The effects of air pollution on children.

Air pollutants have been documented to be associated with a wide variety of adverse health impacts in children. These include increases in mortality in very severe episodes; an increased risk of perineonatal mortality in regions of higher pollution, and an increased general rate of mortality in children; increased acute respiratory disease morbidity; aggravation of asthma, as shown by increased hospital emergency visits or admissions as well as in longitudinal panel studies; increased prevalence of respiratory symptoms in children, and infectious episodes of longer duration; lowered lung function in children when pollutants increase; lowered lung function in more polluted regions; increased sickness rates as indicated by kindergarten and school absences; the adverse effects of inhaled lead from automobile exhaust. These impacts are especially severe when high levels of outdoor pollution (usually from uncontrolled coal burning) are combined with high levels of indoor pollution. In developed countries, where indoor pollution levels are lower, increasing traffic density and elevated NO2 levels with secondary photochemical and fine particulate pollution appear to be the main contemporary problem. By virtue of physical activity out of doors when pollution levels may be high, children may experience higher exposures than adults. Air pollution is likely to have a greater impact on asthmatic children if they are without access to routine medical care.