The nation's leading group of pediatricians has strengthened its stand on the dangers that air pollution poses to children, and offers new recommendations on how to help solve the problem.

"We had a policy statement, but it was a bit old," said Dr. Janice J. Kim, a member of the American Academy of Pediatrics' Committee on Environmental Health and lead author of the new statement. "There has been a lot of new scientific information about the health hazards and health effects related to air pollution."

"The previous focus was on ozone," she said. "Now there is new information on particulate matter and air toxins such as diesel."

Recent studies have found air pollution not only exacerbates asthma in some children, it can negatively affect lung growth and function and lead to increased cases of respiratory tract illness, premature birth and infant mortality.

The academy's statement appears in the December issue of the group's journal, Pediatrics. It updates the previous statement, issued in 1993.

The policy statement is meant to inform physicians and also to provide guidance to government officials and other policymakers who are involved in long-range planning to clean up the air.

Although the Clean Air Act became law in 1970, an estimated 146 million Americans still lived in areas in 2002 where monitored air failed to meet the current standards for at least one of the six "criteria air pollutants," Kim noted in the report. The six are ozone, particulate matter, sulfur dioxide, nitrogen dioxide, carbon monoxide and lead.

For parents, one take-home point is that air pollution could be a trigger for your child's asthma, said Kim, a public health physician with the California Environmental Protection Agency in Oakland.

Among the statement's recommendations: Pediatricians should play a crucial role in educating local and national representatives, policymakers, school sports officials and others about the hazards of air pollution.

The statement also recommends that communities with poor air quality alert local residents about the potential health hazards, that industrial mercury emission levels be lowered, that mass transit and carpools be encouraged, and that older power plants be closed or retrofitted if they don't meet current standards.

New schools should be built away from polluted areas, the doctors also suggested.

Another health-care expert applauded the revised statement.

"The authors are bringing to the clinical forefront what researchers have been preaching for some time," said Dr. Gailen Marshall, a professor of medicine and pediatrics at the University of Mississippi Medical Center in Jackson. He heads the center's division of clinical immunology and allergy.

"There are two problems that are particularly troubling about air pollution," Marshall said. "First, most of the standards were developed with more intermittent exposures in mind. That is, although there are 'average' exposures over given periods of time, this assumes a 'waxing and waning' of exposure. However, if the average becomes more chronic and less episodic, the health implications may be more severe."

"Let me give you an analogy," he added. "I might have a severe muscle strain three or four times per year but, given enough time between episodes, recover fully. But if I have 10 less severe muscle strains per year, the average injury might be the same but my body never had enough time to fully recover. The smaller injuries become additive and ultimately do more harm."

"This may well be the case as the baseline levels of various pollutants on our planet continue to increase," Marshall said.

Kim said parents can help by having their children stay indoors or not exercising heavily outdoors on a day with high pollution levels. Following the air quality index for their area is another good idea, she said.

And parents can serve as advocates for their kids, Kim said, by talking to school officials about ways to minimize air pollution and asking them to rethink policy, if necessary, on outdoor sports training on days when air quality is poor.

Reference Source 101
December 9, 2004

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