Perceptions and knowledge of air pollution and its health effects among caregivers of childhood cancer survivors: a qualitative study

Abstract

Background Emerging research suggests that survivors of childhood and adolescent cancers are at risk for morbidity and mortality associated with air pollutants. However, caregiver perceptions of the effects of air pollution are unknown. Thus, to address this gap we described caregivers’ perceptions of air pollution’s impact on general population health and specifically on childhood cancer survivors, and caregivers’ air pollution information-seeking and exposure reduction behaviors. Methods Participants were Utah residents, ≥18 years, and caregiver of a childhood cancer survivor who had completed treatment. Semi-structured interviews were conducted with caregivers to describe their perspectives on air quality, how air pollution impacts health (general population and survivor health), and their information seeking and exposure reduction behaviors. Interviews were recorded, transcribed, and analyzed through two rounds of structured coding. Results Caregivers (N = 13) were non-Hispanic white and primarily females (92.3%) between 30 and 49 years old (46.2%). Most families lived within the Wasatch Front (69.2%), the main metropolitan of Utah. Two categories emerged pertaining to caregiver’s perceptions of air pollution: 1) Limited awareness about the health effects of air pollution, and 2) Unsuccessful information seeking and minimal exposure reduction behaviors. All caregivers held negative perceptions of air pollution in Utah, but most were unaware of how pollution affects health. While some families limited air pollution exposure by avoiding outdoor activity or physically leaving the region, few practiced survivor-specific exposure reduction. Nearly half of caregivers worried about potential effects of air pollution on survivor health and wanted more information. Conclusions Despite negative perceptions of air pollution, caregivers were divided on whether air pollution could impact survivor health. Few caregivers engaged in exposure reduction for their cancer survivor. As air pollution levels increase in the U.S., continued research on this topic is essential to managing cancer survivor respiratory and cardiovascular health.

Exploring the Association between Air Pollution and Active School Transportation: Perceptions of Children and Youth in India

“…This study also did not consider parental perceptions as potential confounders to engagement in AST, which are particularly important to consider when examining the behaviours of younger children and youth since they have a strong influence on children's participation in AST and independent mobility in general [83]. Previous studies have examined how parental perceptions influence AST among children and youth [40][41][42][43][44]; however, future studies should explore how child and youth perceptions of air pollution and parental perceptions interact to influence AST. Lastly, our study was not able to collect the full suite of socioecological determinants of health; thus, future studies are required to address this important gap.…”

“…While air pollution is associated with numerous health risks, citizens' perception of the severity of this issue ultimately influences time spent outdoors engaging in health behaviours such as active transportation [39]. For vulnerable populations such as children and youth, most studies to date have focused on parental perceptions of air pollution [40][41][42][43][44]. There is a dearth of studies examining how child and youth perceptions of air pollution influence their engagement in AST, particularly in India where AST is a common practice in urban and rural populations [45].…”