Logo of envhperEnvironmental Health PerspectivesBrowse ArticlesAbout EHPGeneral InformationAuthorsMediaProgramsPartnerships
Environ Health Perspect. 2004 Feb; 112(2): 226–232.
PMCID: PMC1241833
Research Article

Assessing the health benefits of air pollution reduction for children.


Benefit-cost analyses of environmental regulations are increasingly mandated in the United States. Evaluations of criteria air pollutants have focused on benefits and costs associated with adverse health effects. Children are significantly affected by the health benefits of improved air quality, yet key environmental health policy analyses have not previously focused specifically on children's effects. In this article we present a "meta-analysis" approach to child-specific health impacts derived from the U.S. Clean Air Act (CAA). On the basis of data from existing studies, reductions in criteria air pollutants predicted to occur by 2010 because of CAA regulations are estimated to produce the following impacts: 200 fewer expected cases of postneonatal mortality; 10,000 fewer asthma hospitalizations in children 1-16 years old, with estimated benefits ranging from 20 million U.S. dollars to 46 million U.S. dollars (1990 U.S. dollars); 40,000 fewer emergency department visits in children 1-16 years old, with estimated benefits ranging from 1.3 million U.S. dollars to 5.8 million U.S. dollars; 20 million school absences avoided by children 6-11 years old, with estimated benefits of 0.7-1.8 billion U.S. dollars; and 10,000 fewer infants of low birth weight, with estimated benefits of 230 million U.S. dollars. Inclusion of limited child-specific data on hospitalizations, emergency department visits, school absences, and low birth weight could be expected to add 1-2 billion U.S. dollars (1990 U.S. dollars) to the 8 billion U.S. dollars in health benefits currently estimated to result from decreased morbidity, and 600 million U.S. dollars to the 100 billion U.S. dollars estimated to result from decreased mortality. These estimates highlight the need for increased consideration of children's health effects. Key needs for environmental health policy analyses include improved information for children's health effects, additional life-stage-specific information, and improved health economics information specific for children.

