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. 2018 Aug 28:6:e5352.
doi: 10.7717/peerj.5352. eCollection 2018.

The effect of outdoor air pollution on the risk of hospitalisation for bronchiolitis in infants: a systematic review

Charlotte King #  1 , Jamie Kirkham  2 , Daniel Hawcutt #  3 , Ian Sinha #  4
Affiliations

The effect of outdoor air pollution on the risk of hospitalisation for bronchiolitis in infants: a systematic review

Charlotte King et al. PeerJ. .

Abstract

Objective: To systematically review the evidence around the effect of ambient levels of particulate and gaseous pollutants, and the risk of hospitalisation with bronchiolitis for infants under two years of age.

Design: Systematic review of observational epidemiological studies including cohort, time series, case crossover and case control study designs.

Data sources: Medline, Scopus, and Web of Science searched to November 2017 with no language restrictions.

Eligibility criteria: Studies investigating impact of air pollution levels on particulate pollutants (diameter <2.5 μm (PM2.5) or <10 μm (PM10) and gaseous pollutants (nitrogen dioxide (NO2), sulphur dioxide (SO2), carbon monoxide (CO), ozone (O3)) on hospital admission for bronchiolitis.

Main outcome measure: Risk of hospitalisation from bronchiolitis.

Results: Eight studies were eligible for review. Long term exposure to PM2.5 may be associated with increased risk of hospitalisation for bronchiolitis. SO2 may also be associated with hospitalisation, but results for other pollutants are inconsistent between studies. In three of the five studies that showed a positive association between air pollutants and hospitalisation, measured concentrations were below World Health Organization (WHO) recommended levels.

Conclusions: Certain particulate and gaseous pollutants may have a clinically relevant effect on hospital admissions for bronchiolitis in children below age two years old. Large cohort or time series studies are needed to examine this possible association.

Protocol: The protocol can be found at PROSPERO (CRD42017080643).

Keywords: Air pollution; Bronchiolitis; Hospitalisation; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. PRISMA flow diagram.
Figure 2
Figure 2. Forest plots of particulate pollutants.
(A) PM2.5 forest plot. (B) PM10 forest plot.
Figure 3
Figure 3. Forest plots of gaseous pollutants.
(A) NO2 forest plot. (B) SO2 forest plot. (C) CO forest plot. (D) O3 forest plot.
See this image and copyright information in PMC

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