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Shi H, Wang T, Zhao Z, Norback D, Wang X, Li Y, Deng Q, Lu C, Zhang X, Zheng X, Qian H, Zhang L, Yu W, Shi Y, Chen T, Yu H, Qi H, Yang Y, Jiang L, Lin Y, Yao J, Lu J, Yan Q. Prevalence, risk factors, impact and management of pneumonia among preschool children in Chinese seven cities: a cross-sectional study with interrupted time series analysis. BMC Med 2023; 21:227. [PMID: 37365601 DOI: 10.1186/s12916-023-02951-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Pneumonia is a common disease worldwide in preschool children. Despite its large population size, China has had no comprehensive study of the national prevalence, risk factors, and management of pneumonia among preschool children. We therefore investigated the prevalence of pneumonia among preschool children in Chinese seven representative cities, and explore the possible risk factors of pneumonia on children, with a view to calling the world's attention to childhood pneumonia to reduce the prevalence of childhood pneumonia. METHODS Two group samples of 63,663 and 52,812 preschool children were recruited from 2011 and 2019 surveys, respectively. Which were derived from the cross-sectional China, Children, Homes, Health (CCHH) study using a multi-stage stratified sampling method. This survey was conducted in kindergartens in seven representative cities. Exclusion criteria were younger than 2 years old or older than 8 years old, non-permanent population, basic information such as gender, date of birth and breast feeding is incomplete. Pneumonia was determined on the basis of parents reported history of clearly diagnosed by the physician. All participants were assessed with a standard questionnaire. Risk factors for pneumonia, and association between pneumonia and other respiratory diseases were examined by multivariable-adjusted analyses done in all participants for whom data on the variables of interest were available. Disease management was evaluated by the parents' reported history of physician diagnosis, longitudinal comparison of risk factors in 2011 and 2019. RESULTS In 2011 and 2019, 31,277 (16,152 boys and 15,125 girls) and 32,016 (16,621 boys and 15,395 girls) preschool children aged at 2-8 of permanent population completed the questionnaire, respectively, and were thus included in the final analysis. The findings showed that the age-adjusted prevalence of pneumonia in children was 32.7% in 2011 and 26.4% in 2019. In 2011, girls (odds ratio [OR] 0.91, 95%CI [confidence interval]0.87-0.96; p = 0.0002), rural (0.85, 0.73-0.99; p = 0.0387), duration of breastfeeding ≥ 6 months(0.83, 0.79-0.88; p < 0.0001), birth weight (g) ≥ 4000 (0.88, 0.80-0.97; p = 0.0125), frequency of putting bedding to sunshine (Often) (0.82, 0.71-0.94; p = 0.0049), cooking fuel type (electricity) (0.87, 0.80-0.94; p = 0.0005), indoor use air-conditioning (0.85, 0.80-0.90; p < 0.0001) were associated with a reduced risk of childhood pneumonia. Age (4-6) (1.11, 1.03-1.20; p = 0.0052), parental smoking (one) (1.12, 1.07-1.18; p < 0.0001), used antibiotics (2.71, 2.52-2.90; p < 0.0001), history of parental allergy (one and two) (1.21, 1.12-1.32; p < 0.0001 and 1.33, 1.04-1.69; p = 0.0203), indoor dampness (1.24, 1.15-1.33; p < 0.0001), home interior decoration (1.11, 1.04-1.19; p = 0.0013), Wall painting materials (Paint) (1.16, 1.04-1.29; p = 0.0084), flooring materials (Laminate / Composite wood) (1.08, 1.02-1.16; p = 0.0126), indoor heating mode(Central heating)(1.18, 1.07-1.30, p = 0.0090), asthma (2.38, 2.17-2.61; p < 0.0001), allergic rhinitis (1.36, 1.25-1.47; p < 0.0001), wheezing (1.64, 1.55-1.74; p < 0.0001) were associated with an elevated risk of childhood pneumonia; pneumonia was associated with an elevated risk of childhood asthma (2.53, 2.31-2.78; p < 0.0001), allergic rhinitis (1.41, 1.29-1.53; p < 0.0001) and wheezing (1.64, 1.55-1.74; p < 0.0001). In 2019, girls (0.92, 0.87-0.97; p = 0.0019), duration of breastfeeding ≥ 6 months (0.92, 0.87-0.97; p = 0.0031), used antibiotics (0.22, 0.21-0.24; p < 0.0001), cooking fuel type (Other) (0.40, 0.23-0.63; p = 0.0003), indoor use air-conditioning (0.89, 0.83-0.95; p = 0.0009) were associated with a reduced risk of childhood pneumonia. Urbanisation (Suburb) (1.10, 1.02-1.18; p = 0.0093), premature birth (1.29, 1.08-1.55; p = 0.0051), birth weight (g) < 2500 (1.17, 1.02-1.35; p = 0.0284), parental smoking (1.30, 1.23-1.38; p < 0.0001), history of parental asthma (One) (1.23, 1.03-1.46; p = 0.0202), history of parental allergy (one and two) (1.20, 1.13-1.27; p < 0.0001 and 1.22, 1.08-1.37; p = 0.0014), cooking fuel type (Coal) (1.58, 1.02-2.52; p = 0.0356), indoor dampness (1.16, 1.08-1.24; p < 0.0001), asthma (1.88, 1.64-2.15; p < 0.0001), allergic rhinitis (1.57, 1.45-1.69; p < 0.0001), wheezing (2.43, 2.20-2.68; p < 0.0001) were associated with an elevated risk of childhood pneumonia; pneumonia was associated with an elevated risk of childhood asthma (1.96, 1.72-2.25; p < 0.0001), allergic rhinitis (1.60, 1.48-1.73; p < 0.0001) and wheezing (2.49, 2.25-2.75; p < 0.0001). CONCLUSIONS Pneumonia is prevalent among preschool children in China, and it affects other childhood respiratory diseases. Although the prevalence of pneumonia in Chinese children shows a decreasing trend in 2019 compared to 2011, a well-established management system is still needed to further reduce the prevalence of pneumonia and reduce the burden of disease in children.
