How Climate Change Affects Children's Health

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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning again, everyone. Now, our Climate Story of the Week. Children's Health and the Perils of Climate Change. That's the title of a new book by Frederica Perera, founder and director of the Center for Children's Environmental Health at Columbia University and professor in the Mailman School of Public Health there. In full disclosure, Dr. Perera was one of my professors when I got my public health degree there and she is an influence on how I see the world to this day. Ricki, thanks for coming on. I've been reading your book and I'm still learning from you, so welcome to WNYC.

Frederica Perera: Well, I'm very happy to be on. Brian, you were one of my star pupils. [laughs]

Brian Lehrer: Thank you. I want to give our listeners some background on you, which you do compellingly in the preface to the book because you tell the story of when you were a grad student at Columbia and you were shocked into a new direction while you were studying the toxic chemicals known as polycyclic aromatic hydrocarbons. Listeners, you don't have to memorize that name. There won't be a test. Ricki, can you tell that story about what shocked you in that process?

Frederica Perera: Sure. Well, I was studying these chemicals. They're part of the particulate matter that we breathe every day even in our beautiful city. I had been studying them in terms of the damage they could do to DNA once inhaled. I had thought and I was doing studies in adults in terms of adult disease. I was looking for a laboratory control because what we were doing was measuring the chemical latched onto DNA. We could measure that using new techniques from the molecular biology lab. I was looking for a clean control tissue and I thought what could be cleaner than placenta or cord blood, which would be untouched, not written on by any environmental--

Brian Lehrer: In other words, from brand newly-born babies?

Frederica Perera: Yes, so it turned out that we and others were finding these smudges, so to speak, on DNA, the genetic material of newborns. That made me realize we needed to learn more about what the exposures were even before birth that could be harming health.

Brian Lehrer: That set you on a lifelong career path to understand not just how environmental exposures affect adults, and not even just children but also the environment and fetal development, in particular. When I was in school with you, global warming as a public health threat was not yet really front and center. People were starting to talk about it as this abstract environmental thing as a threat to the earth less as a threat to people. I think you'll remember it that way. What's another example prior to getting interested in climate of environmental exposures here in New York that you studied with respect to healthy fetal and infant development? Because I think listeners would find some of that research really interesting.

Frederica Perera: Well, I focused a lot on air pollution, but we've also looked at other chemicals, chemicals that can mimic natural hormones, so-called endocrine-disrupting chemicals, and have seen health effects and especially from when children were exposed prenatally. I do want to respond to that comment that climate change was not seen as a public health threat.

Even today if you think about the COP 27 meeting, public health was mentioned, but not really children's health. That's been omitted in the discussions, and yet children are bearing the brunt of climate change, and also from the fossil fuel pollutants that come right out of the same smokestacks. The tailpipes is CO2, the main greenhouse gas. Those pollutants are affecting the children's health as well.

In the book, I tried to put them together, take them out of their silos, and consider them together and how they're piling on, so to speak, to harm children's health because, actually, practically nearly all children are exposed to at least one climate that we call them climate shock or a severe weather event or severe heat. We've had massive heat waves all over the world and in our country this summer, for example, or drought.

Almost every child is breathing polluted air. 90% of children around the world are breathing polluted air. I wanted to bring this to the front and center and make people more aware, engage parents, grandparents, policymakers, government leaders in this effort to curb climate change and fossil fuel pollution for the benefit of children because they are the most vulnerable and they are bearing the brunt.

Brian Lehrer: It's interesting that you see that even at the COP 27 meeting as you referenced, which just took place over the last few weeks. This year's climate change and what are we going to do about it? Meaning that people weren't so focused on public health and certainly not on the public health of children. You write in the book that you hope and people think about climate change.

They don't only think about things like melting icebergs and stranded polar bears but also malnourished children, asthmatic kids using inhalers, and tiny babies born prematurely. You want to go a little deeper into any one of your choice? Maybe the preemies, maybe people have not heard that mentioned in the same breath as climate change before.

Frederica Perera: Sure. Well, heat is a risk factor for a premature birth, that is babies born too soon, and air pollution is as well. Interesting, they have many of the same effects, but as a result of climate change-- [coughs] Excuse me.

Brian Lehrer: You need a minute?

Frederica Perera: [coughs]

Brian Lehrer: We could take a break for a minute if you need it. I'll fill in and let people know, especially if you're just joining us, that we're talking with Columbia University Mailman School of Public Health Professor Frederica Perera. She's got a new book called Children's Health and the Perils of Climate Change. This is our Climate Story of the Week here on The Brian Lehrer Show.

