Advertisement

Environmental Science and Pollution Research

, Volume 24, Issue 23, pp 18860–18869 | Cite as

Air pollution and hospital visits for acute upper and lower respiratory infections among children in Ningbo, China: A time-series analysis

  • Pei-wen Zheng
  • Jian-bing Wang
  • Zhen-yu Zhang
  • Peng Shen
  • Peng-fei Chai
  • Die Li
  • Ming-juan Jin
  • Meng-Ling Tang
  • Huai-chu Lu
  • Hong-bo LinEmail author
  • Kun ChenEmail author
Research Article

Abstract

Acute upper and lower respiratory infections are main causes of mortality and morbidity in children. Air pollution has been recognized as an important contributor to development and exacerbation of respiratory infections. However, few studies are available in China. In this study, we investigated the short-term effect of air pollution on hospital visits for acute upper and lower respiratory infections among children under 15 years in Ningbo, China. Poisson generalized models were used to estimate the associations between air pollution and hospital visits for acute upper and lower respiratory infections adjusted for temporal, seasonal, and meteorological effects. We found that four pollutants (PM2.5, PM10, NO2, and SO2) were significantly associated with hospital visits for acute upper and lower respiratory infections. The effect estimates for acute upper respiratory infections tended to be higher (PM2.5 ER = 3.46, 95% CI 2.18, 4.76; PM10 ER = 2.81, 95% CI 1.93, 3.69; NO2 ER = 11.27, 95% CI 8.70, 13.89; SO2 ER = 15.17, 95% CI 11.29, 19.19). Significant associations for gaseous pollutants (NO2 and SO2) were observed after adjustment for particular matter. Stronger associations were observed among older children and in the cold period. Our study suggested that short-term exposure to outdoor air pollution was associated with hospital visits for acute upper and lower respiratory infections in Ningbo.

Keywords

Air pollution Hospital visits Acute upper respiratory infection Acute lower respiratory infection 

Notes

Acknowledgements

This study was partly supported by the Air Pollution and Health Research Center, Zhejiang University (Grant: 519600-I21502). The sponsors had no role in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

11356_2017_9279_MOESM1_ESM.docx (19 kb)
ESM 1 (DOCX 19 kb)

