North American report on children's health and environment indicators--a global first.

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

The report presents 13 indicators in 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.

The 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 show that certain minority groups remain disproportionately affected.

For lead exposure, case studies from all three countries demonstrate improvements in children's blood lead levels as a result of interventions such as the removal of lead from gasoline. Few biomonitoring data are available in Canada, however, since no national blood level survey has been conducted in the country since 1978. Other exposure pathways for lead remain a concern, such as lead-based paint in older homes. Recently collected data in the United States show that 25 percent of homes had 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. Advances in water and sanitation in Mexico have, however, contributed to a decline in diarrheal 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.

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.

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 the report.

Because it is also the first regional report under the Global Initiative on Children's Environmental Health Indicators (CEHI)--led by WHO, spearheaded by U.S. EPA, and launched at the World Summit for Sustainable Development in Johannesburg--the report is expected to contribute to worldwide efforts to improve children's health. Regional children's environmental health indicator pilot projects are currently under way in Africa, Europe, Latin America and the Caribbean, and the eastern Mediterranean. WHO plans to roll out similar projects in its Southeast Asia and Western Pacific regions in coming years.

A copy of Children's Health and the Environment in North America: A First Report on Available Indicators and Measures, along with the national reports compiled by each of the three governments as source material, can be downloaded from www.cec.org.