by Anthony Mysak, Portfolio Manager, Guys and St Thomas’ Charity
As families prepare for their children’s return to school, many are focused on how to best protect their children from COVID-19. Concerns about children’s health are only compounded for those families with children with asthma.
The start of the school year (known as week 38) coincides with the highest hospital admission rates for asthma. Healthy London Partnership’s annual #AskAboutAsthma campaign focuses on common triggers for asthma and what steps we can all take to help improve the quality of life for London’s children and young people living with asthma.
Air pollution is a key trigger for asthma. Evidence shows new cases of childhood asthma increase with greater exposure to nitrogen dioxide (NO2) and particulate matter 2.5 (PM2.5) pollution, and children exposed to higher levels of air pollution also suffer more frequent chronic respiratory symptoms. The need to combat air pollution to improve children’s respiratory health is heightened further by the increasingly likely links between air quality and the spread of COVID-19.
Protecting the health of those most impacted by air pollution, including children, is the goal of Guy’s and St Thomas’ Charity’s new programme.
While we push for a clean and green recovery from COVID-19, with sustained positive policy and behaviour change around air pollution, we must also act now to reduce air pollution in and around the spaces where children spend their time.
Well over half (59%) of the UK population reported noticing an improvement in air quality during the lockdown. This number increases to three quarters of people with asthma and other respiratory conditions, Londoners (72%) and those with children (62%), especially when compared to those without children (56%).
Protecting children at school
Over 20% of London’s primary schools are in areas which breach the legal limits of NO2. Protecting children from air pollution at school is therefore a key opportunity to improve respiratory health outcomes.
Great work is already being done through the Mayor’s school and nursery air quality audit programmes which help build our understanding of air pollution in and around schools and how we might reduce it. Information and guidance for schools is also getting better. For example, The Global Centre for Clean Air Research recently published tangible guidance for schools and communities on how to mitigate exposure to traffic pollution in and around schools.
It is now imperative to make sure schools have the resources and capacity they need to implement these interventions without having to divert limited funding from other important projects. We are looking for opportunities to build on these insights and help schools more easily identify the most impactful and cost-effective interventions for their school.
Protecting children on their way to and from school
How children get to and from school is as important as the school environment. Children on average are exposed to five-times-higher concentrations of harmful NO2 pollution on the school run than when they are at school. Active travel, taking less polluted routes and cleaner transport are all important.
To sustain the increase in active travel during the pandemic, councils across London are trialling temporary measures to make people feel safer to walk and cycle. For example, we are working with Southwark Council to trial temporary measures to encourage active travel and reduce traffic around the most polluted streets and schools in Southwark.
While the intention of this work is positive, we need to assess and ensure their impacts benefit the whole community, and don’t just move traffic and air pollution elsewhere, causing unintended negative health outcomes in the process.
Protecting children beyond the school gate
To effectively protect the health of children we must also look where else children spend their time.
More than one quarter of London’s parks, playgrounds, and open spaces exceed international safety guidance for air quality. We therefore need to understand how we can re-design urban spaces to protect the health of children. We are working with urban design firm Gehl, to explore opportunities to improve public spaces around Vauxhall and Oval, some of the most polluted areas in London.
The home is probably the most important environment for children’s respiratory health, especially during this global pandemic. Indoor air pollution in homes is an area that has been largely neglected till now. Recent research by the Royal College of Physicians and RCPCH provided insight into the relationship between indoor air pollution and children’s health, as well as strategies and guidance for how to mitigate its effects. We must all consider how our home environment and our behaviours at home impact on our health and that of our children. How we heat our homes, cook and clean can significantly impact on our respiratory health.
Empowering people to protect children’s health
While we can all take steps to reduce air pollution and protect children’s respiratory health, it is critical to empower and support those who are most vulnerable and avoid disproportionately burdening them.
Many families, especially those who live in the most polluted areas, often have the least control over where they live and little agency to make changes in their home environment. We are therefore working to not only make sure information and guidance is accessed by and accessible to those who most need it, but also provide tangible actions which empower families. At the same time, we are working to influence the likes of developers, housing associations and landlords and help them see the importance and benefits of improving air quality in their buildings.
As we trial and test ideas and identify those most effective, we are also are looking to learn from communities around the world. We want to use this learning to inform our work supporting residents, business owners, regulators, and innovators to identify the changes they want to see in their communities. Together with these partners we will build evidence around what works to improve the health of London’s children and young people living with asthma, as we work towards cleaner air for all.