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Air pollution is known bad news for human health, with a particular link to death in babies and children. Previous studies have focused on the bane of particulate matter in children's health, but two investigations establish a direct association between ambient air pollution and pneumonia and death in children
Air pollution has been connected with a broad range of acute and chronic illnesses, along with higher mortality among humans and varying effects on respiratory and cardiovascular health.[i] Of particular concern is ambient pollution rooted in fine particulate matter mostly coming from fuel combustion from cars, power plants, industry, households or biomass burning.[ii]
Around the world, ambient air pollution is estimated to result in around 16% of lung cancer deaths, 26% of respiratory infection deaths and 17% of ischaemic heart disease and stroke.[iii] Low and middle income nations are disproportionately affected by this environmental health problem.
Children are especially at risk. Two different studies from 2019 found that exposure to air pollution may increase the likelihood of death among children younger than 5, as well as the incidence of pneumonia, with varying levels of susceptibility to different air pollutants based on age.
Pollution and Infant Mortality: The Beijing Picture
Researchers probed the concentration of ambient air pollution and the number of deaths in children younger than 5 in Beijing, China, from January 2014 to September 2016.[iv] They used authoritative electronic databases to derive the numbers, along with two-pollutant models to evaluate the potential role of single pollutants.
In the study, sulfur dioxide, nitrogen dioxide and carbon monoxide had the strongest ties with death among children under 5, with the first two emerging as the most stable pollutants that reflect air pollution-death associations. The links were also stronger for deaths related to congenital heart disease than overall and pneumonia-related mortalities.
"Children with congenital heart diseases are more susceptible to air pollution," the researchers noted.[v] "Therefore, it is urgent to implement the clean air targets established by WHO [World Health Organization] and reduce the exposure of children to air pollution."
Air Pollution and Pediatric Pneumonia in Taiwan Study
Yet only a few studies have previously researched the association between air pollution and emergency room visits for pediatric pneumonia, prompting a group of scientists to analyze the impact of short-term exposure to air pollutants on the rates of emergency department visits for this common childhood illness.
In Kaohsiung City, Taiwan, 11 air quality-monitoring stations tracked air pollutant levels from 2008 to 2014. The researchers paired this data with medical records of non-trauma patients aged 17 and below who had visited the emergency room and were diagnosed with pneumonia. They then used a time-stratified case-crossover study design to determine the hazardous effect of air pollution in 4,024 patients.
Their findings revealed that short-term exposure to PM2.5 -- particulate matter with a diameter of less than 2.5 micrometers (μm) -- and nitrogen dioxide was an important factor in the onset of pediatric pneumonia in the city. Older children were more susceptible to PM2.5 while all children were more prone to nitrogen dioxide during warm periods.
Ambient air pollution was also earlier found to play into the following:
- Increased sedentary behavior among freshman students in Beijing[vii]
- The incidence of newly diagnosed tuberculosis[viii]
- An increased risk of Type 2 diabetes in Chinese subjects[ix]
- Obesity in a Chinese rural population, especially among the elderly, women, those with low education and income, and those with unhealthy lifestyles[x]
These recent conclusions cite a greater concern considering the widespread exposure of children and adults alike to ambient air pollution today.
About 91% of people living in cities in 2016 were exposed to particulate matter in concentrations exceeding WHO air quality guidelines.[xi] Data from the same year showed that indoor and outdoor air pollution led to an estimated 7 million deaths, translating to 1 in 9 deaths worldwide. For more information on air pollution's link to disease, review the 330 abstracts with air pollution-linked toxicity research on GreenMedInfo.com.
[i] Chaicharn P et al "Acute effects of air pollutants on daily mortality and hospitalizations due to cardiovascular and respiratory diseases" J Thorac Dis. 2019 Jul ;11(7):3070-3083.
[ii] World Health Organization https://www.who.int/gho/phe/outdoor_air_pollution/en/
[iii] World Health Organization https://www.who.int/gho/phe/outdoor_air_pollution/en/
[iv] Wang J et al "Associations between ambient air pollution and mortality from all causes, pneumonia, and congenital heart diseases among children aged under 5 years in Beijing, China: A population-based time series study" Environ Res. 2019 Sep;176:108531. doi: 10.1016/j.envres.2019.108531. Epub 2019 Jun 11.
[v] Wang J et al "Associations between ambient air pollution and mortality from all causes, pneumonia, and congenital heart diseases among children aged under 5 years in Beijing, China: A population-based time series study" Environ Res. 2019 Sep;176:108531. doi: 10.1016/j.envres.2019.108531. Epub 2019 Jun 11.
[vi] Cheng CY et al "Ambient air pollution is associated with pediatric pneumonia: a time-stratified case-crossover study in an urban area" Environ Health. 2019 Aug 28;18(1):77.
[vii] Yu H et al "Impact of Air Pollution on Sedentary Behavior: A Cohort Study of Freshmen at a University in Beijing, China" Int J Environ Res Public Health. 2018 Dec 10;15(12).
[viii] Zhu S et al "Ambient air pollutants are associated with newly diagnosed tuberculosis: A time-series study in Chengdu, China" Sci Total Environ. 2018 Aug 1;631-632:47-55. doi: 10.1016/j.scitotenv.2018.03.017. Epub 2018 Mar 7.
[ix] Li H et al "Ambient air pollution and risk of type 2 diabetes in the Chinese" Environ Sci Pollut Res Int. 2019 Jun;26(16):16261-16273. doi: 10.1007/s11356-019-04971-z. Epub 2019 Apr 11.
[x] Liu X et al "Association between long-term exposure to ambient air pollution and obesity in a Chinese rural population: The Henan Rural Cohort Study" Environ Pollut. 2020 May;260:114077. doi: 10.1016/j.envpol.2020.114077. Epub 2020 Jan 27.
[xi] World Health Organization https://www.who.int/gho/phe/outdoor_air_pollution/en/