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Affiliation(s)
- Haonan Shi
- School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, No.279, Zhouzhu Highway, Pudong New District, Shanghai, 201318, China
| | - Tingting Wang
- School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, No.279, Zhouzhu Highway, Pudong New District, Shanghai, 201318, China.
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, 200433, China
- Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment (Fudan University), Shanghai, 200433, China
| | - Dan Norback
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-751, Uppsala, Sweden
| | - Xiaowei Wang
- Department of Operation and Security, Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China
| | - Yongsheng Li
- Department of Preventive Medicine, Medical College, Shihezi University, Shihezi, 832002, China
| | - Qihong Deng
- School of Public Health, Central South University, Changsha, 410083, China
| | - Chan Lu
- School of Public Health, Central South University, Changsha, 410083, China
| | - Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, 237016, China
| | - Xiaohong Zheng
- School of Energy and Environment, Southeast University, Nanjing, 214135, China
| | - Hua Qian
- School of Energy and Environment, Southeast University, Nanjing, 214135, China
| | - Ling Zhang
- Wuhan University of Science and Technology, Wuhan, 430081, China
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, 400044, China
- National Centre for International Research of Low-Carbon and Green Buildings, Ministry of Science and Technology), Chongqing University, Chongqing, 400044, China
| | - Yuqing Shi
- Wuhan University of Science and Technology, Wuhan, 430081, China
| | - Tianyi Chen
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, 200433, China
| | - Huaijiang Yu
- People's Hospital of Bayingguoleng Mongolian Autonomous Prefecture, Kuerle, 841099, China
| | - Huizhen Qi
- Department of Neurology, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Ye Yang
- Department of No.1 Cadres, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830063, China
| | - Lan Jiang
- Department of Laboratory Medicine, Xinjiang Uyghur Autonomous Region Maternal and Child Health Hospital, Urumqi, 830001, China
| | - Yuting Lin
- Department of Laboratory Medicine, Xinjiang Uyghur Autonomous Region Maternal and Child Health Hospital, Urumqi, 830001, China
| | - Jian Yao
- School of Public Health, Xinjiang Medical University, Urumqi, 830054, China
- Xinjiang Key Laboratory of Special Environment and Health Research, Urumqi, 830054, China
| | - Junwen Lu
- School of Public Health, Xinjiang Medical University, Urumqi, 830054, China
- Xinjiang Key Laboratory of Special Environment and Health Research, Urumqi, 830054, China
| | - Qi Yan
- School of Public Health, Xinjiang Medical University, Urumqi, 830054, China
- Xinjiang Key Laboratory of Special Environment and Health Research, Urumqi, 830054, China
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Dąbrowiecki P, Chciałowski A, Dąbrowiecka A, Piórkowska A, Badyda A. Exposure to ambient air pollutants and short-term risk for exacerbations of allergic rhinitis: a time-stratified, case-crossover study in the three largest urban agglomerations in Poland. Respir Physiol Neurobiol 2023:104095. [PMID: 37355057 DOI: 10.1016/j.resp.2023.104095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 06/26/2023]
Abstract
Allergic rhinitis (AR) affects 10% of the world population, with an increased prevalence in regions with substantial air pollution, but the association between exposure to air pollutants and the short-term risk of AR exacerbations is unclear. We used a time-series approach to analyze the risk of hospital admissions due to AR over 8 days from exposure to various air pollutants. Distributed lag nonlinear models were used to analyze data gathered between 2012 and 2018 in the three largest urban agglomerations in Poland. The analyses were carried out separately for the warm (April - September) and cold seasons (October - March). Overall, there were 1407 admissions due to AR. In the warm season, the rate ratio (95% confidence interval) for admission per 10µg/m3 was 1.202 (1.044, 1.384) for particulate matter less than 10 microns (PM10); 1.094 (0.896, 1.335) for particulate matter less than 2.5 microns (PM2.5); 0.946 (0.826, 1.085) for nitrogen dioxide (NO2); 0.837 (0.418, 1.677) for sulfur dioxide (SO2); and 1.112 (1.011, 1.224) for ozone (O3). In the cold season, the rate ratio for admission per 10µg/m3 was 1.035 (0.985, 1.088) for PM10; 1.041 (0.977, 1.108) for PM2.5; 1.252 (1.122, 1.398) for NO2; 0.921 (0.717, 1.181) for SO2; and 1.030 (1.011, 1.050) for O3. In conclusion, the risk of admission due to AR increased significantly after exposure to O3 in the warm and cold seasons. Exposure to PM10 was associated with a significantly increased risk of AR hospitalizations in the warm season only, whereas exposure to NO2 was associated with a significantly increased risk of AR admission in the cold season.
