Air pollution and children’s asthma-related emergency hospital visits in southeastern France

Abstract

C h i l d r e n 's a s t h m a i s m u l t i f a c t o r i a l . Environmental factors like air pollution exposure, meteorological conditions, allergens, and viral infections are strongly implicated. However, place of residence has rarely been investigated in connection with these factors. The primary aim of our study was to measure the impact of particulate matter (PM), assessed close to the children's homes, on asthma-related pediatric emergency hospital visits within the Bouches-du-Rhône area in 2013. In a nested case-control study on 3-to 18-year-old children, each control was randomly matched on the emergency room visit day, regardless of hospital. Each asthmatic child was compared to 15 controls. PM 10 and PM 2.5 , meteorological conditions, pollens, and viral data were linked to ZIP code and analyzed by purpose of emergency visit. A total of 68,897 visits were recorded in children, 1182 concerning asthma. Short-term exposure to PM 10 measured near children's homes was associated with excess risk of asthma emergency visits (adjusted odds ratio 1.02 (95% CI 1.01-1.04; p = 0.02)). Male gender, young age, and temperature were other risk factors. Conversely, wind speed was a protective factor. Conclusion: PM 10 and certain meteorological conditions near children's homes increased the risk of emergency asthma-related hospital visits in 3-to 18-year-old children in Bouches-du-Rhône. What is Known:• A relationship between short-term exposure to air pollution and increase in emergency room visits or hospital admissions as a result of increased pollution levels has already been demonstrated. What is New:• This study confirms these results but took into account confounding factors (viral data, pollens, and meteorological conditions) and is based on estimated pollution levels assessed close to the children's homes, rather than those recorded at the hospital.• The study area, the Mediterranean, is favorable to creation of secondary pollutants in these sunny and dry seasons.

Quality of life of the family of children with asthma is not related to asthma severity

“…This study confirms results from other studies in families with a child with conditions other than asthma that chronic childhood disease affects the whole family [6,13] Childhood asthma is a multifactorial disease [15] and not unexpectedly the family's quality of life is associated with many factors, some of which are not primarily asthmatic.…”

Effects of particulate matter on allergic respiratory diseases

“… 8 Many epidemiological studies worldwide have addressed the correlation between the concentrations of PM and hospital visits due to respiratory diseases ( Table 1 ). 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 …”

Particulate matter and childhood allergic diseases

“…In a multicity study in Korea, an interquartile range (IQR) increase in PM 10 (30.7 μg/m 3 ) resulted in an increase of 2.4% in asthma-related hospitalization among children aged 0–14 years [19]. PM 10 was also found to increase the risk of asthma-related hospitalization (aOR, 1.02; 95% CI, 1.01–1.04) in a nested case–control study of children aged 3–18 years in France [20]. An observational time-series analysis in the US showed a 26% increase in intensive care unit admissions and a 19% increase in general hospitalizations for each 12-μg/m3 increase in PM 2.5 [21].…”