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. 2023 Jan 20;20(3):1959.
doi: 10.3390/ijerph20031959.

The Interactive Effects between Drought and Air Pollutants on Children's Upper Respiratory Tract Infection: A Time-Series Analysis in Gansu, China

Yanlin Li  1 , Jianyun Sun  2 , Ruoyi Lei  1 , Jie Zheng  1 , Xiaoyu Tian  1 , Baode Xue  1 , Bin Luo  1   3   4
Affiliations

The Interactive Effects between Drought and Air Pollutants on Children's Upper Respiratory Tract Infection: A Time-Series Analysis in Gansu, China

Yanlin Li et al. Int J Environ Res Public Health. .

Abstract

As a destructive and economic disaster in the world, drought shows an increasing trend under the continuous global climate change and adverse health effects have been reported. The interactive effects between drought and air pollutants, which may also be harmful to respiratory systems, remain to be discussed. We built the generalized additive model (GAM) and distributed lag nonlinear model (DLNM) to estimate the effects of drought and air pollutants on daily upper respiratory infections (URTI) outpatient visits among children under 6 in three cities of Gansu province. The Standardized Precipitation Index (SPI) based on monthly precipitation (SPI-1) was used as an indicator of drought. A non-stratified model was established to explore the interaction effect of SPI-1 and air pollutants. We illustrated the number of daily pediatric URTI outpatient visits increased with the decrease in SPI-1. The interactive effects between air pollutants and the number of daily pediatric URTIs were significant. According to the non-stratified model, we revealed highly polluted and drought environments had the most significant impact on URTI in children. The occurrence of drought and air pollutants increased URTI in children and exhibited a significant interactive effect.

Keywords: DLNM; GAM; SPI; URTI; air pollutants; drought.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Drought characterization for Lanzhou (A), Tianshui (B), Zhangye (C) in Gansu province. Gray strips represent days with no drought conditions, and orange strips represent days with drought conditions.
Figure 2
Figure 2
Dose–response associations between SPI-1 and pediatric URTI outpatient visits of Lanzhou (A), Tianshui (B), Zhangye (C) in Gansu province. The colorful solid line represent the dose-response curve in each city; the colorful dotted lines are the 95% confidence interval of Log RR in each city.
Figure 3
Figure 3
The overall and city-specific effects of air pollutants at lag 021 of daily outpatient visits for pediatric URTI in three cities.
Figure 4
Figure 4
Bivariate response surface analysis of PM2.5 (A), PM10 (B), CO (C), SO2 (D), NO2 (E) and O3 (F), and SPI-1 in pediatric URTI in Lanzhou city.
Figure 5
Figure 5
City-specific estimated relative risks (RR) and 95% confidence interval of daily outpatient visits for pediatric URTI under different age groups with a 10 μg/m3 (0.1 mg/m3 for CO) increase in daily mean air pollutant concentration by drought conditions.
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