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Environmental inequality: air pollution and asthma in children
  • Inês Paciência,
  • João Cavaleiro Rufo,
  • André Moreira
Inês Paciência
Universidade do Porto Instituto de Saude Publica

Corresponding Author:[email protected]

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João Cavaleiro Rufo
Universidade do Porto Instituto de Saude Publica
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André Moreira
Universidade do Porto Instituto de Saude Publica
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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.
09 May 2022Submitted to Pediatric Allergy and Immunology
19 May 2022Reviewer(s) Assigned
26 May 2022Review(s) Completed, Editorial Evaluation Pending
30 May 2022Editorial Decision: Accept
Jun 2022Published in Pediatric Allergy and Immunology volume 33 issue 6. 10.1111/pai.13818