Risk identification and supportive environment construction forpromoting child and adolescent health development from an environmental exposure perspective

ZHANG Lan, DONG Yanhui

Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (7) : 704-711.

PDF(1203 KB)
PDF(1203 KB)
Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (7) : 704-711. DOI: 10.11852/zgetbjzz2026-0673
Professional Forum

Risk identification and supportive environment construction forpromoting child and adolescent health development from an environmental exposure perspective

  • ZHANG Lan, DONG Yanhui
Author information +
History +

Abstract

Children and adolescents represent a uniquely vulnerable population because this life stage is characterized by rapid somatic growth, maturation of organ systems, and the establishment of behavioral patterns. Consequently, their health may be particularly susceptible to changes in the external environment. In recent years, the field has moved beyond the assessment of isolated environmental hazards toward a broader recognition that health effects are shaped by complex interactions across multiple exposures. Increasing attention has therefore been directed to both social and natural environmental determinants, including air pollution, environmental endocrine-disrupting chemicals, artificial light at night, the built environment, and residential greenness. Accumulating evidence suggests that air pollutants are associated not only with impaired lung function and elevated blood pressure, but also with early-life risks of obesity and metabolic syndrome. Endocrine-disrupting chemicals may alter pubertal timing through interference with neuroendocrine pathways. Artificial light at night may further increase obesity risk by disrupting sleep and circadian regulation. In contrast, exposure to green space and supportive built environments may confer health benefits by reducing pollution exposure, promoting physical activity, and alleviating psychological stress. Accordingly, the promotion of environmental health in children should shift from the control of single risk factors to an integrated strategy targeting multiple exposures. Health impact assessments for children should be embedded across urban planning, school construction, family-based care, and public health policy. Such efforts are needed to create safe, green, low-pollution, activity-promoting, and socially supportive environments for healthy growth and development.

Key words

environmental exposures / children and adolescents / air pollution / endocrine-disrupting chemicals / green space / artificial light at night / health promotion

Cite this article

Download Citations
ZHANG Lan, DONG Yanhui. Risk identification and supportive environment construction forpromoting child and adolescent health development from an environmental exposure perspective[J]. Chinese Journal of Child Health Care. 2026, 34(7): 704-711 https://doi.org/10.11852/zgetbjzz2026-0673

