Pediatric Epistaxis and Its Correlation Between Air Pollutants in Beijing From 2014 to 2017

Abstract

Background: Epistaxis is a common symptom in children. The effect of air pollution on epistaxis is not yet clear. Objectives: To explore the characteristics of pediatric epistaxis in Beijing and its correlation with air pollutants. Material and Methods: Data were collected from 2014 to 2017 in Otolaryngology Department of Capital Institute of Pediatrics. Children diagnosed with epistaxis with relevant information with the same period of municipal air pollutants’ concentration were compared. Results: The annual visits of epistaxis showed a bimodal trend. The incidence of epistaxis in infants was low, increased with age, reached the peak between the ages of 4 to 5, and then gradually decreased with age. In different age groups, male patients were more than females. From 2014 to 2017 in Beijing, particulate matter less than 2.5 μm in diameter (PM2.5), particulate matter less than 10 μm in diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) showed a downtrend, lower in summer than in the other 3 seasons. Ozone (O3) was significantly higher in 2016 and 2017, showed an increase trend in summer. The incidence of epistaxis was negatively correlated with PM2.5, PM10, SO2, NO2 and CO, which was positively correlated with O3 ( P < .05). Conclusions: Pediatric epistaxis in Beijing changes with age and has obvious seasonal variation. There are some correlations between air pollutants and the incidence of epistaxis in children.

Age-specific associations between environmental factors and epistaxis

“…However, the association between the concentrations of PM10 and SO2 and epistaxis was statistically significant in age groups 0 and 1 (children and young adults; age < 39 years) but not in older age groups. In a previous study conducted on pediatric patients, the incidence of epistaxis was negatively correlated with PM2.5, PM10, SO2, NO2, and CO, which was positively correlated with O3 ( P < 0.05) ( 9 ). In that study, the concentrations of air pollutants showed a downward trend, lower in summer than in the other three seasons, except for the concentration of O3, which showed an upward trend in summer ( 9 ).…”

“…In a previous study conducted on pediatric patients, the incidence of epistaxis was negatively correlated with PM2.5, PM10, SO2, NO2, and CO, which was positively correlated with O3 ( P < 0.05) ( 9 ). In that study, the concentrations of air pollutants showed a downward trend, lower in summer than in the other three seasons, except for the concentration of O3, which showed an upward trend in summer ( 9 ). In the present study, the concentration of NO2 was higher in the spring and autumn seasons, whereas the concentrations of O3 and PM10 were higher in the spring season, in which an increased incidence of epistaxis was recorded in the younger population ( Figure 2B ).…”

“…In addition, Reddy et al reported that temperature and water vapor pressure were significantly associated with the rate of admission owing to epistaxis ( 8 ). The incidence of epistaxis is also associated with air pollutants, such as particulate matter PM2.5 (≤ 2.5 μm) and PM10 (≤ 10 μm) ( 9 ). However, the results of previous studies on the effects of environmental factors on the incidence of epistaxis are inconsistent.…”

Epistaxis Due to Platelet Dysfunction in a Healthy Person During Office Reconstruciton

“…Temperature, humidity, and their sudden changes are inconsistently shown to be risk factors (1)(2)(3)(4)(5). Similarly, among air pollutants -O3, CO, SO2, NO2, and particulate matter (PM10) -only O3 was firmly associated with epistaxis (1,(6)(7)(8) We found no study that links inhalation of toxins (or any other materials) from construction sites to platelet dysfunction (or nose bleeding). Thus, our patient history suggests that a toxic inhalation could be an environmental risk for epistaxis due to platelet dysfunction.…”

Abordaje y manejo de la epistaxis en población pediátrica

“…Se ha planteado que el aire seco causa un aumento de las costras promoviendo la manipulación endonasal. Los niños poseen mecanismos de adaptación menos efectivos ante los cambios en la humedad ambiental, por lo que son más sensibles a los cambios climáticos en comparación con los adultos (5,13,14).…”