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Affiliation(s)
- Piotr Dąbrowiecki
- Military Institute of Medicine, Department of Allergology and Infectious Diseases, 128 Szaserów St., 04-141 Warsaw, Poland; Polish Federation of Asthma Allergy and COPD Patients Associations, 5/162 Promyka St., 01-604 Warsaw, Poland
| | - Andrzej Chciałowski
- Military Institute of Medicine, Department of Allergology and Infectious Diseases, 128 Szaserów St., 04-141 Warsaw, Poland
| | - Agata Dąbrowiecka
- Medical University of Maria Sklodowska-Curie in Warsaw, 12 Solidarności Ave., 03-412, Warsaw, Poland
| | - Anna Piórkowska
- Warsaw University of Technology, Faculty of Building Services Hydro- and Environmental Engineering, 20 Nowowiejska St., 00-653 Warsaw, Poland
| | - Artur Badyda
- Polish Federation of Asthma Allergy and COPD Patients Associations, 5/162 Promyka St., 01-604 Warsaw, Poland; Warsaw University of Technology, Faculty of Building Services Hydro- and Environmental Engineering, 20 Nowowiejska St., 00-653 Warsaw, Poland.
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Zhang S, Fu Q, Wang S, Jin X, Tan J, Ding K, Zhang Q, Li X. Association between air pollution and the prevalence of allergic rhinitis in Chinese children: A systematic review and meta-analysis. Allergy Asthma Proc 2022; 43:e47-e57. [PMID: 36065105 DOI: 10.2500/aap.2022.43.220044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Allergic rhinitis (AR) is a common chronic inflammatory disease with bothersome symptoms. However, the effect of air pollution on the prevalence of AR in children is controversial. Objective: This study aimed to investigate the association between air pollution and the prevalence of AR in Chinese children. Methods: This study, in China, included 160,356 students ages 0-18 years who completed a questionnaire about the accuracy of the International Study of Asthma and Allergies in Childhood (ISAAC). The effect of different air pollutants on the prevalence rate were evaluated by meta-analysis. Also, it evaluated the effect of different air pollutants on the prevalence rate. Results: The differences in the effects of sulfur dioxide (SO₂) exposure (combined odds ratio [ORcombined] 1.03 [95% confidence interval {CI}, 1.01-1.05]; p = 0.010) and nitrogen dioxide (NO₂) exposure (ORcombined 1.11 [95% CI, 1.05-1.18]; p = 0.0006) on the risk of childhood AR was statistically significant. The effect of particulate matter with aerodynamic diameter of <10 μm (PM10) exposure on the risk of childhood AR was statistically significant (ORcombined 1.02 [95% CI, 1.01-1.03]; p < 0.001), the effect of particulate matter with aerodynamic diameter of <2.5 μm (PM2.5) exposure on the risk of childhood AR was statistically significant (ORcombined 1.15 [95% CI, 1.03-1.29]; p = 0.02), and the effect of ozone exposure on the risk of childhood AR was not statistically significant (ORcombined 0.98 [95% CI, 0.67-1.41]; p = 0.13). Conclusion: NO₂, SO₂, PM2.5, and PM10 were associated with the prevalence of AR in Chinese children. PM2.5 had the highest correlation with AR prevalence.
