In 2015, 5.9 million children under age five died. The major causes of child deaths globally are pneumonia, prematurity, intrapartum-related complications, neonatal sepsis, congenital anomalies, diarrhea, injuries and malaria. Most of these diseases and conditions are at least partially caused by the environment, the World Health Organization (WHO) reports.
WHO estimated in 2012 that 26% of childhood deaths and 25% of the total disease burden in children under five could be prevented through the reduction of environmental risks such as air pollution, unsafe water, sanitation and inadequate hygiene or chemicals.
Children are especially vulnerable to environmental threats due to their developing organs and immune systems, smaller bodies and airways. Harmful exposures can start as early as in utero. Furthermore, breastfeeding can be an important source of exposure to certain chemicals in infants; this should, however, not discourage breastfeeding which carries numerous positive health and developmental effects. Proportionate to their size, children ingest more food, drink more water and breathe more air than adults. Additionally, certain modes of behavior, such as putting hands and objects into the mouth and playing outdoors can increase children’s exposure to environmental contaminants.—“Don’t Pollute My Future”
The report, Don’t pollute my future! The impact of the environment on children’s health, provides a comprehensive overview of the environment’s impact on children’s health, illustrating the scale of the challenge. Every year:
570,000 children under 5 years die from respiratory infections, such as pneumonia, attributable to indoor and outdoor air pollution, and second-hand smoke. 92% of the global population, including billions of children, live in areas with ambient air pollution levels that exceed WHO limits. More than three billion people are exposed to household air pollution from the use of solid fuels.
Air pollution accounts for more than 50% of the overall disease burden of pneumonia which is among the leading causes of global child mortality. Growing evidence suggests that air pollution also adversely affects cognitive development in children and early exposures might induce development of chronic disease in adulthood.
361,000 children under 5 years die due to diarrhea, as a result of poor access to clean water, sanitation, and hygiene.
270,000 children die during their first month of life from conditions, including prematurity, which could be prevented through access to clean water, sanitation, and hygiene in health facilities as well as reducing air pollution.
200,000 deaths of children under 5 years from malaria could be prevented through environmental actions, such as reducing breeding sites of mosquitoes or covering drinking-water storage.
200,000 children under 5 years die from unintentional injuries attributable to the environment, such as poisoning, falls, and drowning.
Globally, road traffic injuries killed 135,000 children under 15 years in 2012. Among young people aged 15 to 29 years road traffic injuries are the leading cause of death. Half of all deaths on the world’s roads are among those with the least protection, including cyclists and pedestrians. The global average for the disease burden (in DALYs) of road traffic accidents in children under five attributable to environmental factors is 41% (24-65%), based on an expert survey. (DALYs—disability adjusted life years—is a weighted measure of deaths and disability or, if specifically mentioned, of premature mortality.)
A polluted environment results in a heavy toll on the health of our children Investing in the removal of environmental risks to health, such as improving water quality or using cleaner fuels, will result in massive health benefits.—Dr Maria Neira, WHO Director, Department of Public Health, Environmental and Social Determinants of Health
For example, emerging environmental hazards, such as electronic and electrical waste (such as old mobile phones) that is improperly recycled, expose children to toxins which can lead to reduced intelligence, attention deficits, lung damage, and cancer. The generation of electronic and electrical waste is forecasted to increase by 19% between 2014 and 2018, to 50 million metric tonnes by 2018.
Worldwide, 11–14% of children aged 5 years and older currently report asthma symptoms and an estimated 44% of these are related to environmental exposures. Air pollution, second-hand tobacco smoke, and indoor mould and dampness make asthma more severe in children.
In households without access to basic services, such as safe water and sanitation, or that are smoky due to the use of unclean fuels, such as coal or dung for cooking and heating, children are at an increased risk of diarrhea and pneumonia.
Children are also exposed to harmful chemicals through food, water, air and products around them. Chemicals, such as fluoride, lead and mercury pesticides, persistent organic pollutants, and others in manufactured goods, eventually find their way into the food chain. And, while leaded petrol has been phased out almost entirely in all countries, lead is still widespread in paints, affecting brain development.
A companion report, Inheriting a Sustainable World: Atlas on Children’s Health and the Environment reveals that a large portion of the most common causes of death among children aged 1 month to 5 years—diarrhea, malaria and pneumonia—are preventable by interventions known to reduce environmental risks, such as access to safe water and clean cooking fuels.
Reducing air pollution inside and outside households, improving safe water and sanitation and improving hygiene (including in health facilities where women give birth), protecting pregnant women from second-hand tobacco smoke, and building safer environments, can prevent children’s deaths and diseases.
WHO suggests that multiple government sectors can work together to improve the following:
Housing: Ensure clean fuel for heating and cooking, no mould or pests, and remove unsafe building materials and lead paint.
Schools: Provide safe sanitation and hygiene, free of noise, pollution, and promote good nutrition.
Health facilities: Ensure safe water, sanitation and hygiene, and reliable electricity.
Urban planning: Create more green spaces, safe walking and cycling paths.
Transport: Reduce emissions and increase public transport.
Agriculture: Reduce the use of hazardous pesticides and no child labor.
Industry: Manage hazardous waste and reduce the use of harmful chemicals.
Health sector: Monitor health outcomes and educate about environmental health effects and prevention.