The indicator shows the mortality rate of infants aged from 1 month to 1 year due to respiratory diseases that may also have been a consequence of exposure to polluted air. The analysis of mortality rate relates to the period 2002–2007. The infant mortality rate for 2006 in selected European countries is given for comparison with Slovenia.

The infant mortality rate due to respiratory diseases is one of the indicators providing an indirect assessment of how exposure to negative environmental factors affects the health of children and, in particular, infants. The infant mortality rate from respiratory diseases depends on a number of factors, including the quality of indoor and outdoor air (WHO, 2005).

Acute lower respiratory infections, in particular pneumonia, are frequent cause of death and serious morbidity in young children and infants (Commission of the European Communities, 2005). The most frequent cause of infant deaths from respiratory diseases is infections of the lower respiratory tract. Causative infective agents differ between developed and developing countries of Europe – bacteria are most common in developing countries and viruses in developed countries. Research has shown a relationship between air pollution rate and infant mortality rate due to respiratory diseases (WHO, 2007).

The average infant mortality rate due to respiratory diseases in Europe is 0.8 per 1000 live-born infants. A detailed breakdown for EU countries is shown in Figure ZD1-3. The infant mortality rate differs greatly from country to country (e.g. 0.025 in Austria and 6.2 in Kyrgyzstan, per 1000 live-born infants). Some 13.6% of all infant deaths are due to respiratory diseases. In general, the infant mortality rate is considerably higher in Eastern Europe than in Western Europe (ENHIS - European Environment and Health Information System, 2007).

In Slovenia, data on infant mortality are collected on a regular basis. The data for the past 6 years indicate a fairly stable infant mortality rate due to respiratory diseases in the country and individual towns and cities (Figure ZD1-2). The data are comparable to the infant mortality rate due to respiratory diseases in the developed countries of Western Europe.

The data for Slovenia (Figure ZD1-1) show that the infant mortality rate due to respiratory diseases in children aged between 28 and 364 days in the period 2002–2007 ranges from 0 to 0.12 per 1000 live-born infants (the highest in 2003). In Celje, Ljubljana and Maribor, the infant mortality rate due to respiratory diseases in children aged between 28 and 364 days is not higher compared to other parts of Slovenia; only one death was recorded in the period 2002–2007 in Celje. Throughout Slovenia, seven infants died in this period due to respiratory diseases. The data show that the proportion of children aged between 28 and 364 days who died in Slovenia from respiratory diseases in the period 2002–2007 was, on average, 6.55% of whole infant mortality (from 0.0% to 12.5%) (Institute of Public Health of the Republic of Slovenia, 2009).

The relationship between the infant mortality rate due to respiratory diseases and indoor air quality is a rather complex one. A variety of respiratory disease forms occur due to several causes, such as outdoor air pollution, the presence of pollutants and allergens inside homes (e.g. deriving from solid fuels used for cooking and heating, tobacco smoke and dust) and because of the presence of infectious agents. Moreover, diet, lifestyle, environmental and sociological factors may be significant and may also have a synergistic effect (Commission of the European Communities, 2005).

In the countries of Western Europe, the infant mortality rate due to respiratory diseases is very low, probably because these countries are highly developed in economic and social terms, and there is more effective environmental legislation in place. The infant mortality rate due to respiratory diseases is most likely a consequence of increasingly resistant micro-organisms, the emergence of new pathogens or the lack of effective antiviral medications. Respiratory diseases are usually discovered at an early stage and treatment starts immediately.