Climate change and children's health
The University of California Center for Climate, Health and Equity and the University of California, San Francisco (UCSF) Academic Senate Committee on Sustainability are co-hosting a series of online seminars, focused on the impacts of climate change at different life stages.
The first in the series was Children’s unique vulnerability to climate change, hosted by Dr Pooja Singal, and a recording is available now.
Climate change in San Francisco
Dr Lisa Patel, executive director of The Medical Society Consortium on Climate and Health, in the US, and clinical associate professor of paediatrics at Stanford School of Medicine, gave the first presentation.
Patel said climate change is no longer a future threat, but something that is profoundly affecting health now. For example, Patel works in the San Francisco Bay area, where wildfires are an increasing issue.
Patel is a paediatrician working in a hospital, attending deliveries and working in the neonatal intensive care unit (NICU). She described a particularly intense wildfire season when the sky in the Bay area turned orange and the smell of smoke reached inside the NICU. “Infants of 32 weeks and up were breathing that very foul pollution,” she said.
Smoke was not the only impact from the wildfires. One night, the hospital’s electricity supply was cut off unexpectedly. Some areas of the hospital had back-up power but others didn’t. In the post-partum unit, patients who had just delivered their babies were walking around in the dark.
Air pollution
Air pollution during wildfire season is often very noticeable but Patel also highlighted the pollution caused by the burning of fossil fuels, which can be exacerbated by heat. When someone who is pregnant breathes in PM2.5 (particulate matter less than 2.5 micrometres in diameter), it crosses the placenta and studies have found evidence of it in the brain, lungs and liver of the foetus.
Breathing in these tiny particles triggers inflammation and Patel said there is good evidence that fossil fuel pollution is a driver for poor health, such as heart disease, asthma, stroke and lung cancer.
Dr Karen G Duderstadt, clinical professor at UCSF School of Nursing gave the second presentation at the event.
Duderstadt highlighted that in addition to the risk of exposure to air pollution and PM2.5 during pregnancy, exposure in children is linked to the development and worsening of asthma, and neurocognitive effects.
Monitoring air pollution has become important in the Bay area, and Duderstadt reported advising families on air quality sensors.
Why are children more vulnerable?
Vulnerability is often described as having three elements – sensitivity, exposure, and adaptive capacity. Patel looked at these in the context of children’s vulnerability to hazards such as air pollution and heatwaves.
Young children are particularly sensitive, as their lungs, brains and immune systems are developing. There are also important differences in physiology, for example, children breathe faster than adults.
Children are often more exposed to hazards such as heat, as they may be more likely to spend time outdoors.
In terms of adaptive capacity, children rely on the people caring for them for a great deal of their safety and comfort. A small child left in a hot car can’t simply get out. An infant can’t take off blankets if they are too hot.
Another important factor in adaptive capacity is the capacity of the family. Families may not have the resources to pay for indoor air filtration devices or to run air conditioning.
Heat-related illness
Burning fossil fuels causes air pollution, but it is also driving climate breakdown, leading to more extreme weather events. As temperatures increase and heatwaves become more common, so do heat-related illnesses.
Duderstadt said that children are more vulnerable to extreme heat, in part because they absorb more heat than adults and have a lower rate of sweat production. Severe heat stress symptoms in adults are more easily recognised than those in children and adolescents.
Infants are more likely to die in their first week of life if they are born during a heatwave. Patel said that in the last heatwave in the area, with temperatures of 110-112 Fahrenheit (43-44 Celsius), she asked the people in her care whether they had air conditioning at home. When one family said they did not, the healthcare team worked with social services to find a family for them to stay with temporarily. Patel said it was important for healthcare providers to be aware of the issues around infants and heat, and to feel equipped to ask appropriate questions to make sure infants and families remain safe.
Patel and the other speakers highlighted that the impacts of factors such as heat and air pollution are not borne equally. In thinking about climate change and health, it’s vital to understand and focus on the people who will be most affected.
Vector- and water-borne diseases
Duderstadt reported a change in the vector-borne diseases being seen in the US. As temperatures rise, there is an increase in the range of vectors (such as mosquitoes) and the length of seasons. She said children tend to be more vulnerable due to their behaviours during play, the time they spend outdoors, and also the potential for play near contaminated water sources.
San Francisco General Hospital has seen several of the commonly cited vector-borne diseases – including Zika and cases of malaria despite preventive treatment. Duderstadt said that West Nile virus is becoming more common in the southwest and south, there have been cases of dengue in Texas and Florida, and rare cases of Chikungunya.
Duderstadt also highlighted that areas on the Atlantic coastline have seen a 24% increase in illness related to Vibrio in the past ten years.
Mental health and toxic stress
Climate change is often described as a risk multiplier, taking existing stressors, such as poverty, housing and food insecurity, or mental ill-health, and making them worse. Toxic stressors, especially those experienced by young children, are often associated with physical and mental health issues in later life.
Patel concluded, “What I worry about as a paediatrician is that climate change really disrupts a child’s ability to live in a safe, stable and nurturing environment. […] Within the United States alone, we expect, with coastal erosion and the way that weather patterns are playing out, that 11 million people could be on the move. And what that means for the stability of our society and for children’s health in particular, is deeply important to the lifetime of their health.”
Further resources
The recording of this webinar, Children’s unique vulnerability to climate change, is available on YouTube.
A recording of the second webinar in this series, Climate change effects on adult reproductive and occupational health, is also available.
Visit the Medical Society Consortium on Climate and Health website.
The Pediatric Environmental Health Specialty Units website.
The California Nurses for Environmental Health and Justice website.