Associations of fine particulate matter and constituents with pediatric emergency room visits for respiratory diseases in Shanghai, China

Wu, Yaojiong; Jin, Tingting; He, Wen; Liu, Lijuan; Li, Hongjin; Liu, Cong; Zhou, Yu‐Feng; Hong, Jian‐Guo; Cao, Lu; Lu, Yanming; Dong, Xiaoyan; Xia, Min; Ding, Bo; Qian, Liling; Wang, Libo; Zhou, Wenhao; Gui, Yonghao; Zhang, Xiaobo; Chen, Renjie

doi:10.1016/j.ijheh.2021.113805

Cited by 18 publications

(6 citation statements)

References 39 publications

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“…Additionally, our study provided a comparative insight into short-term associations of PM 1 and PM 2.5 exposure in raising the risk of childhood illnesses within a day ( Figure 1 ), which coincided with a daily time-series study on EDVs for all ages’ coverage of 26 cities across China [ 11 ]. Highly consistent effect patterns between PM 1 and PM 2.5 were also reported in previous children’s studies on the consequences of daily hospital admission and hospitalizations for cardiovascular [ 7 , 17 ] and respiratory diseases [ 2 , 6 ], along with EDVs [ 24 , 25 ]. When developing strategies to protect children’s health, local authorities should thus consider the adverse effects of sub-daily scale air pollutants to help children avoid exposure to high-risk time windows.…”

Section: Discussionsupporting

confidence: 83%

Emergency Department Visits in Children Associated with Exposure to Ambient PM1 within Several Hours

Zhu

Wang

et al. 2023

IJERPH

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Background: Emerging evidence has integrated short-term exposure to PM1 with children’s morbidity and mortality. Nevertheless, most available studies have been conducted on a daily scale, ignoring the exposure variations over the span of a day. Objective: The main intention of this study was to examine the association between pediatric emergency department visits (PEDVs) and intra-day exposures to PM1 and PM2.5. We also aimed to investigate whether a high PM1/PM2.5 ratio elevated the risk of PEDVs independent from PM2.5 exposure within several hours. Methods: We collected hourly data on aerial PM1 and PM2.5 concentrations, all-cause PEDVs, and meteorological factors from two megacities (i.e., Guangzhou and Shenzhen) in southern China during 2015–2016. Time-stratified case-crossover design and conditional logistic regression analysis were used to assess the associations of PEDVs with exposures to PM1 and PM2.5 at different lag hours. The contribution of PM1 to PM2.5-associated risk was quantified by introducing PM1/PM2.5 ratio as an additional exposure indicator in the analysis adjusting for PM2.5. Subgroup analyses were performed stratified by sex, age, and season. Results: During this study period, 97,508 and 101,639 children were included from Guangzhou and Shenzhen, respectively. PM1 and PM2.5 exposures within several hours were both remarkably related to an increased risk of PEDVs. Risks for PEDVs increased by 3.9% (95% confidence interval [CI]: 2.7–5.0%) in Guangzhou and 3.2% (95% CI: 1.9–4.4%) in Shenzhen for each interquartile range (Guangzhou: 21.4 μg/m3, Shenzhen: 15.9 μg/m3) increase in PM1 at lag 0–3 h, respectively. A high PM1/PM2.5 ratio was substantially correlated with increased PEDVs, with an excess risk of 2.6% (95% CI: 1.2–4.0%) at lag 73–96 h in Guangzhou and 1.2% (95% CI: 0.4–2.0%) at lag 0–3 h in Shenzhen. Stratified analysis showed a clear seasonal pattern in PM-PEDVs relationships, with notably stronger risks in cold months (October to March of the following year) than in warm months (April to September). Conclusions: Exposures to ambient PM1 and PM2.5 within several hours were related to increased PEDVs. A high PM1/PM2.5 ratio may contribute an additional risk independent from the short-term impacts of PM2.5. These findings highlighted the significance of reducing PM1 in minimizing health risks due to PM2.5 exposure in children.

