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Analyzing COVID-19 and Air Pollution Effects on Pediatric Asthma Emergency Room Visits in Taiwan
Yan-Lin Chen1, Yen-Yue Lin2,3, Pi-Wei Chin4
1School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan.
Insights
Pediatric asthma emergency room visits decreased during the COVID-19 pandemic. Increased ozone levels were linked to higher risks of asthma exacerbations in children, highlighting a need for targeted public health interventions.
Area of Science:
- Pediatric Pulmonology
- Environmental Health
- Epidemiology
Background:
- Asthma exacerbations often lead to emergency room visits (ERVs).
- The COVID-19 pandemic's impact on pediatric ERVs in Taiwan was initially unclear.
- This study investigated pediatric asthma ERVs during the COVID-19 era in Taiwan.
Purpose of the Study:
- To analyze trends in pediatric asthma ERVs during the COVID-19 pandemic.
- To assess the influence of air pollution and climate factors on these ERVs.
- To inform public health strategies for managing childhood asthma.
Main Methods:
- Utilized health quality database from Taiwan's National Health Insurance Administration (2019-2021).
- Employed logistic regression to analyze changes in pediatric asthma ERV rates.
- Applied Poisson regression to evaluate the impact of air pollution and climate variables in Taipei.
Main Results:
- A significant decline in pediatric asthma ERVs was observed across various hospital levels.
- Key air pollutants (PM2.5, PM10, NO2, CO) decreased during the COVID-19 lockdown period.
- Ozone exposure showed a positive correlation, increasing the relative risk of pediatric asthma ERVs by 1.094 per 1 ppb increase.
Conclusions:
- Pediatric asthma ERV rates decreased during the COVID-19 pandemic.
- Ozone emerged as a significant environmental risk factor for pediatric asthma exacerbations.
- Public health initiatives targeting environmental factors can help reduce pediatric asthma ERVs and improve child health.
Abstract:
(1) Background: An asthma exacerbation that is not relieved with medication typically requires an emergency room visit (ERV). The coronavirus disease 2019 (COVID-19) pandemic began in Taiwan in January of 2020. The influence of the COVID-19 pandemic on pediatric ERVs in Taiwan was limited. Our aim was to survey pediatric asthma ERVs in the COVID-19 era; (2) Methods: Data were collected from the health quality database of the Taiwanese National Health Insurance Administration from 2019 to 2021. Air pollution and climatic factors in Taipei were used to evaluate these relationships. Changes in the rates of pediatric asthma ERVs were assessed using logistic regression analysis. Poisson regression was used to evaluate the impact of air pollution and climate change; (3) Results: The rate of pediatric asthma ERVs declined in different areas and at different hospital levels including medical centers, regional and local hospitals. Some air pollutants (particulate matter ≤ 2.5 µm, particulate matter ≤ 10 µm, nitrogen dioxide, and carbon monoxide) reduced during the COVID-19 lockdown. Ozone increased the relative risk (RR) of pediatric asthma ERVs during the COVID-19 period by 1.094 (95% CI: 1.095-1.12) per 1 ppb increase; (4) Conclusions: The rate of pediatric asthma ERVs declined during the COVID-19 pandemic and ozone has harmful effects. Based on these results, the government could reduce the number of pediatric asthma ERVs through healthcare programs, thereby promoting children's health.
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