Air pollution and stunting: a missing link?
Sheela S Sinharoy, Thomas Clasen, Reynaldo Martorell.
The Lancet Global Health Comment Volume 8, Issue 4, April 2020, Pages e472-e475
Child linear growth impairment, particularly stunting, remains a global health challenge. Stunting is defined as a height-for-age Z-score more than two SDs below the WHO child growth standards reference median for age and sex. The number of children younger than 5 years who are stunted was 59 million (34%) in south Asia and 58 million (33%) in sub-Saharan Africa in 2018.1 Stunting is associated with poor child development, lower productivity and earnings in adulthood, and increased risk of chronic diseases later in life.2, 3 In this Comment, we argue that air pollution has been largely ignored as a potentially important cause of stunting, we outline a conceptual framework for how air pollution might lead to impaired linear growth in children, and we call for additional research into these mechanisms.