“All I want is to stand in a field and to smell green, to taste air, to feel the earth want me, without all this concrete hating me!”- Phillip Pulfrey
Imagine lying on a cot with your kid on your roof, gazing at the night sky, searching for constellations, shooting stars.. Hard to imagine I suppose, especially if you are a resident of some big metropolitan city!!
Its that time of the year again; crop burning, traffic pollution, winds, cold weather etc; nothing is in our favor.
Anytime you go outside, there is a haze in the atmosphere. You can feel the air is different. Children are having bad coughs and breathing difficulties.
We have forgotten, infact our children don’t even know what a clear blue sky or a night sky full of stars looks like.
Somehow we conveniently like to blame all this on the government for not taking adequate measures. Majorly its true also but what about hundred other additional factors that we are contributing daily to the air we breathe!! Every time we drive to school/office, use appliances like air conditioners constantly, we make choices that affect air pollution. Infact, even watching online shows increases the carbon footprint significantly.
Quick stats: Did you know that 9 out of 10 people worldwide breathe polluted air ( this is an average statistics, not related to any particular day). WHO estimates an alarming death toll of 7 million people ( out of which 1.8 million are kids) caused by outdoor/indoor pollution.
Quick physiology: Children are more susceptible to harmful effects because of smaller lungs/airways, they inhale more air per unit of bodyweight than adults because of faster breathing rate and they remain active outside for longer periods of time. Body defenses are still developing in young bodies. A child’s pollution exposure is linked to: respiratory illnesses, cognitive impairment, poor growth and even deadly diseases like cancers.
Quick facts: Measurements most commonly used for harmful air pollution refers to “PM ( Particulate Matter). PM is a complex mixture of solids and liquids and includes carbon, complex organic compounds, sulphates, nitrates, mineral dust and water suspended in air. They vary in size. Dust, soot and smoke are larger and visible to naked eye and normally get trapped in nose leading to nasal symptoms. Smaller particles are more damaging. These include PM10 ( size is 10 micron-reach the airways), PM2.5 ( fine particles, size is 2.5 microns- reach the smaller airways and hence are particularly dangerous because they can get lodged in the lungs and cause long term health issues) and PM0.1 (ultrafine particles-toxic chemicals which can reach blood).
What is air pollution?
Harmful particles or gases (Particulate matter-PM, nitrous oxide, sulphur dioxide, ground ozone etc.) in the air that we breathe is air pollution. It is equally important both indoors and outdoors as against the common notion that pollution is only outdoors. Road transport still remains a major cause of outdoor pollution all throughout the year. The most common inside sources in a country like ours is use of wood fuel/biomass fuel and poor ventilation and in developed countries like US is Volatile organic compounds (VOC’s) found in consumer products like chemicals used for cleaning homes, heating/cooking in homes, building materials used in construction (the silent killer) and tobacco smoke.
The long term effects include poor lung function, manifesting as wheezing, prolonged cough, recurrent infections, asthma etc. especially in children and elderly. This even affects the unborn child in utero.
Each one of us is in someway responsible for creating this kind of dangerous situation for our precious one’s life.
Since lots has been written and said about how to reduce pollution, I would instead focus on how you can take precautions to help your little ones breathe easy.
- Monitor Air Quality Index (AQI) daily from a reliable source and then make an informed decision about when to let them go out ( except in case of emergencies). Currently in Delhi it hovers somewhere between 250 to 300. On brighter side, it could be worse (like in China, where it is “Crazy Bad”). So limit/restrict strenuous outdoor activity on poor air quality days or during certain time of days, when it is very bad. Best is to get them to play indoors. Quick guide to AQI (courtesy: American Lung Association)
2. Wear effective protection:
Scarves/sleeves/stoles/normal paper masks/surgical face masks do little to protect, as their pore size is much bigger, so although you might feel protected, this isn’t the case.
Anti-pollution masks/respirators. Are they actually useful or not?
Markets are flooded with all types of face masks. The ability of a respirator to remove contaminants from inhaled air depends on the contaminant, type of filter or adsorbent material, respirator type and conditions of use. Face masks sold for public protection in India do not comply with any standards and so many of the so called anti-pollution masks do not actually provide any protection.
For a mask to be effective, the pore size should be less than 2.5 microns (that is the size of the particles which on inhalation cause harm) i.e. N95/N99 masks (thereby meaning that they filter 95% and 99% of the particles inhaled respectively) and it should be tightly fitting with no leaks (improper fitting mask due to inappropriate size is equivalent to no mask).
