Children And The Haze

Child wearing mask

International Medical Clinic (IMC) specialises in family, paediatric and travel medicine, with the medical needs of the international community of Singapore and South East Asia very much in mind.


Should children really be wearing masks during haze season? We have heard that masks can make breathing more difficult, so are not advisable for children…


The best advice continues to be that children should minimise prolonged or strenuous outdoors activities if the PSI is >100, and avoid outdoor activities altogether if the PSI IS >300 (>200 for younger children and those with existing heart or respiratory conditions such as asthma).


Although masks for children have recently been made available through a local manufacturer, these have not received U.S. FDA or Singapore HSA approval. Local studies leading to approval are planned.


If you choose to use these masks for your children, be aware that they may make breathing more difficult, and you should discontinue their use immediately if your child experiences any dizziness, difficulty breathing or discomfort.


We’ve spotted young children wearing surgical masks, perhaps because the standard N95 masks are too large for a child – given that surgical masks don’t offer adequate protection from pm 2.5 particles, is something better than nothing?


Surgical masks are designed to protect other people from the wearer’s saliva or spit, not to protect the wearer from particulate matter. Although the surgical mask may provide some barrier against larger particles, thereby reducing some irritation, it will be of no help in reducing exposure to small particulate matter (PM 2.5 microns)


What are the best precautions to take for children with respiratory issues?


The current recommendations are to minimise outdoors exposure when the PSI is greater than 100, and avoid any outdoors exposure when the PSI is greater than 200 (see above answer to question one).


How can we protect babies and toddlers who cannot wear masks? Should they be kept indoors unless it’s absolutely necessary to bring them outside?


You should follow the same recommendations as for a child with respiratory or heart conditions.


What symptoms should parents look out for in kids who are affected by the haze? What should we do to help treat them at home, and at what stage would they need medical attention?


Symptoms range from mild irritation of the eyes, nose and throat, to worsening difficulty with breathing.


Minimising exposure is the best strategy; close all windows and doors, and use your air conditioner; consider investing in an air purifier with a HEPA filter, especially for the children’s bedrooms. Increase your child’s fluid intake and antioxidant containing fruits such as blueberries, vitamin C containing fruits such as oranges; vitamin E containing foods such as nuts and seeds, and foods rich in omega oils (oily fish). Any child with difficulty in breathing or severe irritation of the eyes, nose or throat should be seen by a doctor to ensure there is no serious illness.


Are there long-term affects for children exposed to the haze at unhealthy levels?


Although exposure to haze has been linked to a potential increased risk of severe illnesses such as heart disease and lung cancer, the actual risk of short term exposure such as during the haze is estimated to be extremely low. Most studies looking at long term risk were evaluating populations with prolonged continuous exposure. Studies in Singapore are ongoing.


An interesting perspective:


To put things in perspective, on a day when PM2.5 levels hit 100 micrograms per cubic m, a person will take in around 1,100 mcg of these pollutants if he or she stays outdoors throughout the day. For comparison, a smoker will inhale between 10,000 mcg and 40,000 mcg of PM2.5 pollutants for every cigarette consumed.


Taken from Straits Times: 24 Sept 2015


Can you describe the signs of respiratory distress to look out for in case of an emergency?


Any child with increased difficulty in breathing should be assessed by a doctor. If your child has asthma or other breathing problems, your doctor may have already given you a plan of action (a written asthma action plan) for you to use in such situations- follow it, but be prepared to take your child immediately to a doctor if your child deteriorates. Signs such as lethargy and poor feeding in younger children, or inability to speak in full sentences (out of breath) in older children are signs of severe compromise- seek immediate medical attention.



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