From smog to microplastics: the invisible enemies of children's health, inside and outside the home.

Smog, climate change, and microplastics, even present in indoor air. These are some of the invisible enemies of children's respiratory health . In Italy, one in four children suffers from asthmatic bronchitis, one in three from allergic rhinitis, and one in ten from asthma . The alarm was raised by pediatricians from the Italian Society for Childhood Respiratory Diseases (Simri) , gathered in Verona for the national congress. "Pollution and toxic substances like PFAS and phthalates affect lung development from the first days of life," explains Stefania La Grutta, president of Simri.

In 2021, air pollution caused 8.1 million deaths globally, including 700,000 among children under five, mostly in low-income countries. This toll continues to rise. " Children are particularly vulnerable : they absorb more pollutants relative to their body weight, have an immature respiratory system , a limited ability to regulate temperature, and are more susceptible to infections," adds La Grutta.

We spend up to 90% of our time indoors. Secondhand smoke, stoves, sprays, paints, mold, and harsh detergents are underestimated sources of exposure . "With simple daily measures, we can reduce the risks: ventilate rooms, use the hood in the kitchen, avoid overly aggressive products," says Giovanni Viegi, a pulmonologist and epidemiologist at the National Research Council (CNR).

Micro- and nanoplastics have been found in the blood, lungs, and even the placenta. "These are invisible particles that can carry toxic substances such as phthalates, PFAS, and heavy metals, posing risks to fetal development, the endocrine system, and metabolism," explains Giacomo Toffol, a family pediatrician (Ulss 2 Veneto). Hence the national campaign to prevent risks from plastic exposure, promoted by several scientific societies. Lifestyle factors also play a role. "It's not just genetics or medicine: the quality of the air a child breathes, the food they eat, whether they exercise or are exposed to secondhand smoke, all have an impact from the first months of life," concludes Maria Elisa Di Cicco, a pediatrics researcher at the University of Pisa. Social inequalities also exacerbate the situation: those living in more polluted areas or in unsanitary housing are more likely to develop asthma and infections. Simri calls for a new vision: an "environmental medicine" capable of not only treating symptoms, but also recognizing and preventing the environmental causes of respiratory diseases.