Multi-city study on air pollution and hospital outpatient visits for asthma in China

Lu, Peng; Zhang, Yongming; Lin, Jiangtao; Xia, Guoxin; Zhang, Wenyi; Knibbs, Luke D.; Morgan, Geoffrey G.; Jalaludin, Bin; Marks, Guy B.; Abramson, Michael J.; Li, Shanshan; Guo, Yuming

doi:10.1016/j.envpol.2019.113638

Cited by 56 publications

(29 citation statements)

References 46 publications

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“…Since a positive significant correlation has been established between the pollution level of NO 2 and human population size ( Lamsal et al, 2013 ), increasing population and traffic sources contribute to the NO 2 pollution level ( Zhao et al, 2020 ). Existing studies have revealed that air pollution due to NO 2 could trigger the risks of several diseases such as asthma, respiratory disease, and cardiovascular disease and even increase the rate of mortality due to the diseases ( He et al, 2020 ; Lu et al, 2020a ; Zhao et al, 2020 ). Brønnum-Hansen et al (2018) reported that life expectancy of people residing in cities and urban areas could be elongated by an additional two years if the NO 2 concentration were reduced to same low level as in rural areas with low populations and vehicular movement.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 pandemic in Wuhan: Ambient air quality and the relationships between criteria air pollutants and meteorological variables before, during, and after lockdown

Sulaymon

Zhang

Hopke

et al. 2021

Atmospheric Research

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Section: Introductionmentioning

confidence: 99%

COVID-19 pandemic in Wuhan: Ambient air quality and the relationships between criteria air pollutants and meteorological variables before, during, and after lockdown

Sulaymon

Zhang

Hopke

et al. 2021

Atmospheric Research

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“…In our study, we did not find the sex difference among patients with air pollution/smog as an asthma trigger. A multicity study in China has similar results, which reported that elevated concentrations of PM10 and NO 2 were associated with increased hospital outpatient visits for asthma (44). Strickland et al (45) found that air pollution was related to wheezing.…”

Section: Air Pollution/smogmentioning

confidence: 80%

The Age, Sex, and Geographical Distribution of Self-Reported Asthma Triggers on Children With Asthma in China

2021

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Background: Asthma can be exacerbated by many triggers, and the heterogeneity of asthma triggers is clear among children with asthma. This study describes asthma triggers using a large-scale electronic dataset from the smartphone-based Chinese Children's Asthma Action Plan (CCAAP) app and aims to examine the difference in asthma triggers among different subgroups of children with asthma.Methods: Data from the smartphone-based CCAAP app between February 22, 2017, and November 23, 2020, were reviewed, and children with asthma who reported their asthma triggers were enrolled. Eight common asthma triggers were listed in the software: upper respiratory infection (URI), allergen sensitization, exercise, emotional disturbances, pungent odors, air pollution/smog, weather change, and tobacco smoke. We compared the incidence of asthma triggers among different subgroups (<6 years vs. 6–17 years; boy vs. girl; eastern region vs. central region vs. western region).Results: We enrolled 6,835 patients with self-reported asthma triggers. When compared by sex, boys had a higher proportion of exercise-triggered asthma than girls (boys vs. girls, 22.5 vs. 19.7%, p < 0.05). The proportion of patients <6 years of age with URI-triggered asthma was higher than that of patients 6–17 years of age (<6 vs. 6–17 years, 80.9 vs. 74.9%, p < 0.001). Patients 6–17 years of age were more likely than patients <6 years of age to report five of the asthma triggers: allergen sensitization (<6 vs. 6–17 years, 26.6 vs. 35.8%, p < 0.001), exercise (<6 vs. 6–17 years, 19.3 vs. 23.7%, p < 0.001), pungent odors (<6 vs. 6–17 years, 8.8 vs. 12.7%, p < 0.001), air pollution/smog (<6 vs. 6–17 years, 9.4 vs. 16.2%, p < 0.001), and tobacco smoke (<6 vs. 6–17 years, 3.5 vs. 5.3%, p < 0.001). In subgroups based on geographical distribution, asthma triggering of allergen sensitization was reported to be the most common in patients from the eastern region (eastern region vs. central region vs. western region, 35.0 vs. 24.6 vs. 28.0%, p < 0.001). Exercise-triggered asthma was found to be the most prevalent among patients from the central region (eastern region vs. central region vs. western region, 21.6 vs. 24.8 vs. 20.4%, p < 0.05). However, the proportion of patients with air pollution/smog as an asthma trigger was the lowest among those from the western region (eastern region vs. central region vs. western region, 14.1 vs. 14.1 vs. 10.8%, p < 0.05).Conclusion: Children with asthma present different types of asthma triggers, both allergenic and nonallergenic. Age, sex, and geographical distribution affect specific asthma triggers. Preventive measures can be implemented based on a patient's specific asthma trigger.