Full Text

The Full Text of this article is available as a PDF (160K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Bates DV. Adverse health impacts of air pollution--continuing problems. Scand J Work Environ Health. 1995 Dec;21(6):405–411. [PubMed]
  • Bobak M. Outdoor air pollution, low birth weight, and prematurity. Environ Health Perspect. 2000 Feb;108(2):173–176. [PMC free article] [PubMed]
  • Bobak M, Leon DA. Air pollution and infant mortality in the Czech Republic, 1986-88. Lancet. 1992 Oct 24;340(8826):1010–1014. [PubMed]
  • Bobak M, Richards M, Wadsworth M. Air pollution and birth weight in Britain in 1946. Epidemiology. 2001 May;12(3):358–359. [PubMed]
  • Burmaster DE, Anderson PD. Principles of good practice for the use of Monte Carlo techniques in human health and ecological risk assessments. Risk Anal. 1994 Aug;14(4):477–481. [PubMed]
  • Burnett RT, Dales RE, Raizenne ME, Krewski D, Summers PW, Roberts GR, Raad-Young M, Dann T, Brook J. Effects of low ambient levels of ozone and sulfates on the frequency of respiratory admissions to Ontario hospitals. Environ Res. 1994 May;65(2):172–194. [PubMed]
  • Burnett RT, Smith-Doiron M, Stieb D, Raizenne ME, Brook JR, Dales RE, Leech JA, Cakmak S, Krewski D. Association between ozone and hospitalization for acute respiratory diseases in children less than 2 years of age. Am J Epidemiol. 2001 Mar 1;153(5):444–452. [PubMed]
  • Chen L, Jennison BL, Yang W, Omaye ST. Elementary school absenteeism and air pollution. Inhal Toxicol. 2000 Nov;12(11):997–1016. [PubMed]
  • Cifuentes L, Borja-Aburto VH, Gouveia N, Thurston G, Davis DL. Assessing the health benefits of urban air pollution reductions associated with climate change mitigation (2000-2020): Santiago, São Paulo, México City, and New York City. Environ Health Perspect. 2001 Jun;109 (Suppl 3):419–425. [PMC free article] [PubMed]
  • Dejmek J, Selevan SG, Benes I, Solanský I, Srám RJ. Fetal growth and maternal exposure to particulate matter during pregnancy. Environ Health Perspect. 1999 Jun;107(6):475–480. [PMC free article] [PubMed]
  • Dockery DW, Cunningham J, Damokosh AI, Neas LM, Spengler JD, Koutrakis P, Ware JH, Raizenne M, Speizer FE. Health effects of acid aerosols on North American children: respiratory symptoms. Environ Health Perspect. 1996 May;104(5):500–505. [PMC free article] [PubMed]
  • Friedman MS, Powell KE, Hutwagner L, Graham LM, Teague WG. Impact of changes in transportation and commuting behaviors during the 1996 Summer Olympic Games in Atlanta on air quality and childhood asthma. JAMA. 2001 Feb 21;285(7):897–905. [PubMed]
  • Gilliland FD, Berhane K, Rappaport EB, Thomas DC, Avol E, Gauderman WJ, London SJ, Margolis HG, McConnell R, Islam KT, et al. The effects of ambient air pollution on school absenteeism due to respiratory illnesses. Epidemiology. 2001 Jan;12(1):43–54. [PubMed]
  • Hall JV, Winer AM, Kleinman MT, Lurmann FW, Brajer V, Colome SD. Valuing the health benefits of clean air. Science. 1992 Feb 14;255(5046):812–817. [PubMed]
  • Hasselblad V, Eddy DM, Kotchmar DJ. Synthesis of environmental evidence: nitrogen dioxide epidemiology studies. J Air Waste Manage Assoc. 1992 May;42(5):662–671. [PubMed]
  • Landrigan Philip J, Schechter Clyde B, Lipton Jeffrey M, Fahs Marianne C, Schwartz Joel. Environmental pollutants and disease in American children: estimates of morbidity, mortality, and costs for lead poisoning, asthma, cancer, and developmental disabilities. Environ Health Perspect. 2002 Jul;110(7):721–728. [PMC free article] [PubMed]
  • Lave LB, Seskin EP. Air pollution and human health. Science. 1970 Aug 21;169(3947):723–733. [PubMed]
  • Maisonet M, Bush TJ, Correa A, Jaakkola JJ. Relation between ambient air pollution and low birth weight in the Northeastern United States. Environ Health Perspect. 2001 Jun;109 (Suppl 3):351–356. [PMC free article] [PubMed]
  • Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997 May 17;349(9063):1436–1442. [PubMed]
  • Norris G, Larson T, Koenig J, Claiborn C, Sheppard L, Finn D. Asthma aggravation, combustion, and stagnant air. Thorax. 2000 Jun;55(6):466–470. [PMC free article] [PubMed]
