Children’s health is often neglected when it comes to air pollution. Many people know that air pollution causes heart disease and lung cancer in adults, but fewer know how it impacts their children. For infants and children, air pollution increases risk for premature birth, low birth weight, impaired lung development, and asthma (1, 2, 3). These health effects have long-term consequences because damage caused by air pollution in childhood can impact people for all of their lives (2).
What is PM2.5 Air Pollution?
Which air pollutants cause diseases in children? The pollutant most to blame is PM2.5 air pollution. PM2.5 pollution is made up of tiny, invisible particulates with a diameter of less than 2.5 microns – many times smaller than the diameter of a human hair. (4)
The particles in PM2.5 pollution are so small that they can penetrate deep into the lungs when they are inhaled and they can enter the bloodstream. Once they are in the bloodstream, they can reach every organ in the body to cause damage to tissues and cells (4, 5).
PM2.5 and Children
PM2.5 is harmful to people of all ages but is especially dangerous for children. Compared to adults, children’s bodies are more susceptible to PM2.5 pollution (1, 6). Because of this, PM2.5. can cause many negative health effects in children including asthma, reduction in brain volume, behavioral dysfunction, ADHD, Autism Spectrum Disorder (ASD), and impaired lung growth. A mother’s exposure to PM2.5 during her pregnancy increases the risk of premature birth, low birth weight, and stillbirth (7-10).
There is also growing evidence that PM2.5 pollution decreases children’s intelligence (11). Performance IQ (PIQ), the type of intelligence that enables children to solve problems and react to new situations, seems to be the form of intelligence most strongly affected by air pollution. IQ scores are highly correlated with academic performance, standardized test scores and high-school graduation rates, and thus loss of IQ caused by air pollution prevents children from attaining their full potential.
What are the Sources of PM2.5 Air Pollution?
Massachusetts sources currently emit around 2,500 tons of PM2.5 pollution each year. Most of this pollution is produced by the combustion of fossil fuels (12). Combustion of gasoline and diesel fuel in cars, trucks, and other vehicles is responsible for about 15% of PM2.5 pollution in Massachusetts. Nearly all of the rest (more than 85%) comes from stationary sources such as industrial facilities and electricity generating plants (13).
Significance of Air Pollution and Children's Health
Air pollution exposure in early childhood can have long-term consequences. Children who are born prematurely or with low birth weight because of a mother’s exposure to air pollution during pregnancy are at high risk of cardiovascular disease, kidney disease, hypertension, and diabetes later in life (14, 15). Similarly, stunted lung growth caused by air pollution can result in impaired lung development and put children at higher risk for chronic respiratory diseases. Lung injury caused by air pollution also puts individuals at higher risk of hospitalization and death from respiratory infections like COVID-19 (16).
Children Don't Choose
Most air pollution is caused by human action and specifically by the burning of fossil fuels – coal, oil and gas. (12). Fossil fuel combustion accounts for 85% of PM2.5 pollution and nearly all pollution by nitrogen oxides and sulfur oxides. Fossil fuel combustion is also the major cause of climate change.
Children have no voice in decisions about whether to burn fossil fuels and yet they are the members of our society who suffer the most serious consequences from these decisions. Moreover, it is our children and their children who will suffer the greatest injury from climate change – the major long-term consequence of fossil fuel combustion. It is morally imperative that we do our best to protect children from the adverse effects of a world they didn’t create.
Children Are the Future
Perhaps the most important reason why we must protect children from the dangers of air pollution is that they represent the future of our society. If we can confront air pollution now, then we will allow the next generations to flourish and tackle even bigger issues that the world so desperately needs.
It is incredibly important to think of our children’s health when addressing air pollution. Air pollution-related diseases will impact children’s health for the rest of their lives.
Fortunately, the US has had success in this field before. When it was recognized in the 1960s and 1970s that airborne lead from leaded gasoline was decreasing children’s IQ, lead was removed from gasoline. As a result, children were far less exposed to the pollutant and there was an average IQ gain of 5 points per child across the United States (17). The US made great leaps and bounds in the health of our children when lead pollution was recognized. It’s high time for Massachusetts to put forth the same effort toward PM2.5.
