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Fuller R, Landrigan PJ, Balakrishnan K, Bathan G, Bose-O'Reilly S, Brauer M, Caravanos J, Chiles T, Cohen A, Corra L, Cropper M, Ferraro G, Hanna J, Hanrahan D, Hu H, Hunter D, Janata G, Kupka R, Lanphear B, Lichtveld M, Martin K, Mustapha A, Sanchez-Triana E, Sandilya K, Schaefli L, Shaw J, Seddon J, Suk W, Téllez-Rojo MM, Yan C. Pollution and health: a progress update. Lancet Planet Health 2022; 6:e535-e547. [PMID: 35594895 DOI: 10.1016/s2542-5196(22)00090-0] [Citation(s) in RCA: 305] [Impact Index Per Article: 152.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 05/23/2023]
Abstract
The Lancet Commission on pollution and health reported that pollution was responsible for 9 million premature deaths in 2015, making it the world's largest environmental risk factor for disease and premature death. We have now updated this estimate using data from the Global Burden of Diseases, Injuriaes, and Risk Factors Study 2019. We find that pollution remains responsible for approximately 9 million deaths per year, corresponding to one in six deaths worldwide. Reductions have occurred in the number of deaths attributable to the types of pollution associated with extreme poverty. However, these reductions in deaths from household air pollution and water pollution are offset by increased deaths attributable to ambient air pollution and toxic chemical pollution (ie, lead). Deaths from these modern pollution risk factors, which are the unintended consequence of industrialisation and urbanisation, have risen by 7% since 2015 and by over 66% since 2000. Despite ongoing efforts by UN agencies, committed groups, committed individuals, and some national governments (mostly in high-income countries), little real progress against pollution can be identified overall, particularly in the low-income and middle-income countries, where pollution is most severe. Urgent attention is needed to control pollution and prevent pollution-related disease, with an emphasis on air pollution and lead poisoning, and a stronger focus on hazardous chemical pollution. Pollution, climate change, and biodiversity loss are closely linked. Successful control of these conjoined threats requires a globally supported, formal science-policy interface to inform intervention, influence research, and guide funding. Pollution has typically been viewed as a local issue to be addressed through subnational and national regulation or, occasionally, using regional policy in higher-income countries. Now, however, it is increasingly clear that pollution is a planetary threat, and that its drivers, its dispersion, and its effects on health transcend local boundaries and demand a global response. Global action on all major modern pollutants is needed. Global efforts can synergise with other global environmental policy programmes, especially as a large-scale, rapid transition away from all fossil fuels to clean, renewable energy is an effective strategy for preventing pollution while also slowing down climate change, and thus achieves a double benefit for planetary health.
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Affiliation(s)
- Richard Fuller
- Global Alliance on Health and Pollution, Geneva, Switzerland.
| | - Philip J Landrigan
- Global Observatory on Planetary Health, Boston College, Chestnut Hill, MA, USA
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, Sri Ramachandra University, Chennai, India
| | | | - Stephan Bose-O'Reilly
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Munich, Germany
| | - Michael Brauer
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Jack Caravanos
- Environmental Public Health Sciences, School of Global Health, New York University, New York, NY, USA
| | - Tom Chiles
- Biology Department, Boston College, Chestnut Hill, MA, USA
| | | | - Lilian Corra
- Global Alliance on Health and Pollution, Geneva, Switzerland
| | - Maureen Cropper
- Department of Economics, University of Maryland, College Park, MD, USA
| | | | - Jill Hanna
- Global Alliance on Health and Pollution, Geneva, Switzerland
| | | | - Howard Hu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - David Hunter
- Translational Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Rachael Kupka
- Global Alliance on Health and Pollution, Geneva, Switzerland
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Maureen Lichtveld
- Environmental and Occupational Health Department, University of Pittsburgh, Pittsburgh, PA, USA
| | - Keith Martin
- Consortium of Universities for Global Health, Washington, DC, USA
| | | | - Ernesto Sanchez-Triana
- Global Practice on Environment and Natural Resources, The World Bank, Washington, DC, USA
| | - Karti Sandilya
- Global Alliance on Health and Pollution, Geneva, Switzerland
| | - Laura Schaefli
- Global Alliance on Health and Pollution, Geneva, Switzerland
| | - Joseph Shaw
- O'Neil School of Public and Environmental Affairs, Indiana University, Bloomington, IN, USA
| | - Jessica Seddon
- Air Quality, Ross Center, World Resources Institute, Washington, DC, USA
| | - William Suk
- Hazardous Substances Research Branch, Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Martha María Téllez-Rojo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Avenida Universidad, Cuernavaca, Mexico
| | - Chonghuai Yan
