Nine-year-old Ella Kissi-Debrah died in 2013 from a massive asthma attack caused by exposure to pollution levels above those recommended by the World Health Organization. This was recognized in late 2020 by the South London Forensic Court, which for the first time linked a death directly to environmental pollution, marking a historic legal milestone with the ruling. “The decision in Ella’s case is very significant as it recognizes that exposure to dangerous levels of air pollution from the area in which she resided had materially contributed to the girl’s death. Currently, more than 70,000 studies examine the relationship between health and pollution. The evidence is overwhelming. What we want is that no politician, no responsible for actions related to air quality, can tell us that he did not know all this. That I didn’t have the information”, explains María Neira, director of the Department of Public Health and the Environment of the WHO, who recalls that asthma is one of those red lights that alert the population. , making it more aware of the link between human health and air quality.
Each year, seven million deaths occur worldwide linked to exposure to polluted air, an invisible killer which, although it does not always manifest its effects immediately, has very serious health effects. Neira says that the WHO is very concerned about the huge repercussions it has on the health of boys and girls, not only at the level of the respiratory system, but also at the level of the central nervous and cardiovascular systems. “We must bear in mind that the toxic substances that are in the air are so small that they not only enter our respiratory system, but the so-called PM2.5 particles, the smallest, have the ability to enter all our organs, with effects on cognitive, neurological, psychomotor development, at the behavioral level. These particles have been shown to cross the placental barrier and can affect the central nervous system of the developing fetus,” he points out.
According to Ferran Campillo and Lopez, pediatrician specializing in environmental health at the Hospital of Olot Comarcal de la Garrotxa, the first impact appears before birth, with an increase in premature or low birth weight births. Already in childhood, says Campillo, deterioration of lung function is associated with an increased risk of bronchitis, recurrence or asthma, and has even been linked to the risk of certain types of childhood cancer. It also very significantly affects their neurological development: “It has been observed that children exposed to poorer air quality do less well in school and may have more behavioral problems. This has a huge impact on an individual level as it reduces their chances of thriving in the future, but also vis-à-vis society as a whole, reducing talented minds and increasing the number of addicts”. The damage does not stop at this stage of life. It can also manifest later: “Those who were exposed to poor air quality during childhood would show an increase in cardiovascular diseases such as heart attacks or strokes in adulthood.”
Mobility changes that affect health
Population mobility has changed in recent decades: we have more cars on the road and we live farther from where we work and study. This has an impact on air quality, but also in terms of noise, increased accidents and occupation of public space, according to Ferrán Campillo i López. An exclusive survey by El País, published last February, revealed that more than 190,000 children under the age of 12 attend schools in Madrid or Barcelona in areas where pollution levels are higher than allowed.
From the Spanish Association of Pediatrics, Environmental Health and Health Promotion Committees published in 2019 Walking to school: a model for innovation in children’s health and the environment, a review of the scientific evidence that walking to school should make available to primary care paediatricians and school communities. The objective of the audit is the promotion of active transportation for the protection of health. For the pediatrician, it must be emphasized that children who go to school by car not only have poorer air quality inside cars compared to those who walk or cycle , but also, children who walk or cycle to school struggle with a sedentary lifestyle and overweight or obesity. “The round trip to school can represent two thirds of the physical activity recommended by the WHO. Important aspects such as socializing with neighbours, parents or other children are also lost and they achieve personal autonomy at a later age,” he explains. Is it worse to walk or ride a bike because of rush hour pollution? “Several studies have looked at this question and the conclusion is often the same: the benefits of physical activity outweigh the disadvantages of air pollution. And the fact is that, moreover, if we don’t do this, there is no way to break the vicious circle: because there is poor air quality, I go by car, which increases the air pollution,” responds Campillo i López.
We are already seeing the effects of changes in mobility: one in three Spanish children is overweight or obese, increasing the risk of preventable diseases such as diabetes, cancer or cardiovascular disease; and also one in three new cases of asthma in urban areas is due to poor air quality linked mainly to motorized traffic. María Neira insists that pollution, together with lifestyle (diet and sedentary lifestyle) and tobacco, are the three most important risk factors for human health. “WHO air quality standards have been revised downwards and, although they are not legally binding, the truth is that many countries are taking action with this in mind. citizens knowing the levels of pollution is also a crucial step in terms of raising awareness, as well as knowing the impact that our mobility has on health,” he argues.
What is in the hands of families
That we are harming the health of an entire generation is as obvious as it is overwhelming. Aware of this, many families around the world have participated in recent years in initiatives that try to change this terrible scenario. Internationally, particularly in the United Kingdom and the United States, there are networks such as Parents for future, Mums for lungs, Our kids Climate, Mères au front, Moms for Clean air or Mothers out front. In Spain, mothers for the time o The school revolt is a good example of activism for children’s health and the environment. Yetta Aguado, spokesperson for both movements in Madrid, is optimistic because while she believes it is true that there is a general perception that we cannot change what is happening, she also believes that “the message penetrates slowly”. What can families do? She replied that Mothers for Climate and School Revolt work on three axes: raising awareness of other families who are unaware of the health risks that exist, demanding decisive political action and taking legal action when necessary.
Initiatives such as these may seem like a silent cry, but María Neira considers it a cry that is gaining strength because she believes that nothing can mobilize a society more than the health of children. “You protect your child from all possible dangers and then, when you leave him at school, the place where he will learn and develop, you expose him to pollution that damages his brain. All of this is very paradoxical. When families understand that mobility and pollution have an impact on the health of their children, a movement begins to be generated. And this movement, irreversible and growing, helps us a lot,” says Neira, who recalls that in addition to raising awareness among other families, the most important thing is to use our vote to bring about real change. “We must vote for those who have a good plan against pollution. As citizens, we must ask for a livable city in which there is a good public transport network, as polluting as possible, which offers pedestrian routes and cycle paths”.
Ferrán Campillo i López also considers that moving away from the source is only a temporary measure, that we need a deep transformation of our cities. “If we want fewer cars, motorbikes and trucks, we have to remove spaces and turn them into places to walk, cycle, play or sit in the shade of a tree. Active mobility is a very powerful public health tool, but so is investing in agile, attractive and emission-free public transport. Whether there is traffic on a street that affects the health and safety of our children depends on the administration, in particular the municipalities. As citizens, we must demand these changes so that in the near future seeing cars in front of a school will seem anachronistic to us,” he concludes.
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