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Affiliation(s)
- Shipeng Zhang
- From the Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qinwei Fu
- From the Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shuting Wang
- From the Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xin Jin
- From the Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Junwen Tan
- From the Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Kaixi Ding
- From the Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qinxiu Zhang
- From the Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinrong Li
- From the Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Wang H, Li XB, Chu XJ, Cao NW, Wu H, Huang RG, Li BZ, Ye DQ. Ambient air pollutants increase the risk of immunoglobulin E-mediated allergic diseases: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:49534-49552. [PMID: 35595897 PMCID: PMC9122555 DOI: 10.1007/s11356-022-20447-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/21/2022] [Indexed: 05/06/2023]
Abstract
Immunoglobulin E (IgE)-mediated allergic diseases, including eczema, atopic dermatitis (AD), and allergic rhinitis (AR), have increased prevalence in recent decades. Recent studies have proved that environmental pollution might have correlations with IgE-mediated allergic diseases, but existing research findings were controversial. Thus, we performed a comprehensive meta-analysis from published observational studies to evaluate the risk of long-term and short-term exposure to air pollutants on eczema, AD, and AR in the population (per 10-μg/m3 increase in PM2.5 and PM10; per 1-ppb increase in SO2, NO2, CO, and O3). PubMed, Embase, and Web of Science were searched to identify qualified literatures. The Cochran Q test was used to assess heterogeneity and quantified with the I2 statistic. Pooled effects and the 95% confidence intervals (CIs) were used to evaluate outcome effects. A total of 55 articles were included in the study. The results showed that long-term and short-term exposure to PM10 increased the risk of eczema (PM10, RRlong = 1.583, 95% CI: 1.328, 1.888; RRshort = 1.006, 95% CI: 1.003-1.008) and short-term exposure to NO2 (RRshort = 1.009, 95% CI: 1.008-1.011) was associated with eczema. Short-term exposure to SO2 (RRshort: 1.008, 95% CI: 1.001-1.015) was associated with the risk of AD. For AR, PM2.5 (RRlong = 1.058, 95% CI: 1.014-1.222) was harmful in the long term, and short-term exposure to PM10 (RRshort: 1.028, 95% CI: 1.008-1.049) and NO2 (RRshort: 1.018, 95% CI: 1.007-1.029) were risk factors. The findings indicated that exposure to air pollutants might increase the risk of IgE-mediated allergic diseases. Further studies are warranted to illustrate the potential mechanism for air pollutants and allergic diseases.
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Affiliation(s)
- Hua Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Xian-Bao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Xiu-Jie Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Nv-Wei Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Hong Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Rong-Gui Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Bao-Zhu Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China.
| | - Dong-Qing Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
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Liu Y, Lu C, Li Y, Norbäck D, Deng Q. Outdoor Air Pollution and Indoor Window Condensation Associated with Childhood Symptoms of Allergic Rhinitis to Pollen. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138071. [PMID: 35805726 PMCID: PMC9266097 DOI: 10.3390/ijerph19138071] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 12/10/2022]
Abstract
Pollen is the main factor causing asthma and allergic rhinitis (AR). However, the key indoor and outdoor factors associated with childhood symptoms of allergic rhinitis (SAR) to pollen are unclear. We investigate the association of exposure to outdoor air pollution and indoor environmental factors with childhood SAR to pollen and consider SAR to pollen in different seasons. A cross-sectional study of 2598 preschool children aged 3–6 was conducted in Changsha, China (2011–2012). The prevalence of SAR to pollen in children and information on indoor environmental factors were obtained by questionnaire. Children’s exposure to outdoor air pollutants (PM10, SO2, and NO2) was estimated from the monitored concentrations. The association of exposure to indoor environmental factors and outdoor air pollution with childhood SAR to pollen was estimated by multiple logistic regression models using odds ratio (OR) and a 95% confidence interval (CI), and the relationship between outdoor air pollutants and childhood SAR to pollen was investigated using restricted cubic splines. We found that early-life and current exposure to outdoor air pollution were significantly associated with childhood SAR to pollen in autumn, including exposure to SO2 one year before conception (OR = 1.60, 95% CI = 1.08–2.37) and during entire pregnancy (OR = 1.49, 95% CI = 1.01–2.20) periods, exposure to PM10 during the current period (OR = 1.78, 95% CI = 1.07–2.96), and exposure to NO2 during the early-life (one year before conception and entire pregnancy) and current periods with ORs (95% CI) of 1.72 (1.10–2.71), 1.82 (1.17–2.83), and 1.94 (1.11–3.40), respectively. Further, we found significant associations of both prenatal and postnatal exposure to window condensation with childhood SAR to pollen, with ORs (95% CI) = 1.37 (1.05–1.77) and 1.38 (1.02–1.88), respectively. We encourage SAR to pollen sufferers to stay indoors due to outdoor air pollution and higher pollen concentration outdoors, but indoor ventilation should be maintained.
