School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China.
Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai 201102, China.
Sci Total Environ. 2021 Jun 25;775:145777. doi: 10.1016/j.scitotenv.2021.145777. Epub 2021 Feb 11.
Few studies have explored the short-term effects of ultrafine particles (UFPs, particles < 0.1 μm) air pollution on the exacerbations of pediatric respiratory diseases.
We aimed to evaluate short-term association between UFP and emergency-department visits (EDVs) for main pediatric respiratory diseases.
We collected daily data on UFP and pediatric EDVs for main respiratory diseases [asthma, pneumonia, bronchitis and upper respiratory tract infections (URTI)] from 66 hospitals in Shanghai, China from 2016 to 2018. Generalized additive models combined with polynomial distributed lag models were applied to explore the associations between UFP level and pediatric EDVs for respiratory diseases. We fitted two-pollutant models with criteria air pollutants and performed stratified analyses by gender and age.
UFP was associated with increased EDVs for all respiratory diseases in cumulative lags up to 2 d and 3 d. The greatest risk was found at cumulative lags (0-2 d) for all respiratory diseases. At cumulative lags (0-2 d), an interquartile range increase in concentrations of UFP (1800 particles/cm) was associated with relative risks of EDVs due to asthma [1.35, 95% confidence interval (CI): 1.14-1.59], pneumonia (1.20, 95% CI: 1.04-1.38), bronchitis (1.17, 95% CI: 1.03-1.33) and URTI (1.14, 95% CI: 1.02-1.28). These associations were almost unchanged when controlling for criteria air pollutants, and there was no threshold below which the associations were not present. There were stronger associations in children aged 0-13 years.
Short-term exposure to UFP may independently increase the risks of EDVs for asthma, pneumonia, bronchitis and URTI exacerbations among children.
鲜有研究探索超细颗粒物（UFPs，粒径<0.1μm）空气污染对儿科呼吸道疾病恶化的短期影响。
评估 UFPs 与儿科急诊就诊（EDV）因主要儿科呼吸道疾病的短期关联。
我们从 2016 年至 2018 年期间，在中国上海的 66 家医院收集了 UFPs 和儿科 EDV 因主要呼吸疾病（哮喘、肺炎、支气管炎和上呼吸道感染（URTI））的每日数据。采用广义加性模型结合多项式分布滞后模型，探讨 UFPs 水平与儿科 EDV 因呼吸道疾病的关联。我们采用标准空气污染物拟合双污染物模型，并按性别和年龄进行分层分析。
UFPs 与所有呼吸道疾病的 EDV 增加在累积滞后 0-2 天和 3 天内相关。所有呼吸道疾病的最大风险发生在累积滞后（0-2 天）。在累积滞后（0-2 天），UFPs 浓度（1800 个/立方厘米）的四分位距增加与因哮喘（1.35，95%置信区间（CI）：1.14-1.59）、肺炎（1.20，95%CI：1.04-1.38）、支气管炎（1.17，95%CI：1.03-1.33）和 URTI（1.14，95%CI：1.02-1.28）导致的 EDV 的相对风险相关。当控制标准空气污染物时，这些关联几乎没有变化，且不存在低于该水平则关联不存在的阈值。0-13 岁儿童的关联更强。
短期暴露于 UFPs 可能会独立增加儿童因哮喘、肺炎、支气管炎和 URTI 恶化而急诊就诊的风险。
