Outdoor particulate matter exposure and upper respiratory tract infections in children and adolescents: A systematic review and meta-analysis

Myriam Ziou; Rachel Tham; Amanda J Wheeler; Graeme R Zosky; Nicola Stephens; Fay H Johnston

doi:10.1016/j.envres.2022.112969

Outdoor particulate matter exposure and upper respiratory tract infections in children and adolescents: A systematic review and meta-analysis

Environ Res. 2022 Jul:210:112969. doi: 10.1016/j.envres.2022.112969. Epub 2022 Feb 17.

Authors

Myriam Ziou¹, Rachel Tham², Amanda J Wheeler³, Graeme R Zosky⁴, Nicola Stephens⁵, Fay H Johnston⁶

Affiliations

¹ Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
² Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
³ Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.
⁴ Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.
⁵ Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.
⁶ Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia. Electronic address: Fay.Johnston@utas.edu.au.

PMID: 35183515
DOI: 10.1016/j.envres.2022.112969

Abstract

Background: While the relationship between outdoor particulate matter (PM) and lower respiratory tract infections in children and adolescents is accepted, we know little about the impacts of outdoor PM on the risk of developing or aggravating upper respiratory tract infections (URTIs).

Methods: We aimed to review the literature examining the relationship between outdoor PM exposure and URTIs in children and adolescents. A systematic search of EMBASE, MEDLINE, PubMed, Scopus, CINAHL and Web of Science databases was undertaken on April 3, 2020 and October 27, 2021. Comparable short-term studies of time-series or case-crossover designs were pooled in meta-analyses using random-effects models, while the remainder of studies were combined in a narrative analysis. Quality, risk of bias and level of evidence for health effects were appraised using a combination of emerging frameworks in environmental health.

Results: Out of 1366 articles identified, 34 were included in the systematic review and 16 of these were included in meta-analyses. Both PM_2.5 and PM₁₀ levels were associated with hospital presentations for URTIs (PM_2.5: RR = 1.010, 95%CI = 1.007-1.014; PM₁₀: RR = 1.016, 95%CI = 1.011-1.021) in the meta-analyses. Narrative analysis found unequivocally that total suspended particulates were associated with URTIs, but mixed results were found for PM_2.5 and PM₁₀ in both younger and older children.

Conclusion: This study found some evidence of associations between PM and URTIs in children and adolescents, the relationship strength increased with PM₁₀. However, the number of studies was limited and heterogeneity was considerable, thus there is a need for further studies, especially studies assessing long-term exposure and comparing sources.

Keywords: Air pollution; Child health; Meta-analysis; Particulate matter; Systematic review; Upper respiratory infections.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Adolescent
Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / analysis
Child
Environmental Exposure / adverse effects
Environmental Exposure / analysis
Humans
Particulate Matter / analysis
Particulate Matter / toxicity
Respiratory Tract Infections* / chemically induced
Respiratory Tract Infections* / epidemiology

Substances

Air Pollutants
Particulate Matter