KUALA LUMPUR: Children's environmental health, vector-borne diseases and contamination of drinking water sources have been identified as the top three major and growing environmental health threats in Malaysia that warrant urgent intervention.
This was revealed in the Health Ministry's National Environmental Health Action Plan's latest publication, Priority List of Environmental Health Issues in Malaysia.
The list, detailing 10 key concerns, was developed by the "Thematic Working Group 10: Environmental Health Experts", which comprised six environmental health experts (appointed by the ministry) and led by its chairman, Professor Dr Jamal Hisham Hashim.
Other issues in rank order in the study are urban health; climate change; food safety and contamination; exposure to pesticides and other environmental chemicals; zoonotic diseases; exposure to ionising and non-ionising radiation; and particulate and ground-level ozone pollution.
Dr Jamal, who is also Universiti Selangor visiting professor of environmental health and director of Provenue Corporation, said the report was a product of elaborated discourse, detailed analyses and scrutiny by the country's prominent panel of environmental experts.
He said environmental health impacts could no longer be considered a minor concern and without a paradigm shift, human health would suffer drastically, besides threatening the planet's sustainability.
The World Health Organisation estimates that 12.6 million deaths or 23 per cent of all global deaths could be linked to environmental risk factors such as poor sanitation, air pollution, climate change, pesticides and vector-borne diseases.
Of these, 7.3 million or 58 per cent of deaths occurred in Southeast Asia and Western Pacific regions, including in Malaysia.
Dr Jamal stressed that "children are not little adults", therefore environmental health programmes and strategies meant to protect adults might not accord the same level of protection for children.
"Many chemical toxicants like pesticides and heavy metals cross the placental barrier from mother to foetus, thus harming children even before they are born.
"Minamata disease due to mercury poisoning in Japan in 1956 was one of the earliest known teratogens or toxicants that affect the foetus.
"Organs such as lungs and brain only mature between the age of 20 and 25. Thus, children are vulnerable to environmental toxicants that affect these organs."
He added that many countries had launched children's environmental health programmes and set up cohort studies, which follow a group of children prospectively through the ages to measure both their environmental exposures and related disease or health outcomes, which Malaysia lacks.
"Therefore, the authorities must conduct studies on birth cohort, the impact of the indoor and outdoor environment, and formulate intervention strategies on how to manage children's environmental health, such as at schools, homes and childcare centres."
On vector-borne diseases like dengue and the re-emergence of malaria, Jamal said they were due to landscape changes, rapid population growth, urbanisation and climate change.
Malaysia, he said, was also battling contamination of drinking water sources and emerging water pollutants, for instance, due to endocrine-disrupting chemicals (EDCs) and pharmaceutical drugs (antibiotics and antimicrobials).
A 2020 study revealed that 14 types of EDCs were detected in Malaysia's drinking water supply system.
EDCs could trigger acute and chronic diseases from alterations in sperm quality and fertility to endometriosis, altered nervous system function, immune function, cancers, respiratory problems, metabolic issues, diabetes, obesity and cardiovascular problems.
Jamal said human exposure to pesticides and other environmental chemicals such as e-waste, industrial chemicals, and lead in paint or consumer products was another cause for concern.
A 2017 study revealed that exposure to dangerous chemicals and metals could lead to deaths, learning disabilities, lung damage, mental retardation, behavioural problems, hearing impairment, the fragility of the bones, and high blood pressure.
Additionally, Dr Jamal said zoonotic diseases from animals, such as the increasing incidences of human malaria cases due to the simian parasite Plasmodium knowlesi, rabies, leptospirosis and melioidosis in Malaysia could be serious and even fatal.
"Exposure to ionising and non-ionising radiation, meanwhile, could cause thermal cell damage, denaturation of proteins, genetic changes and cancers."
Studies had suggested a close link between exposure to fine particles and premature death from heart and lung diseases as it could trigger or worsen chronic diseases such as asthma, obstructive pulmonary disease and heart attack.
Dr Jamal proposed setting up a National Institute of Environmental Health or upgrade the Health Ministry's Environmental Health Research Centre to such a status to steer the environmental health initiatives in the country.