Marcela Valente
BUENOS AIRES, Mar 14 2006 (IPS) – How strong of a role do family habits play in the recurrence of bouts of asthma or diarrhea in children? Are repeated accidents in a school related to flawed building design? Are there links between learning disabilities and pollution?
To answer these and other questions, Argentina s Ministry of Health and the Environment and the city of Buenos Aires Secretariat of the Environment have begun setting up pediatric environmental health units (known here as UPAs), run by multidisciplinary teams specialising in child environmental health.
The first UPA is operating in the Pedro de Elizalde pediatric hospital in Buenos Aires, and teams have also begun working in three other hospitals in the capital and in several provinces. The units work in association with toxicology services, universities and research centres.
This is not a new medical specialty, but a novel and more in-depth focus on children s health, Dr. María Angélica Flores, with the National Office on Maternal and Child Health, told IPS. The pediatrician only focuses on the illness, while our approach is to take a close look at the surroundings that might contribute to it or cause it.
According to the World Health Organisation (WHO), 33 percent of diseases affecting children under the age of five are the result of environmental risk factors, which are nonetheless rarely addressed by doctors or parents.
One of the problems is that pediatricians have traditionally lacked the tools to help bring about changes in the child s surroundings.
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A doctor might suspect that a child s frequent bouts of diarrhea are related to the way water and food are handled in his home, or that repeated respiratory problems are the result of secondhand smoke, a build-up of dust, or poor ventilation in the household.
But in too many cases, environmental hazards are ignored.
UPAs are better prepared to detect whether a child regularly experiences prolonged exposure to the sun, a skin cancer risk, or is exposed to mercury or lead pollution, linked to learning difficulties and poor academic achievement.
The UPAs provide doctors with an institutional umbrella, which allows them to go outside the hospital and interact with members of the community in order to bring about healthier surroundings in homes, schools or parks, Dr. Ana Speranza, in charge of Pediatric Environmental Health in the Ministry of Health, explained to IPS.
The health units have the authority to work with schools, Public Works bodies and local residents in neighbourhoods where a specific health problem has been identified as affecting children.
The approach first emerged in the United States with financial support from the Environmental Protection Agency (EPA). Similar units were then set up in Mexico and Canada, and since 2005 UPAs have been functioning in Argentina.
The idea is to work as part of a network, in a coordinated manner among the units as they are set up, said Flores.
In the Elizalde Hospital, a multidisciplinary team of pediatricians, nurses, social workers, teachers, psychologists, obstetricians and gynecologists investigate the environmental causes of symptoms and illnesses, with a focus on prevention and on improving people s health habits.
You don t need a huge structure, with sophisticated equipment and hospital beds. What we re talking about is a team of one or two specialised professionals working full-time, and a group who come from other disciplines, and who are brought in for consultation when necessary, Flores pointed out.
She said the UPA in the Elizalde Hospital usually receives referrals. For instance, a mother who brings her child to the doctor who is on duty at the hospital or to a clinic may be referred to the environmental health unit when a pediatrician believes a broader follow-up of the case would be beneficial.
Besides attending specific cases and investigating environmental causes of health problems out in the field, the UPA has the task of training other professionals within the hospital and of carrying out more in-depth research into the relations between the environment and child health.
