Breathless beginnings
The alarming impact of air pollution on children in Europe and Central Asia
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Air pollution is a major environmental health risk for children. More than 5,800 children and teenagers in Europe and Central Asia died in 2019 from causes related to air pollution. In Kazakhstan, 199 children and adolescents died from similar causes.
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. These deaths were preventable.
Children are uniquely vulnerable to air pollution, with devastating effects on their health and development. Scientific evidence shows air pollution contributes to adverse birth outcomes including preterm births and low birth weights, infant mortality1, damaged lung function, illness and diseases including asthma, cardiovascular disease and cancer, and an increased risk of neurological disorders. Other respiratory illnesses associated with air pollution include common childhood conditions such as upper respiratory tract infections, otitis media and allergic diseases.
Children are physically more exposed to air pollution than adults because they breathe twice as fast, often by mouth, taking in more pollutants, and are often closer to the ground where pollutants accumulate. Children are physiologically more vulnerable to air pollution than adults because their brains, lungs and other organs are not maturely developed, thus protective mechanisms are not available as they are for adults during exposure to toxic pollutants. Prolonged exposure to toxic pollutants leads to damaged growth and development of their organs, and affects brain development in the critical early years, resulting in long-term consequences to children’s physical and mental development.
The right to clean air is far from the reality for children and young people in Europe and Central Asia. More than 83 per cent of children2 in 50 countries across the region are exposed to ambient air pollution.
Air pollution is the single biggest environmental risk factor for premature death and ill-health. Ill health due to PM2.5 pollution is particularly prevalent among young children during their first 1,000 days of life and for the elderly. Children who breathe polluted air are at higher risks of severe health problems including acute respiratory infections and complications such as pneumonia and asthma.
Air pollution is a public health crisis. Children’s health and development are uniquely vulnerable to the damaging impacts of air pollution, with sometimes deadly and often life-long negative consequences for individuals and increased pressure on public services. There is a strong correlation between early exposure and later health outcomes.
Air pollution – PM2.5 and PM10 – in Europe and Central Asia is mainly caused by residential, commercial and institutional practices that rely on fossil fuels, with the use of coal particularly harmful for children’s health.
- Air pollution causes higher rates of asthma, bronchitis, respiratory tract inflammation and eye irritation among children.
- Early and frequent exposure to air pollution in children leads to long-term health impacts including pulmonary disease, cardiovascular disease, lung cancer, neurodevelopmental impacts and neurodegenerative disease and diabetes, with lasting damage to child health and well-being.
- Ultrafine air pollution particles – PM2.5 – are up to 200 times smaller than the width of a human hair and pose a high risk to children because they can easily enter the blood stream and cross the blood brain barrier more easily. This causes neuroinflammation and disrupts brain development, particularly damaging for young children as their brains go through a period of rapid development during the early years, leading to poor cognitive development and school performance.
- Air pollution can seriously affect the health of a fetus. Pregnant mothers are advised to avoid exposure to air pollution wherever possible. Chronic exposure to high levels of PM2.5 is associated with higher rates of early fetal loss, preterm delivery – and lower birthweight.
What are PM10 and PM2.5?
PM10 is roughly one-seventh the diameter of a human hair. It consists of sulfate, nitrates, ammonia, sodium chloride, and black carbon; it may also include concentrations of natural windblown dust. PM10 is harmful to health because it can block and inflame nasal and bronchial passages, causing a variety of respiratory-related conditions that lead to illness or death. PM10 is a major component of indoor air pollution and forest fires.3 The International Agency for Research on Cancer classifies both outdoor air pollution and particulate matter, a major component of ambient air pollution, as Group 1 carcinogens, causing cancer in humans.
PM2.5 is often considered even more dangerous to human health because of its ultrafine size. Not only can PM2.5 penetrate deep inside the lungs, but it can also enter the bloodstream, causing a variety of health problems including heart disease and other cardiovascular complications. PM2.5 is often the result of fossil fuel combustion from vehicle exhaust, industrial production and power plants, as well as from natural sources such as windblown dust and volcanic activity.4 PM2.5 pose an especially high risk because they can more easily enter the blood stream and travel through the body to the brain, causing neuro-inflammation by damaging the blood-brain barrier – which is a thin, delicate membrane that protects the brain from toxic substances.5
In Europe and Central Asia, the key sectors responsible for PM 2.5 and PM 10 are residential, commercial, and institutional. The sources of air pollution vary between and within countries. Ambient and household air pollution varies depending on the level of development and availability of energy sources. resources.
Ambient and indoor air pollution is a complex mixture of pollutants that includes particulate matter, ozone, nitrogen dioxide, carbon monoxide and sulfur dioxide. It can also include several other noxious substances, such as benzene or heavy metals, which include arsenic, chromium, lead and mercury. Common indoor air pollution comes from heating or cooking using coal, and or biomass, with insufficient ventilation.
Outdoor air pollution interacts closely with indoor air pollution in homes, schools, health facilities and other spaces, which can be major sources of exposure for children. Common outdoor air pollution comes from fossil fuel combustion, such as coal, industrial processes, open burning of waste and waste incineration, agricultural practices, construction and demolition. Climate change is expected to worsen air quality with increased ground-level ozone and wildfires.
