EDC Brief History

• “Many compounds introduced into the environment by human activity are capable of disrupting the endocrine system of animals, including fish, wildlife, and humans. Endocrine disruption can be profound because of the crucial role hormones play in controlling development.”

Investigations into the Effects of EDCs• Sperm quality—several studies report decline• Fertility—implication, exposure to high levels can impair fertility

and increase rate of miscarriage• Abnormalities in male sex organs• Precocious puberty• Association with certain cancers

– Testicular cancer increase from 1973 to 1999 across all age groups• Caucasian: 51.8%• African-American: 49.4%

– Breast cancer increase • Caucasian: 27.9% • African-American: 34.8%

– Brain cancer increase in children 14 or younger• 50.2%

Routes of Exposure

• Oral-- ingestion

• Dermal-- skin contamination (60-90%)

• Inhalation-- breath airborne insecticides (<1%)

• Ocular-- eyes

Acute toxicity

Chronic toxicity

Non communicable Diseases in Low- and Middle-income Countries(All NCDs including cardiovascular diseases, cancers, and diabetes, chronic respiratory disease)

Source: Institute for Health Metrics and Evaluation, Global Burden of Disease Study 2013

Environmental Exposures and Cancer in LMICs

• The prevalence of carcinogenic exposures has been reported as high in many LMICs and the effects of exposures have not been sufficiently studied

• Chemicals can sometimes act together to cause cancer, even when low-level exposures to the individual chemicals might not be cancer-causing, or carcinogenic.

Incidence of all cancers in Sri LankaYear No. Crude incidence rate (per

100,000 population)

1985 5,012 31.6

1990 6,063 35.7

1995 7,325 40.4

2000 10,925 56.4

2005 13,372 67.9

2006 14,080 70.9

2007 13,635 68.0

2008* 16,511 81.6 Source: Sri Lanka Cancer Registry, NCCP

Figure 2 : NCD Trend in Hospital Morbidity Broad Disease Groups, 1990-2009

Figure 3 : NCD Trend in Hospital Mortality by Broad Disease Groups, 1990-2009

5000

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Neoplasms (COO-D48)

Mental and behavioural disorders (FOO-F99)

Diseases of the circulatory system

Diseases of the respiratory system

Injury, poisoning and certain other consequences of external causes

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0

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70 Neoplasms (COO-D48)

Mental and behavioural disorders (FOO-F99)

Diseases of the circulatory system

Diseases of the respiratory system

Injury, poisoning and certain other consequences of external causes

5 | P a g e

Who are at risk?

• HealthGeneral population (Children and adults)

Chronic exposures-Pb, Hg, Ni, Cd, Beryllium etc

Informal sector workers Open burning of plastics in e-waste Occupational exposures

?

What is the Evidence that Toxic Chemicals in the Environment

Cause Disease in Children?

• Children are surrounded by a large and ever increasing number of chemicals • Many of the chemicals to which children are at risk of exposure have not been tested for their possible developmental toxicity

• Children are more heavily exposed and more vulnerable to many environmental chemicals than adults

• These chemicals are detectable in most children's bodies, even in newborn infants

Children our future• Children are not little

adults– Kg to kg, pound for pound,

a child’s exposure is greater than an adults (dose-response)

– Immature blood-brain barrier—allows more chemical passage

– Detoxication systems may not be fully functional—timing of exposure.

• “Because children have more future years of life than most adults, they have more time to develop chronic diseases that may be triggered by early exposures.”

• Landrigan et al. 2003. Assessing the effects of endocrine disruptors in the national children’s study. Environ. Health Perspectives 111(13): 1678-1682.

How are Children Exposed?

By what goes into their mouths (oral)

By what they touch (dermal)

By what they breathe (respiratory)

Even before they are born (pre-natal)

Windows of Susceptibility

RED/dark is highly sensitive period, YELLOW/light for less sensitive period. From: Selevan,et al, Environmental Health Perspectives, Volume 108, Supplement 3, June 2000

“Children can develop and mature in an environment that allows them to reach

and maintain their full potential.”

Vision for health of children

What is health?

• Physical, mental, social and spiritual wellbeing.

• Not merely absence of disease

RIGHT TO LIFE

Is a basic human right

Health is wealth and no wealth is better than health!

It is not only the health of us the adults, the workers most importantly the children‘s health

and health of future generations as well.

Let us not misuse chemicals

Thank you