Young children are far more vulnerable to climate-related disasters and the onus is on adults to provide the protection and care that children need. In a paper published in PLoS Medicine, researchers at Columbia University's Mailman School of Public Health and Columbia University Irving Medical Center set out some specific challenges associated with the impacts of climate change on the world's 2.3 billion children and suggest ways to address their under-prioritized needs.

"Children and adolescents are more vulnerable to climate change stemming from environmental pollution originating from human activity which is expected to increase the magnitude and frequency of extreme events like floods, droughts, and heatwaves and trigger humanitarian disasters," said Madeleine Thomson, PHD, research scholar in the Mailman School's Department of Environmental Health Sciences. "These emergencies enhance a wide range of environmental exposures that directly and indirectly affect children, but because of their anatomic, cognitive, immunologic, and psychologic differences, children and adolescents are more vulnerable to these adverse exposures than adults," noted Thomson, who is also a faculty member in the International Research Institute for Climate and Society at Columbia's Earth Institute and served as guest editor in PLOS Medicine's Special Issue on Climate Change and Health.

For example, because of their small surface to body ratio infants and children are particularly vulnerable to dehydration and heat stress. Additionally, children are more likely to be affected by respiratory disease, renal disease, electrolyte imbalance and fever during persistent hot episodes. Heat waves have also been shown to exacerbate allergens and air pollution which impact children more severely than adults because of their underdeveloped respiratory and immune systems and their relatively high rates of respiration.

Increasing temperatures may expand the potential range of many vector-borne diseases including the Zika virus which, following the 2015 epidemic, has profoundly affected the lives of children and their families across Latin America and the Caribbean. Even children who were asymptomatic at birth may also develop problems later in life.

After Hurricane Maria made landfall in Puerto Rico in September 2017 medical responders encountered increases in gastroenteritis, asthma exacerbations and skin infections. Children were also at increased risk for mosquito-borne diseases such as Chikungunya and Dengue, as well as leptospirosis through the drinking of contaminated water. Flood waters from Hurricane Harvey a few weeks earlier dropped record breaking rain. Most of the Harvey-related toxic releases were never publicized and the long-term implications for children's health is unknown. Studies suggest that climate change is increasing the intensity of North Atlantic hurricanes and the likelihood that the severe consequences for children's health will grow.

In rural households droughts can have significant impacts on child development through increased food insecurity and dietary changes. Droughts may also contribute to conflict and forced migration in resource poor settings, thereby increasing children's vulnerability to a wide range of health issues.

To begin to address the specific needs of children confronted with climate-change related health disasters, Thomson and colleagues are proposing the following:

Establish an international consortium of experts to develop adoptable medical and behavioral protocols and to set research agendas to address the unmet child specific needs that arise from climate-related natural disasters. Develop best practice guidelines for climate-change related event planning that incorporates strategies for addressing the health-related needs of children. Fund mechanisms designed to help the most vulnerable nations prepare for and respond to climate related disasters must consider funding the development of responses that specifically address the unmet needs of children's health.

Co-authors are Lawrence Stanberry, Columbia Department of Pediatrics; Wilmot James, Columbia Department of Pediatrics and School of International and Public Affairs.