Ambient air pollution is associated with pediatric pneumonia: a time-stratified case–crossover study in an urban area

Abstract

Background Pneumonia, the leading reason underlying childhood deaths, may be triggered or exacerbated by air pollution. To date, only a few studies have examined the association of air pollution with emergency department (ED) visits for pediatric pneumonia, with inconsistent results. Therefore, we aimed to elucidate the impact of short-term exposure to particulate matter (PM) and other air pollutants on the incidence of ED visits for pediatric pneumonia. Methods PM 2.5 , PM 10 , and other air pollutant levels were measured at 11 air quality-monitoring stations in Kaohsiung City, Taiwan, between 2008 and 2014. Further, we extracted the medical records of non-trauma patients aged ≤17 years and who had visited an ED with the principal diagnosis of pneumonia. A time-stratified case–crossover study design was employed to determine the hazard effect of air pollution in a total of 4024 patients. Results The single-pollutant model suggested that per interquartile range increment in PM 2.5 , PM 10 , nitrogen dioxide (NO 2 ), and sulfur dioxide (SO 2 ) on 3 days before the event increased the odds of pediatric pneumonia by 14.0% [95% confidence interval (CI), 5.1–23.8%], 10.9% (95% CI, 2.4–20.0%), 14.1% (95% CI, 5.0–24.1%), and 4.5% (95% CI, 0.8–8.4%), respectively. In two-pollutant models, PM 2.5 and NO 2 were significant after adjusting for PM 10 and SO 2 . Subgroup analyses showed that older children (aged ≥4 years) were more susceptible to PM 2.5 (interaction p = 0.024) and children were more susceptible to NO 2 during warm days (≥26.5 °C, interaction p = 0.011). Conclusions Short-term exposure to PM 2.5 and NO 2 possibly plays an important role in pediatric pneumonia in Kaohsiung, Taiwan. Older children are more susceptible to PM 2.5 , and all children are more susceptible to NO 2 during warm days.

Air Pollutants and Hospital Visits for Pneumonia: A Case-crossover Study in Qingdao, China.

“…Meteorological factors such as daily temperature, relative humidity, and atmospheric pressure were adjusted in all models. The hysteresis effect of atmospheric pollutants has been con rmed by previous studies [22]. So, we chose the day of hospital visits (lag0) and subsequent six days (lag1-lag6) to assess the effect of air pollutants.…”

“…In terms of age strati cation, infants less than 1-year-old were proved to more sensitive to PM 2.5 and PM 10 in a study [13]. Cheng et al [22] found children older than four years were more vulnerable to PM 2.5 than those younger than four years. In this study, we found that children younger than four years old seem more susceptible to atmospheric pollutants.…”

“…This research, like previous singular-source studies, discovered a connection in atmospheric pollutants and hospital visits with pneumonia. With an IQR increment of PM 2.5, PM 10 , NO 2 , and SO 2 levels, the odds ratio of ED visits with pneumonia for each air pollutant increased by 14.0%, 10.9%, 14.1%, and 4.5% in Kaohsiung City on lag three days [22]. Another study in Jinan also demonstrated the short-term effects of atmospheric particulates on pediatric patients with pneumonia, and PM 2.5 and PM 10 achieved the most signi cant impact, respectively, on the lag ve days(OR = 1.06, 95%CI: 1,02-1.10) and lag two days (OR = 1.04, 95%CI: 1.00-1.08) [13].…”

Long non-coding RNA NKILA weakens TNF-α-induced inflammation of MRC-5 cells by miR-21 up-regulation

“…Bacteria, viruses and mycoplasma are common pathogens that cause infantile pneumonia (IP) [2]. In recent years, with the changes in the environment and the abuse of antibiotics, the incidence of IP has continued to increase and the clinical symptoms are diverse [3,4]. If not treated in time during acute attack, it can cause serious damage to the respiratory system and other systems, even organ dysfunction [5].…”

Effect of different fabrics types on the adsorption of air pollution in residential and industrial atmosphere in Cairo-Egypt

“…As the environmental atmosphere gets more crowded and polluted without using clean fuels or technologies, the air that we breathe becomes dangerously polluted and cause kills for millions people around the world every year because of stroke, lung cancer and heart disease. Air pollution can penetrating deeply into our respiratory and circulatory system causing damaging to our lungs, heart and brain [1][2][3][4]. One of the main air pollution reasons is industrial processes and traffic.…”