Pediatric Annals

The World Around Us

Stanford T Shulman, MD


Physicians are just beginning to understand the role the environment plays in human health, especially that of children.


Physicians are just beginning to understand the role the environment plays in human health, especially that of children.

Medicine is just beginning to learn about the effect of the environment on humans, especially on children. Even though lead poisoning has long been recognized as an important childhood condition related to a child's immediate environment, the role of environmental influences on asthma, the importance of mercury exposure, the problem of indoor air pollution, arsenic exposure issues, and others are still relatively poorly understood.

These and other topics are reviewed in the articles included in this issue of Pediatric Annals, edited by Dr. Ruth A. Etzel, who is truly an international expert in this field. My medical history genes were stimulated by Dr. Etzel's reference to Sir Perei val Pott, the prominent London surgeon from St. Bartholomew's Hospital who, in 1775, first correlated a medical condition to an occupation. Pott is thus credited with being one of the earliest epidemiologists. He also, of course, is memorialized by Pott's disease of the spine (tuberculosis) and Pott's puffy tumor (forehead swelling associated with extension of frontal sinusitis into the soft tissues).

The effect of outdoor air pollution on pediatric respiratory diseases and on bronchiolitis specifically is also reviewed in this issue, and Sandel and colleagues provide a sobering review of what housing interventions have and have not been proved to be of benefit to children's health. Sadly, the only interventions found to be effective consistently are home visitation programs and home structural modifications, such as installing window guards and carpet removal. Simple outpatient educational efforts seem to have little effect. Also included in this issue is the clearest summary I have seen regarding insect repellents, their safety and efficacy, and recommendations for use. DEET is clearly more effective than other agents and, when used properly, has a fine safety record.

I have chosen an eclectic collection of stamps this month. The blue Swedish stamp graphically portrays an infant wearing a gas mask, exposed to auto exhaust fumes. The blue and brown Mexican stamp emphasizes "a better planet for our children" to celebrate World Day of the Environment. The importance of insect repellents is emphasized by two stamps. The mosquito Aedes aegypti, proposed by Carlos Finlay of Cuba to be the vector of yellow fever, is shown on the stamp from Panama. The black and brown stamp from Gabon illustrates the tsetse fly and Dr. Eugene Jamot. The Frenchman Jamot was educated in Algeria and Montpellier and is credited with discovering that the tsetse fly (genus Glossina) transmits African trypanosomiasis (sleeping sickness or Maladie du Sommeil). He worked effectively to prevent this very serious illness in the West African countries of Gabon, Cameroon, and Chad.

Finally, the colorful Canadian stamp portraying three teddy bears was issued on May 6, 2004. to commemorate the 100th anniversary of the founding of the Montreal Children's Hospital. The special postmark indicates the first day of issue of this stamp.


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