1. Goldizen, F. C., Sly, P. D., & Knibbs, L. D. (2015, July 24). Respiratory effects of air pollution on children. Pediatric Pulmonology 2016; 51: 94-108. doi/full/10.1002/ppul.23262
2. Gauderman WJ, Urman R, Avol E, Berhane K, McConnell R, Rappaport E, Chang R, Lurmann F, Gilliland F. Association of improved air quality with lung development in children. N Engl J Med. 2015 Mar 5;372(10):905-13. doi: 10.1056/NEJMoa1414123.
3. Buka, I., Koranteng, S., & Osornio-Vargas, A. R., The effects of air pollution on the health of children, Paediatrics & Child Health 2006; 11: 513–516, https://doi.org/10.1093/pch/11.8.513
4. World Health Organization. (2021). Ambient Air Pollution: Pollutants. World Health Organization https://who.int/airpollution/ambient/pollutants/ Accessed January 30 2022
5. Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., ... & Pelizzari, P. M. (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2224-2260.
6. Donzelli, G., Llopis-Gonzalez, A., Llopis-Morales, A., Cioni, L., & Morales-Suárez-Varela, M. (2019). Particulate matter exposure and attention-deficit/hyperactivity disorder in children: A systematic review of epidemiological studies. International Journal of Environmental Research and Public Health, 17(1), 67. doi:10.3390/ijerph17010067
7. Sram RJ, Veleminsky M, Veleminsky M, Stejskalová J. The impact of air pollution to central nervous system in children and adults. Neuroendocrinology Letters. 2017 Jan 1;38(6):389-96.
8. Thygesen M, Holst GJ, Hansen B, Geels C, Kalkbrenner A, Schendel D, Brandt J, Pedersen CB, Dalsgaard S. Exposure to air pollution in early childhood and the association with attention-deficit hyperactivity disorder. Environmental Research. 2020 Apr 1;183:108930.
9. Volk HE, Lurmann F, Penfold B, Hertz-Picciotto I, McConnell R. Traffic-related air pollution, particulate matter, and autism. JAMA Psychiatry. 2013 Jan 1;70(1):71-7.
10. Volk HE, Perera F, Braun JM, Kingsley SL, Gray K, Buckley J, Clougherty JE, Croen LA, Eskenazi B, Herting M, Just AC. Prenatal air pollution exposure and neurodevelopment: A review and blueprint for a harmonized approach within ECHO. Environmental Research. 2020 Oct 22:110320.
11. Landrigan PJ, Fisher S, Kenny ME, Gedeon B, Bryan L, Mu J, Bellinger D. A replicable strategy for mapping air pollution’s community-level health impacts and catalyzing prevention. Environmental Health, in press.
12. International Energy Agency (IEA) (2016), World Energy Outlook 2016. IEA, Paris https://www.iea.org/reports/world-energy-outlook-2016. Accessed January 30, 2022
13. US Environmental Protection Agency. National Emissions Inventory. Available at https://gispub.epa.gov/neireport/2017/. Accessed February 23, 2022
14. Wilcox AJ. On the importance—and the unimportance— of birthweight, International Journal of Epidemiology 2001; 30: 1233–1241, https://doi.org/10.1093/ije/30.6.1233.
15. Heindel JJ, Balbus J, Birnbaum L, Brune-Drisse MN, Grandjean P, Gray K, Landrigan PJ, Sly PD, Suk W, Cory Slechta D, Thompson C, Hanson M. Developmental Origins of Health and Disease: Integrating Environmental Influences. Endocrinology, 2015 Oct; 156 (10):3416-21.
16. Dey, T., & Dominici, F. (2020, December 30). COVID-19, air pollution, and racial inequity: Connecting the dots. American Journal of Sociology 2010;
17. Gilbert SG, Weiss B. A rationale for lowering the blood lead action level from 10 to 2 microg/dL. Neurotoxicology. 2006 Sep;27 (5):693-701. doi: 10.1016/j.neuro.2006.06.008.