  • Norris G, YoungPong SN, Koenig JQ, Larson TV, Sheppard L, Stout JW. An association between fine particles and asthma emergency department visits for children in Seattle. Environ Health Perspect. 1999 Jun;107(6):489–493. [PMC free article] [PubMed]
  • Peters JM, Avol E, Navidi W, London SJ, Gauderman WJ, Lurmann F, Linn WS, Margolis H, Rappaport E, Gong H, et al. A study of twelve Southern California communities with differing levels and types of air pollution. I. Prevalence of respiratory morbidity. Am J Respir Crit Care Med. 1999 Mar;159(3):760–767. [PubMed]
  • Pope CA., 3rd Respiratory hospital admissions associated with PM10 pollution in Utah, Salt Lake, and Cache Valleys. Arch Environ Health. 1991 Mar-Apr;46(2):90–97. [PubMed]
  • Pope CA, 3rd, Dockery DW, Spengler JD, Raizenne ME. Respiratory health and PM10 pollution. A daily time series analysis. Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):668–674. [PubMed]
  • Ransom MR, Pope CA., 3rd Elementary school absences and PM10 pollution in Utah Valley. Environ Res. 1992 Aug;58(2):204–219. [PubMed]
  • Ritz B, Yu F. The effect of ambient carbon monoxide on low birth weight among children born in southern California between 1989 and 1993. Environ Health Perspect. 1999 Jan;107(1):17–25. [PMC free article] [PubMed]
  • Ritz B, Yu F, Chapa G, Fruin S. Effect of air pollution on preterm birth among children born in Southern California between 1989 and 1993. Epidemiology. 2000 Sep;11(5):502–511. [PubMed]
  • Ritz Beate, Yu Fei, Fruin Scott, Chapa Guadalupe, Shaw Gary M, Harris John A. Ambient air pollution and risk of birth defects in Southern California. Am J Epidemiol. 2002 Jan 1;155(1):17–25. [PubMed]
  • Rogers JF, Thompson SJ, Addy CL, McKeown RE, Cowen DJ, Decouflé P. Association of very low birth weight with exposures to environmental sulfur dioxide and total suspended particulates. Am J Epidemiol. 2000 Mar 15;151(6):602–613. [PubMed]
  • Samet JM, Dominici F, Curriero FC, Coursac I, Zeger SL. Fine particulate air pollution and mortality in 20 U.S. cities, 1987-1994. N Engl J Med. 2000 Dec 14;343(24):1742–1749. [PubMed]
  • Schwartz J, Dockery DW, Neas LM, Wypij D, Ware JH, Spengler JD, Koutrakis P, Speizer FE, Ferris BG., Jr Acute effects of summer air pollution on respiratory symptom reporting in children. Am J Respir Crit Care Med. 1994 Nov;150(5 Pt 1):1234–1242. [PubMed]
  • Schwartz J, Slater D, Larson TV, Pierson WE, Koenig JQ. Particulate air pollution and hospital emergency room visits for asthma in Seattle. Am Rev Respir Dis. 1993 Apr;147(4):826–831. [PubMed]
  • Ségala C. Health effects of urban outdoor air pollution in children. Current epidemiological data. Pediatr Pulmonol Suppl. 1999;18:6–8. [PubMed]
  • Sheppard L, Levy D, Norris G, Larson TV, Koenig JQ. Effects of ambient air pollution on nonelderly asthma hospital admissions in Seattle, Washington, 1987-1994. Epidemiology. 1999 Jan;10(1):23–30. [PubMed]
  • Smith DH, Malone DC, Lawson KA, Okamoto LJ, Battista C, Saunders WB. A national estimate of the economic costs of asthma. Am J Respir Crit Care Med. 1997 Sep;156(3 Pt 1):787–793. [PubMed]
  • Thompson KM, Burmaster DE, Crouch EA. Monte Carlo techniques for quantitative uncertainty analysis in public health risk assessments. Risk Anal. 1992 Mar;12(1):53–63. [PubMed]
  • Ware JH, Ferris BG, Jr, Dockery DW, Spengler JD, Stram DO, Speizer FE. Effects of ambient sulfur oxides and suspended particles on respiratory health of preadolescent children. Am Rev Respir Dis. 1986 May;133(5):834–842. [PubMed]
  • Weiss KB, Gergen PJ, Hodgson TA. An economic evaluation of asthma in the United States. N Engl J Med. 1992 Mar 26;326(13):862–866. [PubMed]
  • White MC, Etzel RA, Wilcox WD, Lloyd C. Exacerbations of childhood asthma and ozone pollution in Atlanta. Environ Res. 1994 Apr;65(1):56–68. [PubMed]
  • Woodruff TJ, Grillo J, Schoendorf KC. The relationship between selected causes of postneonatal infant mortality and particulate air pollution in the United States. Environ Health Perspect. 1997 Jun;105(6):608–612. [PMC free article] [PubMed]

Articles from Environmental Health Perspectives are provided here courtesy of National Institute of Environmental Health Science


Save items

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...