Over 1.25 lakh children in India below the age of five died in 2016 due to the impact of polluted air and almost one in five children who die from toxic air exposure across the world is from India, a new study by the World Health Organisation has said.
The WHO report, titled ‘Air Pollution and Child Health: Prescribing Clean Air’, found that polluted air inside households — generated from burning fossil fuels for cooking, lighting and heating — contributed to the deaths of about 67,000 children below the age of five in India in 2016. The study also said that outdoor air pollution, specifically PM2.5, caused by vehicular and industrial emissions and a host of other factors, accounted for nearly 61,000 deaths among children of that age group in 2016.
The WHO study, which examined the toll on children breathing hazardous levels of both outdoor and household air pollution, focused on dangerous particulate matter with a diameter of smaller than 2.5 microns (PM2.5). These include toxins like sulfates and black carbon, which pose the greatest health risks since they penetrate deep into the lungs or cardiovascular system.
In a large majority of the cases — over 1.01 lakh — children were found suffering from the combined effects of bad air quality inside as well as outside their houses, according to the report. This was almost one-fifth of the nearly 5.43 lakh deaths of children of that age globally due to the combined effects of indoor and outdoor pollution.
Both indoor, as well as outdoor air pollution, lead to respiratory tract infections, but the causes, or the chemicals involved, are different.
“In India, nearly 65 per cent of homes still use biomass fuel for cooking and there are studies that show a positive association between household air pollution and problems among children,” Sundeep Salvi, chair of the Chronic Respiratory Diseases group for Global Burden of Diseases (India) said. The report described household air pollution as “the single largest environmental health risk factor worldwide”.
Amongst children in the age group of 5 to 14 years, over 7,200 deaths in India in the year 2016 could be attributed to the joint effects of indoor and outdoor air pollution, said the report.
According to the WHO, India was among the countries where over 98 per cent of all children below five years of age live in areas that exceed the WHO air quality standards. It said that nearly 93 per cent of children below 15 years across the world, or nearly 1.8 billion of them “breathe air that is so polluted it puts their health and development at serious risk. Tragically, many of them die.”
“Children are uniquely vulnerable and susceptible to air pollution, especially during fetal development and in their earliest years. Their lungs, organs and brains are still maturing. They breathe faster than adults, taking in more air and, with it, more pollutants. Children live closer to the ground, where some pollutants reach peak concentrations,” said the report.
“They may spend much time outside, playing and engaging in physical activity in potentially polluted air. Newborns and infants, meanwhile, spend most of their time indoors, where they are more susceptible to household air pollution. Children spend much time near their mothers while the latter cook with polluting fuels and devices… Their bodies, and especially their lungs, are rapidly developing and therefore more vulnerable to inflammation and other damage caused by pollutants,” it said.
Many children develop adverse health impacts even before they are born. “When pregnant women are exposed to polluted air they are more likely to give birth prematurely and have low birth-weight children. Recent evidence about the effects of birth-weight on child growth and cognitive development has major implications for India,” said Kalpana Balakrishnan, one of the scientific advisers of the WHO report, in an email response.
“Recent studies in India provide estimates of the effects of birth-weight that are consistent with the global pool of evidence from ambient and household air pollution literature. Including air pollution as a risk factor within maternal and child health programmes is extremely important,” said Balakrishnan, who is director of WHO collaborating centre at Sri Ramachandra University, Chennai.
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