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Affiliation(s)
- Yingjie Liu
- School of Energy Science and Engineering, Central South University, Changsha 410083, China;
| | - Chan Lu
- XiangYa School of Public Health, Central South University, Changsha 410078, China;
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong 999077, China;
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, 752 36 Uppsala, Sweden;
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China
- Correspondence:
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Li S, Wu W, Wang G, Zhang X, Guo Q, Wang B, Cao S, Yan M, Pan X, Xue T, Gong J, Duan X. Association between exposure to air pollution and risk of allergic rhinitis: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2022; 205:112472. [PMID: 34863689 DOI: 10.1016/j.envres.2021.112472] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/15/2021] [Accepted: 11/29/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Allergic rhinitis (AR) is one of the most common allergic diseases in the world, and usually persists throughout the activity. Epidemiological studies have shown a positive association between air pollution and allergic rhinitis. However, we could not find any meta-analysis of the risk of air pollutants (PM2.5, PM10, NO2, SO2, O3 and CO) on the prevalence of AR in people of all ages. OBJECTIVES Carry out a meta-analysis on the results of recent studies (up to 2020) to present valid information about exposure to air pollution and risk of prevalence of AR. METHODS We systematically searched three databases for studies up to December 17, 2020, including air pollution and AR. Random effect models were conducted to estimate the pooled odds ratios (ORs) and 95% confidence intervals (95% CIs). Subgroup analysis, funnel plot, Egger's test, and the trim-and-fill method were also conducted. RESULTS Thirty-five studies across 12 countries, including a total of 453,470 participants, were included. The OR per 10 μg/m3 increase of pollutants was 1.13 (1.04-1.22) for PM10 and 1.12 (1.05-1.20) for PM2.5. The OR per 10 μg/m3 increment of gaseous pollutants were 1.13 (1.07-1.20) for NO2, 1.13 (1.04-1.22) for SO2 and 1.07 (1.01-1.12) for O3. No significant association was observed between CO and AR. Children or adolescents are more sensitive to air pollution than adults. The effects of PM10 and SO2 were significantly stronger in Europe than Asia. The effects of air pollutants were more significant and higher in developing countries than in developed countries, except for PM10. A significant difference of subgroup test was found between developed and developing countries of NO2. CONCLUSION This meta-analysis showed a positive association between air pollution and the prevalence of allergic rhinitis, and identified geographic area and economic level as the potential modifiers for the association.
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Affiliation(s)
- Sai Li
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Wei Wu
- Department of Otolaryngology-Head and Neck Surgery, PLA Strategic Support Force Characteristic Medical Center, Beijing, 100101, China
| | - Gang Wang
- Department of Otolaryngology-Head and Neck Surgery, PLA Strategic Support Force Characteristic Medical Center, Beijing, 100101, China
| | - Xinyi Zhang
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Qian Guo
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Beibei Wang
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Suzhen Cao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Meilin Yan
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, 100871, China
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, 100871, China
| | - Tao Xue
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100871, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, 100871, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China.
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Lin L, Li T, Sun M, Liang Q, Ma Y, Wang F, Duan J, Sun Z. Effect of particulate matter exposure on the prevalence of allergic rhinitis in children: A systematic review and meta-analysis. CHEMOSPHERE 2021; 268:128841. [PMID: 33172665 DOI: 10.1016/j.chemosphere.2020.128841] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/08/2020] [Accepted: 10/29/2020] [Indexed: 05/22/2023]
Abstract
Among various air pollutants, particulate matter (PM) is the most harmful and representative pollutant. At the same time, allergic rhinitis (AR) is getting more and more attention, so we explore the relationship between PM and the prevalence of AR among children. Then, PubMed, Web of Science, Google Scholar was used to search for relevant studies up to January 2020. Literature quality assessment was processed using the Newcastle-Ottawa Scale (NOS) evaluation scale. Adjusted odds ratio (OR) with corresponding 95% confidence interval (CI) was retrieved from individual studies and pooled to generate a summary effect via STATA software. Besides, we test the result stability by Egger's test and funnel plot, and using the trim-and-fill method to modify the possible asymmetric funnel graph. 21 studies were included in the meta-analysis. 9 articles reported about PM2.5 on childhood AR (1.09, 95%CI: 1.01, 1.17, per 10 μg/m3 increase). 15 articles reported about PM10 on childhood AR (1.06, 95%CI: 1.02,1.11, per 10 μg/m3 increase), PM2.5 exposure has a bigger effect on children AR than PM10. In addition, a series of subgroup analysis was performed, and we found that PM2.5 and PM10 have different performances in different subgroups. In addition to this, we analyzed the sources of heterogeneity of the study. Apart from the results we got all have good stability without publication bias. Therefore, it can be concluded that exposure to PM may increase the prevalence of AR among children.
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Affiliation(s)
- Lisen Lin
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Tianyu Li
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Mengqi Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Qingqing Liang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Yuexiao Ma
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Fenghong Wang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Junchao Duan
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China.
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China.
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Kim SH, Lee J, Oh I, Oh Y, Sim CS, Bang JH, Park J, Kim Y. Allergic rhinitis is associated with atmospheric SO2: Follow-up study of children from elementary schools in Ulsan, Korea. PLoS One 2021; 16:e0248624. [PMID: 33735252 PMCID: PMC7971526 DOI: 10.1371/journal.pone.0248624] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/02/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The purpose of this study was to examine the association of allergic rhinitis with air pollutant concentrations using the follow-up data of elementary school children in Ulsan, Korea. METHODS All students of four elementary schools in Ulsan, South Korea were surveyed at two-year intervals. The survey used data collected five times, over a nine-year period from June 2009 to April 2018. The questionnaire used in the survey was a modified version of the ISAAC (International society of asthma and allergy of children) questionnaire. A skin prick test (SPT) was performed with 24 standard antigens. To estimate the levels of exposure to outdoor air pollution, the concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), and particulate matter 10 μm or less in diameter (PM10) were used. As a dependent variable, a history of allergic rhinitis diagnosed by a doctor during the last 1-year was considered. Logistic regression analysis was used to select variables suitable for the statistical model. The selected variables were then used to assess their association with the dependent variable using the generalized estimation equation. RESULTS Among environmental factors, SO2 was associated with a high risk and PM10 was associated with a low risk of allergic rhinitis. The risk of allergic rhinitis from living in a house built within the last year was high, and the risk from living in a multi-family house or apartment was higher than that from living in a segregated house. History of allergic diseases in the family was a high-risk factor for allergic rhinitis. There was a relationship between a history of bronchiolitis at less than 2 years of age and a high risk of allergic rhinitis. Boys were at a higher risk than girls. CONCLUSION From the follow-up data of elementary school students in Ulsan, Korea, the concentration of SO2, which is an indicator of the degree of industrialization, was related to the prevalence of allergic rhinitis. Among all the risk factors, history of allergic disease in the parents was the most important factor, and the study reconfirmed the results of the previous studies.
