Physicians see children with respiratory problems more often than any other chronic health problem, and children are relatively more likely to be hospitalized due to respiratory problems.

Children are particularly vulnerable to respiratory conditions because of their developmental stage and physical differences from adults.

What can you do personally to prevent exposures?

What can we do
as a society?

Respiratory Health Effects

What is the concern regarding children’s respiratory health?

Air-borne pollution is of concern because of the universality of human exposure. Both indoor and outdoor air quality contribute substantially to the burden of illness from asthma and other respiratory problems in children. Physicians see children with respiratory problems more often than any other chronic health problem, and children are relatively more likely to be hospitalized due to respiratory problems. Asthma incidence in children under age fifteen has increased fourfold in the last fifteen years in Canada. Despite improvements in Canadian air quality, pollution, from local and transboundary sources, significantly affects respiratory health among people in Ontario, the southern Atlantic provinces and British Columbia.

What substances can affect respiratory function?

Among the major substances that are harmful to the developing respiratory system are indoor air contaminants, such as environmental tobacco smoke (ETS), combustion products, volatile organic compounds (VOCs), biological compounds and allergens. A number of other pollutants in outdoor air are present in the Canadian environment at levels of concern, including the criteria air pollutants, such as particulates, ground-level ozone, sulfur dioxide, oxides of nitrogen (NO_x) and various air toxics.

How are children exposed to air pollution?

Because children breathe more rapidly and inhale more air per breath compared to adults and because they spend more time outdoors being physically active, they tend to be more exposed to outdoor air pollution than do adults. Children spend up to 80% of their time indoors and are therefore also highly exposed to indoor air contaminants. Their breathing zone is lower than adults so they are more exposed to vehicle exhausts and heavier pollutants that concentrate at lower levels in the air.

What are the potential health effects from air pollutants?

A variety of contaminants, in both indoor and outdoor air, are associated with respiratory problems in children. The adverse respiratory effects range from subtle, non-specific symptoms such as sore throat and redness to increased cough and wheeze, increased rates of asthma attacks, increased physician and hospital visits or admissions, permanent reduction in lung capacity and an increased risk of Sudden Infant Death Syndrome (SIDS).

Ozone and particulates appear to have no threshold in relation to respiratory effects and are responsible for tangible increases in respiratory illness. Long-erm exposure to high levels of air pollutants is associated with significant effects on lung function and may predispose children to developing chronic respiratory problems. Indoor air pollutants also contribute to persistent or recurrent respiratory symptoms, infections and allergies. Certain biological allergens are the suspected cause of asthma, and many others will exacerbate or trigger asthmatic episodes.

Why are children more vulnerable to effects from air pollutants?

Children are particularly vulnerable to respiratory conditions because of their developmental stage and physical differences from adults. Children’s lungs and airways are immature and especially susceptible to insults from pollution. The developing lungs present a large surface area through which pollutants may be easily absorbed. Children breathe faster and therefore inhale and absorb a relatively greater volume of contaminants compared to adults.

What can you do personally to prevent exposures?

One strategy for improving indoor air quality once problems are identified is to "eliminate, separate and ventilate," whether this refers to ETS, chemicals, or biological compounds. It is difficult to prevent exposure to outdoor air pollution, particularly (but not exclusively) in urban areas. As individuals we can be aware of air quality advisories and understand the health risks from being exposed to poor air quality. Parents may also strive to limit children’s strenuous activity outdoors on poor air quality days, especially if their child has pre-existing respiratory problems.

What can we do as a society to prevent these exposures?

We have substantial evidence demonstrating the links between air pollution and respiratory health problems in children. Respiratory health effects are indisputably preventable. However, adequate protection of children’s respiratory health rests upon changes at a societal level. Indoor air quality is a virtually unregulated part of a child’s environment. With the exception of smoking bylaws that prohibit a child’s exposure to ETS in schools, daycares and other public buildings, children’s protection lies with the discretion of others. People need to be aware of the effects on indoor air quality of the choices and activities in their daily lives.

Outdoor air quality also requires societal solutions to protect children’s respiratory health. Lifestyle changes centred on reducing our use of vehicles are one approach. Fundamental to a societal response, however, are regulatory changes to improve air quality. CAPE joins other medical groups in calling for Canadian governments to establish more stringent standards to limit emissions from industry and vehicles as well as more effective enforcement practices. Because air pollution is a transboundary phenomenon, it also requires that the Canadian government be urged to reach agreements with the United States to reduce emissions south of the border.

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