Q&A: Zero-emission vehicles, clean power prevent respiratory illnesses in children

Key takeaways:

• A recent report predicts improved children’s health with zero-emission vehicles and electricity.
• Clinicians play a major role in educating parents on pollution and encouraging policymakers to clean the air.

Transportation pollution puts children’s health at risk on a daily basis, but a switch to zero-emission vehicles and clean power would prevent several poor respiratory outcomes in this population, according to a press release.

These findings come out of the American Lung Association’s latest report: “Boosting Health for Children: Benefits of Zero-Emission Transportation and Electricity.”

According to a release from the association, the report focuses on the impact zero-emission passenger vehicles and trucks could have on children’s health if by 2035 and 2040, respectively, they represent all new cars and trucks being sold. Predictions from this report are also based on use of clean, non-combustion renewable energy to power the nation’s electric grid by 2035.

As Healio previously reported, the American Lung Association’s “Driving to Clean Air” report found that nearly 90,000 lives would be saved and more than 2 million asthma attacks would be avoided by 2050 if all new cars sold in 2035 are zero-emission passenger vehicles.

Healio spoke with Afif El-Hasan, MD, pediatrician with Kaiser Permanente in Orange County, California, and spokesperson for the American Lung Association, to learn more about the findings from the latest report, why children are greatly impacted by transportation pollution and what clinicians can do to support the switch to electric vehicles and clean power.

Healio: Why is the “Boosting Health for Children: Benefits of Zero-Emission Transportation and Electricity” report important for clinicians to read and share?

El-Hasan: Clinicians need to realize how important pollution is as a factor in the health of children, and unfortunately, I don’t think that comes into play very often. You may ask a family, “Does anyone smoke?” but when talking about children and looking for risk factors, do clinicians ever ask, “Do you live near a freeway?”

The same goes for managing asthma. We ask, “Do you have any dogs or cats at home? Do you have any smokers?” But does anyone ask an asthmatic, “What sports do you play? Do you jog during times of peak pollution?”

Clinicians have to realize that air pollution is extremely important to consider when managing both healthy children and chronic disease in children. Because pollution is a big contributor to upper airway illness, lower airway illness, asthma and development of the lungs in children, it needs to be an important factor. Just like clinicians advocate for no smoking in homes, we have to advocate for clean air everywhere because it’s so important to the health of children.

Healio: Why are children vulnerable to pollution, specifically transportation pollution? What are some harms of exposure to this type of pollution?

El-Hasan: Children are vulnerable for several reasons that are a bit unique from adults. One issue is the fact that their lungs are growing and developing. One study by USC showed that the lungs of children who live in areas where there are high levels of pollution are not going to develop as much as the lungs of children who live in clean air. This is an important issue because you’re basically taking a child who is in a polluted area and giving them a lifetime of disadvantage by reducing their lung function slightly over time. That’s terrible and unfair to the child. The child doesn’t have any control over this nor do the parents necessarily because children go outside.

Another aspect is the times of day that children are outside. Children walk to school and play sports after school around the same time as rush hour. They tend to be outside when there are higher levels of pollution. During drop-off at schools, cars are lined up and sitting there idling, leaving a localized cloud of pollution around the school when children are out.

Add to that the fact that children like to be outside. We need them to exercise to be healthy. We talk about sports, walking, biking — all of these are outdoor activities. We want kids outside. They deserve to be out in parks and athletic fields doing sports and walking to school safely, but air pollution compromises and causes issues for kids in those situations. It’s a rough deal, and I feel bad that this is indeed the case.

Further, underserved communities are very often more heavily impacted by pollution. It’s unfair and makes for a difficult situation because not only are underserved communities and communities of color disproportionately suffering more from pollution, but some of these communities also have less access to health care and transportation. Pollution makes the problem even worse. Transitioning to zero-emission vehicles will help with the inequities we’re seeing in that realm.

Healio: How has climate change and disasters related to climate (wildfires, flooding, etc) negatively impacted children?

El-Hasan: Climate change and disasters related to climate increase the frequency of asthma attacks, upper respiratory infections and lower respiratory infections. It’s been a big problem recently.

Different types of pollution irritate the upper airways by going down in the lungs. Pollution affects every part of the whole airway system. One of our great defenses is the ability to drain and expel infection and get rid of destructive factors in our lungs and upper airways, whether it be particles, infection, etc. If the areas are inflamed, mucousy or irritated, it compromises one of our defenses against infection. It makes it more likely to have an asthma attack.

