From Womb to Adolescence: Impact of Pollution on Children

Environmental pollution has become one of the most pervasive yet dangerously underestimated threats to child health. Its effects begin well before birth and persist across the entire life course. Exposure to polluted air, especially fine particulate matter, harms children from the intrauterine stage through adolescence. It disrupts organ development, compromises neurocognitive outcomes, and undermines respiratory health. Drawing on clinical experience as well as global and India-specific evidence, the following discussion links large-scale child mortality directly to pollution and examines its long-term consequences, including chronic lung disease and cancer. Taken together, these insights position pollution not as a peripheral environmental concern, but as a sustained and escalating public health emergency threatening the next generation.

Within this context, The Interview World spoke with Dr. D. K. Gupta, Chairman, Felix Hospital, during the Conference on the Impact of Air Pollution on Health and Preventive Measures, organized by Illness to Wellness Foundation (ITWF) in collaboration with FICCI.

In a wide-ranging and incisive conversation, Dr. Gupta detailed the harmful effects of environmental pollution on children during intrauterine development. He further explained how postnatal exposure leads to lasting neurodevelopmental impairments. He presented global and India-specific data linking environmental pollution to child mortality and emphasized that prolonged exposure to high Air Quality Index (AQI) levels significantly increases the risk of lung cancer in children. What follows are the key takeaways from this compelling exchange.

Q: What adverse effects does environmental pollution have on children during intrauterine life?

A: Children do not experience the adverse effects of air pollution only after birth; they are affected well before delivery, during intrauterine life. In other words, exposure begins in the fetal stage, when critical organs are still developing. As a result, air pollution can impair lung formation and disrupt brain development.

Moreover, when pregnant women are exposed to high levels of fine particulate matter (PM2.5), the risks escalate significantly. Such exposure increases the likelihood of preterm labour, premature delivery, and preterm birth. Consequently, many infants are born with low birth weight.

These vulnerabilities often lead to serious neonatal complications. Newborns may develop septicemia, respiratory distress syndrome, or necrotising enterocolitis, among other conditions. Importantly, these outcomes stem from organ immaturity and, in some cases, congenital abnormalities. Over time, the cumulative impact of these early insults can also manifest as long-term disabilities, including cerebral palsy.

Q: Do children exposed to environmental pollution experience neurodevelopmental impairments after birth?

A: After birth, children who were exposed to high levels of air pollution during intrauterine life face substantially elevated health risks. In particular, they are far more likely to develop neurodevelopmental disorders. These include cognitive impairment, memory deficits, reduced executive functioning, poor attention span, impaired concentration, and lower IQ levels.

Furthermore, the impact extends beyond cognition. Such children may develop mood and behavioural disorders, including depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder. In more severe cases, they may also experience cerebral palsy or psychotic disorders, underscoring the long-term neurological consequences of early exposure.

At the same time, their respiratory system remains highly vulnerable. Because their lungs are continuously exposed to elevated levels of PM2.5, these children are significantly more prone to developing early-onset asthma. As they grow older, this risk progresses further, increasing the likelihood of chronic obstructive pulmonary disease (COPD) and interstitial lung disease. Alarmingly, sustained exposure over time also raises their lifetime risk of developing lung cancer.

Q: Could you share global and India-specific data on child mortality attributable to environmental pollution?

A: Globally, air pollution directly causes an estimated 8 to 10 million deaths each year. Alarmingly, India alone accounts for approximately 26 percent of these fatalities, making it the country with the highest air-pollution–related mortality burden. In absolute terms, this translates to nearly 2 to 2.5 million deaths annually.

The impact on children is particularly devastating. Every single day, around 464 children under the age of five die due to complications directly attributable to air pollution. This figure is not only staggering but also deeply concerning from a public health perspective.

Compounding the crisis, most Indian children are routinely exposed to air quality levels that are 10 to 15 times higher than the limits prescribed by the World Health Organization. Similarly, their exposure to PM2.5 far exceeds safe thresholds, often reaching levels 10 to 15 times above recommended norms. Together, these factors create a sustained and severe risk to child survival, development, and long-term health.

Q: Can long-term exposure to high Air Quality Index (AQI) levels increase the risk of lung cancer in children?

A: This level of exposure is extremely hazardous. By allowing children to breathe polluted air, we are directly putting them at risk of a wide range of serious health complications. In the short term, air pollution triggers acute symptoms such as a runny nose, sneezing, persistent coughing, headaches, skin rashes, asthma, and bronchitis.

However, the damage does not stop there. Over time, continued exposure leads to profound long-term consequences. These include depression, mood disorders, and psychotic conditions, along with impaired concentration, reduced cognitive capacity, poor focus, and lower IQ levels.

Moreover, the cumulative impact on the respiratory system is particularly alarming. Prolonged exposure significantly increases the risk of chronic lung diseases and, ultimately, heightens the likelihood of developing lung cancer later in life.