What have we learned? A review of the literature on children's health and the environment in the Aral Sea area.
OBJECTIVE
To review the published literature examining the impacts of the Aral Sea disaster on children's health.


METHODS
A systematic review of the English language literature.


RESULTS
The literature search uncovered 26 peer-reviewed articles and four major reports published between 1994 and 2008. Anemia, diarrheal diseases, and high body burdens of toxic contaminants were identified as being among the significant health problems for children. These problems are associated either directly with the environmental disaster or indirectly via the deterioration of the region's economy and social and health care services. While links between persistent organic pollutant exposures and body burdens are clear, health impacts remain poorly understood. No clear evidence for the link between dust exposure and respiratory function was identified.


CONCLUSIONS
While important questions about the nature of the child health and environment relationships remain to be answered, the literature unequivocally illustrates the seriousness of the public health tragedy and provides sufficient evidence to justify immediate action. Regrettably, international awareness of the crisis continues to be poor, and the level of action addressing the situation is wholly inadequate.
Health and Environment Analysis Laboratory, Department of Geography, University of Ottawa, Ottawa, ON, K1N 6N5, Canada. eric.crighton@uottawa.ca
Eric James
EJ
Crighton
Lynn
L
Barwin
Ian
I
Small
Ross
R
Upshur
D002648:Child; D002669:Child Welfare; D004787:Environmental Pollution / Q000009:adverse effects*; D006801:Humans; D007623:Kazakhstan; D009792:Oceans and Seas; D014423:Turkmenistan; D014610:Uzbekistan