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Meta-Analysis
. 2024 May 24:12:1402908.
doi: 10.3389/fpubh.2024.1402908. eCollection 2024.

The association between children's exposure to pesticides and asthma, wheezing, and lower respiratory tract infections. A systematic review and meta-analysis

Awoke Keleb  1 , Chala Daba  1 , Lakew Asmare  2 , Fekade Demeke Bayou  2 , Mastewal Arefaynie  3 , Anissa Mohammed  2 , Abiyu Abadi Tareke  4 , Natnael Kebede  5 , Yawkal Tsega  6 , Abel Endawkie  2 , Shimels Derso Kebede  7 , Kaleab Mesfin Abera  6 , Eyob Tilahun Abeje  2 , Ermias Bekele Enyew  7
Affiliations
Meta-Analysis

The association between children's exposure to pesticides and asthma, wheezing, and lower respiratory tract infections. A systematic review and meta-analysis

Awoke Keleb et al. Front Public Health. .

Abstract

Background: Exposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted considerable attention, but the existing evidence remains inconclusive and cannot be certain. Therefore, this systematic review and meta-analysis aim to determine the global pooled effect size of association with pesticide exposure and asthma, wheezing, and respiratory tract infections among children.

Methods: A comprehensive search was conducted for relevant literature from electronic databases, including PubMed, Google Scholar, Hinari, Semantic Scholar, and Science Direct. Studies that provided effect size on the association between pesticide exposure and childhood asthma, wheezing, and respiratory tract infections in children were included. The articles were screened, data was extracted, and the quality of each study was assessed with four independent reviewers. Random effects models for significant heterogeneity and fixed effect models for homogeneous studies were conducted to estimate pooled effect sizes with 95% confidence intervals using Comprehensive Meta-Analysis version 3.3.070 and MetaXL version 2. Funnel plot and Higgins I 2 statistics were used to determine the heterogeneity of the included studies. Subgroup analyses were computed based on the types of pesticide exposure, study design, sample size category, and outcome assessment technique.

Result: A total of 38 articles with 118,303 children less than 18 years of age were included in this meta-analysis. Pesticide exposure among children increased the risk of asthma by 24%; (OR = 1.24, 95% CI: 1.14-1.35) with extreme heterogeneity (I 2 = 81%, p < 0.001). Exposure to pesticides increased the odds of developing wheezing among children by 34% (OR = 1.34, 95% CI: 1.14-1.57), with high heterogeneity (I 2 = 79%, p < 0.001) and also increased the risk of developing lower respiratory tract infection by 79% (OR = 1.79, 95% CI: 1.45-2.21) with nonsignificant low heterogeneity (I 2 = 30%, p-value = 0.18).

Conclusion: This meta-analysis provided valuable evidence supporting the association between childhood asthma, wheezing, and lower respiratory tract infection with pesticide exposure. The findings would contribute to a better understanding of the estimate of the effect of pesticide exposure on respiratory health in children and inform evidence-based preventive strategies and public health interventions.

Keywords: asthma; children; chronic respiratory diseases; meta-analysis; pesticide exposure; respiratory tract infection; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the included studies for the systematic review and meta-analysis of respiratory diseases, 2023.
Figure 2
Figure 2
Forest plot of odds ratios for the association of pesticide exposure and childhood asthma, 2023.
Figure 3
Figure 3
Forest plot of odds ratios for the association of pesticide exposure and childhood wheeze, 2023.
Figure 4
Figure 4
Forest plot of odds ratios for the association pesticide exposure and lower respiratory infections among children, 2023.
Figure 5
Figure 5
Funnel plot of association of pesticide exposure and asthma, wheeze and LRTI, 2023.
See this image and copyright information in PMC

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