Air quality and child health - Current evidence and priorities for Australia
Technical Report No. 7
University of Queensland & University of the Sunshine Coast
Department of the Environment and Heritage, October 2003
ISBN 0 6425 4958 3
This report is the final output of a consultancy undertaken by the University of Queensland and the University of the Sunshine Coast for the Department of the Environment and Heritage. Phase 1 of the project examined the evidence relating air pollution and child health, with a view to identifying its substance, its applicability to Australian children, and the need for additional Australian-based research to inform the review of the standards contained in the National Environment Protection (Ambient Air Quality) Measure. Phase 2 of the project involved consultation with Australian experts regarding the recommendations of Phase 1, followed by the scoping of the prioritised research needs within Australia, and a list of recommended research priorities to address these.
The report focuses on long-term effects and the major outdoor pollutants on the health of children. Phase 1 began with a systematic review of the literature was carried out, and a final short-listing of the major influential studies, including the Southern Californian Child Health Study. The evidence from these studies was synthesised to arrive at final conclusions. It was concluded that links between air pollution had been established for respiratory symptoms and asthma, and for lung function and lung function growth, somewhat less convincingly. Important recent findings in the area of birth outcomes (low birth weight, pre-term births, birth defects) and childhood cancer need to be confirmed, not necessarily in Australia.
In general terms, a future research agenda for examining the role of air pollution in child health should be influenced by:
- The contribution of respiratory illness to child morbidity, and the established role that air pollution plays in this;
- The paucity of good information on child exposures, and the determinants of those exposures;
- The emerging findings that relate air pollution to childhood cancer and birth outcomes, potentially contributing major burdens of disease.
The applicability of results to Australian children rests with an evaluation of the nature and level of their exposure to air pollution and more detailed information than is presently available from the overseas studies on the dose-response relationships. If this information can be obtained, it should be possible to estimate the pollutant effects on respiratory health outcomes. Alternatively, epidemiological studies could estimate this empirically.
Thus, the identified needs and gaps in information relating to Australian children are in the areas of (a) knowledge about actual exposures and (b) given (a), an estimation of the effects on health.