References

[1] Song X, Zhou B, Baird S, et al. Trends andpredictions to 2030 in demographic structures and metabolic health for children and adolescents in China: Analysis of national school health surveys from 2000 to 2019[J]. Lancet Child Adolesc Health, 2025, 9(8): 530-543.
[2] 王蕾, 张改秀, 白丽霞, 等. 儿童青少年肥胖与代谢综合征研究进展[J]. 中国药物与临床, 2025, 25(22): 1436-1440.
Wang L, Zhang GX, Bai LX, et al. Research progress on obesity and metabolic syndrome in children and adolescents[J]. Chin Remedies Clin, 2025, 25(22): 1436-1440. (in Chinese)
[3] Yuan C, Dong Y, Chen H, et al. Determinants ofchildhood obesity in China[J]. Lancet Public Health, 2024, 9(12): e1105-e1114.
[4] 罗乃莹. 健康中国行动推进委员会成立并发布《健康中国行动(2019—2030年)》[J]. 中医药管理杂志, 2019, 27(14): 封2.
[5] 国务院. 国务院关于印发《空气质量持续改善行动计划》的通知:国发〔2023〕24号[EB/OL]. (2023-12-07)[2026-06-13]. https://www.gov.cn/zhengce/content/202312/content_6919000.htm
[6] 中共中央, 国务院. 关于全面推进美丽中国建设的意见[EB/OL]. (2024-01-11)[2026-06-13]. https://www.gov.cn/zhengce/202401/content_6925406.htm
[7] 贾品, 陈天. 我国儿童保健工作发展历程及相关问题 [J]. 社会与公益, 2025(4): 427-429.
[8] 邵金玲, 陈小艳. “四+”模式 助推儿童保健工作提质增效[J]. 人口与健康, 2025(8): 73-74.
[9] 董彦会, 陈璐, 马军, 等. 构建高水平学校卫生体系 促进学生常见病共防行动[J]. 中国学校卫生, 2024, 45(5): 609-614.
Dong YH, Chen L, Ma J, et al. Constructing a high-level school health system to facilitate joint prevention practice of common diseases among students[J]. Chin J Sch Health, 2024, 45(5): 609-614. (in Chinese)
[10] 袁雯, 杨田, 宋逸, 等. 儿童青少年精神健康为核心的共病负担和病因机制研究进展[J]. 中国学校卫生, 2023, 44(9): 1423-1427.
Yuan W, Yang T, Song Y, et al. Research progress on burden and etiological mechanism of mental health as the core comorbidity in children and adolescents[J]. Chin J Sch Health, 2023, 44(9): 1423-1427. (in Chinese)
[11] 生态环境部. 关于印发《“十四五”环境健康工作规划》的通知[EB/OL]. (2022-07-27)[2026-06-13]. https://www.gov.cn/zhengce/zhengceku/2022-07/30/content_5703607.htm
[12] George PE, Thakkar N, Yasobant S, et al. Impact of ambient air pollution and socio-environmental factors on the health of children younger than 5 years in India: A population-based analysis[J]. Lancet Reg Health Southeast Asia, 2024, 20: 100328.
[13] 霍家康, 董彦会, 李伟铭, 等. PM2.5短期暴露与儿童青少年血压的关联[J]. 中国学校卫生, 2021, 42(5): 723-727.
Huo JK, Dong YH, Li WM, et al. Association between short-term exposure of fine particulate matters and blood pressure in children and adolescents[J]. Chin J Sch Health, 2021, 42(5): 723-727. (in Chinese)
[14] Zhang Z, Dong B, Li S, et al. Exposure to ambient particulate matter air pollution, blood pressure and hypertension in children and adolescents: A national cross-sectional study in China[J]. Environ Int, 2019, 128: 103-108.
[15] 陈璐, 张经纬, 袁雯, 等. 空气PM2.5成分的混合暴露对小学生肺功能的急性影响[J]. 中国学校卫生, 2024, 45(7): 1031-1035.
Chen L, Zhang JW, Yuan W, et al. Acute effects of exposure to PM2.5 components on the lung function of primary school students[J]. Chin J Sch Health, 2024, 45(7): 1031-1035. (in Chinese)
[16] Chen L, Xu R, Xie J, et al. Wildfire-related PM2.5 and respiratory transmitted disease among Chinese children and adolescents from 2008 to 2019: A retrospective study[J]. PLoS Med, 2025, 22(12): e1004613.
[17] 张奕, 陈力, 蒋家诺, 等. 大气污染物PM2.5及其组分暴露与中国9~18岁儿童青少年心理困扰的关联研究[J]. 中华流行病学杂志, 2023, 44(10): 1575-1582.
Zhang Y, Chen L, Jiang JN, et al. Research on the association between ambient PM2.5 and its components and psychological distress among Chinese children and adolescents aged 9-18 years[J]. Chin J Epidemiol, 2023, 44(10): 1575-1582. (in Chinese)
[18] Kioumourtzoglou MA, Coull BA, O'Reilly ÉJ, et al. Association of exposure to diethylstilbestrol during pregnancy with multigenerational neurodevelopmental deficits[J]. JAMA Pediatr, 2018, 172(7): 670-677.
[19] 王梦月, 杨静逸, 张琼. 女性月经初潮年龄的影响因素及研究进展[J]. 云南医药, 2024, 45(5): 83-86.
Wang MY, Yang JY, Zhang Q. The influencing factors and research progress of female menarche age[J]. Med Pharm Yunnan, 2024, 45(5): 83-86. (in Chinese)
