On World Environmental Health Day: The Call to Protect Children’s Environment and Health

To commemorate World Environmental Health Day this year and its focus on children’s environment and health, CHE is publishing a series of short essays from partners who are leaders in children’s environmental health.

A very young Frederica Perera

Dr. Perera’s son

written by Frederica Perera, DrPH
CHE Partner

The protection of children, and especially poor children, from air pollution and climate change resulting from the massive burning of fossil fuel is an urgent moral imperative. The large and mounting health and economic costs of pollution and climate change necessitate bold policy change.

The entire global population is affected; however, the first thousand days of life represent the greatest window of susceptibility both to toxic exposures and stressors from climate change. The developing fetus and young child undergo very rapid development during which time they lack the innate defense mechanisms operating in older children and adults. Thus, they tend to be the most affected both by toxic air pollutants and climate change. The impacts of exposure to air pollution include adverse birth outcomes, cognitive and behavioral disorders, asthma and other respiratory problems in children, while climate change increases the likelihood of heat waves, floods, drought, malnutrition, infectious disease, and social and political instability. These early impacts can translate to lifelong consequences for the young.

The population at risk is huge. Of the 7 billion world’s population, 1.9 billion are children below 15 years of age. According to the World Health Organization (WHO), children under 5 years of age bear more than 40 percent of the burden of environmentally related disease and more than 88 percent of the existing global burden of disease from climate change. Compounding the children’s biological susceptibility to exposure is their exposure to socioeconomic stressors related to poverty that can heighten risks of both toxic exposures and climate change. Globally, 1 billion children are living in poverty.

Coal combustion for power generation has continued to be one of the largest sources of toxic air pollution emissions and the leading source of carbon dioxide (CO2) emissions, the primary human cause of global climate change. Besides emitting CO2, coal-fired electric generating utilities directly emit toxic air pollutants such as fine particulate matter (PM2.5), sulfur dioxide, and nitrogen oxides, as well as precursors to ozone. Diesel- and gasoline-powered trucks, cars and buses are also a major contributor of these pollutants.

As with impacts of CO2 emissions on climate change, toxic air pollutants emitted by ground-level emission sources are a global problem. Although populations living close to ground-level emission sources are often most affected, air pollutants can be transported hundreds and thousands of miles from their source, potentially affecting large populations downwind. For example, intercontinental transport of PM2.5 and O3 result in global impacts.

PereraPostEstimated costs of climate change and air pollution are substantial. For example, a recent review paper in The Lancet reported that the impact of climate change on lives lost and ill health in Organisation for Economic Co-operation and Development (OECD) countries, India, and China, was estimated to cost $3.5 trillion annually. Globally, WHO estimated that climate change will result in more than 250,000 annual deaths between 2030 and 2050 through increases in diseases such as diarrhea, malnutrition, malaria, and heat stress, with an estimated cost of $2-4 billion (USD)/year by 2030. According to the California Environmental Health Tracking Program, in California, childhood asthma, childhood cancer, childhood lead exposures, and childhood neurobehavioral disorders associated with environmental exposures amount to $254 million every year and $10-13 billion over the lifetime of all children born every year.

By reducing our dependence on fossil fuel and moving to a decarbonized economy, we will gain significant health and economic benefits for our children and their future and meet our moral responsibility for their protection.


Dr. Perera is a professor at Columbia University, Mailman School of Public Health, Department of Environmental Health Sciences, and the director of The Columbia Center for Children’s Environmental Health.

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