Prevalence of Health Impacts Related to Exposure to Poor Air Quality Among Children in Low and Lower Middle-Income Countries

Abstract

This rapid review provides an assessment of the contemporary health impacts arising from household and ambient air pollution exposure in low income (LIC) and lower middle-income countries (LMICs), with a specific focus upon children aged under 5 years. The WHO estimates that urban air pollution levels increased by 8% from 2008-13 and 97% of cities in LICs and LMICs with over 100,000 inhabitants exceed WHO air quality guidelines; thereby contributing to global health inequity. Air pollution is recognised to exert adverse acute and chronic health effects throughout the human life course, from before birth, through childhood, adulthood and later life. Although overall levels of air pollution have declined in High-Income Countries (HICs) over the past 25 years, they have continued to increase in LIC and LMIC settings, notably the African, South-East Asia, Eastern Mediterranean and Western Pacific regions. Quantifying the association between pollutant exposure and distribution of specific disease outcomes, provides the best available information for policymakers and facilitates public communication concerning air pollution risks. Globally, using available health and demographic data sources it has been estimated that among children aged under 5 years in 2016 air pollution was responsible for 543,000 deaths, including 403,000 deaths from Acute Respiratory Lung Infections and 37 million total Disability Adjusted Life Years.