Protecting the health of infants and children from the impact of
environmental contaminants has become a compelling priority in recent
years. Physicians are particularly well situated to play an essential
part in furthering that goal, and they can contribute in a number
of different capacities that extend their traditional role as healer.1
- Clinicians often detect cases of environmental illness
and thereby bring attention to exposures that might have widespread
- They routinely counsel patients on the risks of exposures
and therefore must frequently interpret and translate research
- Canadian public opinion studies have demonstrated that people
trust their doctors as highly credible sources of information
about environmental health risks.
- Physicians can bring awareness to children’s environmental
health issues and can help people understand the connections between
their behaviour and subsequent effects on the environment and
- They can help engender a major shift in the public mindset
to seeing that our survival depends on working with natural systems,
not at cross-purposes to them.
- Physicians are also increasingly involved as extremely effective
and vocal leaders in advocating for children’s health
at both the public health and policy levels.
- The medical dictum, “first, do no harm,” harmonizes well with
the precautionary paradigm that is crucial to protecting
children’s health in the face of the enormous scientific uncertainty
that surrounds many current environmental health issues.
What Is Primary Prevention?
|Primary prevention is the “prevention
of disease or mental disorders in susceptible individuals or
populations through promotion of health, including mental health,
and specific protection, as in immunization, as distinguished
from the prevention of complications or after-effects of existing
In medicine, we recognize that primary prevention not only addresses
proactive or prophylactic “treatment” to prevent health problems
before they arise, but it also incorporates modification
of behaviours or risk factors that are associated with a given health
outcome. On a broad scale, these can range from the individual reducing
his or her intake of refined sugar to lower the risk of developing
diabetes, to promoting healthy, loving family relationships in an
effort to prevent mental health problems.
In the realm of environmental health, however, primary prevention
clearly encompasses actions on an even broader scale, as the problems
of environmental pollution are all-encompassing. They therefore
necessitate far-reaching solutions. Environmental health prevention
must be founded on the guiding principle that human health and ecosystem
health are one and the same; hence, pollution, waste accumulation,
loss of habitat, species extinctions and loss of biodiversity, climate
change, etc. are all human and ecosystem issues.
What Actions Must Be Taken?
the continuum between prevention and treatment, medical practitioners
are well versed in the treatment end, with a focus on responding
to symptoms of illness.2 Medical practice
as it relates to environmental health relies heavily upon the evidence-based
approach, which aims at “preventing adverse health effects through
education and practical exposure reduction whenever feasible.”3
We are witnessing a transition, however, wherein more physicians
are stepping into the health protection realm that places
emphasis on prevention and on preservation of not only individual
health, but also collective health. In the political economic view
of environmental health issues, this represents a move further “upstream,”
closer to the source of the problem and toward strategies that are
ultimately the most effective in the long run.
Throughout this web resource we have drawn attention to the kinds
of counsel that physicians can provide to their patients to reduce
environmental exposures. While these are important to support the
individual’s quest to protect their own child’s health, such advice
does not fundamentally address why there is a need to be more aggressive
about furthering the agenda for children’s environmental health
in the first place.
The upstream focus that will better safeguard children’s environmental
health encompasses action at increasingly broader spheres of influence,
from local collective action, to policy and regulatory reform and,
finally, to treaties and global action.5
How and where do physicians insert themselves into that scheme to
contribute to the protection of children’s health? Borrowing from
the mission statement for Environmental
Health Watch (EHW), physicians can effectively champion the
children’s environmental health agenda (and protection of ecosystem
health) by helping:
- people protect their children and themselves from serious environmental
- influence corporate, government and individual actions and,
- avoid both imprudent complacency and unnecessary alarm