Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Department of Women's and Children's Health, University of Padova, Padova, Italy.
Risk Anal. 2023 Jun;43(6):1137-1144. doi: 10.1111/risa.14007. Epub 2022 Aug 21.
Air pollution has been linked to an increased risk of several respiratory diseases in children, especially respiratory tract infections. The present study aims to evaluate the association between pediatric emergency department (PED) presentations for bronchiolitis and air pollution. PED presentations due to bronchiolitis in children aged less than 1 year were retrospectively collected from 2007 to 2018 in Padova, Italy, together with daily environmental data. A conditional logistic regression based on a time-stratified case-crossover design was performed to evaluate the association between PED presentations and exposure to NO , PM2.5, and PM10. Models were adjusted for temperature, relative humidity, atmospheric pressure, and public holidays. Delayed effects in time were evaluated using distributed lag non-linear models. Odds ratio for lagged exposure from 0 to 14 days were obtained. Overall, 2251 children presented to the PED for bronchiolitis. Infants' exposure to higher concentrations of PM10 and PM2.5 in the 5 days before the presentation to the PED increased the risk of accessing the PED by more than 10%, whereas high concentrations of NO between 2 and 12 days before the PED presentation were associated with an increased risk of up to 30%. The association between pollutants and infants who required hospitalization was even greater. A cumulative effect of NO among the 2 weeks preceding the presentation was also observed. In summary, PM and NO concentrations are associated with PED presentations and hospitalizations for bronchiolitis. Exposure of infants to air pollution could damage the respiratory tract mucosa, facilitating viral infections and exacerbating symptoms.
空气污染与儿童多种呼吸道疾病（尤其是呼吸道感染）风险增加有关。本研究旨在评估儿科急诊（PED）因细支气管炎就诊与空气污染之间的关系。2007 年至 2018 年，在意大利帕多瓦，回顾性收集了 1 岁以下儿童因细支气管炎而在 PED 就诊的数据，并结合了每日环境数据。采用基于时间分层病例交叉设计的条件逻辑回归，评估了 PED 就诊与接触 NO、PM2.5 和 PM10 之间的关系。模型调整了温度、相对湿度、大气压和节假日等因素。使用分布滞后非线性模型评估了时间上的滞后效应。获得了滞后暴露 0 至 14 天的比值比。总体而言，2251 名儿童因细支气管炎就诊于 PED。在 PED 就诊前 5 天内，婴儿接触到较高浓度的 PM10 和 PM2.5，就诊 PED 的风险增加超过 10%，而在 PED 就诊前 2 至 12 天内，NO 浓度较高则与风险增加高达 30%相关。污染物与需要住院的婴儿之间的关联甚至更大。还观察到在就诊前 2 周内 NO 的累积效应。总之，PM 和 NO 浓度与 PED 就诊和因细支气管炎住院有关。婴儿接触空气污染可能会损害呼吸道黏膜，促进病毒感染并加重症状。
