How indoor air quality affects children
Indoor air pollution can be even worse for developing bodies and brains than outdoor pollution. Here is how to protect your family.
When most people think about air pollution, they think about outdoor pollution. However, with more than 90 per cent of our time spent indoors, much of the air pollution that we breathe is from the air in indoor environments, like our homes, kindergartens, schools and places of work.
In 2019, 5,801 children and teenagers in in 52 countries in Europe and Central Asia died from causes linked to air pollution. Many more suffered the health and development effects of breathing polluted air, including non-fatal diseases, hospitalizations and disabilities.
Around 85 per cent of under-20s who died from causes related to air pollution in Europe and Central Asia in 2019 did so before their first birthday – accounting for the deaths of 4,917 infants.
Household air pollution – often associated with cooking with unvented stoves, using solid fuels – was estimated by the World Health Organization to cause 3.2 million deaths in 2020 alone, including more than 237,000 children under the age of five. In children, most of these deaths are from lower respiratory infections.
In our region in Europe and Central Asia, indoor air pollution often comes from a different source: heating. This can either be from using solid fuels, particularly coal and biomass, in vented stoves for space heating, or from facility level boilers that use coal (such as those used by schools that are not connected to district-level heating supplies). Because these stoves are vented, almost all the pollution is emitted outside. But this leads to high levels of pollution in the immediate neighbourhood – which then infiltrates back into homes. As a result, fine particulate air pollution (PM2.5) concentrations in neighbourhoods where many homes use solid fuels can be much higher than other areas of the city, such as those with district level central heating.
Poor indoor air quality in these neighbourhoods raises the risk of children developing serious health problems. For example, children who are exposed to higher levels of indoor air pollution are more likely to experience lower respiratory infections than children who are not. Asthma symptoms also are exacerbated by poor indoor air quality. Exposure to indoor air pollution can also affect the health of pregnancies, with links found between poor indoor air quality and babies born with low birth weight, as well as impacts to brain development. In fact, of different air pollutants, PM2.5 has been found to have the strongest consequences for ill health in infants and young children, including when exposed during pregnancy.
Smoking is also a major indoor source of poor air quality, as it emits fine particulates where we live and breathe. Because it is emitted right inside the home, a family member – including any children – is 1,000 times more likely to breathe it directly into their lungs than, say, outdoor pollution from a power plant.
In Europe and Central Asia, relatively few families cook with unvented stoves. For those who do, however, this is another major contributor to poor indoor air quality. And because they are more likely to stand near fuel sources to cook, women, along with children, are especially vulnerable to diseases from these sources of indoor pollution.
Indoor air pollution often interacts closely with outdoor air pollution, which may come not just from stoves venting to the outside, but from local industrial processes, open burning of waste and waste incineration, agricultural practices, construction and demolition.
Climate change is expected to worsen air quality further with increased ground-level ozone, due to intensified heatwaves and wildfires.
How to protect children from indoor air pollution
To protect your family from the impacts of poor indoor air quality, it is important to know what causes household pollution and whether pollution is higher indoors or outdoors. When pollution is higher indoors, reducing particulate matters and increasing ventilation are key interventions. In Europe and Central Asia, however, where pollution is higher outdoors than indoors during winter months, opening windows can increase indoor pollution levels.
In Europe and Central Asia, reducing emissions by using clean energy including district-level central heating, gas, or electric heat pumps – combined with measures for improved energy efficiency of homes and public facilities – are important actions for improved indoor air quality.
In terms of choosing how to heat your home, keep in mind that even modern wood-burning stoves may pollute indoor spaces. Gas is better, but still causes emissions of nitrogen oxides, which can cause health problems such as asthma. This is why it is still important to use proper ventilation systems when cooking or heating the home.
Whenever possible, moving to a clean fuel like electricity, particularly when generated from renewable sources like solar or wind, is the best option. For heating, heat pumps that use renewable energy (such as geothermal) are also an excellent alternative. In Europe and Central Asia, district-level central heating is also usually a clean option at the household level.
It is also important to make sure that all of your appliances are maintained and cleaned. This includes stoves and chimneys. It helps them burn more efficiently and release less pollution.
In addition, the use of stand-alone air purifiers can lower concentrations effectively. While air purifiers bought in a store can be costly, there are low-cost DIY air purifiers that can be made that have been shown to effectively reduce indoor air concentrations.
Finally, make sure no one is smoking indoors, and never smoke near children or pregnant women. Also avoid using other sources of pollutants, like incense, air fresheners or industrial paints, particularly around children.
Remember, too, that while indoor air pollution can affect health, many other things affect health, too – including for the better! Children are at less of a risk from indoor air pollution if their health is protected in other areas of their lives, for example, if they are up to date with vaccines, eat nutritious meals and are breastfed for their first six months of life.
It's also important to inform children, so they know how to protect themselves from pollution, too. This child-friendly resource is a way you can explore the topic together.
