The deaths of two young children, Ella Kissi-Debrah in 2013 and Awaab Ishak in 2020, have highlighted the consequences of breathing in air pollution and beingexposed to mould in our homes.
Now a clinic at the NHS Royal London hospital is bringing together academic innovations on children’s environmental exposure to try to help patients.
Between 2017 and 2019, 10,000 children were admitted to hospitals in London with asthma exacerbations. One in 14 of these can be attributed to air pollution.
Dr Abigail Whitehouse, of Queen Mary University of London, who is leading the clinic, said: “These cases are just the tip of an iceberg. It’s not just the asthma attack, it’s the times going to the GP, times off school, times that parents have to take off work. All of these things mount up, even for those that don’t have really bad asthma. Despite this, no NHS service is addressing the role of air pollution in health.”
A recent study by the UK Health Security Agency estimated that exposure to damp and/or mould was associated with about 3,000 new cases of asthma and about 4,000 lower respiratory infections among children in England in 2019. People from black and minority ethnic groups, and those from poor households, had more cases of asthma and mould than average.
Whitehouse said: “Children come to us where there is a concern that we have not fully gotten to the bottom of why they have ongoing asthma and wheeze episodes. The treatment aim for asthma is that they are symptom free and not needing to use their reliever inhaler.”
Funding from Barts Charity enables each child and their family to have a one-hour appointment in the clinic to discuss the child’s asthma, as well as possible air pollution and mould at home. The clinical team then visits each home.
The clinic has 43 patients so far. During the first visits the families all expressed concerns about their child’s exposure to air pollution. Twenty-nine families said they had problems with mould in their home, 72% live in social housing, 59% live within two minutes’ walk of a busy road and 21% are using an air purifier or dehumidifier at home.
Mould samples are taken during the home visits. Each child is given a portable air pollution monitor to wear for three days and keeps a diary of their symptoms. The clinical team and families then work together to develop a plan tailored to each child and track their progress. Practical steps can include travelling by foot or bike, using an extractor or opening a window when cooking and cleaning, and swapping to less polluting cleaning products.
