Differential effects of size-specific particulate matter on lower respiratory infections in children: A multi-city time-series analysis in Sichuan, China

Xiaorong Pu; Liya Wang; Lina Chen; Jingping Pan; Lei Tang; Jing Wen; Hang Qiu

doi:10.1016/j.envres.2020.110581

Differential effects of size-specific particulate matter on lower respiratory infections in children: A multi-city time-series analysis in Sichuan, China

Environ Res. 2021 Feb:193:110581. doi: 10.1016/j.envres.2020.110581. Epub 2020 Dec 9.

Authors

Xiaorong Pu¹, Liya Wang², Lina Chen³, Jingping Pan⁴, Lei Tang⁵, Jing Wen⁶, Hang Qiu⁷

Affiliations

¹ School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China; Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China.
² Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China.
³ West China Second University Hospital, Sichuan University, Chengdu, China.
⁴ Health Information Center of Sichuan Province, Chengdu, China.
⁵ School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China.
⁶ Glasgow College, University of Electronic Science and Technology of China, Chengdu, China.
⁷ School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China; Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China. Electronic address: qiuhang@uestc.edu.cn.

PMID: 33309823
DOI: 10.1016/j.envres.2020.110581

Abstract

Evidence on the short-term effects of size-specific particulate matter with aerodynamic diameter ≤2.5 μm (PM_2.5), ≤10 μm (PM₁₀), and their difference (PM_C) on children's Lower Respiratory Infections (LRI) is scare. This study aimed to estimate the differential effects of three size-specific PM on hospitalizations of children aged <18 years for pneumonia and bronchitis in 18 cities of southwestern China. The city-specific association was firstly estimated using the over-dispersed generalized additive model and then combined to obtain the regional average association. Further, to evaluate the robustness of the key findings, subgroup analyses and co-pollutant models were constructed. PM-related risks of LRI differed by PM fractions and cause-specific LRI. A 10 μg/m³ increment in PM_2.5_lag03, PM₁₀_lag06, and PM_C_lag06 was associated with a 0.79% (95% CI: 0.29%, 1.29%), 0.77% (95% CI: 0.13%, 1.41%), and 2.33% (95% CI: 1.23%, 3.44%) increase in children's LRI hospitalizations, respectively. After adjustment for gaseous pollutants, adverse effects of the three types of size-specific PM on pneumonia hospitalizations were stable, ranging from 0.29% (95% CI: 0.05%, 0.54%) for PM_2.5-2.50% (95% CI: 1.38%, 3.64%) for PM_C. Additionally, PM_C-related risk of bronchitis hospitalizations remained stable after adjustment for gaseous pollutants. Associations of pneumonia with PM_C and PM₁₀ in infants, bronchitis with PM_2.5 in children aged 6-17 years, pneumonia and bronchitis with PM_2.5, PM_C, and PM₁₀ in children aged 1-5 years were all statistical significant. Specifically, the effects of PM_2.5 on LRI hospitalizations increased by age, with the highest effect of 1.72% (95%CI: 1.01%, 2.43%) in children aged 6-17 years. Our study provided evidence for short-term effects of different PM fractions on children LRI hospitalizations in Southwestern China, which will be useful for making and promoting policies on air quality standards in order to protect children's health.

Keywords: Children; Coarse particulate matter; Hospitalization; Lower respiratory infections; Particle size.

MeSH terms

Adolescent
Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / adverse effects
Air Pollution* / analysis
Child
Child, Preschool
China / epidemiology
Cities
Environmental Exposure / analysis
Humans
Infant
Particulate Matter / analysis
Particulate Matter / toxicity

Substances

Air Pollutants
Particulate Matter