Dataset Information

Air pollution influences the incidence of otitis media in children: A national population-based study.

ABSTRACT:

Background

Otitis media (OM) is a major reason for children's visits to physicians and a major cause of their being treated with antibiotics. It not only causes economic burdens but also influences hearing, speech, and education. To our knowledge, no nationwide population-based study has assessed the association between air pollution and OM. Therefore, this study evaluated the association between air pollution levels and the incidence of OM.

Methods

We identified cases of OM that occurred in South Korea between January 2011 and December 2012 from the Korea National Health Insurance Service-National Sample Cohort database, and evaluated its relationship with five air pollutants: particulate matter (PM10, particulates ?10 ?m in diameter), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide, and carbon monoxide. Associations between the weekly incidence of OM and the five air pollutants were analyzed using generalized estimating equations. Conditional logistic regression analysis was used to obtain odds ratios (ORs) and their 99.9% Bonferroni-corrected confidence intervals after adjusting for gender, age, season, and region.

Results

We based our analysis on 160,875 hospital visits for OM by children aged <15 years. Correlations with higher concentrations of the five pollutants showed higher ORs than did the reference values at most time lags. PM10 had the largest influence on the OM incidence at a time lag of 0 weeks, whereas NO2 and O3 had the largest impacts on OM incidence at time lags of 1 and 4 weeks, respectively.

Conclusion

These findings support the notion that the incidence of OM is associated with ambient air pollution.

SUBMITTER: Park M

PROVIDER: S-EPMC6023207 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Air pollution influences the incidence of otitis media in children: A national population-based study.

Park Mina M Han Jiyeon J Jang Myoung-Jin MJ Suh Myung-Whan MW Lee Jun Ho JH Oh Seung Ha SH Park Moo Kyun MK

PloS one 20180628 6

<h4>Background</h4>Otitis media (OM) is a major reason for children's visits to physicians and a major cause of their being treated with antibiotics. It not only causes economic burdens but also influences hearing, speech, and education. To our knowledge, no nationwide population-based study has assessed the association between air pollution and OM. Therefore, this study evaluated the association between air pollution levels and the incidence of OM.<h4>Methods</h4>We identified cases of OM that ...[more]

PMID: 29953484

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Project description:ObjectivesOtitis media is one of the most important causes of hearing loss at an early age. Effective vaccination with the routine 7-valent pneumococcal conjugate vaccine (PCV-7) was introduced in 2000. It has been gradually replaced by the pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine or the higher-valent 13-valent PCV (PCV-13) since 2010. Data on the change in otitis media burden in recent years are sparse at the global, regional, and national levels.DesignThe Global Burden of Disease 2019 study was used to evaluate the prevalence, incidence, mortality, disability-adjusted life year (DALY) rates, and the average annual percentage changes (AAPCs) in otitis media in geographic populations worldwide from 1990 to 2019. These global trends were further analyzed by subgroup (age, sex, and sociodemographic index [SDI]).ResultsGlobally, the all-age rate of prevalence (AAPC = -0.7, 95% confidence interval [CI] = -0.7 to -0.8), DALYs (AAPC = -1.0, 95% CI = -1.1 to -1.0), and mortality (AAPC = -6.8, 95% CI = -7.3 to -6.4) from otitis media decreased constantly between 1990 and 2019. The all-age rate of incidence decreased sharply between 2000 and 2009 with an AAPC of -1.2 (95% CI = -1.4 to -0.9) and continued the downward trend between 2010 and 2019 (AAPC = -0.2, 95% CI = -0.3 to -0.1). In 2019, children aged 1 to 4 years old had the highest incidence at 29,127.3 per 100,000 population, while young adults under 30 years old accounted for 91.3% of the incident cases. Individuals living in middle-SDI countries had the largest increase in the incidence of otitis media, with an AAPC of 0.3 (95% CI = 0.3 to 0.3) between 1990 and 2019. The incidence and DALYs from otitis media decreased with increasing SDI. Regionally, the largest increase in incidence was observed in high-income Asia Pacific, Eastern Europe, and Western Sub-Saharan Africa between 1990 and 2019. Nationally, the largest increase in the incidence of otitis media was observed in the Republic of Korea, with an AAPC of 0.8 (95% CI = 0.6 to 1.1) in the same time period.ConclusionsThere have been successful previous endeavors to reduce DALYs and mortality attributed to otitis media on a global scale. The worldwide incidence of otitis media experienced a sharp decline following the introduction of PCV-7 in 2000, and this downward trend persisted in subsequent years with the adoption of PCV-13/pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine. Continual epidemiological surveillance of otitis media's global trends, pathogen distribution, and resistance patterns remains imperative.

