08 Aug 2019

Toxic air quality is responsible for the vast majority of child deaths worldwide — especially in densely populated regions such as Asia and Africa. That critical aspect is often overlooked when discussing air pollution as a major environmental health threat.

A new study, first-authored by Nihit Goyal, a postgraduate doctoral (PhD) student from the Lee Kuan Yew School of Public Policy, aims to spotlight less developed or Low-to-Middle-Income countries (LMICs), which are becoming increasingly exposed to adverse environmental stresses — showing the strong correlation between air pollution, particularly due to human activity and infant mortality.

“A lot of analysis on the harmful effects of air pollution in less developed countries typically comes from studies conducted in developed or advanced countries. But it’s not clear whether what has been found in developed countries can be extrapolated to LMICs,” points out Goyal.

“Our research, specifically looks at less developed countries and suggests that particulate matter (PM2.5) due to human activity is more harmful than naturally occurring dust and sea-salt.”

Over 2.5 million children die annually within the first 28 days of birth, with three out of four of these neonatal deaths occurring in Southern Asia and sub-Saharan Africa. The study reveals that rising air pollution is a key factor for the continuing high rate of neonatal and child mortality in LMICs.

The research sample consisted of information on approximately 500,000 children from 43 LMICs.

The research sample consisted of information on approximately 500,000 children from 43 LMICs. Children in the sample experienced an average PM2.5 level nearly two and a half times the World Health Organisation (WHO) recommended guideline of 10 micrograms per cubic meter of air. (10 μg/m3). About half of this exposure was due to naturally occurring dust and sea-salt, whereas half was from mainly carbon-based sources.

The results indicate that children with higher exposure to ambient PM2.5 without dust and sea-salt face substantially higher odds of neonatal mortality, even at levels well below the WHO standards. Therefore, the study argues for a new WHO guideline for PM2.5 from carbon-based particles with a lower threshold than the current recommendation of 10 μg/m3.

LMICs at disadvantage

The latest WHO report on Air Pollution and Child Health, claims that 93% of all the children in the world live in areas where air pollution levels exceed global standards. It calculates that one-quarter of all children who die before reaching five years of age do so because they have been directly or indirectly exposed to harmful environmental situations.

While 52% of children under the age of five in High-Income countries are exposed to ambient air pollution, the report claims that the percentage of children exposed in LMICs in South and East Asia regions is as
high as 99%. The risk factor for children being raised in the Middle East and African nations is 100%.

A key challenge facing less developed countries is the lack of research on the ground to show the link between harmful air pollution and infant deaths. Goyal says the study aims to bridge this gap.

“It is difficult to establish what the air pollution level is in LMIC countries due to problems in getting data on the ground. We addressed the problem by using data sets that combine satellite imagery with computer models and ground based monitoring. We merged this data on fine particulate pollution with another data set on child health to understand the relationship.”

Human activity leading cause

While the study does not focus on climate change, it does state human related activities are the main cause for the hazardous effects on the environment.

The United Nations Environment Programme (UNEP) has identified five major sources of air pollution:households, industries, transport, agriculture and wastes.

According to the UNEP, energy production is a leading source of air pollution. Coal-burning power plants are a major contributor, and diesel generators are a growing problem in areas that are off the grid. Industrial processes and solvent use, in the chemical and mining industries, also pollute the air. In Asian and Africa cities, household air pollution is the main cause, which comes from the indoor burning of fossil fuels, wood and other biomass-based fuels for cooking, heating and lighting homes.

“Whatever is accelerating climate change is generally also worsening air pollution, hence affecting human health broadly and child health specifically,” adds Goyal. “Given the severity of the problem, the economic cost of not doing anything is too high. It’s definitely a complex issue, but at the same time things can be done and need to done. We are talking about millions of lives and the health impact is huge.”

Need for action

Governments in less developed nations need to make a conscious shift towards a more sustainable energy and environment, in addition put in place measures that drastically reduce toxic air quality.

The solution lies in ensuring countries have adequate access “to modern cooking fuels, to low-carbon electricity, and alternative modes of transport such as trains and electric vehicles. It’s not just about short-term regulation or legislation, but about creating an environment in which human activities that cause air pollution can be minimised,” says Goyal.

Policies that aim to reduce air pollution in LMICs could contribute significantly to reducing neonatal mortality from the level of 28 per 1000 births observed in the study’s sample. If effective, such policies would help to meet the Sustainable Development Goal of lowering neonatal mortality below 12 per 1000 children by 2030.

“The biggest obstacle is really addressing the connection between the economy, energy, and the environment. The solutions may differ from country to country,” adds Goyal. “We need a concerted effort at mobilising public opinion on the direction to get us there in a manner that is inclusive and doesn’t adversely impact human development.”

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