References

  1. Barnett AG, Williams GM, Schwartz J, Neller AH, Best TL, Petroeschevsky AL, Simpson RW (2005) Air pollution and child respiratory health. AM J RESP CRIT CARE 171:1272–1278CrossRefGoogle Scholar
  2. Bjornson CL, Mitchell I (2000) Gender differences in asthma in childhood and adolescence. J Gend Specif Med 3:57–61Google Scholar
  3. Braga AL, Saldiva PH, Pereira LA, Menezes JJ, Conceicao GM, Lin CA, Zanobetti A, Schwartz J, Dockery DW (2001) Health effects of air pollution exposure on children and adolescents in Sao Paulo, Brazil. Pediatr Pulmonol 31:106–113CrossRefGoogle Scholar
  4. Breitner S, Liu L, Cyrys J, Brüske I, Franck U, Schlink U, Leitte AM, Herbarth O, Wiedensohler A, Wehner B, Hu M, Pan X, Wichmann H, Peters A (2011) Sub-micrometer particulate air pollution and cardiovascular mortality in Beijing, China. Sci Total Environ 409:5196–5204CrossRefGoogle Scholar
  5. Castranova V, Ma JY, Yang HM, Antonini JM, Butterworth L, Barger MW, Roberts J, Ma JK (2001) Effect of exposure to diesel exhaust particles on the susceptibility of the lung to infection. Environ Health Perspect 109(Suppl 4):609–612CrossRefGoogle Scholar
  6. Chen B, Hong C, Kan H (2004) Exposures and health outcomes from outdoor air pollutants in China. Toxicology 198:291–300CrossRefGoogle Scholar
  7. Chen R, Chu C, Tan J, Cao J, Song W, Xu X, Jiang C, Ma W, Yang C, Chen B, Gui Y, Kan H (2010) Ambient air pollution and hospital admission in Shanghai, China. J Hazard Mater 181:234–240CrossRefGoogle Scholar
  8. Darrow LA, Klein M, Flanders WD, Mulholland JA, Tolbert PE, Strickland MJ (2014) Air pollution and acute respiratory infections among children 0–4 years of age: an 18-year time-series study. Am J Epidemiol 180:968–77Google Scholar
  9. Goldman GT, Mulholland JA, Russell AG, Strickland MJ, Klein M, Waller LA, Tolbert PE (2011) Impact of exposure measurement error in air pollution epidemiology: effect of error type in time-series studies. Environ Health 10:61CrossRefGoogle Scholar
  10. Gouveia N, Fletcher T (2000) Respiratory diseases in children and outdoor air pollution in Sao Paulo, Brazil: a time series analysis. Occup Environ Med 57:477–483CrossRefGoogle Scholar
  11. Harrod KS, Jaramillo RJ, Rosenberger CL, Wang SZ, Berger JA, McDonald JD, Reed MD (2003) Increased susceptibility to RSV infection by exposure to inhaled diesel engine emissions. Am J Respir Cell Mol Biol 28:451–463CrossRefGoogle Scholar
  12. Hernandez-Florez LJ, Aristizabal-Duque G, Quiroz L, Medina K, Rodriguez-Moreno N, Sarmiento R, Osorio-Garcia SD (2013) Air pollution and respiratory illness in children aged less than 5 years-old in Bogota, 2007. Rev Salud Publica (Bogota) 15:503–16Google Scholar
  13. Hertz-Picciotto I, Baker RJ, Yap PS, Dostal M, Joad JP, Lipsett M, Greenfield T, Herr CE, Benes I, Shumway RH, Pinkerton KE, Sram R (2007) Early childhood lower respiratory illness and air pollution. Environ Health Perspect 115:1510–1518Google Scholar
  14. Jensen-Fangel S, Mohey R, Johnsen SP, Andersen PL, Sorensen HT, Ostergaard L (2004) Gender differences in hospitalization rates for respiratory tract infections in Danish youth. Scand J Infect Dis 36:31–36CrossRefGoogle Scholar
  15. Le TG, Ngo L, Mehta S, Do VD, Thach TQ, Vu XD, Nguyen DT, Cohen A (2012) Effects of short-term exposure to air pollution on hospital admissions of young children for acute lower respiratory infections in Ho Chi Minh City. Vietnam Res Rep Health Eff Inst:5–72 discussion 73-83Google Scholar
  16. Lin M (2005) Coarse particulate matter and hospitalization for respiratory infections in children younger than 15 years in Toronto: a case-crossover analysis. Pediatrics 116:e235–e240Google Scholar
  17. Lin H, Zhang Z, Lu L, Li X, Liu Q (2014) Meteorological factors are associated with hemorrhagic fever with renal syndrome in Jiaonan County, China, 2006–2011. Int J Biometeorol 58:1031–1037CrossRefGoogle Scholar
  18. Peng RD, Dominici F, Louis TA (2006) Model choice in time series studies of air pollution and mortality. J R STAT SOC A STAT 169:179–198CrossRefGoogle Scholar
  19. Pope CR, Dockery DW (2006) Health effects of fine particulate air pollution: lines that connect. J Air Waste Manag Assoc 56:709–742CrossRefGoogle Scholar
  20. Rodopoulou S, Samoli E, Chalbot MG, Kavouras IG (2015) Air pollution and cardiovascular and respiratory emergency visits in Central Arkansas: a time-series analysis. Sci Total Environ 536:872–879CrossRefGoogle Scholar