- Ministry of Education, Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Landrigan PJ, Stegeman JJ, Fleming LE, Allemand D, Anderson DM, Backer LC, Brucker-Davis F, Chevalier N, Corra L, Czerucka D, Bottein MYD, Demeneix B, Depledge M, Deheyn DD, Dorman CJ, Fénichel P, Fisher S, Gaill F, Galgani F, Gaze WH, Giuliano L, Grandjean P, Hahn ME, Hamdoun A, Hess P, Judson B, Laborde A, McGlade J, Mu J, Mustapha A, Neira M, Noble RT, Pedrotti ML, Reddy C, Rocklöv J, Scharler UM, Shanmugam H, Taghian G, van de Water JA, Vezzulli L, Weihe P, Zeka A, Raps H, Rampal P. Human Health and Ocean Pollution. Ann Glob Health 2020; 86:151. [PMID: 33354517 PMCID: PMC7731724 DOI: 10.5334/aogh.2831] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Pollution - unwanted waste released to air, water, and land by human activity - is the largest environmental cause of disease in the world today. It is responsible for an estimated nine million premature deaths per year, enormous economic losses, erosion of human capital, and degradation of ecosystems. Ocean pollution is an important, but insufficiently recognized and inadequately controlled component of global pollution. It poses serious threats to human health and well-being. The nature and magnitude of these impacts are only beginning to be understood. Goals (1) Broadly examine the known and potential impacts of ocean pollution on human health. (2) Inform policy makers, government leaders, international organizations, civil society, and the global public of these threats. (3) Propose priorities for interventions to control and prevent pollution of the seas and safeguard human health. Methods Topic-focused reviews that examine the effects of ocean pollution on human health, identify gaps in knowledge, project future trends, and offer evidence-based guidance for effective intervention. Environmental Findings Pollution of the oceans is widespread, worsening, and in most countries poorly controlled. It is a complex mixture of toxic metals, plastics, manufactured chemicals, petroleum, urban and industrial wastes, pesticides, fertilizers, pharmaceutical chemicals, agricultural runoff, and sewage. More than 80% arises from land-based sources. It reaches the oceans through rivers, runoff, atmospheric deposition and direct discharges. It is often heaviest near the coasts and most highly concentrated along the coasts of low- and middle-income countries. Plastic is a rapidly increasing and highly visible component of ocean pollution, and an estimated 10 million metric tons of plastic waste enter the seas each year. Mercury is the metal pollutant of greatest concern in the oceans; it is released from two main sources - coal combustion and small-scale gold mining. Global spread of industrialized agriculture with increasing use of chemical fertilizer leads to extension of Harmful Algal Blooms (HABs) to previously unaffected regions. Chemical pollutants are ubiquitous and contaminate seas and marine organisms from the high Arctic to the abyssal depths. Ecosystem Findings Ocean pollution has multiple negative impacts on marine ecosystems, and these impacts are exacerbated by global climate change. Petroleum-based pollutants reduce photosynthesis in marine microorganisms that generate oxygen. Increasing absorption of carbon dioxide into the seas causes ocean acidification, which destroys coral reefs, impairs shellfish development, dissolves calcium-containing microorganisms at the base of the marine food web, and increases the toxicity of some pollutants. Plastic pollution threatens marine mammals, fish, and seabirds and accumulates in large mid-ocean gyres. It breaks down into microplastic and nanoplastic particles containing multiple manufactured chemicals that can enter the tissues of marine organisms, including species consumed by humans. Industrial releases, runoff, and sewage increase frequency and severity of HABs, bacterial pollution, and anti-microbial resistance. Pollution and sea surface warming are triggering poleward migration of dangerous pathogens such as the Vibrio species. Industrial discharges, pharmaceutical wastes, pesticides, and sewage contribute to global declines in fish stocks. Human Health Findings Methylmercury and PCBs are the ocean pollutants whose human health effects are best understood. Exposures of infants in utero to these pollutants through maternal consumption of contaminated seafood can damage developing brains, reduce IQ and increase children's risks for autism, ADHD and learning disorders. Adult exposures to methylmercury increase risks for cardiovascular disease and dementia. Manufactured chemicals - phthalates, bisphenol A, flame retardants, and perfluorinated chemicals, many of them released into the seas from plastic waste - can disrupt endocrine signaling, reduce male fertility, damage the nervous system, and increase risk of cancer. HABs produce potent toxins that accumulate in fish and shellfish. When ingested, these toxins can cause severe neurological impairment and rapid death. HAB toxins can also become airborne and cause respiratory disease. Pathogenic marine bacteria cause gastrointestinal diseases and deep wound infections. With climate change and increasing pollution, risk is high that Vibrio infections, including cholera, will increase in frequency and extend to new areas. All of the health impacts of ocean pollution fall disproportionately on vulnerable