We're going to explore in further detail one of the things that she said a minute ago because one of the premises of the book is that the fight against old-fashioned, ground-level pollution and the fight to prevent catastrophic global warming are really the same cause and should be spoken about together more than they tend to be. I think Ricki's back with us now. Are you okay?

Frederica Perera: Yes, I am. Sorry, I hit something in my throat. Well, as a result of climate change, infants and children are having more heat-related illness, more physical injury, and psychological trauma from weather disasters. We've seen that with Katrina, Harvey, and Ian most recently. Also, they're suffering more asthma attacks because of breathing forest fire smoke. More drought is causing more malnutrition and even stunting in other parts of the world.

We're seeing more Lyme disease in the US in children as climate change has extended the range of ticks. These are serious impacts of climate change and they're certainly not uncommon. In June, we had something like-- I think it was 100 million adults and children in the US who are affected by heat waves. In 2020, more than 900,000 children and adults were displaced due to disasters, so this isn't a remote problem.

Then we have a piling on by air pollution, which is increasing premature births as you mentioned, also the toll in infant deaths, asthma, but also affecting early brain development. That's something that our research at the Columbia Center for Children's Environmental Health has been showing as we have followed cohorts of pregnant mothers and children. We've seen air pollution linked to reduced IQ and attention problems, even autism and mental health problems in children and adolescents.

There's concern about how these are acting and interacting. There's some evidence that they can interact in a synergistic fashion in terms of preterm birth and asthma and what research needs to be done on the other outcomes, including mental health. We do see that so many children are now exhibiting and reporting climate anxiety. In fact, in a survey, it was something like 60% of children reported they were very concerned or extremely concerned about climate change. It was affecting the daily lives of about 50% of them.

Brian Lehrer: Listeners, if you have--

Frederica Perera: We have serious problems.

Brian Lehrer: Listeners, if you have any question or, for that matter, any story about children's health and the perils of climate change, which is the title of Dr. Perera's new book, Children's Health and the Perils of Climate Change, 212-433-WNYC, 212-433-9692.

On this idea, that's the main message of your book and of what you've said here so far, that the fight against old-fashioned, ground-level pollution and the fight to prevent catastrophic global warming are really the same cause because of the centrality of fossil fuels to both things. Politically, I think many people might support basic clean air laws to prevent asthma and things like that but consider climate change too much of an abstraction, and you used the word "abstraction" in your book, to make many lifestyle or political sacrifices for. Do you see that duality in politics?

Frederica Perera: I do, and yet this is not a remote issue for Americans. The problem is right here. We've seen it here. Seven million children every year breathing forest fire smoke and having more asthma attacks. I mentioned evacuations due to severe storms and floods and trauma occurring when children have to be evacuated due to serious storms and hurricanes, flood.

Rather than totally depressing in your audience, I want to mention that the second half of the book is about solutions, hopeful stories, success stories of actions around the world, in cities around the world, and including our country, where regulations and policies have made a difference. They have brought down the threats with significant economic savings, so that's good news.

Brian Lehrer: Pick an example because this book is as global as it is local. I know that's always been a hallmark of your work. You're very much investigating air pollution threats to children in New York City as part of your work at the Mailman School and the Center for Children's Environmental Health that you founded there. You've also been looking globally and the book is really strong on that on pursuing two tracks in that way. What's the success story from anywhere around the world that the United States may not have learned from yet?

Frederica Perera: Sure. Well, there are many success stories in the book. I talk about London, where policies controlling traffic emissions in Central London actually led to a 44% reduction in the main transportation pollutant, nitrogen dioxide, within three years and reduced CO2 emissions by over 12,000 tons. As a result, there were thousands of prevented preterm births, cases of asthma, other respiratory illnesses, and developmental problems according to estimates, predictions using models.

That was good news for London. Then we did studies in Kraków, Poland, where coal burning was shut down, finally banned in part because our research was reporting so many adverse effects of pollution. They finally banned residential coal burning for heating. That resulted very quickly in a 50% reduction in pollution levels during the heating season. Again, children's health benefited.

Then in New York City, we've been able to track some of the policies with respect to transportation, taxi emissions, bus emissions, and cleaner fuel for heating of residences in the city. We have seen good news there where air quality has improved. Those policies have been very effective. Also, in our study in Manhattan, we monitored air pollution in pregnant women and showed that, in fact, the levels in their personal air samples came down significantly over time concurrent with these policies.

