Helping children breathe easier

Olivia, 5, and Ethan, 14, are children from different families, but they have common health issues — asthma and allergies — that are affected by exposure to air pollution.

Born prematurely, Olivia* also has developmental delays and frequently experiences bouts of pneumonia. Both are breathing a little easier with help from the team at the Children’s Environmental Health Clinic in Edmonton, the only program of its kind in Canada.

“Olivia is on medication now . . . [but] the biggest thing is the lifestyle choices we are making with the information that we’re getting,” says Samantha,* Olivia’s mother.

Similarly, Ethan’s parents say his health has improved because they’ve learned about the many environmental factors that trigger his attacks and how to manage his asthma better.

The need to raise awareness about air quality and the negative impact on children’s health is the focus of a new report from the World Health Organization (WHO) that saw significant input from the team at the clinic, the only WHO Collaborating Centre in Children’s Environmental Health in Canada and the only Canadian contributor to the document.

There are significant outdoor and indoor air pollution issues in Alberta, and they’re increasing, says Dr. Irena Buka, director, Children’s Environmental Health Clinic.

The increase in outdoor air pollution is due to growth in vehicle traffic and more Canadians buying larger vehicles that release higher emissions. Other factors are industrial emissions and the rising number of forest fires that occur throughout the province every year.

“Smoke from wildfires is a huge concern for growing and developing lungs,” says Irena.

Ethan knows what it’s like to be exposed to severe smoke. He was an evacuee of the Fort McMurray wildfire in 2016. Although it didn’t make his asthma worse, the air quality in the city prompted his parents to bring him to the children’s clinic. Besides smoke, outdoor elements such as traffic exhaust and snow mould can set off his asthma.

Children in rural areas across the province are also at risk of exposure to pesticides and to dust from gravel roads and harvesting.

When it comes to indoor air pollution, the key concerns in Alberta are off-gassing from consumer products and dust, says Irena. From new cabinets and furniture to cleaning solutions and personal care products, countless household items contain chemicals that pose health risks for people of all ages. Children are especially vulnerable because they put their mouths on objects and play on the floor — activities that expose them to chemicals concentrated in dust.

The WHO report — Air Pollution and Child Health: Prescribing Clean Air — looks at the scientific evidence about the effects of air pollution on children’s health and offers recommendations for healthcare professionals. While most people associate air quality with respiratory problems like those Olivia and Ethan experience, its impact is much broader. Studies have shown links between air pollution and adverse birth outcomes, neurodevelopmental delays and disorders, childhood cancers and many other health issues. Evidence also suggests that children who are exposed to air pollution before birth are more likely to develop diseases later in life, says Irena.

Many children’s disorders also likely have an environmental component, says Lesley Brennan, PhD, clinical assistant, Children’s Environmental Health Clinic. That component may contribute to the severity of a child’s illness, additional symptoms or another disease or disorder occurring at the same time.

Critical to protecting children is educating families about steps they can take to limit exposure to pollutants. It’s a continuing conversation Irena and Lesley have with families as they learn more from growing research in the field. At the top of the list is monitoring the Alberta Air Quality Health Index to see when it’s safe for children to be outdoors. Other measures include keeping the home free of dust and mould, avoiding scented cleaning products and choosing toys carefully.

“The conversation [with parents] isn’t meant to cause fear or anxiety. It’s really about informed decision-making and being mindful,” says Megan McDonald, RN, unit manager for the clinic.

Olivia’s parents say it’s been reassuring to know there are things they can do for their daughter besides administering her puffer, antihistamines and other medications. They’re gradually making changes in their home and lifestyle to control the environment around Olivia as best as they can, including buying wooden and fabric toys, switching to metal and wooden kitchen utensils and dishes and from Teflon to cast iron frying pans, buying organic food and cleaning with non-toxic products.

“There’s a budget, . . . but we’ve learned that it matters. Every little thing matters,” says Robert,* Olivia’s father.

For Ethan’s parents, using air purifiers in the house, both upstairs and downstairs, is one action that's helpful. They also regularly check the Air Quality Health Index for Fort McMurray and keep Ethan indoors on days when the health risk is high.

“We’ve learned so much in regards to [Ethan’s] asthma . . . even how to use the puffer properly,” says Shawna, Ethan’s mother. “It’s been a real blessing to be part of [the clinic].”

As they get older, Olivia and Ethan will continue to have regular respiratory readings and check-ups at the clinic. And their parents will continue to take advantage of the information and support they receive to keep their children on track with their health and development.

“It just gives us a better feeling, knowing that Ethan’s well looked after,” says Matt, Ethan’s father.

“Things are progressing, maybe not at the same rate as other kids, but they’re moving forward,” says Robert.

Although the WHO report was written for healthcare professionals and policymakers, anyone with an interest in health issues affecting children can read and learn from it, says Lesley. The report is available online from the WHO website.  

*Olivia, Samantha and Robert are pseudonyms we are using to respect the family’s request for privacy.