Institute for Infectious Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350012, Fujian, China; 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, National Children's Medical Center, Shanghai 201102, China.
Ecotoxicol Environ Saf. 2022 Sep 15;243:113998. doi: 10.1016/j.ecoenv.2022.113998. Epub 2022 Aug 31.
Few studies have simultaneously explored which size of particles has the greatest impact on the risk for pediatric asthma, bronchitis and upper respiratory tract infections (URTIs).
To investigate the short-term association between size-segregated particle number concentrations (PNCs) and outpatient-department visits (ODVs) for major pediatric respiratory diseases.
Daily counts of pediatric ODVs for asthma, bronchitis and URTIs were obtained from 66 hospitals in Shanghai, China, from 2016 to 2018. Pollutant effects were estimated using Poisson generalized additive models combined with polynomial distributed lag models. We also fitted co-pollutant cumulative effects models included six criteria air pollutants and conducted stratifying analyses by gender, age, season and geographic distances.
We identified a total of 430,103 patients with asthma, 1,547,013 patients with bronchitis, and 2,155,738 patients with URTIs from the hospitals. Effect estimates increased with decreasing particle size. Ultrafine particle (UFP) and PNCs of 0.10-0.40 µm particles (PNC) were associated with increased ODVs for asthma, bronchitis and URTIs at cumulative lags up to 3d. Associations tended to appear stable after adjusting for criteria air pollutants. At the cumulative lag 0-2d, each interquartile range increase in UFP was associated with increased ODVs due to asthma (relative risk 1.21, 95% CI: 1.07, 1.38), bronchitis (1.20, 95% CI: 1.07, 1.34) and URTI (1.17, 95% CI: 1.06, 1.30), whereas the associations for PNC remained significant but attenuated in magnitude.
UFP may be a leading contributor to the adverse respiratory effects of particulate air pollution and the effects increased with decreasing particle size.
很少有研究同时探讨了哪种粒径的颗粒对儿科哮喘、支气管炎和上呼吸道感染（URTI）的风险影响最大。
调查大小分离颗粒数浓度（PNC）与儿科呼吸道疾病门诊就诊（ODV）之间的短期关联。
从中国上海的 66 家医院获得了 2016 年至 2018 年期间哮喘、支气管炎和 URTI 的儿科 ODV 日计数。使用泊松广义加性模型结合多项式分布滞后模型估计污染物效应。我们还拟合了共同污染物累积效应模型，其中包括六种标准空气污染物，并按性别、年龄、季节和地理距离进行了分层分析。
我们从医院共确定了 430103 例哮喘患者、1547013 例支气管炎患者和 2155738 例 URTI 患者。随着粒径的减小，效应估计值增加。超细颗粒（UFP）和 0.10-0.40µm 颗粒（PNC）的 PNC 与哮喘、支气管炎和 URTI 的 ODV 增加相关，累积滞后时间长达 3d。在调整了标准空气污染物后，关联似乎趋于稳定。在累积滞后 0-2d 时，UFP 的每个四分位间距增加与哮喘（相对风险 1.21，95%CI：1.07，1.38）、支气管炎（1.20，95%CI：1.07，1.34）和 URTI（1.17，95%CI：1.06，1.30）的 ODV 增加有关，而 PNC 的关联仍然显著，但强度减弱。
UFP 可能是颗粒物空气污染对呼吸道不良影响的主要贡献者，且影响随粒径的减小而增加。