Brian Lehrer: It's so interesting and you inspired me through the book to look up city statistics on ground-level air pollution, health effects. Because even as the atmosphere is continuing to warm, I think clean air laws have given us progress on the ground-level pollution. That's what you were just saying too. I looked up some New York City stats. You probably know all these, but maybe not all our listeners do.

According to the city health department, between 2009 and 2020, annual average levels of the fine particulate matter PM 2.5, nitrogen dioxide, and nitric oxide, those major pollutants that can exacerbate heart and respiratory problems, have declined 43%, 39%, and 56% respectively. Also, those emissions from buildings, you just mentioned buildings, have continued to decline reflecting the impact of city regulation of heating oil. How is it that ground-level air pollution, conventional air pollution has gotten less bad in New York? At the same time, these same fossil fuels are contributing to persistent warming of the atmosphere. We've gotten them under control in one way and not under control in another way.

Frederica Perera: Well, we have to do more in terms both of air quality and reducing CO2 emissions and other greenhouse gas emissions from fossil fuel. We really only have a brief window. The book is sober for the first part if not a little bit grim on what is happening to help the children and the trends in pollution and CO2, but hopeful. It also sounds a note of real urgency because we just have a short window for action and to control the global warming to that threshold that has been identified as being the threshold beyond which there are truly catastrophic effects of climate change.

Now, we have the window. We can act and we can make a difference, but it does require all countries everywhere in the world, the major emitters. We're number three now behind China and India. It requires all of us to do more on these emissions that affect the global temperature. We can do a lot for local air pollution, but we also have to do more on the CO2 globally. That's due to emissions from all sources around the world.

The solutions really are to transition from fossil fuel to move to energy efficiency, but also to strengthen our natural carbon sinks like soils and forests. We've been cutting down forests at a rapid rate and going in the wrong direction there, so that needs to stop. The good news is that we are beginning to transition. We see price of solar has come down 50% in recent years. Businesses are picking up on this and saying, "Okay, this is good for us," and hopefully thinking about the climate as well. There's some really hopeful signs, Brian. I don't want your audience to be totally depressed here.

Brian Lehrer: Indeed. Let's take a phone call. Daniel in Brooklyn, you're on WNYC. Hi, Daniel.

Daniel: Hi, can you hear me?

Brian Lehrer: Can hear you just fine, yes.

Daniel: Oh, great. Thank you. Thank you so much first of all for your work and dedication to this topic. I just was wondering. I live in a Brooklyn neighborhood, where it's a hop, skip, and a jump to this huge sanitation factory by the BQE and also the BQE Hicks Street. Whenever I drive by there, you can tell. You can smell the smog. Once in a while even in the neighborhoods, it smells like factory smell if the wind is right.

I always just think about the children growing up over here and what differences there are in a place like this and even, say, Manhattan with more ground pollution per se or a suburb or the country. Then also what are some things you think we can do about that, just in our apartment living, air filters, or the like? That's it.

Brian Lehrer: Daniel, thank you very much. I think talking about people who live near the BQE, Ricki, is a good hyperlocal example of another thing that you explore in the book that we've certainly talked about a lot in our Climate Story of the Week series, which is the disparate impact of climate change and other environmental health threats that unfortunately distribute by race and income.

Frederica Perera: That's right, and this is a huge environmental. Also, we're seeing climate injustice because while all children are vulnerable and all at risk, those least advantaged socioeconomically, we call it, are really hurt first and worst. That's true around the world and also in our country, where you have more disproportionately-high air pollution levels and more likelihood of experiencing a heat wave or the effects of heat wave due to less shade and more asphalt, which traps heat in certain urban areas in communities of color and low income.

Those children are affected the most. They're also less buffered, we would say, by protections, by social support, education, and good health care. We know all the solutions and they get rid of fossil fuels as quickly as we can and transition. As I mentioned, energy efficiency, but also policies that will address these inequalities, address poverty, provide basic services, and as I mentioned quality health care and education for all children, including those most vulnerable in the so-called frontline communities.

Brian Lehrer: At the apartment level, individual level, do you have any advice for Daniel or anyone else who lives right by the BQE or any other major thoroughfare where there are a lot of vehicles? He asked about air filters for the home. In the meantime, what kinds of adaptations if you're into it on this level might be useful for individual families?

