Air Pollution and Childhood Asthma Hospitalizations in Chengdu, China: A Time-Series Study

中国成都市空气污染与儿童哮喘住院率:一项时间序列研究

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Abstract

PURPOSE: Research on the relationship between air pollutants and hospitalization for asthma in children in developing countries remains inadequate. This study aimed to assess the short-term effects of air pollutants, including sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)), carbon monoxide (CO), ozone (O(3)), particulate matter ≤ 2.5 µm (PM(2.5)), and particulate matter ≤ 10 µm (PM(10)), on children hospitalized for asthma in Chengdu, China, from 2017-2022. PATIENTS AND METHODS: During the study period, 5592 children were hospitalized for asthma. A generalized additive model was used to control for seasonality, long-term trends, weather, day of the week, and holidays. The analysis was further stratified by age, sex, and season to estimate the associations. RESULTS: PM(2.5), PM(10), SO(2), NO(2,) and CO were significantly associated with an increased risk of hospitalization due to asthma. A 10 μg/m(3) increase in PM(2.5), PM(10,) and CO at lag04 corresponded to an increase of 2.07%, 1.56%, and 0.33% in daily hospital admissions for asthma, respectively. A 10 μg/m(3) increase in SO(2) and NO(2) at lag05 corresponded to an increase of 45.69% and 8.16% in daily hospital admissions for asthma, respectively. Further analysis by age found that PM(10) and PM(2.5) had a greater impact on children aged 5-6 years old while NO(2) and CO mainly affected children under 7 years old. Analysis by by sex found that pollutants had a greater impact on hospital admissions in girls. Seasonal analysis revealed that pollutants had a more significant effect on admission during the winter. CONCLUSION: Our results suggest that increased concentrations of PM(2.5), PM(10), SO(2), NO(2,) and CO in Chengdu lead to hospitalization for asthma in children and that a lag effect was observed, especially with SO(2). These findings highlight the need for stricter air quality controls to reduce childhood asthma hospitalizations.

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