Size-segregated particle number concentrations and outpatient-department visits for pediatric respiratory diseases in Shanghai, China

Li, Hongjin; Liu, Lijuan; Chen, Renjie; Feng, Rui; Zhou, Yu‐Feng; Hong, Jian‐Guo; Cao, Lu; Lu, Yanming; Dong, Xiaoyan; Xia, Min; Ding, Bo; Weng, Yue; Qian, Liling; Wang, Libo; Zhou, Wenhao; Gui, Yonghao; Han, Xiao; Zhang, Xiaobo

doi:10.1016/j.ecoenv.2022.113998

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…Numerous investigations have demonstrated that when UFP concentration increases, the risk of respiratory diseases also elevates noticeably (Belleudi et al 2010 , Lanzinger et al 2016 , Li et al 2021 , Mocelin et al 2022 , Weichenthal et al 2017 ). For example, a time-series study conducted across 66 hospitals in Shanghai, China, demonstrated that the relative risk of outpatient visits for asthma, bronchitis, and upper respiratory tract infections increased with an IQR increase in UFP (1.21, 1.20, and 1.17, respectively) (Li et al 2022 ). Another time-series study in China also showed that an IQR increase in UFP concentrations corresponded to elevated relative risks of emergency-department visits for various respiratory diseases, specifically, 1.35 for asthma, 1.20 for pneumonia, 1.17 for bronchitis, and 1.14 for upper respiratory tract infections (Li et al 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Associations between ultrafine particle pollution and daily outpatient visits for respiratory diseases in Shanghai, China: a time-series analysis

Yan,

Ying,

Jiang

et al. 2023

Environ Sci Pollut Res

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Previous epidemiological studies have linked short-term exposure to particulate matter with outpatient visits for respiratory diseases. However, evidence on ultrafine particle (UFP) is still scarce in China. To investigate the association between short-term UFP exposure and outpatient visits for respiratory diseases as well as the corresponding lag patterns, information on outpatient visits for main respiratory diseases during January 1, 2017, to December 31, 2019 was collected from electronic medical records of two large tertiary hospitals in Shanghai, China. Generalized additive models employing a Quasi-Poisson distribution were employed to investigate the relationships between UFP and respiratory diseases. We computed the percentage change and its corresponding 95% confidence interval (CI) for outpatient visits related to respiratory diseases per interquartile range (IQR) increase in UFP concentrations. Based on a total of 1,034,394 hospital visits for respiratory diseases in Shanghai, China, we found that the strongest associations of total UFP with acute upper respiratory tract infection (AURTI), bronchitis, chronic obstructive pulmonary disease (COPD), and pneumonia occurred at lag 03, 03, 0, and 03 days, respectively. Each IQR increase in the total UFP concentrations was associated with increments of 9.02% (95% CI: 8.64–9.40%), 3.94% (95% CI: 2.84–5.06%), 4.10% (95% CI: 3.01–5.20%), and 10.15% (95% CI: 9.32–10.99%) for AURTI, bronchitis, COPD, and pneumonia, respectively. Almost linear concentration–response relationship curves without apparent thresholds were observed between total UFP and outpatient-department visits for four respiratory diseases. Stratified analyses illustrated significantly stronger associations of total UFP with AURTI, bronchitis, and pneumonia among female patients, while that with COPD was stronger among male patients. After adjustment of criteria air pollutants, these associations all remained robust. This time-series study indicates that short-term exposure to UFP was associated with increased risk of hospital visits for respiratory diseases, underscoring the importance of reducing ambient UFP concentrations for respiratory diseases control and prevention.

