Commitment to Protect Children's Health from Environmental Hazards ("Jerusalem Statement"), International Conference on Children's Health and Environment, 20-22 November 2013  

Jerusalem Statement Commitment to Protect Children's Health from Environmental Hazards
We, participants in the International Conference on Children’s Health and Environment, have come together in Jerusalem, the city of belief for so many people in the world, on 20-22 November 2013 to commit ourselves to work jointly towards the protection of children's health and safety from environmental risks. These risks may result from exposures that occur before conception, in the womb, during birth and thereafter in the cradle, the home, the school, the wider community, and for millions, from child labour. This Statement builds on previous statements asserting the intrinsic, natural moral rights of children, including the World Health Organization Alma Ata "Health for All" Declaration (1978) to protect and promote the health of all people, and the United Nations' Convention of the Rights of the Child signed on 20 November 1989.
In many parts of the world unacceptable dangers to children have occurred from war, child labour, slavery, trafficking, sexual exploitation, terror, torture, genocide, execution, and massive destruction of habitat.
These dangers result from human choice and bystander indifference and are crimes against humanity; That most diseases in children are not inborn, but linked to environmental exposures from waterborne, airborne, foodborne, vector-borne, and physical agents, many from invisible natural or man-made sources;
That children are most often more vulnerable to such exposures than adults, with the most critical effects on fetuses and babies;
That the risks come not only from acute high exposures, but from chronic low level exposures to lead, pesticides, heavy metals, solvents, and radiation —all too often at levels well below regulatory thresholds; Such exposures impair health, growth and lifetime development and body systems function;
That environmental factors acting in early life have consequences that become manifest as an altered disease risk in later life. Babies receive from their mother a forecast of the environment they will encounter after birth and modify their metabolism, whole body physiology, and growth trajectory to maximize postnatal survival.
If environmental exposure after birth is not the same as the one encountered prenatally, this may lead to epigenetic mis-programming, leading to developmental disorders or diseases;
That as emerging countries rapidly industrialize, children are being exposed to hazardous substances at levels now disappearing in richer countries; That not only in developing, but also in developed countries hazardous exposures among children remain;
That primary prevention is a crucial, cost effective and a key strategy for protecting children from adverse effects at all stages of their lifecycle;
That there is a need to evaluate effects in children of new emerging environmental health risks, such as exposure to endocrine disrupting chemicals and other agents, to compounds related to nanotechnology; but precautionary strategies to reduce these exposures need not await complete answers from research;
That protecting the integrity of the life-sustaining systems of Planet Earth is essential to a sustainable strategy of protection and promotion of children's health;
That countermeasures against global climate change and loss of biodiversity are essential to sustainable strategies for promoting children's health and environment.

That children are uniquely vulnerable to the effects of many chemical, biological and physical agents, as well as mental stressors in the social environment.
Children should be protected from injury, poisoning, stress and hazards in the environments where they are born, live, learn, play, and grow;
That in many regions of the world children’s environmental health hazards have been greatly aggravated by war and conflict, incitement to hate, repression, and poverty;
That all children have the right to safe, clean and supportive environments that ensure their survival, growth, development, healthy life and well-being;
That there is a moral and ethical responsibility of decision-makers to protect this right—everywhere, but especially in high threat situations such as war, slavery and child labour.
That the recognition of the forgoing right is essential as the world moves toward the adoption of sustainable development practices;
That the international community should be more active in addressing the outstanding issues of children’s environmental health throughout the world, especially in the cases requiring urgent measures for decontamination, remediation, and rehabilitation;
That children require easy and safe access to healthy outdoor spaces to play as essential to their health and development;
That it is the responsibility of communities, assisted by local, national and international authorities and policy makers, national and international organizations, and professionals dealing with health, environment, water, energy, transport, agriculture and education issues to act. Such actions include: promoting the recognition, assessment, prevention and mitigation of physical, chemical and biological hazards, stress and social hazards that threaten children's health and quality of life;
That it is the responsibility of those actors in children’s health to assess, promote, develop and monitor solutions to all hazards, especially ways to avoid hazards in the first place, and ensure precautionary strategies anticipating these risks;
That precautionary strategies need to weigh difficult choices between alternative strategies.

To require policy makers to recognize their moral and ethical responsibility to protect children from threats in high risk situations and in dangerous places everywhere, but especially in high threat situations such as war, genocide, slavery and child labour;
To increase the awareness of policy makers, governmental and non- governmental agencies, the industry and the public opinion, that investing in prevention of children's environmental and safety hazards is greatly cost- effective, convenient and beneficial for the society, economic growth and better future of mankind;
To provide children and their parents with knowledge about and access to safe water and air, adequate sanitation, safe food, appropriate shelter, and protection from injury;
To encourage industry, manufacturers, communication systems, planners, and agriculturists to ensure safe production, use and disposal of chemicals and other hazardous or potentially hazardous products or agents;
To promote substitution policies by phasing out hazardous chemicals in commonly-used consumer products;
To promote development and dissemination of international standards, criteria, and parameters of a safe environment;
To educate children’s health care providers to incorporate the pediatric environmental history taking as a part of routine practice;
To set an example by working to create more sustainable health care and research facilities;
To strengthen research to identify problem areas in children's environmental health and safety in order to set priorities and allocate resources; and evaluate the efficacy of interventions and their consequences;
To disseminate knowledge about the special vulnerability of children to our peers, colleagues, the community and policy makers;
To develop and/or strengthen partnerships at the local, regional, national and trans-national levels among pediatric, nursing, environmental and education associations and the United Nations Environment Programme, the World Health Organization and other governmental, nongovernmental and international organizations for the protection of children's environmental health and safety;
To promote new approaches for safe and effective therapeutic methods of medical interventions in cases of childhood poisoning by heavy metals, pesticides, and other agents, including targeting the biochemical sites of actions in addition to removing the agents from the body;
To advocate and take action in promotion and protection of children's health environment and safety at all levels, including political, administrative and community levels;
To explore the possibilities of new approaches to protect children more in decision making processes;
And to create mechanisms for rapid early response to emerging threats.
Jerusalem, November, 2013