Environment and Reproductive Health (ERH)
In recent years the people’s awareness of the environmental risks for reproductive health has increased as the scientific research has brought forward more evidence. However, this information is not yet widely used in medical education around the world and therefore it is important to promote this field of studies among health professionals. The Geneva Foundation for Medical Education and Research wants to contribute to these efforts through providing resource materials, on-line training course and expert opinions on matters relating to environment and reproductive health.
To give impetus to the issue, we would like to highlight some recent statements from WHO and relevant professional societies.
According to the WHO fact sheet: “More than three million children under five die each year from environment-related causes and conditions. This makes the environment one of the most critical contributors to the global toll of more than ten million child deaths annually -- as well as a very important factor in the health and well-being of their mothers.
Polluted indoor and outdoor air, contaminated water, lack of adequate sanitation, toxic hazards, disease vectors, ultraviolet radiation, and degraded ecosystems are all important environmental risk factors for children, and in most cases for their mothers as well.
Health-damaging exposure to environmental risks can begin before birth. Lead in air, mercury in food and other chemicals can result in long-term, often irreversible effects, such as infertility, miscarriage, and birth defects. Women's exposure to pesticides, solvents and persistent organic pollutants may potentially affect the health of the fetus.
Improving children and mothers' (and fathers') environmental health by addressing and tackling issues affecting their health, presents an essential contribution towards the achievement of the Millennium Development Goals (MDGs)"
A WHO report published 2018 summarizes the latest scientific knowledge on the links between exposure to air pollution and adverse health effects in children. It is intended to inform and motivate individual and collective action by health care professionals to prevent damage to children’s health from exposure to air pollution. Air pollution is a major environmental health threat. Exposure to fine particles in both the ambient environment and in the household causes about seven million premature deaths each year. Ambient air pollution (AAP) alone imposes enormous costs on the global economy, amounting to more than US$ 5 trillion in total welfare losses in 2013.
This public health crisis is receiving more attention, but one critical aspect is often overlooked: how air pollution affects children in uniquely damaging ways. Recent data released by the World Health Organization (WHO) show that air pollution has a vast and terrible impact on child health and survival. Globally, 93% of all children live in environments with air pollution levels above the WHO guidelines. More than one in every four deaths of children under 5 years is directly or indirectly related to environmental risks. Both AAP and household air pollution (HAP) contribute to respiratory tract infections that resulted in 543 000 deaths in children under 5 years in 2016.
Although air pollution is a global problem, the burden of disease attributable to particulate matter in air is heaviest in low- and middle-income countries (LMICs), particularly in the WHO African, South-East Asia, Eastern Mediterranean and Western Pacific regions. LMICs in these regions – especially the African Region – have the highest levels of exposure to HAP due to the widespread use of polluting fuels and technologies for basic daily needs, such as cooking, heating and lighting (6). Poverty is correlated with high exposure to environmental health risks. Poverty can also compound the damaging health effects of air pollution, by limiting access to information, treatment and other health care resources.
International Federation of Gynecology and Obstetrics (FIGO) held in October 2015 a Summit in Vancouver, Canada, on “Shaping Our Planetary Legacy: Setting an Agenda for Environmental Reproductive Health”.
The report of the summit states: “Exposure to toxic environmental chemicals during pregnancy and breastfeeding is ubiquitous and is a threat to healthy human reproduction. There are tens of thousands of chemicals in global commerce, and even small exposures to toxic chemicals during pregnancy can trigger adverse health consequences. Exposure to toxic environmental chemicals and related health outcomes are inequitably distributed within and between countries; universally, the consequences of exposure are disproportionately borne by people with low incomes. Discrimination, other social factors, economic factors, and occupation impact risk of exposure and harm. Documented links between prenatal exposure to environmental chemicals and adverse health outcomes span the life course and include impacts on fertility and pregnancy, neurodevelopment, and cancer. The global health and economic bur- den related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year. On the basis of accumulating robust evidence of exposures and adverse health impacts related to toxic environ- mental chemicals, the International Federation of Gynecology and Obstetrics (FIGO) joins other leading reproductive health professional societies in calling for timely action to prevent harm. FIGO recommends that reproductive and other health professionals advocate for policies to prevent exposure to toxic environmental chemicals, work to ensure a healthy food system for all, make environmental health part of health care, and champion environmental justice. “
FIGO's Working Group on Reproductive and Developmental Environmental Health has stated in 2018, referring to WHO’s publications: “Globally, minimising environmental threats to human health and reproduction is a necessity if we are to progress towards the 2030 Agenda for Sustainable Development (SDGs), this places an onus on governments and authorities to guarantee ongoing action to protect public health and manage environmental risks.
Although political, economic, and social challenges remain, it is hoped that all stakeholders will continue to collaborate and move the agenda forward, because there is much at stake for reproductive health and fertility for this and future generations.
Course with Alexandria University
Alexandria University and the Geneva Foundation for Medical Education and Research (GFMER), announce the online training course “Impact of Environmental Pollutants on Reproductive Health”, from August to November 2020. This training course is intended for a range of environmental and public health professionals who are interested in understanding the reproductive health risks associated with environmental hazardous exposures and how to assess them. The underlying goal of the training course is to provide the technical knowledge and skills necessary to explore the complex relationship between hazardous environmental exposures and risks to reproductive health. This course gathers the participants from different countries to develop a team of trainees acquainted with these critical issues and capable of resolving their implications in their countries.
- To provide distant education for those who want to acquire knowledge in their field but have limited access to training due to time, location and/or financial constraints.
- To exchange experiences among the participants as well as research institutions by creating a network and training background.
- To develop different types of skills as cognitive skills, which can involve knowledge and comprehension (e.g. understanding scientific concepts), following instructions (procedural skills), as well as applying methods in new situations to solve problems (thinking or mental skills).
- To increase sharing of competence and knowledge between health professionals in developing countries and local and international health and training institutions.
- To offer high-quality instruction through online facilities that include a broad range of information, integrating course content with information resources on the Web.
- To deliver a significant amount of content to a large number of learners; Collaborative activities range from discussions and knowledge-sharing to working together on a common project.
- To provide Social software, such as chats, discussion forums and blogs for online collaboration among learners.
Those interested in participating can receive more information through the website for the course http://ieprh.alexu.edu.eg where the course brochure and the application form can be found. The cost of the course is 150 USD. The deadline for applications is 31 August 2019.
- Heli Bathija
- Aldo Campana
- Meena Cherian
- Raqibat Idris
Alexandria University Team
- Amina T Farag
- Abdalla M Zeen-El Deen
- Mohamed A El Sabbah
- Hend A Marzouk
- Ezzat A Kadous