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Section: Discussionmentioning

confidence: 99%

Associations between ultrafine particle pollution and daily outpatient visits for respiratory diseases in Shanghai, China: a time-series analysis

Yan,

Ying,

Jiang

et al. 2023

Environ Sci Pollut Res

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“…The main culprit in that study was the gaseous air pollutant, sulfur dioxide (SO 2 ), particularly in the younger age group [31]. Zhao et al [33] demonstrated an increased risk for pediatric asthma hospitalization with higher levels of short-term exposure to PM 2.5 , SO 2 and NO 2 [32]. The impact of smaller particles size was demonstrated by a recent study conducted in China, where the smaller the particle size the stronger the observed effect estimates associated with increased outpatient department visits due to asthma.…”

Section: Pollutant Exposures and Asthma Morbiditymentioning

confidence: 99%

Air pollution and childhood asthma

Mukharesh

Phipatanakul

Gaffin

2022

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of reviewAsthma is the most common chronic disease of childhood. Environmental exposures, such as allergens and pollutants, are ubiquitous factors associated with asthma development and asthma morbidity. In this review, we highlight the most recent studies relevant to childhood asthma risk, onset, and exacerbation related to air pollution exposure.Recent findingsIn this article, we review current research that has been published between 2021 and 2022, demonstrating the effects of early-life exposure to key air pollutants (e.g., particulate matter (PM), nitrogen dioxide (NO2), sulfur dioxide (SO2) and ground-level ozone (O3), environmental tobacco smoke, radon, and volatile organic compounds (VOC) on respiratory health.SummaryAir pollution continues to be a global burden with serious consequences related to respiratory health. Interventions aimed at reducing air pollution in the environment must be achieved in an effort to improve asthma outcomes and pediatric health.

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“…This phenomenon is particularly prominent in the Shanghai area (Figure 2). For example, in November 2022, the Children's Hospital Affiliated to Fudan University had an average daily outpatient volume of more than 8600 per day, with a peak of more than 9700 per day [58]. The number of outpatient and emergency visits in a single day in Shanghai Children's Hospital also exceeded the daily 9000 person mark [59][60][61].…”

Section: Research Background 21 Current Situation Of Pediatric Outpat...mentioning

confidence: 99%

Research on the Experience of Influencing Elements and the Strategy Model of Children’s Outpatient Medical Services under the Guidance of Design Thinking

2023

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Faced with the generally poor experience in pediatric outpatient in China, under the guidance of design thinking, based on the analysis and research of the main elements affecting child outpatients’ medical service experiences, this study proposes a set of strategic models that can improve child outpatients’ medical service experiences. Specifically, this study takes Shanghai Xinhua Hospital as a research case, combined with SPSS data statistics software, and comprehensively uses preliminary field research methods, questionnaire descriptive analysis methods, questionnaire satisfaction analysis methods, and questionnaire principal component analysis (PCA) methods as well as the structured interview method; thus, the main elements affecting child outpatients’ medical service experiences were obtained. Then, according to the main elements, a set of child outpatient medical service strategy models is proposed to improve child outpatients’ medical service experiences. Finally, the effectiveness of the strategy model is tested through satisfaction analysis and simulation case verification. The model is a people-centered, sustainable strategic model. With the support of design thinking, the strategic model takes the experience of children as the core improvement point, which is able to fully protect the rights and demands of child patients. At the same time, this strategy model can also reduce the workload of doctors, improve the operational efficiency of hospitals, promote a more equal distribution of medical resources, and reduce medical service costs. More importantly, it also encourages patients and their families to communicate and express their opinions to medical professionals, which can greatly reduce the tension between doctors and patients and effectively avoid doctor–patient conflicts. This has important implications for the sustainability of healthcare. However, this strategy model is only a guiding strategy for improving outpatient care for children. It does not provide detailed solutions around certain specific issues and specific implementations. At the same time, it is not a complex engineering design system but only provides a reference for improving children’s medical services in terms of strategic logic.

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Size-segregated particle number concentrations and outpatient-department visits for pediatric respiratory diseases in Shanghai, China

Cited by 3 publications

References 29 publications

Associations between ultrafine particle pollution and daily outpatient visits for respiratory diseases in Shanghai, China: a time-series analysis

Associations between ultrafine particle pollution and daily outpatient visits for respiratory diseases in Shanghai, China: a time-series analysis

Air pollution and childhood asthma

Research on the Experience of Influencing Elements and the Strategy Model of Children’s Outpatient Medical Services under the Guidance of Design Thinking

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