Summary :

• Context and rational

Air pollution is a major environmental public health problem. In 2012, according to the WHO, 8 million premature deaths worldwide from chronic respiratory diseases, lung cancer, stroke and heart disease were caused by air pollution, including 3.7 million from outdoor pollution and 4.3 million from indoor pollution (WHO, 2012). In developing countries, air pollution is also a major contributor to the onset and aggravation of chronic obstructive pulmonary disease (COPD), and to the onset of acute and chronic respiratory illnesses in children. 

Outdoor air pollution caused by vehicles, industry and rapid urbanization exposes the population to high concentrations of particulate matter (PM) with a diameter of 2.5 µm or less (PM2.5). PM increases the risk of cardiovascular disease, acute (pneumonia) and chronic respiratory illnesses, primarily COPD, as well as impairment of lung function in children and exacerbation of asthma (WHO, 2016). Moreover, indoor air pollution, which is also a major source of inhalation of respiratory pollutants, constitutes a major and additional health risk for people exposed to the use of combustion energy from biomass, such as wood, charcoal, crop waste, and kerosene for cooking, especially children, thus increasing the risk of pneumonia (WHO, 2018).

Children are particularly at risk of pollution-related respiratory diseases. They have a heightened sensitivity to air pollutants, exhibiting increased particle deposition in the lungs due to physiological and anatomical factors at a key period of lung development. Children's environmental exposure to pollution during periods of lung growth and development can lead to irreversible long-term deficits in lung function, and put adults at high risk of COPD. In 2016, approximately 543,000 deaths of children under 5 years of age and 52,000 deaths of children aged 5 to 15 years were attributable to indoor and outdoor air pollution. Exposure to indoor air pollution increases the risk of childhood pneumonia by almost 2-fold, and is responsible for 45% of pneumonia deaths among children under 5 years of age (6). In low- and middle-income countries, air pollution (indoor and outdoor) causes more than 50% of acute lower respiratory tract infections in children under five. 

The health effects of ambient air pollution are understudied in Africa compared to other continents. Few studies evaluate the association between air pollution and negative health effects, and most sub-Saharan African countries have no available data on pollution. As a result, the majority of large African cities are not equipped with pollution level sensor networks or warning systems. Knowledge and perception of pollution risks are still very limited. 
In cities such as Abidjan (Côte d'Ivoire), urbanization has not curbed the use of biomass combustion for cooking and traditional fish smoking. This activity is particularly harmful to the health of these women and their children, as they are exposed repeatedly and intensively to smoke and heat.

• Objective :

To assess the frequency of respiratory disorders and symptoms in children aged 5 to 10 chronically exposed to indoor and outdoor air pollution in Abidjan, Côte d'Ivoire, in 5 steps:
1.    Measuring children's exposure levels to indoor and outdoor pollution and changes in exposure 5 years after the initial measurement.
2.    Identify the socio-economic determinants of children's exposure to indoor and outdoor pollution and its evolution
3.    Evaluate the frequency of respiratory symptoms, respiratory function, and the frequency and impact of functional respiratory disorders in children. 
4.    Study factors associated with respiratory function disorders in children
5.    Assess adults' and children's knowledge, views and perceptions of indoor and outdoor pollution

• Main methods:

Cross-sectional study will focus on the children of women followed up during a previous study in 2016-2017. Covering 104 children for the quantitative part, and 5 to 8 women, 5 to 8 husbands as well as 5 to 8 children aged 8 to 10 from different families recruited for the qualitative part.

• Progress

  •    3 Master's degrees were supported within the framework of this project: . (i) Master2 in Public Health (Respiratory health in children exposed to air pollution in Abidjan, Ivory Coast - interdisciplinary study (SEPol - CI), (Auriane Pajot, September 14, 2022) ; (ii) master2 in Physico-chemistry (Study of indoor and outdoor particulate air pollution in Andokoi commune of Yopougon (Abidjan, Ivory Coast), Marie Yapo, December 23, 2022), and (iii) master2 in Sociology, (Evaluative study of the effects of air pollution on the respiratory health of children aged 5 to 10 in the Andokoi area (Abidjan /Ivory Coast), Sarah Coulibaly, July 30, 2024). 
  •    Final results : Air pollution exposure, respiratory consequences, and perceptions among urban African children living in poor conditions – a case study in Abidjan, Côte d'Ivoire. Submitted to PLOS Global Public Health.