“Air pollution is never recorded as a direct cause of death. It’s always a contributing factor,” says Dr Aparna Birajdar, a consultant pulmonologist in Pune. She adds that it is difficult to get data on the impact of air pollution in India because doctors are overworked and have little time to research, while most lung infections are multi-factorial. This is why air pollution and its health consequences are rarely addressed with the urgency they demand. 

Moreover, studies of air pollution’s effects largely focus on adults, with data on children scarce. In 2019, air pollution caused about 6.7 million deaths globally, and almost 85% were attributed to non-communicable diseases (NCDs), including asthma, heart disease and lung cancer. While NCDs accounted for 63% of total deaths in India in 2018, government data on children such as the Health and Family Welfare Statistics 2023 was restricted to infant mortality, vaccinations, and HIV cases. The 2024 annual WHO India report does not mention air pollution in any context. 

In an earlier article, we focused on the health hazards air pollution poses to children. Here, we examine long-term measures necessary to mitigate air pollution and its effect on children.

Need for interdisciplinary approach and government action

“Limited data is a challenge, but it should not delay action. The impact of worsening air pollution is affecting children and vulnerable populations the most. The urgency of the crisis calls for immediate, on-ground measures alongside efforts to improve monitoring and research,” says Kritika Choudhary, head of the strategy planning and policy team at Air Pollution Action Group (A-PAG).

Experts emphasise an urgent need for a multi-sectoral approach, science-backed policies, government commitment and citizen action to minimise the child health burden caused by air pollution. “A participatory approach is essential, but it’s not been implemented for the longest time now,” says Ankit Bhargav, co-founder of Sensing Local, an urban living lab in Bengaluru.  

Pollution exposure and children 

City policies must focus on enforcing stringent emission standards, especially to protect children. “Pollutants increase the potency of pollen and pollen can travel many kilometres affecting large areas within the city. So, the impact of air pollution is not less in greener neighbourhoods,” points out Dr Vijay Warad, Director of Indian Allergy Asthma Network, Pune. 

Dr Samantha Castellino, paediatric consultant, Giggles Child Health Clinic, Mumbai says that even if air purifiers are used at home, children are exposed to pollutants during the daily commute to schools. And, schools may not be equipped to mitigate poor air quality.  

Not being able to escape from air pollution, children are forced to adopt lifestyle changes, which may have a detrimental impact in the future. 

Regulated playtime is essential

In high pollution areas, children rarely venture out to play with friends. Reduced playtime affects the physical, cognitive, emotional and social abilities of children.  

With a lack of sunlight, children may be at risk for conditions like myopia, bone pain and deformities. Vitamin D in sunlight is important for eye growth, calcium and phosphate regulation in the body, along with other benefits. Experts also point out that reduced playtime would imply increased screen time, which can contribute to ADHD, sleep disorders, anxiety and other mood disorders. Playtimes are crucial in developing the social skills of children and forming meaningful relationships, without which they may experience loneliness at a very young age. 

On the contrary, the myth that the body gets accustomed to poor air quality reflects a lack of awareness of the severity of the crisis. “Immunity is strengthened with quality air, food and water, so letting children play in a polluted environment will not improve their immunity,” said Dr Prahlad Kadambi, junior consultant neonatology and paediatrics, Apollo Cradle and Children’s Hospital, Bengaluru. 

Read more: Will BCAP pave the way for utilising central clean air funds?

“Eco-anxiety is on the rise among older adolescents. This condition arises from extensive discussions on climate change, with little concrete action,” says Dr Preeti Galagali, Vice President, South Zone, Indian Academy of Paediatrics. She noted that this perceived threat is affecting children’s mental well-being. The academic curriculum must be modified to include more talks on climate change, the policies being implemented and individual action to bring positive change; it must encourage children to learn about the subject, she adds.  

Tangible solutions

A survey conducted by Warrior Moms New Delhi showed that one in three nebuliser customers were parents buying for their children across all zones in New Delhi. The survey indicated a growing dependency on respiratory aids to deal with worsening children’s health due to air pollution.

Bhavreen Khandari, co-founder of Warrior Moms stresses the need for safe spaces for children to walk and play. “Children have no space to walk near their schools and vehicles touch children while moving,” she says, adding that school managements must take responsibility for ensuring traffic-free routes around schools. 

“People avoid school routes during peak hours as they get too congested and polluted. Imagine the plight of children, who don’t have an option, but to commute on this route every day,” adds Bhavreen. 

While air purifiers and lung spaces offer limited relief, practical long-term solutions are necessary to tackle air pollution’s impact on children. “We need to curb all sources of dust and smoke including garbage burning, road projects, construction debris and traffic emissions,” says Dr Arvind Kumar, founder trustee of Lung Care Foundation, New Delhi. 

A survey done by Sensing Local reveals that more than 70% of priority network routes which connect schools, offices and parks, that are conducive for walking, are the most polluted in the city. “Traffic is diverting into residential neighbourhoods to avoid main roads, limiting children’s ability to walk and play freely in their own lanes,” adds Ankit.

The global initiative, ‘Safer routes to schools,’ identifies school zones and improves road safety in that radius. Four schools in Bengaluru’s Malleshwaram are to be a part of this project. It aims to ensure walkability in school areas with effective traffic management, thereby reducing air pollution near schools to some extent. 

Ankit adds that investing just Rs 1,500 crores to improve walkability in Bengaluru will create more less-pollution routes in the city. This in turn will have a positive impact on children’s health.  

Also read:

• Why clean air funds have been stalled, even as Bengaluru air worsens
• Why the national programme for clean air failed a gasping Mumbai
• Study shows TNPCB ill-equipped to monitor the environmental impact of pollution