populations in the Global South - environmental injustice on a planetary scale. Conclusions Ocean pollution is a global problem. It arises from multiple sources and crosses national boundaries. It is the consequence of reckless, shortsighted, and unsustainable exploitation of the earth's resources. It endangers marine ecosystems. It impedes the production of atmospheric oxygen. Its threats to human health are great and growing, but still incompletely understood. Its economic costs are only beginning to be counted.Ocean pollution can be prevented. Like all forms of pollution, ocean pollution can be controlled by deploying data-driven strategies based on law, policy, technology, and enforcement that target priority pollution sources. Many countries have used these tools to control air and water pollution and are now applying them to ocean pollution. Successes achieved to date demonstrate that broader control is feasible. Heavily polluted harbors have been cleaned, estuaries rejuvenated, and coral reefs restored.Prevention of ocean pollution creates many benefits. It boosts economies, increases tourism, helps restore fisheries, and improves human health and well-being. It advances the Sustainable Development Goals (SDG). These benefits will last for centuries. Recommendations World leaders who recognize the gravity of ocean pollution, acknowledge its growing dangers, engage civil society and the global public, and take bold, evidence-based action to stop pollution at source will be critical to preventing ocean pollution and safeguarding human health.Prevention of pollution from land-based sources is key. Eliminating coal combustion and banning all uses of mercury will reduce mercury pollution. Bans on single-use plastic and better management of plastic waste reduce plastic pollution. Bans on persistent organic pollutants (POPs) have reduced pollution by PCBs and DDT. Control of industrial discharges, treatment of sewage, and reduced applications of fertilizers have mitigated coastal pollution and are reducing frequency of HABs. National, regional and international marine pollution control programs that are adequately funded and backed by strong enforcement have been shown to be effective. Robust monitoring is essential to track progress.Further interventions that hold great promise include wide-scale transition to renewable fuels; transition to a circular economy that creates little waste and focuses on equity rather than on endless growth; embracing the principles of green chemistry; and building scientific capacity in all countries.Designation of Marine Protected Areas (MPAs) will safeguard critical ecosystems, protect vulnerable fish stocks, and enhance human health and well-being. Creation of MPAs is an important manifestation of national and international commitment to protecting the health of the seas.
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Affiliation(s)
| | - John J. Stegeman
- Woods Hole Center for Oceans and Human Health, Woods Hole Oceanographic Institution, US
| | - Lora E. Fleming
- European Centre for Environment and Human Health, GB
- University of Exeter Medical School, GB
| | | | - Donald M. Anderson
- Woods Hole Center for Oceans and Human Health, Woods Hole Oceanographic Institution, US
| | | | | | - Nicolas Chevalier
- Université Côte d’Azur, FR
- Centre Hospitalier Universitaire de Nice, Inserm, C3M, FR
| | - Lilian Corra
- International Society of Doctors for the Environment (ISDE), CH
- Health and Environment of the Global Alliance on Health and Pollution (GAHP), AR
| | | | - Marie-Yasmine Dechraoui Bottein
- Intergovernmental Oceanographic Commission of UNESCO, FR
- IOC Science and Communication Centre on Harmful Algae, University of Copenhagen, DK
- Ecotoxicologie et développement durable expertise ECODD, Valbonne, FR
| | - Barbara Demeneix
- Centre National de la Recherche Scientifique, FR
- Muséum National d’Histoire Naturelle, Paris, FR
| | | | - Dimitri D. Deheyn
- Scripps Institution of Oceanography, University of California San Diego, US
| | | | - Patrick Fénichel
- Université Côte d’Azur, FR
- Centre Hospitalier Universitaire de Nice, Inserm, C3M, FR
| | | | | | | | | | | | | | - Mark E. Hahn
- Woods Hole Center for Oceans and Human Health, Woods Hole Oceanographic Institution, US
| | | | - Philipp Hess
- Institut Français de Recherche pour l’Exploitation des Mers, FR
| | | | | | - Jacqueline McGlade
- Institute for Global Prosperity, University College London, GB
- Strathmore University Business School, Nairobi, KE
| | | | - Adetoun Mustapha
- Nigerian Institute for Medical Research, Lagos, NG
- Imperial College London, GB
| | | | | | | | - Christopher Reddy
- Department of Marine Chemistry and Geochemistry, Woods Hole Oceanographic Institution, US
| | - Joacim Rocklöv
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, SE
| | | | | | | | | | | | - Pál Weihe
- University of the Faroe Islands and Department of Occupational Medicine and Public Health, FO
| | | | - Hervé Raps
- Centre Scientifique de Monaco, MC
- WHO Collaborating Centre for Health and Sustainable Development, MC
| | - Patrick Rampal
- Centre Scientifique de Monaco, MC
- WHO Collaborating Centre for Health and Sustainable Development, MC
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Abstract
Competing Interests. The author declares no competing financial interests.
