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Climate change impact may affect kids more severely

New highs of sweltering heat, seasonal forest fires and other ramifications of climate change have undoubtedly created new health crises for most of the world, but a new review points to one demographic that may experience more severe impacts of climate change: kids.

Difference in the way children's bodies metabolize toxins, their increased need for air on a per-pound basis, and variations in how their bodies regulate temperature put them at a higher risk for health problems.

A new review of the impacts of pollution and climate on children, authored by Kari Nadeau, MD, PhD, director of Stanford Medicine's Sean N. Parker Center for Allergy & Asthma Research, and Frederica Perera, PhD, of the Columbia University Mailman School of Public Health, outlines children's health and calls for better understanding and intervention from health professionals.

The paper published June 16 in the New England Journal of Medicine.

"While there has been significant progress in reducing poverty-related environmental risks in recent decades, industrialization-related pollution has steadily increased and every single child in the world is expected to suffer from at least one climate change-related event in the next 10 years -- that's something most people might be shocked to learn," Nadeau said. "Similarly, I think it's particularly striking that about a quarter of deaths among children under 5 globally could be prevented by addressing environmental risks."

Rob Jordan, associate editor at the Stanford Woods Institute for the Environment, and Nadeau discussed the climate-related risks to children's health and how caregivers and health workers can better help curb them.

This Q&A has been adapted from its original version.

What can parents and other caregivers do to minimize their children's exposure to air pollution and climate change impacts?

There are a range of personal and family changes people can make. For example, parents that use electric cars for their family can decrease the likelihood of their child getting asthma by 30%. If a family can reduce eating meat just by one day a week, that can help protect the planet and improve the health of their children. Also, buying a filter like MERV 13 or higher for your home can reduce indoor air pollution. Using electric appliances instead of gas can improve the air that your family breathes by 50%.

What should parents and other caregivers in wildfire-prone areas know about the risk of smoke to children?

There is no safe distance from wildfire smoke. Children need to be inside when wildfire smoke pushes the air quality index, or AQI, above 50, especially children with asthma because their lungs are developing and the smoke can be irreversibly harmful to them. Children should wear well-fitted N95 masks outside during days of wildfire smoke. Being outside in heavy wildfire smoke is similar to smoking cigarettes. In fact, even with an AQI as low as 22, breathing outdoor air for eight hours is like smoking one cigarette in terms of smoke inhalation and exposure to a range of chemicals. That may be hard to believe, but it's a real and compelling reason to switch to clean, renewable energy sources.

What are some of the ways in which children in disadvantaged communities suffer a higher burden from these impacts?

Children of color are as much as 10 times more likely to be exposed to toxins, pollution, and climate change than other children. In the U.S., rates of childhood asthma are twice as high among Black children as white children, likely because of higher concentrations of particulate air pollution in Black communities. These and other environmental impacts, combined with poverty-related stress, injustice and lack of access to health care, add up over a lifetime. They lead to worsened health effects and shortened lifespans.

How should pediatricians and other health professionals think about these issues, and how can we better train them in this regard?

We need to incorporate children's environmental health into primary care and essential public health. For example, when a family visits the pediatrician for a well-child visit and for preventive vaccinations, the pediatrician can speak proactively about the importance of breathing clean air, avoiding wildfire smoke. The pediatrician can ask about access to child-fitting N95 masks and home air filters.

We can engage community health workers and networks to help build awareness on children's environmental health, local environmental assessments, and through their participation in community-led pollution and emission reduction measures, among other initiatives.

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