Air Pollution

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TRAINING FOR THE HEALTH SECTOR
[Date …Place …Event…Sponsor…Organizer]
[Date Place

INDOOR AIR POLLUTION

Children's Health and the Environment
WHO Training Package for the Health Sector
World Health Organization
www.who.int/ceh
July 2008 version

1

Indoor Air Pollution
Indoor

LEARNING OBJECTIVES
LEARNING
TO UNDERSTAND, RECOGNIZE AND KNOW:
Hazards of indoor air pollution to children’s health
Different toxicants in indoor air, according to sources, settings and activities
Characteristics and issues relating to indoor air pollution in industrialized and developing countries
How to recognize, assess and address health effects
How to prevent exposure to indoor air contaminants
2

Indoor Air Pollution
Indoor

OUTLINE
OUTLINE
Scope of the problem of indoor air pollution
Particulate matter
Particulate
Carbon monoxide
Carbon
Secondhand tobacco smoke
Secondhand
Pesticides
Pesticides
Solvents
Solvents
Volatile organic compounds
Volatile
Biological pollutants
Biological
- Mites
- Allergens
- Moulds
Built environment
Built
Radon
Asbestos
Asbestos
Occupation-related contaminants
Occupation
3

The indoor contaminants addressed in this module include:
•Particulate matter
•Carbon monoxide
•Secondhand tobacco smoke
•Pesticides
•Solvents
•Volatile organic compounds
•Biological pollutants
- Mites
- Allergens
- Moulds
•Built environment
•Radon
•Asbestos
•Occupation-related contaminants

Indoor Air Pollution
Indoor

CHILDREN’S UNIQUE VULNERABILITY
CHILDREN
Inhale more pollutants per kilogram of body weight than
do adults
do
Because airways are narrower, irritation can result in
proportionately greater airway obstruction
proportionately

WHO

Infants and young children have a higher resting metabolic rate and rate of oxygen consumption per unit body weight than adults because they have a larger surface area per unit body weight and because they are growing rapidly. Therefore, their exposure to any air pollutant may be greater.

In addition to an increased need for oxygen relative to their size, children have narrower airways than do adults. Thus, irritation caused by air pollution that would produce only a slight response in an adult can result in potentially significant obstruction in the airways of a young child.

Ref:
•Moya J et al. Children’s behavior and physiology and how it affects exposure to environmental contaminants. Pediatrics, 2004, 113:996.
•American Academy of Pediatrics Committee on Environmental Health. Pediatric Environmental Health, 2nd ed. Etzel RA, Ed. Elk Grove Village, IL: American Academy of Pediatrics, 2003.
•Children's Health and the Environment – A global perspective. A resource guide for the health sector, WHO, 2005.

4

Indoor Air Pollution
Indoor

SMALLER AIRWAYS MORE VULNERABLE
SMALLER

www.vh.org/pediatric/provider/pediatrics/ElectricAirway/Diagrams/AirwayDIaneterEdema.jpg 5

The effect of oedema on the adult airway is much less dramatic than it is on the newborn’s airway. One millimetre of oedema reduces the diameter of the adult airway by about 19% whereas it reduces the diameter of the infant airway by 56%. Compared to that of adults, the peripheral airway (bronchioles) is both relatively and absolutely smaller in infancy allowing intralumenal debris to cause proportionately greater obstruction. In addition, infants have relatively larger mucous glands, with a concomitant increase in secretions. They also have the potential for increased oedema because their airway mucosa is less tightly adherent. Lastly, there are fewer interalveolar pores (Kohn’s pores) in the infant, producing a negative effect on collateral ventilation and increasing the likelihood of hyperinflation or atelectasis.

The resting minute ventilation normalized for body weight in a newborn infant (400 cc/min/kg) is more than double that of an adult (150 cc/min/kg). Ref:
•Bar-on ME et al. Bronchiolitis. Prim Care, 1996,...
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