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Increased risk of emergency department presentations for bronchiolitis in infants exposed to air pollution

Elisa Gallo1, Silvia Bressan2,3, Simonetta Baraldo4

  • 1Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.

Risk Analysis : an Official Publication of the Society for Risk Analysis
|August 21, 2022
PubMed

Insights

Infants exposed to air pollution, including particulate matter (PM) and nitrogen dioxide (NO2), face a higher risk of pediatric emergency department visits for bronchiolitis. This exposure may damage respiratory tissues, increasing susceptibility to viral infections.

Area of Science:

  • Environmental Health
  • Pediatric Respiratory Medicine
  • Epidemiology

Background:

  • Air pollution is a known risk factor for pediatric respiratory illnesses, particularly infections.
  • Bronchiolitis is a common cause of pediatric emergency department visits in infants.

Purpose of the Study:

  • To investigate the association between daily air pollutant concentrations and pediatric emergency department (PED) presentations for bronchiolitis in infants.
  • To assess the impact of specific pollutants, including nitrogen dioxide (NO2), PM2.5, and PM10, on bronchiolitis-related PED visits.

Main Methods:

  • A retrospective case-crossover study design was employed using data from 2007-2018 in Padova, Italy.
  • Conditional logistic regression and distributed lag non-linear models were used to analyze the association between daily air pollution levels and PED presentations.
  • Models were adjusted for meteorological factors (temperature, humidity, pressure) and public holidays.

Main Results:

  • Higher concentrations of PM10 and PM2.5 were associated with a >10% increased risk of PED visits for bronchiolitis within 5 days.
  • Elevated NO2 levels between 2 and 12 days prior to PED presentation correlated with up to a 30% increased risk.
  • The association between air pollutants and bronchiolitis was stronger for infants requiring hospitalization, with a cumulative effect of NO2 observed over two weeks.

Conclusions:

  • Particulate matter (PM) and nitrogen dioxide (NO2) air pollution are significantly associated with increased pediatric emergency department visits and hospitalizations for bronchiolitis in infants.
  • Exposure to air pollutants may compromise the respiratory tract mucosa, making infants more vulnerable to viral infections and symptom exacerbation.
  • Findings highlight the critical role of air quality in pediatric respiratory health and the need for targeted public health interventions.

Keywords:
bronchiolitisnitrogen dioxideparticulate matter

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