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Main links between environment and health
Air pollution
Respiratory diseases
Gastrointestinal diseases
Lack of water and sanitation
Neurodevelopmental disorders
Chemicals and heavy metals
Overweight and obesity
Physical agents
Unsafe housing
Cardiovascular disorders
Mobility and transport
Cancer
Injuries
Child labor
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The burden

• Globally, ca 24 of diseases in the whole
  population are estimated to be caused by
  environmental risk factors
• Child-specific data is difficult to find
• In Europe, ca 26 of the total disease burden
  (incl 100,000 deaths) in children are caused by
  air pollution, unsafe water and sanitation, lead
  contamination and injuries alone!
• 37 children die every day in Europe due to
  diarrhoeal diseases

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Inequalities large regional differences
Source WHO, EBD of selected environmental
factors and injuries among Europes children and
adolescents, 2004
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Inequalities large sub-national differences
Deaths due to unintentional injuries, (0-14
years) SDR per 100,000 Source WHO, Mortality
database, August 2009

• A boy born in the deprived inner city area of
  Calton, Glasgow, can expect to live to 54 years
  compared with a boy born in the nearby suburb of
  Lenzie, who can expect to live to 82World
  Health Organisation (2008)

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The European environment and health process
Outcomes
WHO Ministerial conferences
1989 1994 1999 2004 2010
Frankfurt Helsinki London Budapest Parma

• - European Charter on Environment and Health
• Concern for Europes Tomorrow
• WHO European Centre for Environment and Health
• Environment and Health Action Plan for Europe
  (EHAPE)
• National Environment and Health Action Plans
  (NEHAPs)
• European Environment and Health Committee (EEHC)
• - Protocol on Water and Health
• Charter on Transport, Environment and Health
• Renewed mandate of the EEHC
• - CEHAPE
• - Declaration
• - Declaration
• - Regional Framework for action on climate change

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Taking the lead in environment and healthThe
future for our children launched in Budapest

• Address the specific vulnerability of children
• Evidence-based political commitment by the Member
  States
• Focus on action
• Framework to develop own policies, programs,
  national targets and indicators
• Addresses both national and region-wide
  priorities
• Cross-sectoral

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CEHAPE Regional Priority Goals
Scientific evidence is the basis of the 4 CEHAPE
Regional Priority Goals
Regional Priority Goal IV. Focus on reducing
risks from exposure to hazardous chemicals and
physical agents (e.g. noise, radiations) and to
hazardous working environments during pregnancy,
childhood and adolescence
Regional Priority Goal I. Focus on safe and
affordable water and adequate sanitation Regional
Priority Goal II. Focus on prevention of
injuries and promotion of physical
activity Regional Priority Goal III. Focus on
prevention of respiratory disease due to outdoor
and indoor air pollution
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(Sub-)National CEHAPs
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Example tools for CEHAPE
From risk assessment to risk management and
monitoring.

• Qualitative assessment
• National Profiles
• Environment and Health Performance Reviews

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Example tools for CEHAPE

• Quantitative assessment Identifying priorities
  based on scientific evidence
• Study on Environmental burden of disease
• Economic valuation of health effects

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Example tools for CEHAPE

• CEHAPE Action-Pack
• Table of child-specific actions
• Evidence-based effective actions
• Catalogue of case studies
• Practical experience
• Environmental lead poisoning in children (Silesia
  Province, Poland)
• Intelligent sunbathing (Bavaria, Germany)
• Di testa mia (Tuscany, Italy)
• Child safety box (Styria, Austria)

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Example tools for CEHAPE

• Capacity building for health and environment
  professionals
• Youth involvement
• WHO Norms and standards
• Drinking water quality guidelines, Recreational
  water quality guidelines, Codex Alimentarius,
  Noise Guidelines, Air Quality Guidelines etc.

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Example tools for CEHAPE

• Web-based country reporting
• Environment and Health Indicators
• Related international processes

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We have made progress,
Trends of dioxins in breast milk
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but more action is still needed!

• Risk factors remain a problem
• Inequity in environment and health
• Climate change
• Specific needs of NIS and SEE
• New stakeholders (e.g. local authorities)
• Economic influence in environment and health
  policy making
• Synergies and new opportunities in working across
  boundaries

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The next milestone in the process

• Fifth Ministerial Conference on Environment and
  HealthParma, 10-12 March 2010
• The Conference will renew governments pledges in
  an era of new global challenges to strengthen
  health systems and their collaboration with other
  sectors to ensure better environments for
  childrens health

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Thanks, and see you in Parma!
www.euro.who.int/parma2010