Of the 54 children who died of asthma between 2019 and 2023, more than 90 per cent were exposed to air pollution levels above World Health Organization (WHO) guidelines, according to a new report published today [12 December] by the University of Bristol’s National Child Mortality Database (NCMD) team. The report uses the NCMD’s unique data on all child deaths in England to examine deaths due to asthma or anaphylaxis between April 2019 and March 2023.
The report finds that all of the children who died of asthma were likely to have been exposed to levels of particulate matter at home and at school that exceeded WHO guidelines, while 92 per cent and 95 per cent were exposed to levels of nitrogen dioxide beyond the WHO limit at home and at school respectively. These levels of exposure are still within current UK guidelines.
The study shows that death rates due to asthma were twice as high for boys than girls, and higher for children from more deprived neighbourhoods – children in the poorest areas were four times more likely to have an emergency hospital admission than those in the least deprived neighbourhoods. Death rates were also higher for those living in urban rather than rural areas.
The report also looks at 19 deaths among children due to anaphylaxis, a severe allergic reaction, during the same period. In 53 per cent of these cases the anaphylactic event occurred at home or the house of a friend or relative, and nuts, milk and eggs were the most common allergens. The most commonly recorded factor in these child deaths was public safety – for example, unclear labelling. One of the most significant findings was that all the children who died due to anaphylaxis who had known allergies were also known to have asthma highlighting that asthma may be an important risk factor.
Karen Luyt, Programme Director for the National Child Mortality Database, Professor of Neonatal Medicine at the University of Bristol and Healthier Childhoods lead at NIHR ARC West, said: “This new and unique analysis of children who have died due to asthma and extreme allergic reactions tells us more than ever before about the impact of these conditions on child mortality.
“The common thread of air pollution among the cases of child deaths due to asthma is particularly striking, and we hope that the report’s recommendations towards saving and improving children’s lives will be heard by those with the power to effect change. Future young lives depend on effective implementation of these recommendations.”
The report also presents recommendations to improve and save children’s lives in future, as well as learning from the detailed child death review that takes place whenever any child dies in England.
National Child Mortality Database (NCMD) programme thematic report
‘Child deaths due to asthma or anaphylaxis’ by Stoianova S, Williams T, Odd D, Sleap V, Fraser J, Garstang J, Grigg J, Levy M, Sharma V, Townshend J, Luyt K on behalf of the National Child Mortality Database
Further information
About the National Child Mortality Database (NCMD)
The National Child Mortality Database (NCMD) was established on 1 April 2018 with the aim of reducing premature mortality by collecting and analysing data on all deaths in children in England, aged between birth and their 18th birthday. The Programme is commissioned by the Healthcare Quality Improvement Partnership (HQIP) and is funded by NHS England, it is led by the University of Bristol, in collaboration with Anna Freud, UCL Partners and the software company QES.
About the National Institute for Health and Care Research (NIHR)
The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:
- Funding high quality, timely research that benefits the NHS, public health and social care;
- Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
- Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
- Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
- Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
- Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.
NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.
The NIHR is the research partner of the NHS, public health and social care.
About the NIHR Applied Research Collaboration West (NIHR ARC West)
The NIHR Applied Research Collaboration West (ARC West) conducts applied health research with its partners and others in the health and care sector, alongside patients and members of the public. Applied health research aims to address the immediate issues facing the health and social care system. ARC West also helps bring research evidence into practice and provides training for the local workforce.
