Clear the Air for Children: Air Pollution & Pneumonia (UNICEF Report 2016)

Clean the Air for Children UNICEF Report

Clear the Air for Children: Air Pollution & Pneumonia (UNICEF Report 2016)

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Around 300 million children currently live in areas where the air is toxic – exceeding international limits by at least six times. Using satellite imagery of outdoor air pollution, this study found that around 300 million children currently live in areas where outdoor air pollution exceeds international guidelines by at least six times. In total, around 2 billion children live in areas that exceed the World Health Organization annual limit of 10 μg/m3 (the amount of micrograms of ultra-fine particulate matter per cubic meter of air that constitutes a long term hazard).

Air pollution is linked directly with diseases that kill. In 2012, air pollution was linked with 1 out of every 8 deaths, globally – or around 7 million people. Around 600,000 of those were children under 5 years old, globally. Almost one million children die from pneumonia each year, more than half of which are directly related to air pollution. Air pollution can considerably affect children’s health.

A boy stands along railroad tracks, as other people, obscured by dust, smoke and debris, pass by in Kibera, a slum area of Nairobi, the capital. A fire burns on the opposite track. The train runs at night, but does not stop in Kibera. The tracks are strewn with garbage and excrement. In May 2006 in Nairobi, the capital of Kenya, more than one-quarter of the city's population lives in Kibera, the largest slum in the nation, and one of the poorest and most densely populated settlements in the world. Over 1 million people live in an area measuring approximately 2.5 square kilometres. Kibera lacks public health and water and sanitation services, garbage collection, electricity and roads. It is heavily polluted by soot, dust and open sewers, and human waste flows into the already contaminated Nairobi River. Lack of latrines and poor drainage leads to the swamping of entire neighbourhoods with animal and human faeces during the rainy season. The combination of poor nutrition and lack of sanitation accounts for soaring malnutrition rates (up to 36 per cent in some areas), elevated under-five mortality (186 per 1,000 live births) and a high incidence of illness due to malaria, measles and diarrhoeal disease. An estimated one-fifth of the 2.2 million Kenyans living with HIV reside in Kibera, as do many children orphaned by the disease. Only one-third of children attend pre-school and the majority of children do not complete their primary education. The social environment of the slum is characterized by unstable family structures, lack of privacy, domestic violence, sexual exploitation and drug and alcohol abuse.

Studies have shown that air pollution is strongly associated with respiratory conditions such as pneumonia, bronchitis and asthma, among others. It can also exacerbate underlying health issues and prevent children from going to school, and there is emerging evidence that it can disrupt physical and cognitive development.

Left untreated, some health complications related to air pollution can last a lifetime.

Air pollution is worsening in many parts of the world. As countries continue to industrialize and urbanize, energy, coal and fuel use tends to increase. A recent publication from the World Health Organization (WHO) indicates that urban outdoor air pollution has increased by about 8 per cent between 2008 and 2013. Projections are unfavorable. According to the Organisation for Economic Co-operation and Development (OECD), under-five mortality could be 50 per cent higher than current estimates by 2050 as a result of outdoor air pollution. Another study published in Nature found it could be even worse – doubling by 2050.

Children are uniquely vulnerable to air pollution – due both to their physiology as well as to the type and degree of their exposure. Air pollution can seriously affect the health of the fetus. Pregnant mothers are advised to avoid air pollution – just as they should avoid smoking or breathing secondhand cigarette smoke.

Studies have shown that chronic exposure to high levels of particulate matter (PM2.5 – which consists of particulate matter with a median diameter of less than 2.5 microns, approximately one thirtieth the width of average human hair) is associated with higher rates of early fetal loss, preterm delivery – and lower birthweight.

Children’s lungs are in the process of growing and developing, making them especially vulnerable to polluted air. The cell layer on the inside of the respiratory tract is more permeable among young children. Children’s respiratory airways are also smaller than adult airways, so infections are more likely to cause blockages than in adults.

Furthermore, children’s immune systems are still developing, especially at young ages. During early childhood, children are highly susceptible to viruses, bacteria and other infections.This both increases the risks of respiratory infection and reduces the ability of children to combat it.

Moreover, the effects of air pollution on a child can have lifelong health implications. Air pollution can impair the development of children’s lungs, which can affect them through to adulthood. Studies have shown that the lung capacity of children living in polluted environments can be reduced by 20 percent – similar to the effect of growing up in a home with secondhand cigarette smoke.14 Studies have also shown that adults who were exposed to chronic air pollution as children tend to have respiratory problems later in life.

Poor children are among the most at risk.

Globally, air pollution affects children in low- and middle income countries more. Up to 88 per cent of all deaths from illnesses associated with outdoor air pollution16 and over 99 percent of all deaths from illnesses associated with indoor air pollution occur in low- and middle-income countries. Asia currently accounts for the vast bulk of total deaths attributable to air pollution.The proportions, however, are changing. In Africa, increasing industrial production, urbanization and traffic is causing the rapid rise of outdoor air pollution. As this happens, the number of African children exposed to outdoor air pollution is likely to increase, especially as the continent’s share of the global child population is set to increase markedly. By midcentury, more than one in three children globally is projected to be African.

Outdoor air pollution tends to be worse in lower-income, urban communities. Lower-income areas are often highly exposed to environmental pollutants such as waste and air pollution. Factories and industrial activity are also more common near lower-income areas, and there is often less capacity to manage waste. This can result in burning, including of plastics, rubber and electronics, creating highly toxic airborne chemicals which are highly detrimental to children. Poorer families are also less likely to have resources for good quality ventilation, filtration and air conditioning to protect themselves from harmful air.

Indoor air pollution is most common in lower-income, rural areas. Over 1 billion children live in homes where solid fuels are used in cooking and heating. While outdoor air pollution tends to be worse in poor urban communities, indoor air pollution tends to be worse in rural communities where biomass fuels are more frequently used in cooking and heating due to lack of access to other forms of energy. Eighty-one per cent of rural households in India use biomass fuel, for instance, because it is relatively inexpensive and readily available. Even at national levels, income is linked with the use of solid fuels for household energy needs: Thailand – with a per capita income of US$5,816 – uses biomass to meet 23 per cent of household energy needs, while the United Republic of Tanzania – with a per capita income of US$864 – uses biomass to meet 95 per cent of household energy needs.

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