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Affiliation(s)
- Suk Hwan Kim
- POSCO Health Center, POSCO, Pohang, Republic of Korea
| | - Jiho Lee
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Inbo Oh
- Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Yeonsuh Oh
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Chang Sun Sim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Jin-Hee Bang
- Environmental Health Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Jungsun Park
- Department of Occupational Health, Catholic University of Daegu, Gyeongsan, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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Allergic Rhinitis: Association with Air Pollution and Weather Changes, and Comparison with That of Allergic Conjunctivitis in Taiwan. ATMOSPHERE 2020. [DOI: 10.3390/atmos11111152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Allergic conjunctivitis (AC) and rhinitis (AR) are common allergic diseases that may be environmentally related. We used a systematic sampling cohort database, which was applied in an AC study previously, to examine the association of AR with air pollution and weather changes. A case-crossover design coupled with conditional logistic analysis was implemented in the analysis; we identified 140,365 eligible AR subjects, and matched their diagnoses with environmental monitoring data. Unlike AC, the descriptive statistics indicated that AR occurred the most in adults under 50 years old by age (44.7%), and in winter by season (28.7%) (p < 0.001); similar to AC, AR occurred more in women than to men. Nitrogen dioxide (NO2) was found to be positively associated with AR (p < 0.001), whereas relative humidity and temperature were negatively related (p < 0.001). We found that the risk of AR increased with descending NO2 levels relative to AC (OR = 0.984, p = 0.003) after adjustment for covariates. It is suggested that AR could be triggered or exacerbated by lower levels of NO2 than is AC. We recommend that AR patients pay extra attention to air pollution and mitigate their allergic problem accordingly.
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Liu W, Huang C, Cai J, Fu Q, Zou Z, Sun C, Zhang J. Prenatal and postnatal exposures to ambient air pollutants associated with allergies and airway diseases in childhood: A retrospective observational study. ENVIRONMENT INTERNATIONAL 2020; 142:105853. [PMID: 32585502 DOI: 10.1016/j.envint.2020.105853] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 05/24/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
It's inconsistent about associations of early exposures to outdoor air pollutants with allergies and airway diseases in childhood. Here, we investigated associations of prenatal and postnatal exposures to outdoor nitrogen dioxide (NO2), sulphur dioxide (SO2), and PM10 (particulate matter with an aerodynamic diameter ≤ 10 μm) with asthma, wheeze, hay fever, rhinitis, pneumonia, and eczema in childhood. We surveyed 3,177 preschoolers who never change residences since birth in Shanghai, China. Parents reported information regarding children's health status. Daily-averaged concentrations of these pollutants in the children's gestation and in the first year of lifetime for district where children lived were collected by Shanghai Environmental Monitoring Center. After adjusting for covariates, exposures to higher level of NO2 during different trimesters of gestation and of the first year of lifetime had significant associations with the increased odds of asthma, hay fever, rhinitis, pneumonia, and eczema in childhood. Associations of NO2 exposures in the early trimesters of gestation and of the first year of lifetime with pneumonia were stronger than in the later trimesters, whereas associations of NO2 exposures in the early trimesters with hay fever and eczema were weaker than in the later trimesters. Our results indicated that prenatal and postnatal exposures to outdoor NO2 could be risk factors for allergies and airway diseases in childhood. Both dose and duration were related with the influence degree of early NO2 exposure on childhood allergies and airway diseases.
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Affiliation(s)
- Wei Liu
- Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China.
| | - Jiao Cai
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center, Shanghai, China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Chanjuan Sun
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Jialing Zhang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
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Impact of microbial air quality in preschools on paediatric respiratory health. SN APPLIED SCIENCES 2019. [DOI: 10.1007/s42452-019-1306-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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12
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Measuring Micrometers of Matter and Inventing Indices: Entangling Social Perception within Discrete and Continuous Measurements of Air Quality. SOCIAL SCIENCES 2019. [DOI: 10.3390/socsci8020048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Environmental protection agencies around the globe are establishing different methods for measuring particulates, and then integrating those measurements into a single air quality index with other pollutants. At the same time, scientific inquiry has also shifted to a theory of measurement that incorporates discrete and continuous measurement. This article reviews the relationship between discrete measurements and indices, while also speculating on the way that the continuous measurement of air pollution could stimulate awareness and action. The paper argues that continuous measurement must include the way people of different backgrounds perceive air pollution in their lives. After reviewing the methods of measuring particulates and their inclusion into various indices, the article argues that in order to take action to mitigate the health impacts of air pollution, we must allow for the social perception of air pollution to become entangled within our scientific measurements.