Project description:BackgroundAcute otitis media (AOM) remains a common infection in children despite the introduction of pneumococcal conjugate vaccines. This study estimated AOM incidence rates (IRs) over time in children < 16 years old in Germany following PCV13 introduction.MethodsAOM episodes were identified in the InGef healthcare claims database from 2014-2019 in children aged < 16 years. Each AOM episode was classified as either simple or recurrent. Recurrent AOM was defined as 3 or more episodes identified within a 6-month period; or 4 or more episodes within a 12-month period with at least one episode in the prior 6 months. AOM-related surgical procedures within 12 months and complications within 21 days of an AOM episode were also identified. Annual IRs were calculated as number of episodes/child-years (CY) at risk. 95% Confidence intervals (95%CI) were calculated using the Wilson method. The Mann-Kendall test was used to assess trends over time.ResultsBetween 2014 and 2019, the study population comprised 916,805 children with 327,726 AOM episodes, of which 15% (49,011) of all episodes were identified as recurrent AOM and 85% (278,715) as simple AOM. There were significant declines in AOM (p = 0.003) in the study population overall and in all age groups over the study period; from 101 (95%CI 101-102)/1000 CY to 79 (95%CI 78-80)/1000 CY in the total study population, from 209 (95%CI 206-212)/1000 CY to 147 (95%CI 145-150)/1000 CY in < 2-year-olds, from 239 (95%CI 237-242) to 179 (95%CI 177-182)/1000 CY in 2-4-year-olds, and from 50 (95%CI 49-50) to 38 (95%CI 37-39)/1000 CY in 5-15-year-olds. No significant trends were identified for AOM-related surgical procedures over the study period; however, AOM-related complications overall increased (p = 0.003).ConclusionBetween 2014 and 2019, AOM incidence overall declined in children aged 0-15 years in Germany. Over the study period, the incidence of complicated AOM cases increased, however the incidence of AOM-related surgical procedures remained constant. Despite the impact of PCV13, the burden associated with AOM in Germany remains substantial.

Project description:BackgroundThe 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2006 and the 13-valent pneumococcal conjugate vaccine (PCV13) in 2010 in the UK. PCVs are active immunization for the prevention of invasive disease, pneumonia and acute otitis media (AOM) caused by Streptococcus pneumoniae in children. The aim of this observational study was to estimate incidence rates (IRs) of AOM in children ≤17 years from 2003 to 2019 in England, before and after the introduction of pneumococcal conjugate vaccines (PCVs).MethodsAOM episodes were identified using Read diagnosis codes in children aged ≤17 years in the Clinical Practice Research Datalink (CPRD) Gold database from 2003 to 2019. Annual IRs with 95% confidence intervals (CI) by age group were calculated as the number of episodes/person-years (PY) at risk. Interrupted time series analyses were conducted to estimate incidence rate ratios (IRR) across post-PCV7 (2007-2009), early post-PCV13 (2011-2014) and late post-PCV13 (2015-2019) periods compared to the pre-PCV7 period (2003-2005) using generalized linear models.ResultsFrom 2003 to 2019, 274,008 all-cause AOM episodes were identified in 1,500,686 children. The overall AOM IR was 3690.9 (95% CI 3677.1-3704.8) per 100,000 PY. AOM IRs were highest in children aged < 5 years and decreased by age; < 2 years: 8286.7 (95% CI 8216.8-8357.1); 2-4 years: 7951.8 (95% CI 7902.5-8001.4); 5-17 years: 2184.4 (95% CI 2172.1-2196.8) (per 100,000 PY). Overall AOM IRs declined by 40.3% between the pre-PCV7 period and the late-PCV13 period from 4451.9 (95% CI 4418.1-4485.9) to 2658.5 (95% CI 2628.6-2688.7) per 100,000 PY, and across all age groups. IRRs indicated a significant decrease in AOM IRs in all the post-vaccination periods, compared to the pre-PCV7 period: post-PCV7 0.87 (95% CI 0.85-0.89), early post-PCV13 0.88 (95% CI 0.86-0.91), and late post-PCV13 0.75 (95% CI 0.73-0.78).ConclusionsThe AOM IRs declined during the 2003-2019 period; however, the clinical burden of AOM remains substantial among children ≤17 years in England.

Project description:BackgroundPopulation exposure assessment methods that capture local-scale pollutant variability are needed for large-scale epidemiological studies and surveillance, policy, and regulatory purposes. Currently, such exposure methods are limited.MethodsWe created 2006 national pollutant models for fine particulate matter [PM with aerodynamic diameter ? 2.5 ?m (PM2.5)], nitrogen dioxide (NO2), benzene, ethylbenzene, and 1,3-butadiene from routinely collected fixed-site monitoring data in Canada. In multiple regression models, we incorporated satellite estimates and geographic predictor variables to capture background and regional pollutant variation and used deterministic gradients to capture local-scale variation. The national NO2 and benzene models are evaluated with independent measurements from previous land use regression models that were conducted in seven Canadian cities. National models are applied to census block-face points, each of which represents the location of approximately 89 individuals, to produce estimates of population exposure.ResultsThe national NO2 model explained 73% of the variability in fixed-site monitor concentrations, PM2.5 46%, benzene 62%, ethylbenzene 67%, and 1,3-butadiene 68%. The NO2 model predicted, on average, 43% of the within-city variability in the independent NO2 data compared with 18% when using inverse distance weighting of fixed-site monitoring data. Benzene models performed poorly in predicting within-city benzene variability. Based on our national models, we estimated Canadian ambient annual average population-weighted exposures (in micrograms per cubic meter) of 8.39 for PM2.5, 23.37 for NO2, 1.04 for benzene, 0.63 for ethylbenzene, and 0.09 for 1,3-butadiene.ConclusionsThe national pollutant models created here improve exposure assessment compared with traditional monitor-based approaches by capturing both regional and local-scale pollution variation. Applying national models to routinely collected population location data can extend land use modeling techniques to population exposure assessment and to informing surveillance, policy, and regulation.

Dataset Information

Air pollution influences the incidence of otitis media in children: A national population-based study.

Background

Methods

Results

Conclusion

Publications

Air pollution influences the incidence of otitis media in children: A national population-based study.

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