Stanford researcher outlines pollution and climate change threats to children’s health

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Horror stories of children trapped in hot cars make headlines, but air pollution and the effects of a changing climate are more persistent threats. Children are at greater risk for health changes from these effects for a number of reasons, including how their bodies metabolize toxins, require more air per pound, and regulate temperature differently than adults. More than 90% of children under the age of 15 regularly breathe air that is sufficiently polluted to pose a serious threat to their health and development, while vector-borne diseases and water scarcity – scourges exacerbated by global warming – affect more than one in four children and more than one of them affect every three.

Kari Nadeau, director of the Sean N. Parker Center for Allergy & Asthma Research at Stanford, studies the effects of air pollution on the heart, lungs and immune system. Their work has confirmed that early exposure to polluted air alters genes in ways that can lead to serious illnesses in adulthood, alter the immune system over time, and impair learning, among other things. Nadeau and Frederica Perera of Columbia University’s Mailman School of Public Health published a study on March 16 New England Journal of Medicine outlines pollution and threats posed by climate change to children’s health and calls for better understanding and action by health professionals.

Here, Nadeau discusses environmental risks to children’s health and what caregivers and health workers can do to reduce them.

What might surprise the average person when they learn how air pollution or climate change affects children’s health?

While significant strides have been made in reducing poverty-related environmental risks over the last few decades, industrialization-related pollution has steadily increased, and every single child in the world is projected to suffer from at least one climate change-related event in the next 10 years – something that most do People might be shocked to find out. Likewise, I find it particularly remarkable that around a quarter of the deaths of children under the age of 5 worldwide could be prevented by tackling environmental risks.

What can parents and other caregivers do to minimize their children’s exposure to air pollution and the effects of climate change?

There are a number of personal and family changes people can make. For example, parents who use electric cars for their family can reduce their child’s chance of developing asthma by 30%. If a family can reduce meat consumption by just one day a week, it can help protect the planet and improve the health of their children. Purchasing a filter such as MERV 13 or higher for your home can also reduce indoor air pollution. Using electrical appliances instead of gas can improve the air your family breathes by 50%.

What should parents and other carers in wildfire prone areas know about the smoke hazard to children?

There is no safe distance from forest fire smoke. Children need to be indoors when smoke from wildfires pushes the Air Quality Index, or AQI, above 50, especially those with asthma, as their lungs are developing and the smoke can be irreversibly harmful to them. Children should wear well-fitting N95 masks outside on wildfire smoke days. Being outside in heavy wildfire smoke is similar to smoking cigarettes. Even with an AQI of just 22, breathing outside air for 8 hours is like smoking a cigarette in terms of smoke inhalation and exposure to a range of chemicals. It may be hard to believe, but it’s a real and compelling reason to switch to clean, renewable energy sources.

How can air pollution and climate change affect children’s mental health and/or cognitive abilities?

Recent epidemiological studies show that air pollution is a risk factor for mental illness in children and adolescents. For example, lifelong exposure to traffic-related air pollution can lead to depression and anxiety symptoms. Of particular concern is the cumulative impact of air pollution and climate change on mental health. Adverse childhood experiences, such as disasters and displacement, not only increase the short-term risk of mental disorders, but also confer a lasting susceptibility to anxiety, depression, and mood disorders in adulthood.

In what ways are children in disadvantaged communities more burdened by these impacts?

Children of color are up to 10 times more likely to be exposed to toxins, pollution and climate change than other children. In the US, the rate of childhood asthma in black children is twice that in white children, likely due to higher levels of particulate air pollution in black communities. These and other environmental pressures, combined with poverty-related stress, injustice and lack of access to health care, accumulate over the course of a lifetime. They lead to worsening health effects and a shortened lifespan.

How should paediatricians and other health professionals think about these issues and how can we better educate them about them?

We must include children’s environmental health in primary care and basic public health. For example, when a family visits the pediatrician for an evaluation of the healthy child and for preventive vaccinations, the pediatrician can be proactive in speaking about the importance of breathing clean air and avoiding wildfire smoke. The pediatrician may ask for access to child-sized N95 masks and home air filters. We may engage local health workers and networks to raise awareness of children’s environmental health, local environmental assessments, and through their participation in community-led pollution and emissions reduction efforts and other initiatives.

Lisa Patel, a clinical assistant professor of pediatrics at Stanford, was instrumental in getting the American Board of Pediatrics to include climate change and health issues in the physician certification exam. Barbary Erny, associate clinical associate professor of pulmonary and critical care medicine, and Michele Barry, director of the Stanford Center for Innovation in Global Health, have developed lessons for medical students and trainees on climate change and health. These lessons are shared across the country and around the world.

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