Air pollutants and hospital admission due to pneumonia in children: a time series analysis

Abstract

Objective: The aim of this study was to estimate the association between exposure to air pollutants and hospitalization for pneumonia among children in a medium-sized city located in the sugar cane plantation region of São Paulo State. Methods: An ecological time-series study was conducted with daily data of hospitalization for pneumonia including children aged 10 years or younger living in Araraquara, state of São Paulo, from January 1 st , 2010, to November 30 th , 2012. To estimate the association between hospitalization due to pneumonia and particulate pollutants with aerodynamic diameter less than 10 µm, nitrogen dioxide and ozone, relative risks for hospitalization according to a generalized additive model of Poisson regression, with Lags of up to five days, were calculated. A percentage increase (PI) was obtained for relative risk (IRR -increase on relative risk) of hospitalization at each 10 μg/m 3 increment in each air pollutants adjusted for the remaining. Results: A total of 234 hospitalizations were recorded during these three years. There was a strong association between hospitalization and PM 10 and NO 2 . The PI in relative risk was 15% to PM 10 in Lag 0 and 7% points in Lag 1 for NO 2 . Conclusion: There was evidence of the action of air pollutants on hospitalization for pneumonia in a medium-sized city located in a region affected by air pollution from sugarcane burning and the data presented here provide subsidies for the implementation of public policies aiming to decrease this risk.

The impact of airborne particulate matter on pediatric hospital admissions for pneumonia among children in Jinan, China: A case-crossover study

“…Souza et al found a strong association between hospitalization and PM 10 and NO 2 . The percentage increase in relative risk was 15% to PM 10 in Lag 0 and 7% in Lag 1 for NO 2 (Souza and Nascimento, 2016). Patto et al reported that a rise of 10 µg/m 3 in the concentration of PM 2.5 leads to significant increase between 25 ppt and 28 ppt in the risk of hospitalization due to pneumonia among children 4 and 5 days after exposure (Patto et al, 2016).…”

“…These reports suggest that primary traffic pollutants, ozone, and fine and coarse particulate air pollution exacerbate upper and lower respiratory infections and the disease burden of respiratory infections such as pneumonia, bronchiolitis, bronchitis, and upper respiratory infection in early life (Darrow et al, 2014;Anenberg et al, 2012;Wang et al, 2013;Kesavachandran et al, 2013). Particulate matter originated from other sources, such as burning of fossil fuels and biomass, is also associated with increased incidence of pneumonia and increased symptoms and respiratory disease (Souza and Nascimento, 2016). Experimental and epidemiologic studies have demonstrated that the severity of pneumonia has positive associations with exposure of air pollutants (Harrod et al, 2003;Mikerov et al, 2008).…”

Examining health disparities and characteristics in general practice utilization: based on outpatient data from 2014 - 2018 in Shanghai

“…Additionally, in high-income developed countries, the estimated loss of YLDs due to respiratory diseases was much lower than that in low-income developed countries, regardless of sex or age [21]. This may be due to air pollution, which is positively associated with the admission of respiratory patients in developing countries among different age groups; this association is especially strong in vulnerable groups (children and elderly individuals) [22][23][24]. However, the fact that community health centre visits were frequently for acute upper respiratory tract infections was ignored in terms of public healthcare resource allocation [25].…”

Exposure to fine particulate matter and hospital admissions due to pneumonia: Effects on the number of hospital admissions and its costs

“…In Araraquara, SP, which is a major producer of sugar and alcohol and is located about 200 km from São José do Rio Preto, exposure to PM 10 was associated with hospitalizations for pneumonia in children, with concentrations of this pollutant (35.7 µg/ m 3 ) similar to the adjusted concentrations found in São José do Rio Preto (31.6 µg/m 3 ). 19 Exposures to PM 2.5 were associated with hospitalizations due to bronchiolitis in a study by Sheffield et al 20 conducted between 1999 and 2007 based on the National Inpatient Sample, the largest database that evaluates hospitalization costs for bronchiolitis in the United States. In this study, the authors identified nearly 48,000 hospitalizations for bronchiolitis associated with exposure to PM 2.5 and estimated a cost reduction of approximately US$ 15 million per year, resulting from the decrease in the concentrations of this pollutant.…”