Despite being one of the leading causes of death globally, relatively little is known about the long term effects of air pollution. Although breakthrough studies have recently found that fine dust concentrations impact virtually every cell in the human body, there are still many unknowns about the issue. However, what we do know is that airborne pollutants are increasingly dangerous.
Although air pollution has been an issue in some areas for decades, it often isn't considered dangerous - or even considered at all. Perhaps this is because the impacts of air pollution are only seen after prolonged periods, or maybe it's because the issue hasn't been publicized enough. Whatever the case, there's no denying that air pollution is something we need to be considering.
This is especially true when it comes to children. While air pollution poses a threat to every individual, children require additional concern for two reasons. Firstly, their developing bodies can feel many of the health effects more than adults do. Secondly, the impacts of air pollution on their bodies will last further into the future and likely impact their lives more.
Although COVID-19 has recently taken the spotlight due to its immediate danger, air pollution is an increasingly present threat. While many people eagerly await the end of the pandemic and mask restrictions, we believe that masks will be essential even after the pandemic ends.
While masks do not solve the issue of air pollution, they are a necessary measure in the short term as they are the only way we can ensure that we are protected while outdoors. This is especially true when safeguarding our youngest family members health.
At AirPOP, protecting children was a founding goal of the company. Chris, AirPop's cofounder, experienced firsthand the dangers of air pollution in his two young children while living in China. Both children began suffering from acute respiratory illnesses due to their local environments. So, in search of a way to protect his children, AirPop was created.
There weren't many high-quality respiratory protection devices for children at the time. While there are plentiful mask and respirator companies, few focus on the wellbeing of our younger family members.
In today's article, we want to take a deeper look at air pollution and its impacts on children. From the effects of air pollution on children's bodies to steps that parents can take to minimise exposure. We will also discuss why masks are so essential and how to find the best product for your children.
The Misconception
Before going any further in this article, a common misconception needs to be addressed. The all too common thought is that 'air pollution is not my issue' or 'air pollution is not impacting me'. Unfortunately, being involved with masks and air pollution for years, we've encountered this thought all too often.
Despite increasing research showing the dangers of air pollution, it's often dismissed, especially among people from the western world. While it is true that the most polluted cities in the world are in Asia - in 2020 IQAir found that nine of the top ten most polluted cities were in India, with the most polluted city being in China (1) - this does not mean that other regions are not impacted.
You will likely be surprised. If you live in a city, it's very likely that air pollutant concentrations regularly exceed the safety guidelines set by the WHO. Even cities and countries known for clean air can regularly exceed pollution guidelines.
Air pollution in Paris. Screenshot from AQICN.
We can find many cities in Europe, North America, and Oceania above the WHO's safe levels of air pollution. Unfortunately, this is likely to become more common in the future as fine particle concentrations increase globally. For this reason, it's essential to check the local air quality every day.
A study done by the WHO found that an almost unbelievable percentage of children breathe air so polluted that it harms their health. 93% of children, or around 1.8 billion children, under 15 breathe polluted air daily (2).
This leads to over 600,000 deaths annually due to acute lower respiratory infections directly tied to air pollution levels. However, with the vast range of ways that air pollution can impact the human body becoming known, air pollution likely leads to even more children deaths every year.
With over 90% of the world's children being impacted negatively by air pollution, it's an issue that affects everyone. Regardless of where you live in the world, it's becoming increasingly likely that air pollution impacts not only you but also your family. It's not someone else's problem.
This study shows that the vast majority of us are impacted by air pollution. Even if we may not notice it today, almost no one is safe from the consequences of modern living.
Therefore, rather than dismissing the issue as something that won't impact you, we recommend doing some research. First, check your local air quality services - what does an average day look like? Does it meet air quality safety standards?
- https://www.iqair.com/world-most-polluted-cities
- https://www.who.int/news/item/29-10-2018-more-than-90-of-the-worlds-children-breathe-toxic-air-every-day
Health Impacts of Air Pollution in Children
Infographic from World Economic Forum.
The issue with air pollution is that it impacts everyone. If high concentrations of airborne pollutants are present in an area, all age groups will be impacted. However, while air pollutant affects us all, it can be especially damaging to children.
Some of the impacts of air pollution are more obvious than others - for example, it can be very harmful to the respiratory system of children. But air pollution is far more impactful than this. A study done in 2019 shows that air pollution damages every organ in the human body (1). Since ultrafine particles are so small, they can directly enter our bloodstream, and some can even bypass the blood-brain barrier.
