1. EDC Brief History “Many compounds introduced into the environment by human activity are capable of disrupting the endocrine system of animals, including fish, wildlife, and humans. Endocrine disruption can be profound because of the crucial role hormones play in controlling development.”

2. Investigations into the Effects of EDCs Sperm quality—several studies report decline Fertility—implication, exposure to high levels can impair fertility and increase rate of miscarriage Abnormalities in male sex organs Precocious puberty Association with certain cancers – Testicular cancer increase from 1973 to 1999 across all age groups Caucasian: 51.8% African-American: 49.4% – Breast cancer increase Caucasian: 27.9% African-American: 34.8% – Brain cancer increase in children 14 or younger 50.2%

3. Routes of Exposure Oral-- ingestion Dermal-- skin contamination (60-90%) Inhalation-- breath airborne insecticides (<1%) Ocular-- eyes

4. Acute toxicity Chronic toxicity

5. Non communicable Diseases in Low- and Middle-income Countries (All NCDs including cardiovascular diseases, cancers, and diabetes, chronic respiratory disease) Source: Institute for Health Metrics and Evaluation, Global Burden of Disease Study 2013

6. Environmental Exposures and Cancer in LMIC s The prevalence of carcinogenic exposures has been reported as high in many LMICs and the effects of exposures have not been sufficiently studied Chemicals can sometimes act together to cause cancer, even when low-level exposures to the individual chemicals might not be cancer-causing, or carcinogenic.

7. Incidence of all cancers in Sri Lanka YearNo.Crude incidence rate (per 100,000 population) 19855,01231.6 19906,06335.7 19957,32540.4 200010,92556.4 200513,37267.9 200614,08070.9 200713,63568.0 2008*16,51181.6 Source: Sri Lanka Cancer Registry, NCCP

8. Figure 2 : NCD Trend in Hospital Morbidity Broad Disease Groups, 1990-2009 Figure 3 : NCD Trend in Hospital Mortality by Broad Disease Groups, 1990-2009 5000 4500 4000 3500 3000 2500 2000 1500 1000 500 0 Neoplasms (COO-D48) Mental and behavioural disorders (FOO-F99) Diseases of the circulatory system Diseases of the respiratory system Injury, poisoning and certain other consequences of external causes 10 0 30 20 40 60 50 70 Neoplasms (COO-D48) Mental and behavioural disorders (FOO-F99) Diseases of the circulatory system Diseases of the respiratory system Injury, poisoning and certain other consequences of external causes 5 | P a g e5 | P a g e

9. Who are at risk? Health General population (Children and adults)  Chronic exposures -Pb, Hg, Ni, Cd, Beryllium etc Informal sector workers  Open burning of plastics in e-waste  Occupational exposures

10. ? What is the Evidence that Toxic Chemicals in the Environment Cause Disease in Children?

11. Children are surrounded by a large and ever increasing number of chemicals Many of the chemicals to which children are at risk of exposure have not been tested for their possible developmental toxicity Children are more heavily exposed and more vulnerable to many environmental chemicals than adults These chemicals are detectable in most children's bodies, even in newborn infants

12. Children our future Children are not little adults – Kg to kg, pound for pound, a child’s exposure is greater than an adults (dose- response) – Immature blood-brain barrier—allows more chemical passage – Detoxication systems may not be fully functional—timing of exposure.

13. “Because children have more future years of life than most adults, they have more time to develop chronic diseases that may be triggered by early exposures.” Landrigan et al. 2003. Assessing the effects of endocrine disruptors in the national children’s study. Environ. Health Perspectives 111(13): 1678-1682.

14. How are Children Exposed? By what goes into their mouths (oral) By what they touch (dermal) By what they breathe (respiratory) Even before they are born (pre-natal)

15. Windows of Susceptibility YELLOW RED/dark is highly sensitive period, YELLOW/light for less sensitive period. From: Selevan,et al, Environmental Health Perspectives, Volume 108, Supplement 3, June 2000

16. “Children can develop and mature in an environment that allows them to reach and maintain their full potential.” Vision for health of children

17. What is health? Physical, mental, social and spiritual wellbeing. Not merely absence of disease

18. RIGHT TO LIFE Is a basic human right

19. Health is wealth and no wealth is better than health!

20. It is not only the health of us the adults, the workers most importantly the children‘s health and health of future generations as well.

21. Let us not misuse chemicals Thank you