Environmental contributions to respiratory disease in children

Progress towards meeting the eight United Nations Millennium Development Goals has been accompanied by a substantial change in the global pattern of disease, with a significant shift towards chronic noncommunicable diseases (NCDs). Globally, early childhood deaths have declined, but years lived with disability have increased over the 20 years 1990-2010: cardiovascular disease by 17.7%; chronic respiratory disease by 8.5%; neurologic conditions by 12.2%; diabetes by 30.0%; and mental and behavioral disorders by 5.0%. These trends are continuing with further increases in the global burden of disease related to chronic NDCs reported in the 2013 updates. There is increasing recognition that many chronic diseases are initiated in early life. This chapter will review the role that environmental exposures, especially those occurring in early life, play in increasing long-term risk of respiratory disease