[20] Mishra SR, Chung HF, Waller M, et al. Association between reproductive life span and incident nonfatal cardiovascular disease: A pooled analysis of individual patient data from 12 studies[J]. JAMA Cardiol, 2020, 5(12): 1410-1418.
[21] Chen X, Liu Y, Sun X, et al. Age atmenarche and risk of all-cause and cardiovascular mortality: A systematic review and dose-response meta-analysis[J]. Menopause, 2018, 26(6): 670-676.
[22] Qiu C, Chen H, Wen J, et al. Associations betweenage at menarche and menopause with cardiovascular disease, diabetes, and osteoporosis in Chinese women[J]. J Clin Endocrinol Metab, 2013, 98(4): 1612-1621.
[23] 汪洁, 罗玲, 陶芳标, 等. 环境内分泌干扰物影响儿童青少年青春发动时相的研究进展[J]. 中国学校卫生, 2026, 47(5): 751-755.
Wang J, Luo L, Tao FB, et al. Research progress on effects of environmental endocrine disruptors on pubertal timing in children and adolescents[J]. Chin J Sch Health, 2026, 47(5): 751-755.(in Chinese)
[24] Zhang Y, Chen L, Song X, et al. Synergisticeffects of bisphenol A and its substitutes with latent insulin resistance on childhood blood pressure and the potential role of lipid metabolism[J]. Environ Int, 2025, 206: 109951.
[25] Dong Y, Gao D, Li Y, et al. Effect ofchildhood phthalates exposure on the risk of overweight and obesity: A nested case-control study in China[J]. Environ Int, 2022, 158: 106886.
[26] Dong Y, Chen L, Gao D, et al. Endogenous sex hormones homeostasis disruption combined with exogenous phthalates exposure increase the risks of childhood high blood pressure: A cohort study in China[J]. Environ Int, 2022, 168: 107462.
[27] Liu J, Gao D, Li Y, et al. Unraveling the relationships of phthalate exposure, long-term trajectories for novel insulin resistance biomarkers and accelerated pubertal onset in children[J]. Ecotoxicol Environ Saf, 2025, 302: 118666.
[28] Liu J, Song J, Gao D, et al. Exploring theassociations between phthalate exposure and cardiometabolic risk factors clustering among children: The potential mediating role of insulin-resistant-related genes DNA methylation[J]. J Hazard Mater, 2024, 461: 132578.
[29] Liu J, Gao D, Wang H, et al. Long-term exposure to exogenous phthalate, masculinity and femininity trait, and gender identity in children: A Chinese 3-year longitudinal cohort study[J]. Environ Health, 2023, 22(1): 81.
[30] Dang J, Shi D, Li X, et al. Artificiallight-at-night exposure and overweight and obesity across GDP levels among Chinese children and adolescents[J]. Nutrients, 2023, 15(4): 939.
[31] Shi D, Dang J, Chen H, et al. Assessment ofindoor light-at-night exposure in children and adolescents during schooldays and weekends[J]. Environ Pollut, 2024, 360: 124689.
[32] Badpa M, Schneider A, Ziegler AG, et al. Outdoor light at night and children's body mass: A cross-sectional analysis in the Fr1da study[J]. Environ Res, 2023, 232: 116325.
[33] Li M, Lanca C, Tan CS, et al. Association of time outdoors and patterns of light exposure with myopia in children[J]. Br J Ophthalmol, 2023, 107(1): 133-139.
[34] Liu J, Song X, Chen M, et al. Modifying effects of compensatory sleep on elevated blood pressure related to school-day sleep patterns[J]. BMC Med, 2025, 23(1): 663.
[35] Asri AK, Liu T, Tsai HJ, et al. Environmental exposures related to gut microbiota among children with asthma: A pioneer study in Taiwan[J]. Ecotoxicol Environ Saf, 2025, 291: 117793.
[36] Wang J, Yu J, Gong Y, et al. Pollution characteristics, sources and health risk of metals in urban dust from different functional areas in Nanjing, China[J]. Environ Res, 2021, 201: 111607.
[37] Bao WW, Yang BY, Zou ZY, et al. Greenness surrounding schools and adiposity in children and adolescents: Findings from a national population-based study in China[J]. Environ Res, 2021, 192: 110289.
[38] Luo YN, Yang BY, Zou Z, et al. Associations of greenness surrounding schools with blood pressure and hypertension: A nationwide cross-sectional study of 61 229 children and adolescents in China [J]. Environ Res, 2022, 204(Pt A): 112004.
