When Maksim Kovaliova was six, he suffered his first asthma attack.

It seemed to 'come out of nowhere' and left him 'scared and weak', recalls his mum Julia, who is raising all three of her children in Manchester city centre.

Following repeated episodes and a trip to hospital, it’s suspected Maksim, now, 11, likely has pollution-induced asthma - thought in part to be a result of living near to the junction of Portland Street and Great Ancoats, where traffic is near-constant.

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Manchester city centre has been Maksim’s home since birth and he is among a quarter of a million babies in the UK born breathing toxic air every year.

Air pollution can damage the lungs and brains of babies while they are still in the womb and emerging evidence shows pregnant women who breathe toxic air are more likely to give birth to premature babies and those with a low birth weight.

Maksim’s mum Julia, 37, a finance manager, says: “We live in an area which was supposed to be family-friendly, yet it is a near a busy main road where traffic is constantly whizzing by and there is not much green space. We live here because we work here, moving is not realistic for us.

"I think people move here thinking there will be more green spaces for children. Maksim’s asthma is always worse when the roads are busy."

Maksim and his family are managing the condition well and he has an inhaler on hand when needed.

But Julia, also mum to Mark, five, and one-year-old Maya, worries about how the condition will affect him long-term, and whether her other children are at risk.

She added: “It is terrifying that air pollution can make children so ill and I worry that Maksim’s asthma will get steadily worse. I am really concerned that Maya will develop asthma like her brother – she was breathing in dirty air while she was in the womb and now is breathing in toxic air as a small, innocent baby."

All but three authorities in Greater Manchester were among the worst 95pc in the country when it came to hospital admissions for asthma for children under nine in 2019, according to Public Health England statistics.

In the Manchester City Council region, there were 373 admissions per 100,000 of the population, compared to the national average of 192.

Oldham ranked the worst in the country, with 521 admissions per 100,000 population - nearly treble the national average.

Asthma hospital admissions are indicative of more than just pollution levels. There are many factors, including the general health of the population, access to healthcare and quality housing.

But experts believe residents’ proximity to the M60, M61, and other congested roads could, are a substantial part of the problem.

And clean air campaigners argue it's relevant that in 2019, almost two-thirds of babies born in Greater Manchester arrived into local authorities where nitrogen dioxide - a toxic gas emitted by vehicles - exceeded legal levels.

Linked to 1,200 deaths a year in Greater Manchester, nitrogen dioxide is one of a raft of air pollutants considered 'silent killers'.

Along with particulates – tiny bits of dust and other contaminants coughed up in noxious exhaust fumes – it’s a major cause of bronchitis, asthma, heart problems and cancer.

It means in Greater Manchester many children, especially those in less well-off neighbourhoods where the likelihood of living near a busy road is higher, are carrying the 'burden' of toxic air, argue charities including Asthma UK and the British Lung Foundation.

Last year, Ella Adoo-Kissi-Debrah, a nine-year-old girl who sadly died following an asthma attack, became the first person in the UK to have air pollution listed as cause of death.

She lived near the South Circular Road in Lewisham, south-east London.

Much is being done in Greater Manchester to tackle air pollution - including the controversial Clean Air Zones to be launched next year.

But Asthma UK and the British Lung Foundation say an ‘unfair distribution’ of air pollution is following children throughout their lives, with those least able to afford a car being the worst hit because of where they live.

They point to the clear link between deprivation and exposure to toxic air conditions.

For example, Manchester City Council - considered the second most deprived local authority in England - ranked third in Greater Manchester for NO2 concentrations. The maximum annual recording in the authority reached 43.5 on the A57, exceeding the legal limit of 40.

Yet it also has the lowest proportion of households with a car or van (55pc).

Trafford meanwhile, has a lower NO2 reading, but the highest percentage of homes in Greater Manchester with a vehicle (78pc).

Meanwhile, nearly a third of hospitals in England are in polluted areas - above the 2005 WHO guideline. This includes 71 maternity units.

The charities are calling for the UK Government to place improving air quality at the heart of its levelling up agenda, ensuring people can access clean air regardless of where they are born or where they live.

They are urging for bolder clean air laws with targets to be met by 2030, and sufficient funding to make that happen.

They want more effective public transport and cycling, as well as expanded clean air zones.

Harriet Edwards, head of policy at Asthma UK and the British Lung Foundation, spoke to the Manchester Evening News ahead of the UN Climate Conference (COP26) this weekend.

She said: “Children and babies are being left behind in Greater Manchester just from where they are born.

“Enviornment and the air we breathe is an exacerbator of people’s situations and poor communities tend to live near the most polluted roads. Lung conditions are twice as high in the poorest areas compared to the richest.”

She said Greater Manchester’s ‘clean air zones’, due to be introduced next year, were a step in the right direction, although they don’t go far enough - or as far as Birminghan or London - because they don’t include private vehicles.

She said leaders in Manchester is making ‘great strides’ toward progress in tackling pollution, but said there had been ‘considerable delays’ with clean air zones and active travel, adding: “There is a really high level of need, Greater Manchester has among the highest asthma admissions in the country, these are things that really need to be driving change.”

Sarah Woolnough, Chief Executive of Asthma UK and the British Lung Foundation, said : “It is a national shame that a quarter of a million babies are born breathing toxic air every year. How can it be acceptable that the first breath a baby takes could be so dirty it could seriously affect their long-term health? Every child deserves the best start in life and our Government needs to act now to cut air pollution levels and do their duty to protect future generations from this invisible threat.

“The UK Government must blaze a trail, not just at COP26 but beyond, to bring in bold new clean air laws and set ambitious targets to clean up the air by 2030. If people are encouraged to swap their car for cleaner modes of transport and Government invests in more cycle routes, more frequent bus routes and if local councils expand clean air zones, there is hope that we can tackle air pollution and all enjoy cleaner air. But we can’t press for change alone. We need people to share their stories of how air pollution affects them and support our campaign to put pressure on the Government to urgently tackle air pollution.”

Andy Ratcliffe, Executive Director of Programmes at Impact on Urban Health, said: “Where a baby happens to be born determines whether, from its very first breath, it will be exposed to toxic levels of poisonous air. This new report shows that pollution levels around maternity units are highest in areas of social deprivation. This is an unacceptable example of inequality in action.

COP26 is a crucial moment for the Government’s levelling up agenda. Do we want to be a society where the burden of poisonous air is disproportionately borne by those whose health is most susceptible - children, older people, people with heart and lung conditions and those in lower income communities? Or do we want to make sure every parent can be confident their baby has equal access to safe air and a healthy life, right from the very first breath?”

The Manchester Evening News has contacted the Greater Manchester Combined Authority for comment.