Air pollution jeopardizing children's health worldwide

U of A author of new World Health Organization report says the devastating death toll is an urgent call to action.

More than half a million children worldwide under the age of five died from respiratory illnesses caused by ambient and indoor air pollution worldwide, according to a new report by the World Health Organization (WHO).

"While the burden of disease attributable for particulate matter in air is heaviest in low- and middle-income countries, air pollution is a global problem," said Irena Buka, a University of Alberta pediatrician and co-author of Air Pollution and Child Health: Prescribing Clean Air.

Premature deaths from pollution

While the WHO report focused on children because of their unique vulnerability, adults are also breathing in polluted air.

  • Ambient air pollution was responsible for 4.2 million premature deaths in 2016; of these, almost 300,000 were children under five years old.
  • Household air pollution was responsible for 3.8 million premature deaths in 2016, including more than 400,000 deaths of children under the age of five.
  • Joint effects of ambient and household air pollution were responsible for seven million deaths.

"Globally, 93 per cent of all children live in environments with air pollution levels above the WHO guidelines. Children have unique vulnerabilities that make them more susceptible to environmental pollutants of all kinds but especially in the air, and the long-term health impacts are truly devastating," she added.

The report is the first to look in-depth at air pollution health impact in children.

"It will hopefully serve to raise awareness and action around the lesser known impact of indoor air pollution as well as outdoor air pollution," said Buka, who is the director of WHO's Collaborating Centre in Child Health and the Environment as well as director of the Children's Environmental Health Clinic (ChEHC)-the only clinic of its kind in Canada.

For example, the report showed that low- and middle-income countries-especially in the African region-have the highest levels of exposure to household air pollution due to widespread use of polluting fuels and technologies for basic daily needs, such as cooking, heating and lighting.

"Dependence on solid fuels and kerosene for cooking, heating and lighting by about three billion people worldwide means far too many children living in heavily polluted home environments," said Buka.

"In Canada, there are indoor air pollutants that pose risks to children including cigarette smoke, carbon monoxide, mould and particulates from many chemicals including cleaning supplies, to name but a few," she added.

Why children are so vulnerable

There are a number of reasons children are at greater risk than adults from adverse effects of air pollution, including the fact that during fetal development and early years their lungs, organs and brains are still maturing, said Lesley Brennan, clinical assistant at ChEHC.

"Also, children breathe faster than adults, taking in more air and pollutants. Indoors they live closer to the ground where pollutants reach peak concentrations. Meanwhile, they also tend to spend much time outdoors in potentially polluted air."

The health impact is enormous according to the research, noted Buka, and includes adverse birth outcomes, infant mortality, negative effects on neurodevelopment and lung function, and increased risk of obesity, acute lower respiratory infections, asthma and childhood cancers.

"Exposure early in life increases risk of future disease and lifelong consequences," said Buka.

The report contains a number of recommendations health professionals can act on, including advocacy and education solutions, Buka noted, adding that synergistic public policy changes are vital for changing the biggest sources of air pollution around the world.

"Children have little or no control over the air they breathe. Health-care professionals and the public can work together to get strong action from decision-makers to protect them."