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Meta-Analysis
. 2020 Jun 26;17(12):4604.
doi: 10.3390/ijerph17124604.

Associations between Particulate Matter and Otitis Media in Children: A Meta-Analysis

Sang-Youp Lee  1 , Myoung-Jin Jang  2 , Seung Ha Oh  3   4 , Jun Ho Lee  3   4 , Myung-Whan Suh  3   4 , Moo Kyun Park  3   4
Affiliations
Meta-Analysis

Associations between Particulate Matter and Otitis Media in Children: A Meta-Analysis

Sang-Youp Lee et al. Int J Environ Res Public Health. .

Abstract

Particulate matter (PM), a primary component of air pollution, is a suspected risk factor for the development of otitis media (OM). However, the results of studies on the potential correlation between an increase in the concentration of PM and risk of developing OM are inconsistent. To better characterize this potential association, a meta-analysis of studies indexed in three global databases (PubMed, EMBASE, and The Cochrane Library) was conducted. These databases were systematically screened for observational studies of PM concentration and the development of OM from the time of their inception to 31 March 2020. Following these searches, 12 articles were analyzed using pooled odds ratios generated from random-effects models to test for an association between an increased concentration of PM and the risk of developing OM. The data were analyzed separately according to the size of particulate matter as PM2.5 and PM10. The pooled odds ratios for each 10 μg/m3 increase in PM2.5 and PM10 concentration were 1.032 (95% confidence interval (CI), 1.005-1.060) and 1.010 (95% CI, 1.008-1.012), respectively. Specifically, the pooled odds ratios were significant within the short-term studies (PM measured within 1 week of the development of OM), as 1.024 (95% CI, 1.008-1.040) for PM2.5 concentration and 1.010 (95% CI, 1.008-1.012) for PM10 concentration. They were significant for children under 2 years of age with pooled odds ratios of 1.426 (95% CI, 1.278-1.519) for an increase in the concentration of PM2.5. The incidence of OM was not correlated with the concentration of PM, but was correlated with an increase in the concentration of PM. In conclusion, an increase in the concentration of PM2.5 is more closely associated with the development of OM compared with an increase in the concentration of PM10; this influence is more substantial in shorter-term studies and for younger children.

Keywords: child; meta-analysis; otitis media; particulate matter.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA 2009 flow diagram of the study selection process for this meta-analysis.
Figure 2
Figure 2
Forest plots for the PM2.5 group. (A)—All subjects. (B)—Short- and long-term effect models. (C)—Case–control and cohort studies. (D)—Younger and older children.
Figure 3
Figure 3
Forest plots for the PM10 group. (A)—All subjects. (B)—Short- and long-term effect models. (C)—Case–control and cohort studies. (D)—Younger and older children.
Figure 4
Figure 4
Trends between odds ratios and representative PM values in the (A) PM2.5 and (B) PM10 groups. Each circle is a study included in this article, and its area means the number of its subjects.
Figure 5
Figure 5
Funnel plot of publication bias in the (A)—PM2.5 and (B)—PM10 groups.
Figure 6
Figure 6
Association of lag with the incidence of OM.
See this image and copyright information in PMC

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