With a proper seal, the National Institutes for Occupational Safety and Health (NIOSH), agency certifying respirators in the US, assigns a “protection factor” of 10 to the filtering-facepiece respirators (commonly referred to as a facemask). This means that when properly worn by an individual who has been fit-tested, these respirators are expected to reduce the concentration of the air contaminant inside the facepiece to ≤10% of the concentration outside the facepiece.
In children, sometimes it is difficult to get an appropriate fit and also due to tight fitting, they might feel uncomfortable/claustrophobic. Also it might restrict their ability to communicate and engage in various activities.
So if possible use masks which comply with the standards and your child is comfortable wearing a mask with tight fit but this is actually impractical in most situations especially if a young child < 3 years of age.
3. Minimize exposure and staying indoors: Exposure to ambient air pollutants occurs in both outdoor and indoor environments. The levels of exposure depend on the fractions of time an individual spends in various environments, as well as the concentration of outdoor-source air pollutants in both environments. Indoor pollution is equally dangerous as outdoor.
But still overall ambient pollution is less indoors if all the necessary precautions are taken. Its been seen that closed doors and windows associated with use of air conditioning can reduce air exchange rates by almost 50%.
So the best way to protect kids is
- Stay indoors and keep doors and windows closed unless area around your home is clean and dust free.
- Avoid dry mopping and dusting, cut down exposure to household chemicals
- Do not burn candles, incense sticks and mosquito coils in your homes especially in small rooms.
- Avoid high smoke cooking/stir frying and have a good quality chimney or vent in your kitchen.
- Avoid bringing outdoor pollutants inside, remove shoes at the entrance and make them shower and change clothes after returning to home
- Avoid travelling during rush hours, avoid busy roads and take quiet streets with less traffic. Step back from road if you see a heavily polluted vehicle approaching.
- Avoid playing near high traffic areas or roadsides (even when AQI is good, vehicles on busy roads can create high pollution up to one third of a mile away or around 500 meters). Avoid physical activity on visibly polluted days and don’t stay outside for long periods.
- Say no to tobacco.
4. Cleaning indoor air: The hot topic for debate – to have an air purifier or not?
Multiple studies show that portable filter-based air cleaners have been used to reduce indoor levels of PM2.5, although they completely do not eliminate indoor pollutants. A portable air cleaner with a high CADR (clean air delivery rate) and an activated carbon filter can filter both particles and gases. Portable air cleaners often achieve a high CADR by using a high-efficiency particulate air (HEPA) filter. Generally speaking, higher fan speeds and longer run times will increase the amount of air filtered. The air purifiers do not address the cause of mold and musty odors.
Several studies using portable HEPA air cleaners have demonstrated small improvements in cardiovascular and respiratory health including asthma and allergy symptoms. The improvements are typically small and not always noticeable to the individual, although they may be measurable by your doctor.
Consider placing the unit (with appropriate specification) in the room your child spends the most time in, mostly his bedroom. But remember the key is to reduce indoor pollutants rather than finding ways to remove it.
5. Diet: More evidence is still required for recommending anti-oxidant and Vitamin supplementation. But it seems prudent to encourage kids (esp vulnerable ones) to eat vegetables and fruits rich in anti-oxidants and Vitamins C and E.
For e.g.supplementing diet with anti-oxidants like sulforaphene found in cruciferous vegetables (vegetables that have cross shaped petals) like brussels sprouts, turnip, cabbage, broccoli, cauliflower and vitamins in Melons, oranges, grapes, papaya, tomatoes, lemons. Make them eat healthy so that they build strong immune defenses.
6. Get involved: Last but not the least start by doing your bit to decrease air pollution in your area. Often we blame the government agencies for not taking adequate measures, when infact we are equally contributing to the problem. Taking action at your end is the first step to protect your loved ones from harmful effects of air pollution.
Everyday choices have the power to make a difference, and help protect our environment for a clean and sustainable future.
Breathe Pure, Stay Healthy !!
Dr Garima | themoppetsclinic 🙂
- BreatheLife2030, World Health Organization
- Laumbach et al: What can individuals do to reduce personal health risks from air pollution? J Thorac Dis 2015;7(1):96-107
- EPA: Guide to air cleaners in the home. 2nd edition, July 2018