Quick read: Position statement on air pollution in the UK
Royal College of Paediatrics and Child Health 2024
1. The issue
Case study: Awaab Awaab Ishak, a two year-old living in Rochdale, tragically died in December 2020 due to severe respiratory problems caused by exposure to black mould in his home, despite his father repeatedly raising the issue with his housing provider. His death has prompted legal reforms known as “Awaab’s Law,” requiring timely repairs for damp and mould in social housing.
Exposure to air pollution is the second leading risk factor for death in children under 5, both globally and in the UK.1 Fine particulate matter (PM2.5) and nitrogen dioxide (NO2) are responsible for a significant proportion of air pollution’s health impacts.2,3 The UK government and devolved nations have not yet committed to meeting the 2021 WHO Air Quality Guidelines, which outline air pollution limits designed to protect public health. UK sources of PM2.5 emissions in 2022
UK sources of NOx emissions in 2022
Source
%
Source
%
Domestic woodburning
22%
Road transport (tailpipe)
30%
Road transport (road/tyre/ brake wear)
18%
Combustion in energy industries
19%
Industrial processes and product use
17%
Non-road transport (air/ rail/shipping)
15%
Child health impacts of air pollution Stage Gestation
Infancy
Childhood
Compiled using data from: Martel E, 2024 ‘Emissions of air pollutants in the UK’ Defra
Pollutants from outdoors enter buildings and impact indoor air quality. Air quality inside buildings is also influenced by building design, construction materials, furnishings, dust, mould, pets, plants, and activities such as cooking, cleaning, smoking, and woodburning.
Adolescence
Short term
Longer term
• Foetal growth and development • Low birth weight • Preterm birth
• Early life mortality • Chronic disease in later life
• Respiratory infections
• Infant mortality
• Asthma • Reduced cognitive function • Skin and eye irritation
• Lung growth and function • Brain development and maturation
• Narrowing of arteries • Psychotic experiences • Metabolic disturbance
• Cardiovascular disease • Obesity • Type 2 diabetes
Compiled using evidence summarised at: www.rcpch.ac.uk
2. Why it matters
Health inequalities: Structural inequalities cause certain groups, especially socioeconomically disadvantaged households, to suffer disproportionately from air pollution. The most deprived 20% of neighbourhoods in England experience higher air pollution levels than the least deprived, even after adjusting for other factors.
Children are especially vulnerable to air pollution because they inhale more air than adults in proportion to their body weight, breathe closer to ground-level sources of air pollution such as vehicle exhausts, and are less able to control their exposure than adults.1 Case study: Ella Ella Kissi-Debrah, a healthy child, developed severe asthma at 7 years old, which was worsened by breathing polluted air, especially from traffic emissions near her home in Southeast London. This led to her tragic death at age nine. Her death certificate is the first in the world to list air pollution as a cause of death and her case highlights the critical need for stricter air quality measures and better education on the health impacts of air pollution.
Economic impact: Outdoor air pollution incurs significant economic losses, costing $2.9 trillion globally and 2.6% of the UK’s GDP annually, while also burdening healthcare systems. In 2017-19, an estimated 7% of paediatric asthma admissions in London were linked to spikes in air pollution.4 Achieving WHO air quality guidelines could boost the UK economy by £1.6 billion per year. 1