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Seasonality in pediatric asthma admissions: the role of climate and environmental factors

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Abstract

Background

Population-based data from Taiwan are used to examine seasonality in pediatric asthma admissions (proxy for asthma exacerbations) and associations with air pollutants and climatic factors. Monthly admission rates per 100,000 population, classified into three age groups, 0~2, 2~5, and 6~14 years (calculated from a total of 27,275 hospitalizations during 1998–2001) were subjected to autoregressive integrated moving average (ARIMA) modeling to examine seasonality. Spearman rank correlations were used to examine associations with criterion air pollutants (PM10, SO2, CO, O3, NO2) and meteorological factors (ambient temperature, relative humidity, atmospheric pressure, rainfall, and sunshine hours).

Results

Both seasonality and associations with air pollutants and climate factors vary by age group. Among under-twos, the rates are lowest in January–February and highest in November, with a trough in June–July. Among preschoolers, the rates are lowest in June–July and highest in November, with two upsurges in August and March. Among school-goers, admission rates are lowest during June–August, with upsurges in March and September. The number of weather and pollutant predictors increases with age. Among under-twos, only two factors, PM10 and rainfall, significantly predict admissions. For preschoolers, five factors (PM10, CO, O3, temperature, and pressure), and for school-goers, all air pollutants except NO2, and all climatic factors except rainfall are significant.

Conclusion

Seasonality in pediatric asthma admissions vary by age in a subtropical island setting.

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Acknowledgments

We gratefully acknowledge Samuel L. Baker, PhD, Associate Professor, Department of Health Services Policy and Management, University of South Carolina, USA, for his helpful comments. This study is based, in part, on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health, Taiwan, and managed by the National Health Research Institutes. The interpretations and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health, or the National Health Research Institutes.

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Authors and Affiliations

  1. Department of Health Services Policy and Management,Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Sudha Xirasagar

  2. School of Health Care Administration, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan, Republic of China

    Herng-Ching Lin

  3. Department of Public Finance, National Taipei University, Taipei, Taiwan, Republic of China

    Tsai-Ching Liu

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  1. Sudha Xirasagar
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  2. Herng-Ching Lin
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  3. Tsai-Ching Liu
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Correspondence to Herng-Ching Lin.

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Xirasagar, S., Lin, HC. & Liu, TC. Seasonality in pediatric asthma admissions: the role of climate and environmental factors. Eur J Pediatr 165, 747–752 (2006). https://doi.org/10.1007/s00431-006-0164-6

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  • DOI: https://doi.org/10.1007/s00431-006-0164-6

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