Children's Health and Environmental Indicators

Montreal, 26 January 2006 - The Commission for Environmental Cooperation (CEC), in partnership with public health organizations and the governments of Canada, Mexico and the United States, today released the first-ever report on children's health and environment indicators in North America.

The report presents 13 indicators under three thematic areas: asthma and respiratory disease, effects of exposure to lead and other toxic substances, and waterborne diseases. It finds that North American children remain at risk from environmental exposures and that children's health reporting must be improved to address the data gaps identified in the report. Only one of the indicators, addressing asthma in children, was fully reported by all three countries.

These data show a rising number of childhood asthma cases across North America. One possible contributor is outdoor air pollution such as ground-level ozone and particulate matter, which remains a problem for all three countries. In Mexico, exposure to smoke from indoor burning of wood or charcoal is also a problem, as 18 percent of the country's population continued to burn biomass for cooking and heating in 2000. And while Canadian and American children are increasingly less likely to be exposed to environmental tobacco smoke, data from the United States shows that certain minority groups remain disproportionately affected.

For lead exposure, case studies from all three countries demonstrate improvements in children's blood lead levels due to interventions such as the removal of lead from gasoline. However, there is little biomonitoring data available in Canada since there has been no national blood level survey in the country since 1978. Other exposure pathways for lead remain a concern, such as older homes with lead-based paint. Recently collected data in the United States show that 25 percent of homes have a "significant lead-based paint
hazard, which could be from deteriorating paint, contaminated dust or contaminated soil outside the house."

Mexico faces the region's largest challenges in the area of water and sanitation. Data from 2003 indicate that 17 percent of the Mexican population did not have water of appropriate bacteriological quality. However, advances in water and sanitation in Mexico have contributed to a decline in diarrheic diseases from a rate of 125.6 deaths per 100,000 children in 1990 to 20 deaths per 100,000 children in 2002. In the United States, the percentage of children living in an area served by a public water system having at least one major monitoring and reporting violation decreased from 22 percent in 1993 to 10 percent in 1999.

"This first set of children's environmental health indicators will help improve public policy and promote the cause of improved air and water quality, pollution prevention and better management of toxic chemicals," says William V. Kennedy, the executive director of the CEC. "While this report finds improvement in some indicators and challenges in others, it's clear that measurable progress will require a uniform data set for policy-makers to adequately address the risks to children's health."

Indicators are important to tracking and communicating the health and well-being of North America's 123 million children because environmental contaminants can affect the young quite differently than adults. Children generally eat more food, drink more water and breathe more air relative to their size than adults do, and children's normal activities-such as putting their hands in their mouths or playing outdoors-can result in higher exposures to certain contaminants. In addition, environmental contaminants may affect children disproportionately because their immune defenses, for example, are not fully developed and their organs are more easily harmed.

The CEC, the International Joint Commission, the Pan American Health Organization, the World Health Organization (WHO), and the governments of Canada, Mexico and the United States collaborated in the development and selection of the children's environmental health indicators and the release of this report.

As the first regional report under the Global Initiative on Children's Environmental Health Indicators (CEHI)-led by WHO, spearheaded by the US EPA and launched at the World Summit for Sustainable Development in Johannesburg-it is anticipated that this report will contribute to worldwide efforts to improve children's health. Children's Environmental Health regional indicator pilot projects are currently underway in Africa, Europe, Latin America and the Caribbean, and the Eastern Mediterranean. WHO plans on rolling out similar projects in its Southeast Asia and Western Pacific regions in the coming years.

A copy of the report, along with the national reports compiled by each of the three governments as source material for the CEC's North American report, can be downloaded from .


List of Indicators for Children's Health and the Environment in North America*

Asthma and Respiratory Disease Issue Area Indicator
Outdoor Air Pollution Percentage of children living in areas where air pollution levels exceed relevant air quality standards
Indoor Air Pollution Measure of children exposed to environmental tobacco smoke (Canada and the United States); measure of children exposed to emissions from the burning of biomass fuels (Mexico)
Asthma Prevalence of asthma in children
Effects of Exposure to Lead and Other Toxic Substances
Issue Area Indicator
Lead Body Burden Blood lead levels in children
Lead in the Home Children living in homes with a potential source of lead
Industrial Releases of Lead Pollutant release and transfer register (PRTR) data on industrial releases of lead
Industrial Releases of Selected Chemicals PRTR data on industrial releases of 153 chemicals
Pesticides Pesticide residues on foods
Waterborne Diseases
Issue Area Indicator
Drinking Water (2)
(a) Percentage of children (households) without access to
treated water
(b) Percentage of children living in areas served by public water systems in violation of local standards
Sanitation Percentages of children (households) that are not served with sanitary sewers
Waterborne Diseases (2)
(a) Morbidity: number of cases of childhood illnesses
attributed to waterborne diseases (Canada, Mexico and the United States)
(b) Mortality: number of child deaths attributed to waterborne diseases (Mexico)

The countries' efforts to compile these indicators revealed a number of data gaps and opportunities for improvement. None of the countries were able to compile all the indicators but often were able to present related data sets.
Lack of comparability among the data held by the three countries also posed a considerable challenge to compiling a North American set of indicators.