Air pollution continues to wreak havoc on the health of the population of Earth, charting new ground to become an even stronger menace than ever before. With a population over 1 billion, India saw a whopping 2.1 million deaths related to air pollution. A new report by the State of Global Air (SoGA), produced for the first time in partnership with UNICEF this year, finds that children under five years old were especially vulnerable to air pollution, with health effects including premature birth, low birth weight, asthma and lung diseases. In 2021, exposure to air pollution was linked to more than 700,000 deaths of children under five years old, making it the second-leading risk factor for death globally for this age group, after malnutrition.
In 2021, India (169,400 deaths) saw the largest numbers of air pollution death among children under 5 due to air pollution followed by Nigeria (114,100 deaths), Pakistan (68,100 deaths), Ethiopia (31,100 deaths), and Bangladesh (19,100 deaths). More than 7,00,000 deaths globally in children under 5 years were linked to air pollution which represents 15% of all global deaths in children under five. Of the 7 lakh deaths in children, a staggering 5 lakh were linked to household air pollution due to cooking indoors with polluting fuel, mostly in Africa and Asia.
Why are children more at risk?
Some of the greatest health impacts of air pollution are seen in children. The report suggests that children are uniquely vulnerable to air pollution. The damage from air pollution can start in the womb with health effects that can last a lifetime. For example, children inhale more air per kilogram of body weight and absorb more pollutants relative to adults while their lungs, bodies and brains are still in development.
Exposure to air pollution in young children is linked to pneumonia, responsible for 1 in 5 child deaths globally, and asthma, the most common chronic respiratory disease in older children. The inequities linked to the impact of air pollution on child health are striking. The air pollution-linked death rate in children under the age of five in East, West, Central and Southern Africa is 100 times higher than their counterparts in high income countries. Air pollution– linked asthma has the highest health impacts on children between 5–14 years of age, especially in high-income countries.
Death of Ella Kissi-Debrah
On February 15, 2013, nine-year-old Ella Kissi-Debrah died of a fatal asthma attack in London, UK. She is the first person in the world to have air pollution listed as part of the cause of death on her death certificate. She had over 30 emergency hospital admissions between the first diagnosis of asthma and her death, just over two years later. Throughout her short life and illness, there had been no mention of air pollution being a possible factor in relation to her illness.
On Ella’s original death certificate it said she died of acute respiratory failure. At no point in her illness did any medical professional mention that air pollution could be an asthma trigger, alongside traditional triggers such as pollen or the weather. Dr. Stephen Holgatea, consultant respiratory physician at the University of Southampton, examined Ella’s medical papers and came to the conclusion that in his opinion the severity of her asthma, and also her death, were linked to the high levels of air pollution in the area where she lived.
Damage to the health due to Air Pollution:
The SoGA Report also offered a detailed analysis of recently released data from the Global Burden of Disease study from 2021 which includes data from nearly 200 countries. It highlights the severe health impacts that pollutants like outdoor fine particulate matter (PM2.5), household air pollution, ozone (O3), and nitrogen dioxide (NO2) are having on human health around the world.
With populations over 1 billion each, India (2.1 million deaths) and China (2.3 million deaths) together account for 54% of the total global disease burden. Disease burden is the impact of a health problem on a given population.
Air pollution from PM2.5 and ozone was estimated to contribute to 8.1 million deaths [95% UI: 6.7–9.5] — about 12% of the total global deaths — in 2021. PM2.5 air pollution comes from the burning of fossil fuels and biomass in sectors such as transportation, residential homes, coal-burning power plants, industrial activities, and wildfires.
More than 90 per cent of these global air pollution deaths – 7.8 million people – are attributed to PM2.5 air pollution, including from ambient PM2.5 and household air pollution.
In 2021, nearly 50% of all ozone-related COPD deaths were in India (237,000 deaths) followed by China (125,600 deaths) and Bangladesh (15,000 deaths). COPD (Chronic obstructive pulmonary disease () is a chronic inflammatory lung disease that obstructs airflow from the lungs.
For the first time, this year’s report includes exposure levels and related health effects of nitrogen dioxide (NO2), including the impact of NO2 exposures on the development of childhood asthma. Traffic exhaust is a major source of NO2, which means densely populated urban areas, particularly in high-income countries, often see the highest levels of NO2 exposures and health impacts.
Is progress is being made?
The report was not all grim news however as it also revealed that since 2000, the death rate linked to children under five has dropped by 53 per cent, due largely to efforts aimed at expanding access to clean energy for cooking, as well as improvements in access to healthcare, nutrition, and better awareness about the damage caused by household air pollution. Many countries, particularly those experiencing the highest levels of air pollution, are finally tackling the problem head on.
Several countries in regions like Africa, Latin America, and Asia, are taking measures such as installing air pollution monitoring networks, implementing stricter air quality policies, or reducing traffic-related air pollution by encouraging the use of hybrid or electric vehicles rather than Internal Combustion Engines, all of which are having measurable impacts on pollution and improving public health.
While progress is being measured, more can be done to stop air pollution from continuing to outrank other health risks as one of the biggest threats to millions of lives.
The State of Global Air is a research and outreach initiative to provide reliable, meaningful information about air quality around the world. The Health Effects Institute (HEI) is an independent, non-profit research institute funded jointly by the U.S. Environmental Protection Agency, industry, and foundations to provide credible, peer-reviewed science on air pollution and health effects to inform air quality decisions.