Potential health effects of greenhouse effect and ozone layer depletion in Australia.

OBJECTIVE: To identify potential health effects of the greenhouse effect and ozone layer depletion in Australia. DATA SOURCES: Data were derived from a number of sources: (i) published articles accessed from relevant databases in the disciplines of health, public health and climatology over the past 20 years; (ii) published conference proceedings, review monographs and government reports covering the topic; (iii) a survey of experts in public health and climatology/geography (150 individuals were surveyed in the first phase with a 63% response rate); and (iv) a consensus conference in which 22 invited experts reviewed the results of the literature review and survey and a second conference in which 18 senior members of the health bureaucracy and public health profession considered the implications of the findings. STUDY SELECTION: Over 200 published articles or monographs were reviewed. Criteria for selection were whether the papers contributed information to the objectives of the review. DATA EXTRACTION: Because of the nature of the problem under investigation, predictions based on reasonable scientific assumptions were the major content of the review rather than conclusions based on scientific research. DATA SYNTHESIS: The major predicted health effects of long-term climatic change in Australia are skin and eye damage from increased ultraviolet radiation exposure, increased incidence of some respiratory diseases, vector-borne and water-borne diseases, and the social and physical effects of natural hazards and social and economic restructuring. The most vulnerable groups include the aged, the very young, the chronically ill, those living in poorly designed neighbourhoods and those working in outdoor occupations or heavy industry. CONCLUSIONS: The potential effects on health of long-term climatic change cover the broad spectrum of public health concerns. Detailed predictions of likely problems in specific geographic areas are not yet possible, but progressive development of such predictive capability is a high priority. Doctors will have an increasingly important role in monitoring local health status and participating in disease prevention and surveillance programmes.

Evaluation of preschool meals programmes on the nutritional health of Aboriginal children.

One hundred and sixteen three to five year old Aboriginal children were included in an evaluation of the effect of preschool meals programmes on their nutritional health. Sixty-one children attending preschools in five communities were examined at the beginning and end of the school year. Fifty-five control children in five matched communities had two examinations, 38 weeks apart. Height, weight and haemoglobin concentrations were determined on all children and serum levels of ascorbic acid, ferritin, iron, total protein, albumin, cholesterol and triglycerides were determined on a subsample. Aboriginal children in both groups had initial measurements and nutrient levels below acceptable levels. The 61 children who received preschool meals had consistently better growth than the control children. A negative correlation was found between gains in weight and height and serum levels of ferritin, haemoglobin and ascorbic acid, indicating that more rapidly growing children may have been rapidly utilizing nutrients for growth.

Morbidity and growth of infants and young children in a rural Mexican village.

The relationship between childhood illnesses and growth increments in length and weight was investigated in a 13-month birth cohort of rural Mexican children. Increments in length and weight for each year from birth to three years were related to high and low frequencies of reported time ill during the same period. Seventy-two of the 276 children had already been characterized as exhibiting "growth failure" relative to other members of the cohorts, and this was considered as a separate factor in the study. We found that upper and lower respiratory infection did not affect incremental gain in height or weight. A high frequency of diarrheal infection was found to reduce weight gain, although gain in height was not affected. Relative to the total sample, the average child with a high frequency of diarrhea achieved only 95 per cent of expected body weight age three; a chidl with both growth failure and high diarrheal frequency reached only 90 per cent of expected body weight at age three.