Gutiérrez-Avila Iván, Wright Robert O, Rosa María José, Just Allan C
Department of Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York.
Environ Epidemiol. 2025 Jun 25;9(4):e408. doi: 10.1097/EE9.0000000000000408. eCollection 2025 Aug.
Few studies have evaluated the association between short-term PM exposure and children's respiratory mortality. This study examines the relationship between daily mean and maximum 1-hour PM exposures and age-specific pediatric respiratory mortality, addressing a gap in understanding the effects of subdaily PM peaks.
We analyzed ICD-10-coded mortality records (n = 90,566) from the Mexico City Metropolitan Area (2004-2019). PM exposures came from our satellite-based models for daily mean and maximum 1-hour concentrations. Using a time-stratified case-crossover design and conditional logistic regression with distributed lags, we examined associations between PM and nonaccidental mortality, and specific respiratory conditions (e.g., influenza, pneumonia, bronchopulmonary dysplasia) across neonates, infants, children, and adolescents, accounting for sex-based effect modification. Our models included negative control exposures to address potential confounding.
Among all age groups, infants were the most affected by daily mean and maximum 1-hour PM concentrations. Mean PM was associated with higher risk of respiratory, and influenza and pneumonia mortality in infants. In the same age group, an increase of 10 μg/m in the maximum 1-hour PM concentration was associated with nonaccidental (odds ratio [OR][lag] = 1.02 [95% confidence interval {CI}: 1.00, 1.03]), respiratory (OR[lag] = 1.04 [95% CI: 1.02, 1.06]), influenza and pneumonia (OR[lag] = 1.05 [95% CI: 1.02, 1.08]), and bronchopulmonary dysplasia-related (OR[lag] = 1.07 [95% CI: 1.00, 1.15]) mortality. Our results suggest effect modification by sex in the association between mean PM and respiratory mortality, with positive associations observed primarily in male neonates and adolescents.
Our study contributes to the evidence on the association between daily PM exposure and pediatric respiratory mortality, while also revealing new insights into the impact of maximum 1-hour PM on age- and cause-specific respiratory mortality.
很少有研究评估短期颗粒物（PM）暴露与儿童呼吸死亡率之间的关联。本研究探讨每日平均和1小时最大PM暴露与特定年龄儿童呼吸死亡率之间的关系，填补了对每日以下PM峰值影响理解上的空白。
我们分析了墨西哥城大都市区（2004 - 2019年）国际疾病分类第十版（ICD - 10）编码的死亡记录（n = 90,566）。PM暴露来自我们基于卫星的每日平均和1小时最大浓度模型。使用时间分层病例交叉设计和带有分布滞后的条件逻辑回归，我们研究了PM与非意外死亡率以及新生儿、婴儿、儿童和青少年中特定呼吸疾病（如流感、肺炎、支气管肺发育不良）之间的关联，并考虑了基于性别的效应修正。我们的模型包括负对照暴露以解决潜在的混杂因素。
在所有年龄组中，婴儿受每日平均和1小时最大PM浓度的影响最大。平均PM与婴儿呼吸、流感和肺炎死亡率的较高风险相关。在同一年龄组中，1小时最大PM浓度每增加10 μg/m³与非意外（优势比[OR][滞后] = 1.02 [95%置信区间{CI}：1.00, 1.03]）、呼吸（OR[滞后] = 1.04 [95% CI：1.02, 1.06]）、流感和肺炎（OR[滞后] = 1.05 [95% CI：1.02, 1.08]）以及支气管肺发育不良相关（OR[滞后] = 1.07 [95% CI：1.00, 1.15]）死亡率相关。我们的结果表明，在平均PM与呼吸死亡率之间的关联中存在性别效应修正，主要在男性新生儿和青少年中观察到正相关。
我们的研究为每日PM暴露与儿童呼吸死亡率之间的关联提供了证据，同时也揭示了1小时最大PM对特定年龄和病因的呼吸死亡率影响的新见解。
