The silent killer: over 100 daily deaths of children under five linked to air pollution in East Asia and the Pacific

New UNICEF analysis reveals staggering impact of toxic air on millions of children, urging immediate action to protect their health and future

As Thailand’s capital, Bangkok, grapples with unhealthy levels of air pollution, leading to school closures and widespread health concerns, UNICEF’s latest analysis sheds light on the devastating impact of toxic air on children across East Asia and the Pacific. Air pollution, which peaks in many parts of the region during the dry season from now until April, is linked to over 100 deaths in children under five every day.

The analysis reveals that all children in East Asia and the Pacific – 500 million children in total – live in countries with unhealthy levels of air pollution. Household air pollution, caused by solid fuels used for cooking and heating, is linked to more than half of all air pollution-related deaths in children under five. Meanwhile, 325 million children live in countries where average annual particulate matter (PM2.5) levels exceed World Health Organization (WHO) guideline levels by more than five times, and 373 million live in countries with unhealthy levels if nitrogen dioxide (NO₂). Additionally, 91 percent of children in the region – 453 million – live in countries where ozone pollution exceeds WHO guideline levels. Nearly half of the PM2.5 in countries with the highest levels of this pollutant, came from the burning of fossil fuel, biomass fuel, and agriculture waste, which also generate the greenhouse gases driving climate change.

“Every breath matters, but for too many children every breath can bring harm,” said June Kunugi, UNICEF Regional Director for East Asia and the Pacific. “The air they breathe, at a time when their bodies and minds are still developing, too often contains unhealthy levels of pollution that can comprise their growth, harm their lungs, and impair their cognitive development.”

Air pollution is linked to nearly one in four deaths of children under five in East Asia and the Pacific, and can impact every stage of a child’s life. It begins in the womb with risks of premature delivery and low birth weight. The harm continues into early childhood, as young children breathe more rapidly and are closer to ground-level pollutants like vehicle exhaust, making them more vulnerable to asthma, lung damage, and developmental delays. The threat is often worse for low-income children living near factories or highways, where exposure to pollution is higher. Over time, air pollution can silently fuel chronic illnesses such as diabetes and cardiovascular disease, jeopardizing children’s futures.

Air pollution’s toll goes far beyond children’s health – it strains already overwhelmed healthcare systems, drives up costs, and disrupts learning and productivity. School absences due to illness, hindered brain development, and the risk of school closures limit children’s potential, while parents caring for sick children lose income. The economic fallout is staggering: the World Bank estimated that in 2019, air pollution from PM2.5 caused premature deaths and illnesses that cost East Asia and the Pacific 9.3 per cent of its gross domestic product (GDP), equivalent to more than $2.5 trillion.

UNICEF urges governments, businesses, the health sector, parents and educators to urgently address air pollution’s impact on children for children in East Asia and the Pacific, more specifically:

Governments must lead by strengthening climate and environmental policies, transitioning to clean energy, and enforcing WHO-aligned air quality standards to protect children’s health.

Businesses should adopt clean technologies, reduce emissions, and ensure their practices and products prioritize the safety and well-being of children.

The health sector should take measures to improve detection and treatment, and adopt sustainable, net-zero operations.

Parents and educators should play a crucial role in raising awareness, advocating for cleaner environments, and empowering young people to take action.

UNICEF is partnering with governments, businesses, health systems, and communities across East Asia and the Pacific to protect children from the devastating effects of air pollution. Key initiatives include:

Advocating for climate and environmental policies that create a cleaner, more sustainable world for children.

Implementing programmes that reduce children’s exposure to household air pollution with solutions like chimney ventilation and cleaner heating systems.

Improving air quality monitoring and public reporting through initiatives like installing affordable sensors.

Strengthening healthcare systems to address pollution-related illnesses and investing in cleaner medical waste management systems.

Collaborating with communities and empowering young people as clean air advocates to raise awareness, monitor air quality, and push for stronger policies.

“Addressing air pollution will lead to enormous improvements in children’s health, education, and well-being, with ripple effects across entire societies and economies,” Kunugi emphasized. “The solutions exist, and our collective future depends on implementing them.”
The silent killer: over 100 daily deaths of children under five linked to air pollution in East Asia and the Pacific