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“…Chen et al, 2017) thus lowering the ER visit number. The other factors that affect the degree of associations of pollutants involve average concentrations of pollutants (Lu et al, 2019), heterogeneous composition of particulate matter and gaseous mixture varying with seasons, and age and gender of the exposed population (Rodríguez-Villamizar et al, 2018; Song et al, 2018). Several studies have shown that with an increase in NO 2 , CO and SO 2, there is a significant percentage increase in ER visits for respiratory diseases in children (Sunyer et al, 1997; Lee et al, 2006; Canova et al, 2010; Rodríguez-Villamizar et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

“…China, South Korea, etc. These studies have reported a positive association between ambient air pollution exposure and increase in respiratory symptoms (Preutthipan et al, 2004), daily non-accidental mortality (Cropper et al, 1997), cardio-respiratory morbidity (Rodríguez-Villamizar et al, 2018; Tapia et al, 2019), and mortality (R. Chen et al, 2012), hospitalizations (Lu et al, 2019), and emergency room (ER) visits (Babin et al, 2007; G. Chen, Li, et al, 2017; Khan et al, 2019; Pande et al, 2002). However, studies showing adverse health effects of air pollution from different parts of India are limited (Balakrishnan et al, 2011; Jayaraman & Nidhi, 2008; Maji et al, 2018; Pande et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Effects of ambient air pollution on emergency room visits of children for acute respiratory symptoms

Yadav

Nagori

Mukherjee

et al. 2020

Preprint

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BackgroundData on the relation between the increase in ambient air pollution and acute respiratory illness in children are scarce. The present study aimed to explore the association between daily ambient air pollution and daily emergency room (ER) visits due to acute respiratory symptoms in children of Delhi.MethodsIn this epidemiological study, the daily counts of ER visits (ERV) of children (≤15 years) having acute respiratory symptoms from 1st June 2017 to 28th February 2019 were obtained from two general hospitals of Delhi. Simultaneously, data on daily average concentrations of particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), sulphur dioxide (SO2), carbon monoxide (CO), and ozone (O3), and weather variables were provided by Delhi Pollution Control Committee from their four continuous ambient air quality monitoring stations. We used K-means clustering with time-series approach to derive pollutant-derived clusters and the study period was categorized into high, moderate and low air pollution days. The combined effect of these air pollutants on acute respiratory ERV was assessed. Multi-pollutant generalized additive models (GAM) with Poisson link function was used to estimate the 0-6 day lagged change in daily ER visits with the change in multiple pollutants levels, adjusting for weather variables, days of the week and public holidays.ResultsIn 21 months, 132,029 children were screened at the ER of the participating hospitals. Of these 19,320 (14.6%) were eligible, and 19120 were enrolled with complete data collection. The study period could be divided into 3 pollutant-derived clusters with high (Cluster 1, 150 days), moderate (Cluster 2, 204 days) low (Cluster 3, 284 days) levels of air pollution. There was a 28.7% and 21% increase in ERV among children respectively, on high and moderate level pollution days (Cluster 1 and 2) compared to low pollution days (Cluster 3) on the same day of exposure to air pollutants. Similar results were found when the exposure to ambient air pollution of previous 1-6 days were taken into account. GAM analysis showed that the association of the acute respiratory ER visits with every 10 unit change of PM10, NO2, O3, CO and SO2 remained significant after adjusting for multi-pollutant and confounding variables effects. In contrast, no effect was seen for PM2.5. The ERVs for acute respiratory symptoms rose with increase in pollutants and the trends showed a percentage change (95% CI) 1.07% (0.32, 1.83) increase in ERVs for an increase of 10 micrograms per cubic meter of NO2 at previous day 1, 36.89% (12.24,66.95) for 10 milligrams per cubic meter of CO at previous day 3, and 12.77% (9.51, 16.12) for 10 micrograms per cubic meter of SO2 at same day while decrease of −0.18% (−0.32, - 0.03) for 10 micrograms per cubic meter of PM10 at same day, and −4.16 % (−5.18, −3.13) for O3 at previous day 3.ConclusionAn increase in the daily ER visits of children for acute respiratory symptoms was seen for 1-6 days after increase in daily ambient air pollution levels in Delhi.

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Multi-city study on air pollution and hospital outpatient visits for asthma in China

Cited by 56 publications

References 46 publications

COVID-19 pandemic in Wuhan: Ambient air quality and the relationships between criteria air pollutants and meteorological variables before, during, and after lockdown

COVID-19 pandemic in Wuhan: Ambient air quality and the relationships between criteria air pollutants and meteorological variables before, during, and after lockdown

The Age, Sex, and Geographical Distribution of Self-Reported Asthma Triggers on Children With Asthma in China

Effects of ambient air pollution on emergency room visits of children for acute respiratory symptoms

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