Ferran Campillo, environmental pediatrician: “Schools with green areas perform better”

Convinced that environmental factors are decisive in the development of numerous pathologies that affect children, Ferran Campillo, 36, focused his studies in this field. For this reason, he works as an environmental pediatrician at the Hospital d’Olot i Comarcal de la Garrotxa (Girona). His specialty emerged in the nineties in North America, but is now booming in Spain. From the forest near his workplace to carry out therapies and promote healthy habits, he delves into childhood illnesses associated with climate change and pollution, is concerned about the lack of contact with nature that children and adolescents have, and proposes solutions.

Ask. Why did you decide to become an environmental pediatrician?

Answer. When I was a resident in Pediatrics, families asked us about the causes of an asthma attack or any other pathology. We were very well trained to make a diagnosis and offer a treatment, but we had few tools to know the origin of some diseases. One day, while researching respiratory complications, I became aware that there were numerous environmental factors such as air pollution, home conditions or tobacco smoke that interfered with the conditions. There were answers, but they needed to be applied to the patient. For this reason, in 2015 I completed a subspecialty at the Pediatric Environmental Health Unit in Murcia, the only one in the country at that time.

P. Is your profession unusual in Spain?

R. We are a benchmark because our drive in recent years has positioned us very well to be world leaders in this field. Fortunately, we specialize many pediatricians. Although the first Environmental Health Unit was created in New York in 1998, the model gained strength in the United States and was developed in Canada and Latin America. Currently, in Spain it is present in Murcia and Catalonia, where there is a regional network, and many colleagues in different areas of the country, such as Navarra or Granada, carry out activities related to this sector. Through the Spanish Association of Pediatrics we want to create a state organization to respond to the challenges that the environment poses to the health of children and adolescents.

P. What are environmental pediatricians most concerned about?

R. One of the main threats to the well-being of children is air pollution, which, according to the World Health Organization (WHO), affects more than 90% of the population, but is particularly harmful to children. It even causes fetal damage. This pollution is toxic to respiratory health and neurodevelopment. There is concern about its link to the appearance of different cancers and it is suspected that it promotes the early onset of puberty. It also increases exposure to endocrine disruptors such as pesticides or microplastics.

P. Are you concerned about climate change?

R. Of course. According to the WHO, although children under 5 years of age do not reach 12% of the population, they suffer 88% of the illnesses related to global warming. Climate change is taking its toll on children and this is very worrying. In the last decade, heat-related consultations in Pediatric Emergency Departments have increased significantly. The health system will bear a greater burden of pathologies that until now were occasional because extreme weather events change the distribution of some conditions. Dengue and chikungunya were imported tropical diseases, but now there are already autochthonous cases in Spain.

P. Why does pollution affect children more?

R. Due to their anatomical characteristics, they are shorter and air pollutants tend to concentrate at a height of one metre. In addition, their organs are still developing and toxins persist longer in their bodies and take longer to be eliminated. On the other hand, their metabolic rate is higher. A newborn breathes between 30 and 40 times per minute, twice as much as an adult. In addition, due to their need to grow, children ingest more water and food with a high presence of microplastics.

P. What pathologies associated with global warming and pollution do children suffer from?

R. Almost a third of childhood asthma in Europe is due to poor air quality, and in cities such as Madrid or Barcelona it can reach 50%. It is a disease that now has a large health burden, as does recurrent bronchitis. A high percentage of Spanish children are also exposed to second-hand smoke from tobacco and cannabis during pregnancy. There is also concern about eco-anxiety, which affects, above all, adolescents who are worried about the deterioration of the planet. After an adverse meteorological event, many children are left in a state of extreme poverty. shock for the losses suffered.

P. Are allergies on the rise?

R. It is not clear. As a result of climate change, flowering and pollination periods are earlier, later or have several peaks. As a result, there are more episodes of allergic rhinitis and conjunctivitis at different times than usual. On the other hand, children who live in areas with higher air pollution may be more prone to atopic dermatitis.

P. What role does the environment play in a person’s health?

R. 80% of the factors that determine health and illness are outside the health system. It is important to influence habits and the environment. Often the postal code has more influence than the genetic code, although the characteristics of the person have a fundamental weight. Citizens with a low socioeconomic level have a shorter life expectancy. Poverty is a very important environmental factor. Green areas protect health, but most of these are located in wealthy neighborhoods.

P. Do children have little contact with nature?

R. Yes, many children spend too much time in front of screens and stop doing outdoor activities. We live in a time when nature has been expelled from cities and priority has been given to concrete squares. In some Spanish municipalities, trees are cut down to make way for other infrastructures. Green spaces are health facilities: they reduce the heat island effect, act as a meeting point, improve mental health and preserve flora and fauna.

P. What dose of nature is essential for healthy growth?

RThis is not paracetamol, ibuprofen or dalsy, but two hours a week are enough to start to detect improvements, especially in the feeling of emotional well-being. It is advisable to spend one hour a day in contact with nature, even if it is in an urban park. Sometimes during the week it is important to go to a nearby natural space and at least once a month you should be in a conservation area to feel connected to the environment.

P. How are environmental risks perceived in the prenatal stage?

R. People who are going to have a child and come to our hospital visit the midwife, have their blood tests and ultrasound done, and also fill out the green form to detect the most relevant risk factors during pregnancy: exposure to pesticides, drugs or herbal products with embryotoxic effects. We look at their contact with nature and their j
obs. Working outdoors is not the same as working with dyes in a hair salon or at a petrol station. We also record the conditions of the home and its surroundings.

P. Does the environment influence academic success?

R. Schools surrounded by green areas have a higher academic performance, children have a greater memory and attention span. Vegetation also reduces depression and anxiety.

P. Is it necessary to transform school mobility?

R. It is anachronistic that there are urban roads in front of schools, which expose children to air and noise pollution, which causes premature mortality, high blood pressure, insomnia and affects cognitive development. Traffic around educational centres is also a source of accidents. Schools are not healthy places for children to spend seven or eight hours a day.

P. Can this problem be alleviated?

R. The Administration must take action. Traffic-free spaces are needed, the use of polluting vehicles must be restricted, parking and lanes must be reduced, trains and mobility must be encouraged. There are high rates of sedentary lifestyles, many children do not walk or cycle to school. All this implies greater dependence on screens, learning, speech and behavioural problems. A substantial change is needed, just as was done with the anti-smoking law. Children are at the mercy of the decisions of adults. The youngest do have a voice, even if they do not have a vote, and our role is to communicate their needs to society.

P. Is nature your best medical prescription?

R. I think so. If we could condense all its advantages into a pill, pharmaceutical companies would be fighting over the patent. Nature promotes well-being and reduces premature mortality. It is a challenge to preserve these beautiful green spaces, not only for ourselves, but also for future generations.

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