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Zou QY, Shen Y, Ke X, Hong SL, Kang HY. Exposure to air pollution and risk of prevalence of childhood allergic rhinitis: A meta-analysis. Int J Pediatr Otorhinolaryngol 2018; 112:82-90. [PMID: 30055746 DOI: 10.1016/j.ijporl.2018.06.039] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 06/22/2018] [Accepted: 06/23/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Allergic rhinitis (AR), a common chronic inflammatory disease in the upper airways. The prevalence of AR in children seems to be increasing recently, and the most significant causes of the increase are thought to be changes in environmental factors, especially air pollution. However, we could not find any meta-analysis on the risk of air pollution exposure on the prevalence of AR in childhood. The aim of this research was to carry out a meta-analysis on the results of recent studies (21 s t century) to present valid information about exposure to air pollution and risk of prevalence of childhood AR. METHODS PubMed, Science, Google Scholar, Elsevier and MDPI web database were searched up to January 1, 2000 to February 28, 2018. Including of air pollution and AR in childhood related to the observation of literature. Meta-analysis, study quality assessment, heterogeneity analysis and publication bias test were using Stata-MP 14.1 and Review Manager version 5.3 software. RESULTS 13 studies will be included in the meta-analysis (8 cross-sectional studies, 5 cohort studies). Exposure to NO2 (OREurope = 1.031, 95%CI [1.002,1.060], P = 0.033; ORAsia = 1.236, 95%CI [1.099,1.390], P = 0.000; ORoverall = 1.138, 95%CI [1.052,1.231], P = 0.001); Exposure to SO2 (OREurope = 1.148, 95%CI [1.030,1.279], P = 0.012; ORAsia = 1.044, 95%CI [0.954,1.142], P = 0.352; ORoverall = 1.085, 95%CI [1.013,1.163], P = 0.020); Exposure to PM10 (OREurope = 1.190, 95%CI [1.092,1.297], P = 0.000; ORAsia = 1.075, 95%CI [0.995,1.161], P = 0.066; ORoverall = 1.125, 95%CI [1.062,1.191], P = 0.000); Exposure to PM2.5 (OREurope = 1.195, 95%CI [1.050,1.360], P = 0.007; ORAsia = 1.163, 95%CI [1.074,1.260], P = 0.000; ORoverall = 1.172, 95%CI [1.095,1.254], P = 0.000). CONCLUSIONS Exposed to air pollution probable is a risk of prevalence of childhood AR. And the prevalence of AR will be increase when exposed to NO2, SO2, PM10 and PM2.5, but maybe the relationship between SO2/PM10 and prevalence of AR are not closely in Asia.
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Affiliation(s)
- Qi-Yuan Zou
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
| | - Yang Shen
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
| | - Xia Ke
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
| | - Su-Ling Hong
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
| | - Hou-Yong Kang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
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The Association between Ambient Air Pollution and Allergic Rhinitis: Further Epidemiological Evidence from Changchun, Northeastern China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030226. [PMID: 28241509 PMCID: PMC5369062 DOI: 10.3390/ijerph14030226] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 01/01/2023]
Abstract
With the continuous rapid urbanization process over the last three decades, outdoors air pollution has become a progressively more serious public health hazard in China. To investigate the possible associations, lag effects and seasonal differences of urban air quality on respiratory health (allergic rhinitis) in Changchun, a city in Northeastern China, we carried out a time-series analysis of the incidents of allergic rhinitis (AR) from 2013 to 2015. Environmental monitoring showed that PM2.5 and PM10 were the major air pollutants in Changchun, followed by SO2, NO2 and O3. The results also demonstrated that the daily concentrations of air pollutants had obvious seasonal differences. PM10 had higher daily mean concentrations in spring (May, dust storms), autumn (October, straw burning) and winter (November to April, coal burning). The mean daily number of outpatient AR visits in the warm season was higher than in the cold season. The prevalence of allergic rhinitis was significantly associated with PM2.5, PM10, SO2 and NO2, and the increased mobility was 10.2% (95% CI, 5.5%–15.1%), 4.9% (95% CI, 0.8%–9.2%), 8.5% (95% CI, −1.8%–19.8%) and 11.1% (95% CI, 5.8%–16.5%) for exposure to each 1-Standard Deviation (1-SD) increase of pollutant, respectively. Weakly or no significant associations were observed for CO and O3. As for lag effects, the highest Relative Risks (RRs) of AR from SO2, NO2, PM10 and PM2.5 were on the same day, and the highest RR from CO was on day 4 (L4). The results also indicated that the concentration of air pollutants might contribute to the development of AR. To summarize, this study provides further evidence of the significant association between ambient particulate pollutants (PM2.5 and PM10, which are usually present in high concentrations) and the prevalence of respiratory effects (allergic rhinitis) in the city of Changchun, located in Northeastern China. Environmental control and public health strategies should be enforced to address this increasingly challenging problem.
