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. 2018 Sep 6;18(1):150.
doi: 10.1186/s12890-018-0716-3.

Acute effects of ambient air pollution on outpatient children with respiratory diseases in Shijiazhuang, China

Jie Song  1   2 , Mengxue Lu  3 , Liheng Zheng  4 , Yue Liu  5 , Pengwei Xu  6 , Yuchun Li  6 , Dongqun Xu  5 , Weidong Wu  6   7
Affiliations

Acute effects of ambient air pollution on outpatient children with respiratory diseases in Shijiazhuang, China

Jie Song et al. BMC Pulm Med. .

Abstract

Background: Associations between ambient air pollution and child health outcomes have been well documented in developed countries such as the United States; however, only a limited number of studies have been conducted in developing countries. This study aimed to explore the acute effects of five ambient air pollutants (inhalable particles [PM10], fine particles [PM2.5], sulfur dioxide [SO2], nitrogen dioxide [NO2] and 0zone [O3]) on children hospital outpatients with respiratory diseases in Shijiazhuang, China.

Methods: Three years (2013-2015) of daily data, including cause-specific respiratory outpatient records and the concentrations of five air pollutants, were collected to examine the short-term association between air pollution and children's respiratory diseases; using a quasi-Poisson regression generalized additive model. Stratified analyses by season and age were also performed.

Results: From 2013 to 2015, a total of 551,678 hospital outpatient records for children with respiratory diseases were collected in Shijiazhuang, China. A 10 μg/m3 increase in a two-day average concentration (lag01) of NO2, PM2.5, and SO2 corresponded to an increase of 0.66% (95% confidence interval [CI]: 0.30-1.03%), 0.13% (95% CI: 0.02-0.24%), and 0.33% (95% CI: 0.10-0.56%) in daily hospital outpatient visits for children with respiratory diseases, respectively. The effects were stronger in the transition season (April, May, September and October) than in other seasons (the hot season [June to August] and the cool season [November to March]). Furthermore, results indicated a generally stronger association in older (7-14 years of age) than younger children (< 7 years of age).

Conclusions: This research found a significant association between ambient NO2, PM2.5, and SO2 levels and hospital outpatient visits in child with respiratory diseases in Shijiazhuang, China.

Keywords: Air pollution; Children; Outpatients; Respiratory disease; Time-series study.

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Conflict of interest statement

Ethics approval and consent to participate

This project was approved by the Standing Committee of Ethics of Xinxiang Medical University. In this study, only the daily number of outpatient records (not including personal names and other privacy information) was extracted, and the whole study only used the daily number of records. The ethics committee considers that there is no need for informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Data cleaning flow diagram
Fig. 2
Fig. 2
Box plots of five air pollutans in the cool, transition and warm season. Boxes indicate the interquartile range (25th percentile – 75th percentile); lines within boxes indicate medians; whiskers below boxes represent minimum values; whiskers and dots above boxes indicate maximum values
Fig. 3
Fig. 3
Percent increase of hospital outpatient visits with 10 μg/m3 increase of NO2, O3, PM10, PM2.5 and SO2 due to respiratory disease classified by degrees of freedom per year
Fig. 4
Fig. 4
Percent increase of hospital outpatient visits with 10 μg/m3 increase of NO2, O3, PM10, PM2.5 and SO2 due to respiratory disease in different lag days
See this image and copyright information in PMC

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