Pollution and child health

Abstract

Air pollution is a major environmental health threat. Exposure to fine particles in both the ambient environment and in the household causes about seven million premature deaths each year.[1,2] Ambient air pollution (AAP) alone imposes enormous costs on the global economy, amounting to more than US$ 5 trillion in total welfare losses in 2013.[3] Recent data released by the World Health Organization (WHO) show that air pollution has a vast and terrible impact on child health and survival. Globally, 93% of all children live in environments with air pollution levels above the WHO guidelines. More than one in every four deaths of children under 5 years of age is directly or indirectly related to environmental risks.[4] Both AAP and household air pollution contribute to respiratory tract infections that resulted in 543,000 deaths in children under 5 years of age in 2016.[1] It is estimated that, by 2030, climate change will be responsible for 250,000 deaths each year.[5] As many of the same pollutants that threaten health, such as black carbon and ozone (O3), are also the important agents of atmospheric warming, interventions that reduce their emissions are likely to result in benefits for both children’s health and the climate. We must seize this opportunity to create healthy, sustainable environments for our children. Everyone has a role to play, at every level: individuals, families, pediatricians, family doctors, nurses, obstetricians and gynecologists, primary health-care providers and other community workers, communities, medical students, national governments, and international agencies. Pollution can also be classified into indoor air pollution (indoor air pollution is the degradation of indoor air quality by harmful chemicals and other materials. It can be up to 10 times worse than outdoor air pollution because contained areas enable potential pollutants to build up more than open spaces) and outdoor pollutions (outdoor pollution primarily results from the combustion of fossil fuels by industrial plants and vehicles. This releases carbon monoxide (CO), sulfur dioxide (S02), particulate matter, nitrogen oxides, hydrocarbons, and other pollutants). The measurement of air quality is based on eight pollutants: particulate matter (size <10 pm), particulate matter (size <2.5 pm), nitrogen dioxide, S02, CO, O3, ammonia (NH3), and lead (Pb). The air quality index values and their associated health impacts for outdoor activities: good (0–50), satisfactory (51–100), moderate (101–200), poor (201–300), very poor (301–400), and severe (401–500). The common clinical manifestations of environmental pollution in children are new-onset asthma, bronchitis, deficits of lung growth, respiratory infections, eczema, and behavioral disorders. Simple measures to safeguard our children are as follows: At home: Keep your home as clean as possible. Dust, mold, pests, secondhand smoke, dust from soft toys, woolen rugs and pets, and dander can trigger asthma attacks and allergies. Improve the indoor air quality by clean fuel, solar, electricity, avoid incense sticks, and mop instead of dusting the house. Optimize ventilation during construction and renovation of house and use HEPA-fitted air purifiers (no obstruction from furnishings, wall, should have a high clean air delivery rate) Promoting physical activity: Encourage active transport (cycling or walking), but when and where air pollution levels are high, encourage moderate outdoor physical activity. Decrease or stop exercising when there is coughing, chest tightness, or wheezing Interventions to modify individual risk factors: Treat and manage respiratory conditions-optimized care. Treating comorbidities such as reducing obesity, allergic rhinitis, GERD, and avoidance of second-hand smoke. Regular follow-up with the doctor to recheck the technique of using inhalers and adjusting the dose of medications. Balanced healthy diet and physical activity Few challenges we encounter during day-to-day life are child traveling in a diesel school bus is exposed to exhaust that contains small particles and toxic particles. Advocate using electrical buses or using low-sulfur diesel for school buses. We should educate the driver and the vehicle should be regularly serviced and maintained. One has to encourage active school travel by walking. In buildings where air conditioner is used, they should be regularly serviced and maintained as per the manufacturer instructions. Remember, if your family members who smoke and want to hold your baby, ask them to first wash their hands and change their clothes. This will decrease your baby’s exposure to dangerous poisons Critical role of the health and environment professionals: Diagnose and treat, do research and publish sentinel cases, community-based interventions, educate patients and families as well as colleagues and students, advocate, and provide good role models.