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短期暴露于空气污染与儿童哮喘住院风险增加:来自中国北方的病例交叉证据。

Increased Risk of Hospital Admission for Asthma in Children From Short-Term Exposure to Air Pollution: Case-Crossover Evidence From Northern China.

机构信息

Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

National Key Laboratory of Medical Molecular Biology, Department of Biochemistry, Institute of Basic Medical Sciences, Peking Union Medical Colleges, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Front Public Health. 2021 Dec 17;9:798746. doi: 10.3389/fpubh.2021.798746. eCollection 2021.


DOI:10.3389/fpubh.2021.798746
PMID:34976938
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8718688/
Abstract

Previous studies suggested that exposure to air pollution could increase risk of asthma attacks in children. The aim of this study is to investigate the short-term effects of exposure to ambient air pollution on asthma hospital admissions in children in Beijing, a city with serious air pollution and high-quality medical care at the same time. We collected hospital admission data of asthma patients aged ≤ 18 years old from 56 hospitals from 2013 to 2016 in Beijing, China. Time-stratified case-crossover design and conditional Poisson regression were applied to explore the association between risk of asthma admission in children and the daily concentration of six air pollutants [particulate matter ≤ 2.5 μm (PM), particulate matter ≤ 10 μm (PM), sulfur dioxide (SO), nitrogen dioxide (NO), carbon monoxide (CO), and ozone (O)], adjusting for meteorological factors and other pollutants. Additionally, stratified analyses were performed by age, gender, and season. In the single-pollutant models, higher levels of PM, SO, and NO were significantly associated with increased risk of hospital admission for asthma in children. The strongest effect was observed in NO at lag06 ( = 1.25, 95%CI: 1.06-1.48), followed by SO at lag05 ( = 1.17, 95%CI: 1.05-1.31). The robustness of effects of SO and NO were shown in two-pollutant models. Stratified analyses further indicated that pre-school children (aged ≤ 6 years) were more susceptible to SO. The effects of SO were stronger in the cold season, while the effects of NO were stronger in the warm season. No significant sex-specific differences were observed. These results suggested that high levels of air pollution had an adverse effect on childhood asthma, even in a region with high-quality healthcare. Therefore, it will be significant to decrease hospital admissions for asthma in children by controlling air pollution emission and avoiding exposure to air pollution.

摘要

先前的研究表明,儿童接触空气污染可能会增加哮喘发作的风险。本研究旨在调查暴露于环境空气污染对北京儿童哮喘住院的短期影响,北京是一个空气污染严重但医疗水平很高的城市。

我们收集了 2013 年至 2016 年期间北京 56 家医院≤18 岁哮喘患者的住院数据。采用时间分层病例交叉设计和条件泊松回归方法,探讨儿童哮喘住院风险与六种空气污染物(PM2.5、PM10、二氧化硫(SO2)、二氧化氮(NO2)、一氧化碳(CO)和臭氧(O3))的日浓度之间的关系,同时调整气象因素和其他污染物。此外,还按年龄、性别和季节进行了分层分析。

在单污染物模型中,较高水平的 PM、SO 和 NO 与儿童哮喘住院风险增加显著相关。NO 在滞后 06 时的影响最强( = 1.25,95%CI:1.06-1.48),其次是 SO 在滞后 05 时的影响( = 1.17,95%CI:1.05-1.31)。SO 和 NO 的影响在双污染物模型中具有稳健性。分层分析进一步表明,学龄前儿童(≤6 岁)对 SO 更敏感。SO 的影响在寒冷季节更强,而 NO 的影响在温暖季节更强。没有观察到明显的性别特异性差异。

这些结果表明,即使在医疗水平较高的地区,高水平的空气污染也会对儿童哮喘产生不良影响。因此,通过控制空气污染排放和避免接触空气污染来降低儿童哮喘住院率将具有重要意义。

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引用本文的文献

[1]
Update of a systematic review on associations between environmental exposures and asthma control and exacerbations in young children.

BMJ Open. 2025-8-31

[2]
Short-term exposure to ambient air pollution increased in-hospital non-ST-elevation myocardial infarction mortality risk, but not ST-elevation myocardial infarction: case-crossover based evidence from Beijing, China.

Front Public Health. 2025-6-20

[3]
The short-term association between environmental variables and daily pediatric asthma patient visits in Hangzhou, China: A time-series study.

Heliyon. 2024-9-13

[4]
The Influence of Fine Particulate Matter and Cold Weather on Emergency Room Interventions for Childhood Asthma.

Life (Basel). 2024-4-29

[5]
Prediction of Asthma Exacerbations in Children.

J Pers Med. 2023-12-22

[6]
The relationship between PM2.5 and the onset and exacerbation of childhood asthma: a short communication.

Front Pediatr. 2023-8-1

[7]
Editorial: Environmental stressors, multi-hazards and their impact on health.

Front Public Health. 2023-7-11

[8]
Causal relationship between outdoor atmospheric quality and pediatric asthma visits in hangzhou.

Heliyon. 2023-3-7

[9]
Associations between air pollutant and pneumonia and asthma requiring hospitalization among children aged under 5 years in Ningbo, 2015-2017.

Front Public Health. 2022

[10]
Air pollution and childhood asthma.

Curr Opin Allergy Clin Immunol. 2023-4-1

本文引用的文献

[1]
Energy consumption and pollutant emission of diesel-fired combustion from 2009 to 2018 in Beijing, China.

J Environ Manage. 2021-5-1

[2]
Associations of short-term exposure to air pollution and emergency department visits for pediatric asthma in Shanghai, China.

Chemosphere. 2020-8-6

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Association of air pollution with outpatient visits for respiratory diseases of children in an ex-heavily polluted Northwestern city, China.

BMC Public Health. 2020-6-2

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Int J Biometeorol. 2020-5-9

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Short-term effects of ambient PM and PM air pollution on hospital admission for respiratory diseases: Case-crossover evidence from Shenzhen, China.

Int J Hyg Environ Health. 2019-11-19

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Global, national, and urban burdens of paediatric asthma incidence attributable to ambient NO pollution: estimates from global datasets.

Lancet Planet Health. 2019-4-11

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The Short-Term Effects of Ambient Air Pollutants on Childhood Asthma Hospitalization in Taiwan: A National Study.

Int J Environ Res Public Health. 2019-1-12

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Biomed Environ Sci. 2018-12

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Environ Res. 2018-12-1

[10]
Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

Lancet. 2018-11-8

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