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Affiliation(s)
- Lilian Corra
- Director, Master of Information on Health and Environment, School of Medicine, University of Buenos Aires. Argentina
- Director, Medical Specialist Program on Health and Environment, School of Medicine, University of Buenos Aires. Argentina
- Government Relations Advisor, South America, Pure Earth
- President, International Society of Doctors for the Environment - ISDE
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Corra L. A Call to Re-Evaluate the Role and Responsibility of the Physician in Environmental Health. J Health Pollut 2017; 7:1-3. [PMID: 30524816 PMCID: PMC6259482 DOI: 10.5696/2156-9614-7.14.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Laborde A, Tomasina F, Bianchi F, Bruné MN, Buka I, Comba P, Corra L, Cori L, Duffert CM, Harari R, Iavarone I, McDiarmid MA, Gray KA, Sly PD, Soares A, Suk WA, Landrigan PJ. Children's health in Latin America: the influence of environmental exposures. Environ Health Perspect 2015; 123:201-9. [PMID: 25499717 PMCID: PMC4348745 DOI: 10.1289/ehp.1408292] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 12/02/2014] [Indexed: 05/18/2023]
Abstract
BACKGROUND Chronic diseases are increasing among children in Latin America. OBJECTIVE AND METHODS To examine environmental risk factors for chronic disease in Latin American children and to develop a strategic initiative for control of these exposures, the World Health Organization (WHO) including the Pan American Health Organization (PAHO), the Collegium Ramazzini, and Latin American scientists reviewed regional and relevant global data. RESULTS Industrial development and urbanization are proceeding rapidly in Latin America, and environmental pollution has become widespread. Environmental threats to children's health include traditional hazards such as indoor air pollution and drinking-water contamination; the newer hazards of urban air pollution; toxic chemicals such as lead, asbestos, mercury, arsenic, and pesticides; hazardous and electronic waste; and climate change. The mix of traditional and modern hazards varies greatly across and within countries reflecting industrialization, urbanization, and socioeconomic forces. CONCLUSIONS To control environmental threats to children's health in Latin America, WHO, including PAHO, will focus on the most highly prevalent and serious hazards-indoor and outdoor air pollution, water pollution, and toxic chemicals. Strategies for controlling these hazards include developing tracking data on regional trends in children's environmental health (CEH), building a network of Collaborating Centres, promoting biomedical research in CEH, building regional capacity, supporting development of evidence-based prevention policies, studying the economic costs of chronic diseases in children, and developing platforms for dialogue with relevant stakeholders.
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Affiliation(s)
- Amalia Laborde
- Faculty of Medicine, University of the Republic of Uruguay, Montevideo, Uruguay
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Aguilar Madrid G, Beaudry M, Bell W, Bowes D, Brophy J, Burdorf A, Carlsten C, Castleman B, Chaturvedi S, Conti ME, Corra L, Corrêa Filho HR, Cranor CF, Cullen E, Dalvie A, Dickson RC, Digon A, Egilman D, Eisner Falvo C, Fischer E, Frank AL, Frank E, Gee D, Giannasi F, Goldstein BD, Greenberg M, Guidotti TL, Harris WA, Hindry M, Houlson A, Hu H, Huff J, Infante PF, Thambyappa J, Juarez Perez CA, Jeebhay MF, Joshi TK, Keith M, Keyserlingk JR, Khatter K, King D, Kodeih N, Kristensen J, Kulsomboon V, Landrigan PJ, Lee CW, Leigh J, Lemen RA, Lippman A, London L, Matzopoulos R, McCulloch J, McDiarmid MA, Mehrdad R, Mirabelli D, Moshammer H, Notebaert É, Nycz Z, Oberta AF, O'Connor J, O'Neill R, Orris P, Ozonoff D, Paek D, Rickard C, Rodriguez EJ, Sass J, Sentes KE, Simpson IM, Soffritti M, Soskolne CL, Sparling SP, Spiegel J, Takahashi K, Takaro TK, Terracini B, Thébaud-Mony A, Trosic I, Turcotte F, Vakil C, Van Der Walt A, Waterman YRK, Watterson A, Wegman DH, Welch LS, Weiss SH, Winston R, Yassi A. Statement in response to asbestos industry efforts to prevent a ban on asbestos in Pakistan: chrysotile asbestos use is not safe and must be banned. Arch Environ Occup Health 2013; 68:243-249. [PMID: 23697697 DOI: 10.1080/19338244.2013.780807] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Butler C, Castleden W, Ruff T, Westberg G, Corra L. A call for publishers to declare their conflicts of interest. Med Chir Trans 2007; 100:355. [PMID: 17682023 PMCID: PMC1939945 DOI: 10.1177/014107680710000805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Butler C, Castleden W, Ruff T, Westberg G, Corra L. A call for publishers to declare their conflicts of interest. J R Soc Med 2007. [DOI: 10.1258/jrsm.100.8.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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