Air Pollution and Acute Respiratory Infections Among Children 0–4 Years of Age: An 18-Year Time-Series Study

Abstract

Upper and lower respiratory infections are common in early childhood and may be exacerbated by air pollution. We investigated short-term changes in ambient air pollutant concentrations, including speciated particulate matter less than 2.5 μm in diameter (PM2.5), in relation to emergency department (ED) visits for respiratory infections in young children. Daily counts of ED visits for bronchitis and bronchiolitis (n = 80,399), pneumonia (n = 63,359), and upper respiratory infection (URI) (n = 359,246) among children 0-4 years of age were collected from hospitals in the Atlanta, Georgia, area for the period 1993-2010. Daily pollutant measurements were combined across monitoring stations using population weighting. In Poisson generalized linear models, 3-day moving average concentrations of ozone, nitrogen dioxide, and the organic carbon fraction of particulate matter less than 2.5 μm in diameter (PM2.5) were associated with ED visits for pneumonia and URI. Ozone associations were strongest and were observed at low (cold-season) concentrations; a 1-interquartile range increase predicted a 4% increase (95% confidence interval: 2%, 6%) in visits for URI and an 8% increase (95% confidence interval: 4%, 13%) in visits for pneumonia. Rate ratios tended to be higher in the 1- to 4-year age group compared with infants. Results suggest that primary traffic pollutants, ozone, and the organic carbon fraction of PM2.5 exacerbate upper and lower respiratory infections in early life, and that the carbon fraction of PM2.5 is a particularly harmful component of the ambient particulate matter mixture.

How Air Pollution Affects Subjective Well-Being

“…Air pollution is directly linked with pneumonia and other respiratory diseases [31]. Pneumonia accounts for up to 16% of all under-five deaths [33]; more than half of childhood pneumonia deaths are directly associated with air pollution [31,34].…”

Exposure to traffic-related air pollution and acute bronchitis in children: season and age as modifiers

“…In the present study, we aimed to investigate the association between traffic-related air pollutants and daily department visits for AB in children in Hefei from 2015 to 2016. Because they are often found in exhaust fumes, NO 2 , PM 2.5 and CO, three markers of primary traffic exhaust,9 were chosen as principal air pollutants in our present study.…”

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

“…Infectious agents associated with pneumonia include bacteria, viruses, and fungi. Susceptibility to pneumonia may be increased by environmental factors, such as ambient air pollution (Darrow et al, 2014).…”

“…Epidemiological studies in Europe, North America, and developing countries indicate that exposure to pollutants in ambient air has a detrimental effect on the health status of children (Darrow et al, 2014;Anenberg et al, 2012;Wang et al, 2013;Kesavachandran et al, 2013). 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).…”