The toxic journey begins in the womb. When mothers are exposed to polluted air during pregnancy, the foetus is at serious risk. The risk escalates into a massive disease burden for infants, children and adolescents, lasting a lifetime. The problem has reached alarming proportions in the Global South, with India bearing the infamy of accounting for a quarter of the global infant deaths— within the first month of birth. Well-established science has defined the biological pathways through which pollutants enter the body and damage organs. These estimates consider not only lower-respiratory infections affecting children but also a much broader range of health impacts. Additionally, children from poorer households are at greater risk.
Foetuses exposed to toxins in the womb have lower chances of survival. Exposure to toxins also leads to stillbirth, preterm birth and low birth weight. It predisposes foetuses to a range of diseases later in life, including endocrine and metabolic disorders, such as diabetes. If air pollution affects the mother’s respiratory health, oxygen and nutrient delivery to the foetus can be reduced. Impaired lung development in utero increases the risk of airway diseases. Scientists explain that particulate matter can trigger a maternal inflammatory response, reduce maternal immunity, and increase the risk of infection and of poor neurological development. Babies born too small are more vulnerable to, and less able to cope with, the risks of lower-respiratory infections, diarrhoeal diseases, brain damage and inflammation, blood disorders and jaundice.
In children under five, exposure to polluted air poses severe risks. It impacts lung function, can lead to obesity, and affects brain and neurological development, resulting in conditions such as attention deficit hyperactivity disorder (ADHD), reduced intelligence and impaired neurodevelopment. Even at lower levels of exposure, children can develop lasting deficits in lung function, which makes them vulnerable to chronic lung diseases in adulthood and affects their quality of life.
This is the foreword of Slow Murder Continues: India’s suffocating journey of knowing and forgetting the deadly air pollution (2025), published by the Centre for Science and Environment. It documents 40 years of reportage on air pollution and the fight against it in India