  21. Romieu I, Samet JM, Smith KR, Bruce N (2002) Outdoor air pollution and acute respiratory infections among children in developing countries. J Occup Environ Med 44:640–649CrossRefGoogle Scholar
  22. Samoli E, Analitis A, Touloumi G, Schwartz J, Anderson HR, Sunyer J, Bisanti L, Zmirou D, Vonk JM, Pekkanen J, Goodman P, Paldy A, Schindler C, Katsouyanni K (2005) Estimating the exposure–response relationships between particulate matter and mortality within the APHEA multicity project. Environ Health Perspect 113:88–95CrossRefGoogle Scholar
  23. Sarnat JA, Brown KW, Schwartz J, Coull BA, Koutrakis P (2005) Ambient gas concentrations and personal particulate matter exposures: implications for studying the health effects of particles. Epidemiology 16:385–395CrossRefGoogle Scholar
  24. Sonego M, Pellegrin MC, Becker G, Lazzerini M (2015) Risk factors for mortality from acute lower respiratory infections (ALRI) in children under five years of age in low and middle-income countries: a systematic review and meta-analysis of observational studies. PLoS One 10:e0116380CrossRefGoogle Scholar
  25. Strickland MJ, Gass KM, Goldman GT, Mulholland JA (2013) Effects of ambient air pollution measurement error on health effect estimates in time-series studies: a simulation-based analysis. J EXPO SCI ENV EPID 25:160–166CrossRefGoogle Scholar
  26. Tam WWS, Wong TW, Ng L, Wong SYS, Kung KKL, Wong AHS (2014) Association between air pollution and general outpatient clinic consultations for upper respiratory tract infections in Hong Kong. PLoS One 9Google Scholar
  27. Tao Y, Mi S, Zhou S, Wang S, Xie X (2014) Air pollution and hospital admissions for respiratory diseases in Lanzhou, China. Environ Pollut 185:196–201CrossRefGoogle Scholar
  28. Tolbert PE, Klein M, Peel JL, Sarnat SE, Sarnat JA (2007) Multipollutant modeling issues in a study of ambient air quality and emergency department visits in Atlanta. J Expo Sci Environ Epidemiol 17(Suppl 2):S29–S35CrossRefGoogle Scholar
  29. Venners SA, Wang B, Xu Z, Schlatter Y, Wang L, Xu X (2003) Particulate matter, sulfur dioxide, and daily mortality in Chongqing, China. Environ Health Perspect 111:562–567CrossRefGoogle Scholar
  30. Williams BG, Gouws E, Boschi-Pinto C, Bryce J, Dye C (2002) Estimates of world-wide distribution of child deaths from acute respiratory infections. Lancet Infect Dis 2:25–32CrossRefGoogle Scholar
  31. Xiong Q, Zhao W, Gong Z, Zhao W, Tang T (2015) Fine particulate matter pollution and hospital admissions for respiratory diseases in Beijing, China. INT J ENV RES PUB HE 12:11880–11892CrossRefGoogle Scholar
  32. Yang C, Chen A, Chen R, Qi Y, Ye J, Li S, Li W, Liang Z, Liang Q, Guo D, Kan H, Chen X (2014) Acute effect of ambient air pollution on heart failure in Guangzhou, China. Int J Cardiol 177:436–441CrossRefGoogle Scholar
  33. Yu HL, Chien LC (2016) Short-term population-based non-linear concentration–response associations between fine particulate matter and respiratory diseases in Taipei (Taiwan): a spatiotemporal analysis. J Expo Sci Environ Epidemiol 26:197–206CrossRefGoogle Scholar
  34. Zeka A, Zanobetti A, Schwartz J (2006) Individual-level modifiers of the effects of particulate matter on daily mortality. Am J Epidemiol 163:849–859CrossRefGoogle Scholar
  35. Zhang Y, Wang SG, Ma YX, Shang KZ, Cheng YF, Li X, Ning GC, Zhao WJ, Li NR (2015) Association between ambient air pollution and hospital emergency admissions for respiratory and cardiovascular diseases in Beijing: a time series study. Biomed Environ Sci 28:352–363Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Pei-wen Zheng
    • 1
  • Jian-bing Wang
    • 1
    • 2
  • Zhen-yu Zhang
    • 3
  • Peng Shen
    • 4
  • Peng-fei Chai
    • 4
  • Die Li
    • 1
  • Ming-juan Jin
    • 1
  • Meng-Ling Tang
    • 1
  • Huai-chu Lu
    • 4
  • Hong-bo Lin
    • 4
    Email author
  • Kun Chen
    • 1
    • 2
    Email author
  1. 1.Department of Epidemiology and Health StatisticsZhejiang University School of Public HealthHangzhouChina
  2. 2.Research Center for Air Pollution and HealthZhejiang UniversityHangzhouChina
  3. 3.John Hopkins School of Public HealthBaltimoreUSA
  4. 4.Center for Disease Control and Prevention of Yinzhou DistrictNingboChina

Personalised recommendations