Air pollution is no longer just an environmental headline, it’s slowly becoming a daily health reality for children, especially those growing up in cities with poor air quality. Paediatricians across the country are noticing a worrying trend: kids are developing breathing problems much earlier than they used to. What once showed up in later childhood is now being seen in toddlers and even infants, often after episodes of smog, dust, or recurring viral infections.Parents are understandably confused. Is it just a stubborn cough? Another cold? Or something more serious like asthma? The challenge is that early asthma symptoms often look exactly like common childhood illnesses, making it easy to miss the warning signs. Add polluted air into the mix, and young lungs, still growing and highly sensitive, struggle even more.
From traffic-related smog and fine dust particles to seasonal smoke and poor ventilation, children today are exposed to pollutants far more frequently than previous generations. And while not every child exposed to pollution will develop asthma, bad air can act as a powerful trigger, bringing symptoms earlier and making them more severe.In an exclusive interview with TOI, Dr. Jyothi Raghuram, Senior Consultant – General Pediatrics & Pediatric Rheumatology, Aster Whitefield Hospital explains why children are more vulnerable to air pollution, how asthma is showing up at younger ages, what signs parents should watch out for, and whether tools like masks and air purifiers actually help. Most importantly, it looks at what needs to change, at home, in cities, and at a policy level, to protect young lungs and prevent asthma before it takes hold.
Are doctors seeing children develop asthma earlier than before because of poor air quality?
Yes, honestly, we are seeing this more than we used to. Earlier, asthma would usually show up a little later in childhood, but now we’re seeing very young children having breathing issues. Cities that have very bad AQI, these conditions become worse. Smoggy weather results in a sudden increase in children with symptoms of cough, wheezing, or breathlessness. However, only a few children who are exposed to pollution will develop asthma, but bad air definitely makes the breathing problems start earlier and more frequently.Asthma is multi-factorial – genetics, environment and host (that means the child) all contribute, not just one cause. If there is a strong family history of asthma and the child has frequent viral triggered wheeze from early childhood, then that child has a stronger possibility of developing asthma than one without family history. However we do see asthma in children without any other family member being affected. Pollution interferes with the lung development of a child and makes them more susceptible, thus, family history is not the only factor now.
Which pollutants are most harmful, and why are children more affected than adults?
The major problems with smog are that the dust particles are extremely fine and that smog is a traffic- related air pollution. Those dust particles are so tiny that they reach the deepest parts of your lungs and remain there, therefore they cause irritation to your lungs. Children are considered the most vulnerable group of kids as their lungs are still in the process of development. Children breathe more than adults since they are more active, playing outside, and thus they take in more dust than adults.Asthma can be very difficult to diagnose in young children because the symptoms of the disease are very similar to the symptoms of other viral illnesses. Apart from wheezing, some other symptoms are a persistent cough after an exercise, or a rise in the number of times your child coughs during a cold, night time cough, low stamina, easy fatiguability. Prolonged cough continuing after a short 2-3 day fever and cold may be a sign that they have asthma.
Will air purifiers and masks help to protect children from pollution if they are exposed to it (like smog or smoke) when they’re playing outdoors?
Air purifiers or masks may help decrease a child’s interaction with air pollution to some extent. However, it is recommended that for parents who live in polluted areas, children should avoid outdoor activities in high-polluted periods and go out only when air quality is better or when otherwise required medically. Another equally important thing is to make children conscious of air quality. Educating them to sense when air is bad and make decisions concerning outdoor activities accordingly may help them change their habits and avoid respiratory problems in future.
What changes parents need to adopt to prevent children from developing asthma?
Air pollution must be controlled to protect children. There needs to be less pollution caused by cars, improvement of mass transit systems, the use of cleaner fuels, and as much as possible keeping heavy traffic away from schools and homes. Air quality is an environmental issue, but it’s also the basis of preventive healthcare. If we want to see fewer children suffering from asthma, improving air quality needs to be our top priority, however that’s easier said than done. Relocation is not always feasible and may not solve the problem in all cases. A strong suspicion of asthma, early diagnosis by detailed history taking, physical examination, Pulmonary function tests ( if child is over 7 years of age), treating co-morbid conditions such as allergic rhinitis, worm infestation is necessary. Parents should understand that inhaled corticosteroids are safe and effective in treatment of asthma and they should regularly follow-up with their Pediatrician and comply with the treatment given.
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