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Short-term effects of air pollution on respiratory diseases among young children in Wuhan city, China - PubMed

Short-term effects of air pollution on respiratory diseases among young children in Wuhan city, China

Zeng-Hui Huang et al. World J Pediatr. 2022 May.

Abstract

Background: The high risks for childhood respiratory diseases are associated with exposure to ambient air pollution. However, there are few studies that have explored the association between air pollution exposure and respiratory diseases among young children (particularly aged 0-2 years) based on the entire population in a megalopolis.

Methods: Daily hospital admission records were obtained from 54 municipal hospitals in Wuhan city, China. We included all children (aged 0-2 years) hospitalized with respiratory diseases between January 2017 and December 2018. Individual air pollution exposure assessment was used in Land Use Regression model and inverse distance weighted. Case-crossover design and conditional logistic regression models were adopted to estimate the hospitalization risk associated with air pollutants.

Results: We identified 62,425 hospitalizations due to respiratory diseases, of which 36,295 were pneumonia. Particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and nitrogen dioxide (NO2) were significantly associated with respiratory diseases and pneumonia. ORs of pneumonia were 1.0179 (95% CI 1.0097-1.0260) for PM2.5 and 1.0131 (95% CI 1.0042-1.0220) for NO2 at lag 0-7 days. Subgroup analysis suggested that NO2, Ozone (O3) and sulfur dioxide (SO2) only showed effects on pneumonia hospitalizations on male patients, but PM2.5 had effects on patients of both genders. Except O3, all pollutants were strongly associated with pneumonia in cold season. In addition, children who aged elder months and who were in central urban areas had a higher hospitalization risk.

Conclusions: Air pollution is associated with higher hospitalization risk for respiratory diseases, especially pneumonia, among young children, and the risk is related to gender, month age, season and residential location.

Keywords: Air pollution; Children; Hospitalization; Respiratory disease.

© 2022. The Author(s).

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Conflict of interest statement

No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Figures

Fig. 1
Fig. 1

Location of air monitoring station and cases in Wuhan, China and the results of LUR model. This map is adapted from the standard map provided by Ministry of Natural Resources of China. LUR, land use regression; PM2.5, particles with aerodynamic diameter ≤ 2.5 μm. The map is obtained from Ministry of Natural Resources, China with the drawing no. GS(2020) 3183, which is permitted to be used publicly

Fig. 2
Fig. 2

Odds ratios (with 95% CIs) of hospitalization for pneumonia among subgroups stratified by sex, age, season and region associated with per 10 μg/m3 increase in exposure to PM2.5, NO2, SO2 and O3. All analysis was controlled for temperature and humidity. CIs, confidence intervals; PM2.5, particles with aerodynamic diameter ≤ 2.5 μm; NO2, nitrogen dioxide; SO2, sulfur dioxide; O3, ozone

Fig. 3
Fig. 3

Concentration–response curves (smoothing by NCS function with df = 3) between air pollutants and risks of hospital admission for pneumonia. The exposure days of each pollutant were selected as the days with the strongest effect in the lag analysis. All analysis was controlled for temperature and humidity. The solid line represents the predicted odds of hospital admission and the shadow represents the 95% CIs. NCS, natural cubic spline; CIs, confidence intervals; PM2.5, particles with aerodynamic diameter ≤ 2.5 μm; NO2 nitrogen dioxide; SO2 sulfur dioxide; O3 ozone

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