Sri Lanka: report on its children's environmental health

Our plain-English summary of Sri Lanka: report on its children's environmental health, by H. Galappaththi (Reviews on Environmental Health, 2020).

The study

• Author: H. Galappaththi
• Journal: Reviews on Environmental Health
• Published: 2020;35(1):65-70
• Type of article: Review
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Sri Lanka is an island country located in the Indian Ocean, characterized by tropical weather, with an estimated population of 21.4 million in 2017, one third of them being children. Advancing and rapidly changing technology, novel industries, consumer goods and equipment have introduced new health hazards of a chemical, biological and physical nature to future generations. The infant mortality rate has declined to around 8-9 per 100,000 since 2015. Congenital malformations were the most significant cause of neonatal death. Thus, there might be unproven environmental factors which affect infant mortality rates despite robust field and hospital services. Air pollution is a major environmental health hazard to children, largely due to hazardous industries, vehicular emissions and traditional cooking stoves. The health of children living in urban households and attending schools in cities is adversely affected by air pollution. Usage of polythene and plastic for toys, utensils, bags, lunch sheets and other daily essentials leads to overusage and improper waste management and open burning. This emits dioxins, which are carcinogens, hormone disruptors, and which can be transferred to the fetus via the placenta. In rural areas, the burning of agricultural waste and certain agro-forestry activities have also led to air pollution. Indoor air pollution (IAP) remains a large threat as 66% of the population use biomass for cooking. Use of inefficient stoves and biomass, poor ventilation and absence of chimneys, contribute to IAP. Other indoor air pollutants such as tobacco smoke, volatile organic compounds, asbestos, pesticides, kerosene, mercury, mosquito coils and biological pollutants also prevail. Biological pollutants, such as dust mites, droppings and urine from pets, insects and rodents, pollen from indoor plants and outdoor air, and fungi, including moulds in poorly maintained buildings, can trigger asthma or cause allergic reactions and infections among children inhabiting these environments. In rural areas, chemicals were accountable for 30.2% of acute poisonings, with kerosene oil being the most common cause, followed by paracetamol. More than 80% of agricultural workers in the country work in the informal sector with limited personal protective equipment use, while pesticide usage is increasing. Children who engage in agriculture-related work and hazardous industries are at risk of developing health consequences at early stages. Dengue remains a major environmental health problem as the reduction of mosquito breeding sites has been a challenging task for many years. It is essential to gain more evidence of existing environmental risk factors and their associations with the health of children. Information dissemination among local and international experts on Children's Environmental Health (CEH) issues needs to be enhanced and properly established. Training programs should be conducted for healthcare workers to update their knowledge. Pediatricians are needed for remote hospitals and primary healthcare centers. Environmental parameters and biological parameters are not routinely monitored in most of the hazardous environments.

In plain English

This article is a review: a country report on children's environmental health in Sri Lanka. It did not collect new data. It drew on national statistics and earlier studies. The author described outdoor and indoor air pollution as a major hazard for Sri Lankan children, citing a national survey figure that 66% of the population used biomass fuel for household cooking. Other hazards covered included pesticides, accidental poisoning (kerosene was described as still the number one cause of poisoning among children), child labor and dengue. Asbestos was mentioned only briefly. The author wrote that asbestos, known as an occupational carcinogen causing mesothelioma, is used in residential and school buildings and poses a possible exposure risk to children. The author added that research evidence in Sri Lanka on this possible association is not currently available. The author stated that data specific to Sri Lanka are inadequate and that the country mostly relies on international or regional studies. The author concluded that multi-disciplinary health research and a system of routine environmental and biological monitoring are needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: review (country report summarizing national statistics and published studies; no new data collected)
• Who was studied: children in Sri Lanka; at the 2012 census about one third of the 20.3 million population was aged 1 to 19 years
• Exposure: a range of environmental hazards: outdoor and indoor air pollution (vehicles, industries, biomass cooking, open burning of plastics), asbestos in residential and school buildings, pesticides and agrochemicals, kerosene and other household chemicals, mercury, dengue and climate change
• Main results:
  • The author wrote that asbestos is used in residential and school buildings and poses a possible exposure risk to children, but that no research evidence on this possible association is currently available in Sri Lanka
  • Citing the 2016 Demographic and Health Survey, the author reported that 66% of the population used biomass fuel for household cooking
  • Citing an earlier study of a rural Sri Lankan setting, the author reported that chemicals accounted for 30.2% of acute poisonings, with kerosene oil the most common cause, followed by paracetamol
  • The author stated that kerosene is still the number one cause of poisoning among children in Sri Lanka
  • Citing the 2016 Child Activity Survey, the author reported that 43,714 children (1% of the child population) were engaged in child labor, of whom 39,007 were in hazardous forms of work
• The authors' conclusion: The author concluded that multi-disciplinary research is needed to establish causality or associations between existing hazards and diseases, and that a system of routine environmental and biological monitoring should be established
• Limitations the authors state:
  • The author noted that data specific to Sri Lanka are inadequate
  • The author noted that Sri Lanka mostly relies on international or regional studies
  • The author noted that no research evidence is available in Sri Lanka on childhood asbestos exposure

Related studies

• Environmental health of children — A.M. Dunn, C. Burns, et al. (2003)
• Children's health in Latin America: the influence of environmental exposures — A. Laborde, F. Tomasina, et al. (2015)
• The contribution of environmental monitoring in the epidemiological assessment of exogenous risk. The experience of ARPA in the Emilia-Romagna Region of Italy — A. Zavatti, P. Lauriola (1999)
• Environmental threats to children's health in Southeast Asia and the Western Pacific — W.A. Suk, K.M. Ruchirawat, et al. (2003)
• Exposure to asbestos-containing vermiculite ore and respiratory symptoms among individuals who were children while the mine was active in Libby, Montana — L.C. Vinikoor, T.C. Larson, et al. (2010)
• Environmental Health Education for Asbestos-Contaminated Communities in Italy: The Casale Monferrato Case Study — D. Marsili, A. Canepa, et al. (2019)

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