Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Hanoi University of Public Health, Hanoi, Viet Nam.
Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
Environ Int. 2018 Jan;110:139-148. doi: 10.1016/j.envint.2017.10.024. Epub 2017 Nov 8.
Lower respiratory diseases are the most frequent causes of hospital admission in children worldwide, particularly in developing countries. Daily levels of air pollution are associated with lower respiratory diseases, as documented in many time-series studies. However, investigations in low-and-middle-income countries, such as Vietnam, remain sparse.
This study investigated the short-term association of ambient air pollution with daily counts of hospital admissions due to pneumonia, bronchitis and asthma among children aged 0-17 in Hanoi, Vietnam. We explored the impact of age, gender and season on these associations.
Daily ambient air pollution concentrations and hospital admission counts were extracted from electronic databases received from authorities in Hanoi for the years 2007-2014. The associations between outdoor air pollution levels and hospital admissions were estimated for time lags of zero up to seven days using Quasi-Poisson regression models, adjusted for seasonal variations, meteorological variables, holidays, influenza epidemics and day of week.
All ambient air pollutants were positively associated with pneumonia hospitalizations. Significant associations were found for most pollutants except for ozone and sulfur dioxide in children aged 0-17. Increments of an interquartile range (21.9μg/m) in the 7-day-average level of NO were associated with a 6.1% (95%CI 2.5% to 9.8%) increase in pneumonia hospitalizations. These associations remained stable in two-pollutant models. All pollutants other than CO were positively associated with hospitalizations for bronchitis and asthma. Associations were weaker in infants than in children aged 1-5.
Strong associations between hospital admissions for lower respiratory infections and daily levels of air pollution confirm the need to adopt sustainable clean air policies in Vietnam to protect children's health.
下呼吸道疾病是全球儿童住院的最常见原因，尤其是在发展中国家。许多时间序列研究表明，空气污染的日水平与下呼吸道疾病有关。然而，在越南等中低收入国家的调查仍然很少。
本研究调查了越南河内儿童因肺炎、支气管炎和哮喘住院的每日病例数与环境空气污染之间的短期关联。我们探讨了年龄、性别和季节对这些关联的影响。
从河内当局收到的电子数据库中提取了 2007 年至 2014 年的每日环境空气污染浓度和住院人数。使用准泊松回归模型，调整季节性变化、气象变量、节假日、流感流行和星期几，估计了 0 至 7 天的滞后时间内户外空气污染水平与住院人数之间的关联。
所有环境空气污染物与肺炎住院均呈正相关。在 0-17 岁儿童中，除臭氧和二氧化硫外，大多数污染物均存在显著关联。7 天平均水平的 NO 增加一个四分位距（21.9μg/m），与肺炎住院人数增加 6.1%（95%CI 2.5%至 9.8%）相关。在双污染物模型中，这些关联仍然稳定。除 CO 外，所有污染物均与支气管炎和哮喘住院呈正相关。在婴儿中，这些关联比在 1-5 岁儿童中较弱。
下呼吸道感染住院与空气污染日水平之间的强烈关联证实了越南需要采取可持续的清洁空气政策来保护儿童健康。
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