Air pollution and children: What we know and what more we need to know - Professor Jonathan Grigg
There is overwhelming evidence that outdoor fossil-fuel derived air pollution has major effects on children’s health. The most robust evidence is related to pulmonary effects, including increased risk of pneumonia, suppression of lung growth, and the development of asthma. Emerging associations that need more evidence to be convincing are effects on the brain and endocrine system. Understanding of mechanisms has lagged behind these epidemiological data, but the recent observation that carbon particles are excreted in the urine of children offers an explanation for effects on organs remote from the lung. An integrated national policy is needed to reduce exposure of all children, but until this happens, there is emerging evidence that awareness of exposure hot spots may help to reduce exposures of the most vulnerable children.
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Air pollution and children: What we know and what more we need to know - Professor Jonathan Grigg
- 1. Air pollution and children’s health what we know and what we need to know Jonathan Grigg Queen Mary University of London
- 4. PM10 = less than 10m
- 6. the modern pollution mix has long-term effects
- 10. increased exposure - lower lung function
- 11. Kulkarni N et al. N Engl J Med 2006;355:21-30 NEJM 2006 355:21-30 Induced sputum
- 15. Rennard 2015 Lancet reduced lung function – long term effects
- 17. Thorax 2006
- 18. PM2.5 and pneumonia EHP MacIntyre et al January 2104
- 19. What do we need to know? • new adverse health effects • communicating evidence • reducing personal exposure of children – emissions – behavior
- 20. • quantify the burden of neurodevelopmental disease in children attributable to PM2·5 air pollution • quantify the burden of pre- term birth and low birth weight attributable to PM2·5 air pollution
- 22. Reducing personal exposure by changing behavior
- 23. • reduce or avoid strenuous, outdoor exercise on high pollution days • stay away from pollution hotspots • if you cycle, run or walk as part of your commute, use back streets • if you have asthma, use your preventer inhaler regularly
- 25. personal exposure to black carbon
- 26. cleaner routes – medical student study
- 28. apps
- 29. Students – preliminary results B C 1 B C 2 0 1 0 0 0 2 0 0 0 3 0 0 0 4 0 0 0 5 0 0 0 B C ng/m3per60s N O 1 N O 2 0 5 1 0 1 5 2 0 2 5 N O µg/m3per60s
- 30. Children with asthma after BC feedback – preliminary
- 31. Tackling emissions • do low pollution zones/traffic management reduce children’s exposure?
- 32. in real world emissions.. Real-world exhaust emissions from modern diesel cars ICCT 2014
- 33. Real-world exhaust emissions from modern diesel cars ICCT 2014 ...diesel is a valid target
- 36. less background pollution results in improved lung function
- 37. conclusions • fossil-fuel air pollution has a wide range of long- and short-term adverse effects in children • diesel is especially bad • policy must be evidence-based • clinicians should become advocates for healthy air
- 38. Thank you