Dirty air kills 476 000 newborns

Air pollution contributed to the deaths of almost half a million babies in 2019, during their first month of life, according to the first comprehensive analysis of how dirty air affects babies.

In sub-Saharan Africa about 80% of the nearly 236 000 deaths in the first month of life are attributable to household air pollution; in South Asia, half of the 186 000 deaths are attributable to household air pollution.

About 236 0000 of the total number of deaths were in sub-Saharan Africa and 116 000 in India.

Over the past decade, scientific evidence from multiple countries has shown that women exposed to particulate air pollution are more likely to have babies who have a low birth weight or are born premature. 

“It’s thought air pollution may affect a pregnant women, her developing foetus, or both through pathways similar to those of tobacco smoking, which is a well-known risk factor for low birth weight and preterm birth,” says the report, produced by the United States-based Health Effects Institute and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle. 


“One plausible mechanism is that pollution particles or their components may move across the membranes of the lungs and be carried to other parts of the body, affecting placental function and the foetus. Another is that pollutants may initiate systemic inflammation or oxidative stress that affects the health of both the pregnant women and her baby.” 

Babies born in sub-Saharan Africa and South Asia have the highest rate of neonatal deaths attributable to air pollution, says the report, based on the Global Burden of Disease study in The Lancet last week. 

Globally air pollution, which comprises ambient PM2.5 (fine inhalable particles), ozone and household air pollution is linked to 6.7-million deaths last year and 213-million years of healthy lives lost. 

China and India accounted for more than 3.5-million deaths from total air pollution in 2019. In sub-Saharan Africa, the 10 countries with the highest PM2.5 attributable deaths are Nigeria, “followed more distantly” by South Africa, Ghana, the Democratic Republic of the Congo, Cameroon, Ethiopia, Côte d’Ivoire, Tanzania, Angola and Kenya.

In September last year, a paper in the South African Journal of Science — titled 15 Years After the National Environmental Management Air Quality Act: Is Legislation Failing to Reduce Air Pollution in South Africa? — found that the problems associated with air pollution are “far from being solved”. This applies especially to observed levels of particulate matter and ozone in areas declared as pollution hotspots.

“Particulate matter and ozone are two pollutants for which there is noncompliance with the national ambient air quality standards,” the authors state. 

Ambient PM2.5 is the largest driver of air pollution’s burden of disease worldwide, according to the State of Global Air 2020 report. It accounted for 4.14-million deaths, household air pollution for 2.31-million deaths and ozone for about 365 000 early deaths.

Although air pollution is the fourth highest health risk globally, outstripped only by high blood pressure, smoking and dietary risks, it is being ignored in many parts of the world.

“The reality is that despite the explosion in data in recent years, that have brought intense focus on air pollution, little or no progress has been made toward reducing air pollution and its associated health burden in many regions of the world. Over the last decade levels of PM2.5 exposure have remained high or increasing, particularly in parts of Asia, Africa and the Middle East,” the report noted. “Ozone levels continue to creep upward, reflecting growing emissions of its precursor chemicals and a warming climate that helps accelerate ozone’s formation. Roughly half the world’s population continues to rely on solid fuels for cooking.”

Low and middle income countries “remain the dirtiest” while high income regions are getting cleaner. 

“The interaction of Covid-19 with the continued global rise in chronic illness and related risk factors including obesity, high blood sugar and outdoor air pollution, over the past 30 years have created a perfect storm fuelling Covid-19 deaths,” says Christopher Murray of the IHME.

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Sheree Bega
Sheree Bega is an environment reporter at the Mail & Guardian.

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