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Fine particulate pollution and asthma exacerbations
Naïm Bouazza1,2, Frantz Foissac1,2, Saik Urien1,2
1Pharmacology and Clinical Research Departments, Paris Descartes Necker Cochin, Assistance Publique - Hopitaux de Paris, Paris, France.
Insights
Fine particulate matter (PM2.5) exposure is linked to increased childhood asthma exacerbations, particularly in urban environments. This study highlights the non-linear relationship between PM2.5 and emergency department visits for pediatric asthma.
Area of Science:
- Environmental Health
- Pediatric Pulmonology
- Epidemiology
Background:
- Epidemiological studies on outdoor air pollution and childhood asthma show mixed results.
- Understanding the specific impact of air pollutants on pediatric asthma exacerbations is crucial for public health.
Purpose of the Study:
- To investigate the association between exposure to air pollutants and asthma exacerbation in children.
- To analyze the relationship between fine particulate matter and emergency department visits for pediatric asthma.
Main Methods:
- Utilized a large database of over 1.2 million pediatric emergency department visits from 2010-2015.
- Collected hourly/daily data on air pollutants (PM2.5, PM10, NO2, O3), meteorological factors, RSV, and pollen.
- Employed mixed-effects quasi-Poisson regression modeling to assess air pollution's impact on asthma exacerbations.
Main Results:
- Fine particulate matter (PM2.5) was the only pollutant independently associated with emergency department visits for asthma.
- The relationship between PM2.5 exposure and asthma exacerbation was non-linear, best described by a sigmoid function.
- The estimated PM2.5 concentration for half the maximum effect was 13.5 µg/m³.
Conclusions:
- A significant association exists between daily asthma exacerbations in pediatric emergency department visits and exposure to fine particulate air pollutants.
- PM2.5 is a key environmental factor contributing to childhood asthma exacerbations.
- The findings underscore the need for air quality interventions to mitigate pediatric asthma burden.
Objective:
As the results from epidemiological studies about the impact of outdoor air pollution on asthma in children are heterogeneous, our objective was to investigate the association between asthma exacerbation in children and exposure to air pollutants.
Methods:
A database of 1 264 585 paediatric visits during the 2010-2015 period to the emergency rooms from 20 emergency departments (EDs) of 'Assistance Publique Hôpitaux de Paris (APHP)', the largest hospital group in Europe, was used. A total of 47 107 visits were classified as asthma exacerbations. Concentration of air pollutants (nitrogen dioxide, ozone, fine particulate matter (PM) with an aerodynamic diameter smaller than 10 µm (PM10) and 2.5 µm (PM2.5)), as well as meteorological data, evolution of respiratory syncytial virus infection and pollen exposition, were collected on an hourly or daily basis for the same period using institutional databases. To assess the association between air pollution and asthma, mixed-effects quasi-Poisson regression modelling was performed.
Results:
The only compound independently associated with ED visits for asthma was PM2.5 (P<10-4). The association between asthma exacerbation and PM2.5 was not linear, and a sigmoid function described the relationshipsatisfactorily. PM2.5 concentration, which gives half the maximum effect, was estimated at 13.5 µg/m3.
Conclusions:
We found an association between daily asthma exacerbation in paediatric visits to the ED and fine particulate air pollutants.
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