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Effects of Fine Particulate Matter and Its Components on Emergency Room Visits for Pediatric Pneumonia: A
Ming-Ta Tsai1,2, Yu-Ni Ho1,2, Charng-Yen Chiang1,2
1Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Ta-Pei Road, Niao-Sung, Kaohsiung 833, Taiwan.
Abstract:
Pneumonia, one of the important causes of death in children, may be induced or aggravated by particulate matter (PM). Limited research has examined the association between PM and its constituents and pediatric pneumonia-related emergency department (ED) visits. Measurements of PM2.5, PM10, and four PM2.5 constituents, including elemental carbon (EC), organic carbon (OC), nitrate, and sulfate, were extracted from 2007 to 2010 from one core station and two satellite stations in Kaohsiung City, Taiwan. Furthermore, the medical records of patients under 17 years old who had visited the ED in a medical center and had a diagnosis of pneumonia were collected. We used a time-stratified, case-crossover study design to estimate the effect of PM. The single-pollutant model demonstrated interquartile range increase in PM2.5, PM10, nitrate, OC, and EC on lag 3, which increased the risk of pediatric pneumonia by 18.2% (95% confidence interval (Cl), 8.8-28.4%), 13.1% (95% CI, 5.1-21.7%), 29.7% (95% CI, 16.4-44.5%), 16.8% (95% CI, 4.6-30.4%), and 14.4% (95% Cl, 6.5-22.9%), respectively. After PM2.5, PM10, and OC were adjusted for, nitrate and EC remained significant in two-pollutant models. Subgroup analyses revealed that nitrate had a greater effect on children during the warm season (April to September, interaction p = 0.035). In conclusion, pediatric pneumonia ED visit was related to PM2.5 and its constituents. Moreover, PM2.5 constituents, nitrate and EC, were more closely associated with ED visits for pediatric pneumonia, and children seemed to be more susceptible to nitrate during the warm season.
Insights
Particulate matter (PM) exposure, including PM2.5 and PM10, is linked to increased pediatric pneumonia emergency department visits. Key PM constituents like nitrate and elemental carbon show significant associations, with children being more vulnerable during warmer months.
Area of Science:
- Environmental Health
- Pediatric Pulmonology
- Air Pollution Epidemiology
Background:
- Pneumonia is a leading cause of childhood mortality.
- Particulate matter (PM) exposure is a suspected environmental risk factor for pediatric respiratory illnesses.
- Limited research exists on the specific associations between PM constituents and pediatric pneumonia emergency department (ED) visits.
Purpose of the Study:
- To investigate the association between exposure to PM2.5, PM10, and specific PM2.5 constituents (elemental carbon, organic carbon, nitrate, sulfate) and pediatric pneumonia-related ED visits.
- To identify which PM components are most strongly linked to pediatric pneumonia ED visits.
- To explore potential seasonal variations in the effects of PM on pediatric pneumonia.
Main Methods:
- A time-stratified, case-crossover study design was employed.
- Data on PM2.5, PM10, and four PM2.5 constituents were collected from air monitoring stations in Kaohsiung City, Taiwan (2007-2010).
- Pediatric pneumonia ED visit records for individuals under 17 were obtained from a major medical center.
Main Results:
- An interquartile range increase in PM2.5, PM10, nitrate, organic carbon (OC), and elemental carbon (EC) on lag 3 was associated with increased pediatric pneumonia ED visit risk.
- Nitrate and EC remained significant risk factors in two-pollutant models, even after adjusting for PM2.5, PM10, and OC.
- Nitrate showed a significantly greater effect on children during the warm season (April-September).
Conclusions:
- Pediatric pneumonia ED visits are associated with exposure to PM2.5 and its constituents.
- PM2.5 constituents, specifically nitrate and EC, are closely linked to ED visits for pediatric pneumonia.
- Children exhibit increased susceptibility to the effects of nitrate exposure during warmer periods.
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