The smoke from wildfires and the increased mold from flooding both increase irritation in the upper airways of our lungs and, especially for kids, it makes them more susceptible to illness.

Healio: The report found several reductions in adverse outcomes that will occur by 2050 with the transition to zero-emission transportation powered by clean non-combustion energy. Could you share these major benefits and the impact they will have on pediatricians?

El-Hasan: The report states prevention of:

• 2.79 million pediatric asthma attacks;
• 147,000 pediatric acute bronchitis cases;
• 2.67 million pediatric upper respiratory symptoms; and
• 1.87 million pediatric lower respiratory symptoms.

This switch will also save the lives of 508 infants if you look at public health calculations.

The bottom line is we’re talking about millions of kids whose quality of life is better. It will lead to better attendance at school, parents who don’t have to leave work to take their children to a doctor, parents who themselves don’t become ill because of their children’s illness and vice versa. Transitioning to zero-emission transportation creates a rippling effect and affects everyone.

Even if you forget about quality of life and illness, think about the unnecessary expenses to the health care system, the decreased productivity in the country and how schools are impacted by air pollution. A lot of the school districts in my area are paid based on attendance of the children, and if they’re not in school, they don’t get paid for that day for that child.

Healio: What action can clinicians/pediatricians take to support the transition to electric vehicles and clean power?

El-Hasan: It starts first with educating parents of children and building an understanding that pollution and outside air are factors that will impact their child’s health. We need to get parents to think about the world that their children are in and possible ways that they can make that world better. One way to do this is an electric vehicle.

It’s very important that parents receive this education because who more than a parent wants the world to be a better, safer and healthier place for their kids. Transitioning to electric vehicles, advocating and supporting the infrastructure to make it easier to charge the electric vehicles is going to help all of us.

Additionally, clinicians must understand that they themselves are important advocates to local governments and agencies. Just like we advocate for no smoking and vaping, advocating for clean air is another huge factor that’s going to affect children.

Clinicians can talk to lawmakers and policymakers and make them understand the impact of decisions on the health of children through personalized stories. For example, clinicians can share how walking to school every day in a polluted area negatively impacts asthma and increases illness in children.

In addition to the impacts on the quality of life of patients, clinicians need to talk about the cost to society because there is a very expensive cost that needs to be emphasized. Taking care of ill people — people who didn’t necessarily have to be ill if the air was cleaner — is costly. They need to talk about resources used, as well as quality of life because that will have more of an impact on policymakers as they realize what we’re trying to do not only makes the world better for children and gives us healthier children, but it allows us to have resources for other important aspects of society that we wouldn’t need to use on sick children if we made the air cleaner.

It’s important for physicians to share their stories and advocate as best they can for clean air in every way possible, both to policymakers and parents.

Healio: Considering all the report’s findings, what is the American Lung Association’s message for the EPA?

El-Hasan: The primary role of the EPA is to keep our environment safe and clean so we all remain healthy regardless of where we live or where we’re traveling in the country. I’d urge the EPA to make the transition to electronic vehicles a top priority. This report reinforces the need to make this transition for the sake of children to ensure their health and well-being both now and when they become adults.

If we do not make every effort to make our air cleaner, we risk the deterioration of the quality of life and health of children in this country throughout their lifetimes. We know and we acknowledge that the EPA is working on rules to make cars and trucks cleaner. We are advocating with them for these rules, and we urge the EPA to finalize strong pollution limits for new cars and trucks that drive a nationwide transition to zero-emission vehicles.

We look forward to our continued partnership with the EPA because both of us are interested in the same end result of a safer and healthier environment. We continue to look forward to that partnership.

References:

• Boosting health for children: Benefits of zero-emission transportation and electricity. https://www.lung.org/getmedia/dec4362b-0467-4609-9639-2e62301409a4/EV-Boosting-Health-for-Children.pdf. Published Feb. 21, 2024. Accessed Feb. 21, 2024.
• Boosting health for children: Transition to electric vehicles and clean power would prevent 2.7 million asthma attacks in U.S. kids. https://www.lung.org/media/press-releases/boosting-health-for-children-transition-to-electr. Published Feb. 21, 2024. Accessed Feb. 21, 2024.
• Gauderman WJ, et al. N Engl J Med. 2004;doi:10.1056/NEJMoa040610.