Impact of air pollutants on pediatric admissions for Mycoplasma pneumonia: a cross-sectional study in Shanghai, China

Abstract

Background: Children are especially vulnerable to pneumonia and the effects of air pollution. However, little is known about the impacts of air pollutants on pediatric admissions for Mycoplasma pneumonia. This study was conducted to investigate the impacts of air pollutants on pediatric hospital admissions for Mycoplasma pneumonia in Shanghai, China. Methods: A cross-sectional design was applied to explore the association between pediatric hospital admissions and levels of air pollutants (fine particulate matter, particulate matter, ozone, sulfur dioxide, nitrogen dioxide, and carbon monoxide). Data on hospital admissions for pneumonia and levels of ambient air pollutants were obtained for the period of 2015 to 2018. Associations between pediatric admissions for Mycoplasma pneumonia and ambient air pollutants were calculated using logistic regression and described by the odds ratio and relevant 95% confidence interval. The hysteresis effects of air pollutants from the day of hospital admission to the previous 7 days were evaluated in single-pollutant models and multi-pollutant models with adjustments for weather variables and seasonality. Lag 0 was defined as the day of hospital admission, lag 1 was defined as the day before hospital admission, and so forth. Results: In the single-pollutant models (without adjustment for other pollutants), pediatric hospital admissions for pneumonia were positively associated with elevated concentrations of nitrogen dioxide and fine particulate matter. A 0.5% increase in daily admissions per 10-μg/m 3 increase in the nitrogen dioxide level occurred at lag 1 and lag 2, and a 0.3% increase in daily admissions per 10-μg/m 3 increase in fine particulate matter occurred at lag 1. In the multi-pollutant models, nitrogen dioxide and fine particulate matter remained significant after inclusion of particulate matter, ozone, sulfur dioxide, and carbon monoxide.

Indoor air quality in day-care centres: a global review

“…Proper aeration regulates room temperature and dilutes indoor airborne pollutants (Yip et al 2017 ; Bukina 2018 ; Namvar et al 2020 ; Langer et al 2020 ; Agarwal et al 2021 ; Wolkoff 2018 ; Kedare et al 2020 ). Heating, ventilation and air conditioning systems (HVACs) should be serviced and inspected regularly to avoid the accumulation of indoor pollutants (Canha et al 2016 ; Chen et al 2020 ; Lucattini et al 2018 ) Frequent cleaning of classrooms using microfiber mops and a vacuum with a clean high-efficiency particulate air (HEPA) filter (Rosário Filho et al 2021 ; Zainudin et al 2019 ). Low-emission materials should be used rather than general building finishing materials in childcare facilities (Arar and Jung 2021 ).…”

“… Air purifiers can deactivate suspended particles in the atmosphere by trapping a high proportion of airborne dust particles, allergens and odours, thereby improving indoor air quality (IAQ) in a room. However, it must be maintained optimally to prevent ozone emissions (Agarwal et al 2021 ; Wolkoff 2018 ; Kedare et al 2020 ; Chen et al 2020 ; Lucattini et al 2018 . Nicholl 2019 ; Yoda et al 2020 ).…”

“…Heating, ventilation and air conditioning systems (HVACs) should be serviced and inspected regularly to avoid the accumulation of indoor pollutants (Canha et al 2016 ; Chen et al 2020 ; Lucattini et al 2018 )…”

Associations between air pollutant and pneumonia and asthma requiring hospitalization among children aged under 5 years in Ningbo, 2015–2017

“…Those findings are likely explained by NO 2 being a free radical whose action has the potential to deplete tissue antioxidant defenses and lead to increased inflammation. Furthermore, exposure to NO 2 was associated with reduced lung volume growth ( 63 ) an increased pneumonia incidence ( 64 – 66 ) and increased penicillin MIC against Streptococcus pneumoniae among children ( 67 ). In addition, prenatal and postnatal exposure to NO 2 was found to be a likely risk factor for pediatric allergies and respiratory diseases ( 68 ).…”

Disease composition and epidemiological characteristics of primary care visits in Pudong New Area, Shanghai: a longitudinal study, 2016–2018

“…More (and more serious) air pollution may have led to the increase in respiratory system diseases. 34 Increases of both prevalence and detection rates likely led to the increases in endocrine/nutritional/metabolic diseases and lipoprotein metabolism Open access disorders. Our findings for the disease composition of primary care visits are very different from those reported by recent studies of specialist visits in large hospitals.…”