Landrigan P J
Department of Community Medicine, Mount Sinai School of Medicine, New York 10029, USA.
Int J Occup Med Environ Health. 1998;11(2):189-94.
Children are not little adults. Their tissues and organs are rapidly growing, developing and differentiating. At various stages these growth processes create windows of great vulnerability to environmental toxicants. Children's patterns of consumption and exposure are very different from those of adults. Children's combination of disproportionately heavy exposure plus biologic vulnerability makes them very susceptible to injury caused by toxicants in the environment. Development and adoption of a child-centered agenda for research and risk assessment will be necessary if disease in children of toxic environmental origin is to be controlled, prevented and eventually eradicated. This agenda will need to be multidisciplinary. It should include epidemiology, pediatrics, exposure assessment, toxicology, and health economics. The ultimate goals of this agenda need to be (1) the identification of etiologic associations between environmental exposures and pediatric disease; (2) the elucidation of disease mechanisms; (3) improved treatment; and (4) prevention.
儿童并非缩小版的成人。他们的组织和器官正处于快速生长、发育和分化阶段。在各个阶段,这些生长过程都会形成对环境毒物高度敏感的窗口期。儿童的消费和接触模式与成人截然不同。儿童过度大量接触毒物与生物易感性的结合,使他们极易受到环境中毒物造成的伤害。如果要控制、预防并最终根除源于有毒环境的儿童疾病,就有必要制定并采用以儿童为中心的研究和风险评估议程。该议程需要多学科协作,应涵盖流行病学、儿科学、接触评估、毒理学和健康经济学。这一议程的最终目标应为:(1)确定环境暴露与儿科疾病之间的病因关联;(2)阐明疾病机制;(3)改善治疗方法;(4)预防疾病。