While the impacts of air pollution are still being researched, it’s already been linked to thousands of conditions. It’s connected to cognitive diseases such as dementia (3), heart diseases (4), and it can even lead to depression (5) and suicide (6). This is barely scratching the surface as air pollution has been linked to even more conditions.
When it comes to children, air pollution has been discovered to have even more profound implications. Even before children are born, air pollution can impact the health of both the mother and child as air pollution has been linked to preterm births (7). In addition, after children are born, airborne pollution has been shown to limit lung growth.
Multiple studies have shown that decreasing children’s exposure to air pollution increases their lung health. With recent research coming to light, it stands to reason that other air pollution-related issues will become less prevalent as exposures are decreased.
Perhaps most worryingly, a Harvard study found that children exposed to air pollution at very young ages have a significantly increased risk of autism spectrum disorder (ASD) (8).
We don’t intend to share this information to scare people. There are many ways to reduce the impacts of airborne pollutants on both ourselves and our younger family members. With that being said, the effects of air pollution are rarely taken seriously, and it’s essential to show precisely why it’s an issue that we need to be concerned with.
While the severity of many of these impacts on children has not yet been researched, it’s vital that we are aware of the dangers of air pollution and are proactive in protecting our children. As more research is carried out, the health issues linked to air pollution will likely increase.
- https://www.theguardian.com/environment/ng-interactive/2019/may/17/air-pollution-may-be-damaging-every-organ-and-cell-in-the-body-finds-global-review
- https://www.pnas.org/content/117/25/13856
- https://www.alz.org/aaic/releases_2021/air-pollution-dementia-risk.asp
- https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/air-pollution-and-heart-disease-stroke
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447209/
- https://www.theguardian.com/environment/2019/dec/18/depression-and-suicide-linked-to-air-pollution-in-new-global-study
- https://www.lung.org/clean-air/outdoors/who-is-at-risk/children-and-air-pollution
- https://www.hsph.harvard.edu/news/hsph-in-the-news/air-pollution-linked-with-increased-risk-of-autism-in-children/
At-Risk Children
While air pollution doesn't discriminate, some groups of children are more at risk than others. These children are more likely to experience the adverse effects of high concentrations of airborne particles and are more likely to experience severe symptoms.
The first at-risk group are children with respiratory conditions. The most common among these is asthma. Chronic bronchitis, emphysema, and chronic obstructive pulmonary disease can also increase the severity of air pollution reactions (1).
The second group of at-risk children are those with cardiovascular conditions. Children with heart-related conditions or families with a history of such conditions should take extra precautions regarding air pollution.
We recommend checking with a doctor or medical professional for the most accurate information. They will inform you as to whether or not you need to take extra considerations into account to protect your child.
- https://www.pca.state.mn.us/air/who-risk-air-pollution
When Do Children Need to Wear Masks?
Depending on your child's sensitivity level, masks will need to be donned at different times.
With increasing awareness of air pollution's impacts on our bodies, it's becoming easier to monitor the local concentrations. As a result, nearly every large city, and many smaller cities and towns, will have local air pollution monitors capable of measuring pollutant concentrations.
If your city, town, or region doesn't have official air pollution monitors, it may be worth investing in a cheap monitor for your local air quality. While these devices tend to be less accurate than official monitors, they can provide air pollution trends.
A number and colour will be provided when checking the air pollution (more on how to do that soon). These numbers generally range from 1 to 500 with a representative colour - typically green, yellow, orange, red, purple and brown will be used.
Confusingly, different countries have different air quality measuring systems. While the U.S system is the most common, other countries have their own tiers that can significantly differ. For this reason, we recommend checking the pollutant concentrations rather than the overall air quality level.
While AQI (Air Quality Index) readings can vary based on location, PM2.5 and PM10 concentrations are measured in μg/m3. As such, they can easily be viewed no matter what country you are based in. The WHO guidelines (1) for safe levels of PM2.5 and PM10 are as follows:
Fine particulate matter (PM2.5)
5 μg/m3 annual mean
15 μg/m3 24-hour mean
Coarse particulate matter (PM10)
15 μg/m3 annual mean
45 μg/m3 24-hour mean
While PM2.5 and PM10 get the most media attention and are the most well-known, gaseous pollutants can also be harmful. At the moment, the WHO has identified three of them as being harmful air pollutants. These are as follows:
O3
100 μg/m3, 8-hour daily maximum
60 μg/m3 8-hour mean, peak season
NO2
10 μg/m3 annual mean
25 μg/m3 24-hour mean
SO2
40 μg/m3 24-hour mean
Unfortunately, many areas regularly exceed these guidelines. This is especially true for cities and fine dust (PM2.5 and PM10) concentrations. The good news is that certified masks and respirators can filter these particles.
