ETC HE Report 2022/22: Environmental health risks to children and adolescents: an umbrella review on indoor and outdoor air pollution

This report relates to the ETC technical proposal WP 2.1 to assess impacts on health and well-being from exposure to air and water pollution, environmental noise, chemicals and a changing climate in Europe. In this report the results of an umbrella review related to the effects of indoor and outdoor air pollution on children and adolescents with a separate evaluation of intervention studies.

03 Mar 2023

Alberto Castro (Swiss TPH), Ron Kappeler (Swiss TPH), Sarah Kienzler (UBA), Meltem Kutlar Joss (Swiss TPH), Michelle Laeremans (VITO), Dietrich Plass (UBA), Martina Ragettli (Swiss TPH), Martin Röösli (Swiss TPH), Ana Maria Scutaru (UBA), Kerttu Valtanen (UBA), Karen Van de Vel (VITO), Natasha Wauters (VITO)

Children are particularly vulnerable to environmental factors including indoor and outdoor air pollution. In order to present the state-of-the-art knowledge for the health effects for children related to outdoor and indoor air pollution, scoping reviews followed by umbrella reviews is conducted. Thereby, intervention studies are included as a special case of evidence generation as they may directly point to solutions to improve the situation. Prioritization of topics among numerous potential health risks and pollutants is based on available evidence, potential health impact on population level, potential individual health risks for exposed children, possibility to conduct interventions and specificity of the topic for children in Europe. For ambient air pollution there is strong evidence for effects on mortality, respiratory endpoints such as development of asthma, decreased lung function and lung function development, and respiratory infections. Similarly strong evidence exists for the development of asthma and severe asthma attacks in relation to secondhand smoke exposure. Further, studies provide reliable evidence for children exposed to mould to be at risk for a number of health outcomes of the respiratory tract including development of asthma, exacerbation of asthma, allergic rhinitis and wheeze. For numerous other outcomes there are indications of health effects, although uncertainty remains about causality. These health effects amount to substantial burden of disease in Europe. Unfortunately data on the effectiveness of interventions to reduce exposure levels and/or health risks in children are scarce. There is thus an urgent need for a better understanding of which interventions are most useful to prevent environmental health problems in European children. In future reports health effects in children from other research areas such as noise, climate change and chemicals will be dealt with.