The association between climate, geography and respiratory syncitial virus hospitalizations among children in Ontario, Canada: a population-based study

Abstract

Background: Respiratory syncytial virus (RSV) infection is a major cause of hospitalization in young children in Canada, despite routine immunoprophylaxis in those with medical risk factors. We aimed to determine if cold temperatures are associated with RSV hospitalization. Methods: We conducted a population-based nested case-control study of children in Ontario, Canada, using health administrative data. We compared children hospitalized for RSV between September 1, 2011 and August 31, 2012 to age and sex matched controls. We used multivariable logistic regression to identify associations between minimum daily temperature and RSV hospitalizations with adjustment for sociodemographic and environmental factors. Results: We identified 1670 children with RSV hospitalizations during the study period and 6680 matched controls. Warmer temperatures (OR = 0.94, 95%CI: 0.93, 0.95) were associated with lower odds of RSV hospitalization. Southern ecozone (OR = 1.6, 95%CI: 1.2, 2.1), increased ozone concentration (OR = 1.03, 95%CI: 1.01, 1.06) and living in a lower income neighbourhood (OR = 1.3, 95%CI: 1.1, 1.5) significantly increased the odds of RSV hospitalization, as did living in a household with a larger number of siblings in a sub-cohort of children (OR = 1.34, 95%CI: 1.26, 1.41). Conclusions: In Ontario, the likelihood of having an RSV hospitalization is associated with colder temperature exposures and socioeconomic factors.

Air Pollutants’ Concentrations Are Associated with Increased Number of RSV Hospitalizations in Polish Children

“…Certainly, there are evident discrepancies in the published data, and some studies did not confirm a relationship between the particular air pollutants and RSV; for example, an analysis of 1670 RSV hospitalizations in children under 36 months of age matched with 6680 controls showed an increased risk of hospitalization in relation to higher annual ozone levels (OR = 1.03 per 1 parts per billion/ppb increase), but not with annual PM 2.5 or NO 2 , yet the authors concluded that these figures might be underestimated due to the annual values that were used for the calculations [ 19 ]. On the other hand, an analysis of 266 infants with RSV bronchiolitis showed lower and higher PM 10 , PM 2.5 , benzene, NO, and SO 2 concentrations in the months with a high RSV activity, although the only independent predictor of the RSV incidence was the benzene concentration [ 18 ].…”

“…In-depth analyses have focused on the attention to particulate matter characterized by an aerodynamic diameter no greater than 10 μm and 2.5 μm (PM 10 and PM 2.5 ), sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), and carbon monoxide (CO). According to the literature, the increased risk for RSV-related hospitalizations or emergency department consultations has been associated with exposure to PM 10 [ 10 , 11 , 12 , 13 , 14 ], PM 2.5 [ 13 , 16 , 17 ], benzene [ 18 ], NO 2 [ 11 , 13 ], ozone [ 19 ], or SO 2 [ 11 ], yet in the latter case, there are also contradictory reports [ 13 ]. Fewer analyses focused on RSV morbidity in an outpatient setting, but a large-scale Chinese study by Qing Ye confirmed a correlation with PM 2.5 , PM 10 , SO 2 , NO 2 , and CO, emphasizing an association with the dosage, length of exposure (lag), or cumulative effects, also suggesting possible cut-off values specific for each pollutant [ 20 ].…”

Clinico demographic profiling of the Respiratory syncytial virus (RSV) infected children admitted in tertiary care hospital in North India

“…reported a median age of 9 months. [ 13 ] Thomas et al . also observed male predominance (51%) over females (49%).…”

“…also reported a male predominance (63.8%) in their study. [ 13 ] RSV infection occurs worldwide, especially during the winter months, and majority children are infected till they reach age of 2 years, but, lower respiratory tract symptoms develop in only 40% of them. [ 17 18 ] Presently also, cases presented in winter months that is from November to March.…”

Influences of environmental exposures on preterm lung disease

“…Multiple geographic factors may also interact to alter outcomes through complex or poorly defined mechanisms. For example, one study conducted in Ontario, Canada identified colder temperatures, increased ozone levels, and lower income neighborhoods as risk factors for hospitalizations for RSV in children between the ages of 0 and 36 months [79]. Similar data for preterm infants with respiratory disease is lacking.…”