Ambient Anthropogenic Carbons and Pediatric Respiratory Infections: A Case-Crossover Analysis in the Megacity Beijing

Hongbing Xu; Jing Song; Xinghou He; Xinpeng Guan; Tong Wang; Yutong Zhu; Xin Xu; Mengyao Li; Lingyan Liu; Bin Zhang; Jiakun Fang; Qian Zhao; Xiaoming Song; Baoping Xu; Wei Huang

doi:10.1029/2023GH000820

Ambient Anthropogenic Carbons and Pediatric Respiratory Infections: A Case-Crossover Analysis in the Megacity Beijing

Geohealth. 2023 Aug 1;7(8):e2023GH000820. doi: 10.1029/2023GH000820. eCollection 2023 Aug.

Authors

Hongbing Xu^{1

2}, Jing Song³, Xinghou He^{1

2}, Xinpeng Guan^{1

2}, Tong Wang⁴, Yutong Zhu^{1

2}, Xin Xu⁵, Mengyao Li^{1

2}, Lingyan Liu^{1

2}, Bin Zhang^{1

2}, Jiakun Fang^{1

2}, Qian Zhao^{1

2}, Xiaoming Song^{1

2}, Baoping Xu⁵, Wei Huang^{1

2}

Affiliations

¹ Department of Occupational and Environmental Health Sciences Peking University School of Public Health Peking University Institute of Environmental Medicine Beijing China.
² State Key Laboratory of Vascular Homeostasis and Remodeling Peking University Beijing China.
³ The First Affiliated Hospital of Xiamen University Xiamen China.
⁴ Key Lab of Medical Protection for Electromagnetic Radiation Ministry of Education of China Institute of Toxicology College of Preventive Medicine Army Medical University (Third Military Medical University) Chongqing China.
⁵ China National Clinical Research Center of Respiratory Diseases Respiratory Department of Beijing Children's Hospital Capital Medical University National Center for Children's Health Beijing China.

Abstract

Carbon loading in airway cells has shown to worsen function of antimicrobial peptides, permitting increased survival of pathogens in the respiratory tract; however, data on the impacts of carbon particles on childhood acute respiratory infection (ARI) is limited. We assembled daily health data on outpatient visits for ARI (bronchitis, pneumonia, and total upper respiratory infection [TURI]) in children aged 0-14 years between 2015 and 2019 in Beijing, China. Anthropogenic carbons, including black carbon (BC) and its emission sources, and wood smoke particles (delta carbon, ultra-violet absorbing particulate matter, and brown carbon) were continuously monitored. Using a time-stratified case-crossover approach, conditional logistic regression was performed to derive risk estimates for each outcome. A total of 856,899 children were included, and a wide range of daily carbon particle concentrations was observed, with large variations for BC (0.36-20.44) and delta carbon (0.48-57.66 μg/m³). Exposure to these particles were independently associated with ARI, with nearly linear exposure-response relationships. Interquartile range increases in concentrations of BC and delta carbon over prior 0-8 days, we observed elevation of the odd ratio of bronchitis by 1.201 (95% confidence interval, 1.180, 1.221) and 1.048 (95% CI, 1.039, 1.057), respectively. Stronger association was observed for BC from traffic sources, which increased the odd ratio of bronchitis by 1.298 (95% CI, 1.273, 1.324). Carbon particles were also associated with elevated risks of pneumonia and TURI, and subgroup analyses indicated greater risks among children older than 6 years. Our findings suggested that anthropogenic carbons in metropolitan areas may pose a significant threat to clinical manifestations of respiratory infections in vulnerable populations.

Keywords: aerosols and particles; anthropogenic effects; anthropogenic source; black carbon; case‐crossover study; children; health impact; public health; respiratory infection; wood smoke.