Frederica Perera: Well, I think for a family living right off on the expressway or right near an emission source, I do think the HEPA filters are a very good choice also to make sure that children are getting the best nutrition because many of the fruits and vegetables, for example, do offset the ill effects of pollution on health and so-called antioxidants. Those would be good to do, and then to make sure that children play in areas that are well-shaded to prevent heat-related illness in those during heat waves.

Also, I'm digressing from the pollution, but parks where there is less pollution. If there's a park nearby that can be traveled to, to take the children at a reasonable period of time, that would be very good for them to get outdoors and play away from these sources. Those are things that we can do, but we can also make a difference in terms of climate change as individuals. As I mentioned, conserving energy. We can do that in our homes. Turn air conditioners. Turn the temperature up in the summer and down in the winter so that we're not using so much energy.

We can actually help by eating more plant-based food rather than so much dairy and meat because the production of dairy and meat are sources of greenhouse gases and then we can all advocate. That was what I was hoping to do with the book to get people energized, to become involved and advocate in their own ways in any way for child-centered climate policies, and also to vote for government representatives who take climate change and effects on children's health seriously. That's important. We have a lot of power there.

Brian Lehrer: On that point, and I don't expect you to take a partisan position here, you're a scientist, but do you find it interesting that sometimes the same people who are so determined to ban abortion rights and call themselves pro-life of the fetus are among the weakest when it comes to environmental laws that clamp down on fossil fuels that can affect fetal health?

Frederica Perera: Well, I do find that very ironic and disturbing actually because that fetal window is so important to protect in terms of children's health. That period of development is so important to protect because they're particularly vulnerable. They don't have the same defenses we do, biological defenses. In many ways, I could spend quite a time on that, but I do find that extremely ironic and of great concern. I would like to end though with some more hope because we have passed by our Congress, believe it or not, an infrastructure bill that was bipartisan.

An Inflation Reduction Act that wasn't bipartisan but did get passed. They together do a lot on climate change and getting the solutions that we all need. There's an estimate that if we effectively implement the inflation reduction at the climate provisions there, we're going to see prevented 100,000 asthma attacks, mostly in children, as well as about 4,000 premature adult and infant deaths and 40% of those funds building on the bipartisan infrastructure law.

The Inflation Reduction Act is going to deliver 40% of those overall benefits of climate and clean energy to disadvantaged communities. This will go a long way to moving us toward our goal of being a leader in the world on climate change. I dearly hope that there will not be any obstruction of that work to quickly implement those provisions of this very, very important act.

Brian Lehrer: Let me take one more phone call for you. Sharon in Westchester, you're on WNYC with Frederica Perera, author of Children's Health and the Perils of Climate Change. Hi, Sharon.

Sharon: Hi. Dr. Perera, thank you so much for your lifelong contribution. I was a close associate of Sally Lederman, with whom you worked for years and had such prescient ideas. I was originally going to just add that you've been such a devoted person to equity. Since that's clear, I wanted to just say two things. One is you are one of the original translational scientists.

We need more people like you and more training of people who can go from the molecular biology to the epidemiology, from the local to the global. It's just magnificent what you've done. The last thing is I think maybe I'm wrong about this, but anything we do for children, it means we've impacted everyone at every stage of life. If we can do what you're asking to focus on children, it seems that we'll have the greatest ultimate impact. Again, thank you for your just tremendous work.

Brian Lehrer: Nice to hear from a fan, huh?

Frederica Perera: Oh, you said that so beautifully. Yes, Sally Lederman was a wonderful colleague. You make a very, very important point. By protecting children, the most vulnerable, we protect everyone. These effects that we're seeing in children don't just go away. Many of them persist over that child's lifetime. They affect learning, ability to earn, ability to contribute to society. By protecting this vulnerable period, as you say, everyone benefits. I couldn't have said it better than you, Sharon. [chuckles]

Brian Lehrer: Biologically, I know there's a chapter in your book that would be really interesting basic science reading. Some people called children are not just little adults. [chuckles]. Of course, that's the way that children's bodies are developing. It's not like an adult of the same size would have the same exact effects. It, of course, is often much more intense for children because their bodies are continuing to develop and children are not just little adults.

We will leave it there with the science, with the analysis, with the hope we hear you that you've given us for the future with some of the stories from the book. The book is called Children's Health and the Perils of Climate Change by Frederica Perera, founding director of the Center for Children's Environmental Health at Columbia University and professor in the Mailman School of Public Health there. I am still learning from you even after all these years being out of your class, so thank you so much, and please keep it up.

Frederica Perera: Oh, it was my pleasure, Brian. Thank you so much and thank you to the callers.

 

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