Ambient Air Pollution: Health Hazards to Children

Author:

Brumberg Heather L.1,Karr Catherine J.2,Bole Aparna,Ahdoot Samantha,Balk Sophie J.,Bernstein Aaron S.,Byron Lori G.,Landrigan Philip J.,Marcus Steven M.,Nerlinger Abby L.,Pacheco Susan E.,Woolf Alan D.,Zajac Lauren,Baum Carl R.,Campbell Carla C.,Sample Jennifer A.,Spanier Adam J.,Trasande Leonardo

Affiliation:

1. Division of Neonatology, Maria Fareri Children’s Hospital, Westchester Medical Center and Departments of Pediatrics and Public Health, New York Medical College, Valhalla, New York; and

2. Departments of Pediatrics and Environmental and Occupational Health Sciences and Northwest Pediatric Environmental Health Specialty Unit, University of Washington, Seattle, Washington

Abstract

Ambient air pollution is produced by sources including vehicular traffic, coal-fired power plants, hydraulic fracturing, agricultural production, and forest fires. It consists of primary pollutants generated by combustion and secondary pollutants formed in the atmosphere from precursor gases. Air pollution causes and exacerbates climate change, and climate change worsens health effects of air pollution. Infants and children are uniquely sensitive to air pollution, because their organs are developing and they have higher air per body weight intake. Health effects linked to air pollution include not only exacerbations of respiratory diseases but also reduced lung function development and increased asthma incidence. Additional outcomes of concern include preterm birth, low birth weight, neurodevelopmental disorders, IQ loss, pediatric cancers, and increased risks for adult chronic diseases. These effects are mediated by oxidative stress, chronic inflammation, endocrine disruption, and genetic and epigenetic mechanisms across the life span. Natural experiments demonstrate that with initiatives such as increased use of public transportation, both air quality and community health improve. Similarly, the Clean Air Act has improved air quality, although exposure inequities persist. Other effective strategies for reducing air pollution include ending reliance on coal, oil, and gas; regulating industrial emissions; reducing exposure with attention to proximity of residences, schools, and child care facilities to traffic; and a greater awareness of the Air Quality Index. This policy reviews both short- and long-term health consequences of ambient air pollution, especially in relation to developmental exposures. It examines individual, community, and legislative strategies to mitigate air pollution.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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