Pallapies Dirk
BASF Aktiengesellschaft, GOA/CP-H308, D-67056 Ludwigshafen, Germany.
Mutat Res. 2006 Sep 28;608(2):100-11. doi: 10.1016/j.mrgentox.2006.03.007. Epub 2006 Jul 18.
Child mortality has declined remarkably during the last decades. While neonatal disorders, diarrhoea, pneumonia, and malaria as well as being underweight account for most of the child deaths worldwide, children's health discussions in Europe and the USA focus on other issues such as asthma, neurodevelopmental disorders, male genital malformations, and childhood cancer. There is clear evidence of increasing rates of asthma in various countries during the last decades, although rates in some countries may now have stabilised or even decline as recent UK data indicate. Although an increase in the frequency of neurodevelopmental disorders such as autism and attention deficit disorder has frequently been discussed, the limited data in this field does not justify such a conclusion. While geographic heterogeneity regarding reproductive outcomes is apparent, global trends have not been identified. Interpretation of the available information on asthma, neurodevelopmental disorders and reproductive outcomes is hampered by inconstant diagnostic criteria over place and time and the lack of good and comprehensive population-based surveillance data, which makes it impossible to ascertain trends in actual disease frequency. Data indicate that developed countries have a gradually increasing incidence in leukaemia with a corresponding drop in the incidence of lymphoma. Increases in brain tumour frequency may be related to the development and wide application of new diagnostic capabilities, rather than a true change in the incidence of malignant disease. With a better prognosis for childhood cancer survival, secondary cancers following chemotherapy appear to be increasing. A wide range of environmental factors is thought to have an impact on children's health. These factors include nutrition (protein, vitamins, antioxidants), lifestyle and behaviour choices such as tobacco and alcohol use, parental health, socio-economic status, choice of living environment (urban versus rural, etc.), and parent-sibling behaviour. From the available data, no general conclusions on the contribution of specific chemicals can be drawn.
在过去几十年中，儿童死亡率显著下降。虽然新生儿疾病、腹泻、肺炎、疟疾以及体重不足占全球儿童死亡的大部分，但欧洲和美国关于儿童健康的讨论集中在其他问题上，如哮喘、神经发育障碍、男性生殖器畸形和儿童癌症。有明确证据表明，在过去几十年中，各国哮喘发病率不断上升，不过正如英国最近的数据所示，一些国家的发病率现在可能已经稳定甚至下降。虽然经常讨论自闭症和注意力缺陷障碍等神经发育障碍发病率的增加，但该领域有限的数据并不足以支持这一结论。虽然生殖结果的地理异质性很明显，但尚未确定全球趋势。由于不同地区和不同时间的诊断标准不一致，以及缺乏良好且全面的基于人群的监测数据，使得难以确定实际疾病频率的趋势，这妨碍了对哮喘、神经发育障碍和生殖结果现有信息的解读。数据表明，发达国家白血病发病率逐渐上升，淋巴瘤发病率相应下降。脑瘤发病率的增加可能与新诊断能力的发展和广泛应用有关，而不是恶性疾病发病率的真正变化。随着儿童癌症生存率预后的改善，化疗后的继发性癌症似乎在增加。人们认为多种环境因素会对儿童健康产生影响。这些因素包括营养（蛋白质、维生素、抗氧化剂）、生活方式和行为选择，如吸烟和饮酒、父母健康状况、社会经济地位、居住环境选择（城市与农村等）以及父母与兄弟姐妹的行为。从现有数据来看，无法就特定化学物质的影响得出一般性结论。