[39] Song Z, Song X, Chen L, et al. Environmental greenness, physical activity, and their synergistic effects on vital capacity weight index in children and adolescents exposed to PM2.5 and O3 in economically developed provinces of China[J]. BMC Public Health, 2025, 25(1): 3427.
[40] 教育部. 关于全面推进健康学校建设的指导意见:教体艺〔2026〕3号[EB/OL]. (2026-02-27)[2026-06-13]. http://www.moe.gov.cn/srcsite/A17/moe_943/moe_6/202602/t20260227_1429365.html
[41] 董彦会, 马军. 健康学校建设 教育强国战略的具体实践——《关于全面推进健康学校建设的指导意见》解读[J]. 中国校医, 2026, 40(3): 161-164.
Dong YH, Ma J. Healthy school construction: Practice of strategies for building a leading country in education—An interpretation of the Guiding Opinions on Comprehensively Promoting Healthy School Construction[J]. Chin J Sch Dr, 2026, 40(3):161-164.(in Chinese)
[42] 邹志勇, 董彦会. 重视儿童成长早期环境促进性别角色健康发展[J]. 中国学校卫生, 2022, 43(2): 161-164.
Zou ZY, Dong YH. The early environment of childhood promotes the healthy development of children's gender role[J]. Chin J Sch Health, 2022, 43(2): 161-164. (in Chinese)
[43] Calcaterra V, Cena H, Magenes VC, et al. Sugar-sweetened beverages and metabolic risk in children and adolescents with obesity: A narrative review[J]. Nutrients, 2023, 15(3): 702.
[44] Espinosa A, Mendoza K, Laviada-Molina H, et al. Effects of non-nutritive sweeteners on the BMI of children and adolescents: A systematic review and meta-analysis of randomised controlled trials and prospective cohort studies[J]. Lancet Glob Health, 2023, 11(Suppl 1): 8.
[45] Ashton JJ, Beattie RM. Screen time in children and adolescents: Is there evidence to guide parents and policy?[J]. Lancet Child Adolesc Health, 2019, 3(5): 292-294.
[46] Foreman J, Salim AT, Praveen A, et al. Association between digital smart device use and myopia: A systematic review and meta-analysis[J]. Lancet Digit Health, 2021, 3(12): e806-e818.
[47] Song X, Zhou B, Baird S, et al. Trends andinequalities in thinness and obesity among Chinese children and adolescents: Evidence from seven national school surveys between 1985 and 2019[J]. Lancet Public Health, 2024, 9(12): e1025-e1036.
[48] 国家卫生健康委, 国家疾控局, 中央网信办, 等. 关于印发儿童青少年“五健”促进行动计划(2026—2030年)的通知:国卫妇幼发〔2025〕21号[EB/OL]. (2025-12-25)[2026-06-13]. https://www.gov.cn/zhengce/zhengceku/202512/content_7053270.htm
[49] 董彦会, 蒋家诺, 马军. 多病共防背景下校园传染病防控策略[J]. 中国校医, 2025, 39(5): 323-329.
Dong YH, Jiang JN, Ma J. Strategies for campus infectious disease prevention and control under the context of simultaneous prevention of multiple diseases[J]. Chin J Sch Dr, 2025, 39(5): 323-329. (in Chinese)
[50] 国家卫生健康委办公厅, 教育部办公厅. 关于印发中小学生健康体检管理办法(2021年版)的通知[EB/OL]. (2021-10-13)[2026-06-13]. https://www.gov.cn/zhengce/zhengceku/2021-10/21/content_5644100.htm
[51] 董彬, 冯天舒, 宋逸. 以高质量学校卫生标准为牵引推动学生常见病多病共防[J]. 中华预防医学杂志, 2025, 59(2): 138-143.
Dong B, Feng TS, Song Y. Implementing high-quality school health standards to promote joint prevention of common diseases and multimorbidity among students[J]. Chin J Prev Med, 2025, 59(2): 138-143. (in Chinese)
[52] 董彦会, 吴双胜, 胡翼飞, 等. 中国儿童青少年校园流感防控专家共识[J]. 中国校医, 2025, 39(4): 241-250, 258.
Dong YH, Wu SS, Hu YF, et al. China expert comsensus on influenza prevention and control in schools for children and adolescents[J]. Chin J Sch Dr, 2025, 39(4): 241-250, 258. (in Chinese)
[53] Yuan C, Dong Y, Chen H, et al. Public health interventions against childhood obesity in China[J]. Lancet Public Health, 2024, 9(12): e1115-e1124.
[54] Dong Y, Yuan C, Dang J, et al. Control of childhood obesity and implications for policy in China[J]. Lancet Public Health, 2024, 9(12): e1125-e1135.
[55] Chen TJ, Dong B, Dong Y, et al. Matching actions to needs: Shifting policy responses to the changing health needs of Chinese children and adolescents[J]. Lancet, 2024, 403(10438): 1808-1820.
PDF(1203 KB)

Accesses

Citation

Detail

Sections
Recommended

/