How does one personally prevent such exposures?

What do we do as a society to prevent these exposures?

child with umbrellaDermatological Effects

What is the concern regarding environmental effects on childrenís skin?

Skin is an important "organ" in the context of environmental exposures. It is the only body system that is perpetually exposed to the environment. Skin is both a crucial physical barrier and a significant route of absorption of toxic substances. The skin is also an important site of excretion and biotransformation of toxins and plays a role in the bodyís immune system.

A babyís skin is more permeable than an adultís is, and skin is thinner in the very young. As a result, it absorbs more and is more susceptible to damage from environmental agents. The fact that children are smaller in size means that their skin presents a large surface area relative to their body weight for absorption of environmental substances.

What substances can affect a childís skin?

There are a vast number of environmental factors that can affect skin or that enter the body primarily by dermal absorption. This unit focuses on specific physical or chemical agents wherein children are exposed involuntarily and the degree of exposure has been largely influenced by human behaviour:

  • UV radiation
  • Persistent organochlorine pollutants (such as dioxins, PCBs some pesticides)
  • A variety of chemicals (such as solvents, formaldehyde, vinyl chloride, some pesticides, ingredients in cosmetics or other substances applied directly to skin)
  • Metals (such as nickel, chromium, etc.)

How are children exposed to toxins and agents that affect skin?

Percutaneous absorption of foreign substances is largely a passive phenomenon. It does vary, however, depending on factors such as the concentration and nature of the substance, the composition of the vehicle, the properties and state of the stratum corneum, including its thickness, the anatomical region, its integrity and skin occlusion, and finally, the area of exposure. Dermal absorption is also a route of exposure to contaminants that are found in soil, air and water but make contact with skin.

What are the potential effects on skin from environmental exposures?

Most of our understanding of primary dermal effects or of systemic toxicity that affects the skin comes from knowledge of the circumstances for adults. Skin symptoms can be immediate or may occur days, months or even years after initial exposure. Clinical signs of environmentally induced dermal effects will vary depending on the environmental agent involved. The most common such skin disorders, or those most readily recognized as being related to environmental exposure, include:

  • rash
  • dermatitis
  • pigmentary changes
  • photosensitivity reactions
  • urticaria
  • scleroderma-like conditions
  • chloracne lesions
  • malignancy

Why are children more vulnerable to dermal effects?

Because the infantís skin is immature developmentally, it provides a less effective barrier to absorption of harmful substances. A childís skin is thinner compared to an adultís and therefore is also subject to greater damage from environmental agents such as ultraviolet radiation. (Such damage will not manifest as malignancy until adulthood. )

The absorption of compounds through the childís skin may be more problematic because metabolic differences in childhood make such substances more toxic to children. There may also be greater risk of health effects from dermal absorption due to the windows of vulnerability of developing systems such as reproductive tissues and the brain.

How does one personally prevent such exposures?

Because of the complexity of dermatological effects and the variety of associated exposures, personal and primary prevention is a challenge. In the case of allergic or immune-mediated skin responses, personal protection, avoidance and hygiene are strategies to reduce the risk of such afflictions in the future. Patient education and awareness is another important strategy to prevention.

Because there is a wealth of information and ongoing public awareness aimed at reducing the risks of skin cancers from sun exposure, this area of prevention is generally well understood by the public. However, since the thinning of the ozone layer has resulted in higher exposures to UV, reinforcing prevention and skin protection messages to parents and young patients is a worthwhile endeavour nonetheless.

What do we do as a society to prevent these exposures?

CAPE joins other health advocacy organizations in Canada and the United States in calling for precaution in health policies and environmental regulations to prevent harm to childrenís health from contaminants and agents to which they are involuntarily exposed. As a society and as individuals we need to be mindful of the effects of our behaviour on the ecosystem and consequently on our own health. For example, consumers should avoid purchasing products that use or have been produced with ozone-depleting substances and should support appropriate alternative technologies.

Copyright © 2000 Canadian Association of Physicians for the Environment
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