Association of air pollution with outpatient visits for respiratory diseases of children in an ex-heavily polluted Northwestern city, China

Abstract

Background: A great number of studies have confirmed that children are a particularly vulnerable population to air pollution. Methods: In the present study, 332,337 outpatient visits of 15 hospitals for respiratory diseases among children (0-13 years), as well as the simultaneous meteorological and air pollution data, were obtained from 2014 to 2016 in Lanzhou, China. The generalized additive model was used to examine the effects of air pollutants on children's respiratory outpatient visits, including the stratified analysis of age, gender and season. Results: We found that PM 2.5 , NO 2 and SO 2 were significantly associated with the increased total respiratory outpatient visits. The increments of total respiratory outpatient visits were the highest in lag 05 for NO 2 and SO 2 , a 10 μg/m 3 increase in NO 2 and SO 2 was associated with a 2.50% (95% CI: 1.54, 3.48%) and 3.50% (95% CI: 1.51, 5.53%) increase in total respiratory outpatient visits, respectively. Those associations remained stable in twopollutant models. Through stratification analysis, all air pollutants other than PM 10 were significantly positive associated with the outpatients of bronchitis and upper respiratory tract infection. Besides, both NO 2 and SO 2 were positively related to the pneumonia outpatient visits. PM 2.5 and SO 2 were significantly related to the outpatient visits of other respiratory diseases, while only NO 2 was positively associated with the asthma outpatients. We found these associations were stronger in girls than in boys, particularly in younger (0-3 years) children. Interestingly, season stratification analysis indicated that these associations were stronger in the cold season than in the transition or the hot season for PM 10 , PM 2.5 and SO 2. Conclusions: Our results indicate that the air pollution exposure may account for the increased risk of outpatient visits for respiratory diseases among children in Lanzhou, particularly for younger children and in the cold season.

Association of short-term exposure to air pollution with emergency visits for respiratory diseases in children

“…Compared to previous studies conducted in heavily polluted cities such as Shijiazhuang, Jinan, and Lanzhou, the average air pollutant concentration in Guangzhou was relatively low. An observed association between air pollution and EDVs was consistent with other studies that demonstrated an increased risk for respiratory disease associated with air pollution ( Zhang et al., 2019 ; Liu et al., 2019 ; Song et al., 2018 ; Ma et al., 2020 ).…”

“…Previous studies on air pollution and respiratory diseases were mainly concentrated in polluted western cities and northern industrial cities in China, such as Beijing, Jinan, Shijiazhuang, and Lanzhou ( Zhang et al., 2019 ; Liu et al., 2019 ; Song et al., 2018 ; Ma et al., 2020 ). However, little has been documented about such effects in children in other cities where the pollution levels have received limited attention, especially less industrialized cities in the south of China.…”

Association Between Air Pollutants and Pediatric Respiratory Outpatient Visits in Zhoushan, China

“…Previous studies, most in developed country, have discussed the impact of air pollutants, such as NO 2 and PM 2.5 , on the development of asthma in children ( 23 – 25 ). Other studies have found that changes in air quality affect the development of respiratory diseases in children, with an incidence rate ratio of ~0.8 for NO 2 and PM 2.5 ( 26 ), consistent with other studies in north China ( 13 , 14 , 27 , 28 ). However, the ocean currents, climate, and economic development in south coastal cities have led to variations in the type and components of pollutants in different places ( 29 ).…”

“…The relationship between air pollution and children's respiratory health is predominantly established in developed countries. In China, previous studies were mostly conducted in northern cities where air pollution was relatively severe and found a relationship between air pollution exposure and increased outpatient visits in children with respiratory problems ( 13 , 14 ). Only one study in Shanghai used data from a limited range of air pollutants tested before 2013 ( 15 ).…”

Increased Risk of Hospital Admission for Asthma in Children From Short-Term Exposure to Air Pollution: Case-Crossover Evidence From Northern China

“…We found that the effect of SO 2 was stronger in the cold season, while the effect of NO 2 was stronger in the warm season. Previous studies have shown inconsistent seasonal patterns of ambient air pollutant effects (20,39,(46)(47)(48)(49), which could be related to the temporal-spatial variation of pollutants and different patterns of activity in different seasons and regions. In the region Beijing locate in, fossil fuel combustion are the main sources of SO 2 and NO 2 .…”