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Exposure to multiple environmental agents and their effect / Koppe JG in Acta paediatrica supplement [Acta Paediatr Suppl], Vol. 95, N° Suppl 453 (10/2006)

[article]  inActa paediatrica supplement [Acta Paediatr Suppl] > Vol. 95, N° Suppl 453 (10/2006) . - 106-13 Titre : Exposure to multiple environmental agents and their effect Type de document : Article scientifique Auteur(s) : Koppe JG ; Bartonova A ; Bolte G ; Bistrup ML ; Busby C ; Butter M ; Dorfman P ; Fucic A ; Gee D ; van den Hazel P ; Howard V ; Kohlhuber M ; Leijs M ; Lundqvist C ; Moshammer H ; Naginiene R ; Nicolopoulou Stamati P ; Ronchetti R ; Salines G ; Schoeters G ; Ten Tusscher G ; Wallis MK ; Zuurbier M Appartenance auteur(s) InVS DSE Année de publication : 2006 Article en page(s) : 106-13 Langues : Anglais (eng) Mots-clés : Enfant ; Foetotoxique ; Exposition multiple ; Maladie environnementale ; Nouveau né ; Toxicité ; Principe précaution ; Evaluation risque ; Europe ; Pollution atmosphérique ; PCB ; Dioxine ; Mercure ; Synthèse connaissance Résumé : Introduction: All children are exposed to multiple physical, chemical and biological challanges that can result in adverse health effects before and after birth. In this context, the danger of multiple exposures cannot be assessed from a single-chemical approach as used in classical toxicology. Aim: To open up a 'negotiation space' for the problem of multiple exposure to environmental stressors, defined as any physical, chemical or biological entity that can induce an adverse response. In this context, two further questions obtain: to what extent can synergistic risks be assessed, and how far could potential adverse effects be prevented by enhanced regulation? Methods: A discussion of two general approaches is taken: 1) the investigation of mixtures such as smoking or air pollution without specifying the individual agents, and 2) the investigation of individual substances with a focus on possible interactions in the context of dose to receptor. Results: Although mixtures of compounds can have effects, it may not be possible to ascribe causation to a single compound. Furthermore, cumulative low-dose insult can, in some circumstances, be more toxic than a single high-dose exposure, e.g. endocrine disruptive effects of a combination of PCBs and dioxins which disrupt the thyroid hormone status; this tends to contradict elements of classical toxicology. These cumulative insults may further combine with heavy metals and can disrupt the heme synthesis. It is possible that groups of pollutants could be used to test their cumulative capacity to multiple stress-susceptible receptor targets as is done in smoking and air pollution. This methodology could be used for further groups of potential pollutants, for example those associated with cleaning products, or cosmetics. Testing individual substances with a focus on interactions means that not only chemicals but also concurrent diseases should be taken into account. We suggest that the enhanced regulation of potential multiple stressors falls into two discrete categories. The first comprises a more precautionary approach (as demonstrated by the banning of chemicals such as some brominated flame retardants in Europe). The second comprises a more 'permissive' liberal approach involving the initial study of an individual compound, and subsequent interrogation of that compound in combination with another (as demonstrated by lowering the carcinogenicity of aflatoxin by vaccination against hepatitis B). Conclusions: It is necessary to define and study groups of multiple stressors as in US EPA's Framework for Cumulative Risk Assessment (U.S. EPA 2003). Recent increased knowledge of the greater sensitivity of the unborn baby, the infant and the child, has led to general recognition that a higher degree of precaution is now needed in regulating for multiple stressors on the young. The more liberal permissive approach proceeding from established effects of the individual exposures is becoming less acceptable now that we know that there is much we do not understand about chronic effects of stressors during the early development phases. Conflicts over which approach to take may have to be resolved through engagement and negotiation with a wide community of stakeholders. This ¿community of interest¿ may include fundamental research scientists, practicing clinical paediatricians, patient groups, and others concerned with the health and wellbeing of infants and children. PMID Pubmed : Pubmed : 17000577 Corpus : Production scientifique InVS Permalink : http://opac.invs.sante.fr/index.php?lvl=notice_display&id=4292 [article]

Today's epidemics in children: possible relations to environmental pollution and suggested preventive measures / van den Hazel P in Acta paediatrica [Acta Paediatr], Vol. 95, N° suppl 453 (10/2006)

[article]  inActa paediatrica [Acta Paediatr] > Vol. 95, N° suppl 453 (10/2006) . - 18-25 Titre : Today's epidemics in children: possible relations to environmental pollution and suggested preventive measures Type de document : Article scientifique Auteur(s) : van den Hazel P ; Zuurbier M ; Babisch W ; Bartonova A ; Bistrup ML ; Bolte G ; Busby C ; Butter M ; Ceccatelli S ; Fucic A ; Hanke W ; Johansson C ; Kohlhuber M ; Leijs M ; Lundqvist C ; Moshammer H ; Naginiene R ; Preece A ; Ronchetti R ; Salines G ; Saunders M ; Schoeters G ; Stilianakis N ; Ten Tusscher G ; Koppe JG Appartenance auteur(s) InVS DSE Année de publication : 2006 Article en page(s) : 18-25 Langues : Anglais (eng) Mots-clés : Enfant ; Maladie environnementale ; Recommandation ; Asthme ; Allergie ; Diabète ; Cancer ; Trouble audition ; Obésité ; Autisme ; Trouble apprentissage ; Synthèse connaissance ; Glande endocrine [pathologie] ; Prématurité ; Foetotoxique ; Exposition multiple ; Toxicité ; Europe Mots-clés : MALFORMATION Résumé : Background: Facts and hypotheses on the relationship between some children's diseases or disorders and external stressors during the developmental stage of a child, both prenatally and postnatally are described in literature. In this paper the following changes in patterns and causes of the main childhood illnesses are summarized and recommendations for actions are made. - Prematurity - Intra-uterine growth restriction - Testicular dysgenesis syndrome - Type I and Type II diabetes - Asthma, atopy and hay fever - Autism - Attention deficit hyperactivity disorder (ADHD) - Learning disabilities - Cancer - Obesity - Hearing problems Results: Literature provides a growing amount of information on changing patterns in childhood diseases. Conclusions: The following recommendations for action are formulated: - Immediate research on endocrine disrupters in relation to prematurity - Diabetes: avoid Maillard Compounds in liquid baby food and in food in general: promote breastfeeding - Asthma: avoid exposure to smoking, the use of chemical household products, dioxin and dioxin-like chemicals, and avoid air pollution with high levels of particulate matter, especially around conception, during pregnancy and in the first years of life - Autism: more research on incidence and causes - ADHD and learning disabilities: more research on prevalence and causes. Preventions: 1) preconception counselling to avoid potentially harmful substances; 2) controlling and further lowering levels of polychlorinated biphenyls, lead and methyl mercury - Cancer: promote breastfeeding, carry out research into effects of foetal exposure to internal fission-product radionuclides - Obesity: stop smoking in pregnancy, avoid parental obesity, longer night sleep - Hearing problems: problems: lower noise levels in discothe`ques, promote the day-evening-night level to avoid noise (longer night sleep). PMID Pubmed : Pubmed : 17000565 Corpus : Production scientifique InVS Permalink : http://opac.invs.sante.fr/index.php?lvl=notice_display&id=4280 [article]