World Pneumonia Day: Air Pollution Increases Risk Of Pneumonia: Here's What Parents Can Do To Protect Their Kids

The deteriorating quality of air in major cities across the country has dominated newspaper headlines. This has become such a serious concern as the effects of air-pollution are far-reaching, especially for children. On World Pneumonia Day, lets know more about pneumonia and how we can keep our kids safe. 

A recent World Health Organization report showed that over 100,000 children under five in India died due to indoor and outdoor air pollution in 2016¹. One important threat to child health posed by household air pollution is pneumonia, which is the leading infectious cause of death among children under five in the country and the world.

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Air pollution can increase risk of pneumonia
Photo Credit: PTI

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Pneumonia is an acute respiratory infection that causes inflammation or fluid accumulation in the lungs. In 2017, it was responsible for 1.4 lakh under-five child deaths in India, roughly one in every seven deaths in that age group. It is a threat to all children, but children who are malnourished or exposed to household air pollution or parental smoking are especially vulnerable.

Besides costing lives, pneumonia has other far-reaching consequences. Pneumonia can weaken children's immune systems, placing them at greater risk of other illnesses. Sick children are more likely to miss time at school, and parents often have to skip work to care for them. The costs of treating pneumonia can also be catastrophic, pushing already vulnerable families deeper into poverty.

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Perhaps worst of all, however, is the fact that we continue to lose lives to pneumonia despite advances in science and technology that allow us to protect against, prevent, and treat some forms of the disease. Exclusive breastfeeding can help children develop strong immune systems. Handwashing, vaccination, and reducing exposure to smoking and air pollution can help prevent some of the leading causes of pneumonia and other serious diseases. And ensuring all children, regardless of where they live or how wealthy their families are, have access to health care and appropriate antibiotics if they are ill can help treat pneumonia cases and reduce the number of child deaths from this life-threatening disease.

One critical intervention against pneumonia is the pneumococcal conjugate vaccine (PCV), which was introduced in our national immunization program in 2017. PCV helps protect against a bacterium that can cause serious pneumonia and other diseases like meningitis (infection of the brain) and sepsis (infection in the blood stream).

Integrated with other interventions such as breastfeeding, adequate nutrition and other already available vaccines for measles, pertussis and Haemophilus influenzae type b (Hib)-other causes of child pneumonia-PCV can go a long way in protecting our children from this serious, potentially fatal disease. One study estimates that over a 10-year period, PCV introduction could avert 25 million cases of disease, 19 million outpatient visits and 2.2 million hospitalisations². Another cost-effectiveness study estimates that introducing and scaling up coverage of the vaccine can drastically reduce out-of-pocket expenditure. Given the correlation between pneumonia and poverty, this can also contribute significantly towards meeting the sustainabale development goal of ending poverty.

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Yet, while the government has taken the commendable step of introducing this critical vaccine, only six states have rolled out PCV so far. This means that these life-saving vaccines are still not available to many communities that need them most. Unless we can ensure that this vaccine and an integrated package of important child health interventions is equitably delivered, it will be impossible to sustain the momentum we've built in reducing child mortality over the years. This is especially true of children living in poverty or in hard-to-reach areas who are often at greatest risk of serious disease.

While we need to develop and implement strong policies that tackle air pollution head on, we must not forget preventive interventions that can go a long way in ensuring that the harmful effects of environmental factors such as pollution are minimised. This could be the difference between a healthy, thriving India and a country still grappling with basic public health problems. It's time for all of us as a nation to rise to the challenge, to protect our children and be leaders in the global fight against child pneumonia.

¹WHO. Air pollution and chid health: prescribing clean air. 2018. Available from http://www.who.int/ceh/publications/Advance-copy-Oct24_18150_Air-Pollution-and-Child-Health-merged-compressed.pdf?ua=1

²Yuvaraj Krishnamoorthy, S. K. (2019). Impact and cost effectiveness of pneumococcal conjugate vaccine in India . Elsevier. https://www.sciencedirect.com/science/article/pii/S0264410X18316499?via%3Dihub

(Dr Madhu Gupta is a Professor at the Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. Her key areas of interest are maternal and child health, vaccinology, infectious diseases and inequalities in health access.)

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