Climate change and child health in Europe: a scoping review of emerging impacts

Children are extremely vulnerable to climate-related environmental impacts and air pollution due to both biological and behavioral factors. Despite the emerging evidence of the increasing effects of climate change on the world and on children's health, policies to drive change and halt the effects are lacking. Climate change is causing Europe to heat up faster than other continents. Here, we assessed the evidence-based effects of climate change and air pollution on child health in Europe. A scoping review was performed to map the impact of climate-related exposures on the health of children in Europe. A literature search was conducted in three bibliographic databases (PubMed, Embase.com, and Cochrane Database of Systematic Reviews/Cochrane Central Register of Controlled Trials), for studies published between January 1, 2014, and November 11, 2024. Studies were included if they met the following criteria: original studies performed in Europe, addressing climate-related exposures (i.e., the effects of air pollution, heat stress and/or wildfires) on clinical outcomes in neonates, infants, and children (<18 years). The literature search generated a total of 3838 unique articles; upon screening, 73 articles were included in this scoping review. Most studies were conducted in South and West Europe. Climate-related exposures were linked to negative neonatal outcomes, increased risk of respiratory and allergic disease, adverse neurological development, and a higher incidence of metabolic conditions in children. Most studies assessed the impact of air pollution (mainly particulate matter with a diameter smaller than 2.5 micrometers PM_2.5 and PM₁₀ exposure); few studies assessed other climate-related outcomes such as heat stress or wildfires.

Climate change is an active driver of pediatric morbidity in Europe, posing urgent respiratory, neurological, and perinatal risks amplified by social inequality. Protecting future generations demands a paradigm shift in healthcare that moves beyond treating acute symptoms to addressing upstream environmental drivers, including the integration of environmental exposure data into clinical practice.

• Children are biologically vulnerable to environmental hazards and more prone to climate-related exposures. • Europe is warming up faster than other continents; therefore, children in Europe are at increased risk of climate-related adverse health outcomes.

• This scoping review confirms climate change may lead to increased pediatric morbidity in Europe, linking air pollution, heat stress, and wildfires to perinatal, respiratory, metabolic, and neurological risks. • European studies regarding climate change and children's health have mainly focused on the impact of air pollution, but hardly focused on the impact of heat stress, highlighting the need for broader research and a coordinated pan-European change in political interventions tackling climate change.