Abstract
Whether you benefit from high-quality urban environments, such as those
rich in green and blue spaces, that may offer benefits to allergic and
respiratory health depends on where you live and work. Environmental
inequality, therefore, results from the unequal distribution of the
risks and benefits that stem from interactions with our environment.
Within this perspective, this article reviews the evidence for an
association between air pollution caused by industrial activities,
traffic, disinfection-by-products and tobacco/e-cigarettes and asthma in
children. We also discuss the proposed mechanisms by which air pollution
increases asthma risk, including environmental epigenetic regulations,
oxidative stress, and damage, disrupted barrier integrity, inflammatory
pathways, and enhancement of respiratory sensitization to aeroallergens.
Environmental air pollution is a major determinant of childhood asthma,
but magnitude of effect is not shared equally across the population,
regions, and settings where people live, work, and spend their time.
Improvement of the exposure assessment, a better understanding of
critical exposure time windows, underlying mechanisms, and drivers of
heterogeneity may improve the risk estimates. Urban conditions and air
quality are not only important features for national and local
authorities to shape healthy cities and protect their citizens from
environmental and health risks, but they also provide opportunities to
mitigate inequalities in the most deprived areas where the environmental
burden is highest. Actions to avoid exposure to indoor and outdoor air
pollutants should be complementary at different levels – individual,
local, and national levels – to take effective measures to protect
children who have little or no control over the air they breathe.