UNICEF’s work on cleaner air for children in Kazakhstan
In Kazakhstan, UNICEF works with government, civil society, and business to support air quality monitoring, train, and empower youth, and give them a platform to raise their voices on air quality issues in their communities and share their knowledge with children.
Recommendations to governments across Europe and Central Asia
UNICEF calls on governments and institutions in countries across the region to devote greater attention and resources to prevent worsening air pollution, support energy efficiency and access to clean energy, support cleaner air measures and protect children from exposure. Particular attention must be paid to addressing the magnified health risks faced by the most vulnerable children.
The policy framework provides national governments and institutions with recommendations on how to protect children.
Walk the talk
- Ensure air quality standards are in line with WHO guidelines.
- Support access to clean energy and the use of cleaner fuels and reduce the dependency on the use of fossil fuels. Promote energy efficiency including expanding district heating, revision of existing building standards for public facilities (schools, kindergarten and hospitals) for children, improved ventilation and insulating of private and public buildings and using energy certification systems and labelling.
- Ban smoking in all public indoor areas, including public transport, workplaces, health institutions, educational and government facilities, universities, retail shops and shopping malls, hospitality and catering facilities, such as restaurants, pubs, bars, hotels, community and sports centres, manufacturing and processing plants, and all public areas in multiple unit dwellings, including lobbies, elevators and stairwells.
- Scale up and expedite the implementation of plans to reduce air pollution at national and municipal levels.
Focus on child-sensitive interventions
- Ensure pollution free zones near schools, kindergartens, and health facilities.
- Set up and maintain air quality monitoring systems nearby kindergartens and schools, and report information to the public and noting levels of air pollution that are dangerous to children and pregnant women.
- Train health providers and professionals to assess child history of air pollution exposure and provide counsel on exclusive breastfeeding, nutrition, exercise, immunization, early screening to detect air pollution-related illnesses and recommend ways to reduce air pollution exposure.
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Mobilize financial resources at national and regional levels to support implementation of air quality plans with focus on child-sensitive interventions, and advocate for greater focus on air quality issues.
Raise awareness and advocate
- Raise awareness of air pollution and its impact on child health
- Collect disaggregated data on the effects and sources of air pollution, with a specific focus on research and recognition for pregnant women, infants and children.
- Advocate for air pollution and its impacts on children to be considered in national climate and environmental policies, such as municipal action plans for air quality, National Adaptation Plans or Nationally Determined Contributions, ensuring inclusion of child-sensitive health commitments and specific air quality targets.
- Incorporate air quality in children’s education and include young people in air quality policy processes development and implementation and enhance awareness among policymakers to inform child-sensitive action on air quality issues including municipal action plans on air quality.
- Air pollution is a children’s rights issue. In 2022 the UN Human Rights Council officially recognized the right to access a clean, healthy, and sustainable environment. Articles 24 and 29 of the Convention on the Rights of the Child include specific protections related to the environment. Article 24 states that every child has the right to the best possible health, including the right to safe drinking water and protection from environmental pollution. Additionally, the UN Committee on the Rights of the Child clarified that to “meet their obligation to adopt measures to ensure that business enterprises respect children’s rights, States should require businesses to undertake child-rights due diligence”. Ensuring the effective prevention of adverse impacts by business on children’s rights also contributes to the achievement of the Sustainable Development Goals, namely Goals 8 and 12.
[1] Heft-Neal, S. et al., ‘Robust Relationship Between Air Quality and Infant Mortality in Africa’, Nature, 27 June 2018
[2] Разработанный ЮНИСЕФ Индекс климатического риска для детей *ТЧ2,5 основан на пороговом значении 10 мкг/м3
[3] The National Institute of Environmental Health Sciences: National Institutes of Health, ‘Ozone Alerts’, дата обращения - 12 июля 2016 года
[4] United States Environmental Protection Agency, ‘Health Effects of Ozone in Patients with Asthma and Other Chronic Respiratory Disease’, 2016, дата обращения - 3 августа 2016 года
[5] MacIntyre, E., et al., ‘Air Pollution and Respiratory Infections during Early Childhood: An analysis of 10 European birth cohorts within the ESCAPE Project’, Environmental Health Perspectives, vol. 122, no. 1, 2014, pp. 107–113, дата обращения - март 2021 года
[7] IPCC. Climate Change 2021: The Physical Science Basis. In: V Masson-Delmotte, P Zhai, A Pirani, SL Connors, C Péan, S Berger, et al. editors. Contribution of Working Group I to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press (2021).
Highlights
Children are uniquely vulnerable to air pollution, with devastating effects on their health and development. Scientific evidence shows air pollution contributes to adverse birth outcomes including preterm births and low birth weights, infant mortality, damaged lung function, illness and diseases including asthma, cardiovascular disease and cancer, and an increased risk of neurological disorders.
The right to clean air is far from the reality for children and young people in Europe and Central Asia.