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Section: Discussionsupporting

confidence: 83%

Emergency Department Visits in Children Associated with Exposure to Ambient PM1 within Several Hours

Zhu

Wang

et al. 2023

IJERPH

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“…There were approximately 540 million people diagnosed with respiratory diseases worldwide in 2017, making it the third leading cause of death according to the Global Burden of Disease (GBD) 2020 report [ 1 ]. Air pollution in urban areas is primarily composed of particulate matter (PM), which poses a significant risk for respiratory diseases [ 2 ]. As compared with adults, children and adolescents are more susceptible to air pollution because their respiratory rates per body weight and lung surface area are greater [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Association between PM1 Exposure and Lung Function in Children and Adolescents: A Systematic Review and Meta-Analysis

Zong

Zhao

Zhang

et al. 2022

IJERPH

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The detrimental effects of PM2.5 and PM10 (particulate matter less than 2.5 or 10 μm) on human respiratory system, including lung function, have been widely assessed. However, the associations between PM1 (particulate matter of less than 1 μm) and lung function in children and adolescents are less explored, and current evidence is inconsistent. We conducted a meta-analysis of the literature on the association between PM1 and lung function in children and adolescents to fill this gap. With no date or language constraints, we used a combination of MeSH (Medical Subject Headings) terms and free text to search PubMed, EMBASE and Web of Science databases through, 1 October 2022 for “PM1 exposure” and “lung function”. A total of 6420 relevant studies were identified through our initial search, and seven studies were included in our study. In this meta-analysis, the fixed effect and random effects statistical models were used to estimate the synthesized effects of the seven included studies. For every 10 μg/m3 increase in short-term PM1 exposure, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak expiratory flow (PEF) and maximal mid-expiratory flow (MMEF) decreased by 31.82 mL (95% CI: 20.18, 43.45), 32.28 mL (95% CI: 16.73, 48.91), 36.85 mL/s (95% CI: 15.33, 58.38) and 34.51 mL/s (95% CI: 19.61, 49.41), respectively. For each 10 μg/m3 increase in long-term PM1 exposure, FVC, FEV1, PEF and MMEF decreased by 102.34 mL (95% CI: 49.30, 155.38), 75.17 mL (95% CI: 39.61, 110.73), 119.01 mL/s (95% CI: 72.14, 165.88) and 44.94 mL/s (95% CI: 4.70, 85.18), respectively. Our study provides further scientific evidence for the harmful effects of PM1 exposure on lung function in children and adolescents, indicating that exposure to PM1 is detrimental to pulmonary health. To reduce the adverse health effects of air pollution on children and adolescents, effective preventive measures should be taken.

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“…This is conducted by first defining a flexible specification where the importance of each ambient air pollutant's lagged high frequency observations are decided by data, rather than taking a simple average to aggregate these variables to the same frequency as disease case counts. This prevents subjective lag selection in a model specification to detect associations [ 51 – 53 ] as all past pollutant measurements can be placed in a model, with their importance post-hoc decided. Furthermore, having a flexible weighting scheme reduces discretization bias due to simple averaging and increases the statistical efficiency of the model.…”

Section: Discussionmentioning

confidence: 99%

Association between ambient air pollutants and upper respiratory tract infection and pneumonia disease burden in Thailand from 2000 to 2022: a high frequency ecological analysis

Choo,

Janhavi,

Koo

et al. 2023

BMC Infect Dis

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Background A pertinent risk factor of upper respiratory tract infections (URTIs) and pneumonia is the exposure to major ambient air pollutants, with short term exposures to different air pollutants being shown to exacerbate several respiratory conditions. Methods Here, using disease surveillance data comprising of reported disease case counts at the province level, high frequency ambient air pollutant and climate data in Thailand, we delineated the association between ambient air pollution and URTI/Pneumonia burden in Thailand from 2000 – 2022. We developed mixed-data sampling methods and estimation strategies to account for the high frequency nature of ambient air pollutant concentration data. This was used to evaluate the effects past concentrations of fine particulate matter (PM2.5), sulphur dioxide (SO2), and carbon monoxide (CO) and the number of disease case count, after controlling for the confounding meteorological and disease factors. Results Across provinces, we found that past increases in CO, SO2, and PM2.5 concentration were associated to changes in URTI and pneumonia case counts, but the direction of their association mixed. The contributive burden of past ambient air pollutants on contemporaneous disease burden was also found to be larger than meteorological factors, and comparable to that of disease related factors. Conclusions By developing a novel statistical methodology, we prevented subjective variable selection and discretization bias to detect associations, and provided a robust estimate on the effect of ambient air pollutants on URTI and pneumonia burden over a large spatial scale.

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Associations of fine particulate matter and constituents with pediatric emergency room visits for respiratory diseases in Shanghai, China

Cited by 18 publications

References 39 publications

Emergency Department Visits in Children Associated with Exposure to Ambient PM1 within Several Hours

Emergency Department Visits in Children Associated with Exposure to Ambient PM1 within Several Hours

Association between PM1 Exposure and Lung Function in Children and Adolescents: A Systematic Review and Meta-Analysis

Association between ambient air pollutants and upper respiratory tract infection and pneumonia disease burden in Thailand from 2000 to 2022: a high frequency ecological analysis

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