WASHINGTON – When Dr. Lisa Patel was working on a project for the Environmental Protection Agency in 2005, she visited a children’s hospital for asthma in Mumbai, India. After seeing the main parts of the center, she was surprised when the coordinators took her to a nearby gymnasium that had been converted into a children’s asthma ward. It was filled with even more children who were receiving care.
Seeing an entire gymnasium full of child asthmatics struggling to breathe was moving for Dr. Patel, the executive director of the Medical Society Consortium on Climate and Health. But the global climate crisis became much more personal when the California wildfires reached her own children almost a decade later.
“That’s when it became very concrete to me that no child should be breathing in this absolutely foul pollution that’s ruining their health,” she said.
According to a report by the Harvard T.H. Chan School of Public Health, children face disproportionate ill effects as a result of climate change, largely because they are actively developing both mentally and physically.
Children are affected by both “indoor air” and their surrounding climate, Executive Director of the Children’s Environmental Health Network Nsedu Obot Witherspoon said at a Moms Clean Air Force (MCAF) event about children’s health in the face of the climate crisis on Feb. 8.
According to Witherspoon, “indoor air” is impacted by a number of products including cleaners, toys, pesticides and other human-made items children encounter. “Climate” encompasses air quality, water quality, pollution, natural disasters and any additional environmental factors.
While everyone is impacted by these types of exposure, children are more likely to be negatively impacted.
“Their airways are smaller. They have developing immune systems,” Dr. Patel said. “So things like NOx or PM2.5 irritate the lung lining and put children at higher risk for respiratory illnesses.”
NOx, also known as nitrogen oxides, are “a group of highly reactive gasses, including nitrogen dioxide, nitrous acid, and nitric acid,” according to the Arizona Department of Environmental Quality (ADEQ). Similarly, the ADEQ classifies PM2.5 as “the smallest, most harmful particulate pollution.” PM2.5 is a combination of nitrogen oxides and other harmful substances.
In the U.S., 49% of parents say climate change has affected their decision about having more children, according to a recent study conducted by Morning Consult on behalf of the technology company, HP.
Moreover, the study concluded that 91% of parents globally are worried about the climate crisis and have changed their purchasing habits as a result.
“I studied climate change in college and at the time, it felt like a calling, and it felt like something that I wanted to do,” Dr. Patel said. “But I think when I had my kids, it no longer felt like a choice. It felt like something that I had to do.”
Even so, parents have little control over what substances their children come into contact with. With more than 12 million children under the age of five in the United States in some form of nonparental care, Witherspoon said the industry lacks sufficient regulations, focusing on these “critical windows of exposure.”
Prevention through policy
Existing health and safety policy surrounding child care is largely centered around the prevention of the spread of infectious diseases and violence, though there are also climate-related regulations to highlight.
The National Resource Center for Health and Safety in Child Care and Early Education is the most prevalent organization setting health and safety standards for child care facilities. Their resources give providers national and state standards to follow.
One national standard largely influenced by the Clean Air Act stated that providers must check the air quality index before determining if it is safe for children to play outside. There are also established protocols surrounding natural disasters to keep facilities prepared to protect children in the event of an emergency.
States can establish their own rules for child care providers too. For example, a 2018 California law required licensed child care centers to test their water for lead by 2023.
After results found shocking levels of the poisonous substance in the water supplies, Rep. Katie Porter (D-Calif.) said California children’s lead exposure was alarming.
“One in four California child care centers has dangerously high levels of lead in their drinking water,” Porter said. “Children are our future, and we owe it to every American to protect all kids’ safety and well-being.”
In remarks made in Pittsburgh on Feb. 20, Vice President Kamala Harris promised to eliminate all lead pipes in the United States, recognizing the impact that lead has on children’s health.
The Biden-Harris Lead Pipe and Paint Action Plan “includes over 15 new actions from more than 10 federal agencies that ensure the federal government is marshalling every resource to make rapid progress towards replacing all lead pipes in the next decade.”
“When children drink toxic water through lead pipes, it has an impact on their learning ability, on their health,” Harris said. “And for too long, this has been the case, that communities have been crying out for support to get rid of these lead pipes.”
There are also environmental justice concerns around the quality of drinking water, which Porter alluded to in her remarks.
“Many of the worst facilities for lead levels are in low-income areas or communities of color,” she said.
According to Witherspoon, the child care industry is a space where environmental injustice is heightened because the profession is largely dominated by women, including women of color and women of childbearing age. She said there is a dual benefit of reducing the environmental hazards and limiting the negative health effects for both children and their care providers.
Exposure to plastic
Another concern for children’s environmental health is exposure to plastics. Judith Enck is the founder and president of Beyond Plastics and a former EPA regional administrator. Her work focuses on the dangers of plastic pollution. At the MCAF event in early February, she cited how plastic emissions are replacing those originally produced by the coal industry.
“Plastics is Plan B for the fossil fuels industry,” she said. “All of us have microplastics in our bodies.”
Microplastics are a particular danger because they are being found in a variety of organs, from livers to placentas. According to a study by a peer reviewed journal titled Birth Defects Research, exposure to microplastics as a newborn “is linked to the development of multiple illnesses in adulthood.”
Yet exposure can also occur before a child is born, “which may have the potential to cause harmful effects later in life,” according to a recent study by Environment International.
While action has been taken against the rise of plastics, Enck said she is still working toward more change.
In December, the EPA decided that vinyl chloride, which has been a known carcinogen for about 50 years, will be among five chemicals that will begin the risk evaluation prioritization process under the Toxic Substances Control Act, Enck said. “But that’s the beginning of a ten-year journey to ban vinyl chloride,” she added.
The mental health toll of the climate crisis
Research shows that children’s mental wellness is also affected by the climate crisis.
“There’s actually some emerging data that early exposure to air pollution places children at higher risk for anxiety and depression,” Dr. Patel said.
Dr. Lise Van Susteren, a medical doctor and general and forensic psychiatrist, indicated the youth population is paying a mental toll for the climate crisis.
“The extreme weather events they face not only bring – acutely – fear, anger, sorrow, etc. But over time, what happens is they become dispirited, even demoralized and feel potentially a feeling of abandonment and betrayal by their government,” Dr. Van Susteren said.
While the public might differ over which initiatives to support, two-thirds of Americans agree that the government should be doing more to solve the climate crisis, according to a 2020 study conducted by the Pew Research Center. This support extends across partisan lines.
Dr. Van Susteren said there should be more psychiatrists who specialize in climate mental health. This support could help improve the morale of a younger generation that feels a widening gap between themselves and their government.
At the MCAF event, she said it is important to consider a child’s particular age, behavior and the context in which they live before talking to them about climate change. Supporting a child’s mental well-being is not a “one size fits all approach.”
While some kids need more transparency, others need protection, Dr. Van Susteren said. It is up to those supporting the children to assess what they need based on existing factors.
Dr. Van Susteren said adults should also be aware of their own mental well-being. She wants people who are struggling mentally with the climate crisis to “recognize that it’s really our collective effort – individually counted, it’s just like votes on election day – but this is what ends up changing the course of our history.”
Dr. Patel said she feels a particular responsibility to protect her own children.
“I brought them into this world. And so it’s incumbent on me to make sure that this is a world worthy of them,” she said.
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