If you check local PM2.5 or PM10 levels and see them above the 24-hour mean guidelines mentioned above, a respirator may be necessary. For sensitive and at-risk groups, consult with a doctor as to when protection is needed.
When it comes to gases, masks will not provide protection (1). While there are masks capable of filtering gases, they are very large and cumbersome. Further, they don't come in children's sizes. For this reason, the best way to avoid exposure to these gases is to stay inside or in an environment with clean air when possible.
- https://www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health
- https://www.cdc.gov/niosh/npptl/topics/respirators/factsheets/respfact.html
How to Check Air Pollution Levels
Air pollution as seen on IQAir.
There are many different apps and websites that provide regular air quality updates. While this is mainly up to personal preference, we prefer to use AQICN and IQAir. Both platforms aggregate air quality data from a range of monitors worldwide and break down the levels of individual pollutants.
AQICN offers a great website that shows detailed readings for each pollutant. It also shows air quality forecasts and history. Most interestingly, it's possible to see seasonal trends, which allows you to prepare for upcoming conditions.
AQICN can feel overwhelming, however. IQAir provides a fantastic app and website for a more easily understandable reading. In addition, the platform provides both an overall air quality reading and individual concentrations for all of the pollutants mentioned above.
Due to the clear and logical formatting of IQAir, many people prefer to use this app. It also sources data from local sources, typically government and other official monitors are used.
While these platforms use official monitors, sometimes getting information directly from the source is preferable. Many local and regional governments provide air quality readings if this is the case. If you Google Search your area followed by 'AQI', these websites should appear.
On days when the overall reading is 'good' or when individual pollutant levels are under the WHO guidelines, respiratory protection is not needed. However, when air pollution levels exceed those mentioned in the guidelines, it's essential to don a performant device.
Finding the Best Air Pollution Mask for Children
Luckily, many certified masks and respirators exist that are capable of filtering fine and even ultra-fine particles. Respirators and certified masks are capable against PM1, PM2.5 and PM10 particles.
For context, PM2.5 particles are particles around 2.5μm in size. PM1 are around 1μm in diameter, and PM10 are around 10μm. Testing for most respirator standards such as KN95, KF94 and N95 is carried out at 0.3μm. Therefore, these devices are effective against these particles and even smaller pollutants.
When choosing a device for your child, make sure to choose one that has undergone some lab testing against fine particles or is officially certified as KN95, N95, KF94, FFP2, or another regional standard. For air pollution, cloth masks and surgical masks provide minimal protection.
Choosing the best mask for a child can be a challenging process. Due to COVID, most adults are now familiar with mask-wearing, even if it's very uncomfortable! However, children tend to be far less tolerant of uncomfortable devices.
For this reason, it's essential to find a mask that balances the three pillars - filtration, fit and comfort. While filtration is typically easy to solve as high filtration masks and respirators are prevalent in 2022, fit and comfort are another matter.
The mask shopping process is even more difficult because we can judge neither fit nor comfort before purchasing a mask. Therefore, it's tough to know whether or not a mask will work well for your children without physically trying it.
Luckily, a few factors can indicate whether a mask is likely to be comfortable or not. While these are no replacement for trying the mask physically, they can provide a good basis for determining your purchasing decisions.
The first thing to consider is the mounting mechanism. For example, does the mask use ear loops, a headband or a neckband? By far, the most common method is ear loops which are used on most consumer devices.
If a mask has ear loops, check if they are thick or soft. Both of these tend to be more comfortable because they put less pressure on any single spot behind your child's ears.
While looking at the earloops, it's also worth checking for any adjustment toggles. To get the best fit, you will want to ensure that a mask has adjustable earloops. If a mask doesn't have an adjustment method, it's possible to tie/shorten the earloops manually. However, this extra step can be difficult to perfect, and adjustment beads will simplify the process.
Another aspect to consider when looking for a comfortable mask for children is the breathability of a device. Breathability is perhaps the most important factor of all when it comes to comfort - so much so that it's often considered the fourth pillar of personal filtration devices.
