Pollution hurts everyone. This is known and documented by a great deal of scientific literature. But it hurts children more. And to the little ones in particular. The first thousand days of life, that is, those that go from conception to the completion of the second year, are the most critical, from this point of view.
Because in those first thousand days, the organs, the possible targets of pollutants, are growing very rapidly, because we are talking about structures that are not yet mature, and because given the low body weight of children in that first, crucial phase of life, the absorption of potentially harmful substances is greater.
To safeguard the health of children, present and future, and to reduce the exposure of the pediatric range to air pollution, pediatricians and neonatologists have moved, who have signed the Consensus Document “Air pollution and health. proposals from the pediatric scientific societies and the working group ‘Environment and the first 1000 days to improve the health of children and families “.
A document originating from the “Environment and first 1000 days” research project funded by the CCM, the National Center for Disease Prevention and Control of the Ministry of Health. The document was signed by the main scientific societies and associations that deal with the health of children – Cultural Association of Pediatricians (Acp), the Pediatric Group for a Possible World, the Italian Federation of Pediatric Doctors (Fimp), the Italian Society of Perinatal Medicine (Simp), Italian Society of Neonatology (Sin) and Italian Society of Pediatrics (Sip) – which by signing it undertake to work concretely to reduce air pollution and reduce its impact on children.
“The document focuses on outdoor air pollution, linked to the release of pollutants into the air due to transport, traffic, domestic heating and industrial emissions,” he says. Luca Ronfani, of the maternal and child IRCCS Burlo Garofolo of Trieste and scientific referent of the ‘Environment and first 1000 days’ project. We are therefore talking about atmospheric particulate matter or PM, that is, fine dust, nitrogen dioxide (NO2), ozone. “And also of cigarette smoke, which is not an outdoor pollutant, but is an important harmful agent with a mechanism of action similar to that of outdoor air pollutants. Children must be protected from all this.”
The decalogue to protect children
Let’s start with protection. What can families do to protect children’s health from harmful agents in the air? Here are 10 expert tips (source: edited by: millegiorni.info)
1) Schedule physical activity of at least one hour a day in green spaces. Green plays an important mitigation role in the urban environment, exerts an action of temperature control, of rain falling on the ground, and provides a barrier against noise and atmospheric pollution.
2) Choose active mobility. Always when it is possible to move on foot, by bicycle or on public transport: it is good for health directly (for example, it reduces the risk of obesity) and indirectly, because it reduces emissions from motor vehicle traffic. When walking or cycling with children, always consider routes in less polluted areas and avoid outdoor activities near busy roads and near industrial areas.
3) In summer, avoid outdoor activities from 12 to 18, when ozone levels are highest. Concentrations of ozone increase with increasing temperature.
4) In winter it is better to stay outside the house during the hottest hours. In cold weather, particulate matter (fine dust) condenses and forms aerosol droplets that are more easily inhaled.
5) Find out about the pollution levels in your city to plan activities. In particular, pay attention to the levels of PM10 and summer ozone, consulting the sites of the Regional Environmental Protection Agencies and avoid letting children go out on days with high levels of pollution, especially if suffering from respiratory diseases.
6) Send the children to the neighborhood school so they get used to walking or cycling and avoid schools near busy roads and industries.
7) Children also inhale the emissions of the family car. It is important to know that the concentrations of pollutants inside the car are greater than those outside: those who use motor vehicles breathe a part of their exhaust.
8) Stop smoking if you have a child, if you do not succeed, decrease the number of cigarettes, since for some negative effects of smoking, such as low birth weight or some respiratory problems such as bronchospasm and asthma, there is a dose-response effect: increasing the number of cigarettes increases the risk . If you are unable to quit smoking, join support groups or join specialized interventions to support you on this journey.
9) Do not smoke in the presence of the child and ask others not to. It is important never to expose the child to secondhand smoke, keeping him at a minimum “safety distance” from smokers of at least a few meters.
10) Avoid third-hand smoke for children, that is, do not let them stay where they smoked. The children of smokers are more exposed to diseases even if their parents do not smoke in their presence because toxic residues are deposited on clothes, curtains, carpets, furniture, objects, as well as on the skin and hair of smokers.
The risks: the PiccoliPiù study
These are the tips for reducing the effects of pollution on health. But what are these effects? And how many children are at risk? These questions were answered by the PiccoliPiù study and nine systematic reviews of the scientific literature published on the topic of pollution and pediatric health. Both activities carried out within the Environment project and the first 1000 days.
“PiccoliPiù was conducted on a cohort of 3000 children recruited in 5 Italian cities (Trieste, Turin, Florence, Viareggio and Rome), between October 2011 and March 2015 and followed from intrauterine life and for 7 years following birth. 2011 we collected information on exposures to the most common air pollutants: PM10, PM2.5 nitrogen dioxide, socio-economic conditions, lifestyle, growth and health status of the whole cohort through visits and collection of biological samples. Thanks to ministerial funding, we have analyzed all the data collected over the years, also crossing them with information on the concentration of pollutants in the areas where the children live. The study was completed about six months ago “, says Ronfato.
The result? “The most interesting was that 15% of children are exposed to concentrations above the limits set by law, which in Italy for particulate matter 2.5 (PM2.5) is 25 milligrams per cubic meter. the WHO has also lowered, this means that if the new recommendations of the World Health Organization were followed, the children outside the threshold would obviously be more “, says the pediatrician. “Governments – he continues – should implement the new threshold values recommended by the WHO, which have been updated on the basis of more recent scientific evidence”.
The new WHO guidelines
“The new Air Quality Guidelines of the World Health Organization, published last September 22, have considerably reduced the limit values for long-term exposure to the most harmful pollutants for health, in particular particulate matter. fine (PM2.5) and nitrogen dioxide (NO2), “he says Francesco Forastiere dell’Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College di Londra.
The average annual concentrations of PM2.5 go from 10 to 5 μg / m3 (milligrams per cubic meter), those of NO2, nitric oxide, from 40 to 10 μg / m3, and the average concentration of ozone (for the which there were no recommended limits before today) in the 8 hours in the summer period must not exceed 60 μg / m3. “The values indicated by the WHO are not legally binding but serve to inform national and European Union legislations. These are clear scientific indications – continues Forastiere – pollution is responsible for serious damage to health, especially for childhood, right from the first exposure in pregnancy. There is no alternative to a profound and radical change to protect children and the most vulnerable people “.
And the data
From the nine scientific reviews carried out by “Environment and first 1000 days” it was clear an association between air pollution and respiratory problems (in particular bronchial asthma, frequent infections) and neonatal, and in this case we are talking about low birth weight or of preterm births: conditions that predispose to feeding problems or the need for special care in the first period of life. Less strong is the association between exposure to environmental toxicants and neurodevelopmental problems.
A document in defense of children
That said, we understand the need to sign an agreement between those involved in pediatric health. That is, we understand the reason and the meaning of the Consensus Document. Whose drafters, who are basically children’s advocates, undertake to work for:
– To improve knowledge and skills on climate change and prevention measures through training.
– Inform patients and families about the danger of air pollution, particularly in the presence of clinical conditions that may be caused or exacerbated by air pollution and in the case of residence in areas with high environmental pollution. Including advice on changes that can be made to reduce individual exposure and contribution to pollution.
– Carry out promotion and dissemination activities and promote the issues addressed in the document in other scientific societies that deal with women’s and children’s health.
– Be the first to adopt healthy behaviors and lifestyles and encourage change within your workplace and, more generally, the National Health System.
– Implement political and regulatory advocacy activities, promoting existing initiatives at local and national level to improve air quality.