Air Pollution Is a Fatal Threat to Children in Europe

FRANCE — Air pollution causes more than 1200 premature deaths per year in people under the age of 18 years in Europe and significantly increases the risk of disease later in life, according to European Environment Agency (EEA) air quality assessments.

"Children and adolescents are particularly vulnerable to air pollution, because their bodies, organs, and immune systems are still developing," wrote the EEA.

So, "[m]ore needs to be done to protect the health of children and adolescents from the negative impacts of air pollution."

Impact of Pollution

Maternal exposure to air pollution during pregnancy is linked to low birth weight and risk for preterm birth.

In addition, children's lung function and lung development are affected by air pollution, especially by ozone and nitrogen dioxide (NO₂) in the short term and by fine particles (PM_2.5) in the long term.

After birth, ambient air pollution increases the risk for several health problems, including asthma, reduced lung function, respiratory infections, and allergies.

It also can aggravate chronic conditions like asthma, which afflicts 9% of children and adolescents in Europe, and increase the risk of some chronic diseases later in adulthood.

Reducing Emissions Insufficient

Under the European Green Deal's Zero Pollution Action Plan, the European Commission set the 2030 goal of reducing the number of premature deaths caused by PM_2.5 (a key air pollutant) by at least 55% compared with 2005 levels. Exposure to PM_2.5 is a leading cause of stroke, cancer, and respiratory disease.

The results obtained are encouraging: Emissions of key air pollutants have declined over recent decades, a very positive trend with real-world effects. In 2020, the number of premature deaths attributable to exposure to fine particulate matter above the World Health Organization (WHO) guideline level fell by 45% in the EU-27, compared with 2005.

Despite improvements over past years, the level of key air pollutants in many European countries remains stubbornly above WHO health-based guidelines, especially in central-eastern Europe and Italy.

Urban Exposure

According to measurements obtained in more than 4500 monitoring stations across Europe, in 2021, upwards of 90% of the EU's urban population was exposed to harmful levels of NO₂, ozone, and PM_2.5.

More precisely, 97% of the urban population was exposed to concentrations of PM_2.5 above the 2021 WHO annual guideline of 5 µg/m³.

According to preliminary data from 2022, central-eastern Europe and Italy reported the highest concentrations of PM_2.5 due primarily to the burning of solid fuels like coal for domestic heating and industrial use.

Of the 375 cities included in the EEA's European City Air Quality Viewer, the cities of Faro, Portugal; Umeå, Sweden; and Uppsala, Sweden were ranked as the three cleanest. They had the lowest average levels of PM_2.5 over the past two calendar years.

The two highest ranking French cities were Saint-Denis (on the island of Réunion in the Indian Ocean off the African coast, 14th), and Brest (18th). Their PM_2.5 concentrations were 5.8 μg/m³ and 6.8 μg/m³, respectively. Paris was 210th on the list (11.2 μg/m³).

Improving Air Quality

To help reduce children's exposure to air pollution, the EEA recommends that air quality be improved around settings like schools and childcare facilities and during activities such as school commutes and sports.

In many cities, urban planners are working to come up with designs that follow this guidance.

Establishing "clean air zones" around schools can reduce the concentration of pollutants found around them. Lower pollution levels can be achieved through restrictions on traffic, such as no-idling zones around schools, "school streets" (traffic is banned at the start and end of the school day in the immediate vicinity of the school), or relocation of drop-off and pick-up points away from school entrances.

The design of school and childcare facilities can contribute to minimizing children's exposure to air pollution while onsite. Ventilation is certainly an important consideration. But just as much thought should be given to the most frequented rooms or areas, ensuring that they are located as far away from road traffic as possible. As for outdoor spaces, playgrounds should be shielded behind buildings, walls, or 'green' infrastructure (ie, using plants).

This article was translated from the Medscape French Edition.

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