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Review
. 2021 Jul;148(1):1-14.
doi: 10.1016/j.jaci.2021.05.006.

Air pollution and lung function in children

Erika Garcia  1 , Mary B Rice  2 , Diane R Gold  3
Affiliations
Review

Air pollution and lung function in children

Erika Garcia et al. J Allergy Clin Immunol. 2021 Jul.

Abstract

In this narrative review, we summarize the literature and provide updates on recent studies of air pollution exposures and child lung function and lung function growth. We include exposures to outdoor air pollutants that are monitored and regulated through air quality standards, and air pollutants that are not routinely monitored or directly regulated, including wildfires, indoor biomass and coal burning, gas and wood stove use, and volatile organic compounds. Included is a more systematic review of the recent literature on long-term air pollution and child lung function because this is an indicator of future adult respiratory health and exposure assessment tools have improved dramatically in recent years. We present "summary observations" and "knowledge gaps." We end by discussing what is known about what can be done at the individual/household, local/regional, and national levels to overcome structural impediments, reduce air pollution exposures, and improve child lung function. We found a large literature on adverse air pollution effects on children's lung function level and growth; however, many questions remain. Important areas needing further research include whether early-life effects are fixed or reversible; and what are windows of increased susceptibility, long-term effects of repeated wildfire events, and effects of air quality interventions.

Keywords: Children; FEV(1); FVC; air pollution; biomass; gas stoves; lung function; wildfire.

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Conflict of interest statement

Conflict of Interest:

None declared.

Figures

FIGURE 1
FIGURE 1
Hypothetical lung function trajectories depicting normal and reduced growth and early decline (figure adapted from McGeachie et al)., (a) Normal pattern of lung function growth. (b) Reduced prenatal growth with postnatal growth tracking at a fixed percent predicted lower than normal. (c) Normal growth until late teen years, when peak lung function growth is reduced, and lung function begins to decline early. (d) Reduced growth and (e) reduced growth with early decline. Both (d) and (e) can result in levels of lung function consistent with diagnosis of chronic obstructive lung disease.
FIGURE 2
FIGURE 2
Examples of current or potential air pollution interventions at various intervention levels.
See this image and copyright information in PMC

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