Article Text

Download PDFPDF
Children’s exposure to nitrogen dioxide in Sweden: investigating environmental injustice in an egalitarian country
  1. Basile Chaix1,
  2. Susanna Gustafsson2,
  3. Michael Jerrett3,
  4. Håkan Kristersson4,
  5. Thor Lithman5,
  6. Åke Boalt5,
  7. Juan Merlo1
  1. 1Community Medicine and Public Health, Department of Clinical Sciences, Malmö University Hospital, Malmö, Sweden
  2. 2Environmental Department, City of Malmö, Malmö, Sweden
  3. 3Department of Preventive Medicine, University of Southern California, Los Angeles, USA
  4. 4City Planning Office, City of Malmö, Malmö, Sweden
  5. 5Region Skåne, Sweden
  1. Correspondence to:
 Dr B Chaix
 Community Medicine and Public Health, Department of Clinical Sciences, Malmö University Hospital, S–205 02 Malmö, Sweden; basile.chaix{at}


Study objective: Prior studies have shown that children are particularly sensitive to air pollution. This study examined whether children of low socioeconomic status suffered greater exposure to outdoor nitrogen dioxide than more affluent ones, both at their place of residence and at school, in a country with widespread state intervention for social equity.

Design: Local scale data on outdoor nitrogen dioxide obtained from a validated air pollution model were analysed, along with all school children accurately geocoded to their building of residence and school.

Participants: All 29 133 children in grades one through nine (aged 7 to 15 years) residing and attending school in Malmö, Sweden, in 2001.

Main results: Defining the socioeconomic status of children according to the mean income in their residential building, the spatial scan statistic technique allowed the authors to identify eight statistically significant clusters of low socioeconomic status children, all of which were located in the most polluted areas of Malmö. Four clusters of high socioeconomic status children were found, all of them located in the least polluted areas. The neighbourhood socioeconomic status better predicted the nitrogen dioxide exposure of children than the socioeconomic status of their building of residence. Exposure to nitrogen dioxide at the place of residence and school of attendance regularly increased as the socioeconomic status of a child’s neighbourhood of residence decreased.

Conclusions: Evidence of environmental injustice was found, even in a country noted for its egalitarian welfare state. Enforcement of environmental regulations may be necessary to achieve a higher level of environmental equity.

  • air pollution
  • child health
  • environment
  • nitrogen dioxide
  • spatial analysis

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding: this study was supported by the French Foundation for Medical Research (BC), and the Swedish Scientific Council and the Swedish Council for Working Life and Social Research (principal investigator: JM). The funding sources had no role in the study design, the interpretation of data, the writing of the report, or in the decision to submit the paper for publication.

  • Conflicts of interest: none declared.

Linked Articles

  • In this issue
    Carlos Alvarez-Dardet John R Ashton