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Liu W, Huang C, Hu Y, Fu Q, Zou Z, Sun C, Shen L, Wang X, Cai J, Pan J, Huang Y, Chang J, Sun Y, Sundell J. Associations of gestational and early life exposures to ambient air pollution with childhood respiratory diseases in Shanghai, China: A retrospective cohort study. ENVIRONMENT INTERNATIONAL 2016; 92-93:284-293. [PMID: 27128713 DOI: 10.1016/j.envint.2016.04.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 04/12/2016] [Accepted: 04/13/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Associations of ambient air pollutants with respiratory health are inconsistent. OBJECTIVES We analyzed the associations of gestational and early life exposures to air pollutants with doctor-diagnosed asthma, allergic rhinitis, and pneumonia in children. METHODS We selected 3358 preschool children who did not alter residences after birth from a cross-sectional study in 2011-2012 in Shanghai, China. Parents reported children's respiratory health history, home environment, and family lifestyle behaviors. We collected daily concentrations of sulphur dioxide (SO2), nitrogen dioxide (NO2), and particulate matter with an aerodynamic diameter ≤10μm (PM10) during the child's total lifetime (2006-2012) for each district where the children lived. We analyzed the associations using logistic regression models. RESULTS After adjusting for covariates and the other studied pollutants, we found that exposure to NO2 (increment of 20μg/m(3)) during the first year of life was significantly associated with asthma [odds ratio (OR)=1.77; 95% confidence interval (CI): 1.29-2.43] and allergic rhinitis (OR=1.67; 95% CI: 1.07-2.61). Exposure to NO2 during gestation, the first two and three years, and over total lifetimewas all consistently associated with increased odds of allergic rhinitis. Quartiles of NO2 concentration during different exposure periods showed a slight dose-response relationship with the studied diseases. These diseases had significant associations with pollutant mixtures that included NO2, but had no significant association with exposures to SO2 and PM10 individually or in mixtures. CONCLUSIONS Gestational and early life exposures to ambient NO2 are risk factors for childhood respiratory diseases.
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Affiliation(s)
- Wei Liu
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China.
| | - Yu Hu
- Tongji Architectural Design (Group) Company Limited (TJAD), Shanghai, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Chanjuan Sun
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Li Shen
- R&B Technology (Shanghai) Company Limited, Shanghai, China
| | - Xueying Wang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Jiao Cai
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Jun Pan
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Yanmin Huang
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Jing Chang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China; Department of Thermal Energy and Power Engineering, Shandong Jiaotong University, Jinan, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Jan Sundell
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China; Department of Building Science, Tsinghua University, Beijing, China
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Association between the First Occurrence of Allergic Rhinitis in Preschool Children and Air Pollution in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13030268. [PMID: 26927153 PMCID: PMC4808931 DOI: 10.3390/ijerph13030268] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/23/2016] [Accepted: 02/23/2016] [Indexed: 12/03/2022]
Abstract
The occurrence of allergic rhinitis (AR) may be significantly influenced by air pollution. This study examined the association between the first occurrence of AR in preschool children and the pre-incident levels of air pollutants in Taiwan. We identified 9960 eligible subjects from a systematic sampling cohort database containing 400,000 insureds of the National Health Insurance from 2007 to 2011 and matched them with the environmental monitoring data from 2006 to 2011 according to the locations of their clinics. Pre-incident levels were determined using the average concentrations of air pollutants one or two weeks prior to the AR diagnoses. Logistic regression analyses were performed to determine any significant relationships between AR and specific air pollutants. The first AR incidence for Taiwanese preschool children, which increased with age, was 10.9% on average; boys appeared to have a higher percentage (14.2%) than girls (8.27%). Among the air pollutants, carbon monoxide (CO) and nitrogen oxides (NOX) were significantly related to AR after adjusting for age and gender (p < 0.05). Because both pollutants are considered to be traffic emissions, this study suggests that traffic emissions in Taiwan need to be controlled to lower the prevalence of children’s AR.
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Zhang Y, Li B, Huang C, Yang X, Qian H, Deng Q, Zhao Z, Li A, Zhao J, Zhang X, Qu F, Hu Y, Yang Q, Wang J, Zhang M, Wang F, Zheng X, Lu C, Liu Z, Sun Y, Mo J, Zhao Y, Liu W, Wang T, Norbäck D, Bornehag CG, Sundell J. Ten cities cross-sectional questionnaire survey of children asthma and other allergies in China. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/s11434-013-5914-z] [Citation(s) in RCA: 173] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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