Hiran Selvadurai, a clinical professor of pediatrics and child health at The Children’s Hospital in the Sydney suburb of Westmead, says he has already seen the impact of the bushfires on children in the city. Over the past monththere was a 30% increase in children presenting themselves at Westmead’s emergency department with symptoms of asthma. This is unusual, he points out, because asthma and other respiratory conditions usually decrease in the summer months. (Australia is in the Southern Hemisphere and its seasons are the opposite of those in the Northern Hemisphere.) “It’s a time of year when we don’t usually see a lot of asthma in hospital,” Selvadurai explains. And yet “it was easily the busiest Christmas and December I’ve ever had.”

Selvadurai also saw an increase in the number and severity of infections, including empyema, a condition in which pus collects in the lungs, causing symptoms similar to those of pneumonia. There were three cases of empyema at The Children’s Hospital at Westmead in both December 2017 and December 2018; in December 2019, there were six.

Nobody knows how long the risk of severe smoke exposure from the fires will last, but scientists agree that “ongoing exposure is the real concern,” explains Dominic Fitzgerald, a pediatric respiratory specialist at Westmead. Studies conducted in some of the world’s most polluted low-and middle-income countries show that chronic exposure to bad air quality (pdf, p. 12) in children can be associated with an increased risk of asthma, acute lower respiratory infections, damaged lung function, and some childhood cancers.

Fitzgerald cautioned that it’s too early to tell what the long-term impact of the smoke on children’s health will be—or whether there will be any long-term impact at all. “Most healthy kids…can manage fairly well,” he explained, save for relatively mild symptoms such as irritation of the eyes, nose, and throat, as well as a cough. “With intermittent or occasional smoke exposure, one does not expect any long-term consequences.”

“Children are usually incredibly resilient,” Selvadurai concurs, because their bodies are still developing. But “that also comes with a price, because indulging them with inflammation over a significant period of time may well impact on airway growth and long-term health.”

Scientists are cautious about the likely long-term effects of temporary acute exposure to air pollution in Australia, where the air quality is generally pretty good. “We don’t really understand the mechanism of how PM 2.5 impacts health,” Raynes-Greenow explains.

“It’s uncharted territory,” says Selvadurai. “And that’s what’s making us all incredibly uneasy.”

Read more from our series on Rewiring Childhood. This reporting is part of a series supported by a grant from the Bernard van Leer Foundation. The author’s views are not necessarily those of the Bernard van Leer Foundation.

📬 Sign up for the Daily Brief

Our free, fast, and fun briefing on the global economy, delivered every weekday morning.