Ultrafine particulate air pollution and pediatric emergency-department visits for main respiratory diseases in Shanghai, China.

Affiliation

Li H(1), Li X(2), Zheng H(2), Liu L(2), Wu Y(1), Zhou Y(3), Meng X(1), Hong J(4), Cao L(5), Lu Y(6), Dong X(7), Xia M(5), Ding B(6), Qian L(2), Wang L(2), Zhou W(8), Gui Y(9), Kan H(1), Chen R(10), Zhang X(11).
Author information:
(1)School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China.
(2)Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai 201102, China.
(3)Institute of Pediatrics, Children's Hospital of Fudan University, Shanghai 201102, China; Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, China.
(4)Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai 200080, China.
(5)Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University, Shanghai 200127, China.
(6)Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University, Shanghai 201112, China.
(7)Department of Respiratory Medicine, Children's Hospital of Shanghai Jiaotong University, Shanghai 200040, China.
(8)Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China.
(9)Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102, China.
(10)School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China. Electronic address: [Email]
(11)Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai 201102, China. Electronic address: [Email]

Abstract

BACKGROUND: Few studies have explored the short-term effects of ultrafine particles (UFPs, particles < 0.1 μm) air pollution on the exacerbations of pediatric respiratory diseases. OBJECTIVES: We aimed to evaluate short-term association between UFP and emergency-department visits (EDVs) for main pediatric respiratory diseases. METHODS: We collected daily data on UFP and pediatric EDVs for main respiratory diseases [asthma, pneumonia, bronchitis and upper respiratory tract infections (URTI)] from 66 hospitals in Shanghai, China from 2016 to 2018. Generalized additive models combined with polynomial distributed lag models were applied to explore the associations between UFP level and pediatric EDVs for respiratory diseases. We fitted two-pollutant models with criteria air pollutants and performed stratified analyses by gender and age. RESULTS: UFP was associated with increased EDVs for all respiratory diseases in cumulative lags up to 2 d and 3 d. The greatest risk was found at cumulative lags (0-2 d) for all respiratory diseases. At cumulative lags (0-2 d), an interquartile range increase in concentrations of UFP (1800 particles/cm3) was associated with relative risks of EDVs due to asthma [1.35, 95% confidence interval (CI): 1.14-1.59], pneumonia (1.20, 95% CI: 1.04-1.38), bronchitis (1.17, 95% CI: 1.03-1.33) and URTI (1.14, 95% CI: 1.02-1.28). These associations were almost unchanged when controlling for criteria air pollutants, and there was no threshold below which the associations were not present. There were stronger associations in children aged 0-13 years. CONCLUSIONS: Short-term exposure to UFP may independently increase the risks of EDVs for asthma, pneumonia, bronchitis and URTI exacerbations among children.