[The pediatrician facing the problem of polluted air]

The enormous amount of data concerning outdoor pollution has allowed quantifying the damage caused by single pollutants. On the basis of these data, and knowing the concentration of a pollutant in a given area, to date it is possible to foresee the expected risk for a given disease in our community. For instance, in an average size town like Parma, it can be calculated that in the middle of the winter, suspended particulate pollution (PM10), one day/three, will increase by 30% the number of symptomatic asthmatic children. In the long term, in a town like Parma, PM10 and NO2 pollution increases the number of children with more than 4 episodes of bronchitis or persistent cough by 30-50%. With regard to the typical summer pollution by O3, extremely harmful as it expands outside towns, in Parma and surroundings in August one should expect in 1/3 days double the number of symptomatic asthmatic patients, and every other day a 25% reduction of the respiratory function in asthmatic children exercising. With regard to indoor pollution besides the well known and severe problem of passive smoking, and that of volatile organic compounds still under investigation, one must consider NO2 pollution originating from the burning processes for heating and cooking. As this latter is extremely important in Italy, as gas is used in practically every house, the Author has done a specific research in which it is shown that if this kind of pollution was eliminated one could reduce the incidence of asthma in childhood from 7 to 5%, and noticeably the severity of the disease in affected subjects. Thus, paediatricians have two new aims. The first is to identify in pollution one of the possible causes of respiratory problems in each single patient, giving recommendations (ex. advise asthmatic children to avoid physical activity in the open and in the sunny hours during the summer, or avoid having children in the kitchen while cooking, or have boilers, heaters, etc. checked). Second, paediatricians should make aware, using the local actual data on pollution, not only the local administrators, but also and may be more important the parents of children with respiratory problems. These are in fact the ones who can and must become the most active in facing the big problem of pollution.