‘Children who go to daycare are extra susceptible to air pollution’

Exposure to particulate matter and other air pollutants increases the risk of diseases ranging from bronchiolitis in babies to Covid-19 in the elderly.

“The tightening of the low-emission zone in Brussels may be challenged,” says Professor Daan Van Brusselen, pediatrician at the GZA hospitals in Antwerp. ‘The tightening was intended to further reduce air pollution in the city by banning even more cars. But anyone who jeopardizes that plan puts the health of children at even greater risk. That cannot be the intention.’

Babies with RSV

Van Brusselen publishes with a number of colleagues in the European Journal of Pediatrics a study showing that air pollution plays a striking role in the appearance of bronchiolitis in children: a chronic infection of the lower respiratory tract, which can cause a feeling of shortness of breath and fever.

It mainly affects babies, who often require hospitalization. Pollution makes children more susceptible to infections with viruses, such as the infamous respiratory syncytial virus, RSV for short.

‘RSV bronchiolitis is the most frequent cause of hospital admission in children in the Western world and one of the most important worldwide,’ says Van Brusselen.

‘In the winter, the children’s wards of hospitals are full. There are medical options in the pipeline, such as vaccinating mothers or administering antibodies to newborns, but the fact that an improvement in air quality can prevent hospitalization due to bronchiolitis unfortunately remains underexposed.

‘It is important that policymakers who make decisions about low-emission zones in cities are aware of this.’

Unfortunately, Antwerp is a suitable city for research into the link between air pollution and child health. In The Lancet Planetary Health a study was published showing that the city is among the world’s record holders for nitrogen oxide pollution – a factor from traffic exhaust fumes that influences the amount of particulate matter in the air.

Van Brusselen and his colleagues specifically investigated whether there is a link between the occurrence of bronchiolitis and the place where a child lives. They found a striking link between the extent to which children were exposed to ‘coarse particulate matter’ in the past month and the chance that they would end up in hospital with bronchiolitis.

Moreover, they were able to show that the effect is greatest among children who go to daycare. It is possible that daycare centers are generally located on busier streets than the children’s homes, making the effect more important, but this would have to be confirmed by traffic studies. In any case, it is clear that air pollution can endanger the health of babies.

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The link between air pollution and bronchiolitis has to do with the fact that particulate matter and other pollutants cause chronic damage to the respiratory tract, making it easier for viruses such as RSV to infect the body. The same effect plays an important role in susceptibility to Covid-19.

In the trade magazine Cardiovascular Health it was shown that 15 percent of coronavirus victims worldwide would still be alive if they had not had to deal with chronic air pollution. For our country, with its ubiquitous air pollution, the figure was as high as 21 percent, especially in the older population categories.

Last year, scientists from KU Leuven submitted Science of the Total Environment a direct link between the prevention of serious coronavirus infections and various aspects of air pollution in Brussels – the city that now wants to weaken its low-emission zone policy. In Environmental Research A study by Dutch researchers will soon be published showing that particulate matter and nitrogen pollution increased both the incidence and severity (the rate of hospital admissions) of corona infections.

By the way, it is not just about nitrogen oxides from traffic. Ammonia emissions from agriculture also increase the risk of serious infections. Traffic and agriculture reinforce each other in their disastrous effect on public health.

The trade magazine Science recently presented a long list of infections and conditions that can be caused by air pollution. Pollution can affect ‘most organs’ in our body and induce ‘a wide range of physiological changes’, causing organs to function less well and develop symptoms.

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Asthma in children

Into the analysis Science highlights a discrepancy between the air pollution standards proposed by the World Health Organization (WHO) and those of the European Union (EU). In the fall of 2021, the WHO lowered “safe standards” for particulate matter and nitrogen oxides, although it indicated that even at concentrations below those standards, health concerns could emerge.

The lowered threshold values ​​had a major effect on the European situation. According to EU standards, less than 1 percent of the European urban population was exposed to excessive air pollution, but according to the new WHO standards it was no less than 97 percent.

Colleagues of pediatrician Van Brusselen reported that not a single school in Antwerp meets the WHO standards for air quality. Asthma in children is one of the conditions related to air pollution.

In 2020, around 275,000 people in the EU are said to have died from exposure to particulate matter, but analysts at Science point out that the effects could be much higher, especially because the impact of chronic exposure to lower concentrations of pollutants is systematically underestimated.

From a public health perspective, action against air pollution cannot therefore be strict enough. Unfortunately, the fight for a better living environment in Europe in recent months, under pressure from farmers’ and other lobbies, has been hit hard.

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