Born in smog: immediate and persistent health consequences of acute air pollution exposure in historical London, 1892–1919

This paper examines how acute pollution exposure in historical London (1892–1919) affected child health. I proxy acute, extreme pollution exposure using daily data on fog events, which reflect meteorological conditions where pollution emitted in the city was not dispersed across space leading to a sharp spike in pollution. I also use rich individual-level data on child health drawn from the Queen Charlotte Hospital, a maternity hospital, and the Foundling Hospital, an orphanage. I find no effect of pollution exposure at birth on birth or growth outcomes or on upper respiratory morbidity. However, exposure on the day of birth had persistent effects on health, increasing mortality risk in childhood and adolescence from respiratory diseases and raising incidence, prevalence and sickness duration of influenza and measles. There was no persistent effect of in utero and postnatal pollution exposures. These mixed results show that extreme pollution at birth had lasting impacts on specific, but also limited, dimensions of child health.