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Increased Risk of Hospital Admission for Asthma in Children From Short-Term Exposure to Air Pollution: Case-Crossover Evidence From Northern China.

ABSTRACT: Background: Previous studies suggested that exposure to air pollution could increase risk of asthma attacks in children. The aim of this study is to investigate the short-term effects of exposure to ambient air pollution on asthma hospital admissions in children in Beijing, a city with serious air pollution and high-quality medical care at the same time. Methods: We collected hospital admission data of asthma patients aged ≤ 18 years old from 56 hospitals from 2013 to 2016 in Beijing, China. Time-stratified case-crossover design and conditional Poisson regression were applied to explore the association between risk of asthma admission in children and the daily concentration of six air pollutants [particulate matter ≤ 2.5 μm (PM_2.5), particulate matter ≤ 10 μm (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), and ozone (O₃)], adjusting for meteorological factors and other pollutants. Additionally, stratified analyses were performed by age, gender, and season. Results: In the single-pollutant models, higher levels of PM_2.5, SO₂, and NO₂ were significantly associated with increased risk of hospital admission for asthma in children. The strongest effect was observed in NO₂ at lag06 (RR = 1.25, 95%CI: 1.06-1.48), followed by SO₂ at lag05 (RR = 1.17, 95%CI: 1.05-1.31). The robustness of effects of SO₂ and NO₂ were shown in two-pollutant models. Stratified analyses further indicated that pre-school children (aged ≤ 6 years) were more susceptible to SO₂. The effects of SO₂ were stronger in the cold season, while the effects of NO₂ were stronger in the warm season. No significant sex-specific differences were observed. Conclusions: These results suggested that high levels of air pollution had an adverse effect on childhood asthma, even in a region with high-quality healthcare. Therefore, it will be significant to decrease hospital admissions for asthma in children by controlling air pollution emission and avoiding exposure to air pollution.

SUBMITTER: Zhao Y

PROVIDER: S-EPMC8718688 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundLittle is known about the associations between ambient environmental exposures and the risk of acute episodes of psychiatric disorders. We aimed to estimate the link between short-term exposure to atmospheric pollutants, temperature, and acute psychiatric hospital admissions in adults aged 65 years and older in the USA.MethodsFor this study, we included all people (aged ≥65 years) enrolled in the Medicare programme in the USA who had an emergency or urgent hospital admission for a psychiatric disorder recorded between Jan 31, 2000, and Dec 31, 2016. We applied a case-crossover design to study the associations between short-term exposure to air pollution (fine particulate matter [PM2·5], ozone, and nitrogen dioxide [NO2]), ambient temperature, and the risk of acute hospital admissions for depression, schizophrenia, and bipolar disorder in this population. The percentage change in the risk of hospital admission and annual absolute risk differences were estimated.FindingsFor each 5°C increase in short-term exposure to cold season temperature, the relative risk of acute hospital admission increased by 3·66% (95% CI 3·06-4·26) for depression, by 3·03% (2·04-4·02) for schizophrenia, and by 3·52% (2·38-4·68) for bipolar disorder in the US Medicare population. Increased short-term exposure to PM2·5 and NO2 was also associated with a significant increase in the risk of acute hospital admissions for psychiatric disorders. Each 5 μg/m3 increase in PM2·5 was associated with an increase in hospital admission rates of 0·62% (95% CI 0·23-1·02) for depression, 0·77% (0·11-1·44) for schizophrenia, and 1·19% (0·49-1·90) for bipolar disorder; each 5 parts per billion (ppb) increase in NO2, meanwhile, was linked to an increase in hospital admission rates of 0·35% (95% CI 0·03-0·66) for depression and 0·64% (0·20-1·08) for schizophrenia. No such associations were found with warm season temperature.InterpretationIn the US Medicare population, short-term exposure to elevated concentrations of PM2·5 and NO2 and cold season ambient temperature were significantly associated with an increased risk of hospital admissions for psychiatric disorders. Considering the increasing burden of psychiatric disorders in the US population, these findings suggest that intervening on air pollution and ambient temperature levels through stricter environmental regulations or climate mitigation could help ease the psychiatric health-care burden.FundingUS National Institute of Environmental Health Sciences, US Environmental Protection Agency, and US National Institute on Aging.

Project description:BackgroundBecause of the limited epidemiological evidence on the association between acute air pollutants and allergy, there is a need to investigate this association, especially between the short-term exposure to air pollution and the serum Immunoglobulin E (IgE)-mediated allergy.MethodsA total of 39,569 IgE test results and demographic characteristics were obtained in the First Affiliated Hospital of Guangzhou Medical University between August 2012 and September 2019. Ninety-nine specific allergens were tested according to clinical diagnosis. The logistic regression was used to assess the effects of CO, NO2 and PM2.5 exposure on the risk of sensitization to specific inhalant/food allergens. Generalized additive models with multivariate adjustments were utilized to model the exposure-response relationship. Stratified analyses were performed to estimate the reliability of correlations in various subgroups.FindingsSingle-pollutant models indicate that the 3-day moving average (lag2-4) of CO, PM2.5 or NO2 is associated with the increased risk for allergic diseases related to specific inhaled allergens. In multi-pollutant models, the adjusted Odds Ratio (OR) 95% (Confidence Interval, CI) increases by 8% (95% CI, 2%-15%) for per increment of 0.2 mg/m3 in CO levels, and rises by 8% (95% CI, 2%-13%) for each increase of 16.3 μg/m3 in PM2.5 concentration. The associations are stronger in youngsters (<18, years) but not significantly different by gender. Particularly, a significantly stronger association between PM2.5 exposure and hospital visits for inhaled allergy is observed in patients who are exposed to lower concentration of SO2 (<10.333 μg/m3) and higher levels of NO2 (≥42.0 μg/m3), as well as patients enrolled after 2017.InterpretationThe short-term exposure to CO/PM2.5 increases the number of hospital visits for IgE-mediated allergy, especially for the sensitization to specific inhalant allergens. Therefore, to prevent inhaled allergies, the public policy for controlling air pollution needs to be considered seriously.FundingThis study was supported by the University of Macau (grant numbers: FHS-CRDA-029-002-2017 and MYRG2018-00,071-FHS) as well as the Science and Technology Development Fund, Macau SAR (File no. 0004/2019/AFJ and 0011/2019/AKP). This work was also supported by the National Natural Science Foundation of China (81,871,736), the National Key Technology R&D Program (2018YFC1311902), the Guangdong Science and Technology Foundation (2019B030316028), the Guangzhou Municipal Health Foundation (20191A011073), and the Guangzhou Science and Technology Foundation (201,804,020,043).

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Increased Risk of Hospital Admission for Asthma in Children From Short-Term Exposure to Air Pollution: Case-Crossover Evidence From Northern China.

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