Breathability is measured in two ways, exhalation resistance and inhalation resistance. These two factors are measured in pressure drop, the pressure difference between the interior and exterior of the mask. Essentially, a lower pressure drop means that inhaled and exhalation air can pass through the filter more easily.
This is crucial because an everyday mask should not interfere with breathing. If a mask is causing laboured breathing, it should be avoided. Ideally, you want a mask that allows your child to breathe without any noticeable difference.
Luckily, there are many highly breathable masks available. With advances in filtration technology, many highly breathable children's masks offer high filtration. One example is the AirPop Kid mask, which provides inhalation and exhalation resistance well under the requirements set by the KN95 standard.
Another critical factor for both comfort and fit is the nosepiece. Most masks and respirators rely on wire nosepieces. These pieces of wire are designed to mould around the wearer's nose and seal the device.
However, not all masks rely on wire nosepieces. Instead, some will implement other materials such as memory foam or silicone seals. While these have their merits and flaws, silicone seals and memory foam nosepieces tend to be more comfortable with a superior fit.
While some masks using wire nosepieces can provide a good experience, many masks do not. The issue with wire nosepieces is that they are very inconsistent - some are too sturdy, some are too malleable, and some are perfect.
This can lead to issues as a nosepiece that is too soft or sturdy can leak and lead to discomfort while wearing the mask. If you are considering a mask that uses such a fitting mechanism, it's worth trying a single device before investing in more masks.
The final factor that parents should consider before purchasing a mask for their child is the shape. A few common forms are cup, boat (most KF94 respirators use this boat-like shape) and bifold. These masks are easily obtainable, and some children will find specific shapes more comfortable than others.
If you have any of these devices on hand, try them on your child and see what they prefer. Cup-shaped devices tend to be the least comfortable as they are designed for professional environments. Bifold and boat-shaped devices are intended for public use and are designed to be easily wearable.
Although finding a children's mask that balances fit, filtration and comfort can be difficult, it's a worthwhile process. Finding a well-fitting, high-filtration device will ensure your child is protected from the harmful effects of air pollution. In addition, a comfortable device will make sure that your child is happy and willing to wear a mask.
How Children can Avoid Air Pollution
Although donning a mask is a good method for exposure to fine particles such as PM2.5 and PM10, they are ineffective against gaseous pollutants. Further, even masks can be penetrated by some particles. As such, avoidance is always the best method for air pollution.
If it’s possible to get away from the source of the pollutants or remove it altogether, this is the best option. With that being said, it’s not always possible to avoid air pollution - that’s where masks become particularly important. Luckily, there are some ways to avoid air pollution in day to day life.
Roads and highways with large amounts of traffic are hotspots for pollution. If your child walks to school along a busy road, it’s worth looking into possible alternative paths. Walking a few hundred metres away from a highway or busy road can significantly reduce air pollution levels. If there’s no alternative, a mask is the best choice.
Even if you drive your child to school, air pollution can enter the vehicle. As such, avoiding these roads is important even when in a car. Alternatively, see about getting a HEPA filter put in your vehicle. Many modern vehicles come with these included.
On days with exceptionally high air pollution concentrations, keep your child inside if possible. While staying active is extremely important, many indoor venues allow for exercise. Gyms, swimming pools, and indoor centres are great alternatives on high pollution days.
Exercising during days of high air pollution can be particularly impactful because this is when our lungs are taking in the most air. While masks can provide some protection, they can often become dislodged through activity - especially on children. As such, exercising inside is the best choice at these times.
When it comes to indoor areas, try to ventilate as much as possible. Airflow is key. If particle concentrations are exceptionally high or some places can’t be properly ventilated, consider investing in an air purifier. Some air purifiers have been found to be highly effective against indoor air pollution, reducing the chance of both the mild and severe effects of air pollution on children.
Conclusion
With air pollution becoming more of an issue globally, we must be aware of the dangers and protect ourselves from them. This is especially important for our children, who are more at risk due to their developing bodies.
While air pollution is an issue that needs to be dealt with at the source, we must do what we can to reduce our exposures in the shorter term. Unfortunately, while we can control the air quality in our homes, the same can’t be said for outdoor ambient air pollution.
This is where avoidance techniques and masks are of the utmost importance. As the only method we have to protect ourselves on a personal level, masks are effective against particle pollution when fitted correctly.
It’s also a good opportunity to educate future generations on a matter that is likely to become more of a danger in years to come. Simply being aware of air pollution's dangers and ways to mitigate the impacts can go a long way towards safeguarding our children.